Poliklinik für Kieferorthopädie, Präventive Zahnmedizin und Kinderzahnheilkunde
Refine
Year of publication
Document Type
- Article (21)
- Doctoral Thesis (21)
Language
- English (42) (remove)
Has Fulltext
- yes (42)
Is part of the Bibliography
- no (42)
Keywords
- - (19)
- Caries (5)
- Karies (5)
- periodontitis (4)
- Caries epidemiology (3)
- Caries experience (3)
- Children (3)
- Germany (3)
- Caries index (2)
- Consensus (2)
Institute
- Poliklinik für Kieferorthopädie, Präventive Zahnmedizin und Kinderzahnheilkunde (42)
- Institut für Community Medicine (1)
- Institut für Diagnostische Radiologie (1)
- Institut für Klinische Chemie und Laboratoriumsmedizin (1)
- Klinik für Anästhesiologie und Intensivmedizin (1)
- Klinik für Psychiatrie und Psychotherapie (1)
- Klinik und Poliklinik für Augenheilkunde (1)
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie/Plastische Operationen (1)
- Klinik und Poliklinik für Orthopädie und Orthopädische Chirurgie (1)
- Kliniken und Polikliniken für Innere Medizin (1)
Publisher
- S. Karger AG (12)
- SAGE Publications (3)
- MDPI (2)
- Frontiers Media S.A. (1)
- Hindawi (1)
- Wiley (1)
40-Year Longitudinal Caries Development in German Adolescents in the Light of New Caries Measures
(2019)
This study assessed the 40-year longitudinal caries development in German adolescents in the light of the sixth National Oral Health Survey in Children (NOHSC, 2016) employing initial DMFT (IDMFT), Significant Caries Index (SiC) and Specific Affected Caries Index (SaC). On the basis of the current NOHSC (randomized cluster selection using school list or regional community school surveys, 55,956 12-year-old sixth-graders examined by 482 calibrated community/study dentists) DMFT, SiC, a novel IDMFT including initial lesions (IT) and the recently introduced SaC were calculated and also recalculated for national and international surveys from the last 4 decades. In 2016, 78.8% of children were caries-free (DMFT = 0), 65.5% including IT lesions. The mean DMFT was 0.44 (single components: DT = 0.14, MT = 0.02, FT = 0.29, IT = 0.52) showing a clear association with the school type as marker for the socio-economic status. The mean number of affected teeth in children with DMFT >0 was 2.07 (SaC) in comparison to almost 9 teeth in the 1970s. The current care index on the tooth level was 66.3%, leaving only 7.7% of children with restorative treatment needs. Longitudinally, a continuous caries decline of more than 80%, including the risk groups (SiC/SaC), to an internationally extremely low level was observed. In conclusion, the National Oral Health Surveys reveal a continuous caries decline to a very low caries level in 12-year-old 6th-graders in Germany even if IT lesions are included (IDMFT). In spite of proportional reductions in the risk groups (SiC/SaC), the polarized caries distribution according to socio-economic parameters reveals the need for targeted preventive programmes.
Despite a plethora of therapeutic approaches, the injection of local anaesthetics itself remains one of the most painful and dreadful procedures among children. Stimulation of acupoint LI4 is associated with analgesic effects in dentistry. Goal of the study To investigate whether stimulation of LI4, added to standard therapy (ST), reduces pain and distress during injection of local anaesthetic (LA) in comparison with ST alone. Materials and Methods Children, scheduled for dental treatment in local anaesthesia on 2 separate days were enrolled in this trial, approved by local ethics commission. On one day each child received bilateral acupuncture of LI4 point, using indwelling fixed “New Pyonex” needles (0.2 x 1.5 mm; Seirin, Japan). The parents of the children were asked to stimulate the needles by massage. Standardized injection of LA was performed 5 min following acupuncture. The needles were withdrawn at the end of dental treatment. On the other day of treatment children received LA injection without acupuncture. The order of treatment days (acupuncture first or vice versa) was randomised. Primary endpoint was the pain intensity during LA injection reported by children on Visual Rating Scale from 0=no pain to 10=maximal pain imaginable (VRS-11). Secondary endpoints were parent- and dentist-assessed pain intensity (measured on Numeric Rating Scale 1-10), patients’ heart rate before and during dental treatment and satisfaction with received therapy (measured on Numerical Rating Scale 1-5.) Side effects of LI4 stimulation were also recorded. Results and Discussion The data of 49 children (22 females; age 10 ± 4 yrs; mean ± SD), who completed both visits, were analysed. Children reported less pain with than without acupuncture: 2.2 ± 2.5 vs. 3.9 ± 2.7; mean ± SD, p<0.001. Heart rate decreased after LI4 stimulation compared to ST alone throughout the dental treatment (p<0.05). LI4 stimulation was safe and raised better satisfaction with the treatment among children and parents, than ST alone (p<0.05). Other secondary endpoints were comparable between both sessions. Conclusion Stimulation of acupuncture point LI4 reduces pain and autonomous stress during injection of local anaesthetics in paediatric dentistry.
Less invasive caries management techniques for treating cavitated carious primary teeth, which involve the concept of caries control by managing the activity of the biofilm, are becoming common. This study aimed to compare the clinical efficacy (minor/major failures) and survival rates (successful cases without any failures) of 3 carious lesion treatment approaches, the Hall Technique (HT), non-restorative caries treatment (NRCT), and conventional restorations (CR), for the management of occlusoproximal caries lesions (ICDAS 3-5) in primary molars. Results at 2.5 years are presented. A total of 169 children (3- to 8-year-olds) were enrolled in this secondary care-based, 3-arm parallel-group, randomised controlled trial. Participants were allocated to: HT (n = 52; sealing caries with stainless-steel crowns without caries removal), NRCT (n = 52; opening up the cavity and applying fluoride varnish), CR (n = 65; control arm, complete caries removal and compomer restoration). Statistical analyses were: non-parametric Kruskal-Wallis analysis of variance, Mann-Whitney U test and Kaplan-Meier survival analyses. One hundred and forty-two participants (84%; HT = 40/52; NRCT = 44/52; CR = 58/65) had follow-up data of 1-33 months (mean = 26). Overall, 25 (HT = 2, NRCT = 9, CR = 14) of 142 participants (17.6%) presented with at least 1 minor failure (reversible pulpitis, caries progression, or secondary caries; p = 0.013, CI = 0.012-0.018; Mann-Whitney U test). Ten (HT = 1, NRCT = 4, CR = 5) of 142 participants (7.04%) experienced at least 1 major failure (irreversible pulpitis, abscess, unrestorable tooth; p = 0.043, CI = 0.034-0.045). Independent comparisons between 2 samples found that NRCT-CR had no statistically significant difference in failures (p > 0.05), but for CR-HT (p = 0.037, CI = 0.030-0.040) and for NRCT-HT (p = 0.011, CI = 0.010-0.016; Kruskal-Wallis test) significant differences were observed. Cumulative survival rates were HT = 92.5%, NRCT = 70.5%, and CR = 67.2% (p = 0.012). NRCT and CR outcomes were comparable. HT performed better than NRCT and CR for all outcomes. This study was funded by the Paediatric Dentistry Department, Greifswald University, Germany (Trial registration No. NCT01797458).
Objectives:
This study investigates the effectiveness of the Cold AP on the alteration of the enamel surface
without using acid etchant by using Conventional photo-activated resin bond to bond the
orthodontic brackets.
Materials and Methods:
One hundred and twenty-five Enamel specimens are prepared from disinfected bovine
mandibular incisors are divided into five groups. Group I: brackets are attached on the enamel
surface with the standard adhesive technique (etch + primer +bond). Group II: the brackets are
attached with the Standard Orthodontic adhesive technique without etching. Group III: the
enamel surface is conditioned with pure Argon Cold atmospheric plasma before the application
of the primer without using an acid etchant. Group IV: the enamel surface is conditioned with
the admixture of Argon Cold atmospheric plasma with 0.5 % Oxygen before the application of
the primer without using acid etchant Group V: after the application of Argon Cold atmospheric
plasma with 0.5 % Oxygen the surface is rewetted by deionized water before the application
of the primer and adhesive. After that, the samples are exposed to thermal cycling. The shear
bond strength of the samples is tested by the universal testing machine which measured the
maximum force at which the brackets are deboned from the tooth surface at a speed of
1mm/minute is measured.
Results:
Significant intergroup differences were found. Group V showed the highest shear bond
strength followed by Group I, VI, III, II respectively. There isn’t a statistical difference in the
values of The Shear bond strength values between Group III and IV.
Conclusions:
this study implies that Cold Atmospheric Plasma is a safe method to change the chemical
surface characteristics of the enamel surface.in addition to the significant importance of plasma
treatment followed by water rewetting, which could enhance adhesion between the orthodontic
attachments and the enamel layer
(1) Background: In Germany, new recommendations for dental examinations of children and the use of fluorides have been introduced. The pediatrician (PA) should refer the patient to the dentist for dental examinations and check-ups (DEs) from the sixth month of age. Therefore, our aim was to determine with a questionnaire the extent to which PAs find DE useful, make referrals for DE and recommend fluoride. (2) Methods: The nationwide empirical survey was conducted with a self-developed and validated standardized online questionnaire. In addition to personal information, 16 items were collected. Agreement with the items was recorded using Likert scales. The data were primarily analysed descriptively. (3) Results: 696 PAs participated in the survey (age: 51.7 (8.4) years, women/men: 428/286 (61.5/38.5%). A total of 11% of PAs found referral by eruption of first tooth very important (important/neutral/unimportant: 13.8/32/43.2%), compared to 70% for complete deciduous teeth (21.3/7.3/1.4%). A total of 48.8% of PAs always recommended fluoridated toothpaste from the first tooth (often/occasionally/rarely/never: 18.3/7.8/8/17.1%) and 50.6% completely refused to recommend fluoride-free toothpaste (always/often/occasionally/rarely: 9.8/9/14.7/15.9%). A total of 44.8% never recommended the use of fluoridated toothpaste if the child cannot yet spit (always/often/occasionally/rarely: 19.2/13.9/7.8/14.3%). (4) Conclusions: Among PAs, referral to DEs was increasingly implemented as children grew older. Specific fluoride recommendations were accepted.
This paper reviews the first part of the outcomes of the ORCA Saturday Afternoon Symposium 2014 dealing with ‘caries epidemiology and community dentistry: chances for future improvements in caries risk groups'. After the caries decline in many countries, there are remaining pockets of higher caries levels, mostly in the primary dentition and/or linked to a low socio-economic status (SES). The review into the evidence of caries-preventive measures clearly points to the use of fluorides, especially toothbrushing with fluoridated toothpaste and collective measures such as water fluoridation. In contrast to several unsuccessful high-risk approaches, community and public health programmes seem to be able to ensure a population-wide access and compliance in risk groups. Their simple and evidence-based measures mostly combine regular plaque removal and fluoride applications via toothbrushing, at least for children and adolescents. For the future, the common risk factor approach which addresses associations between oral health, social deprivation, diet, hygiene, smoking, alcohol use and stress should lead to combined efforts with other community health and education specialists. Further engagement with public policy, community leaders and administration is needed in order to strengthen healthy choices and behaviour, e.g. in ‘healthy' schools and kindergartens. It seems advisable that these population programmes also aim at improving upstream factors.
Background: Despite of the remarkable caries reduction in permanent dentition, caries levels of primary teeth has stagnated in Germany. Early Childhood Caries (ECC) or also known as baby bottle tooth decay is the most vulnerable form of caries in young children, but minimal data and information from different German states are available to determine the appropriate preventive programs. Aim: The purpose of the current study is to find the prevalence of ECC among young children in the state of Mecklenburg-Vorpommern (North-East Germany) and to optimize an intervention on ECC prevention in a community setting. In addition to education, fluoride varnish is evaluated on young children with active ECC. Design: In this cross-sectional study, a total of 4283 children living in the state of Mecklenburg-Vorpommern were examined. Four age groups - with an accuracy of one day - were formed as follows: less than one year (n=8), one year (n=293), two years (n=1618) and three years (n=1888). The examination was carried out by community dental service’s examiners whom are calibrated to ECC diagnostic criteria of Robke and Buitkamp (2002), and dmf-t values for caries diagnosis. These data are compared by those of children (n=5355) of same age group for the year 2011-2012. In addition, a structured questionnaire on the starting preventive programme on ECC was filled out by the community dentists and for the city of Greifswald, fluoride varnish (Duraphat®, 5% NaF = 2.26%F, Colgate-Palmolive, Germany) was applied for 32 children previously diagnosed with active ECC (ECC1: n=15, ECC2: n=17). Lesions are identified as active or non active according to texture and luminosity, and oral hygiene index (OHI-S) is measured and re-evaluated at three months follow up. Results: The percentage of children under three years old in 2012-2013 with ECC was comparatively low (4%) which possibly reflects the very young age of the children and a restriction for ECC on the upper incisors. The overall caries prevalence in Mecklenburg-Vorpommern varied from 9% to 15%. Most cavitated lesions are untreated. These results are comparable with the results from other German counties. The interventions of the ECC programme vary considerably among the different counties. There was no significant difference in the oral hygiene index (OHI-S) prior and post fluoride varnish application (p-value = 0.25). The use of fluoride varnish resulted in an 81%, statistically significant decrease of active ECC lesions in Greifswald (p < 0.001). Conclusion: The prevalence of caries among young children was considerable in Mecklenburg-Vorpommern. A preventive intervention in nurseries and fluoride varnish applications for active ECC lesions seems to be a feasible approach in controlling caries in early childhood. However, further quality management and standardization of the program should be reinforced.
Long-term nationally representative caries data in the primary dentition are rare, but nonetheless central to assess needs in caries prevention and treatment. This study evaluated the prevalence and trends of caries levels in the primary dentition of 6- to 7-year-olds in Germany as a whole and its federal states individually. In 2016, employing a randomized cluster selection, 6- to 7-year-old first graders were included in the National German Oral Health Survey performed regularly since 1994/95. Children were examined by 482 calibrated dentists in all 17 German regions using the WHO criteria for the decayed, missing, and filled teeth (dmft) including the assessment of initial carious lesions (it). In total, 151,555 6- to 7-year-olds were examined. Caries prevalence in the primary dentition dropped from 65% in 1994 to 44% in 2016, while the mean caries experience dropped from 2.89 to 1.73 dmft (dt = 0.74, mt = 0.19, ft = 0.80). When initial lesions were included, the mean caries experience increased to idmft = 2.12 (it = 0.38). In 2016, 49.7% of the examined 6- to 7-year-olds were caries-free including initial lesions. The Care Index at the tooth level was 57.5%, and the Significant Caries Index was 4.84 dmft. Depending on the German region, the mean dmft varied considerably, ranging from 1.37 to 2.31. In conclusion, despite the overall caries decline in 6- to 7-year-olds in Germany, only minor caries reductions were observed over the last decade, with a still existing high proportion of untreated dental decay. This calls for more effective preventive and restorative efforts with focus on the primary dentition in Germany.
Until now proximal caries is still a significant problem in the clinical dentistry in spite of the caries decline recently. As resin infiltration offers a new micro-invasive treatment to arrest the progression of proximal initial carious lesions, this study aimed to evaluate its clinical applicability, safety and effect. In the study population of 50 children, adolescents and young adults (mean age 17.9 years ± 6.8), ten dentists at University of Greifswald applied the infiltration material ICON® (DMG, Germany) on non-cavitated proximal lesions in permanent and primary teeth as described in the manual instructions from the producer. The results showed good patient satisfaction with the procedure. The time for the infiltration (24.3 min ± 7.4), which included rubber dam application (7.7 min ± 4), and the effort were perceived as comparable to a composite filling by the dentist or as even easier. In three patients (6%), it was not possible to gain sufficient proximal space for the application of an infiltration. The location of the infiltrated tooth, separation problems as well as the routine of the dentists with the infiltration technique had an effect on the duration of the infiltration. A clear learning curve with a reduction of treatment time for subsequent treatments was observed (P < 0.001). Within the follow-up interval of 12 months, vitality of all infiltrated teeth was still positive and no relevant differences in plaque accumulation or gingival status were recorded. In addition, the infiltrated surfaces showed smooth margins and considerable decrease in the discoloration. In the radiographic evaluation after one year, only two lesions (4.7%) have progressed. Thus, caries infiltration is an applicable method for the treatment of initial non-cavitated proximal lesions without prior temporary tooth separation. Even without special training it can be applied easily by dentist and they experience a clear learning curve within the first 5-10 applications. In addition, the infiltration technique shows a high acceptance by the patients. Furthermore, caries infiltration lead to very good results regarding safety and preventing the lesion progression of non-cavitated proximal caries lesions located in the enamel or in the outer third of dentin.