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Institute
- Poliklinik fĂŒr KieferorthopĂ€die, PrĂ€ventive Zahnmedizin und Kinderzahnheilkunde (77) (remove)
Hintergrund
Die stetig steigende Anzahl von akademischen Veröffentlichungen macht es zunehmend schwierig, Publikationen zu identifizieren, welche die neuesten wissenschaftlichen Erkenntnisse reprÀsentieren und es ermöglichen, auf dem neuesten Stand der Forschung und evidenzbasierter Behandlungsempfehlungen zu bleiben.
Ziel
Ziel dieser Studie war es, die Suchstrategien und AuswahlprĂ€ferenzen zu untersuchen, die verschiedene akademisch tĂ€tigen ZahnĂ€rzte bei der Auswahl der fĂŒnf bedeutendsten Publikationen aus dem Jahres 2016 im Fachgebiet der Kinderzahnheilkunde verwendeten.
Design
Die fĂŒnf an der Studie teilnehmenden ZahnĂ€rzte wurden gebeten, ohne untereinander darĂŒber zu kommunizieren, die Datenbanken PubMed, Google Scholar und Livivo zu durchsuchen. Zudem sollten sie dabei ihre individuelle Suchstrategie dokumentieren. Die Aus-wahlkriterien wurden anschlieĂend gemÀà einer 10-Punkte-Checkliste evaluiert. Der Evidenzlevel der identifizierten Publikationen wurde anschlieĂend gemÀà ihrer Publikationsart bewertet.
Ergebnisse
Alle Studienteilnehmer wĂ€hlten unterschiedliche Publikationen ohne Ăberschneidungen aus. Alle von ihnen ausgewĂ€hlten Publikationen waren Zeitschriftenartikel. Neunzehn Artikel wurden in der Datenbank PubMed identifiziert, jeweils drei Artikel wurden in Google Scholar und Livivo gefunden. Die Relevanz des Artikels fĂŒr die klinische Entscheidungsfindung war das wichtigste Kriterium bei der Auswahl durch die Teilnehmer.
Fazit
Die persönlichen Interessen und Fachgebiete der Kliniker beeinflussten die Auswahl der Zeitschriftenartikel in erheblichem MaĂe. Dies könnte die interindividuelle VariabilitĂ€t der diagnostischen und therapeutischen AnsĂ€tze erklĂ€ren, die bei ZahnĂ€rzten beobachtet wer-den kann, und trĂ€gt wahrscheinlich zu einer Verbreiterung des Wissenspools bei. Dies wird jedoch richtigerweise durch evidenzbasierte Behandlungsempfehlungen komplementiert, was die QualitĂ€t der Behandlung ĂŒberregional sicherstellt.
Up to now, indices like the mean dmft/DMFT and the SiC (Significant Caries Index) have been used to depict caries experience in populations with high prevalence. With the caries decline, particularly for populations with low caries levels, these indices reach their statistical limits. This paper aims to introduce a specific term, the Specific affected Caries Index (SaC) for the risk groups in populations with low caries prevalence and to illustrate its use based on the consecutive German National Oral Health Survey (GNOHS) in children. In groups with a caries prevalence less than one-third of the population, many caries-free children (DMFT = 0) are included in the SiC (risk group), which calls for a new way of illustration. Mean caries experience (DMFT), caries prevalence, the SiC and SaC were portrayed for 12-year-olds in the GNOHS from 1994/95 to 2016. The SaC describes the mean caries experience (DMFT) in the group presenting caries experience (DMFT > 0). In 12-year-old 6th graders in Germany, the mean caries experience decreased from 2.4 (1994/95) to 0.4 DMFT (2016), with a recent prevalence of 21.2% (DMFT > 0, 2016). In 2016, the mean number of affected teeth in children with DMFT > 0 (SaC) was 2.1, while the SiC including 12% DMFT-free children in the risk group was 1.3. The SiC fails to reflect the caries severity in children in a population with low caries prevalence. Therefore, the newly introduced term Specific affected Caries Index (SaC) may be used to describe accurately caries experience in caries risk children in populations presenting low caries prevalence.
The aim of this study was to analyse the predictive power of several clinical baseline parameters and the de-/remineralisation properties of in vivo etched sites measured with quantitative light-induced fluorescence (QLF) for subsequent 2-year caries increment. At baseline, in 44 children (8.23 ± 1.5 years) two areas (diameter 2 mm) of the buccal surface of a primary posterior tooth were etched with 36% phosphoric acid gel for 1 and 4 min, respectively. The etched sites were analysed immediately after etching (ÎQ1) and 24 h (ÎQ2) later by QLF. Additionally, caries status (deft/DMFT and initial caries), approximal plaque, bleeding on probing, and the patientâs current use of fluorides were recorded. In the 2-year follow-up, 29 children were re-assessed. After clinical examination, the caries increment was calculated (ÎDMFT) and correlated with the baseline clinical variables and the QLF readings. Results showed a significant positive correlation between ÎQ<sub>1 min</sub> and the ÎDMFT (r = 0.44, p = 0.02). The ÎDMFT was significantly correlated with the baseline deft (r = 0.56, p = 0.002), cavitated active caries lesions (r = 0.52, p = 0.003), and filled teeth (r = 0.53, p = 0.003). In a regression analysis the use of fluoridated salt (SC = â0.10) and fluoride gel (SC = â0.14) were negatively associated with ÎDMFT. In conclusion, these findings suggest that the demineralisation properties of the etched sites and the outcome of the 24-hour measurements with QLF are significantly associated with caries increment. Previous caries experience strongly correlated with caries increment in this group of children.
This paper reviews the first part of the outcomes of the ORCA Saturday Afternoon Symposium 2014 dealing with âcaries 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 âhealthy' schools and kindergartens. It seems advisable that these population programmes also aim at improving upstream factors.
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).
In fixed orthodontic treatments debonding of brackets during treatment is an unpleasant occurrence for the clinician and the patients and resultes in an increase in treatment costs and duration. For Damon Q brackets recycling would considered as an economic saving option which could be done with using of in office methods such as the sandblasting.
A sample of sixty sound bovine first upper central incisers, were collected, cleaned, and mounted in acrylic blocks for shear bond strength testing.
The total sample was equally divided into two main groups. Each group had 30 teeth and 30 brackets.
The first group had 30 teeth bonded with metal Damon Q brackets, the second group had 30 teeth bonded with metal Mini-MonoÂź brackets.The study included bonding and rebonding experiments. Therefore the same brackets with their same teeth were used in bonding and in the rebonding experiments. The bonding and the rebonding procedures were done with using 3M Unitek etching, Grengloo adhasive, and Ortho solo bonding. In addition the rebonding procedure was done after cleaning the teeth and recycling their brackets with sandblasting. All specimens were recycled 5000 times for the bonding and rebonding experiments.
The first and second debonding forces were done in Newton using a Zwick Roell machine.
After that SBS and SRS were computed in MPa. Furthermore all the teeth, after each debonding, were examined under a digital scanning microscope VHX-5000, 50X magnifying, to performe the ARA and ARI.
The collected data was statistically analyzed for descriptive statistics as well as significance of differences among the different bracket types, and their ARI scores, in the bonding and rebonding experiments.
The results showed that SRS was significantly higher than SBS of both types of the brackets, and Damon Q brackets had higher SBS, and SRS than Mini-MonoÂź brackets, and there was no correlation between SBS, SRS and their ARI, ARA.
Entwicklung und klinische Anwendung einer röntgenfreien dreidimensionalen kephalometrischen Analyse
(2018)
Zweidimensionale Röntgenkephalometrie, die in der kieferorthopĂ€dischen Praxis mittels FRS durchgefĂŒhrt wird, weist neben der Strahlenbelastung weitere Nachteile wie Ungenauigkeiten und Projektionsfehler auf und erlaubt keine differenzierte Analyse der rechten und linken GesichtshĂ€lfte. Das noXrayCephÂź ermöglicht röntgenfreie dreidimensionale Kephalometrie im MaĂstab 1:1 basierend auf Magnetfeldinduktion und könnte dem FRS damit in vielen Aspekten ĂŒberlegen sein. Die zugehörige Software DirectCephÂź verrechnet die Messwerte zu bekannten zweidimensionalen kephalometrischen Analysen, wobei die Lage bestimmter Messpunkte im SchĂ€delinneren nĂ€herungsweise berechnet wird. Das stellt eine mögliche Fehlerquelle dar und schöpft das Potential der dreidimensionalen Analyse nur ungenĂŒgend aus.
Das Ziel dieser Arbeit war die Entwicklung einer neuen röntgenfreien dreidimensionalen kephalometrischen Analyse fĂŒr das noXrayCephÂź, die sich auf direkt erfassbare Messpunkte beschrĂ€nkt sowie die Anwendung auf eine Gruppe junger kaukasischer eugnather Probanden. Zuvor sollten die Messgenauigkeit, die WiederholprĂ€zision des GerĂ€ts und die Reproduzierbarkeit der Messkoordinaten untersucht werden.
Die Messgenauigkeit und WiederholprĂ€zision wurden durch Messreihen an einem SchĂ€delmodell und einem Dummy bestimmt. AnschlieĂend wurden 10 Probanden jeweils dreimal von drei Untersuchern mit dem noXrayCephÂź vermessen. Aus diesem Datensatz konnte die WiederholprĂ€zision und Reproduzierbarkeit der Messpunkte am Probanden bestimmt werden. Eine neue Analyse fĂŒr das noXrayCephÂź wurde entwickelt. Sie umfasst 13 Parameter, die Auskunft ĂŒber vertikale, sagittale, transversale und dentale Winkel bzw. StreckenverhĂ€ltnisse geben. Diese Analyse wurde auf 34 junge eugnathe kaukasische Erwachsene angewandt. Eine Korrelations- sowie eine multiple Regressionsanalyse wurden durchgefĂŒhrt, um statistische Beziehungen zwischen den einzelnen Parametern zu untersuchen.
Die Messgenauigkeit des noXrayCephÂź liegt in einem Bereich von 0,036 mm bis 0,668 mm. Am vormarkierten Dummy lassen sich 79 % und am nicht-vormarkierten Dummy 51 % der Messpunkte mit einer Standardabweichung unter 1 mm reproduzieren. Die Wiederholgenauigkeit und Reproduzierbarkeit der Messpunkte am Patienten ist fĂŒr die meisten Messpunkte gut bis sehr gut und scheint abhĂ€ngig von der Lage der Messpunkte und der Erfahrung des Behandlers. Einige wenige MessÂŹpunkte lassen sich nur schwer reproduzieren und sollten nicht in eine kephalometrische Analyse einflieĂen. Tendenziell zeigt sich eine höhere Ungenauigkeit in der y-Koordinate verglichen mit der x-und z-Koordinate. Die Analyseparameter der eugnathen Erwachsenen sind untereinander zum Teil hoch korreliert. Die multiple Regressionsanalyse zeigt signifikante statistische Beziehungen zwischen mehreren Analyseparametern, sodass eine Tabelle mit harmonischen Wertekombinationen und eine Harmoniebox (vgl. Segner und Hasund 1998) erÂŹstellt werden konnten.
Das noXrayCephŸ bleibt ein vielversprechendes diagnostisches Hilfsmittel, das prÀzise dreidimensionale röntgenfreie kephalometrische Messungen am Patienten ermöglicht. Es zeigt sich, dass sich Erfahrung und Sicherheit im Umgang mit dem GerÀt positiv auf die Wiederholgenauigkeit und Reproduzierbarkeit der Messpunkte auswirken und damit Einfluss auf die Analyseergebnisse besitzen.
Abstract
Background: Behavior management techniques (BMT) are essential in order to
achieve a successful dental treatment with a minimum amount of stress in paediatric
dentistry, but parents are not equally accepting different advanced BMT.
Purpose: To investigate the differences in parental acceptance of advanced
behavior management techniques between University of Greifswald/Germany and
Jordan University/Jordan.
Methods: Parents of the children treated in the pedodontic departments at the
University of Greifswald/Germany and Jordan University/Jordan rated their
acceptance level of four advanced behavior management techniques (passive
restraint, active restraint, nitrous oxide sedation and general anesthesia) for normal
treatment, and for urgent treatment using a five points Likert scale. 200 parents (100
in each university) completed the questionnaire forms for analysis.
Results: Nitrous oxide sedation was rated the most accepted technique in
Greifswald and Jordan (mean 3.78±1.34; 3.22±1.50, respectively). The least
acceptable technique in Greifswald was passive restraint (2.05±1.18) and in Jordan
general anesthesia (2.11±1.30). The parents in Greifswald are significantly more
accepting nitrous oxide sedation than parents in Jordan (p=0.010), while parents in
Jordan are significantly more willing to accept passive restraint (p=0.001). The
acceptance of all advanced behavior management techniques increased significantly
in both groups when the treatment is urgent (pâ€0.05),
Conclusions: Parental culture and the urgency of the treatment affect the
acceptance to different behavior management techniques. Moreover, the parental
attitude to the pharmacological technique has changed, as nitrous oxide sedation
generally appears to be the most preferred advanced technique in both groups.
Das Anliegen dieser Studie war es, die mögliche Interaktion zwischen Okulomotorik und orofacialem System zu untersuchen.Der Einfluss der dentalen Okklusion auf das muskuloskelettale System wurde durch viele Publikationen eingehend untersucht. Wir stellten uns die Frage nach Auswirkungen der Okklusion und KaumuskelaktivitĂ€t auf die Ă€uĂeren Augenmuskeln.
ZunĂ€chst konnte durch die Literaturrecherche ein intensiver Austausch zwischen diesen funktionell und anatomisch eng verknĂŒpften Kompartimenten dargestellt werden. Die durchgefĂŒhrten optometrischen Tests zeigten signifikante Ănderungen wĂ€hrend der Messungen mit Bissmanipulation durch Zinnfolien im Vergleich zu denen ohne Intervention. Es wurde der Konvergenznahpunkt und die Fusionsbreite in der Horizontalen bei 100 Probanden bestimmt. Die Ergebnisse legen eine Wechselwirkung zwischen Augenbewegung und Kaumuskulatur nahe. FĂŒr weiterfĂŒhrende Studien wĂ€re eine interdisziplinĂ€re Zusammenarbeit mit Optometristen empfehlenswert.