International Poster Journal of Dentistry and Oral Medicine, 02/2003

Recommendations on age diagnostics of living persons in criminal proceedings were elaborated by the German interdisciplinary Working Group for Age Diagnostics (AGFAD) in 2000, including anthropologists, forensic dentists, forensic medicines, pathologists, orthodontics and radiologists. The expertise regarding the age of an accused female individual is presented. Schlagwörter: age diagnostics, forensic odontology, law

Objectives: The aim of this study was to assess of the effects of different image processing modes (filters) on the reproducibility and accuracy of the assessment of proximal carious lesions viewed in direct digital radiographs. Variables studied were exposure time and tissue scatter radiation. Methods: Standardized direct digital radiographs of 50 extracted teeth were obtained and 44 areas of proximal caries were detected histologically. Four radiographs were obtained of each tooth using a charge coupled device sensor. Two radiographs were obtained with and 2 without tissue scatter radiation equivalent (TSRE) each of them at normal exposure time (0.06 s) and underexposed (0.01 s). On each of the 200 radiographs, the central depth (CD) of each carious lesion was measured at 21fold magnification both on the unchanged image and af-ter use of 2 different filters (median, median plus inversion). All measurements were re-peated after one week to estimate reproducibility. Histometric CD assessments provided a gold standard for compari-son with the radiographic measurements (accuracy). Results: Whereas reproducibility was not influenced significantly by any of the investigated parameters, defect type and exposure time influenced the overall accuracy of CD measurements. Conclusions: In this study, basic digital filtering of radiographic images failed to result in statis-tically significant improvement of the accuracy of CD measurements. Clinical Significance: Applied to caries monitoring direct digital radiographs using the investigated CCD sensor are equivalent to E speed conventional films. Basic digital filtering fails to adjust for further reduction of exposure time. Schlagwörter: direktes digitales Röntgen, Diagnostik der Approximalkaries, digitale Filter

20 patients participated in this study, who had undergone comprehensive periodontal treatment at the Department of Operative Dentistry and Periodontology at Heidelberg University Dental School from 1998 to 2000 and who exhibited probing pocket depths (PPD) = 5 mm and BOP or >/= 6 mm at single rooted teeth. Two different treatments were assigned randomly: DOXI (exclusively subgingival application of a 14% doxycyclin gel) or SRP (mechanical subgingival debridement using sonic scalers). Clinical examinations (PlI, PPD, RAL-V, GI) were obtained before, 3, and 6 month after therapy. In 20 patients (8 female) from 30 to 76 years of age a total of 103 single rooted teeth (DOXI: 61; SRP: 42) were treated. In both groups statistically significant (p /= 7 mm) than in shallow pockets (PPD 5-6 mm). For therapy of residual or recurrent pockets during supportive maintenance care subgingival application of the 14% doxycyclin gel provides as good clinical results as subgingival debridement with sonic scalers. Schlagwörter: lokale Antibiotikaapplikation, Doxicyclin, unterstützende Parodontitistherapie, Schallinstrumentierung

Computer-assisted surgery (CAS) has not been a routine part of cranio-maxillofacial surgery so far. Out of a total pool of experience with 102 navigation-guided procedures between 1/1998 and 12/2000, we report on 2 cases of navigation-aided resection of severe ankylosis of the mandibular condyle with a predetermined safety margin of the resection towards the middle cranial fossa, and identification of the oval foramen. We regard navigation-aided resection of an ankylosis of the mandibular condyle as a valuable additional technique in this potentially complicated procedure. Schlagwörter: Intraoperative Navigation, computergestützte Chirurgie

Introduction: Recently our group could show that spontaneous T-lymphocyte migration regulated by protein tyrosin kinase (PTK) being different from the protein kinase C (PKC) regulated induced type of migration in a 3-D collagen matrix model is modulated by foreign bodies such as dental alloys. However, little is known about the transition from the motile into a sessile state induced by 'foreign bodies' placed subgingival or by impaired immune reponse in periodontally compromized patients. Specific T-cell activation requires stable cell-cell interaction. In our in vitro model we tested the hypothesis of whether changes of locomotory behavior and receptor expression of CD4+ and CD8+ lymphocytes after induction of chemotaxis by different 'foreign bodies' (precious-pa, reduced precious dental alloys-rpa), cell-cell and mediated (via secreted signal substances) and interactions with different tumor cells could be ascribed to changes of the T-cell regulatory signal transduction of migration and receptor expression mimicing the influence of both either artificial tooth surfaces either impaired immune response on the development of periodontal diseases. Materials and Methods: The locomotion of immunomagnetically isolated human peripheral blood lymphocytes suspended in100 µl PBS and 200 µl type I 3-D collagen gels was recorded using time-lapse videomicroscopy as previously described. Computer assisted cell tracking was analyzed as to the percentage of cells moving and to the velocity influenced by 2 dental alloys and with epithelial carcinoma cells from breast (MDA-MB-468), bladder (T24) and colon (SW480). CD25 as well as CD45R0 receptor expression of CD4+ and CD8+ lymphocytes governing cell-dental material with 2 different groups of dental alloys and direct and mediated cellular interactions with the three lines of carcinoma cells were assessed by FACS analysis after 24h of incubation. Results: The medium percentage of CD4+ and CD8+ cells migrating was reduced on the 2 dental alloys tested versus the controls (pa 85,9%, rpa 39,7%) whereas being enhanced on titanium (110,9%). The velocity was reduced in all cases (pa=63,3%, rpa=39,4%, cp-Ti=28%) whereas percentage and velocity of T lymphocytes in direct and indirect cell interaction were enhanced. The results were highly significant (Mann-Whitney-U-test, pConclusions: We presume that CD4+ and CD8+ lymphocytes are migrating in a 3-D collagen matrix migration model influenced by the eluated ion-profiles of the oxide material top layers in a concentration dependent manner. Thus the cell-material governed alterations of migration do not seem to be interdependent on the alterations of the expression of CD25 and CD45RO T lymphocyte cell receptors while enhanced migration due more to direct than to indirect cell interactions is coincident with changes in the status of activation of these receptors. This model is suitable for investigating further items of signal transduction pathways within cell migration and for the evaluation of modulating factors leading to impaired host response in immunologically compromized patients with periodontal diseases. Schlagwörter: in vitro-Model, migration assay, impaired Immune Response, chronic periodontitis

Hard tissue resorption occurs under physiological conditions in deciduous dentition and under pathological conditions in deciduous and permanent dentition. It has been discussed whether there are differences in the resorption mechanisms between physiological root resorption and pathological dental hard tissue resorption. Therefore, we studied different resorption patterns with SEM under physiological and pathological conditions. Teeth extracted for the following reasons, physiological root resorption, chronic periodontitis, acute apical inflammation after root resection and one exhibiting an internal granuloma were dried in acetone, sputtered with gold-paladium and investigated with SEM (Philips XL 30 FEG) at 20 kV beam current. Additionally the tooth with the internal granuloma was decalicified and histological sections were stained with Azan. Physiological root resorption showed a regular resorption pattern with shallow resorption lacunae. The teeth with chronic periodontitis showed irregular resorption patterns especially in areas with cement destruction. The resorption lacunae were distinct and very shallow. In acute inflammation after root resection the resorption appeared to be very aggressive with irregular dissolution of the dentin around the apex. In contrast to all other investigated cases this dentin resorption was globular, no resorption lacunae were found. In the case of the internal granuloma the resorption lacunae were very deep and regular exposing dentin tubules and showing the typical keyhole structure where ranging into the enamel. The crown thickness was reduced and dentin almost completely resorbed. Histological investigation revealed numerous odontoclasts at the pulp dentin border. From these results we conclude that different reasons causing resorption under physiological and pathological conditions lead to different morphologies. Chronic inflammation of the periodont leads to distinct resorption in areas with cement distruction, whereas acute inflammation causes agressive rapid resorption. This might also be of clinical and forensic interest. Schlagwörter: dental hard tissue, resorption, SEM

Surface topography and chemical composition of mucosal-implant interfaces is thougt to be critical to their clinical success. The aim of our study was to investigate the topography and chemical composition of titanium mucosal-implant interfaces using surface analytical techniques. The mucosal surface compartments of 10 different implant systems were utilized as a test area. The ultramorphological analyzes were carried out using Confocal Laser Scanning Microscopy (CLSM), X-ray photoelectron spectroscopy (XPS), Metastable Induced Electron Spectroscopy (MIES), Scanning Electron Microscopy (SEM) and Scanning Force Microscopy (SFM). The surfaces of samples showed different fracturing of metal chips and pitting attack. From the CLSM- and SEM analyzes in comparison to the Developed Surface Area (DSA) as ratio of microroughnesses it appears that the diameter of the pits varied in the range of 0,1 to 10 µm. MIES showed the presence of Ti, O and C. Several peaks pertaining to titanium and oxygen can be found. The Ti-surface is covered by a 3-5 nm thick TiO2 layer. Only titanium in the oxidic, not in the metallic state is found within the observation depth of 10 Ångstroms. We find clear evidence from MIES that saturated hydrocarbon chains form the outermost molecular layer. Virtually no signal from TiO2 is found at the very surface. The results suggest a two-layer structure for the passive film formed on titanium after exposition to the sulcus crevicular fluid. The inner layer has a structure close to TiO2, while the outlayer is dominated by CH2-groups with a few -C=O groups inside the hydrocarbon overlayer. The granular structure observed on mucosal-implant surfaces seems to indicate that the dissolution occurs at localized defects in the passive film influencing the barrier function of implanto-gingival tissues. This was confirmed by the DSA as a hybrid parameter including both spatial and amplitude aspects of the surfaces. Schlagwörter: Ti-Surface topography, Ti-chemical composition, mucosal-implant interfaces, ultramorphological analyzes, Confocal Laser Scanning Microscopy (CLSM), X-ray photoelectron spectroscopy (XPS), Metastable Induced Electron Spectroscopy (MIES), Scanning Electron

The aim of this clinical study was to present potential sources of errors influencing the analysis of fluorescence images by using Quantitative Light-induced Fluorescence (QLF). Fluorescence images of 1835 lingual/ buccal surfaces and 517 occlusal fissures of thirty four 15-yr-old adolescents were captured after professional tooth-cleaning four times during a longitudinal study. Images were taken with a CCD camera with the mirror version in a dental office without any ambient light under standardised conditions. The computer program (Inspektor QLF 2.00) was used to display, store and analyse the images. QLF images were analysed by two trained examiners. Average fluorescence loss (DF) of the lesion, the area (A) of the lesion (mm2) and DQ (DF*A) were determined. Based on a large amount of analysed fluorescence images following confounding factors were compiled: 1. Despite of professional tooth-cleaning performed before QLF recordings red fluorescing areas caused by residual plaque/ calculus may be limited longitudinal measurements. 2. Different brightness of fluorescence images observed in several clinical examinations can pretend to remineralisation of lesions. 3. The analytical stage of the QLF method is limited if lesions extended to the gingival margin or to more than one surface. 4. Surfaces attacked by hypoplasia and developmental disorders have to be differentiate clinically from carious lesions before the QLF assessment. 5. Angular errors during image capturing can not be adjusted or eliminated completely by the time-consuming analytical process. An efficient control of all confounding factors is an important prerequisite in longitudinal studies. The new Video Repositioning System may be able to eliminate some sources of errors in future studies. Schlagwörter: QLF, clinical, diagnostics, optical methods of caries diagnosis, fluoresence technique

TRACK-system distractors for vertical alveolar distraction have been tested biomechanically under different in-vitro-conditions. Additional torque measurements on patients during the clinical course of distraction were conducted to differentiate clinical and in-vitro data. Experimental findings and clinical trials led to the conclusion that according to indication and appropriate size of the device biomechanical stability and proper function can be assured under normal circumstances. Schlagwörter: vertical distraction stability, biomechanical investigation

The aim of this study was to compare the cleaning efficacy of an experimental toothbrush (GABA International AG) with a standard toothbrush (ADA reference toothbrush) in a controlled, examiner blinded, 48h plaque regrowth splitmouth study. 87 subjects between 18 and 63 years of age (27.3±6.8y) took part in the study. After a 12 day acclimatisation period and 48h of no oral hygiene measures the teeth of the upper right and lower left quadrant were brushed for one minute with either the test or the control toothbrush according to a pre-determined randomisation list followed by cleaning the other two quadrants with the complementary toothbrush, respectively. Immediately before and after tooth brushing plaque was measured by one examiner (E.B.) blinded with respect to the used toothbrushes utilizing the Turesky modification of the Quigley-Hein Plaque Index. Related to all tooth surfaces plaque was reduced by the test toothbrush from 1.95±0.48 to 1.02±0.41 (p Schlagwörter: Filamente, Gingivitisreduktion, Handzahnbürsten, Zahnbürsten