Objective: The aim of this study was to investigate patients with classical (cEDS) and hypermobile (hEDS) Ehlers-Danlos syndrome (EDS) with regard to the prevalence and quality of temporomandibular disorders (TMD). In addition, the connection to chronic pain and psychological distress was investigated. EDS are classified as rare diseases, of which 13 subtypes can be distinguished according to the current classification (1). hEDS and cEDS are among the two most common subtypes (1,2). A characteristic feature is hypermobility of the joints. According to current literature, patients with EDS suffer more frequently from temporomandibular joint problems (3). The study conducted here is intended to be a further step in the research of the disease and the development of individualised treatment methods. Methods: Participants were recruited via self-help groups in Germany, Austria and Switzerland as well as via social media and subjected to an online questionnaire. Free-text questions on TMD-specific symptoms and previously diagnosed TMDs and their treatment, the German version of the Depression Anxiety and Stress Scale and the German version of the Graded Chronic Pain Status were used. Results: 259 participants were included (230 hEDS/29 cEDS). 49.2% of participants had painful or restricted jaw movements, and 84.9% had pain in the masticatory muscles, with 46.3% having a previously diagnosed TMD. A significance analysis showed a 2.5-fold higher risk of chronic pain in participants with diagnosed TMD. 22% of participants had a critical score for depression, 53.3% had a critical score for anxiety and 34.0% had a critical score for stress. Conclusion: CMD problems and chronic pain are common in patients with cEDS and hEDS. The lack of knowledge about these problems can lead to psychological distress. Further research is needed to adequately treat patients with EDS and to develop individualised treatment concepts. Keywords: Ehlers-Danlos syndrome, oral health, rare diseases, temporomandibular disorder

Die regelmäßigen Patientenkontakte in der zahnmedizinischen Praxis ermöglichen es Zahnärzten und Zahnärztinnen, eine entscheidende Rolle bei der Aufdeckung häuslicher Gewalt zu spielen. Das Auftreten von häuslicher Gewalt kennt keine sozialen Grenzen und betrifft Menschen jeden Alters, unabhängig von sexueller Orientierung oder Ethnizität. Häusliche Gewalt kann sich in verschiedenen Formen manifestieren, körperlich, sozioökonomisch, sexuell, psychologisch und in Form von Stalking. Zusätzlich kann Vernachlässigung, also das Ausbleiben angemessener Fürsorge, ebenfalls eine schwerwiegende Form häuslicher Gewalt sein.

In autoimmune diseases, such as oral lichen ruber planus, a sufficient prosthetic restoration without dental implants is often not possible. Due to the extreme vulnerability of the oral mucosa, the indication for an implant restoration should be considered, especially for tegument relief. Interdisciplinary planning between prosthodontist and surgeon is necessary to realize an individual, mucosa-relieving treatment for the patient. Implants in patients with immunodeficiencies are therefore justified when strictly indicated and can lead to a rehabilitation of the physiological masticatory function, an increased quality of life, and a positive influence on the general state of health. Keywords: Oral lichen planus, implant, oral mucosal diseases

This case series reports the rehabilitation of the anterior maxilla using immediate implant placement and provisional restoration in combination with preservation of the alveolar foramen. Four patients presented to the Department of Oral and Maxillofacial Surgery with a non-preservable maxillary incisor following dental trauma. Treatment planning was performed digitally using Co-DiagnostiX software. The treatment protocol included atraumatic extraction followed by immediate implant placement and provisional restoration with an implant-supported single crown. In all cases, the non-salvageable tooth was carefully extracted and a dental implant (2 BLT, 2 BLX, Straumann) was placed using a flapless approach. Augmentation was performed with a combination of autogenous and xenogenous material, and the soft tissue was augmented with a connective tissue graft. After surgery, intraoral scans were taken and a CAD-CAM provisional crown was fabricated and placed on the same day as surgery. The final ceramic crown was placed after three to six months. The soft tissue profile was compared by superimposing the baseline intraoral scans (before and immediately after surgery) with the follow-up scans. Six months after surgery, soft tissue changes were considered minimal compared to baseline. Keywords: Dental implants, immediacy, digital planning, soft tissue

In order to achieve a functional and, from an aesthetic point of view, optimal treatment result, various things have to be taken into account in cleft patients: comprehensive interdisciplinary cooperation, favourable tooth positions and intermaxillary relationships, and appropriate peri-implant soft tissue management. Nevertheless, difficult conditions, e.g., narrow interdental gaps, often persist despite extensive pretreatment over many years from a preimplantological point of view. The present case report shows a patient with a left-sided cleft. At the age of 21, the patient could be treated implantologically with a single-tooth implant in region 22. The success prognosis of implants in the cleft jaw region is comparable to implants placed after trauma. Sufficient bone supply is absolutely essential for this. Keywords: cleft, implant

Zahnmediziner/-innen sehen ihre Patienten/-innen meist in regelmäßigen Abständen und können daher bei der Aufdeckung häuslicher Gewalt eine entscheidende Rolle spielen. Häusliche Gewalt ist unabhängig von der sozialen Schicht, von Alter, sexueller Orientierung oder Ethnie. Auch wenn es viele Ausprägungen von häuslicher Gewalt gibt, sind die häufigsten Formen die körperliche, sozioökonomische, sexuelle, psychologische Gewalt und Stalking. Vernachlässigung, also die Nichterbringung der angemessenen Fürsorge körperlicher oder seelischer Art, die für eine bestimmte Entwicklungsstufe, eine Krankheit, eine Behinderung oder andere persönliche Umstände notwendig wäre, ist ebenfalls eine Folge von häuslicher Gewalt. Neben Frauen als Betroffene können auch Kinder und Männer häusliche Gewalt erleiden; ca. 70 % der Betroffenen sind allerdings weiblich. Laut WHO erleben etwa ein Drittel aller Frauen einmal in ihrem Leben häusliche Gewalt. Die Wahrscheinlichkeit, ein Opfer in der zahnärztlichen Praxis anzutreffen, ist also hoch.

Objective: This case report and systematic review aimed to answer whether patients with osteogenesis imperfecta (OI) can be prosthetically treated with implants. Osteogenesis imperfecta is a rare genetic disease characterized by a type I collagen defect leading to bone fragility and connective tissue disorders. Case Report: A 64-year-old female patient with OI type 1 presented for the first time to a specialty consultation for rare diseases with oral involvement in May 2019. The patient had received alendronic acid (p.o.) for many years to treat OI. At the consultation time, she was fitted with maxillary and mandibular complete dentures, and the complete mandibular denture had inadequate support. Implants were planned to stabilize the prosthesis. Under local anaesthesia, two tissue-level implants (Straumann Standard Plus®, Basel, Switzerland, SLActive 3.3 mm × 10 mm) were placed in regions 32 and 44. After a healing period of three months, uncovery took place, and the prosthetic restoration with locators could be performed two weeks later. Since implant placement, the patient has attended regular check-ups for one year and has shown no signs of drug-associated osteonecrosis or peri-implant infection. Methods: Because of the paucity of studies on implants in individuals with OI, a systematic review was performed. The search queries were based on the Population Intervention Comparison Outcome (PICO) procedure with the question, "Can people with osteogenesis imperfecta (P) be successfully treated and prosthetically restored (O) with dental implants (I)?" Results: The primary outcome was implant survival. Supporting data were analysed descriptively. Twelve studies were finally included. Twenty-three patients were treated with a total of 116 implants, with 5.0 (±3.8) implants placed per patient. Bone augmentation was performed before or during implant placement in 30 implants (25.8%). A sinus lift was performed before the placement of 19 implants (28.8%). In 18 patients, implants were placed in a two-stage procedure. In four patients, 14 implants (12.1%) were immediately loaded. Implant survival was 94.0%, with a mean follow-up of 59.1 months (±36.1). A total of seven implants were lost in four different patients. Three implants (2.6%) were lost before loading, and two implant fractures (1.7%) were described. Conclusion: The available data show the loss of only seven implants, with two of these implants lost due to implant fractures not attributable to the patient. With the limitations of this review and based on the available data, implants have a high survival rate (94.0%) in patients with osteogenesis imperfecta. Therefore, implants may be a viable treatment option for replacing missing teeth in patients with OI and should be considered in treatment planning after a detailed individual risk assessment. Keywords: Osteogenesis imperfecta, implants, rare disease, case report, systematic review

CBCT devices offer a scanning protocol mode with a partial rotation arc of 180^o, followed by a 360^o image reconstruction through algorithms. This scan mode is associated with a low number of basis images and subsequent reduced image quality. However, it does not influence the appearance of artefacts, and it offers a reliable alternative for assessing peri-implant bone. Although the appearance of dental implant artefacts is well documented in literature, metal artefacts are usually determined by grey values or contrast-noise-ratio, but fewer studies have reported the influence of artefacts on diagnostic image quality. Keywords: CBCT, partial rotation arc of 180 degrees, followed by a 360 degree, peri-implant bone, artefacts, diagnostic image quality

Surgical crown lengthening is one of the most common surgical procedures in periodontal practice. It is divided into functional and esthetic surgical crown lengthening. In general, surgical crown lengthening is a predictable periodontal surgical procedure. Its most common complication is excessive regression of the dentoalveolar complex coronally. Esthetic surgical crown lengthening can be performed predictably through prior digital planning, minimizing the risk of potential complications such as excessive regression of the dentoalveolar complex coronally. The present study reported in this article is a clinical case of surgical crown lengthening with digital planning to derive practical recommendations. Keywords: surgical crown lengthening, digital planning, esthetics

Eine unausgewogene Ernährung wirkt sich nicht nur negativ auf den Allgemeinzustand aus, sondern beeinflusst auch die orale Gesundheit. Das Ziel dieser Arbeit ist darzustellen, wie Nährstoffe und ernährungsbedingte Zustände (Fettsäure und Vitamin D, Adipositas) die Implantattherapie beeinflussen können. Die Literatur zeigt, dass ein erhöhter Körperfettanteil einen chronischen inflammatorischen Zustand verursacht, welcher zu einem erhöhten Risiko für die Entwicklung einer Periimplantitis führt. Ebenfalls wirken Omega-6-Fettsäuren proinflammatorisch, wohingegen Omega-3-Fettsäuren eine antiinflammatorische Wirkung zeigen. Bislang fehlen allerdings Studien, die den Zusammenhang zwischen Implantaten und Fettsäuren untersucht haben. Eine Supplementation von Vitamin D vor einer Implantation bei Patienten mit mangelnder Serumkonzentration kann die Osseointegration verbessern. Manuskripteingang: 11.05.2022, Manuskriptannahme: 18.05.2022 Keywords: Zahnimplantat, Ernährung, Adipositas, Fettsäuren, Vitamin D