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Objectives: The 6th German Oral Health Study (DMS • 6) reports on the periodontal status in population-based cohorts of younger adults (35- to 44-year-olds) and younger seniors (65- to 74-year-olds). Method and materials: Participants answered questionnaires regarding oral health behavior, and general and oral health status. Probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were measured on all teeth except third molars. Number of teeth, BOP, mean PD, mean CAL, the stages of the 2018 classification of periodontal diseases, the prevalence of Community Periodontal Index (CPI), and the Centers for Disease Control and Prevention (CDC)/ American Academy of Periodontology (AAP) case definition were reported. Results: In total, 9.2%/20.6% of younger adults/younger seniors had a low education status, 25.6%/14.1% of younger adults/younger seniors were current smokers, and 2.1%/15.4% of younger adults/younger seniors had type 2 diabetes. Of all younger adults/younger seniors, 24.4%/38.7% stated that they performed interdental cleaning at least daily. The mean number of teeth in dentate younger adults/younger seniors was 26.6/20.4, of which 5.6/8.3 teeth had PD ≥ 4 mm and only 0.6/1.7 teeth had PD ≥ 6 mm. The mean number of teeth with CAL ≥ 5 mm was 1.1/3.6 in younger adults/younger seniors. Mean PD in younger adults/younger seniors was 2.1 mm/ 2.6 mm; correspondingly, mean CAL was 1.1 mm/2.4 mm. A CPI score of 4 occurred in 16.2%/42.4% of younger adults/younger seniors. In total, 13.6%/26.3% of younger adults/younger seniors were classified as having stage III periodontitis, while 3.9% and 26.4% were classified as having stage IV periodontitis according to the 2018 case classification, respectively. Conclusion: The periodontitis prevalence according to the 2018 classification (including all stages) was very high at 95.1%/85.2% in younger adults/younger seniors. In total, 31.6%/8.3% of younger adults/younger seniors were classified as stage I (ie, interdental CAL 1 to 2 mm), which, from a clinical point of view, appears to be a transitional phase between gingivitis and periodontitis, which can probably be managed with preventive rather than therapeutic measures. In younger adults and younger seniors, the prevalence of periodontitis in Germany is high, with severe periodontitis (stages III and IV) in 17.5%/52.7% of younger adults/younger seniors. Keywords: classification, dental care, dentists, DMS 6, epidemiology, prevalence, periodontitis

Objectives: The objective of this study was twofold: firstly, to provide an overview of trends in periodontal status among younger adults aged 35 to 44 years and younger seniors aged 65 to 74 years between 2005 and 2023, based on data from the German Oral Health Studies (DMS); secondly, to quantify the extent to which observed differences in tooth count variables between consecutive studies can be attributed to differences in characteristics. Method and materials: The data from DMS IV (2005), DMS V (2014), and DMS • 6 (2023) were analyzed. The participants completed questionnaires concerning their oral health behaviors, and general and oral health. For this analysis, probing depths (PD) were calculated from three sites on 12 index teeth as a common denominator. The number of teeth, severity, and extent of PD and the Community Periodontal Index (CPI) were reported. Multivariate decomposition was employed to analyze differences by time. Results: The proportion of edentate younger seniors notably declined, from 23.2% to 5.4%, between 2005 and 2023. Similarly, the mean number of teeth for dentate younger seniors was 2.4 teeth higher in DMS • 6. While the mean PD remained 2.4 mm for younger adults and 2.8 mm for younger seniors, inconsistent patterns were observed for extent variables. In most cases, a decline of the extent variables was observed between DMS IV and DMS V, with a rebound at DMS • 6 for severe cases in younger seniors (with PD ≥ 6 mm). The proportion of younger adults and seniors with CPI scores of 0 to 2 increased considerably between DMS IV and DMS V, but rebounded at DMS • 6. Overall, the prevalence of these cases increased by approximately 10% points and 5% points, respectively. The majority of the observed reduction in the number of missing teeth (in younger adults) or the prevalence of having less than 20 teeth (in younger seniors) between DMS IV and DMS V and between DMS V and DMS • 6 were explained by an increase in the proportion of highly educated individuals, an increase in the proportion of those who have never smoked (only younger adults), an increase in the proportion of individuals using electric toothbrushes or interdental cleaning devices, and a reduction in the proportion of individuals with lifetime periodontal treatment. Conclusion: Over the last two decades, there has been a significant improvement in periodontal health in Germany, with the most notable enhancements occurring between DMS IV and DMS V. The prevalence of periodontal disease has decreased significantly in recent decades, largely due to the implementation of preventive measures. This underscores the importance of integrating preventive measures into dental practice as a public health strategy. Keywords: dental care, dentists, DMS 6, multivariate decomposition, number of missing teeth, periodontitis, trend analysis

Zahnärztliche Untersuchungen gewinnen im Zusammenhang mit zahlreichen systemischen Erkrankungen, die mit oralen und/oder parodontalen Manifestationen einhergehen, eine besondere Bedeutung für die Früherkennung. Auch bei seltenen Erkrankungen, wie dem Melkersson-Rosenthal-Syndrom, können orale Manifestationen entscheidende Hinweise zur Diagnose liefern. Das Melkersson-Rosenthal-Syndrom ist eine orofaziale Granulomatose unbekannter Ätiologie, die durch die Symptomtrias Cheilitis granulomatosa, Fazialisparese und Lingua plicata charakterisiert ist. Diese Symptome treten nur in seltenen Fällen zusammen auf, womit eine Diagnose erschwert ist. Der folgende Fallbericht beschreibt den Krankheitsverlauf eines 29-jährigen Patienten mit besonderem Fokus auf die frühzeitigen Veränderungen der Gingiva und der Mundschleimhaut. Zu Beginn zeigten sich klinisch eine generalisierte Rötung sowie eine stellenweise vergrößerte und granulomatöse Gingiva. Im weiteren Verlauf traten Gesichtsödeme, Lippenschwellungen und Lippenrhagaden auf. Das Allgemeinbefinden des Patienten verschlechterte sich zunehmend. Zahlreiche medikamentöse Therapieansätze, darunter Kortikosteroide und Immunsuppressiva, blieben ohne nachhaltigen Erfolg. Erst durch den Einsatz des Tumor-Nekrose-Faktor(TNF)-α-Inhibitors Adalimumab konnte eine deutliche Verbesserung der Symptomatik erzielt werden, die sich nach Beendigung der medikamentösen Therapie über einen Beobachtungszeitraum von mehr als 19 Jahren stabil zeigte. Keywords: Melkersson-Rosenthal-Syndrom, seltene Erkrankungen, Orphan Diseases, orofaziale Granulomatosen, Cheilitis granulomatosa, Lingua plicata, periphere Fazialisparese