Mahmoodi, Benjamin

Radikuläre Zysten sprechen schlechter auf die alleinige endodontische Therapie an als apikale Parodontitiden. Führt ein rein konservatives, orthogrades Vorgehen durch eine Wurzelkanalbehandlung nicht zum gewünschten Therapieerfolg, muss im Anschluss eine Wurzelspitzenresektion durchgeführt werden. Der folgende Fallbericht behandelt einen endodontisch-chirurgischen Therapieansatz bei einer Zyste als Spätkomplikation nach dentalem Trauma. Keywords: radikuläre Zyste, Wurzelspitzenresektion, apikaler Plug, DVT, dentales Trauma

Purpose: To evaluate the clinical characteristics of dental emergency patients with special regard on gender-specific differences related to the utilisation and use of antibiotics. Materials and Methods: A retrospective analysis of all patients who presented to the emergency service of a university hospital in from 2010 to 2013 was performed. Demographic data, diagnosis, conducted treatment and the prescription of antibiotics were recorded and further analysed. Results: Altogether, 16,296 patients visited the emergency service. Of these patients, only one-fourth (25.7%; n = 4185) suffered from a diagnosis with urgent treatment needs. Gender-specific differences were found in the reason of visit. Males presented significantly more often with severe diagnoses, like abscess or trauma. Females presented significantly more often with non-urgent diagnoses, not directly connected to oral hygiene habits, like temporomandibular disorders (TMD), denture sore or dolor post extractionem. Moreover, an overuse of antibiotics was found among emergency patients, with every fifth patient (20.2%; n = 3291) being prescribed an antibiotic. Conclusion: Better public education on dental emergencies and constant updates for dentists about the use of antibiotics in dental emergency care is necessary to secure adequate medical supply for severe dental emergencies and to avoid an inappropriate use of antibiotics. Keywords: antibiotics, dental emergencies, emergency patients, gender dentistry

Objectives: The per-patient number of dental implants is increasing year after year. This study summarises the implant complications that occurred in a university hospital's dental emergency service in a four-year period. Methods: The data of four years (01-01-2010 - 12-31-2013) were analysed retrospectively. In this time period, 16,296 patients sought treatment in the dental emergency service. The Chi-square test was used to detect significances. Results: Out of all 16,296 emergency service patients, 0.6 % (n=94) came due to problems with one or more dental implants. Significantly more women (n=53; 56.4 %) were affected (p=0.023). The median age was 54.5±16.2 years. Implants in the lower jaw were distinctly more often the reason for the visit; the most frequent diagnosis was periimplantitis (31.9%; n=30), followed by damage or loss of the supraconstruction (20.2 %; n=19). 70.2% (n=66) of the affected implants were inserted alio loco versus 25.5% (n=24) in domo. Most complications occurred less than one year after implantation (n=11; 11.8%). Problems due to implants that were in situ more than one year (n=6; 6.5%), more than two years (n=4; 4.2%), or more than three years (n= 1; 1.1%) were less frequent. Conclusions: Problems with dental implants remain a rare reason for visiting the dental emergency service. Periimplantitis rarely leads to pain; nonetheless it was the most common implant problem in our study. The fact that women are affected significantly more often as well as that implants in the lower jaw cause problems significantly more often could be of interest in terms of possible causes. Keywords: Implants, emergency

Aim: The incidence of traumatic dental injuries (TDIs) is higher in evenings and on weekends. They require early and appropriate management to minimise complications and to save the affected tooth. Consequently, many patients present in dental emergency services, which operate outside regular consulting hours. The aim of this study was to analyse the TDI cases in a dental emergency service unit of a university hospital over 4 years. Methodology: All patients with TDIs between 2010 and 2013 were determined from the hospital database and subjected to further analysis. Demographic data, classification of trauma (according to the WHO), teeth involved, and cause of trauma were evaluated. Results: Of 16 301 patients who received treatment in the dental emergency service over a period of 4 years, 1305 (8.0%) came due to TDIs. Average age was 14.4 years (range: 0.6- 88.1). More than half of the trauma patients (54.2%) were under the age of ten and about two-thirds (74.5%) under twenty. Males experienced trauma more often than females (range 1.5 : 1). Nearly half of cases (48.2%) occurred on weekends. The most common diagnosis was subluxation (27.8%), followed by uncomplicated enamel-dentin fracture (25.9%), and lateral luxation (21.7%). 355 patients (27.2%) had an additional soft tissue injury. In 48.6% of cases only one tooth was involved, in 33.5% two. The permanent dentition was injured in 56.6% of cases, the primary dentition in 41.1%. The maxillary central incisors were affected in 79.2% of cases. The most common causes of TDIs were falls (54.6%) and sport accidents (13.4%). Conclusions: The prevalence of TDIs in the dental emergency unit was high. Due to the complexity of management, possible complications, and lifelong consequences, the dentist on duty as well as the one providing further treatment have to be aware of the endodontic and surgical measures. A regular update of the dentists' knowledge about traumatology is required and more attention should be given to the prevention of trauma. Keywords: TDI, dental trauma, traumatic dental injuries, emergency