International Poster Journal of Dentistry and Oral Medicine, 01/2015

After the hype of using computers in the 2000's in pure e-learning environments, the results have been disappointing. Blended learning is suspected to combine the benefits of traditional courses with e-learning. Aims: What are student's perceptions of their learning experience in traditional courses, e-learning and blended-learning groups? Is there an influence on the test results afterwards? Materials and Methods: 75 students attending a orthodontic course in diagnostics (facial diagnostics) were divided into three groups, traditional lecture and seminar (A:n=26), e-learning (B:n=11) and blended-learning (C:n=38). The students had no prior knowledge to the facial analysis used. Special e-learning software for facial analysis was developed (Borland Delphi 7, including patient management and facial analysis). Each student was evaluated with a questionnaire with 20 items in four categories (motivation, didactics, response and effect) after completing the course. In addition each student had to pass a test with 20 images to analyse afterwards. Results: The questionnaires showed that blended learning leads to a more active role of the student (C:77% vs B:33% and A:35%) and the perceived increase in knowledge was also higher in group C. Group differences were tested with Kruskal-Wallis-test and multiple pair comparison (Dunn). Group B was rated inferior or at least equal from most students in all categories. In the category supposed effect group B is significantly inferior to all other groups. In the test there was been no significant difference between the groups. Conclusions: As a result e-learning only cannot be recommended in teaching facial analysis in orthodontics. Regardless of the content e-learning may be at best equal to a lecture. The networking of electronically generated content and personal contact leads to higher motivation but there can be no better test results expected. Keywords: e-learning, blended learning, orthodontics

In the present study the tissue reaction to a synthetic hydroxyl-apatite-based bone substitute material and a xenogenic bovine-based bone substitute material were analyzed. A split-mouth sinus augmentation trial was performed to analyze the capacity of new bone formation within the augmented region together with clinical stability of the inserted implants. Six months after augmentation cylindrical bone biopsies were extracted for histological and histomorphometrical investigation. The cellular reaction, a potential inflammatory response and the ratio of newly formed bone, connective tissue and remaining bone substitute material were evaluated. Further, the amount of multinucleated giant cells and the vascularization within the implantation bed was evaluated. Implants placed in the augmented regions were analyzed clinically two years after placement. Histomorphometric analysis revealed significantly more vessels and a significantly higher vessel fraction in the synthetic study group. Further, significantly more multinucleated giant cells in the synthetic augmentation sides could be detected. In contrast, the differences in fraction of connective tissue, amount of remaining bone substitute and newly formed bone did not show statistical significant differences. Both biomaterials led to a clinical successful implantation in all patients. The results of this study highlight the different cellular reactions of synthetic and xenogenic bone substitute materials. The significant higher amount of multinucleated giant cells within the synthetic implantation bed seems to not affect its biodegradation. Accordingly, it seems that the observed multinucleated giant cells within the implantation bed of the synthetic bone substitute material have characteristics rather similar to foreign body giant cells than to osteoclasts. Keywords: Biomaterial, Bone graft, Histology, Foreign body reaction

Background: Laser-Lok microchannel is a proprietary dental implant surface treatment. Laser-Lok surface has been shown to elicit a biologic response that includes the inhibition of epithelial downgrowth and the attachment of connective tissue .This physical attachment produces a biologic seal around the implant that protects and maintains crestal bone health. Aims and objectives: To assess crestal bone levels of laser lok implants versus identical non treated implants Materials and Method: A total of 20 implants, 10 tapered Laser-Lok with micro collar implants (Group A) and 10 identical non treated implants (Group B), placed in the mandible were assessed for crestal bone loss after placement of implant immediately and after 3 months using radiographs with Schie's radiographic grid 1 x 1 mm. The distance from top of the implant to the first implant bone contact was measured. Statistical analysis: Paired t test and wilcoxon sign test were done for inter and intra group analysis. P value less than 0.05 was considered as statistically significant. The baseline change in the bone levels didn't differ significantly between group A and Group B. But a statistically significant difference was observed in the mean crestal bone loss (p0.05) around Laser-Lok implants (1.6 mm) as compared to non treated implants (2.19 mm) as observed after 3 months. Within the limits of the present study, it can be concluded that the crestal bone loss around Laser-Lok implants is significantly lesser than around non treated implant surface. Clinically this may contribute to lesser than around non treated implant surface. Clinically this may contribute to lesser peri-implant tissue breakdown. However further studies with larger sample size and longer follow up time are essential. Keywords: implant, laser-lok, microchannels, crestal bone, bone implant contact, connective tissue

Objective: Study of the dimensional stability of three addition silicones after steam autoclave sterilization. Material and Methods: For this study, addition silicones were used in an automatic mixing machine, Pentamix 2 (3M ESPETM): Express Penta H (3M ESPETM), Affinis System 360 (Coltène/Whaledent), Aquasil Ultra Heavy Regular - Smart Wetting Impression Material (Dentsply). Six groups were formed. Groups 1, 2 and 3 followed a protocol of chemical disinfection with sodium hypochlorite 5.25% for 10 minutes. Groups 4, 5 and 6 were submitted to the same disinfection followed by autoclaving at 134°C for 25 minutes. The samples were obtained with a metallic matrix from ADA Specification n°19 and ISO 4823:2000. The measurements were taken right after obtaining the samples, after the applied procedures, 24 hours later, two weeks later and six months later. Two lines were measured in each sample, line A and line B. Results: The Aquasil Ultra Heavy Regular - Smart Wetting Impression Material (Dentsply) had the lowest dimentional modification, in contrast with the Express Penta H (3M ESPETM) which had the highest values of dimensional changing. Conclusion: The studied addition silicones have showed dimensional changes. However, the ADA Specification n°19 (1977) established that these changes aren't significant for they don't exceed 0,5%. In this study, addition silicones didn't suffer significant dimensional changes after autoclaving. Keywords: dimensional stability, addition silicones, sterilization

A case of desquamative reaction of the oral mucosa following the use of 0.2% Chlorhexamed® alcohol-free mouthwash and local application of Chlorhexamed® 1% gel is presented. Causes of desquamation and alternatives to Chlorhexamed 1% gel are discussed; i. e. an alternative use of 0.2% Chlorhexamed® in a diluted (0.1%) concentration or a general discontinuation of the application of chlorhexidine-containing products. Because of adverse events, close monitoring and short-term use of chlorhexidine are both recommended. Keywords: Chlorhexidine, desquamative changes, desquamation of the oral mucosa

Introduction: Along with clinical examination Magnetic Resonanz Imaging (MRI) has become a standard tool in Temporomandibular joint disorder diagnosis. Even though MRI diagnosis usually focuses on pathologies of the joint directly, pathological alterations of the muscles can be found as well. Objectives: Is there evidence for correlations between MRI muscle findings and clinical symptoms of TMD? Material and Methods: Digital MR- Images of 65 patients treated for TMD at the dental clinic of Goethe University Frankfurt, Germany between 2004- 2012 have been evaluated. One patient showing noticeable alterations in MR muscle appearance between right and left muscles was defined as reference for the muscle alterations of interest. Fibrous, lipomatic and edematic alterations were recorded and the width of the masseter, medial and lateral pterygoid muscle was measured in the axial plane. Those findings were then matched with clinical findings of palpation, limitation or hypermobility in jaw opening and klicking, deviation and deflexion. Results: Just like in the clinical examinations most alterations in MR signaling were found in the masseter muscle. 93% showed at least one of the alterations of interest while 46% of the masseter were painful on palpation. Still, statistically this was not significant (p> 0,05). With 17% alterations in MR signaling and 13% of clinical symptoms, findings in the medial pterygoid muscle were less frequent. Here as well, there was no proof of correlation between MR - and clinical findings (p> 0,05). Most of the MR- findings in lateral pterygoid muscles (42%) were of lipomatic nature. They were correlated with clinical findings of klicking, limitation or hypermobility in jaw opening and deviation or deflexion but no statistically significant correlations were found (p> 0,05). Conclusion: Although MR findings of muscle alteration such as fibrosis, liposis or edema can be detected quite frequently in patients with TMD, there is no evidence of correlations between MR signaling and clinical symptoms. Therefore a thoroughly performed clinical examination is inevitable. Since no differenciation has been made between severeties of muscle alterations, further investigation is needed to determine if the severness of signal alterations correlates with clinical symptoms. Keywords: MRI pathologies, TMD, masticatory muscles

Palatoradicular groove is a developmental anomaly which has been implicated as an initiating factor in localized gingivitis and periodontitis. Palatal radicular groove or radicular lingual groove represents an infolding of the enamel organ and epithelial sheath of hertwig. Groove is a locus for plaque accumulation, which destroys sulcular epithelium and later deeper parts of periodontium, finally resulting in formation of severe localized periodontal defect. A 28 year old male patient presented to department of periodontics and oral implantology with chief complaint of forwardly placed and mobile tooth with bleeding gums in left upper front region. On examination a groove running from cingulum towards root was found on the palatal aspect of 22. Probing depth was 8mm in mid palatal region. Radiographically, extensive bone loss was present. After completion of non-surgical therapy, flap reflection was done. Scaling and debridement was done followed by restoration with glass inomer cement. Guided tissue regeneration was placed over localized bone defect and flaps were approximated and sutured. Keywords: developmental anomaly, palatal groove, GTR membrane, localized periodontitis

Aim: To assess whether the pre-surgical microbiology in a group of cleft lip and palate patients has an effect on the surgical outcome. Method: The study was undertaken over a two year period at the Royal Hospital for Sick Children, Yorkhill, Glasgow. Throat and nasal swaps were collected prospectively from all cleft lip and palate patients on the day prior to elective surgery. All swabs were processed in the on-site microbiology laboratory and the results were categorised according to culture findings into normal oral flora or a specific pathogen or pathogens. In addition, each patient's age, gender and surgical procedure were recorded. Each patient was assessed at review clinic and the surgical outcome was noted to be good or bad (dehiscence/fistula). The data was then analysed by a statistician and compared with the surgical outcome. Results: We will present the microbiological data from 188 cleft lip and palate cases treated in a two year period and demonstrate the association between microflora cultured / age / gender and surgical outcome, including the statistically significant relationship between poor surgical outcome and culture of haemophilus influenza from nasal samples. Keywords: cleft lip and palate, microbiology, haemophilus influenzae, screening

Correlation of histologic features with complete historical, clinical and radiographic information is not only helpful, but also essential to ensure an accurate diagnosis of odontogenic tumours. This poster aims at highlighting the significance of clinico-radiological-histological correlation by detailed presentation of a case of Odontoameloblastoma with calcifying cystic odontogenic tumour that reported to our dental hospital. Keywords: odontoameloblastoma, CCOT, doagnosis

Aim: This study aimed to evaluate the reproducibility of the ICDAS visual classification system in clinical setting along with conventional dental charting. Materials and methods: Thirty adult patients attending SEGI University dental clinic were screened using ICDAS detection codes along with conventional dental charting. Three clinicians, 2 Dental Public Health Specialists (KCG, DD) and 1 Oral Medicine specialist (AM) with previous training in ICDAS, screened these patients separately under same clinical setting. The teeth were visually examined after air-drying with 3 way syringe and the codes per tooth were recorded on new clinical chart which includes ICDAS score per tooth and conventional dental chart. Kappa analysis was done to calculate the inter-examiner reproducibility. Results: Kappa values for inter-examiner reproducibility were calculated to assess reproducibility of the examiners. The inter-examiner reproducibility between KCG-DD ranged from 0.775 to 0.852, from 0.740 to 0.827 between AM-DD and from 0.768 to 0.849 between observers KCG-AM. The time difference in the charting was found to be not significant Conclusion: The ICDAS system has demonstrated reproducibility and diagnostic accuracy for the detection of caries at varying stages of the disease process. Combining conventional dental charting along with ICDAS showed no significant time difference in charting. The ICDAS system achieved substantial to good agreement between examiners, is practical in clinical dental practice with training and can be improved with experience. Keywords: ICDAS, inter-examiner, calibration