Auschill, Thorsten

Purpose: To examine the influence of abutment emergence angle and abutment height on marginal peri-implant bone stability in patients not considered susceptible to peri-implantitis. Furthermore, it was analyzed whether titanium-base (Ti-base) abutments lead to wider abutment emergence angles compared to one-piece abutments. Materials and Methods: A total of 48 abutments (ie, 24 Ti-base and 24 one-piece abutments in 24 patients) were evaluated at abutment installation, after 1 year, and thereafter on a yearly basis for up to 5 years. Clinical and radiographic outcome variables were assessed. Results: With regard to peri-implant marginal bone stability, only moderately negative, albeit significant, correlations were found on the mesial sides of the one-piece abutments after 4 and 5 years for an abutment emergence angle > 30 degrees. No statistically significant negative correlations were found for distances of ≤ 1.5 mm between the restoration margin and the crestal peri-implant bone level for either Ti-base or for one-piece abutments. Furthermore, abutments bonded to Ti-bases were not associated with larger emergence angles than one-piece abutments. Conclusions: For patients at low risk of developing peri-implantitis, it can be concluded that neither a larger abutment emergence angle (> 30 degrees) nor a distance of ≤ 1.5 mm between the restoration margin and the crestal peri-implant bone level are associated with marginal peri-implant bone loss. Furthermore, abutments bonded to Ti-bases are not associated with wider emergence angles than one-piece abutments.

Titanbasen zur Verbindung mit CAD/CAM-gefertigten Abutments oder Kronen werden in der täglichen Praxis häufig verwendet. Aufgrund des engen Kontakts können sowohl die physikalischen als auch die chemischen Eigenschaften des Haftmaterials oder der Spalt selbst den Zustand des periimplantären Weichgewebes beeinflussen. Daher war es das Ziel der aktuellen klinischen Studie, die langfristigen Auswirkungen von individualisierten Abutments, die auf Titanbasen geklebt wurden, auf die periimplantäre Gesundheit zu untersuchen. An dieser prospektiven einfach verblindeten randomisierten kontrollierten klinischen Studie nahmen insgesamt 24 Patienten mit je einem Test- und einem Kontrollabutment teil. Dabei handelte es sich bei den Testabutments um CAD/CAM-gefertigte Titanabutments, die auf Titanbasen geklebt wurden. Als Kontrollabutments wurden individualisierte einteilige CAD/CAM-gefertigte Titanabutments verwendet. Bei der Installation der Abutments und danach jährlich bis zu 5 Jahren wurden die klinischen und röntgenologischen Parameter evaluiert. Signifikante Unterschiede des marginalen Knochenlevels (MBL) zwischen Titanbasen und einteiligen Abutments konnten zu keinem Nachuntersuchungszeitpunkt festgestellt werden. Wurde der MBL jedoch mit dem MBL zu Beginn der Behandlung verglichen, wurden bei mehreren Vergleichen signifikante Unterschiede festgestellt. Der Vergleich zwischen den Gruppen ergab für die Titanbasis-Abutments signifikant tiefere Taschen zu den Zeitpunkten der 4- (p = 0,006) und 5-Jahres-Nachbeobachtung (p = 0,024). Es scheint, dass die periimplantären Gewebe der spezifischen Patientenkohorte auf Titanbasis-Abutments im Vergleich zu einteiligen Abutments über einen längeren Zeitraum von 5 Jahren recht ähnlich reagieren. Aufgrund der geringen Aussagekraft der vorliegenden Studie können jedoch keine definitiven Schlussfolgerungen gezogen werden. Manuskripteingang: 04.01.2022, Annahme: 18.02.2022 Schlagwörter: Titanbasis, Titanabutment, Klebeabutment, Implantat, Klebebasis, periimplantärer Knochenverlust

Purpose: Titanium bases are used frequently in daily practice for bonding to CAD/CAM abutments or crowns. Due to intimate contact between the adhesive gap of the titanium-base abutment and the peri-implant bone, the physical and chemical characteristics of the bonding material, or the gap itself, may affect peri-implant inflammatory reactions. The present study therefore aimed to examine the long-term effects of individualised abutments bonded to titanium bases on peri-implant health. Materials and methods: A total of 24 patients, each with one test and one control abutment, participated in the present prospective, single-blind, randomised controlled clinical trial. The test abutments were CAD/CAM titanium abutments bonded to titanium bases. As the control abutments were individualised, one-piece CAD/CAM titanium abutments were used. Clinical and radiographic parameters were assessed at abutment insertion and then on a yearly basis over the following 5 years. Results: No significant differences in marginal bone level were observed between the titanium-base and one-piece abutments at any of the follow-up time points; however, when intragroup marginal bone levels were compared to the baseline values, significant differences were found at several follow-up time points. Intergroup differences were only found to be significant for pocket depth at the 4- (P = 0.006) and 5-year follow-ups (P = 0.024), favouring titanium-base abutments. Conclusions: Within the limitations of the present study, it appears that the peri-implant tissues of this specific patient cohort responded to titanium-base abutments in a rather similar manner to one-piece abutments over a 5-year period; however, no definitive conclusions can be drawn due to the low power of the present study. Schlagwörter: abutment, dental implant, peri-implant bone loss, titanium-base abutment Conflict-of-interest statement: The authors declare there are no conflicts of interest relating to this study.

Purpose: This single-center, clinically controlled, double-blinded, randomised, crossover study aimed to evaluate and compare the antibacterial effect, substantivity and patients’ acceptance of three toothpaste slurries after a single application on established biofilms observed for 24 h. Materials and Methods: Twenty-four participants started a test cycle after refraining from oral hygiene for 48 h, with a baseline plaque sample measuring biofilm vitality (in %; VF0) using vital fluorescence (VF). They were instructed to rinse for 1 min with either an amine fluoride, stannous chloride (ASC), an herbal (SBC) or a sodium fluoride (SFL) toothpaste prepared as slurries. Every two hours up to 12 and after 24 h, plaque samples were harvested (VF2-VF24%). Plaque-covered areas (PA in %) were evaluated after 24 h using digital photographs. Patients’ acceptance was determined by visual analogue scale (VAS) questionnaire. Results: All participants (16 women, 8 men; 27.5 ± 7.9 years) completed all cycles. Two hours after application (VF2), all toothpastes showed a statistically significant reduction in bacterial vitality (p < 0.05), maintained up to 12 h. ASC revealed statistically significantly lower vitality values compared to SBC at VF2, VF4, VF8, VF12 and VF24, and at VF4, VF12 and VF24 compared to SFL (p < 0.05), while SBC and SFL did not differ statistically significantly at any time point. The preferred toothpastes were SFL (18/24 participants) and ASC (15/24 participants). Conclusions: All toothpastes showed statistically significant anti-plaque effects on established plaque biofilm and a substantivity up to 24 h compared to their baseline, while ASC still presented a statistically significant effect after 12 and 24 h compared to SBC and SFL. Schlagwörter: anti-plaque agents, biofilm vitality, chemical plaque control, substantivity, toothpaste

Die wichtigste Prophylaxestrategie in der Prävention der Gingivitis ist die regelmäßige und vollständige Entfernung des dentalen Biofilms. Allerdings wird in der Praxis mit mechanischen Mundhygienemaßnahmen häufig nicht das erforderliche Niveau erreicht. Hier können chemische Hilfsmittel die häusliche Mundhygiene ergänzen. Die neue Leitlinie gibt eine Entscheidungshilfe zur Verwendung von Mundspüllösungen in der Prävention und Therapie gingivaler Erkrankungen.

Die "Leitlinien" der Wissenschaftlichen Medizinischen Fachgesellschaften sind systematisch entwickelte Hilfen für Ärzte/Zahnärzte zur Entscheidungsfindung in spezifischen Situationen. Sie beruhen auf aktuellen wissenschaftlichen Erkenntnissen und in der Praxis bewährten Verfahren und sorgen für mehr Sicherheit in der Medizin, sollen aber auch ökonomische Aspekte berücksichtigen. Die "Leitlinien" sind für Ärzte/Zahnärzte rechtlich nicht bindend und haben daher weder haftungsbegründende noch haftungsbefreiende Wirkung.

Purpose: This double-blind, clinical, cross-over study evaluated the antibacterial effect of three toothpastes (ASF, HTP and STP) and a chlorhexidine mouthrinse (0.2%; CHX; positive control) after a single application on established biofilm over a period of 24 h (substantivity). Materials and Methods: Twenty-four subjects refrained from all oral hygiene measures for a period of 72 h. After 48 h, a baseline biofilm sample was taken and vitality of the biofilm flora was examined (baseline, VF0). Then they rinsed for 1 min with one of the randomly allocated, freshly prepared toothpaste slurries (ASF, HTP, STP) or CHX. Further biofilm samples were taken every second hour up to 14 h as well as 24 h after rinsing, and biofilm vitality was assessed (VF2-24). After a wash-out period of 4 days, a new test cycle was started. Results: All subjects (18 female, 6 male) finished the four test cycles. At VF2, all products showed a statistically significant reduction in vitality compared to VF0 (p0.05). CHX and ASF revealed the most pronounced effect (49% and 40% reduction), while the other toothpastes (HTP: 24%, STP: 11%) reached lower but still statistically significant effects. At each further time point CHX and ASF showed the lowest biofilm vitality. ASF demonstrated a significant antibacterial effect on dental biofilm over a 24-h period compared to baseline and superiority over both other toothpastes at time points VF2-VF14. Conclusion: ASF toothpaste showed a significant antibacterial action on biofilm and a high substantivity which was maintained up to 24 hours. Schlagwörter: amine fluoride, biofilm vitality, chlorhexidine, substantivity, stannous fluoride, toothpaste

Purpose: To determine whether fluorosed areas of teeth can be successfully treated with resin infiltration and whether the results are long lasting. Materials and Methods: For the present case of mild to moderate dental fluorosis, the microinvasive resin infiltration technique was chosen, following suboptimal results of in-office vital tooth bleaching to improve the aesthetic appearance of the affected teeth. Results: Six months after treatment, the white opaque and brown discolourations remain masked. Conclusion: This case report demonstrates that resin infiltration is an agreeable option for this type of tooth discolouration, rather than choosing more invasive, conventional procedures. More studies need to be completed to determine longer-term outcomes of the technique. Schlagwörter: dental fluorosis, long-term stability, tooth discolourations, resin infiltration

Objective: To investigate the efficacy, tolerability, and long-term color stability of tooth whitening using two different bleaching techniques: an at-home tray technique (5.0% H2O2) and an over-the-counter strip technique (5.3% H2O2). Method and Materials: Thirty subjects were included in this two-cell, parallel, examiner-blinded, randomized clinical trial. Shade evaluations were performed with a value-oriented VITA shade guide. The null hypothesis was that there would be no differences between the groups and no improvements from baseline with regard to tooth shade. Bleaching sensitivity, gingival irritation, and patient acceptance were recorded on a visual analog scale (VAS). Scanning electron microscopy (SEM) was performed to detect any enamel surface changes. Results: After bleaching, both treatments demonstrated significant improvements in tooth shade (P .001 for both groups). At the 18-month recall, tooth shade remained significantly lighter than at baseline (P = .006 for tray group; P = .001 for strip group). However, a relapse of the tooth shade was observed compared with the immediate postbleaching result (P .05). VAS data yielded no significant differences between groups regarding bleaching sensitivity and gingival irritation. None of the teeth studied showed detectable enamel surface changes. Patient acceptance was statistically significantly higher in the tray group compared with the strip group (P .05). Conclusion: Both techniques demonstrated significant and comparable levels of tooth shade improvement after 2 weeks and 18 months. Each treatment caused similar, transient oral adverse effects. Schlagwörter: follow-up, hydrogen peroxide, long-term stability, randomized clinical trial, shade relapse, tooth bleaching

Das Ziel der regenerativen Parodontitistherapie ist die Wiederherstellung verloren gegangener parodontaler Gewebe wie Wurzelzement, Desmodont und Alveolarknochen. Histologische Studien an Mensch und Tier konnten zeigen, dass Schmelzmatrixproteine die parodontale Regeneration fördern. Außerdem wurden zahlreiche weitere positive Eigenschaften dieser Proteine entdeckt. Die vorliegende Literaturübersicht hat zum Ziel, eine auf der vorhandenen Evidenz basierende Indikation für die Behandlung mit Schmelzmatrixproteinen aufzuzeigen. Schlagwörter: Schmelzmatrixproteine, parodontale Regeneration, intraossäre Defekte, Furkationsdefekte, Rezessionsdeckung, Traumatologie, antibakterielle Wirkung