Purpose: To compare in a randomized controlled trial the 5-year clinical outcomes of (1) 3-unit fiber-reinforced resin-bonded fixed dental prostheses (RBFDPs) to 3-unit metal-ceramic RBFDPs; and (2) 3-unit fiber-reinforced RBFDPs to 2-unit cantilevered metal-ceramic RBFDPs. Materials and methods: A consecutive sample of 50 young adult patients with tooth agenesis or trauma in the anterior region was included. The recruitment period was from 2005 to 2009, during which a total of 62 RBFDPs were inserted. In group A, 27 participants were randomly treated with 18 metal-ceramic 3-unit RBFDPs and 15 3-unit fiber-reinforced RBFDPs. In group B, 23 participants were randomly treated with 16 metal-ceramic 2-unit RBFDPs and 13 3-unit fiber-reinforced RBFDPs. All patients were followed up at baseline registration and at 1, 3, and 5 years. The primary outcome parameter was survival rate of the RBFDPs, and the secondary outcome parameters were periodontal and technical/esthetic outcomes and patient-reported evaluation of the RBFDPs. Results: Seven patients dropped out of the study during the 5-year observation period. In group A, the fiber-reinforced RBFDPs had a cumulative survival rate of 23% after 5 years, which was significantly less than for the 3-unit metal-ceramic RBFDPs. In group B, the cumulative 5-year survival rate was 36% for the fiber-reinforced RBFDPs and 91% for the 2-unit cantilevered metal-ceramic RBFDPs. Conclusion: The 3- and 2-unit metal-ceramic RBFDPs had a significantly higher 5-year survival rate than the 3-unit fiber-reinforced RBFDPs. The accessibility for oral hygiene practice was better with 2-unit compared to 3-unit RBFDPs, and the degree of gingivitis was lower. The esthetic outcome was better for the RBFDPs with ceramic pontics than the composite ones.

Purpose: To compare in a randomized controlled trial the 5-year clinical outcomes of (1) 3-unit fiber-reinforced resin-bonded fixed dental prostheses (RBFDPs) to 3-unit metal-ceramic RBFDPs; and (2) 3-unit fiber-reinforced RBFDPs to 2-unit cantilevered metal-ceramic RBFDPs. Materials and methods: A consecutive sample of 50 young adult patients with tooth agenesis or trauma in the anterior region was included. The recruitment period was from 2005 to 2009, during which a total of 62 RBFDPs were inserted. In group A, 27 participants were randomly treated with 18 metal-ceramic 3-unit RBFDPs and 15 3-unit fiber-reinforced RBFDPs. In group B, 23 participants were randomly treated with 16 metal-ceramic 2-unit RBFDPs and 13 3-unit fiber-reinforced RBFDPs. All patients were followed up at baseline registration and at 1, 3, and 5 years. The primary outcome parameter was survival rate of the RBFDPs, and the secondary outcome parameters were periodontal and technical/esthetic outcomes and patient-reported evaluation of the RBFDPs. Results: Seven patients dropped out of the study during the 5-year observation period. In group A, the fiber-reinforced RBFDPs had a cumulative survival rate of 23% after 5 years, which was significantly less than for the 3-unit metal-ceramic RBFDPs. In group B, the cumulative 5-year survival rate was 36% for the fiber-reinforced RBFDPs and 91% for the 2-unit cantilevered metal-ceramic RBFDPs. Conclusion: The 3- and 2-unit metal-ceramic RBFDPs had a significantly higher 5-year survival rate than the 3-unit fiber-reinforced RBFDPs. The accessibility for oral hygiene practice was better with 2-unit compared to 3-unit RBFDPs, and the degree of gingivitis was lower. The esthetic outcome was better for the RBFDPs with ceramic pontics than the composite ones.

Hyaluronan (HY) wird aufgrund seiner Eigenschaften (bakteriostatisch, entzündungshemmend etc.) vermehrt in der Parodontaltherapie eingesetzt. Die vorliegende narrative Literaturübersicht ergänzt eine kürzlich publizierte systematische Übersichtsarbeit zu den therapeutischen Möglichkeiten einer HY-Applikation als Monotherapie oder als Adjuvans in der Therapie von Parodontitis, um den Effekt in der Therapie von Gingivitis. Die Literatursuche in drei Datenbanken ergab 18 kontrollierte Studien. Die Mehrheit der Studien beschrieb für die HY-Testgruppe im Vergleich zur Kontrollgruppe a) eine statistisch signifikante Verbesserung der Gingiva-Indizes von Gingivitispatienten und b) eine statistisch signifikante Reduktion des Blutens auf Sondieren und der Sondierungstiefe in der nicht-chirurgischen Parodontitistherapie, wenn auch nur von moderat klinisch relevantem Ausmaß. Ein zusätzlicher Gewinn an klinischem Attachment durch HY-Applikation in der Parodontalchirurgie ist vermutlich nicht gegeben. Es liegen keine Berichte zu unerwünschten Nebenwirkungen nach HY-Applikation vor. Deshalb kann seine Anwendung als sicher angesehen werden. Die beträchtliche Heterogenität der vorliegenden Studien (Produktunterschiede, variierende Anwendungsmodi) erlaubt noch keine eindeutige Schlussfolgerung zu Applikationsart und Effektgröße von HY in der Therapie von Gingivitis oder Parodontitis. Schlagwörter: Hyaluronan, Hyaluronsäure, Natriumhyaluronat, Gingivitis, Parodontitis, vertikale Knochendefekte, Literaturübersicht, klinische Studien

The aims of this study were to evaluate the influence of implant position on clinical crown length and marginal soft tissue dimensions at implant-supported single crowns of maxillary central incisors and to validate the papilla index score (PIS). Twenty-five patients were included. Standardized and clinical photographs and periapical radiographs from baseline were used to assess three-dimensional positional parameters. The contralateral central incisors were used as controls. Paired sample t test and Pearson correlation analysis were used to analyze implant position, dimension of crown, and papilla fill. Cohen κ and Spearman correlation were used to validate the PIS. The implant-supported crown was statistically significantly longer than the contralateral tooth, and there was significant correlation between the orofacial position of the implant and the crown length difference. The distal papilla was significantly shorter than the mesial papilla at implant-supported crowns, but this difference was not significant at the contralateral tooth. A significant relationship between the PIS and papilla fill was found. An implant protruding the mucosa in a buccal position will result in an increased implant crown length compared to the contralateral tooth. Minor buccal angulations of the implant could be corrected with customized angulated abutments and did not necessarily result in an increased crown length. The distal implant papilla height was obviously shorter, although the mesial papilla height was similar to that of the healthy dentition. The PIS was found to be a valid index for papilla fill.

Purpose: To compare the biological, technical and aesthetic outcomes of single implant-supported all-ceramic versus metal-ceramic crowns. Materials and methods: Thirty-six patients with premolar agenesis were randomly treated with 38 all-ceramic (AC) and 37 metal-ceramic (MC) implant-supported single-tooth restorations. A quasirandomisation of consecutively included restorations in patients with one or more implants was used, i.e. a combination of parallel group (for 13 patients with one restoration) and split-mouth (for 23 patients with >=2 restorations). All patients were recalled for baseline and 1-year followup examinations. Biological and technical outcomes, including complications, were clinically and radiographically registered. The Copenhagen Index Score and visual analogue scale (VAS) score were used to assess professional and patient-reported aesthetic outcomes, respectively, by blinded assessors. Results: One-year after loading, no patient dropped out and no implant failed, though one MC restoration had to be remade. The marginal bone loss was not significantly different between AC and MC restorations (AC: mean 0.08 mm, SD 0.25; MC: mean 0.10 mm, SD 0.17). Seven out of 10 inflammatory reactions were registered at AC restorations. Two technical complications, one loss of retention and one chipping of veneering porcelain were recorded at two metal-ceramic crowns. The marginal adaptation of the all-ceramic crowns was significantly less optimal than the metal-ceramic crowns (P = 0.014). The professional-reported colour match of all-ceramic crowns was significantly better than metal-ceramic crowns (P = 0.031), but other aesthetic parameters as well as the VAS scores demonstrated no statistically significant difference between AC and MC restorations. Conclusions: Marginal bone loss and the aesthetic outcomes were not significantly different between AC and MC restorations in this short-term follow-up study, though inflammatory reactions in the peri-implant mucosa as well as less optimal marginal adaptation were more frequently registered for all-ceramic compared to the metal-ceramic crowns. Schlagwörter: all-ceramic crowns, dental implants, metal-ceramic restorations, randomised controlled trial, zirconia abutments

Purpose: The effect of impaired oral functions is best described by the patient, and a shift toward a patient-oriented decision-making process in oral rehabilitation is evident. The Oral Health Impact Profile-49 (OHIP-49) questionnaire has been the most commonly used method to measure oral health-related quality of life (OHRQoL) in dentistry. An individualized method, the Schedule for the Evaluation of Individual Quality of Life-Direct Weighing (SEIQoL-DW), has proven to fulfill most of the criteria for a method to assist in the decision-making process. The purpose of this study was to compare the ability of the OHIP-49 questionnaire and the SEIQoL-DW method in measuring OHRQoL and generating useful information for decision making in oral rehabilitation. Materials and Methods: Sixty participants in need of oral rehabilitation were enrolled in the study. Patients received a clinical examination, were interviewed using the SEIQoL-DW, filled out the OHIP-49 questionnaire, and answered two global oral health-rating questions. Results: The SEIQoL-DW generated additional information compared to the OHIP-49. The information was more oral- and treatment-specific, including consultation issues and the patient-practitioner relationship. The overall SEIQoL-DW and OHIP-49 scores were significantly correlated. The OHIP-49 and SEIQoL-DW scores were related to oral health subjectively. Conclusions: The SEIQoL-DW method proved a useful aid in clinical decision making for oral rehabilitation. The SEIQoL-DW was more appropriate for generating information useful for decision making than measuring OHRQoL; the OHIP-49 was more appropriate for measuring OHRQoL than generating information.

Purpose: The aim of this study was to assess the outcome of treatment with implantsupported mandibular overdentures in terms of biting and chewing, in entirely satisfied and not fully satisfied patients. Materials and Methods: Twelve edentulous patients who had worn dentures for at least 5 years participated. They were in good health but had retention problems with their mandibular dentures. First, all patients received new dentures. After 3 months, two Astra Tech implants were placed in the anterior part of the mandible, and 6 months later the abutments were connected. Patient assessment (questionnaire) and functional recordings (chewing ability, bite force, electromyographic activity) were performed with the new dentures, and again 3 months, 1 year, and 5 years after overdenture treatment. Results: After treatment, all patients were able to comminute hard and tough food, the maximum bite force and the chewing activity increased in parallel, and the duration of the chewing cycle was reduced. Every patient felt improved function and reduction of chewing pain. However, the seven patients not fully satisfied with the function of the implant-supported mandibular overdentures were characterized by lower muscle activity, even before implant placement, than the entirely satisfied patients. Conclusion: Implant-supported mandibular overdenture treatment permits better biting and chewing function than conventional complete dentures.

Purpose: The aim of the present study was to evaluate the periimplant conditions and the maintenance requirements for implant-supported overdentures in the mandible retained with ball or bar attachments during a 5-year period. Materials and Methods: Twenty-six completely edentulous patients had two Astra Tech dental implants placed in the anterior part of the mandible. The denture attachment system for the patients was chosen randomly by drawing lots. Eleven patients drew the bar attachment system and fifteen patients drew the ball attachment system. Plaque Index, Gingival Index, and probing pocket depth were assessed around each implant. Periotest values were recorded, and periodically identical intraoral radiographs were obtained with a specially designed filmholding device. Results: No implants were lost from baseline to the 5-year registration. The periimplant conditions were very healthy after 5 years. No significant differences of the periimplant variables were recorded between the bar and the ball groups. During the first year of function, significantly more complications/repairs were registered in the bar group than in the ball group. In the following years, no significant differences were registered. The mean frequency of complications/repairs per patient per year was 1.0 in the bar group and 0.6 in the ball group during the 5-year observation period. Conclusion: Two implants with ball or bar attachment supported an overdenture in the mandible for 5 years with a 100% survival rate. No differences in marginal bone loss or health of the periimplant mucosa were observed between bar and ball attachment, but the frequency of technical complications/repairs per patient was higher around bar than ball attachments.