Objectives: Oral health plays a central role in overall well-being, including in the elderly. The demographic transition and its effects are resulting in a higher proportion of older people, both with and without care requirements. This paper provides an overview of the dental situation of the elderly from the 6th German Oral Health Study (DMS • 6). Method and materials: DMS • 6 is a population-representative oral epidemiologic study that surveys oral health in Germany. Data from 797 younger seniors aged 65 to 74 were collected by calibrated examiners. The methodology remains largely consistent with that of the previous studies. Results: Among the younger seniors (65- to 74-year-olds), edentulism has more than halved to 5.0% compared to the Fifth German Oral Health Study (DMS V) (12.4% in 2014). The mean number of missing teeth (8.6) decreased further, compared to DMS IV (14.1) and DMS V (11.1). At 18.8 teeth, the FST Index (number of filled or sound teeth) has shown improvement compared to the previous studies (DMS IV, 13.6; DMS V, 16.4). The root caries (59.1%) increased compared to DMS IV (28.0%). Caries experience (decayed, missing, filled teeth [DMFT]: 17.6), in contrast, hardly changed from DMS V (17.7). Half of 65- to 74-year-olds were diagnosed with moderate periodontitis (49.4%) and almost a third (30.4%) with severe periodontitis. In younger seniors with care requirements, therapeutic capability was greatly reduced for almost half (47.4%) and oral hygiene ability for one fifth (18.5%). Conclusion: The prevalence of tooth loss and edentulism among younger seniors in Germany continues to decline. Due to further morbidity compression, the challenges of dental treatment lie in the continuous treatment of younger seniors to prepare them for older stages of life. Schlagwörter: care needs, dental care, dental care for persons with disabilities, dental caries, dentists, DMS 6, epidemiology, geriatric dentistry, oral health

Objectives: The German Oral Health Study (DMS) is a series of consecutive studies designed to assess the oral health status of adults, seniors, and children in Germany. DMS is a major program of the Institute of German Dentists (Institut der Deutschen Zahnärzte) with the aim to produce health statistics for Germany. Tooth loss, edentulism, and prosthetic care have considerable socioeconomic significance; it is the aim of this paper to report findings on these aspects. Method and materials: The survey combines interviews and clinical examinations. Previous DMS studies focused primarily on tooth loss, edentulism, and prosthetic care. In the DMS • 6 survey, the condition of removable dentures and need for adjustments were additionally recorded, as well as necessary repair measures that were grouped according to their complexity (chairside or laboratory). Results: The prevalence of edentulism decreased considerably compared to that in the Fifth German Oral Health Study (DMS V) in 2014. Among younger adults (35- to 44-year-olds), the prevalence of edentulism was negligible, with an average of 26.6 teeth present. The younger senior group (65- to 74-year-olds) had an average of 19.3 teeth; the prevalence of edentulism was 5%, which is a reduction of > 50% compared to 2014 (12.4%). Lower education status was an important prognostic factor for tooth loss. Owing to the low prevalence of edentulism in younger adults, removable dentures were not prevalent in this age group, whereas combined fixed–removable dentures were most frequently used in seniors. Regarding the type of denture, a shift towards fixed as well as implant-supported types was observed. Of the removable dentures, 50% to 60% were in a very good or good clinical condition. Problems were mainly identified with simple acrylic dentures. Nonetheless, participants’ satisfaction with removable dentures was extremely high, and the dentures were used almost continuously. Conclusion: The most important finding in this study is the continued significant decline in the prevalence of complete edentulism among seniors that suggests a further reduction in edentulism in the future with an estimate of around 4% in 2030. The shift observed in primary prosthetic care from removable to fixed prostheses as well as the increasing prevalence of implants placed are positive developments. The data revealed further compression of morbidity compared to DMS V. Complete edentulism declined, and fixed partial dentures, including implant-supported prostheses, were increasingly used. Lower education status was an important predictor for tooth loss. Schlagwörter: dental care, dental prostheses, dentists, DMS 6, edentulous mouth, epidemiology, tooth loss

Ziel: Die Pfeilerzahnfraktur von Teleskopprothesen (TP) ist eine häufige Misserfolgsursache bei dieser prothetischen Versorgungsoption. In vielen Fällen kann die Teleskopkrone (TK) nur nach Rekonstruktion mittels Stiftaufbau (SA) wiedereingesetzt werden, da die Retentionsfläche nicht ausreicht. Wenn der Wurzelkanal dabei einen elliptischen Querschnitt aufweist oder der koronale Defekt ausgeprägt ist, stellt ein individuell gegossener Stift-Stumpfaufbau (GSA) nach wie vor die Therapie der Wahl dar. GSA haben jedoch die Nachteile einer verlängerten Behandlungszeit, da ein zweiter Termin für das Einsetzen erforderlich ist und die mechanischen Eigenschaften der Legierung nicht an das Dentin angepasst sind, was zu einem höheren Risiko von Wurzelfrakturen führen kann. In diesen Fällen kann ein CAD/CAM-SA, der in einem volldigitalen Chairside-Workflow hergestellt wird, die Behandlung beschleunigen und das Risiko von Wurzelfrakturen verringern, indem Materialien mit dentinähnlichen mechanischen Eigenschaften verwendet werden. Material und Methode: In dieser Fallserie werden 12 Patienten mit einer Teleskoppfeilerzahnfraktur vorgestellt, bei denen ein Stiftaufbau zur Wiederbefestigung der TK erforderlich war. Die Stiftbettpräparation sowie die TP wurden gescannt und in weniger als 10 Minuten ein CAD/CAM-SA aus einem faserverstärkten CAD/CAM-Komposit hergestellt. Schlussfolgerung: Mit dem vorgestellten volldigitalen Chairside-Workflow kann die SA-Behandlung beschleunigt werden, da individuelle SA nicht mehr zwingend einen zweiten Termin zum Einsetzen benötigen. Daher kann dieser Workflow eine Alternative für die Versorgung von frakturierten Teleskoppfeilern mit konventionellen GSA sein. Die CAD/CAM-SA zeigen hierbei ein mechanisches Verhalten ähnlich dem des Dentins und können chairside in kurzer Zeit hergestellt werden. Schlagwörter: CAD/CAM, Intraoralscanner, Stiftaufbau, Teleskopprothese, Pfeilerzahnfraktur, faserverstärktes Komposit

Ziel: Auch wenn viele Bereiche der Zahnmedizin heute digitale Prozesse ermöglichen, sind analoge Verfahren immer noch weit verbreitet. Ziel dieser Querschnittsstudie war es, am Beispiel des Bundeslandes Hessen den Stand der Digitalisierung von Zahnarztpraxis zu untersuchen. Material und Methode: Zwischen April und Juni 2022 wurden 4.840 aktive, bei der Landeszahnärztekammer Hessen registrierte niedergelassene Zahnärztinnen und Zahnärzte per E-Mail eingeladen, einen Online-Fragebogen zu ihrer technischen Ausstattung in der Zahnarztpraxis, den zahnärztlichen Behandlungsabläufen und ihrer Einstellung zur Digitalisierung in der Zahnmedizin auszufüllen. Zusätzliche wurden demografische Daten erhoben. Neben einer deskriptiven Auswertung, wurden Korrelationen statistisch analysiert (P < 0,05). Ergebnisse: Insgesamt konnten Fragebögen von 937 Zahnärzten (279 weiblich, 410 männlich, 4 inter/divers, 244 keine Antwort; Durchschnittsalter 51,4 ± 10,4 Jahre) ausgewertet, was einer Rücklaufquote von 19,36 % entspricht. Im Bereich der Praxisverwaltung und des zahnärztlichen Röntgens arbeitet die Mehrheit der befragten Zahnärzte digital, was überwiegend als positive Entwicklung bewertet wird. Bereits ein Drittel der Befragten gibt an, einen Intraoralscanner für die zahnärztliche Behandlung zu verwenden, wobei sich die Indikation hauptsächlich auf kleinere Restaurationen beschränkt. Die Nutzung von Social-Media-Accounts und Telemedizin wird von vielen Zahnärzten jedoch eher negativ bewertet. Schlussfolgerung: Im Rahmen dieser Pilotstudie erfolgen viele Prozesse insbesondere in der zahnärztlichen Behandlung noch analog. Allerdings planen 60 % der Teilnehmer eine weitere Digitalisierung ihrer Praxis innerhalb der nächsten 5 Jahre, was auf einen deutlichen Wandel von der analogen zur digitalen Zahnmedizin hindeutet. Schlagwörter: digitale Technologie, CAD/CAM, Zahnmedizin, zahnärztliches Praxismodell, Zahnärzte, Analog-Digital-Wandlung, Erhebungen und Fragebögen, reale Daten aus der Welt der Zahnmedizin, Intraoralscanner, Organisation und Verwaltung

Purpose: To update data on the transfer accuracy of digital implant impressions using a coordinate-based analysis, the latest intraoral scanners (IOS) were investigated in an established clinical close model setup. Materials and Methods: An implant master model (IMM) of the maxilla with four implants in the posterior area (maxillary first premolars and first molars) and a reference cube were scanned 10 times each with four different IOS: i700 (i7; Medit), Primescan (PS; Dentsply Sirona), and Trios 4 (T4) and Trios 5 (T5; 3Shape). Datasets were compared to a reference dataset of IMM that was generated with x-ray computed tomography in advance. 3D deviations for the implant-abutment interface points (IAIPs) were calculated. Statistical analysis was performed by multifactorial ANOVA (P < .05). Results: Overall deviations for trueness (mean) ± precision (SD) of the IAIPs ranged from 88 ± 47 μm for PS, 112 ± 57 μm for i7, 121 ± 42 μm for T4, and 124 ± 43 μm for T5 with decreasing accuracy along the scan path. For trueness, a significant difference between the PS and the T4 was detected for one implant position. For precision, no significant differences were noticed. Conclusions: Although the latest IOS showed a significant improvement in transfer accuracy, the accumulating deviation along the scan path is not yet resolved. Considering the Trios system, the innovation seems to be limited because no improvement could be detected between T4 and T5.

Purpose: The aim of this study was to evaluate the marginal quality and wear of bulk-fill composite resins (BFs) for Class-II restorations of primary and permanent molars in comparison to a conventionally layered composite resin (RC) and to compare the results of the two dentitions. Materials and Methods: Eighty (40 primary and 40 permanent) extracted molars received standardized Class-II cavity preparations and were restored with either one of two flowable BFs, one of two high viscous BFs, or a composite resin (RC). Thermomechanical loading (TML; 2,500 cycles +5°C/+55°C; 100,000 cycles, 50N, 1.67Hz) followed. A quantitative marginal analysis using SEM images and a profilometric quantification of two-body wear were carried out using replicas. ANOVA, Kruskal–Wallis, Mann–Whitney U, and Wilcoxon signed-rank tests were used for statistical analysis (P < 0.05). Results: For both dentitions, a significant reduction of perfect margins was observed after TML (P < 0.02). For the primary dentition, the flowable BFs showed significantly less perfect margins than all high viscous materials (P < 0.005). For the permanent dentition, RC showed significantly fewer gaps than the flowable BFs (P < 0.04). Regarding wear, within the dentitions, no significant differences could be computed between groups with regard to the maximum height loss (P < 0.05). Conclusion: All of the investigated bulk-fill composite resins showed satisfactory in-vitro results for both tested parameters in primary and permanent teeth, with a superiority of the high-viscosity materials in terms of marginal quality. Schlagwörter: bulk-fill composite resins, marginal quality, permanent teeth, primary teeth, restoration materials, wear

Purpose: To assess the survival of double-crown-retained implant-and-tooth-supported removable partial dentures (DCR-ITSRPDs), evaluate abutment survival, and identify first aftercare measures. Materials and Methods: The influence of various factors on the survival of the DCR-ITSRPDs and the abutments were observed in this retrospective and clinical follow-up study using the Kaplan-Meier estimate. In addition, the first-required aftercare measure for each prosthesis was evaluated. Results: In total, 47 DCR-ITSRPDs were investigated (mean observation: 4.3 ± 3.8 years; max: 14.3 years), 3 of which (6.4%) had to be replaced. The survival probability for DCR-ITSRPDs was 100% at 5 years and 75% at 10 years. A total of 297 abutments (120 natural teeth and 177 dental implants) were observed, 22 of which (7.4%; 6 teeth and 16 implants) failed. The survival probability for teeth was 90.2% at the 5- and 10-year mark; for dental implants, it was 90.4% at 5 years and 76.3% at 10 years. Conclusions: DCR-ITSRPDs are a successful and durable treatment option for patients with substantially reduced residual dentitions. Both prostheses and abutments show good survival times after 5 and 10 years in function. The patient-associated factors tested showed no influence on the survival of DCR-ITSRPDs and abutments. Peri-implant infection was the decisive factor for abutment loss; therefore, regular dental prophylaxis and examinations are of major importance.  Schlagwörter: removable dental prosthesis, double crown, dental implants, tooth-implant supported, survival

Parodontitis ist eine multifaktorielle Erkrankung, welche primär durch organisierte Mikroorganismen des oralen Biofilms verursacht wird und im Zusammenhang mit einer Vielzahl entzündlicher Erkrankungen steht. Der Zusammenhang zwischen Parodontitis und chronischen Lebererkrankungen rückt dabei immer mehr in den Fokus der Forschung. Tierstudien und klinische Studien fanden parodontopathogene Bakterien in der Leber, die über den Gastrointestinaltrakt oder direkt durch die Entzündungsreaktion im Parodont in den Blutkreislauf der Leber gelangt sein könnten. Erkrankungen wie die nichtalkoholische Fettleber, die nichtalkoholische Steatohepatitis, die Leberzirrhose und das hepatozelluläre Karzinom können sich dadurch manifestieren. Nach einer Parodontitistherapie kann es zu einer Remission hepatogener Entzündungsparameter kommen. Ein kausaler Zusammenhang ist bisher noch nicht evident. Im Rahmen des DIU-Masterstudiengangs für Parodontologie und Implantattherapie der DG PARO erfolgte zu diesem Thema eine Literaturrecherche mit dem Fokus auf die nichtalkoholische Fettleber. Die Ergebnisse werden in dem folgenden Diskussionsbeitrag dargestellt, wichtige Studien werden präsentiert sowie kritisch evaluiert und ein Ausblick aufgezeigt. Schlagwörter: Parodontitis, Lebererkrankung, nichtalkoholische Fettlebererkrankung, nichtalkoholische Steatohepatitis, Oral-Gut-Liver-Axis

Purpose: The aim of this in-vitro study was to evaluate the marginal integrity and wear of eight bulk-fill materials in comparison to a compomer in Class-II cavities in primary molars after thermomechanical loading (TML). Materials and Methods: Prepared Class-II cavities in 72 extracted primary molars were filled with eight bulk-fill materials. A compomer served as the control group. After water storage (incubator, 28 days, 37°C), samples were subjected to TML (2500 thermal cycles 5°C/55°C; 100,000 load cycles, 50 N, 1.67 Hz). Before and after TML, replicas were made which were used for both SEM analysis of marginal integrity and 3-D wear analysis. Statistical analysis was performed using Kruskal-Wallis and Wilcoxon tests (p < 0.05). Results: A significant reduction in perfect margins was observed for all groups, while marginal gap formation increased (Wilcoxon test, p < 0.02) for all groups but the compomer. Significant interindividual differences were observed between the tested materials regarding marginal integrity (Kruskal-Wallis test, p < 0.05). Wear analysis revealed no significant differences between groups (Kruskal-Wallis test, p > 0.05). Conclusion: Some of the bulk-fill materials investigated here achieved better results than the compomer and should be further evaluated clinically. Schlagwörter: Class-II restoration, composite, marginal analysis in SEM, polyacid modified resin, wear