DZZ International, 05/2020

Dental implants are an indispensable part of the dental treatment spectrum and represent an integral component of contemporary prosthodontic treatment concepts. The use of implants for both removable and fixed prosthodontics offers clinically relevant advantages, which have been recorded for patients in the form of an improvement in the oral health-related quality of life and masticatory function, as well as, better long-term restorative treatment prognosis.

Introduction: This article presents possibilities regarding how orthodontists and prosthodontists can cooperate together to create conditions for an esthetically pleasing and functionally oriented treatment result. When planning the prosthetic treatment of anterior gaps, the gaps can be adjusted in advance by means of orthodontic treatment so that they can subsequently be treated in the best possible esthetic and functional manner. Material and Methods: Adhesive bridges represent a suitable treatment option in adolescents for congenitally missing lateral incisors or after anterior tooth loss due to trauma. When designed with one wing, adhesive bridges can be used before the completion of jaw bone development and, if necessary, they can be orthodontically positioned together with the abutment tooth. Prior to complex prosthetic rehabilitation in the esthetic area, malpositioned abutment teeth can be orthodontically positioned or aligned to generate space for an ideal restoration design. Moreover, orthodontic extrusion provides the possibility of achieving sufficient abutment heights in the case of deeply destroyed or fractured teeth, thus permitting the adequate treatment of these critical teeth according to prosthetic guidelines. Oftentimes, in the case of tilted, protruded or retruded teeth, an orthodontic intervention previous to tooth preparation is useful for tooth substance conservation and maintaining the vitality of abutment teeth. Conclusion: It can be concluded that a specific combination of orthodontic and prosthetic treatment measures can achieve a better restorative treatment result in terms of function, esthetics and long-term stability. Often, this is accompanied by a reduction in treatment duration and costs. Keywords: adhesive bridges, esthetics, extrusion, gap management, interdisciplinary treatments

Introduction: Orthodontic treatment with fixed elements increases the risk of developing white spot lesions due to additional retention opportunities for biofilm. One approach for the esthetic treatment of these lesions is caries infiltration. In order to estimate the final masking effect of the resin infiltration, re-wetting with water or ethanol is often performed just after the etching procedure. Patient cases: Four patients who were diagnosed with white spot lesions in the esthetically visible area during treatment with fixed orthodontic appliances were informed about the possibility of optically masking these lesions using resin infiltration. The infiltration (Icon, DMG) was performed according to the manufacturer's instructions, but the etching procedure was performed up to three times. The decision regarding whether to repeat the etching procedure was made subjectively by the practitioner during the re-wetting test with ethanol. The masking effect generated by ethanol and resin infiltration was analyzed using digital photographs before treatment, before and during the first 9 sec of re-wetting as well as one week after treatment. Result: In all 4 patient cases, the observed minimum color difference during re-wetting appears to be a good indicator for assessing whether a satisfactory masking effect can be achieved. Furthermore, in the total of 55 treated white spot lesions, lesions with higher color value differences were etched more frequently than lesions with less pronounced color value differences. Overall, the masking effect one week after resin infiltration was satisfactory in all cases. Discussion: During the re-wetting test, the minimum color difference between the initial lesion and the intact enamel which surrounds the lesion seems to be a good predictor of the final outcome of resin infiltration of post-orthodontic white spot lesions. Furthermore, white spot lesions with a higher initial color difference appear to require multiple etching procedures. Conclusion: Resin infiltration is a useful microinvasive method for masking white spot lesions which develop during orthodontic treatment with fixed appliances. Moreover, the temporary masking effect achieved by the re-wetting test with ethanol can be used as an indicator for estimating the number of etching procedures required. Keywords: caries infiltration, enamel lesion, esthetics, post-orthodontic treatment, white spot lesion

Introduction: At this point in time, treatment of adult patients is part of the everyday lives of orthodontists. There is no difference when determining the indication for therapy in children and adolescents: the goal is the prevention and treatment of misalignments of jaws and teeth, as well as maintaining a healthy masticatory system. Discussion: Nevertheless, there are some characteristics that need to be taken into consideration: The biomechanics should be adjusted in accordance to the progressing loss of attachment. Simultaneously, there is a great desire for preferably subtle treatment options. Furthermore, interdisciplinary treatment concepts play a more important role in adults compared to children and adolescents. Results: The digitalization in orthodontics resulted in new and innovative therapy options for all these requirements. Generated data records using intraoral scans offer various options in diagnosis as well as planning in order to improve treatments and patient comfort. Special orthodontic software solu-tions were necessary to establish individualized therapy concepts. Treatment appliances with different systems can be printed using the export of STL data and made available for orthodontists. Further advances are expected in the next few years, which makes digital orthodontics an exciting work field. Keywords: 3D-print, CAD/CAM restorations, digital orthodontics, interdisciplinary orthodontics, orthodontics for adults

Introduction: Orthognathic surgery has steadily developed since its establishment in 1849, and is characterized by consistent collaboration with orthodontics. Materials and Methods: Computer-based operation planning, that also takes resulting changes in soft tissue into account, can now be carried out through three-dimensional X-ray imaging, face scans and powerful data processing. This procedure can also be used to produce individualized osteosynthesis material and osteotomy templates, which in combination even enable orthog-nathic surgery without the use of an occlusal wafer. Piezo surgery represents a minimally invasive alternative to conventional methods for the osteotomy. As an alternative to titanium, resorbable polymers can also be used as osteosynthesis material. Conclusion: Due to modern orthodontics and computer-based operation planning, the surgery-first concept enables orthognathic surgery without prior orthodontic treatment for eligible cases. The effects of orthognathic surgery on the upper airway must be considered during planning. In addition to treating dysgnathia, orthognathic surgery expands the upper airway and has become established as a treatment option for obstructive sleep apnea. Keywords: computer-based surgery planning, effects on the upper airways, iindividualized osteosynthesis material, piezosurgical osteotomies, prediction of soft tissue changes, resorbable osteosynthesis material, surgery first

Dental implants are an integral part of modern dental, oral and maxillo¬facial medicine. Apart from rehabilitating the physiological masticatory function and increasing the quality of life, dental implants have a positive influence on the general health condition. For successful treatment, a key prerequisite is the osseous healing of the inserted implants (osseointegration). This strongly depends on an adequately functioning immune system, as it is involved in regulating postoperative wound healing and it has an important modu¬lating effect on the tendency of subsequent peri-implantitis development. In this respect, immunocompromised patients exhibit a particularly higher risk profile.