International Poster Journal of Dentistry and Oral Medicine, 03/2008

The aim of this prospective study was to evaluate the clinical performance of the selfetch adhesive AdheSE One (Ivoclar Vivadent) in combination with the composite Tetric Evo Ceram (Ivoclar Vivadent) for class I and II restorations. The improvement of the marginal adaptation with the additional use of a flowable resin composite (Tetric Flow, Ivoclar Vivadent) for cavity lining was tested. In accordance with a split mouth design, 50 patients received 100 restorations in premolars and molars. A total of 25 class I and 75 class II cavities were restored. Each restoration was scored according to the modified Ryge criteria at baseline, after 6 and 12 months. After 1 year (recall rate 100%) the results of the Ryge evaluation for both groups with/ and without application of Tetric Flow were: marginal adaption: Alpha: 47/47, Bravo: 3/2, Charlie: 0/1; marginal discoloration: Alfa: 49/47, Bravo: 1/3; color match: Alfa: 49/48, Bravo: 1/1, Charlie: 0/1; filling integrity: Alfa: 48/50, Bravo: 2/0. All restored teeth remained vital, the parameter hypersensitivity, recurrent caries, surface and proximal contact were scored Alfa for all teeth. Between both groups no statistical significant differences could be detected (Mann- Whitney- U- Test, p Keywords: klinische Studie, niedrigvisköse Komposite, selbstkonditionierendes Adhäsiv, Ryge-Kriterien

The aim of the this prospective, randomised blinded study was to compare the clinical performance of two Adhesive Systems (Excite and AdheSE, Ivoclar Vivadent, Schaan, Liechtenstein) in combination with Tetric Ceram HB over a period of twelve month. A total of 100 class I (27 teeth) and II (73 teeth) restorations were placed in molars and premolars in 50 patients in this prospective study. At each patient one filling was placed using AdheSE and Excite. The fillings were placed under rubber dam according to the manufactures instruction. Evaluations took place at baseline, 6, 12, 24 and 48 months based on the modified Ryge criteria by a blinded dentist. 60 restorations could be observed all five recalls (Excite: 30, AdheSE: 30). One filling in each group had to be replaced due to filling fracture. None of the fillings showed signs of secondary caries. Except for the criteria "marginal adaptation" all other criteria showed no significant differences between baseline and the four year recall (p Keywords: Bonding, Kompositfüllung, Dentinhaftvermittler, klinische Studie, Kavitätenklasse I und II

Objectives: Several investigations demonstrated a difference in the formation of plaque between different individuals enabling the clinician to distinct between "slow" and "heavy" plaque formers. Our aim was to compare the percentage of vital micro-organisms in slow and heavy plaque formers, in different areas of the mouth, and at different teeth. Methods: 38 female and 12 male participants were included in the study. A professional tooth cleaning was performed and than the plaque formation rate observed after 8h, 24h, and 72h of undisturbed plaque accumulation using the plaque index (Silness and Löe 1964) and the plaque formation rate index (Axelsson 1990). Concomitantly plaque samples were taken and analyzed by vital fluorescence microscopy (Netuschil et al. 1989).The statistical analysis was performed using Wilcoxon-test and Mann-Whitney-test. Results: Generally, a statistically significant increase of plaque vitality with duration of plaque formation was observed. No differences in plaque vitality could be found between upper and lower jaw and between different quadrants of the mouth. At all investigation time points a higher amount of vital microorganisms was registered in heavy plaque formers when compared to low plaque formers (p Keywords: Plaque formation rate, heavy plaque formers, light plaque formers, bacterial vitality, vital fluorescence technique

Objectives: Clinical indices are the most widely used parameters for the assessment of plaque and gingivitis in clinical trials on oral hygiene products. However, a full-mouth recording of these indices is the most time consuming part of a study. Therefore, the aim of this investigation was to determine whether correlations exist between full-mouth and partial-mouth recording of plaque, gingivitis, and discoloration in experimental gingivitis (EG) studies. Methods: Two study populations who had different oral hygiene habits were investigated. Group A consisted of 79 dental students, group B included 78 subjects of a local population. During a 21-day EG study in parallel groups the subjects rinsed with 0.20 % or 0.06% chlorhexidine digluconate, amine fluoride/stannous fluoride, or a placebo. No oral hygiene was permitted. Gingival index (GI, Löe 1967), plaque index (PlI, Silness and Löe 1964), and discoloration index (Brecx et al. 1993) of the entire dentition were recorded. Parameters were scored two weeks before the start of the study, at baseline, and after 7, 14, and 21 days of rinsing. To test the association between full-mouth scores and "Ramfjord teeth" scores the Pearson correlation coefficients were calculated. Results: Statistically significant correlations between full-mouth and partial-mouth approaches were determined for GI, PlI, and DI. Correlations existed at all time points and in all mouthrinse groups. The majority of the correlations exceeded 0.90 but 0.80 in any case. When the means of the full-mouth recording were compared to the means of the "Ramfjord teeth", the differences were not higher than 0.07. Conclusions: Assessment of the "Ramfjord teeth" is as reliable as the full-mouth scoring in EG studies. The assessment of the "Ramfjord teeth" saves time for both participants and investigators, reduces costs, and results in a study simplification without distorting the outcome. The study was supported by GABA International AG. Keywords: clinical trial, experimental gingivitis, full-mouth recording, partial-mouth recording, mouthrinse, plaque index, gingivitis index, discoloration index

Soft tissue sarcoma of head & neck are seldom. Particularly our knowledge concerning diagnosis, treatment modalities and pathologic features of the sub type sarcoma- NOS is already very limited. A case of pleomorphic sarcoma-NOS of the face in adult, originating from the region between the zygoma bone and parotid gland is presented. The entire procedure of the diagnosis and therapy as well as the 11 months follow-up time is discussed. Keywords: Sarcoma-NOS, adult soft tissue sarcoma, head and neck, case report

Adhesive protocols allow clinicians to predictably restore fractured teeth. We applied different techniques of restoration in two cases of crown fractures involving superior central incisors. First case: a 10 year-old boy, with uncomplicated crown fractures in both superior central incisors; one of the fractured dental fragments being retrieved. We used the reattachment technique in 2.1 and silicone key reconstruction technique in 1.1. Second case: a male teenager with: cervical horizontal fracture, with loss of the coronal fragment in 1.1; an oblique crown-root fracture, with the coronal fragment still in place in 2.1. The treatment consisted in: 1.1: a post-and-core supported prosthetic restoration, 2.1: reattachment technique combined with periodontal surgery. The reattachment technique was successfully applied. Complex cases, with more than one tooth involved, require specific treatment of each different type of fracture, taking advantage of the remaining tooth structures. Keywords: esthetic restoration, crown fracture, reattachement

The use of reduced angle of insertion during miniscrew implant placement has been reported to increase the mechanical retention of miniscrew implants. However, the effects of the insertion angulation in the dentoalveolar bone have not been investigated. Purpose: The purpose of this study was to investigate the effects of insertion angulation on the biomechanical performance of the miniscrew implanted in the dentoalveolar bone. Materials and Methods: 360 self-tapping miniscrew implants (1.6 x 8 mm) (BMK, Seoul, Korea) were systematically inserted in fresh maxillary and mandibular dentoalveolar bone (anterior, middle and posterior area) of minipigs with 30, 60 and 90 degrees to the bone surface aided by a 3-D Surgical Guide (Y&B Products, Chiangmai, Thailand). Maximum insertion torque and pullout strength were assessed with an Imada torque wrench and a Universal Instron Testing Machine, respectively. Results were recorded and analyzed by one-way ANOVA and Pearson correlation coefficients. Results: Maximum insertion torque and pullout strength showed significant correlation (r = 0.81). In the maxilla, no significant difference in the maximum insertion torque and pullout strength was observed between miniscrews implanted with 30, 60 or 90 degrees. Although miniscrews inserted with 30 degrees exhibited highest mechanical performance in the anterior portion of mandible, significant reduced insertion torque and pullout strength values was observed in the middle and posterior areas. No significant difference was observed between miniscrews inserted with 60 and 90 degrees. Conclusions: Insertion angulation did not improve the mechanical performance of miniscrew implanted on the maxillary dentoalveolar bone. Reduced insertion angulation (30 degrees) was only effective on the anterior portion of the mandible. Keywords: miniscrew implants, orthodontics, anchorage, insertion angulation

After radiation treatment of head and neck cancer quality of life and pathological changes in oral health are significantly dependent on functional insufficiency of salivary glands. Satisfactory therapies for treating resulting diseases such as xerostomia, radiation caused dental decay and osteoradionecrosis have not yet been found. New strategies aim at containing these side effects without reducing radiation dose. We test protectionary effects of 3dimensional conformal radiation therapy (3D-CRT) including medicamentary treatment using radioprotector and contralateral parotid gland sparing. Using a sample of 106 patients under radiation treatment of head and neck cancer we measured changes of pH-value, salivary flow rates and buffer capacity to analyse the protectionary effects of Amifostin in contrast to contralateral parotid gland sparing. A cumulative dose of between 64Gy - 70Gy was given to primary planning target volume. Exact measurement of the radiation dose was achieved by using CT-based dose-volume-histograms. We extracted salivary before, during and after radiation treatment as well as one six and twelve month after radiation. Based on salivary flow rates we tested the protection of salivary glands/normal tissue compliance probability of Parotiden by Amifostin and contalateral parotid gland sparing controlling for the amount of radiation given. The best protection in these experiments was found with contralateral parotid gland sparing by using modern 3D-CRT. Although Amifostin offers some protection, too, it is less effective and due to high costs and considerable side effects not suitable for routine treatments. The study was supported by a research grant of Deutsche Krebshilfe. Keywords: Radiotherapie, Speicheldrüsenschonung, Amifostin, Speichel

Objectives: In designing a clinical controlled trial for the assessment of the efficacy of oral antiseptics the selection of parameters and participants is a basic principle. The aim of this experimental gingivitis study was to determine whether correlations exist between different gingivitis parameters in distinctive populations. Methods: Three study populations were selected depending on the oral hygiene level of the participants (excellent vs modest). Population A (excellent) consisted of 39 dental students, B (modest) of 38 participants from a local population, and C was a mixed population (A+B, n=77). During a 21 day experimental gingivitis study the participants rinsed with either a placebo or 0.2 % chlorhexidine (CHX). After 21 days, Gingival Index (GI, Löe et al. 1967), Modified Gingival Index (MGI, Lobene et al. 1986), Bleeding on Probing (BOP, Ainamo and Bay 1975), gingival crevicular fluid (GCF), and colony forming units (CFU) were assessed. The association between the parameters was tested using the Pearson correlation coefficients. Results: Statistically significant correlations were observed between GI and MGI in all groups and populations. GI and BOP as well as MGI and BOP correlated in group C. GI and GCF correlated only in group A after rinsing with CHX as did MGI and GCF. No correlations were found between GI and CFU. Conclusion: GI and MGI are the most reliable parameters regardless of the composition of the study population. For the use of BOP during experimental gingivitis, however, a mixed population is preferred. Supported by GABA International AG. Keywords: clinical trial, experimental gingivitis, mouthrinse, study population, gingivitis indices, discoloration index, gingival crevicular fluid, colony forming units

Objectives: Several indices are recognized as reliable for scoring plaque and gingivitis during evaluation of mechanical and chemotherapeutic antiplaque procedures. The aim of this investigation was to determine whether correlations exist between different plaque parameters as well as between plaque- and gingivitis parameters in distinctive populations. Methods: Three study populations were selected depending on the oral hygiene level of the participants (excellent / modest). Population A (excellent) consisted of 39 dental students, B (modest) of 38 participants from a local population, and C was a mixed population (A+B, n=77). During a 21 day experimental gingivitis study using parallel group design the participants rinsed with either a placebo or 0.2 % chlorhexidine (CHX). After 21 days, plaque indices according to Silness & Löe (1964, PlI) as well as to Quigley & Hein modified by Turesky (1970, QHI) were evaluated. Furthermore the Gingival Index by Löe (1967, GI), and the Modified Gingival Index by Lobene et al. (1986) (MGI) were assessed. For statistical analysis the Pearson correlation coefficient was used. Results: Statistically significant correlations were observed between PlI and QHI in all groups and populations. A correlation between plaque recording systems and gingivitis parameters (GI, MGI) was only shown for population A, and for the CHX-groups in population B and C. Conclusions: For assessment of plaque accumulation PlI and QHI are the most reliable parameters regardless of the composition of the study population. In determining associations between plaque accumulation and inflammation, populations with excellent oral hygiene are advisable. Supported by GABA International AG Keywords: clinical trial, experimental gingivitis, mouthrinse, plaque index, gingivitis index

Objective: The aim of this clinical controlled trial was to determine whether correlations exist between full-mouth and partial-mouth recording of plaque, gingivitis, and discoloration in six-month home-use studies on adjunctive application of mouthrinses. Methods: Two study populations who had different oral hygiene habits were recruited. Group A consisted of 82 medical and dental students who had a gingival index 0.8. During the six-month study period in parallel groups, the subjects rinsed with 0.06 % or 0.12 % chlorhexidine digluconate, amine fluoride/stannous fluoride, or a placebo in addition to their habitual mechanical oral hygiene measures. Study parameters were: Plaque indices (Silness& Löe 1964, Turesky 1970), gingival index (Löe 1967), and discoloration index (Brecx et al. 1993). The indices were scored at all teeth of the dentition. Parameters were recorded at two weeks prior baseline, at baseline, three weeks, three months, and six months after baseline. To test the association between full-mouth scores and "Ramfjord teeth" scores the Pearson correlation coefficients were calculated (p Keywords: klinisch kontrollierte Studie, Mundspüllösung, Ramfjord-Zähne, Plaqueindex, Gingivitisindex, Verfärbungsindex

Patients with congenitally missing lateral incisors more frequently wish by means of implants the gap reduction. In this poster a solution with diameter reduced BEGO-Compress-Implants is shown by lacking of bone supply in vestibulo-oral direction and reduced intercoronale space of 5 mm. The results after 2 years and 6 years, by 2 cases, were presented. Keywords: congenital missing lateral incisors, reduced diameter implants, Bego-Compress-Implants