International Poster Journal of Dentistry and Oral Medicine, 01/2022

Objectives: The usage of CAD/CAM-manufactured single implant restorations is a common method in prosthetic dentistry. Several benefits lead to an adhesive connection of individualized ceramic crowns and prefabricated titanium bonding bases. However, the bonding has to resist permanent thermal, chemical and mechanical stress in the oral cavity. The durability of the bonding is a weak point and especially dependent on sufficient surface pretreatment. Cold atmospheric pressure plasma (CAP) is a conventional method for improving surface characteristics in car industry and space engineering. The aim of this study was to evaluate the impact of CAP on shear bond strength in two-piece abutments. Methods: Two different pretreatment protocols were tested in this study. Ten CAD/CAM-manufactured and sintered crowns of zirconia and ten prefabricated titanium bonding bases were divided into 2 groups (n=5): (A) as specified by the manufacturer (sandblasting (Al2O3, 50μm, 1bar) + adhesive primer (Ceramic Bond, VOCO GmbH, Cuxhaven, Germany)), (B) sandblasting + CAP + adhesive primer. Optimal pretreatment with CAP (piezobrush PZ2, relyon plasma GmbH, Regensburg, Germany) was evaluated in pretrial studies by analyzing water contact angles on polished surfaces after different duration of exposure. The wetting properties suggested a minimal CAP application time of 15 seconds. After pretreating the interfaces, the pieces were glued together under standardized pressure by using Bifix Hybrid-Abutment-Cement by VOCO. The specimens were thermocycled for artificial aging and then shear bond strength (SBS) was measured. Results: The SBS in two-piece abutments pretreated with CAP was higher than in those without. Mean values differed significantly (Mann-Whitney-Test, p=0.008) from 601.6±86.3N (Group A) to 755.0±37.2N (Group B). Conclusions: The study showed that additional usage of CAP for surface pretreatment in two-piece abutments leads to a significant increase of shear bond strength by about 25%. Thus, CAP can be recommended as a pretreatment procedure in this special field of indication. Further investigations by using different ceramic materials and luting cements are intended. Keywords: Two-piece-abutments, shear-bond-strength, pretreatment, cold atmospheric-pressure-plasma, adhesives, zirconia, titanium

Background: Asthma is a serious global health problem that has steadily increased in prevalence during the last two decades. It is one of the most common chronic medical conditions affecting children's oral health-related quality of life. Objective of the study: To assess and compare the dental caries experience and salivary S.mutans level among asthmatic and non-asthmatic children of Davanagere City, India. Methodology: A cross-sectional comparative study was conducted on 5 to 12-year-old children. Forty asthmatic and 62 healthy children were recruited as study and healthy subjects. Selection criteria: a) children with a diagnosis of asthma as diagnosed by lung function test, who were currently on asthmatic medication b) non-asthmatic status of healthy children was ascertained by asking relevant questions to parents and children which can elicit any symptoms of asthma. Study and healthy subjects were matched for age, gender socioeconomic status, diet, and oral hygiene practices. Dental caries experience for permanent and mixed dentition was assessed by Decayed, Missing, Filled Teeth (DMFT) and decayed, exfoliated, filled (def) index, respectively. Stimulated saliva was collected for S.mutans analysis. Results: The dental caries experience was found to be high among asthmatic children when compared to healthy children (mean DMFT/def score =3.05 vs 1.92). A high prevalence of dental caries (mean DMFT/def score = 5.27) was seen among asthmatic children who were under beta 2 agonists and had asthma for >4 years. A mean salivary S.mutans colony count (mean colony forming count = 94.1 vs 57.0) was greater among asthmatic children. Conclusion: The severity of asthma and prolonged duration of asthmatic medication were the contributing factors for dental caries experience among asthmatic children. Keywords: Dental caries, asthma, beta 2 agonists, S.mutans

Oral health is a matter of public health concern, as it affects a large proportion of the population and is linked with overall health status. With the demographic transition, there is a shift in disease profile, unequal distribution of dental professionals, and no existing oral health care system targeting the elders. It possess a challenge for the health authorities to overcome the financial burden for individuals and society. Given the ageing of the population, there is an immediate necessity to develop an oral health care system tailored to provide appropriate care for an ageing population. The time to plan and act is now The need of the hour is to develop a potentially effective community-based theoretical model i.e Quality care Age friendly Technologically enabled Interconnected and Competent (QuATIC) – system for elderly, so as to enhance oral health of the elderly and improve their quality of life. In this multilevel model, the upstream level includes policy making, a common risk factor approach, the implementation of geriatric subjects in the dental curriculum, and goal settings for oral health programs. The second level focuses on the methods to tackle social determinants of oral health through life course approach. The third level emphasizes primary care by bringing the competent oral health care system close to the elders. The fourth level pays attention to strengthening community and to provide on-site dental services to reduce transportation barriers. The last level concentrates on individual factors which can influence the utilization of dental services by the elderly. The factors in all these levels should be evidence-based, focusing on effective, efficient, equitable, and holistic care. All the levels should be interconnected to each other so as to create a sustainable oral health care system. Such combined forces can move a mountain, thereby enhancing the quality of life of elders. Keywords: Oral care utilization, elderly, geriatric dentistry, dental policy, India

Case report: A 26-year-old patient with an unremarkable medical history presented to Münster University Hospital with persistent complaints after an alio loco abscess incision in region 47. The orthopantomogram showed a sharply delimited, uniform radiolucency in region 46-48, which led to the suspicion of a cyst. Cystectomy and surgical removal of tooth 48 was performed. The pathohistological result revealed the presence of an odontogenic keratocyst. After 10 months, a local recurrence occurred, which was treated by a new cystectomy. After 4 months, a fistula appeared again, and the CT scan showed renewed osteolysis in the right mandible. A partial mandibular resection with reconstruction by iliac crest followed. After 9 months the metal was removed, and after another 11 months without recurrence 2 implants were inserted. 3 months later, 2 crowns were inserted. Discussion: According to the current WHO classification of head and neck tumours, the odontogenic keratocyst belongs to the group of developmental odontogenic cysts. It is the third most common jaw cyst and occurs particularly in the region of the lower wisdom teeth. In terms of age distribution, there is a peak incidence between the ages of 20 and 30. Men are more frequently affected. Symptoms often first appear as a result of a secondary infection. The treatment of choice is cystectomy. Here, the recurrence rate is 25%. With surgical resection, it is less than 2%. It is unclear whether and when implantological treatment can be carried out after cyst treatment. However, functional rehabilitation is not possible without implants. The use of autologous bone remains the gold standard. What is certain is that the integration of the bone graft must be waited for. Regular radiological and clinical follow-up is obligatory. Conclusion: In this case, the iliac crest augmentation and subsequent implant placement made it possible to insert two fixed implant-supported crowns. Due to the risk of recurrence, careful patient information and regular follow-up are required. A universal therapy concept cannot be propagated for odontogenic keratocysts. Keywords: Keratocyst, implant, iliac crest augmentation

Background: In response to the global COVID-19 pandemic, governmental measures have been undertaken. The impact of the crisis on the healthcare of patients with cancer is largely unexplored. This multicenter cohort study aimed to investigate a potential screening delay and its consequences in patients with oral cancer (OC) during the pandemic. Material and Methods: Data of patients who were first diagnosed with OC during different periods were collected, especially in terms of OC incidence, tumor stage/entity, and time to intervention. The lockdown (LD) (13 March–16 June 2020) and post-lockdown (PLD) (17 June–1 November 2020) periods and the corresponding equivalents in 2018/19 were differentiated and compared. Results: There was no obvious trend towards a higher incidence of OC or higher tumor stages, whereas a trend towards a shorter time to intervention during the LD2020 could be observed. Subgroup analyses revealed an increased incidence in OC within the PLD2020 in Mainz, which might be explained by the partial closure of dental practices in this federal state during LD. Conclusions: While there was no overall higher incidence of OC, we found closure of practices during LD possibly delay cancer diagnosis. Therefore, measures must be taken to identify patients at risk and to ensure basic healthcare, especially in the context of dental screening measures. Keywords: COVID-19, SARS-CoV-2, oral cancer, oral malignant lesions, screening; precursor lesions, lockdown, pandemic, head and neck cancer, HNSCC

Questions: Orofacial clefts (CLP) are among the most common congenital malformations of the orofacial system with a prevalence of approximately 1:500 live births, and are often associated with malocclusions and abnormalities in tooth formation, eruption, position and tooth number2. The nature and frequency of malposition are of great interest with regard to orthodontic treatment planning and rehabilitation of these patients. Therefore, the aim of the present study was a retrospective analysis and three-dimensional evaluation of the nature and frequency of occlusal and den-tal malposition and their association with the cleft type. Methods: A total of n = 58 cleft patients, born in between 1982-2010, which had been treated in the Department of Orthodontics, Medical Faculty Carl Gustav Carus, TU Dresden, were systematically evaluated. Thirty-one of them met the inclu-sion criteria: non-syndromic unilateral (UCLP) or bilateral (BCLP) orofacial cleft, sufficient documentation, mixed or permanent dentition, intact initial plaster cast, which were recorded by means of a 3D-scanner (OrthoxScan, Dentau-rum, Ispringen, Germany) and measured three-dimensionally (CleftDynamic, S.K.M. Informatik GmbH, Schwerin, Germany) to evaluate occlusal and dental malposition. Statistical evaluation was carried out by comparison of mean values using the software SPSS Statistics 27.0 (IBM Deutschland GmbH, Ehningen, Germany) (significance level p = 0.05). Results: As the most common finding, an aberration of the inclination and angulation as well as a distal position of the upper central incisors (tooth 11 and 21) could be determined, whereat the extent of these anomalies was significantly correlated to the cleft side. Overjet and overbite of these teeth werealso significantly smaller on the cleft side; in addition, in the area of the first permanent molar a cross bite could be found, which was also significantly more frequently located on the cleft compared to the non-cleft side. Conclusions: Abnormalities of the upper central incisors most frequently occur in cleft patients and are strongly correlated to the cleft side, but a cross bite in the region of the first permanent molar can also be frequently found compared to the non-cleft side. This should be taken into account concerning orthodontic treatment planning in these patients. Keywords: Cleft lip and palate, oral clefts, tooth malpositions, digital analysis, 3D model

The most common form of cystic lesions affecting the maxillofacial region are odontogenic cysts. It is classified into developmental and inflammatory origin, in which the developmental group includes keratocysts and dentigerous cysts and inflammatory group includes radicular cysts. The odontogenic keratocyst was first termed by Philipsen and designated by the World Health Organization as a keratocystic odontogenic tumour, now reclassified from benign odontogenic tumour to odontogenic developmental cyst due to the emergence of marked evidence of morphogenesis and biological behaviour. Its occurrence is anywhere in the jaws, but 70% of cases involve the posterior body of the mandible. It is more prevalent in males, especially in the second and third decade of life. It has characteristic histopathological and clinical features that makes this cyst special in its aggressive behavior and higher recurrence. It can also be classified on the basis of appearance as unilocular or multilocular. Smaller odontogenic keratocysts are unilocular, but larger lesion mostly associated with multilocular appearance. Multilocular odontogenic keratocysts are most commonly accompanied with syndromes, but unilocular are not. In this present case it is unilocular and not associated with syndromes. Radiographically, it appears as well-defined unilocular or multilocular radiolucency with thin radiopaque borders. Conventional radiographic imaging, such as panoramic views and intraoral periapical films, are adequate to estimate the size and determine the location of an KCOT. However, the clinical use for cone-beam computed tomography (CBCT) is increasing and provides more information about the extent and borders of the large lesions. This poster explains an atypical appearance of odontogenic keratocyst with an absence of scalloping border and septa; usually smaller lesion lesions are associated with unilocular appearance, but here is a larger lesion associated with unilocular appearance. Keywords: Odontogenic keratocyst, keratocystic odontogenic tumour, cone beam computed tomography, aspiration

Chelitis granulomatosis is a rare, persistent, painless, idiopathic chronic swelling of the lip. It is a manifestations of orofacial granulomatosis(OFG), which is characterized by non- necrotizing granulomatous inflammation of the oral and maxillofacial region. Clinically, chelitis granulomatosa represents labial enlargement, perioral and mucosal swelling, and oral ulcerations. OFG is an increasingly recognized entity. The exact etiology of not clear, and therefore the precise treatment and long-term prognosis remain uncertain. Chelitis granulomatousa has no predisposition to race, sex, or age, and the incidence is 0.08 % in the general population. Clinician should know about the history, clinical features, etiopathogenesis, and proper investigations to diagnose the disease so as to provide various means of treatment. We present a case report of a 45-year-old male patient with histopathologically confirmed chelitits granulomatosa, which is diagnosed and managed with a nonsurgical treatment approach. The present case highlights the importance of thorough investigations in the diagnosis of this lesion, as the findings mimic many other granulomatous conditions. Keywords: Chelitis granulomatousa, lip swelling, granulomas, giant cell