Aim: Even though today, many fields in dentistry allow digital processes, analogue procedures are still widely used. This cross-sectional pilot study aimed to survey insights on the digitalisation of dental practices using the example of Hesse. Materials and Methods: Between April and June 2022, 4840 active practicing dentists registered by the State Dental Association of Hesse were invited via e-mail to fill out an online questionnaire regarding their technical requirements in dental practice, dental treatment procedures, and attitude towards digitalisation in dentistry. Demographic questions were asked. Besides descriptive statistics, correlations were analyzed (P < 0.05). Result: Questionnaires of 937 dentists (279 female, 410 male, four inter/divers, 244 no answer; mean age of 51.4 ± 10.4 years) were examined representing a respond rate of 19.36%. In the area of practice administration and dental radiography, the majority of the dentists surveyed is already working digitally, which is predominantly assessed as a positive development. Already one third of the respondents state that they use an intraoral scanner for dental treatments, but the indication is mainly limited to smaller restorations. However, many dentists rate the use of social media accounts and telemedicine rather negative. Conclusion: Within the limitation of this pilot study, many processes especially in dental treatments are still analogue. However, 60% of the participants plan digitalisation of their dental practices within the next five years, which indicates a clear shift from analogue to digital dentistry. Schlagwörter: Analog-Digital Conversion, CAD/CAM, Dental Practice Pattern, Digital Technology, Intraoral Scanner, Organisation and Administration, Real World Data on Dentistry, Surveys and Questionnaires

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

Purpose: To survey the clinical performance of telescopic-retained removable implant-supported dental prostheses (TR-RISDPs) in edentulous patients, as well as incidental maintenance measures and technical complications. Materials and Methods: In this retrospective analysis, the former presence of oral cancer, prosthesis location (maxilla or mandible), and participation in a follow-up program were analyzed as possible factors with an influence on survival and maintenance treatments of the TR-RISDPs and dental implants using Kaplan-Meier estimates. Results: A total of 86 TR-RISDPs (mean follow-up: 4.62 ± 3.24 years; maximum 13.8 years) and 465 implants (mean follow-up: 5.67 ± 3.59 years; maximum 16.5 years) were observed. Six (6.9%) of the TR-RISDPs had to be remade, and 11 (2.3%) implants failed. Regular attendance in the follow-up program showed significantly higher survival times and fewer maintenance treatments for the TRRISDPs (P < .05). Implants in patients with former oral cancer showed significantly lower survival times (P < .001). Conclusions: TR-RISDPs in edentulous patients show excellent clinical outcomes. Regular check-ups are decisive for success.

Purpose: To evaluate the accuracy (trueness and precision) achievable with four intraoral scanners (IOSs) and different preparation geometries. Materials and methods: A model of a maxillary arch with different preparation geometries (onlay, inlay, veneer, full-crown) served as the reference master model (RMM). The RMM was scanned 10 times using four commonly used IOSs (Trios 2 [TR], 3Shape; Omnicam [OC], Dentsply Sirona; True-Definition [TD], 3M ESPE; and Primescan [PS], Dentsply Sirona). Scans were matched using a 3D measurement software (Inspect 2019, GOM) and a best-fit algorithm, and the accuracy (trueness and precision) of the preparation types of the scanning data was evaluated for positive and negative deviations separately. All data were subjected to univariate analysis of variance using SPSS version 24 (IBM). Results: Mean (± SD) positive deviations ranged from 4.6 ± 0.7 μm (TR, veneer) to 25.9 ± 2.4μm (OC, full crown). Mean negative deviations ranged from -7.2 ± 0.6 μm (TR, veneer) to -26.4 ± 3.8 μm (OC, full crown). There were significant differences (P < .05) in terms of trueness and precision among the different IOSs and preparation geometries. Conclusion: The transfer accuracy of simple geometries was significantly more accurate than those of the more complex prosthetic geometries. Overall, however, the IOSs used in this study yielded results that were clinically useful for the investigated preparation types, and the mean positive and negative deviations were in clinically acceptable ranges.