Books

In the case of vascular malformations of the face and neck, such as venous malformations, a purely mucosa-supported prosthesis can often not be tolerated. Implant-supported restorations are therefore the only way to provide these patients with a functionally and aesthetically satisfactory restoration. The present case describes a patient with an extensive venous low-flow malformation in the area of the right cheek and the right maxilla. It was possible to fix a bar-supported prosthesis on three implants, which hardly stresses the mucosa. Keywords: vascular malformation, implant, prosthetics

Introduction: Cancer-related malnutrition is often an unnoticed problem, although almost 60% of all oncological patients are already malnourished before diagnosis and more than 25% die of the consequences. Material and methods: In this prospective observational study, the nutritional status of patients with oral squamous cell carcinoma (OSCC) was assessed pre-, peri- and postoperatively using Body Mass Index (BMI), Subjective Global Assessment (SGA) and Bioelectrical Impedance Analysis (BIA) over four months. Patients with orthognatic surgery served as a control group due to comparable nasogastric tube feeding. Results: Patients with OSCC showed a worse nutritional status pre-therapeutically than the control group and fulfilled the criteria for malnutrition in SGA and BIA. Peri- and post- operative, the nutritional status deteriorated in both groups. In the group of OSCC patients, the nutritional status improved from the second postoperative week, but at the end of the observation period, the status was still predominantly in the pathological range according to BIA and SGA. In the control group, the nutritional status returned to baseline during the observation period. Conclusion: Based on these data, malnutrition is also widespread in the collective of oncological patients with OSCC. In order to improve the nutritional status of OSCC patients in general and thus also the prognosis of the patient, it is recommended to assess the nutritional status before therapy. Standard procedures such as SGA or BIA should be established and used. BMI alone is not suitable for this purpose. Professional nutrition therapy should be introduced as an integral part of the therapy in order to improve the patients’ prognosis. Keywords: malnutrition, OSCC, observation study, cancer-related cachexia, nutrition treatment

The dental treatment of patients with epidermolysis bullosa is complex and challenging. In general, a fixed restoration should be aimed for, as this puts only minimal strain on the fragile mucosa. Implants can significantly improve the quality of life of these often young patients. This case report describes the treatment of a 19-year-old female patient with epidermolysis bullosa. All of her impacted teeth were first removed and auxiliary implants were inserted. Bone was then augmented so that eight implants could subsequently be inserted. Finally, the patient received a fixed prosthetic restoration. Keywords: epidermolysis bullosa, implant, oral diseases

In autoimmune diseases, such as oral lichen ruber planus, a sufficient prosthetic restoration without dental implants is often not possible. Due to the extreme vulnerability of the oral mucosa, the indication for an implant restoration should be considered, especially for tegument relief. Interdisciplinary planning between prosthodontist and surgeon is necessary to realize an individual, mucosa-relieving treatment for the patient. Implants in patients with immunodeficiencies are therefore justified when strictly indicated and can lead to a rehabilitation of the physiological masticatory function, an increased quality of life, and a positive influence on the general state of health. Keywords: Oral lichen planus, implant, oral mucosal diseases

This case series reports the rehabilitation of the anterior maxilla using immediate implant placement and provisional restoration in combination with preservation of the alveolar foramen. Four patients presented to the Department of Oral and Maxillofacial Surgery with a non-preservable maxillary incisor following dental trauma. Treatment planning was performed digitally using Co-DiagnostiX software. The treatment protocol included atraumatic extraction followed by immediate implant placement and provisional restoration with an implant-supported single crown. In all cases, the non-salvageable tooth was carefully extracted and a dental implant (2 BLT, 2 BLX, Straumann) was placed using a flapless approach. Augmentation was performed with a combination of autogenous and xenogenous material, and the soft tissue was augmented with a connective tissue graft. After surgery, intraoral scans were taken and a CAD-CAM provisional crown was fabricated and placed on the same day as surgery. The final ceramic crown was placed after three to six months. The soft tissue profile was compared by superimposing the baseline intraoral scans (before and immediately after surgery) with the follow-up scans. Six months after surgery, soft tissue changes were considered minimal compared to baseline. Keywords: Dental implants, immediacy, digital planning, soft tissue

In autoimmune diseases such as oral lichen planus or mucosal pemphigoid, a sufficient prosthetic restoration without dental implants is often not feasible. Interdisciplinary planning between the prosthodontist and surgeon is necessary to realize an individual, mucosa-relieving treatment for the patient. Implants in patients with immunodeficiencies are therefore justified when strictly indicated and can lead to a rehabilitation of the physiological masticatory function, an increased quality of life, and a positive influence on the general state of health. Keywords: Dental implant, oral diseases, oral lichen planus, mucous membrane pemphigoid

Der Anteil gut bezahnter, älterer, multimorbider und multimedizierter Patient/-innen wird in den kommenden Jahren zunehmen und die medizinische und zahnmedizinische Betreuung vor neue Herausforderungen stellen. Diese Patient/-innen haben zum Teil einen hohen Anspruch an eine zweckorientierte, und ästhetische kaufunktionelle Rehabilitation nach Zahnverlust, sodass die implantologische Planung und Versorgung neben den intraoralen Gegebenheiten auch eine stetig wachsenden Varietät an Grunderkrankungen, Medikamentenwirkungen und Arzneimittelinteraktionen sowie ein verändertes Komplikationsspektrum berücksichtigen muss. Im vorliegenden Beitrag werden wichtige pharmakologische Grundlagen und Zusammenhänge summiert und konkrete Handlungsempfehlungen für die implantologische Versorgung älterer Patient/-innen unter Multimedikation abgeleitet. Manuskripteingang: 15.07.2024, Manuskriptannahme: 06.08.2024 Keywords: Multimedikation, Arzneimittelinteraktion, Komplikation, Notfallmanagement

In order to achieve a functional and, from an aesthetic point of view, optimal treatment result, various things have to be taken into account in cleft patients: comprehensive interdisciplinary cooperation, favourable tooth positions and intermaxillary relationships, and appropriate peri-implant soft tissue management. Nevertheless, difficult conditions, e.g., narrow interdental gaps, often persist despite extensive pretreatment over many years from a preimplantological point of view. The present case report shows a patient with a left-sided cleft. At the age of 21, the patient could be treated implantologically with a single-tooth implant in region 22. The success prognosis of implants in the cleft jaw region is comparable to implants placed after trauma. Sufficient bone supply is absolutely essential for this. Keywords: cleft, implant

Objective: This case report and systematic review aimed to answer whether patients with osteogenesis imperfecta (OI) can be prosthetically treated with implants. Osteogenesis imperfecta is a rare genetic disease characterized by a type I collagen defect leading to bone fragility and connective tissue disorders. Case Report: A 64-year-old female patient with OI type 1 presented for the first time to a specialty consultation for rare diseases with oral involvement in May 2019. The patient had received alendronic acid (p.o.) for many years to treat OI. At the consultation time, she was fitted with maxillary and mandibular complete dentures, and the complete mandibular denture had inadequate support. Implants were planned to stabilize the prosthesis. Under local anaesthesia, two tissue-level implants (Straumann Standard Plus®, Basel, Switzerland, SLActive 3.3 mm × 10 mm) were placed in regions 32 and 44. After a healing period of three months, uncovery took place, and the prosthetic restoration with locators could be performed two weeks later. Since implant placement, the patient has attended regular check-ups for one year and has shown no signs of drug-associated osteonecrosis or peri-implant infection. Methods: Because of the paucity of studies on implants in individuals with OI, a systematic review was performed. The search queries were based on the Population Intervention Comparison Outcome (PICO) procedure with the question, "Can people with osteogenesis imperfecta (P) be successfully treated and prosthetically restored (O) with dental implants (I)?" Results: The primary outcome was implant survival. Supporting data were analysed descriptively. Twelve studies were finally included. Twenty-three patients were treated with a total of 116 implants, with 5.0 (±3.8) implants placed per patient. Bone augmentation was performed before or during implant placement in 30 implants (25.8%). A sinus lift was performed before the placement of 19 implants (28.8%). In 18 patients, implants were placed in a two-stage procedure. In four patients, 14 implants (12.1%) were immediately loaded. Implant survival was 94.0%, with a mean follow-up of 59.1 months (±36.1). A total of seven implants were lost in four different patients. Three implants (2.6%) were lost before loading, and two implant fractures (1.7%) were described. Conclusion: The available data show the loss of only seven implants, with two of these implants lost due to implant fractures not attributable to the patient. With the limitations of this review and based on the available data, implants have a high survival rate (94.0%) in patients with osteogenesis imperfecta. Therefore, implants may be a viable treatment option for replacing missing teeth in patients with OI and should be considered in treatment planning after a detailed individual risk assessment. Keywords: Osteogenesis imperfecta, implants, rare disease, case report, systematic review

Simpson-Golabi-Behmel syndrome is an x-linked recessive overgrowth disorder characterized by macrosomia, mental deficits, a large head, prominent cranial sutures, midface deficits, hypertelorism, a broad nose, a wide mouth, macroglossia, dental malocclusions, a strongly arched palate, and musculoskeletal and limb abnormalities. The male sex is more commonly affected, with only about 200 cases being described. The presented case of a 2-year-old patient showed a flat facial profile, macroglossia, a deep tongue position with forced mouth closure, a large upper and lower jaw, and enamel formation disturbances at the primary molars. Preventive, interdisciplinary care of the patient regarding his oral health as well as dentition and speech development are recommended. Keywords: Simpson-Golabi-Behmel syndrome, rare diseases associated with oral symptoms