International Poster Journal of Dentistry and Oral Medicine, 01/2004

Objectives: to determine by a systematic review the proportion of gingival squamous cell carcinoma (GSCC) in relation to all oral squamous cell carcinomas (OSCC).Material and methods: Two independent reviewers searched the Medline database for relevant English language publications. Studies were selected if they met the following criteria: case series of histologically confirmed OSCC, excluding extraoral and vermilion border of lip carcinomas. Recorded data for each study: total number of patients with OSCC, number of patients with GSCC, which included alveolar ridge and retromolar area occurrences and excluded other unspecified oral sites. Other recorded data were age, gender, relative exposures to tobacco, alcohol, betel nut, and occurrence of oral lichen planus or other putative risk factors. Results: the search yielded a list of 118 publications, of which 33 were selected and 4 were included. The total number of patients with OSCC, in the 4 studies, was 2167. The proportion of patients with GSCC was: 36.5 % in the Indian study, 28% and 25% in the two US studies, and 10,9 % in the Italian. Data from the Indian and the US studies indicated that men are less affected by GSCC than women (proportions: 27.8 % vs 31.7 %, odds ratio 0.81, 95 % confidence interval: 0.67-0.99). Conclusions: GSCC proportions were highly variable. To establish if such differences are due to methodological flaws or to ethnic, geographic or cultural factors, further appropriate investigations are required. Keywords: gingiva, squamous cell carcinoma, epidemiology, systematic review

This study evaluated the influence of irradiation on the dentin bond strength. Sixty irradiated and sixty nonirradiated human third molars were used. The irradiation dose of 60 Gy was fractionally applied over six weeks (2 Gy/day, 5 days/week). All teeth were prepared in a special manner allowing the simulation of intrapulpal pressure and dentin perfusion. Dentin specimens with a thickness of 2.0 mm were obtained under standardized conditions. The specimens were randomly assigned to four experimental groups. Tensile bond strength of four different dentin bonding agents (ScotchbondTM 1, Solobond Plus®, Prime&BondTM 2.1 and Syntac®) was evaluated using an Instron Universal testing machine. Pairwise comparison did not showed any significant differences between the irradiated and nonirradiated groups. The influence of the different dentin adhesives was significant (P = 0.0001; ANOVA). Compared to the other dentin adhesive agents, the use of ScotchbondTM 1 resulted in a significantly higher tensile bond strength (P Keywords: irradiation, dentin adhesive, bond strength, dentin

Purpose: The aim of this study was to assess the accuracy of linear measurements of bone loss within infrabony defects on digitized radiographs after digital filtering particularly designed to image periodontal bone loss. Methods: Before surgery 50 standardized radiographs of 50 infrabony defects were obtained. Intrasurgically the distances from the ce-mentoenamel-junction (CEJ) to the alveolar crest (AC), from the CEJ to the bottom of the bony defect (BD), and the depth of the infrabony component (INFRA) were assessed. All radiographs were digitized and the distances CEJ-AC, CEJ-BD, and INFRA were measured on digitized but unchanged radiographs and after use of the filter. Results: There was a small overestimation of CEJ-AC (0.35-0.68 mm) and underestimation of CEJ-BD (0.84-1.12 mm) and INFRA (0.66-0.76 mm). Accuracy of measurement of the distance CEJ-AC was influenced by vertical angulation difference (p = 0.047) and the intrasurgical CEJ-AC (p = 0.003). Accuracy of CEJ-BD was influenced by intrasurgically assessed bone loss (p = 0.012). Accuracy of INFRA was influ-enced by individual patient, intrasurgically assessed INFRA (p Keywords: periodontal bone loss, infrabony defects/diagnostics, radiography, dental, radiography, dental, linear measurements, angle measurements

A 24 year-old healthy woman showed a diffuse erythematous gingival hyperplasia predominating in the anterior part of lower gingiva, in continuity with hyperplastic interdental papillae.The patient had suffered for 3 years of frequent migrainous attacks, and had taken for the last 1 year only flunarizine, a calcium channel blocker. Gingival hyperplasia does not belong to the list of adverse reactions to flunarizine treatment. Keywords: gingiva, gingival hyperplasia, Flunarizine, drug-induced gingival hyperplasia

Introduction: Immediate loading of dental implants in the mandible has not been an unknown method since the introduction of the Ledermann-screw (1977). Whereas Ledermann performed immediate prothetic supply over a fixed framework with a removable overdenture, in the present study a fixed construction has been installed. Material and Methods: 17 patients (average age 69,8 years) with edentulous mandibles were provided with 4- 6 ASTRA-Universalimplants.Operative access was made after infiltration anaesthesia with Ultracain DS by an incision in the middle of the fixed gingiva. On both sides the upper margin of the foramen mentale was represented. The distal implants were placed before the nerve's exit point keeping a security distance of 3 mm. The remaining implants were distributed between the distal implants excluding the symphysis area. The prosthetic construction was placed and screwed in on 20 degrees Universal abutments 3 days postoperatively at the latest. The denture was placed in a distance of 2-3 mm to the gingiva. This distance was adapted to the changed gingival level. In the course of the wearing period. 10 patients were provided with a framework of casted titanium, 7 patients received one of gold alloy. The metal framework of the first 3 patients was made out of metal on the basal side, all other patients were provided with a framework completely covered by plastic material in order to create a uniform distance between the mucosa and the denture after the final healing of the soft tissue. Polymer teeth from 35-45 or 36-46 were fixed on the metal framework with Palapress Vario after cephalic articulation of the models. All patients received new prosthetic dentures in the maxilla. Clinical controls for the removal of sutures followed 10 days postoperatively, after 6 and 12 weeks and after every 6 months. X-ray controls by panoramic radiography (Orthophos, Siemens, Standard Maximization Program 1/1,25) were made after placement of the fixed restorations after 6, 12, 24 und 36 months. Evaluation of the radiographs was made after digitalization by the FRIACOM OPG-planning module. Hygienic controls made by a dental hygienist took place every three months. Results: After 6 months one implant (area 35) showed no osseointegration and was removed without replacement. All other implants showed clinically non-irritated soft-tissues and were still in function. After 3 years the average bone loss was 0,6 mm (min. 0,0 mm, max. 1,3 mm). All patients were satisfied with the results. Conclusion: The single-stage use of ASTRA-Universalimplants with immediately loaded fixed restorations has proved to be a successful procedure in edentulous mandibles. With low production costs and easy oral hygiene this method may be recommended especially to older patients. Keywords: immediate loading, edentulous mandibles, Astra Tech Implants

Background: The aim of this 5 year randomized controlled clinical trial was to evaluate the long-term results after GTR-therapy of infrabony defects using 2 bioabsorbable barriers (test: polydioxanon; control: polylactide ace-tyltributyl citrate).Methods: In 15 patients suffering from moderate to severe periodontitis 15 pairs of contralateral infrabony defects were treated. Within each patient one defect received a polydioxanon (test: T) and the other a polylactide acetyltributyl citrate (control: C) barrier by random assignment. At baseline, 12, and 60 ± 3 months after surgery clinical parameters and standardized radiographs were obtained. Vertical bone levels (PBL-V) were measured intrasurgically and 60 ± 3 months later by transgingival bone sounding. Results: 13 of 15 patients were available for the 60-months re examinations. Twelve and 60 ± 3 months after GTR therapy statistically significant (P 2 mm compared to the 12 months re examination. Twelve and 60 ± 3 months after surgery statistically significant (P Keywords: interproximal infrabony defects/therapy, guided tissue regeneration, membranes, artificial, membranes, barrier, bioabsorbable barriers, radiography, dental, randomized controlled clinical trial, long-term results

Astra Tech Implantas have been placed at the University of Heidelberg since 1992. The patients have been reexamined clinically and radiologically on a regular basis. In the present clinical study the survival rate of enossal ASTRA TECH Implants as well as the bone situation after functional loading have been examined. The reexamined implants were inserted between 1992 and 2002 at the Clinic and Policlinic of Oral and Maxillofacial Surgery at the University of Heidelberg. Although the thickness of the soft tissue has not been measured in many cases there is no marginal bone loss on the Astra Tech Implants in the sense of an establishment of the 'biological width'. Keywords: bone apposition, functional loading

Single teeth, fragments of the jaws, of the skull and restorative elements used in modern dental practice are important for identification purposes of dead bodies. These individual specific structures are fire resistant and remain radiopaque. They shrink significantly and are likely to fall out of the cavities after being burned, and it may be possible to identify the white filling materials used to restore teeth by their radiopacity and morphology. Keywords: carbonization, extreme temperature, forensic odontology, identification

Purpose: The objective of this controlled randomized split-tooth study was to investigate the effect of dentinal disinfection with a 0.1% chlorhexidine-digluconate solution on the hybridization of 3 dentin bonding agents with dentin. Materials and Methods: Twenty one non-carious molars were randomly divided into 3 groups according to the restoration material used. Two Class-II-restorations in mesial and distal side were performed. One of the two cavities per tooth was washed with chlorhexidine solution (0.1%) for 1 min according to a random list. Restorations were carried out with one of the three materials: AquaPrime/Resolcin, Optibond/Herculite or Prime&Bond NT/Esthet-X. After sectioning and surface etching (15 s H3PO4 and 120 s NaOCl) the specimens were investigated under SEM. Hybrid layer thickness and tag lengths were documented. Results: Hybrid layers and tags were found in every group. The hybrid layer thicknesses were: It is concluded that using chlorhexidine before acid etching significantly effects hybridization of bonding resins with dentin. Keywords: dentin adhesion, hybrid layer, chlorhexidine

Aim of this study was to investigate the influence of the age of a study population on the association between periodontitis and ischemic stroke. Methods: 303 consecutive patients with acute ischemic stroke (T) and 300 representative population controls (C) matched for age, gender and area of resi-dence were divided into subjects with a maximum age of 60y (T: 144, C:159; group I) and those, who were older (T:159, C:141, group II). Subjects were clinically and radiographically examined for the presence of periodontitis. A questionnaire was used by trained interviewers in a face-to-face in-terview to investigate all known and/or suspected risk factors for stroke and periodontitis. Results: In group I, stroke patients showed statistically significant higher attachment loss (CAL; T: 4.0 ± 1.3 mm; C: 3.5 ± 0.8mm). There was no statistically significant difference in group II (T: 4.6 ± 1.4mm; C: 4.3 ± 1.4mm). After correction for age, gender and tooth loss, in group I a CAL of >4mm (OR 7.52; 95%-CI 2.77-20.39; p 4mm (7.40; 95%-CI 2.36-23.23; p=0.001) remained a significant risk factor. In group II in neither model any statistically significant association could be detected. Conclusion: As-sociations between periodontitis and cerebrovascular disease seem to be detectable in younger pa-tients, only. This study was funded by The German Research Council (DFG Grant# Gr1102/3-1) Keywords: periodontitis, ischemic stroke, cerebrovascular disease

An oily Calcium Hydroxide formulation proved over the last years to be highly efficient in promoting bone regeneration in closed defects (Sigusch: Parodontologie 2000; 3:243-250). Aim of the study is the presentation of the surgical technique and of the clinical results after the treatment of intrabony defects with a combination of Alpha-TCP and an oily suspension of Calcium Hydroxide. Fourteen patients, each with a deep intrabony defect were treated with a combination of Alpha-Tricalcium Phosphate (BioBase® Ü-pore, Biovision GmbH., llmenau, Germany) and oily Calcium Hydroxide suspension (Osteoinductal®, Osteoinductal GmbH., Muenchen, Germany). An excellent postoperative healing was noticed. The clinical measurements six months after treatment revealed a reduction of the probing pocket depth (PPD) from 7.93 ± 1.44 mm to 3.7 ± 1.69 mm and a change of the mean clinical attachment level (CAL) from 8.07 ± 1.44mm to 4.21 ± 1.81 mm, while the mean gingival recession (GR) changed from 0.14 ± 0.53 mm to 1.29 ± 1.38 mm. Both the PPD and CAL changes were statistically significant compared to baseline (p Keywords: periodontal defects, oily calcium hydroxide suspension, alpha-TCP