International Poster Journal of Dentistry and Oral Medicine, 04/2005

Introduction: The earliest concepts of the stomatognathic system derived fromstudies performed by Hanau, Trappozzano and Levin, were concentrated onrelationship between occlusion and temporo-mandibular joints. The laterconcepts, described by Held (Fig.1), Wigdorowicz-Makowerowa et al. (Fig. 2),Majewski, Fuhr and Solberg as well as by Troest, the importance ofadditional elements, such as periodontium, neuro-muscular system and CNS,are stressed. In holistic concept of stomatognathic system proposed by Panekan environment is included. Keywords: stomatognathic system

Craniofacial dysraphia, orbito-maxillary and lateral facial clefts are rarecongenital malformations compared to the cleft lip and palate. Theoccurrence of lateral facial clefts is reported in 0.7 up to 5.4 out of 1000cases of cleft lip and palate. The anatomical classification describedby Tessier is commonly used for further differentiation. Among these 15malformations, clefts no. 0, 1, 2, 3, 4, 5, and 7 are often associated withclefts of the lip, the alveolar process and the palate. The combination of acleft lip and palate on the one hand and the gradual evidence of associatedsymptoms of the central and the lateral face on the other can be regarded asa severe dysmorphic disorder in terms of aesthetic as well as functionalaspects. In these cases an extensive surgical management is required. Theaesthetic and functional correction of facial clefts poses a specialsurgical challenge. The extent of the defects involving the soft tissues andthe bony structures is often underestimated. We present the clinicalfeatures and therapeutic concepts in 11 patients with median and paramediancraniofacial clefts, unilateral and bilateral oculofacial clefts and obliquefacial clefts treated in our surgical center between 01/1993 and 04/2001.The general and special surgical principles in the treatment of thesecomplex clefts are described. The basic condition for the normalization ofthe facial growth is an extensive mobilisation with consecutive anatomicalreconstruction of the perioral, perinasal, and infraorbital facial muscles.It often takes a second or third surgical intervention for the bony cleftsto be closed. We present casuistics of four exemplary patients withdifferent complex facial clefts (Tessier 0, 3, 4, and 7) includingphotographs with preoperative, intraoperative and later follow-upfeatures. Keywords: lateral facial cleft, cleft lip and palate, Tessier classification, surgical treatment

Objectives: The aim of this study was to assess factors contributing to the long-term effect of periodontal treatment 10 yearsafter initiation of antiinfectious therapy. The main outcome variable of this analysis was tooth loss. Methods: 64 adultpatients were recruited for the study. Inclusion criteria were full-mouth radiographs from the beginning of therapy andcompletion of antiinfectious therapy. Clinical examinations including periodontal findings, Plaque (PCR) and Gingival (GBI)Index, samples for analysis of interleukin-1 polymorphism (IL-1), and a detailled questionary on smoking habits, dental care,social status, and nutrition were obtained by the same examiner (BP). Additionally periodontal conditions were surveyedaccording to the criteria of the Swiss Dental Association (Schweizerische Zahnärzte-Gesellschaft 1999). Medical files weresearched for initial diagnosis, documentation of tooth loss, regularity of maintenance and prognosis index (Checchi et al.2002). The statistical analysis was performed with SPSS using linear regression. Results: The following means of tooth lossper patient were observed: regular maintenance (yes / no): 0.46 / 3.44; IL-1 polymorphism (positive / negative): 2.04 / 0.88;initial diagnosis (moderate chronic / severe chronic or aggressive periodontitis): 0.44 / 2.15; prognosis (A or B / C): 1.54 /2.36; gender (male / female): 1.50 / 1.89; smoking (no / yes): 1.02 / 3.65. Linear regression revealed increased tooth lossfor irregular maintenance patients (p=0.024) and those exhibiting the interleukin-1-polymorphism (p=0.049). Conclusions: Somecriteria seem to interact with tooth loss whereas only regular maintenance and absence of the interleukin-1-polymorphism couldbe proven to be statistically significant preventive of tooth loss. Keywords: supportive periodontal therapy, long-term success after systematic periodontal therapy, tooth loss, periodontitis risk factors, interleukin-1 polymorphism

Introduction and aim: Regenerative therapy in furcation envolvement class IIis evidence based. Minimal invasive operation technique using minimalizedinstruments offers the opportunity for largely atraumatic operations. It isthe aim of our presentation to give a detailed picture of the operativesteps, the healing process after the regenerative procedure using clinicalparameters, x-ray and clinical photography. Material and method: A 60-yearold female patient in April 2003 had the wish to maintain her prosthodonticrestorations as far as possible. Clinical and radiographical evaluationshowed the possibility to keep the restorations but revealed periodontaltreatment necessity due to chronic periodontitis. Clinical parameters (PBI,PPD, cAL) were improved after conservative periodontal treatment (SRP). Thepersisting furcation defect class II at tooth 47 offered the indication forperiodontal regenerative treatment with a bovine bone mineral substitute(0,25 ? 1mm) and an absorbable porcine collagen membrane. Chronologicallyincision technique, flap raising, periosteal releasing, root depuration,membrane application, augmentation and defect coverage are demonstratedphotographically. X-ray control was performed 6 and 12 months after therapy. Results: wound healing was uneventful. The patient was without pain withinthe wound healing period. Clinical and radiographical reevaluations showed aclosed furcation. Conclusion: The minimal invasive operation techniqueoffered an excellent adaptation and healing of the periodontal tissuessuggesting regeneration as far as this can be drawn from clinical andradiographical parameters. Thus due to periodontal regeneration theprognosis of the prosthodontic reconstruction could be enhanced and thepatient's wish was fulfilled. Keywords: Minimalinvasiv, Gesteuerte parodontale Geweberegeneration, Furkationsbefall Grad II, bovine Knochenersatzmaterialien, Kollagenmembran

Mechanical debridement and biofilm removal from periodontally diseased rootsurfaces form an integral part of initial periodontal therapy. This isusually achieved with traditional hand instruments, sonic-, ultrasonic, oroscillating scalers. Aim of this study was the clinical investigation of aultrasonic device (Vector, Duerr, Bietigheim, Germany) with a new approachof creating ultrasonic vibration, compared to scaling and root planing withhand instruments for non-surgical periodontal therapy. 14 patients weretreated using either the Vector device or manual scaling and root planing inthis controlled, prospective split-mouth study. 3 and 6 months aftertreatment probing depth and degree of inflammation were reduced in bothgroups, with relevant differences between the two groups. However, asignificant gain of clinical attachment was found in the Vector-group. Keywords: periodontitis, periodontal therapy

Objectives: Certain human leucozyte antigens (HLA) could influence thesubgingival colonization with periodontopathic bacteria. The aim of thepresent study was to evaluate HLA associations to A. actinomycetemcomitans(A.a.), P. gingivalis (P.g.), P. intermedia (P.i.), T. forsythensis (T.f.)and T. denticola (T.d.) in patients with aggressive periodontitis (AP) (N =33, age 37 years) and patients with chronic periodontitis (CP) (N = 35, age47 years). Methods: In both patient groups the smoking status, theapproximal plaque index (API), bleeding on probing (BOP) and the clinicalattachment loss (CAL) were determined. Bacterial infection was analyzedemploying a PCR-rSSO microDent DNA-Strip technique (Hain Lifescience GmbH,Nehren, Germany). HLA-A, -B, -Cw, -DR, -DQ typing was performed by bothComplement Depending Cytotoxicity assay, BAG, Lich, Germany) and PCR-SSP(GenoVision VertriebsmbH Schwechat, Austria). Statistical calculations werecarried out by Chi²-testing, with Yates correction or Fishers Exact test, ifappropriate. Results: The occurence of an A.a. infection was found to bepositively associated with the haplotypesHLA-B*08:Cw*07:DRB1*03:DRB3*(DR52):DQB1*02 as well asHLA-DRB1*13:DRB3*:DQB1*06, whereas a negative association was found toHLA-DRB1*04:DRB4*:DQB1*03. HLA-A*02 positve patients were always infectedwith P.g.. An infection with P.i. occurred less frequent in patientsexpressing HLA-B*5, HLA-DRB1*13, -B*44:DRB1*13 or-DRB1*13:DRB3*(DR52):DQB1*06. T.f. was negatively associated with HLA-A*33. Conclusions: Single HLA markers and HLA combinations appear to influence thesusceptibility for an infection with periodontopathic bacteria. In thiscontext, it may be of interest that both HLA-B*08 andHLA-DRB1*04:DRB4*(DR53) positive haplotypes are also associated with severalother chronic inflammatory or autoimmune diseases. Keywords: HLA, aggressive periodontitis, chronic periodontitis, bacteria, subgingivalcolonization

In the present study the light transmitting capacity of differently shapedglass-fibre posts were estimated using visible light with a wavelengths of400-470 nm. The factory-made root canal posts' energy transmission wasevaluated in a preliminary exclusion procedure analysing their translucencyas well as in a following examination verifying their hardness. In theexclusion procedure, 3 different types of pins ( FRC Postec®, Twin LuscentAnchors® and ParaPost® FIBER WHITE) were illuminated in the darkroom.Pictures were taken of both the pin and of the emitted cloud of light. FRCPostec® and Twin Luscent Anchors® showed differences in light energydistributions whereas ParaPost® FIBER WHITE was found to have a limitedability of light transmission. In the following examination the rate ofpolymerization which depends on the light transferred through the pin, wasevaluated by estimating the hardness of dental cement (Knoop). 10 pins ofFRC Postec® and Twin Luscent Anchors® were fixed to the equipment with lightinduced polymerising composit Tetric®, illuminated for four differentexposure times and prepared as grinding compounds in order to measure thehardness of the surrounding dental cement. Assuming 25,8 KHM ± SD to bethe clinically acceptable hardness, Twin Luscent Anchors® showed a depth ofpolymerization of about 7.8 mm, FRC Postec® of 8.0 mm. Glass-fibrereinforced root canal posts revealed that light transmission depends on theindividual geometrical shape of the pin. Considering the size and the littledifferences in shape associated with it, the geometrical shape of the pointhas only a slightly distinctive impact on the light transmission.Consequence of which is a difference in degree of the dental cements'polymerisation. Keywords: glass-fiber post, capability of transmitting light, translucsnsy, light polymerisation

Introduction: New studies show, that SRB are associated with periodontaldisease. We could identify in a pilot study, that 90% of isolated SRB aremember of the new species Desulfomicrobium oraleb(Langendijk et al., 2001),whereas Desulfovibrio fairfieldensis oral was infrequent detected. The aimof our study is the detection of these two SRB strains as a part of themicrobiologic periodontal diagnostics using quantitive PCR. Material and method: 15 patients undergoing Supportive Periodontal Treatment (SPT)participated in this study, who got before a complex periodontal therapy.After the baseline examination a supportive periodontal treatment wasperformed, and reevaluated after 3 and 6 months .The following clinical parameters were evaluated: Pocket depth (PD), Clinical Attachment Level(AL), Bleeding Index (BI), Gingival Index (GI), Plaque Index (PI).Furthermore, GCF samples were taken and examined using ELISA-Essaysquantitatively for PGE2, IL-1ß and IL-6. The plaque samples were takensubgingivally with paper points before the SPT, and after 3 and 6 months.The DNA was isolated from all samples using High Pure PCR TemplatePreparation Kit (Roche). The Quantitative real-time PCR was accomplishedusing QuantiTect Probe PCR Kit (Qiagen) in Gene Amp 5700 Sequence DetectionSystem. A DNA fragment of the gene served as standard for the 16S rRNA of D.orale and D. fairfieldensis. Results: A significant gain of PD, AL, GI andBI was observed in the test group after 6 months comparing with baselineexamination. The immunological analysis showed the parallel reduction of theconcentration of IL-1ß- and der IL-6. The qPCR showed in contrast thesuccessfull reduction of SRB with partial recolonisation after 3 months,which was obviously after 6 months completed. Conclusion: The quantitativePCR is an adequate methode for detection of SRB prevalence in patients withperiodontal disease. Keywords: Parodontitis, parodontale SRB, Desulfomicrobium orale, mikrobiologische Parodontitis-Diagnostik, quantitative PCR

Introduction: Gingival recession represent a functional and cosmetic relevant problem. The usage of free connective tissuegraft is presented in the literature as the most successful method for recession coverage. The aim of our study is theretrospektive evaluation of the patients, in whom this method had been applied. Material and method: 13 patients (6 women and7 men) with an average age of 39,3 (17-61) were treated after clinical evaluation of pocket probing depth, recession,attachment level, width of attached gingiva. 30 recessions were covered in 17 operations using coronally advanced flap andfree connective tissue graft, which was taken from the palate using a single-incision-technique (Hürzeler et Weng 1999). Thetreatment was carried out using minimal invasive operation technique. An postoperative antibiotic therapy with Doxycycline wascarried out with patient weight depending dosage. Antiphlogistic medication was administered for pain and swellingprophylaxis. The non absorbable sutures were removed 10 days postoperatively. The same clinical parameters were evaluatedafter 12 months average observation time (51-6 months) and compared to the baseline findings. Results: The wound healing wasuneventful in all cases. The clinical recession coverage was 81% in average. A 100% coverage was achieved in the cases, whichhad a baseline recession of less than 4mm. The following improvement of clinical parameter was achieved: Average pocket depthreduction of 0,53mm, average gain in attachment level of 3,2mm and average gain in the attached gingiva of 1,7mm. Conclusion:A recession coverage with a free connective tissue graft and coronally advanced flap using minimal invasive operationtechnique reliable procedure in case of class I and II recessions = 4 mm. Complete coverage of recessions, which are atbaseline = 4 mm, cannot be expected in 100% of the cases. It could only be evaluated histologically, if the attachment gain isdue to periodontal regeneration. Keywords: longterm study, root coverage, minimal invasive, periodontal surgery, connective tissue graft

An oily Calcium Hydroxide suspension (OCHS) has beendocumented clinically and histologically to enhance the bone regeneration inclosed bone defects and to stimulate the periodontal regeneration inintrabony defects. So far, there are no controlled clinical studies tocompare the effect of the OCHS with the effect of other "biological agents"in treating deep intrabony defects. Aim of the study was to compare thetreatment of deep intrabony defects with an OCHS (Osteoinductal®,Osteoinductal GmbH, München, Germany) to an enamel matrix protein derivative(EMD; Emdogain®, Straumann AG, Waldenburg, Switzerland). Thirty healthypatients, each of whom displayed one intrabony defect, were randomly treatedeither with the OCHS (test) or with EMD (control). Soft tissue measurementswere made at baseline and 6 months following the therapy. No differences inany of the investigated parameters were observed were observed at baselinebetween the two groups. No adverse healing response was observed in any ofthe patients. At six months after the therapy, the sites treated with OCHSshowed a reduction in probing pocket depth (PPD) from 8.60 ± 2.06 mm to 3.27± 1.39 mm and a change in clinical attachment level (CAL) from 10.20 ± 2.08mm to 5.80 ± 2.37 mm (p Keywords: oily calcium hydroxide suspension, enamel matrix proteins, periodontal regeneration