International Poster Journal of Dentistry and Oral Medicine, 02/2010

Aim of the Study: To compare the effect of conventional intra lesional dexamethasone injections and topically applied mucosal patch with dexamethasone in OSMF. Materials and Methods: 10 clinically diagnosed OSMF patients were selected for the study approved by the ethical committee. Group I (5 patients) were treated with conventional intralesional injections of dexamethasone 4mg/ml and Group II (5 patients) were treated with topical mucosal patch with dexamethasone of 2mg/patch bilaterally on buccal mucosa once/week for 6 weeks. Mouth opening, burning sensation and discomfort level of the method were recorded on each visit. Results: Group II patients showed better mouth opening compared to Group I. Both the groups showed similar improvement in the burning sensation. Discomfort level of Group I was very high when compared with Group II. Conclusion: Dexamethasone mucosal patch appears to be a promising treatment method in OSMF which has to be confirmed with further studies. Keywords: submucous fibrosis, management, steroid, mucosal patch

For dental implant systems, clinical long-term follow-up examinations with high patient numbers are necessarily. Therefore, the following study evaluated the cumulative survival rate (CSR), the success criteria according to Albrektsson and Buser as well as the vertical bone loss of the TiOblast®-implant (n=216) in the edentulous, not-augmentated mandible in a 10-year follow-up examination. In 60 of those implants, an irradiation prior or post implantation had been conducted. The CSR of all implants was 94%, the CSP of the implants inserted prior or post radiation was 97%. Reasons for implant loss were insufficient bony healing (n=8) and periimplantitis (n=5). The analysis according to success criteria showed cummulative values of 86% (Albrektsson) and 91% (Buser). The vertical bone loss added up to a mean value of 2.2mm/year. In regard to the "critical" patients (28% of the implants in the irradiated mandible), the implant system showed, with an in situ rate of 94% after 10 years of clinical use, satisfying results. A mean bone loss of 2.2mm after 10 years seems to be acceptable Keywords: Astra, TiOblast, implant, long-term results, edentulous mandible

The application of synchrotron radiation for non-destructive study of human enamel during in situ demineralisation was investigated. Enamel samples of freshly extracted caries free third molars were prepared. One sample (control) was directly examined using synchrotron micro computed tomography. The other samples were integrated into four removable intraoral mandibular appliances under gold-micromeshes. Each appliance was worn by a randomly chosen participant throughout day and night. The desired demineralisation was therefore generated in a natural way in the oral cavity by acid producing bacteria and consume of acid and carbohydrate containing food. The depth and grade of structural changes were quantified after either 21 or 29 days of exposition in the oral cavity. By using µCT-synchrotron radiation we were able to visualise and quantify initial and further progressed stages of demineralisation. The development of mineral loss was dependent on the exposing time of the samples in the oral cavity and the individual nutrition behaviour and salivary properties of the participants. Keywords: synchrotron radiation, enamel, demineralization, in situ

Objectives: The study aim was to determine the level of oral health state in persons with handicap, first of all in those with the diagnosis of mental retardation and epilepsy. Materials and Methods: Group of consecutive patients with handicap (N=225), who had been sent for dental care to the Clinic of Stomatology, Masaryk University in Brno, was examined by one experienced dentist and patients were treated later under general anaesthesia. The subjects for this study were selected according to diagnosis of a specialist. DMFT (WHO 1997 criteria) and RI (%) indices were used to evaluate the oral health state of the risk patients. Of this number, 104 persons had the diagnosis of mental retardation and epilepsy and these were divided into four subgroups. The first two groups included patients only with diagnosed mental retardation (N=35) or epilepsy (N=6), further then mental retardation and other diseases (N=33), epilepsy and other diseases (N=30), the last group was formed by combinations of more different diagnoses (N=121). The age of patients at risk ranged between 18.6 -61.3 years. The study was approved by the ethical committee of Masaryk University. Results: Patients with mental retardation had the following scores: DMFT was 16.66 and value of RI was 34.37. Patients with mental retardation and combinations of more different diagnoses had DMFT 17.48 and value of RI=32.36. DMFT score in patients with epilepsy was 21.33 and RI value was 50.95. Patients with epilepsy and combinations with other diseases had DMFT=19.03 and RI=38.18; similarly to group of more different diagnoses (DMFT=20.77 and RI=37.43). Conclusion: Our study demonstrated relatively high DMFT scores and RI values in patients with handicap (mental retardation, epilepsy). The results suggest the necessity to improve dental care in these patients. Keywords: oral health data, risk group, patient with handicap, DMFT, RI, mental retardation, epilepsy

Aims: In periodontitis susceptibility individuals, disease progression involves a predominantly Th2-like immune response. Since interleukin (IL)-4 stimulates a T helper (Th)2-type of immune response and promoter polymorphisms of the interleukin-4 gene have been associated with altered IL-4 expression we assume that IL-4 promoter polymorphisms could be indicative for periodontitis. Therefore, the aim of this study was to evaluate three polymorphisms at positions -1098T/G, -590C/T and -33C/T in 121 patients with sever generalized periodontitis (attachment loss >4mm in 80% of the teeth, chronic periodontitis: n=54, mean age=49.3 ±10.0 years; aggressive periodontitis: n=67, mean age=41 ±9.9 years) in comparison to periodontitis free controls (n=81, mean age=46.9 ±10.7 years). Methods: Interleukin-4 promoter polymorphisms were analyzed by PCR-SSP (CTS-Kit, Heidelberg). Distributions of single alleles, genotypes, and haplotypes were calculated by Chi2-Test with Yates correction or Fisher's exact test. Risk factor analyses were carried out by logistic regression under consideration of established cofactors for periodontitis such as age, gender, smoking status, and plaque index. Results: The mutant allele IL-4 -1098 G and the haplotype -1098, -590, -33 GCC increased the adjusted Odds ratio for both, chronic periodontitis (OR=4.1-5.3) and aggressive periodontitis (OR=3.8-5.0). Genotypes and haplotypes with the mutant allele T at the positions -590 and/or -33 were positive associated only with an aggressive periodontitis (OR=2.3-3). Conclusions: Genotypes and haplotypes with the mutant allele G at position -1098 were indicative for both, CP and AP. Polymorphisms (C>T) at positions -590 and -33 (high interleukin-4 producer genotypes) increased the Odds ratio for an AP. Therefore it would be interesting to assess a putative association of IL-4 gene polymorphisms to IL-4 production in a further study. Keywords: chronic periodontitis, aggressive periodontitis, interleukin-4, promoter polymorphisms

Background: Periodontitis is characterized as a chronic inflammatory disease. Periodontopathogens induce innate responses amongst others via CD14 and 4 resulting in activation of NF-κB. Functional important SNPs are described for these genes. The aim of this study was to evaluate links between SNP and the subgingival occurrence of periodontopathogens. Patients and Methods: 133 periodontitis patients (chronic periodontitis: n=60, mean age: 48.7+9.7y, aggressive periodontitis: n=73, mean age: 41+9.9y) and 80 healthy controls without periodontitis were included in the study. SNPs in CD14 (c.-159C>T), in TLR4 (Asp299Gly, Thr399Ile) were determined by RFLP. Subgingival bacterial colonization (A. actinomycetemcomitans, P. gingivalis, P. intermedia, T. forsythia, T. denticola) was analysed molecularbiologically using the micro-Ident®test. Results: Associations between genotype and the occurrence of periodontopathogens could be shown: P. intermedia occurred less frequently in individuals positive for the TT genotype of CD14-SNP c.-159C>T (OR=0.36, 95%CI: 0.14-0.91, p=0.045). In binary logistic regression analyses, the associations for TT-genoytpe (OR=0.31, CI: 0.12-0.81, p=0.017) could be proven considering age, gender, smoking, and clinical attachment loss as confounding factors. No genotype dependent association with subgingival occurrence of periodontopathogens could be proven for SNPs in TLR4. However, no significant association with chronic and or aggressive periodontitis and polymorphisms in CD14 and TLR4 could be proven. Conclusions: Although, the CD14 c.-159C>T polymorphism could be shown to be associated with subgingival colonization with P. intermedia there is no evidence that CD14 and TLR4 polymorphisms investigated are independent risk factors for chronic or aggressive periodontitis in German periodontitis patients. Keywords: Parodontitis, SNP, CD14, TLR4, Pardontopathogene

The aim of this study is to assess the prevalence of missing teeth and treatment needs in adult population (35-44 years old) in Iasi county. 928 persons were examined by 3 calibrated dentists according to the WHO criteria. Results: The mean value of prevalence in Iasi, 66.59% was higher in male compared to female (68.1% versus 64.9%), and people with low income had more missing teeth than persons with high financial level (76% versus 57%, p=0.001). Using logistic regression we found that family with low income and smokers had more risk for needing partial dentures. Keywords: dental prosthetic status, adult population, social inequality

Introduction: All-ceramic CAD/CAM crowns should improve esthetic and occlusion of patients of advanced age. The Aim of the study was to present successful rehabilitation of anterior teeth of the patient by all-ceramic CAD/CAM crowns. Material and Methods: Upper incisors 11, 12 and 21 of the patient (69 yrs. ) were prepared ( Jota Praparations set , Nr 1450, Switzerland ). A full-arch closed impression of abutments was made using light body silicone (Oranwash L, Zhermack ) in custom tray . A bite registration has been done in her mouth. Master cast was poured (Galigranit stone , Galenika). Optical impression In - Eos (Sirona Dental Systems) of each abutment in relation to the neighboring dentition was provided. Dental Database mode in PC was chosen to facilitate design. Each core-coping has been viewed on-screen from proximal locations, as well as apically . CAD / CAM technology allowed the 3-D crown design to help compensate for aesthetic and occlusion. In-Ceram alumina (VITA, Europe ) blocks were used for aesthetic properties. Veneering porcelain (VITA VM9) was added. The restorations were strained and glazed with Vita Akzent kit to add natural characterization in the Vita Vacumat oven. The dentin of prepared incisors was treated with 3 % hydrogen and the Interface porcelain adhesive system (Apex Dental Materials). Crowns were cemented using transparent Multilink -Sprint resin ( Ivoclar, Vivadent). Results: The marginal and external fit of the crowns was excellent at the baseline, in the1st year, the 2nd year as well as in the 3rd year recall. Conclusion: Accuracy, aesthetic and short-time fabrication of CAD/CAM generated all-ceramic crowns is satisfactory in dental prosthetic rehabilitation of patients of advanced age. Keywords: fixed restorations, crowns, ceramic

Objectives: Assessment of effort (number of visits) and costs of tooth preservation 10 years after initiation of anti-infective therapy. Methods: Data of 98 patients who had received active periodontal treatment 10 years ago by the same examiner were analyzed to gather information on effort and costs of supportive periodontal therapy (SPT). Clinical examination, interleukin-1 polymorphism test (IL-1), smoking, search of patients' files (i.e. initial diagnosis), as well as a questionnaire on medical history and socioeconomic data were performed. Statistical analysis was performed using multivariate linear regression analysis. Results: During 10 years of SPT patients had 14.8 ± 7.4 visits. Number of visits was statistically significantly higher for individuals with a mean PCR >= 24%. The number of subgingival scalings per tooth ranged from 0 to 14 (mean: 1.2 2.1). On tooth level several confounders could be identified: tooth type, initial bone loss, furcation involvement, abutment status, and previous regenerative surgery (p = 0.003). Costs for therapy per tooth during SPT ranged from 1.21€ to 266.26€ with a mean value of 60.73€ ± 42.05€. On tooth level the tooth type, initial bone loss, abutment status, furcation involvement, and previous regenerative surgery showed statistical significance (p = 0.002). Conclusion: Costs for tooth retention via SPT are relatively low compared to alternatives (i.e. implants or fixed bridgework) even in periodontally impaired teeth. Keywords: UPT, Kosten, Zahnerhalt

Our study aim was to analyze the oral health state data obtained from 13-15 year old children from the ELSPAC group (European Longitudinal Study of Pregnancy and Childhood) monitored in Brno city. Material and Methods: Randomly selected children from the ELSPAC group (n=780) were examined clinically for dental and periodontal status, dental plaque, dental calculus and orthodontic anomalies. The following clinical parameters were assessed: DMFT score and its components, gingival index (GI), plaque index (PI) and calculus index (CSI). Gingivitis was measured using the modified Löe-Silness GI index. The presence of plaque and calculus was recorded according Silness-Löe (PI) and calculus surface index (CSI), respectively, without any disclosing agents. GI, PI and CSI were recorded on selected teeth. Presence/absence of orthodontic anomalies and its severity was recorded. To evaluate of the significance of differences between groups, F test for quantitative and 2 test for qualitative parameters were used. The study was approved by the ethical committee of Masaryk University. Results: Mean DMFT of the group was 2.82 (SE 0.36), share of caries-free children 25.4%. Mean GI index of the cohort was 0.204 (SE 0.011), grade 0 was found in 36.9% children, grade 1 in 43.0%, and grade 2 in 19.5%. Statistical differences (p Keywords: Oral health data, DMFT, GI, PI, CSI, gingivitis, caries prevalence, Elspac

The esthetic and functional rehabilitation of the partially edentulous patient can be successfully realized using fixed and removable partial dentures retained and supported with precision attachments. The attachment often presents the problem of restricted vertical space above, so the appearance of the artificial tooth located upon it is the most difficult problem to solve for both the clinician and technician. Keywords: vertical space, artificial tooth, attachment, esthetics, function