DZZ International, 01/2020

Question? Can we easily just raise the vertical dimension of occlusion? Background For esthetic and functional reasons, patients with visible attrition of their teeth often have the wish to compensate the loss of their tooth hard tissue (Fig. 1). Many dentists try to accommodate these concerns. In this regard, they reconstruct the original tooth shape by means of prosthetic measures such as by crowning the teeth or by applying veneers or table-tops. In doing this, the majority of dentists assume, that by restoring the original tooth shape and size, that they automatically reconstruct the original vertical dimension of occlusion. They simply equate the loss of tooth structure with a loss of bite height.

Introduction: The use of nitrous oxide for minimal sedation in dentistry is only recently advocated by European and German associations, but its use in dental practice routine is hardly examined. Thus, the aim of this study is to evaluate the circumstances of nitrous oxide sedation in German dental practices. Results: In general, German dentists exhibit a neutral (57 %) or positive attitude (29 %) towards minimal sedation with nitrous oxide (response rate 14 %). Due to the recent purchase of the devices, the years of experience of users were mostly low (only 16 % > 3 years, response rate 30 %) with varying levels of formal training. Still, the equipment, techniques and outcomes were in line with established recommendations. Mainly adults (62 %) with anxiety (87 %) were treated with surgical procedures (59 %) with a very high success rate and few minor side effects such as euphoria (5 %), sweating, nausea or vomiting (3 % each). Conclusion: The responding dentists and patients were highly satisfied and saw nitrous oxide as an easy and predictable way to achieve minimal sedation during dental treatment, sometimes preventing a referral to general anesthesia. Thus, there is a potential that nitrous oxide could be as widely used in Germany as it is in other countries. Keywords: dentistry, nitrous oxide, paediatric dentistry, sedation

The shift from reparative to regenerative dentistry reflects the current trend in medicine and also mirrors the new understanding of caries as a chronic disease. Selfassembling peptide P11-4 showed promising results in the regenerative biomimetic remineralization of initial carious lesions. This approach may present safe and acceptable preventive and minimal invasive treatment for initial caries in children and adolescents. Further studies it is suggested to investigate this novel approach in treatment of molar incisor hypomineralization and cavitated carious lesions. Keywords: P11-4, biomimetic remineralization, caries prevention, enamel, minimal invasive treatment, pediatric dentistry, self-assembling peptide