International Poster Journal of Dentistry and Oral Medicine, 01/2018

Einleitung: Weltweit sind 6000-8000 Seltene Erkrankungen (SE) bekannt. Rund 15% aller bekannten SE können sich dabei im Zahn-, Mund- Kiefer- und Gesichtsbereich manifestieren. Etwa ein Drittel davon treten mit Lippen-Kiefer-Gaumenspalten auf. Innerhalb der Medizin und Zahnmedizin gibt es meist wenig Kenntnis zur klinischen Manifestation, Diagnostik und Therapie von SE. Informationsquellen sind dabei nur schwer zugänglich oder nicht bekannt. Ziel dieser Arbeitsgruppe ist daher die Etablierung einer open-access Datenbank für SE mit orofazialen/kraniofazialen Manifestationen, welche neben Kieferchirurgen und Zahnärzten auch Betroffenen und Angehörigen als Informationsquelle zur Verfügung steht. Material und Methode: 2011 wurde damit begonnen, Datenbanken wie die Orphanet, OMIM und Pubmed zur Erfassung seltener Erkrankungen zu sichten und auszuwerten. Seit 2013 werden die gewonnenen Informationen in die webbasierte, frei zugängliche Datenbank (ROMSE) eingearbeitet, mit aktueller fachgebietsbezogener Literatur hinterlegt und die Erkrankungen entsprechenden Kategorien zugeteilt. Die Datenbank ist unter http://romse.org frei zugänglich. Ergebnisse: Bisher konnten 478 SE mit orofazialen/kraniofazialen Manifestationen in ROMSE hinterlegt werden. Darunter befinden sich auch 145 Erkrankungen mit Lippen-Kiefer-Gaumenspalten. An 2 Einrichtungen wird inzwischen eine spezialisierte Sprechstunde für SE mit oraler Beteiligung als erste Anlaufstelle für die Betroffenen angeboten. Schlussfolgerungen: SE und ihre Symptome stellen Medizin, Kieferchirurgie und Zahnmedizin vor hohe Anforderungen in Diagnostik und Therapie. Eine Datenbank zur Erfassung von SE mit Veränderungen im Mund-Kiefer- und Gesichtsbereich kann einen Beitrag zur Diagnostik und zu den Therapieoptionen in der Zahn-Mund- und Kieferheilkunde leisten. Spezialisierte Sprechstunden und Expertenzentren sollten flächendeckend angeboten werden. Schlagwörter: Seltene Erkrankungen, Datenbank, orofaciale Manifestation

Objectives: Stock Abutments are a common therapeutic method in implant dentistry. The geometric form is round like the implant. Teeth have a natural geometry which is individual for every patient. Apart from the purely functional side of the implant restorations, aesthetic aspects are very important for the patient. The design of the emergence plays an important role. Prefabricated abutments have a rotationally symmetrical basic shape and do not correspond to the passage area of the shape of natural teeth. Atlantis® Abutments (Astra Tech GmbH, Elz) are individual abutments, CAD-designed and CAM- fabricated. The VAD® (Virtual-Abutment-Design) reduces the nature tooth geometry to an individual abutment. This leads to an emergence profile that supports the gingiva like the lost tooth. It is possible to produce the abutments in zirconia, titanium and in titanium-gold hue. Methods: In this retrospective study, from July 2008 to November 2012 a total of 225 Atlantis abutments (titanium, zirconia, gold hue) were incorporated in 109 patients and followed up using a standardised findings arc. Clinical and radiographic parameters were evaluated one year after inclusion and compared to the baseline conditions. After the first year, clinical examinations were made once a year and radiographic every two years. Results: 70 patients with a total of 124 abutments were followed in the observation period. The mean observation time was 21 months (SD ± 9.7). During the observation period, there were only 2 ceramic fractures with exposure of the framework (Fig. 2). All abutments were in situ; only one abutment loosening (during the second year) occurred, which could be fastened again (Fig. 3). The radiograph showed stable peri-implant bone conditions in comparison to the initial situation. The design of the abutments allowed for optimal adaptation of the peri-implant soft tissue. Conclusion: The production of individual abutments using prefabricated pieces is often difficult and costly. With the Atlantis method, abutments are designed starting from the ideal shape of the individual crown. This saves time and therefore costs. The data presented reveal that Atlantis is a viable method to treat patients. Furthermore, functionally and natural aesthetic results can be achieved. The application of this method can be recommended. Schlagwörter: CAD/CAM Abutments, Emergence profile, Individual Abutments

There is a constant evolution of newer file systems with different motion kinematics to refine the field of endodontics. This has not only revolutionised the way clinicians shape the root canal system, but also confuses the clinician as to which system to choose. Hence, this poster aims at comparing different contemporary motion kinematics like rotary, reciprocation motion, and the vertical vibration of a self-adjusting file, their efficiency on various clinically-relevant parameters like fatigue life, post-operative pain, and shaping ability and provide a practical guide in choosing the appropriate system that best suits the clinical situation. Schlagwörter: rotary, reciprocation, self-adjusting file, post operative pain, shaping ability, cyclic fatigue

The healing process is a dynamic procedure, characterised by a sequence of phases and accompanied by some classical symptoms of inflammation such as redness, swelling, pain, and loss of function. Chitosan is soluble in an acidic environment and exhibits excellent tissue affinity, and consequently it could be used in hydrogel forms. The aim of the study was to evaluate and compare the effect of chitosan hydrogel and concentrated growth factor on alveolar bone healing after third molar extractions. This experimental pilot study is a split-mouth design carried out among 16 patients with bilaterally impacted mandibular third molars indicated for surgical extraction. The subjects were randomly assigned to 2 groups. Group 1: Chitosan hydrogel mixed with concentrated growth factor. Group 2: Platelet-rich fibrin. After extracting the tooth, the socket was filled with chitosan on the right side, and on the left side PRF was placed. The clinical outcome variables were pain, swelling, maximum mouth opening, and pocket depth, which were measured using a 10-point visual analog scale, suture thread, Vernier caliper, and William's periodontal probe, respectively. Periapical radiographs were obtained at 7 days, and 4 and 6 months postoperatively. Pain, swelling, and trismus were less in the chitosan mixed with CGF group when compared to PRF. Some classic signs of inflammation were observed in a short period of time where the chitosan acted. In these cases, a decrease in pain and an absence of bleeding were observed. Both groups showed a significant reduction in pocket depth over the 6-month period. The evaluation of bone density at the extraction site by radiological assessment showed higher grey level values on the 7th day, and 4th and 6th months in the chitosan group when compared to PRF. Within the limits of this study, there was significant improvement in pain, swelling, and trismus in the chitosan group. PD was observed to be the same on the third molar sites. The bone regenerative property of chitosan was significantly better than PRF. Schlagwörter: chitosan, alveolar bone healing, growth factor

Objective: The purpose of this study was to describe and analyse cephalometric floating norms to describe the individual skeletal pattern of Chinese people by constructing a harmony box. This harmony box based on cephalometric floating norms may used as a diagnostic tool in orthodontics. By using Chinese cephalometric data, the harmonious relationship between five cephalometric variables can give a prognosis in treatment planning for these population. Material and Methods: 139 cephalometric x-rays from Chinese people undergoing orthodontic treatment at the University of British Columbia, Canada, were landmarked. They were separated into 58 females under 18 years, 18 females over 18, 14 males over 18, and 49 males under 18. Each picture was analysed with 40 landmarks, in which 5 angular measurements (SNA, SNB, N-S-Ba, NL-NSL, ML-NSL) were digitised. By using linear regression analysis, a harmony-box-like form was constructed. Results: The five variables correlated significantly with each other. A harmony box was constructed by using the linear regression analysis. This harmony scheme was divided into three zones. To be reliant on the facial type, it was separated into prognatic, orthopgnatic, and retrognatic. As shown in the constructed harmony box, most of the analysed samples were more prognatic. Conclusion: The craniofacial pattern with the five correlating variables based on a sample of Chinese cephalometrics were inserted into a harmony-box-like form. Schlagwörter: cephalometric, Chinese population, harmony box, floating norms

Einleitung: Der Patient stellte sich erstmalig am 20.06.2013 in der Zahnklinik der Universitätsmedizin Greifswald mit dem Wunsch der Schaltlückenversorgung regio 11 vor. Der Zahn wurde vor 12 Jahren aufgrund eines Unfalls totalluxiert und mit einem Interimsersatz versorgt. Eine Replantation war dennoch nicht möglich. Die Zähne 12 und 21 waren vital und perkussionsnegativ. Problematisch waren das geringe Knochenangebot und die Lückeneinengung regio 11. Parodontologisch gab es keine Auffälligkeiten. Anamnestisch gab der Patient Asthma, Allergien gegen Tierfelle und Gräser sowie das Rauchen von einem Packyear an. Therapie: Zur Versorgung der Schaltlücke wurden dem Patienten mehrere Therapieoptionen zur Auswahl gestellt. 1.Knochenaugmentation regio 11, kieferorthopädische Lückenöffnung, anschließende Implantation und prothetische Versorgung 2.Adhäsivbrücke (Marylandbrücke) von 12 nach 21 3.Brücke von 12 nach 21 Aufgrund der karies- und füllungsfreien Nachbarzähne wurde sich gegen eine Brückenversorgung entschieden. Auch die Lückeneinengung hätte zu keinem befriedigenden ästhetischen Ergebnis geführt. Am 14.10.2013 erfolgte die operative Augmentation eines ca. 1 x 0,75 cm Kortikospongiosa-Sporns aus dem retromolaren Bereich. Die Blockentnahme wurde mit der operativen Entfernung des Zahnes 48 kombiniert. Der Block wurde dann durch Osteosynthese (Ustomed-Schraube (D:1,2mm, L:11mm)) fixiert, mit Bio-Oss versorgt und mit einer Bioguide-Membran abgedeckt. Nach der Einheilung und regelrechten Wundverhältnissen erfolgte am 28.11.2013 die kieferorthopädische Versorgung. Dazu wurden im Oberkiefer von 16 nach 26 Brackets geklebt und mittels einer Druckfeder die Lücke regio 11 geöffnet. Zur temporären Lückenversorgung wurde in die Multibracketapparatur ein provisorischer Zahn eingegliedert. Insbesondere diese Interimsversorgung im ästhetisch ansprechenden Bereich war für den Patienten von großer Bedeutung und ist im Verlauf einer Multibrackettherapie und auch während der Einheilphase von Implantaten oft schwierig zu realisieren. Nach dem die Lücke regio 11 ausreichend geöffnet wurde, fand am 19.05.2014 die Implantation mit einem Ankylos Implantat statt. Während der Einheilphase wurde die Lücke mit passiven Druckfedern kieferorthopädisch offen gehalten und das Provisorium von basal reduziert. Die implantatprothetische Versorgung begann am 13.10.2014 mit der Freilegung des Implantates und der Einbringung des Sulkusformers (Größe 3,0). Am 18.12.2014 wurde das Implantat mit einer VMK-Krone versorgt. Die übrig gebliebenen Restlücken wurden anschließend wieder kieferorthopädisch verschlossen, so dass am 06.01.2015 auch die Multibracketapparatur entfernt werden konnte. Das Ergebnis wurde anschließend mit einer Miniplastschiene retiniert. Am 17.02.2015 erfolgte zusätzlich eine konservierende Versorgung des Frontzahnes 21 und eine Neuanfertigung der Miniplastschiene. Der Patient befindet sich seit dem in halbjährlichen Recalls und ist nach eigenem Empfinden äußerst zufrieden mit seiner Versorgung. Die operative Entfernung der 8er ist noch geplant. Schlussfolgerung/Ergebnis: Nachdem der Patient 12 Jahre lang unzufrieden mit seiner Interimsversorgung therapiert wurde, konnte innerhalb von 1,5 Jahren eine ästhetisch ansprechende und parodontal gut zu reinigende festsitzende Lückenversorgung erfolgen. Sowohl das Implantat als auch das Augmentat heilten dabei regelrecht ein. Durch die begleitende kieferorthopädische Therapie konnte zudem eine Lückenöffnung erfolgen und eine ästhetisch ansprechende Interimsversorgung während der Einheilphase des Implantetes gewährleistet werden. Somit wurde für das Implantat ausreichend Platz geschaffen und zusätzlich für die anschließende prothetische Versorgung die Grundlage einer ausreichend breiten Krone erzeugt. Durch die Zusammenarbeit verschiedener zahnmedizinischer Fachdisziplinen der Zahnheilkunde kann unter Berücksichtigung der Einheilzeiten und der Reaktionslage des Körpers innerhalb einer bestimmten Zeit eine für den Patienten und die Behandler zufriedenstellende Versorgung eines länger als eine Dekade zurückliegenden Frontzahntraumas erfolgen. Diskussion: Durch seine tiefe Lachlinie empfindet der Patient das Ergebnis als ästhetisch sehr gut. Aufgrund der Gingivaatrophie jedoch und der dadurch sichtbaren Metallränder ist dennoch der Zahnersatz bei genauem Hinsehen erkennbar. Hätte zusätzlich zum Oberkiefer auch eine kieferorthopädische Therapie des Unterkiefers stattgefunden hätten beide Zahnbögen zu einander ausgeformt werden können. Somit hätten sowohl die Engstände im Unterkiefer als auch die Bisslage korrigiert werden können. Die Form der definitiven prothetischen Versorgung hätte individueller angepasst sein können. Schlagwörter: Implantat, Knochenaugmentation, Kieferorthopädie, Prothetik

Introduction: The purpose of this study was to evaluate the outcome of a small exam in terms of the effectiveness of PINGO (Peer Instruction for very large Groups) for topics in a special lecture. A cohort of dental students within an orthodontic course at the University of Greifswald was tested after every lecture with 10 questions presented with PINGO to the lectured topic. Material/Methods: Eleven lectures were read by orthodontic clinicians. At the end of every speech, 51 dental students reviewed their knowledge about that topic by using their smartphone or tablet to cast their votes. At the end of every vote, all possible answers were discussed with the audience by showing the results. The students had a chance to ask questions and resolve problems. Subsequently, every student filled out a questionnaire with appropriate or incorrect statements to evaluate the educational effect of PINGO. Results: All 51 students participated in PINGO. Most of them enjoyed this new type of interactive learning. Nearly everyone had a chance to deepen their orthodontic knowledge with this online survey. They learned more and felt better prepared for the final exam. More than two thirds of all students would recommend PINGO for other lectures. Discussion: Just a small part of students listening to lectures understand the central concepts of the topic. If they participate actively with the lecture, complex topics are easier to understand. To motivate students to actively participate during a lecture, CRSs are one possibility. 51 students listened to every lecture, but not everyone was in possession of a smartphone or tablet. Although the others worked together, in most of them PINGO had a positive outcome. Conclusion: PINGO as part of CRS is an effective tool for the integration of students during a lecture and to present them a conclusion about the most important information during a dissertation. PINGO seems to be an important step to motivate students listening to lectures. Schlagwörter: PINGO, CRS, digital lecture, education

Objectives: The objective of this study is to measure the prevalence of anterior loop presence, the average length of the loop on the right and left sides, and to evaluate age-, sex-, and ethnicity-related variations in prevalence and the length of the anterior loop in the study population. Methods: Using the DICOM database from the Oral Health Centre at the International Medical University, the inferior alveolar nerve was manually traced along with the anterior loop and part of the incisive nerve using the software. The vertical length of the nerve was estimated from the canal to the opening of the mental foramen from the cross-sectional view and translated to the OPG view. A measurement was made from this point to the most anterior point of the anterior loop following the trajectory of the nerve. Measurements were repeated for the opposite side. Results: A total 100 CBCT DICOM files were selected for study. The anterior loop was present in 94% of the subjects. The length of the anterior loop ranged between 0.73mm to 7.99mm, with the mean length being 3.90±1.41mm on the left side and 4.06±1.53mm on the right. Among all the subjects, there were no statistically significant differences between the left and right sides of the mandible (P=0.689), and no statistically significant differences was found between gender (P=0.108). When comparing the left anterior loop length between males and females, there were significant differences seen (P=0.041). Between 3 ethnic groups, there were no statistically significance differences seen. Conclusion: The mean anterior loop length was found to be 3.90±1.41mm on the left side and 4.06±1.53mm on the right, with a range of 0.73mm to 7.99mm. Due to its inconsistency and high variability, a CT scan is recommended for visualisation of the anterior loop before placing implants close to the mental foramen region. Schlagwörter: anterior loop, CBCT, dental implants, inferior alveolar nerve

The location of the inferior alveolar nerve is generally constant in a fully-grown mandible. If we know its average distance from the lower border of the mandible, available bone length from the crest of the edentulous ridge can be estimated by physical measurement of the whole length of the mandible in that area. Purpose: This study aimed to measure the superior-inferior distance of the inferior alveolar nerve (SIDIAN) from the base of the mandible in posterior regions on the right and left sides based on cone beam computed tomography (CBCT) scans and to evaluate gender- and ethnicity-related variations in the Malaysian population. Material and methods: A total of 100 CBCT Digital Imaging and Communications in Medicine (DICOM) files of patients of three ethnic populations (namely Malay, Chinese and Indian) between the age of 18-80 years were selected for the study. The files were imported onto the iCAT software. The SIDIAN measurements to the lower border of the mandible in molar regions were done on both sides. The data were analysed with 't' test, one-way analysis of variance (ANOVA) test, and correlation coefficient test using the software SPSS. Results: Statistically significant positive correlations were identified between the SIDIAN from the lower border of the mandible in the first and second molar regions within same side as well as between both sides of the mandible (r≈.8). There were no statistically significant differences between genders. However, there were statistically significant differences in both molar regions and on both sides in all three ethnic groups (P.05). In general, the SIDIAN from the lower border of the mandible was greatest amongst Chinese and smallest amongst Indians. Conclusions: The strong positive correlations on both sides of the mandible indicate the presence of symmetry. Only ethnicity-related variations were identified. Additional variables may aid in the development of a robust algorithm that can be used to determine the safe zone for implant osteotomy in the posterior mandible. Schlagwörter: Keywords. Dental Implants; Implant osteotomy; Inferior alveolar nerve; Mandibular landmarks; Nerve injury

Background: The World Health Organization's Framework Convention on Tobacco Control (FCTC) directs countries around the world to adopt pictorial health warning labels (HWLs) on cigarette packages to warn consumers about smoking-related risks. India has also implemented HWLs, and a third revision has been done with 85% coverage of cigarette packets. However, the effectiveness of HWLs in the control and prevention of smoking habits is still unclear. Objective of this systematic review: to collect evidence and evaluate role of pictorial HWLs on cigarette packs in changing smoking behaviour. Methods: A systematic and comprehensive literature survey was carried out in electronic data bases like Pubmed, Google scholar, IndMed, and Index Copernicus with MeSH terms "tobacco products" and "health" and keywords like "cigarette", "warning", "labels", and "plain packaging" for articles published until April 2017. Data collection and analysis: 850 articles were extracted, among which 113 relevant articles were shortlisted after going through titles based on the inclusion-exclusion criteria. After screening their abstracts, 31 articles were selected for this review. Results: We identified 31 studies conducted in 13 different countries, with a maximum of 7 studies from Australia. In 4 studies, international comparisons were made on the effectiveness of implemented HWLs. The outcome variables reported in this review are cognitive changes in intention to quit or avoiding, forgoing cigarettes and cessation of habit. An interaction between participants' age, educational level, and socioeconomic status with quitting rates is investigated in few studies. 22 studies identified that pictorial HWLs increase the likelihood of quitting smoking, while 2 studies did not show any significant association. Studies on plain packaging reveal its high impact in smoking cessation. Conclusion: There is fair evidence from heterogeneous studies that pictorial health warning labels are effective in changing smoking behaviour. Plain packages may be even more effective, and efforts are necessary for universal implementation. Schlagwörter: cigarette, warning, labels plain packaging