Introduction: Self-report of awake or sleep bruxism (AB/SB) has been the subject of critical scrutiny, as it is yet unclear whether it corresponds to the neurophysiological bruxism activity. Contingent electrical stimulation (CES) has been proposed as a possible treatment that reduces bruxism episodes. The aim of this cohort study was to investigate whether bruxism self-report is influenced by CES. Methods: Forty healthy adults were allocated to the intervention (N = 20) or control group (N = 20). Each participant filled out the Oral Behavior Checklist (OBC) and an anamnestic questionnaire including questions on bruxism behavior, at the beginning and at the end of the study. The evaluation period was divided into three GrindCare intervals (1 inactive week -2 active CES weeks/ 2 inactive weeks -2 inactive weeks). The OBC score and the amount of positive and negative bruxism answers were compared with baseline using the Wilcoxon test and the McNemar (McN) test. Results: The OBC score/categories and the self-report of AB/SB did not significantly change (p > 0.05), indicating no effects of CES in the intervention group. Conclusions: Within the scope of this study, CES could not significantly improve the self-report of bruxism or bruxism-related symptoms. However, it is recommended that the study be repeated with the study design extending the CES intervention to a longer interval and with a larger sample size. Keywords: bruxism, electrical stimulation, self-report, diagnosis, questionnaires

Implantatgetragene Restaurationen können aus unterschiedlichen keramischen Werkstoffen gefertigt werden. Dabei sind jedoch einige Besonderheiten zu beachten, insbesondere bei Patienten, die mit den Zähnen knirschen und/oder pressen. Daher müssen sowohl bei der Materialauswahl als auch bei der Gestaltung der Restaurationen besondere Aspekte berücksichtigt werden, um Schädigungen des Zahnersatzes möglichst zu vermeiden. Einige dieser Aspekte werden im Beitrag näher beleuchtet. Keywords: Keramik, Bruxismus, Implantat

Purpose: This study compared different methods of bruxism diagnosis used in clinical practice. The purpose of this study was to investigate the agreement between two diagnostic tools for bruxism (questionnaires and portable EMG measuring device). Methods: Seventy-six (76) subjects without craniomandibular dysfunction (CMD) were examined for their bruxism behavior in a clinical study over an observation period of 5 weeks. Measurements of episodes per hour were performed in the home setting using the GrindCare (GC) portable EMG device. The period was divided into 3 intervals (1 week – 2 weeks – 3 weeks). A minimum of 5 h of recorded sleep was a prerequisite for all participants. In addition, sleep (SB) and awake bruxism (AB) self-reports were collected at baseline and the end of the study using questionnaires, including the Oral Behavior Checklist (OBC). Results: There is a significant correlation between increased jaw activity (diagnosed by OBC) and SB/AB self-reports, as well as between SB and AB self-reports, but not between questionnaires and instrumental (GC) diagnostics. Conclusion: Questionnaires cannot replace EMG measurements in bruxism diagnostics. Dentists should always use a combination of self-reports in the form of validated questionnaires and instrumental diagnostics to detect bruxism. Keywords: teeth grinding, diagnostics, sleep bruxism, awake bruxism, electromyography

The present case report describes a rare case of a lateral and anterior open bite caused by a right trigeminal nerve paresis due to compression of the trigeminal ganglion by a meningioma. Based on the initial diagnosis of TMD, the patient was treated conservatively (also with occlusal splints) for over a year without success, although sensory deficits in the face and tongue, wave-like pain, and a continuous increase in pain symptoms were observed simultaneously. This case report emphasizes the importance of carefully taking the medical history in cases of unclear orofacial pain, supplemented by a clinical examination in which all symptoms and signs can be systematically identified and assigned to a diagnosis. Keywords: lateral open bite, meningioma, malocclusion, numbness, chewing difficulties

In den letzten Jahrzehnten hat sich der Fokus in der Funktionsdiagnostik und -therapie stark gewandelt. Standen früher oftmals rein zahnärztliche Maßnahmen im Mittelpunkt der Therapieversuche, vorzugsweise Veränderungen der Okklusion, so haben sich auf der Grundlage wissenschaftlicher Erkenntnisse multimodale Behandlungskonzepte als erfolgreicher erwiesen. Es ist hierbei eine Herausforderung für Behandler und Patienten, diese erweiterten Therapieoptionen zielführend zu nutzen. Je nach Beschwerdebild und -intensität sowie Erkrankungsdauer stehen unterschiedliche Optionen zur Verfügung. Oft unterschätzt wird die Bedeutung der Informationstherapie, die jeder anderen Behandlung vorausgehen sollte. Auch ist stets zu überlegen, welche Maßnahmen eine Schienenbehand-lung ergänzen oder ersetzen können. Der nachfolgende Artikel fokussiert auf ausgewählte Behandlungsmaßnahmen. Psychologische Verfahren sind in Abhängigkeit von der Indikation ggf. ergänzend einzusetzen. Manuskripteingang: 25.02.2022, Manuskriptannahme: 03.03.2022 Keywords: Kraniomandibuläre Dysfunktion (CMD), physikalische Maßnahmen, multimodale Therapie, indikationsspezifische Schienentherapie

Purpose: To investigate the effect of missing teeth on patients’ oral health–related quality of life (OHRQoL). Materials and Methods: A total of 151 patients participated in this prospective bicenter clinical study (mean age: 64.7 ± 10.5 years; 71 women). Four subgroups were defined based on the number of missing teeth. OHRQoL was assessed using the German version of the Oral Health Impact Profile-49/53 (OHIP-G49/53) and visual analog scale (VAS) questionnaires. The effect of missing teeth on OHIP (total and dimension scores) and VAS scores before and after prosthetic treatment was investigated at baseline (T0), 1 week (T1), and 3 months (T2) after prosthetic treatment. Scores were analyzed using Kolmogorov-Smirnov, Kruskal-Wallis, and Mann- Whitney U tests. Correlations were assessed using Spearman ρ correlation. The level of significance was set at P = .05. Results: Initial OHIP and VAS scores were highest for patients with 11 to 28 missing teeth. Scores improved among all groups between T0 and T1/T2. After prosthetic rehabilitation (T1), improvements in total OHIP scores were greatest for patients with no missing teeth or with 11 to 28 missing teeth. Patients with no missing teeth or with 1 to 4 missing teeth before treatment had the lowest posttreatment OHIP scores. Total OHIP scores among the groups were in the same value range (P > .185). No direct correlation was found between the VAS and total OHIP scores. Conclusion: OHIP and VAS scores for OHRQoL were associated with the number of missing teeth. Prosthetic treatment resulted in improved OHRQoL and oral function among all groups. The use of a VAS yielded additional detailed information.

Vollkeramischer Zahnersatz ist heute aus der modernen Zahnheilkunde nicht mehr wegzudenken. Auch implantatgetragene Restaurationen können aus unterschiedlichen keramischen Werkstoffen gefertigt werden. Dabei sind jedoch einige Besonderheiten dieser Art der Versorgung zu beachten, insbesondere bei Patienten, die mit den Zähnen knirschen und/oder pressen. So kann es aufgrund der starren/steifen Verankerung der Implantate im Knochen zu biomechanisch besonders herausfordernden Krafteinwirkungen auf die Suprakonstruktion kommen. Daher müssen sowohl bei der Materialauswahl als auch bei der Gestaltung der Restaurationen besondere Aspekte berücksichtigt werden, um Schädigungen des Zahnersatzes möglichst zu vermeiden. Einige dieser Aspekte sollen im vorliegenden Beitrag näher beleuchtet werden. Zusätzlich zeigt der Beitrag auch einige grundlegende Aspekte zur Diagnose von Bruxismus auf. Manuskripteingang: 12.10.2022, Annahme: 20.10.2022 Keywords: Bruxismus, Keramikrestaurationen, Dentalimplantate

Purpose: To assess the influence of substructure (enamel vs dentin) and thickness on the fracture strength of ceramic discs made from lithium disilicate (LDS) vs zirconia (Zi). Materials and Methods: A total of 128 intact maxillary third molars were collected, and standardized enamel and dentin discs were fabricated. LDS (n = 64) and Zi (n = 64) discs with 0.5-mm (n = 32 each) and 1-mm (n = 32 each) thicknesses were produced, and each group was divided into two subgroups (n = 16 each), which were luted to the enamel/dentin discs. Half of the specimens in each subgroup were aged via chewing simulation and thermocycling, and all specimens were loaded until fracture in a universal testing machine. Differences between LDS and Zi with respect to enamel vs dentin as substructure and ceramic thickness were analyzed by use of nonparametric testing (Mann-Whitney U test). Results: In unaged specimens, fracture loads were not significantly (P > .05) different between Zi and LDS specimens for the 1- and 0.5-mm thicknesses. However, fracture loads were significantly higher (P < .001) in specimens supported by enamel independent of the ceramic material. In aged specimens, the fracture loads were significantly (P < .01) higher when supported by enamel; however, in the 0.5-mm groups, Zi achieved significantly higher breaking loads than LDS when luted to dentin. Conclusion: When 0.5-mm ceramic discs were luted to dentin, Zi outperformed LDS with respect to fracture loads.

Aim: With the development of new materials, 3D printing has had an immense impact on dentistry. The latest innovations are the direct manufacturing of temporary and permanent crown and bridge restorations, inlays, onlays, and veneers. In the present case report, 3D-printing technology was used to control and adjust the occlusal rehabilitation with 3D-printed crowns. Materials and methods: A 44-year-old male patient with pathologic dental attrition visited the Department of Restorative Dentistry at the University of Würzburg (Würzburg, Germany). The attrition process was far advanced, and no conventional conservative therapy was indicated. For the rehabilitation of the tooth substance loss, dental height, and appearance, a permanent solution with dental crowns was elected. After the preparation, the restorations were constructed digitally. For the control of the occlusal height, appearance, and color, the restorations were fabricated with a 3D printer and temporarily cemented. The crowns showed a high precision, and only minimal occlusal corrections were needed. After a trial period of 2 weeks and another fine occlusal adjustment, the temporary crowns were removed and scanned. The data were matched to the original construction file, which could be used to optimize the final rehabilitation. The final restorations were made of monolithic zirconia, with only minimal occlusal corrections required. Conclusion: At the present time, dentistry is experiencing a great shift toward new and interesting production solutions with 3D-printing technologies. Such technologies give dentists the ability to create more predictable and cost-effective treatments. 3D printing is already being used to create temporary and definitive dental crowns as well as complex treatments, as is shown in the present case report. (Int J Comput Dent 2022;25(3):325–332; doi: 10.3290/j.ijcd.b3380909) Keywords: digital dentistry, 3D printing, stereolithography, additive manufacturing, rapid prototyping, CAD/CAM, temporary crowns, ceramic restorations, dental prosthetics

Purpose: To assess the impact of different types of dental prostheses, including definitive and interim restorations, on oral health-related quality of life (OHRQoL) before and after prosthetic treatment. Materials and methods: A total of 151 patients received prosthetic treatment at one of two German departments of prosthetic dentistry. The patients' OHRQoL was assessed using the German version of the Oral Health Impact Profile (OHIP-G53) at baseline (T0) and at 1 week (T1) and 3 months (T2) after treatment. Patients were divided into 10 subgroups according to their pre- and posttreatment status. The effect of the type (no prosthesis; fixed prosthesis; removable prosthesis) and duration of wear (definitive; interim) of the restorations was evaluated. Results were analyzed using Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests with a significance level of P = .05. Results: The highest OHRQoL was recorded for patients with fixed restorations, as indicated by the fact that their OHIP scores were lowest. A significant improvement in OHRQoL (P ≤ .034) was observed for patients who needed prostheses and were then treated with removable or fixed restorations. The OHIP score was affected by a change in restoration type. Rehabilitation with definitive prostheses had a significant effect on posttreatment OHRQoL (P ≤ .006). Conclusion: In general, prosthetic rehabilitation by use of fixed or removable prostheses resulted in an improvement in OHRQoL. The use of the same type of restoration before and after treatment had a positive effect on OHRQoL. If possible, a change of restoration type should be avoided. For patients who require permanent prostheses, the use of fixed and removable restorations is recommended. For oral rehabilitation, fixed restorations should be preferred in order to achieve best possible improvement of OHIP score.