Purpose: This cross-sectional longitudinal observational study aimed to clarify the question of whether painful temporomandibular disorders (TMD) in psychiatrically confirmed patients hospitalised for post-traumatic stress disorder (PTSD) therapy after using splint therapy (ST) show long-term therapeutic effects in the case of functional disorders. Materials and Methods: One hundred fifty-three (153) inpatients (123 male and 20 female soldiers, age 35.8 ± 9.2 years, 26.6 ± 2.2 teeth) with confirmed PTSD (Impact of Event Scale – Revised ≥33), grade 3 to 4 chronic pain according to von Korff’s Chronic Pain Scale and the research diagnostic criteria of painful TMD (RDC-TMD) were recorded. All participants received a maxillary occlusal splint that was worn at night. Control check-ups of the therapeutic effect of the splint were conducted for up to 9 years during psychiatric follow-ups. Results: TMD pain worsened in 22 (14.4%) patients within the first 6 weeks and led to the removal of the splint. The pain intensity (PI) at BL was reported to be a mean of VAS 7.7 ± 1.1. Six weeks after ST (n = 131), the average PI was recorded as VAS 2.6 ± 1.3. Based on the last examination date of all subjects, the average PI was recorded as 0.7 ± 0.9. Seventy-two (72) patients used a second stabilisation splint in the maxilla after 14.4 ± 15.7 months, and 38 patients used between 3 and 8 splints during their psychiatric and dental treatment time (33.7 ± 29.8 months). Conclusion: The presented data shows that therapeutic pain reduction remained valid in the long term despite continued PTSD. The lifespan of a splint seems to be dependent on individual factors. Long-term splint therapy appears to be accepted by the majority of patients with PTSD and painful TMD. Keywords: bruxism, PTSD, splint therapy, TMD

Background: Especially in the anterior region, late implantation can lead to unsatisfactory aesthetic soft tissue results. This case report is intended to demonstrate a possibility to achieve aesthetic soft tissue contours and emergence profiles even in late implantations. Case report: In February 2022, a then 27-year-old courier cyclist presented to the Interdisciplinary Ambulance Centre of the Department of Oral and Maxillofacial Surgery Münster after a fall. Teeth 11 and 21 were avulsed (non-recoverable); tooth 22 had a complicated crown-root fracture and was also not worth preserving. For insurance reasons, the implantation could not take place until 5 months after the accident. In the meantime, the patient was treated with a deep-drawn splint designed for maximum papilla preservation. Three Straumann implants BL 3.3 mm (10/12/12 mm) were placed in region 11, 21, and 22. After another three months, the implants were uncovered and the emergence profiles were designed with PMMA crowns. Over a period of three months, the PMMA crowns were successively adjusted in the subgingival area to ensure the most aesthetic soft tissue contouring possible. For the definitive restoration, individualised zirconium abutments on a titanium adhesive base were fabricated and restored with fully veneered zirconium crowns. Due to the long shaping phase with PMMA crowns, highly aesthetic results could be achieved even though implant placement took place only 5 months after the accident. Discussion: Several studies have already addressed the shaping of implant crowns (including temporaries) and the transfer of the emergence profile to the definitive model in order to achieve aesthetic results. The case presented takes up several of these approaches to achieve aesthetic results here with delayed implant placement and restoration. Keywords: dental implants, missing teeth, soft tissue, prosthodontics, ceramic crowns

Although bruxism, also known as teeth clenching or grinding, is no longer considered a disorder or disease entity per se, the excessive masticatory muscle activity and increased and prolonged tooth contact associated with it can lead to serious orofacial health problems. In addition, bruxism activity can indicate general illnesses such as obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD). In dentistry in the past, localized damage to teeth and dental restorations, abnormal tooth wear, and/or painful temporomandibular disorders (TMD) have been the main reasons for retrospectively looking for evidence of bruxism in the patient’s history and dental examinations. According to the recommendations of the current version of the “S3 Guideline: Diagnosis and Treatment of Bruxism”, published by the German Society of Dentistry and Oral Medicine (DGZMK), the signs and symptoms of current bruxism should be recorded prospectively, e.g., during the initial dental examination or before restorative treatment, to allow appropriate preventive or curative treatment planning and the identification of possible comorbidities. Here, we describe a screening instrument for awake and sleep bruxism that was developed by a working group commissioned by the board of the German Society for Craniomandibular Function and Disorders (DGFDT) based on current recommendations in the literature. Keywords: bruxism, diagnosis, screening, TMDs

Background: Amelogenesis imperfecta (AI) is a group of genomic developmental disorders that can affect the structure and clinical appearance of the enamel of all or almost all teeth. They can affect both the primary and permanent dentition. Not only are patients aesthetically compromised by the altered enamel, but in severe cases the exposed dentin can exacerbate carious lesions. This case report shows an all-ceramic restoration in a young female patient. Case report: At the time of presentation to the Department of Prosthodontics at the University Hospital of Münster, the patient was 28 years old. Since 2010, carious lesions had been repeatedly treated with composite fillings due to the diagnosis of amelogenesis imperfecta (hypoplastic type 1). As the fillings had to be replaced regularly and the patient had already suffered a moderate loss of bite height of approximately 4 mm, a bite augmentation was planned by crowning all teeth with all-ceramic crowns. The new bite height was first tested with long-term PMMA temporaries. After preparation of all teeth, these were placed in 6 blocks and worn for 3.5 months. The patient showed no problems after the wearing period. Therefore, the new bite height was transferred to all-ceramic crowns for the final restoration. Monolithic zirconia crowns were used in the posterior and mandibular anterior regions, and zirconia frameworks were veneered in the maxillary anterior region to improve aesthetics. Discussion: A few cases of restorations in patients with amelogenesis imperfecta have been described in the literature. In less severe forms, composite abutments or veneers can be used to treat the enamel malformation. As enamel may be completely absent in type 1, crowns are the treatment of choice. A full crown prevents future substance loss and provides the best possible protection for the remaining tooth substance. With modern all-ceramic restorations, highly aesthetic results can be achieved even in severe initial conditions. Keywords: amelogenesis imperfecta, all-ceramic crowns, hereditary disease

Purpose: Dental symptoms of post-traumatic stress disorder (PTSD) patients include a majority of painful temporomandibular joint and masticatory muscle findings, restricted mouth opening, and pronounced attritions. Traumatic occlusal force resulting in injury of the teeth and/or the periodontal attachment apparatus may exceed the adaptive capacity of the individual person or site. This observational cross-sectional study in soldiers with PTSD and a non-PTSD control group after military deployments aimed to evaluate a possible relationship between bruxism and periodontal diagnosis. Materials and Methods: Ninety-six in-patients and 27 out-patients (21 women, 102 men) with specialist-confirmed PTSD and bruxism after up to 17 foreign assignments, and 36 male non-PTSD controls with up to 15 foreign assignments underwent general dental, functional, and periodontal examinations. Results: All three groups showed no statistically significant differences in terms of age (34.8 ± 8.6 years), number of teeth (n: 26.3 ± 3.4), status of dentition (DMFT 9.7 ± 6.6), incidence of periodontitis (36%) and recessions (n: 5.8 ± 5.7). From the control group to the out-patient group to the in-patient group, the proportion of smokers and tobacco use increased statistically significantly, as did the extent of attrition. In the in-patient group, with statistically significantly lower educational levels, the number of perceived prophylaxis sessions was statistically significantly reduced in the last two years. Conclusions: Taking into account the retrospective recording of the last traumatic event, the average time of five years until therapy does not seem to have any consequences for the frequency and severity of inflammatory periodontal disease, recession, and wedge-shaped defects in soldiers with bruxism in PTSD, regardless of the need for in-patient or out-patient treatment. Keywords: attrition, bruxism, periodontitis, PTSD, tobacco

860 Seiten geballtes Wissen zum Thema "Psychosomatik": Als Zahnarzt/Zahnärztin fragt man sich, ob man das braucht. Spontan wird man feststellen, dass sicher nicht alle dort verfügbaren Informationen zahnmedizinisch relevant sind. Dennoch ist das Thema für die Zahnärzteschaft wichtig, da man nicht außer Acht lassen sollte, dass ein hoher Anteil an Patienten, die eine haus-(zahn-)ärztliche Praxis aufsuchen, ein zumindest erhöhtes Risiko haben, an einer psychosomatischen Störung zu leiden bzw. ein solches Leiden zu entwickeln. So waren während eines Zeitraumes von 12 Monaten 28 % der deutschen Allgemeinbevölkerung im Alter von 18 und 79 Jahren von mindestens einer psychischen Störung betroffen. Diese Information lässt sich u.a. dem vorliegenden Buch entnehmen und ist ein Beispiel dafür, dass Inhalte gezielt gefunden werden können. In diesem Kontext wird zudem sehr gut verstehbar Hintergrundwissen zu den Grundbegriffen der Epidemiologie vermittelt. Weitere für die Zahnmedizin wichtige Themen sind Kapitel zu dem biopsychosozialen Krankheitsmodell, zur Stressforschung, zum gesunden Altern, zur Krankheitsbewältigung, zur soma-tischen Belastungsstörung, körperdysmorphen Störung, Essstörung, Schmerzchronifizierung und einem eigenen Kapitel Zahnmedizin, um nur einige Beispiele aus insgesamt 65 Kapiteln zu den Kategorien Grundlagen, Grundkonzepte, Krankheitsbilder, Diagnostik, Behandlung, Prävention und Begutachtung zu benennen.

Einleitung: Das Krankheitsbild der "somatoformen Prothesenunverträg-lichkeit" umfasste bisher ein breites Spektrum an Betroffenen mit diffusen Beschwerdebildern. Material und Methoden: Mittlerweile sind neue zahnmedizinische Krankheitsbilder beschrieben, sodass eine Differenzierung möglich ist. Zu nennen sind diesbezüglich das Mundschleimhautbrennen/Burning-Mouth-Syndrome (BMS), die atypische Odontalgie (persistierender [idiopathischer] dentoalveo-lärer Schmerz) und die okklusale Dysästhesie. Diese Krankheitsbilder lassen sich einordnen unter die 2015 neu eingeführte Diagnose der "somatischen Belastungsstörung", welche gekennzeichnet ist durch eine mehr als 6-mona-tige Beschwerdedauer, der intensiven Beschäftigung der Betroffenen mit den Beschwerden und einer deutlich eingeschränkten Alltagskompetenz. Die bisherige Diagnose der somatoformen Prothesenunverträglichkeit kann als eine Untergruppe zahnmedizinisch-spezifischer Erkrankungen im Sinne einer somatischen Belastungsstörung verstanden werden. Schlussfolgerung: Aufgrund der bisher vorliegenden klinischen Erfahrung darf man davon ausgehen, dass diese Diagnose zukünftig insbesondere auf Patienten zutreffen wird, die in der Regel mit Zahnersatz (festsitzend und/oder herausnehmbar) objektiv gut versorgt sind, jedoch damit Schwierigkeiten haben und im Sinne einer somatischen Belastung dadurch auffällig werden. Eine für alle Krankheitsbilder notwendige strukturierte Vorgehensweise im Sinne der initialen und erweiterten Grundversorgung beschreibt die S3 AWMF-Leitlinie "Funktionelle Körperbeschwerden". Keywords: Burning-Mouth-Syndrom, atypische Odontalgie, funktionelle Körperbeschwerden, okklusale Dysästhesie, somatische Belastungsstörung, somatoforme Prothesenunverträglichkeit

Introduction: Until recently "somatoform prosthesis intolerance" covered a wide range of patients with diffuse symptoms. Material and Methods: Meanwhile, new dental conditions have been established so that it is possible to differentiate among Burning Mouth Syndrome (BMS), atypical odontalgia (persisting [idiopathic] dental alveolar pain), occlusal dysesthesia, and somatoform prosthesis intolerance. These clinical pictures can be categorized under diagnosis of "somatic symptom disorders", which was newly established in 2015. It is marked by a duration of symptoms of more than 6 months, intense preoccupation with those symptoms, and a significantly reduced capability to cope with everyday life. The formerly used diagnosis "somatoform prosthesis intolerance" can likewise be understood as a subcategory of specific dental somatic symptom disorder. Conclusion: Based on available clinical experience it can be assumed that this diagnosis will be particularly applicable for patients that are equipped with objectively well-fitting fixed and/or removable dentures but experience difficulties with them and therefore attract attention with somatic stress symptoms. A structured approach is necessary for initial and basic treatment. This is described by the S3-guideline "functional disorders". Keywords: atypical odontalgia, burning mouth syndrome, functional disorders, occlusal dysesthesia, somatic stress disorder, somatoform prosthesis intolerance