International Poster Journal of Dentistry and Oral Medicine, 01/2009

Study aims: to evaluate the pattern of missing teeth in families, to observe similarities and differences of dental phenotype among affected relatives, to characterize the mode of inheritance and to identify distinct groups of patients for further molecular investigations. Patients and Methods: Clinical examinations were carried out on 26 Caucasian patients from 11 families with a family history of missing teeth. Combined examination of clinical phenotypes and panoramic radiographs improved the precision of diagnosis. Family study was used to determine whether there is a hereditary basis for tooth agenesis. Results: In all families, the patients and their affected relatives did not share the same pattern of missing teeth. There were differences according to the tooth type, region, symmetry and number of teeth involved even in the same family. The most commonly missing teeth were: upper lateral incisors, second lower and upper premolars, lower central incisors, upper canines. Symmetrical hypodontia and anterior tooth agenesis were predominant. Anomalies of tooth-size and tooth-shape were observed in association with hypodontia phenotype. Conclusions: Familial isolated tooth agenesis is a genetic trait with clinical heterogeneity and autosomal dominant inheritance pattern. Keywords: tooth agenesis, congenital missing teeth, familial hypodontia

Objectives: Hypoallergenic-denture-base-materials [HDBM] are free from toxic or potential allergic substances. To clinically substitute conventional PMMA-denture-base-resins [PDBR] HDBM should meet the standards in mechanical-physical properties. Fundamental material properties are flexural strength [FS] and flexural modulus [FM]. High FS/FM-values contribute to the preservation of edentulous jaw areas. FS is an indicator of the strength and work capability in denture materials. A High FM value specifies rigidity as well as stiffness and represents denture base material's resistance to elastic deformation. The aim of this in-vitro study was to evaluate mechanical-physical properties of HDBMs and the comparison to established PDBRs. Methods: The 7 tested HDBMs (Acetal, Erkokryl, Luxene, Microbase, Polyan, Sinomer, Versio.com) were free from toxic or potential allergic substances. 3 PDBRs (Paladon65, PalaXpress, SR-Ivocap) represented the standard levels [SL-FS/SL-FM]. Specimens (60x10x4mm) were produced by the respective manufactures. 6 specimens from each product were tested in the three-point-bending-test according to ISO178:2006. The automatically recorded force measurement (TestXpert 8.1, Zwick, Germany) was performed until fracturing at a test speed of v=5mm/min. FS and FM were calculated and analyzed (T-test, p Keywords: flexural strength, flexural modulus, hypoallergic, denture base materials

Self-adhesive resin cements have gained popularity over the past few years because of their improved physical properties as compared to conventional cements. New brands have simplified clinical handling, a wider range of applications and reduced pulp injury. Postoperative hypersensitivity and pulp injury was a problem in the past. The aim of this prospective controlled clinical study was to evaluate a new self-adhesive resin cement for postoperative sensitivity. Additionally, changes in cement colour, quality of the marginal seal, as well as the occurrence of decementations were registered. 16 patients received 43 full-coverage restorations on vital abutment teeth. The crowns were cemented with new self-adhesive resin cement. The teeth were inspected immediately after cementation, after 2 weeks (baseline) and after 6 months. Tooth sensitivity (abutment tooth and reference tooth) was examined with an ice spray test. After cementation postoperative hypersensitivity was diagnosed in 7% of the 43 vital abutment teeth. At baseline (after 2 weeks) the rate was reduced to 4.7%. Postoperative hypersensitivity was not reported after 6 months. The overall clinical experience proofed the cement to be an encouraging alternative to conventional cements with regard to postoperative sensitivity and ease of application. Keywords: postoperative sensitivity, self-adhesive cement, dental cements, luting of crowns

Objectives: The aim of the present study was to evaluate the influence of a commercially available home bleaching agent (Perfect Bleach 17%, Voco, Germany) on microtensile bond strength of four different dentin adhesives (Syntac and AdheSE, Vivadent, Liechtenstein; XP Bond, Dentsply DeTrey, Germany; Futurabond NR, Voco, Germany) in class V cavities in vitro. Methods: 120 freshly extracted third molars were included in this study. In all teeth cervical class V dentinal cavities were prepared also allowing the simulation of dentin perfusion. The specimens were randomly assigned to eight experimental groups of fifteen each: S: Syntac/ control; S17: Syntac/ Perfect Bleach; A: AdheSE/ control; A17: AdheSE/ Perfect Bleach; X: XP Bond/ control; X17: XP Bond/ Perfect Bleach; F: Futurabond NR/ control; F17: Futurabond NR/ Perfect Bleach. Bleaching was performed 8 hours at 36°C for 7 days. Microtensile bond strength of the above mentioned bonding agents was measured using an universal testing machine. Results: Statistical analysis showed a significant influence of the used dentin bonding agent and the bleaching agent on microtensile bond strength (p Keywords: bond strength, home bleaching, dentin adhesives

Objectives: The aim of the present study was to evaluate regional microtensile bond strengths (mTBS) to root canal dentin using different adhesive systems- two dentin adhesives, one resin cement and one adhesive root canal sealer. Methods: 120 human single rooted teeth were used. Crowns were removed at the CEJ. The roots were bisected along their long axis and sectioned into three thirds: apical (a), middle (m) and coronal (c). Flat root dentin specimens were prepared. The specimens were randomly assigned to four experimental groups of ten samples each: Group S: Syntac; group F: Futurabond NR; group P: Panavia F 2.0; group R: Resilon. The different adhesive materials were applied as recommended by the manufacturer. A composite build up (Ø 1mm) was created over each root canal section to allow mTBS tests. Bond strength was measured using a special device in an universal testing machine. Results: Statistical analysis showed a significant influence of the used materials and the different regions on mTBS (p Keywords: bond strength, root canal dentin, adhesives

Objective: Susceptibility to periodontal disease (PD) is partially genetically determined and HLA genes are candidates for playing a role in the genetic background of susceptibility as their products are essential in immune response against periopathogenic bacteria. The literature relating to HLA and PD identifies conflicting ranges of possible HLA associations as different ethnic origin and diagnoses have been examined in several studies. Therefore, the aim of the study was to estimate the overall associations between HLA phenotypes among Caucasians and to establish the odds ratio conferred by HLA phenotypes by meta-analysis. Methods: Literature search was done for publications reporting on the relation between PD and HLA class I and II phenotypes. Case-control studies with clearly described diagnostic criteria for patients and controls of Caucasian origin were considered for combined analyses. Periodontal diagnoses were adapted to the latest nomenclature of the AAP. Odds ratios were calculated using both fixed-effects and random-effects-model when appropriate. Results: The search yielded a list of 18 Caucasian case-control studies, of which 11 were included for meta-analysis. In patients with aggressive periodontitis (AP) positive associations to HLA-A9 (OR = 2.18) and -B15 (OR = 1.81) and a negative association to HLA-B5 (OR = 0.50) were identified. In patients with chronic periodontitis (CP) no positive HLA association was found. For both CP and AP there was a clear evidence for a negative association to HLA-A2 (CP: OR = 0.59; AP: OR = 0.69). Conclusion: The results suggest HLA-A2 to be a protective factor for CP and AP among Caucasians, whereas HLA-A9 and -B15 might contribute genetic background susceptibility factors for aggressive periodontitis. Further subgroup and combination analyses of these HLA markers as well as their associations to peptides of periodontopathic bacteria may elucidate how these markers confer susceptibility or resistance to AP or CP. Keywords: periodontitis, HLA, MHC

Mucormycosis is an oppurtunistic fungal infection more commonly seen in immunocompromised individuals. Herewith presenting a similar case involving the maxillary sinus in a middle aged male with uncontrolled diabetes. Keywords: mucormycosis

Objectives: Crohn's disease (CD) has been reported to have periodontal manifestations. However, data on periodontal parameters and microbiology is rare. Recent studies showed an association of single nucleotide polymorphisms (SNPs) in the NOD2/CARD15 gene with CD. These SNPs are involved in immune response towards bacterial products. Our aim was to investigate the periodontal status of patients with CD taking into account periodontal pathogens and the NOD2 SNPs 8, 12 and 13. Methods: The periodontal status of 147 patients with CD was assessed. Detection of periodontopathic bacteria were established by PCR using 16S rRNA probes. NOD2 genotyping was done with the Taqman assay. Results: Mean clinical attachment level (CAL) was 3.79 ± 1.01 mm and mean probing depth (PD) 3.59 ± 0.79 mm. 89.1% of the patients had at least one site with CAL > 3.5 mm and 32.0 % at least one site with CAL >5.5 mm. There was no significant difference of CAL and PD between the 3 SNPs. A. actinomycetemcomitans was detected in 76.8%, T. forsythensis in 64.6% and C. rectus in 94.6%. Smoking and medication had no influence on CAL, PD and detection of pathogens. Discussion: Our results suggest that CD patients have an increased prevalence but only moderate severity of periodontal disease. Our data do not support a role of NOD2/CARD15 on periodontal status in CD. However, colonization of periodontal pathogens, in particular C. rectus, might be of particular value for periodontal manifestation of CD. Keywords: periodontitis, Crohn's Diseases, NOD2, periodontal pathogens

Objective: Presentation of etiology, clinical signs and therapy of the odontogenic thrombophlebitis of the cavernous sinus by MRSA ( Methicillin resistant Staphylococcus aureus ) in form of a case report and review of the literature. Material and Methods: A 63 year old, male patient contacted the emergency room with reduced general condition and the following main clinical symptoms : fever more than 39,5 °C , massive headache, nausea, vomiting, meningism, exophthalmos and chemosis of the right eye and abducens paralysis at the right. Anamnestic the patient reported operative extraction of wisdom tooth 18. The following diagnostic procedures were performed : clinical neurological, medical and maxillofacial diagnostic assessment, CT, MRT, dental radiology ( OPG, dental x-rays ), diagnostic serology, lumbar punction and CSF examination including microbiology / polymerase chain reaction, and intraoral smear. Review of the literature was made in databases PubMed / Medline and Embase. Results: Diagnostic views confirmed the diagnosis "septic thrombophlebitis of the right cavernous sinus". Initially high-dose wide-spectrum antibiotics, anticoagulation and intensive care treatment was required. Microbiology and CSF examination showed intraoral and intracranial the same variety of MRSA, without findings of other relevant bacterias or viruses. After diagnosis by exclusion, as only potential cause the tooth extraction remained. After sensivity testing, changing of antibiotics, anticoagulation and conservative therapy without invasive treatment lead to a quick regression of clinical and serological signs with a complete restitutio ad integrum. In total we found only 18 relevant publications concerning odontogenous thrombophlebitis of the cavernous sinus. Non of them reported clearly ascending intracranial infection with MRSA after dental oral surgery as etiology. Conclusions: Odontogenous intracranial infections are rare and need quick adequate interdisciplinary diagnostics and therapy. Multiresistant and nosocomial buds show raising incidence and gain more and more clinical relevance. Special treatment is required in such cases. Keywords: Sinus cavernosus, Thrombophlebitis, odontogen, MRSA