International Poster Journal of Dentistry and Oral Medicine, 04/2012

Introduction: The chondromatosis of the jaw is a proliferative disease coming with a metaplastic formation of chondral nodules in the structures of the joint area. Its manifestation in the temporo mandibular joint is a rarity. The average time frame from the occurrence of the first symptoms until surgical intervention avarages two years. Patients and diagnosis: The diagnosis, the clinical procedure and the histological appraisal of two patients - female, 47 years and male, 39 years - are described. After clinical examination and MRI radiology, the surgical resection of the lesions was performed via pre-auricular approach. Results: In both cases the over 50 chondral nodules, in parts adherent to the joint structures, were of different size and shape, invariably sharply bounded and could be removed completely. There were no complications as wound infections or lesions of the facial nerve. The function of the temporo mandibular joint was fully restored: there were no lateral deviations, pain or sounds. The mouth opening was undisturbed. The pathohistological diagnosis was synovial chondromatosis respectively. Conclusion: The synovial chondromatosis takes an intermediate position between benign enchondromas and malignant chondrosarcomas. A malignant progression of the chondromatosis is observed in 5% of the cases; in 15% recurrent disease appears despite a complete removal of the initial lesion. A stringent recall system for the patients concerned is indispensable. Keywords: Synoviale Chondromatose, Kiefergelenk, gutartig, Synovia

Aim: The aim of this invitro study was to evaluate the antifungal efficacy of 5·25 percent Sodium Hypochlorite, 2 percent Chlorhexidine Gluconate, and 17 percent EDTA as final irrigant with and without the inclusion of an Antifungal agent that is 1 percent Clotrimazole on Candida albicans. Methods: 30 single rooted instrumented teeth were inoculated with the suspension of Candida albicans. These 30 samples were divided into TWO groups of 15 samples each. GROUP 1 - Without antifungal agent GROUP 2 - With antifungal agent that is 1 percent Clotrimazole. The GROUP 1 containing 15 samples was further subdivided into three subgroups of 5 samples each. Samples in subgroup 1 were irrigated with 5·25 percent sodium hypochlorite, samples in subgroup 2 were irrigated with 2 percent chlorhexidine gluconate, and samples in subgroup 3 with 17 percent EDTA. The GROUP 2 containing 15 samples which is with antifungal agent was similarly subdivided into three subgroups of 5 samples each and was similarly irrigated with 5·25 percent sodium hypochlorite, 2 percent chlorhexidine gluconate, and 17 percent EDTA respectively but was followed by 1percent clotrimazole as a final rinse. Then aliquots from these samples were plated on 4 percent sabouraud agar, and the colony forming units were evaluated. Results: 5·25 percent sodiumhypochlorite exhibited superior antifungal efficacy compared to 2 percent chlorhexidine gluconate and 17 percent EDTA. On inclusion of 1 percent clotrimazole, there was a significant decrease in colony forming units. 5·25 percent sodiumhypochlorite and 2 percent chlorhexidine gluconate with clotrimazole showed significantly greater antifungal properties than 17 percent EDTA with clotrimazole. Conclusion: 1 percent clotrimazole proved to be effective against Candida albicans when used along with root canal irrigants as a final rinse. Keywords: antifungal, Candida albicans, chlorhexidine gluconate, clotrimazole, EDTA, irrigation, sodium hypochlorite

Introduction: Between 2000 and 2008, internet usage worldwide has almost tripled and a current population penetration of over 20% exists. It allows increased access to medical and dental information and can be used for patient self education. There is little evidence about how the Internet is impacting dentistry and how it is used by dental patients as a source of information on oral health & its effects on oral hygiene practices of patients. Material and methods: The data was collected from 572 patients attending outpatient department of public and private sector hospitals by administering a specially designed proforma. Results: Out of 572 respondents using internet 150 (26.2%) of the respondents used internet for information on oral health, a higher number of males & a significantly higher percentage of people aged between 18 to 40 years used the internet. Significantly higher number of respondents in private sector used internet as a source of information on oral health. Discussion: Difference in the usage of internet for information on oral health by gender and age groups was due to relatively higher access of internet at work place and through cybercafés; which is similar to study conducted by Riordain et al. Significantly higher number of patients from private sector and higher educational background used internet as socio- economic status and education act as a barrier for the usage of internet. Similar models can be developed to replicate amongst different regions of the world. Conclusion: Patients from younger age group, private sector and higher educational qualification used net as source of oral health information. Keywords: internet, oral health, information

However, within the limitations of the study it can be concluded that the dental status in elderly patients reflects itself in some of the tested nutritional-blood-markers. But the question whether the sole independent variable for the nutritional status is the dental status or which role other variables play (e.g. the socioeconomic status8) remains open. Keywords: nutritional blood markers, dental status

Introduction: The solitary plamocytoma of the bone (SPB) is the solitary manifestation of the multiple myeloma. It belongs to the oncological entity of non-Hodgkin lymphomas and comes with an uncontrolled proliferation of a malignantly transformed plasma cell clone. Plasmocytomas of the head and neck are rare and are mostly found in the soft tissue, solitary plasmocytoma of the jaw is a rarity. Patient and diagnosis: The 45- patient presented with an increasing swelling of the left temporo mandibular joint, which had developed during the last 3 weeks. The opening movement of the jaw was painful and reduced to a SKD of 20 mm. The patient showed a lateral deviation to the right side of 2 mm. The panoramic x-ray showed a 7x3 cm sharply bounded osteolysis hollowing the entire condylar processus. The MRI confirmed these dimensions and displayed the homogenous tumour mass. Results: The excision of the lesion was performed via pre-auricular approach. The major bony part of the condyle was replaced by necrotic soft tissue. The pathological appraisal diagnoses a plasmocytoma of the bone in an average stage of maturation. The further oncological therapy is exerted by the heamato-oncological department following standard protocols of chemotherapy and radiation. Conclusion: The solitary plasmozytoma of the jaw is a rarity; its prognosis is good with a 10 years survival rate over 75 %. Recurrent disease or the progression to a disseminated form of myeloma is generally possible and comes with a drastic pejoration of the prognosis. Keywords: Plasmozytom, solitär, Unterkiefer

However, within the limitations of the study it can be concluded that the dental status in elderly patients reflects itself in one of the tested nutritional-blood-markers. Nevertheless, the question whether the only independent variable is the dental status or which role other variables (e.g. the socioeconomic status) play, remains open. Keywords: nutritional blood markers, dental status

Objectives: The aim of this prospective study was to evaluate the clinical performance of CERCON all-ceramic anterior and posterior fixed partial dentures (FPDs). Material and Methods: Between 2003 and 2009 a total of 121 patients with 236 restorations (200 single crowns and 36 bridges with a maximum span length of 21 mm, altogether 322 units) were included in this study. All teeth were prepared with an equi- or subgingival chamfer preparation (r = 2.25 mm). The cores of the crowns and bridges were produced using the computerized CERCON technique (DeguDent, Germany) and did not differ in design and thickness. The mean thickness of core plus veneering layer (CERCON Ceram Kiss, DeguDent, Germany) was 2.0 ± 0.5 mm. The crowns were luted onto vital abutments using ZnO-P-cement (Harvard, Hoffman&Richter, Germany) or composite cement (BiFix, Voco, Germany) in case of non vital teeth. Occurring failures (chipping, fracture, marginal gaps, etc.) were determined at half year check-ups and documented. FPDs with major failures were excluded from further recalls. The type of crown failure was analyzed in detail by clinical examination. Data was evaluated statistically using the survival analysis after Kaplan-Meier (Logrank- Test p=0.005). Results: The mean observation period of the whole sample was 31±6 months. CERCON all-ceramic system demonstrated natural and esthetical appearance. Three framework fractures were recorded, 12 chippings and 5 de-attachments were seen mainly during the initial wearing period (0-4 months). After an observation period of 71 months, the overall failure was 10,2 % including 5,8 % for chipping defects. Conclusions: Zirconia demonstrated sufficient stability as framework material for crowns and brigdes. The analysis of chipping defects suggested occlusal and technology causes. Keywords: all-ceramics, crown, bridge, fixed partial dentures, chipping, cercon, long-term

Within the limits of the study it can be concluded that the shark-fin-test primarily reflects zero shear viscosity and yield stress of impression materials and might, therefore, be useful to predict flow properties of an impression material during the working time. But it does not fully reflect the setting behavior of impression materials.

Introduction: Common indications for temporo mandibular joint prothesis are ankylosis, tumours or dysplasia. Therapeutic options are the surgical insertions of osteochondral autologous rib transplants, alloplastic titan prosthesis or total endo prostesis in combination with polyethylene as chondral replacement. Patient and therapy: We report on a patient with bilateral congenital aplasia of the condylar processus. At the age of 10 years she was provided with alloplastic titan prosthesis with spheric joints by a combined intra- and extraoral approach. The functional and aesthetic results were good. After 18 years of use the routinely performed CT scan showed an intracranial dislocation of the titan prosthesis through the glenoid fossa into the middle cranial fossa with close anatomical relation to the temporal flap. Results: The patient presented no neurologic symptoms; the function of the temporo mandibular joint was unaffected. The SKD was 35 mm. The patient had no pain or joint sounds. There was no lateral deviation during the opening movement. Due to the unaffected joint function and the lack of restraining symptoms, the patient wishes no surgical intervention to remove the dislocated prosthesis and replace them by a total endoprosthesis. Conclusion: Autologous and alloplastic joint replacement represent a reliable therapeutic intervention in the functional and aesthetic rehabilitation of temporo mandibular joint ankylosis, dysplasia or degenerative joint disease. Continuous and pressures may lead to a bony degradation of the glenoid fossa and the dislocation of the prosthesis. Alloplastic transplants should be replaced after two years by an autologous transplant or a total prosthesis, according to their accreditation. Keywords: Kiefergelenk, Dislokation, Perforation, Gelenkersatz

Esthetic and functional rehabilitation of severely mutilated fractured central incisors teeth using homogenous biological fragment bonding. Freshly extracted maxillary central incisors were treated endodontically and post spaces were prepared. Intra-radicular biological post core were fabricated from the sectioned roots of extracted canines. Cementation of biological post core in prepared space was done after clinical and radiological confirmation. Subsequent esthetic rehabilitation was done using adaptation of biological crown which was prepared from morphologically similar extracted maxillary central incisor. The association between biological crowns and post core offers excellent esthetic, functional, and psychosocial results, which justifies the use of this technique to achieve the morphofunctional recovery of extensively damaged teeth. The biological restorations are an alternative technique for reconstruction of extensively damaged teeth that provides highly functional and esthetic outcomes. Keywords: prosthetic reincarnation