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

Introduction: 6,000 to 8,000 rare diseases are known worldwide. Around 15% of all the rare diseases known can manifest themselves in the dental, oral, and maxillofacial areas. About one-third occur with a cleft lip and/or palate. In the fields of medicine and dentistry, not much is known about the clinical manifestation, diagnostics, and treatment of rare diseases. Sources of information are not easily accessible or are not known. The aim of this working group is therefore to establish an open-access database for rare diseases with orofacial/craniofacial manifestations which is available as a source of information not only for oral surgeons and dentists, but also for patients and their families. Material and method: In 2011 work was begun on trawling through databases such as Orphanet, OMIM, and Pubmed for rare diseases and on assessing the contents. Since 2013 the information gained has been incorporated into the web-based, freely-accessible ROMSE database, including current specialist literature, with the diseases allocated to relevant categories. The database is freely accessible at http://romse.org. Results: So far, 478 rare diseases with orofacial/craniofacial manifestations have been entered into ROMSE. These include 145 diseases with cleft lip and/or palate. Two institutes now offer special consultation times for rare diseases with oral involvement, providing an initial place of contact for patients. Conclusions: Rare diseases and their symptoms make great demands on medicine, oral surgery, and dentistry in regard to diagnostics and treatment. A database for recording rare diseases with changes in the oral and maxillofacial areas can help in making diagnoses and considering options for treatment in dental and oral medicine. Special consultation times and centres of expertise should be offered on a nationwide scale. Keywords: rare diseases, database, orofacial 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. Keywords: 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. Keywords: 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. Keywords: 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. Keywords: cephalometric, Chinese population, harmony box, floating norms

Introduction: In 2013 the patient's wish was a crown supply for his lost front tooth after more than 12 years of treatment with a denture. His bone was atrophied, and the gap between 21 und 12 was not wide enough for an implant-crown treatment. Therapy: At first, an augmentation-slice with dimensions of 1cm x 0.75 cm was withdrawn from a retromolar during the extraction of tooth 48. This cortico-spongiosa-slice was fixed with osteosynthesis (Ustomed screw, 1.2mm x 11mm) and covered with Bio-Oss and a Bioguide-membrane. After healing, the orthodontic treatment began. The gap was opened, and for temporary aesthetic reasons, a denture tooth was included in the fixed orthodontic appliance for the missing tooth 11. When the gap had enough space for the implant, an Anklylos implant was inserted in this region. Even during the healing of the implant, the interim supply of tooth 11 was solved by using the fixed orthodontic appliance. Than a VMK crown was inserted and the small mesial and distal gaps of 11 were closed by the orthodontist. The retention phase was realised by using a splint. Every six months, the patient is checked. Conclusion: After 12 years without an adequate solution, the orthodontist and the prosthodontist realised an aesthetically appealing provision for the gap in region 11. It healed properly, with a periodontally and aesthetically good interim solution during the therapy. The patient's deep smile line gave him a good impression of his outer appearance. Keywords: implant, bone augmentation, orthodontics, prosthodontics

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. Keywords: 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. Keywords: 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. Keywords: 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. Keywords: cigarette, warning, labels plain packaging