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[Systemic communication in a dental context]. [牙科背景下的系统交流]。
Q3 Medicine Pub Date : 2024-11-11 DOI: 10.61872/sdj-2024-04x-06
Christian Besimo, Julia Ledergerber, Ruth Besimo-Meyer, Nicola U Zitzmann

As patients in a dental or medical context, persons find themselves in a vulnerable, exceptional psychological and physical situation, in which the solution-oriented regulation of emotions requires mindful, systemic communication. This review describes typical placebo and nocebo effects in verbal, paraverbal and non-verbal communication and their impact on patients and their relationship with dental or medical professionals. In addition, a training curriculum for second-year undergraduate dental master’s students is described, that not only provides students with the necessary competences for solution-oriented systemic communication, but also enables them to experience its effectiveness in the clinical context.

作为牙科或医学领域的患者,他们处于一种脆弱、特殊的心理和生理状况中,在这种状况下,以解决问题为导向的情绪调节需要用心、系统的沟通。这篇综述描述了语言、辅助语言和非语言沟通中典型的安慰剂效应和应急效应,以及它们对患者及其与牙科或医学专业人员关系的影响。此外,还介绍了一种针对牙科硕士二年级本科生的培训课程,该课程不仅为学生提供以解决问题为导向的系统性沟通所需的能力,还能让他们在临床环境中体验其有效性。
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引用次数: 0
Systemische Kommunikation im zahnmedizinischen Kontext. 牙科领域的系统交流。
Q3 Medicine Pub Date : 2024-11-11 DOI: 10.61872/sdj-2024-04x-06
Christian Besimo, Julia Ledergerber, Ruth Besimo-Meyer, Nicola U Zitzmann

As patients in a dental or medical context, persons find themselves in a vulnerable, exceptional psychological and physical situation, in which the solution-oriented regulation of emotions requires mindful, systemic communication. This review describes typical placebo and nocebo effects in verbal, paraverbal and non-verbal communication and their impact on patients and their relationship with dental or medical professionals. In addition, a training curriculum for second-year undergraduate dental master’s students is described, that not only provides students with the necessary competences for solution-oriented systemic communication, but also enables them to experience its effectiveness in the clinical context.

作为牙科或医学领域的患者,他们处于一种脆弱、特殊的心理和生理状况中,在这种状况下,以解决问题为导向的情绪调节需要用心、系统的沟通。这篇综述描述了语言、辅助语言和非语言沟通中典型的安慰剂效应和应急效应,以及它们对患者及其与牙科或医学专业人员关系的影响。此外,还介绍了一种针对牙科硕士二年级本科生的培训课程,该课程不仅为学生提供以解决问题为导向的系统性沟通所需的能力,还能让他们在临床环境中体验其有效性。
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引用次数: 0
Periodontal status after autologous tooth transplantation (ATT) of premolars and wisdom teeth. 前臼齿和智齿自体牙齿移植 (ATT) 后的牙周状况。
Q3 Medicine Pub Date : 2024-11-06 DOI: 10.61872/sdj-2024-04-05
Marco Züger, Khaleed Mukkadam, Andreas Filippi, Patrick R Schmidlin

This study explored the clinical and radiological outcomes after autologous premolar and wisdom tooth transplantation, with a focus on periodontal status. A systematic search was conducted using all relevant databases up to April 5, 2024. The inclusion criteria were as follows: a) human participants, b) a sample size of at least five autotransplanted teeth, c) molar or premolar transplants, d) English language use, and e) at least 1 year of follow-up. The following parameters were assessed: probing pocket depth, recession, tooth mobility, ankylosis, bone level, and tooth loss. Our search identified 466 records, and after our selection process, 25 articles were suitable for analysis, with a total of 3732 teeth (569 premolars and 350 molars) with a mean follow-up duration of 6.1 years. The 10-year survival rate of autologous tooth transplants ranged from 33.8% to 100%, and the mean complication rates of root resorption and ankylosis were 8.9% (13 studies) and 14.0% (10 studies), respectively. Periodontal complications such as periradicular radiolucency, periodontal defects, and attachment loss occurred in less than 10% of patients. The premolars exhibited superior clinical and radiological outcomes compared with the molars. In conclusion, the survival rate and periodontal status after autologous tooth transplantation (ATT) of premolars and molars were consistent with those of traditional dental implants. Therefore, autotransplantation may be considered in cases where dental implants are indicated. As specific reports on periodontal complications are scarce, further research is warranted to identify the specific factors associated with periodontal complications in autologous transplant recipients.

本研究探讨了自体前磨牙和智齿移植后的临床和放射学结果,重点关注牙周状况。研究使用了截至 2024 年 4 月 5 日的所有相关数据库进行系统检索。纳入标准如下:a)人类参与者;b)样本量至少为五颗自体移植牙齿;c)臼齿或前臼齿移植;d)使用英语;e)至少随访一年。对以下参数进行了评估:探查袋深度、后退、牙齿活动度、强直、骨水平和牙齿缺失。我们的搜索发现了 466 条记录,经过筛选,25 篇文章适合进行分析,共涉及 3732 颗牙齿(569 颗前磨牙和 350 颗臼齿),平均随访时间为 6.1 年。自体牙移植的 10 年存活率从 33.8% 到 100% 不等,牙根吸收和强直的平均并发症发生率分别为 8.9%(13 项研究)和 14.0%(10 项研究)。牙周并发症,如牙周放射状突起、牙周缺损和附着丧失的发生率低于 10%。与磨牙相比,前磨牙的临床和放射学效果更佳。总之,前磨牙和磨牙自体牙移植(ATT)后的存活率和牙周状况与传统种植牙一致。因此,在需要种植牙的情况下,可以考虑自体牙移植。由于有关牙周并发症的具体报告很少,因此有必要开展进一步研究,以确定与自体牙移植受者牙周并发症相关的具体因素。
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引用次数: 0
Neck lumps: Early Detection with Dental Magnetic Resonance Imaging? [颈部肿块:利用牙科磁共振成像进行早期检测?]
Q3 Medicine Pub Date : 2024-11-05 DOI: 10.61872/sdj-2024-04-04
Adib Al-Haj Husain, Martina Broglie Däppen, Sebastian Winklhofer, Bernd Stadlinger

Cervical lymphadenopathy can indicate a range of diseases, including infections, inflammation, and neoplastic processes. Accurate diagnosis is crucial for identifying the underlying cause and determining appropriate treatment. Diagnostic procedures include clinical examination, ultrasound, fine needle aspiration, biopsy, and imaging techniques. While conventional imaging methods such as X-ray and computed tomography (CT) have proven useful, they exhibit limitations in sensitivity and specificity, especially for soft tissue structures. Magnetic resonance imaging (MRI) provides superior soft tissue contrast, offering additional critical information for differential diagnosis. This article presents a case study of a 29-year-old male with a cervical mass. Advanced dental MRI protocols, including DESS, SPACE-SPAIR, and SPACE-STIR sequences, have significantly enhanced the imaging capabilities of the den-tomaxillofacial region, enabling the generation of high-resolution images of both hard and soft tissues. Especially, MR OPGs have demonstrated the capacity to identify early signs of potential pathology. These protocols have the potential to enhance early detection, thereby con-tributing to accurate diagnosis and effective treatment planning.

宫颈淋巴结肿大可预示多种疾病,包括感染、炎症和肿瘤过程。准确的诊断对于确定潜在病因和开始适当的治疗至关重要。在评估临床症状后,诊断工作包括进一步检查,如临床状态、超声波、细针穿刺、活检和成像技术。X 光和计算机断层扫描(CT)等传统成像技术已被证明是有用的,但在灵敏度和特异性方面存在局限性,尤其是在观察软组织结构时。磁共振成像(MRI)可提供更好的软组织对比度,并为鉴别诊断提供额外的重要信息。本文介绍了一名患有宫颈肿瘤的 29 岁男子的病例,并描述了随后的诊断和治疗。包括 DESS、SPACE-SPAIR 和 SPACE-STIR 序列在内的现代牙科磁共振成像方案大大提高了牙颌面区域的成像能力。它们能利用高分辨率图像同时显示硬组织和软组织。特别是,MR-OPT 已显示出检测潜在病变早期征兆的能力,这有助于准确诊断和有效的治疗规划。
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引用次数: 0
Challenges in the diagnosis and management of soft tissue tumors of the oral cavity. 口腔软组织肿瘤诊断和管理的挑战。
Q3 Medicine Pub Date : 2024-10-29 DOI: 10.61872/sdj-2024-04-03
Adib Al-Haj Husain, Esra Salzer, Bernd Stadlinger

Soft tissue lesions are among the most prevalent forms of tumors or tumor-like alterations within the oral cavity. They exhibit a wide spectrum of characteristics, ranging from benign, noninvasive lesions to malignant tumors, which collectively present a diagnostic challenge. A 67-year-old patient presented with an incidental finding of induration on the right cheek during dental hygiene. The intraoral examination revealed a soft, non-tender swelling measuring 20 mm in diameter. The sensitivity and percussion tests for the teeth in the fourth quadrant yielded unremarkable results. Panoramic radiography (OPG) revealed tip-ping of the premolars and an unclear apical finding in region 44. Cone-beam computed tomography (CBCT) revealed a sharply defined, lobulated hypodense lesion in the right buccal area. To clarify the diagnosis and optimize perioperative management, a 3 Tesla dental magnetic resonance imaging (MRI) scan was performed. This identified a 23×6×23 mm lipoma along the right mandibular ramus, causing detachment of the buccinator and de-pressor anguli oris muscles. A cinematic rendering reconstruction derived from the MRI data facilitated enhanced visualization for preoperative planning. The surgical excision was performed under local anesthesia, resulting in the successful removal of the neoplasm while preserving the mental nerve and submandibular gland. Histo-pathology confirmed the presence of a lobulated mature cell lipoma. The patient exhibited no complications during the removal of the sutures, with complete wound healing and no recurrence observed. This article highlights the efficacy of advanced MRI diagnostics and post-processing techniques in the management of ambiguous soft tissue neoplasms.

软组织病变是口腔中最常见的肿瘤或肿瘤样改变。它们表现出多种特征,从良性、非侵袭性病变到恶性肿瘤,共同构成了诊断难题。一名 67 岁的患者在进行牙齿清洁时偶然发现右侧脸颊有压痕。口腔内检查发现一个直径 20 毫米的无触痛的柔软肿物。第四象限牙齿的敏感度和叩诊测试结果均无异常。全景X光片(OPG)显示前臼齿尖平,44区的根尖发现不清楚。锥形束计算机断层扫描(CBCT)显示右侧颊区有一个轮廓清晰的分叶状低密度病变。为明确诊断并优化围手术期管理,患者接受了 3 特斯拉牙科磁共振成像(MRI)扫描。扫描结果显示,右下颌横梁上有一个 23×6×23 毫米的脂肪瘤,导致颊肌和去压角肌脱落。根据核磁共振成像数据绘制的电影渲染重建图有助于增强术前规划的可视化。手术切除在局部麻醉下进行,成功切除了肿瘤,同时保留了精神神经和下颌下腺。组织病理学证实这是一个分叶状成熟细胞脂肪瘤。患者在拆线过程中未出现任何并发症,伤口完全愈合,未见复发。本文强调了先进的磁共振成像诊断和后处理技术在治疗模糊软组织肿瘤方面的功效。
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引用次数: 0
[Kommunikation bei Demenz]. [与痴呆症患者交流]
Q3 Medicine Pub Date : 2024-09-16 DOI: 10.61872/sdj-2024-04x-02
Sheila Pellegrino, Christian Emanuel Besimo

A scoping review investigated the effectiveness of different communicative interventions for patients with dementia. It demonstrated that communication between caregivers and dementia patients is improved by music, multisensory stimulation, and communication training. As a result agitation, mania, fear, anger and corrective touching are reduced, and fluency, spontaneous speech, eye contact, smiling and affective touching are enhanced. The recommendations, summarized in a fact sheet, also contribute to improved therapeutic decision making with bystanders and oral health of people with dementia.

一项范围广泛的综述调查了针对痴呆症患者的不同沟通干预措施的有效性。研究表明,音乐、多感官刺激和交流训练可以改善护理人员与痴呆症患者之间的交流。因此,激动、狂躁、恐惧、愤怒和纠正性触摸会减少,流畅性、自发言语、眼神交流、微笑和情感性触摸会增强。概况介绍中总结的这些建议还有助于改善旁观者的治疗决策和痴呆症患者的口腔健康。
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引用次数: 0
Impact of final rinse with saline or alcohol solution on root canal sealability. 最后用生理盐水或酒精溶液冲洗对根管密封性的影响。
Q3 Medicine Pub Date : 2024-09-09 DOI: 10.61872/sdj-2024-04-01
Nidambur Vasudev Ballal, Rajkumar Narkedamalli, Josette Camilleri, Vasileios Kapralos, Matthias Zehnder

Endodontic irrigation protocols are not only used to clean and disinfect the root canal system, but also to condition the canal wall dentine for subsequent root filling. In this study we tested whether a final irrigation step with saline solution or 80% ethanol improved root canal sealabilty by two popular sealers, an epoxy resin (AH Plus) and a hydraulic calcium silicate cement-based product (BioRoot RCS). Root canals in extracted single-rooted human teeth were instrumented and filled with a matched gutta-percha cone and sealer. During instrumentation and prior to root filling, sealer-specific irrigation protocols were applied. These involved a combined sodium hypochlorite/1-hydroxyethylidene-1,1-diphosphonic acid application, which was followed by irrigation with ethylenediaminetetraacetic acid (EDTA) for AH Plus. Protocols were followed by a 5-ml ultimate rinse with saline solution or 80% ethanol. No such final rinse was the control (N = 9). Canals were then dried with matched paper points. One week after root filling and storage of the teeth at 37°C in a humid environment, Rhodamine B was used to trace leakage. Two-way ANOVA revealed that the type of sealer had a significant (P < 0.05) impact on apical dye penetration while the final rinse did not (P > 0.05). AH Plus provided the slightly better seal (P < 0.05). Leakage occurred between the sealer and the dentin with AH Plus, and between the sealer-to-dentin as well as the sealer-to-gutta-percha interface with BioRoot RCS. In summary and under current conditions, there was no benefit from applying saline or ethanol as an ultimate rinsing solution prior to drying the canal with matched paper points.

根管冲洗方案不仅用于清洁和消毒根管系统,还用于调节根管壁牙本质以利于随后的根管充填。在这项研究中,我们测试了使用生理盐水或 80% 乙醇进行最后冲洗是否能改善两种常用封药(环氧树脂 (AH Plus) 和硅酸钙水门汀产品 (BioRoot RCS))的根管封闭性。对拔出的单根人类牙齿的根管进行了器械检查,并用相匹配的牙胶锥和封闭剂进行了填充。在器械操作过程中和根管充填之前,采用了封孔器专用的灌洗方案。其中包括次氯酸钠/1-羟基亚乙基-1,1-二膦酸联合应用,然后用乙二胺四乙酸(EDTA)冲洗AH Plus。随后用生理盐水或 80% 乙醇进行 5 毫升的最终冲洗。不进行最后冲洗的为对照组(N = 9)。然后用相匹配的纸点干燥根管。牙根充填一周后,将牙齿保存在 37°C 的潮湿环境中,使用罗丹明 B 追踪渗漏情况。双向方差分析显示,封闭剂的类型对根尖染料渗透有显著影响(P < 0.05),而最终冲洗则没有影响(P > 0.05)。AH Plus 的封闭效果稍好(P < 0.05)。使用 AH Plus 时,封闭剂和牙本质之间会发生渗漏;使用 BioRoot RCS 时,封闭剂和牙本质之间以及封闭剂和牙釉质之间会发生渗漏。总之,在目前的条件下,使用生理盐水或乙醇作为最终冲洗溶液,然后再用匹配的纸点干燥牙道,没有任何益处。
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引用次数: 0
Dental Magnetic Resonance Imaging in Implant Surgery - Status Quo and Outlook [种植手术中的牙科磁共振成像]。
Q3 Medicine Pub Date : 2024-08-14 DOI: 10.61872/sdj-2024-03-12
Adib Al-Haj Husain, Bernd Stadlinger, Sebastian Winklhofer, Marco Piccirelli, Silvio Valdec

Numerous technical advances in magnetic resonance imaging have opened up promising new approaches in dentomaxillofacial radiology in recent years. With its ability to simultaneously visualize soft and hard tissues, MRI has the potential to become an innovative method for accurate diagnosis and planning of dental implants. Dental MRI is already a valuable and useful complement to conventional X-ray imaging techniques and could further minimize the risks of surgery by optimizing existing treatment protocols. Considering current efforts in dentistry to reduce radiation exposure and take a further step toward personalized oral diagnostics that consider patient-specific factors, this article reviews the capabilities of dentomaxillofacial MR imaging in implant surgery. It highlights the various applications of MRI in dental implant surgery and evaluates both the benefits and the clinical challenges. Overall, considering the specific indications and limitations of MR sequences, dental MRI represents a further significant advance in individualized treatment planning in dentistry. It allows consideration of parameters not visualized by conventional imaging techniques and is particularly useful for evaluating surgically relevant parameters, especially those related to soft tissue.

近年来,磁共振成像技术的发展为牙科颌面放射学开辟了前景广阔的领域。磁共振成像可以同时观察软组织和硬组织,而且不会对患者造成辐射,因此有可能成为精确诊断和规划牙科植入物的创新方法。牙科磁共振成像已成为传统 X 射线成像程序的有益补充,并能通过优化现有治疗方案,进一步降低手术干预的相关风险。目前牙科界正在努力实现个性化口腔诊断,并将患者的具体因素考虑在内,在此背景下,本文简要概述了牙科磁共振成像在种植手术中的应用。总之,考虑到特定序列的适应症和局限性,所介绍的应用说明了牙科磁共振成像在个性化种植治疗规划方面的潜力。它可以考虑传统成像技术无法观察到的参数,尤其适用于评估影响软组织的手术相关参数。
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引用次数: 0
[Milch-Zahnerhaltung am Limit (?)]. [乳牙保存的极限(?]
Q3 Medicine Pub Date : 2024-08-09 DOI: 10.61872/sdj-2024-03-11
Patrick R Schmidlin, Adrian Lussi

Das kongenitale Fehlen von Milchzähnen ist ein Problem. Mit Ausnahme der dritten Molaren sind die zweiten Unterkiefer-Prämolaren (2.5-4.5%) am häufigsten betroffen. Der Erhalt des Vorgängerzahnes ist eine Möglichkeit, den Platz zu erhalten und die definitive prothetische Entscheidung hinauszuzögern. Eine Literaturübersicht fand pathologiefreie Überlebensraten von 82-89 % über einen Zeitraum von 5-13 Jahren. Neben Karies und Gingivitis stellen eine Infraokklusion oder Wurzelresorption typische biologische Komplikationen dar.

先天性乳牙缺失是一个问题。除第三磨牙外,下颌第二前磨牙(2.5%-4.5%)最常受到影响。保留前牙是一种保留空间和延迟最终修复决定的方法。文献综述发现,5-13 年的无病理存活率为 82-89%。除了龋病和牙龈炎外,咬合下移或牙根吸收也是典型的生物学并发症。
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引用次数: 0
Tooth preservation and "the treatable or hopeless tooth": Re-thinking a concept [牙齿保存与 "未经治疗或无药可救的牙齿":一个应重新考虑的概念?]
Q3 Medicine Pub Date : 2024-08-07 DOI: 10.61872/sdj-2024-03-10
Patrick R Schmidlin

The masticatory organ is at the center of dental practice. Tooth loss, regarded as an organ failure, is a core dispute in our profession, as it more often than not does not happen spon-taneously but is influenced by the dentist's treatment plan. Despite the prosthetic possibili-ties of tooth replacement, efforts should be made to preserve as many teeth as possible. Decisions between tooth preservation and extraction are complex and have far-reaching consequences. This article discusses this problem using a clinical case study of a 43-year-old female patient with pronounced localized periodontitis. After a comprehensive diagnosis and treatment planning, a daring regenerative therapy was carried out to try to preserve the tooth. The case shows that even seemingly hopeless teeth can be successfully treated syn-chronously using modern therapeutic approaches. Initial literature data supports the possi-bility of preserving severely compromised teeth in the long term in compliant patients. An integrative treatment approach based on individual patient factors and modern regenerative techniques may well be a viable alternative to tooth extraction and prosthetic restoration, albeit not inexpensive and uncomplicated. This communication emphasizes the need for precise diagnostics, a comprehensive treatment plan, and honest communication with pa-tients about the prospects of success and possible risks, and highlights the strengths of con-sistent tooth preservation.

咀嚼器官是牙科实践的核心。牙齿脱落被视为器官衰竭,是一个重大问题。尽管可以选择修复方法,但目标应该是尽可能多地保留牙齿。在保留牙齿和拔除牙齿之间做出决定是非常复杂的,而且会产生深远的影响。本文以一名 43 岁女性患者的临床病例为基础,探讨了这一话题,该患者患有明显的局部牙周炎。在经过全面诊断和治疗规划后,患者接受了再生治疗以保留牙齿。该病例表明,即使是看似无望的牙齿,只要患者有保持良好口腔卫生的积极性,也可以通过现代治疗方法成功治疗。初步文献数据支持长期保留严重受损牙齿的可能性。基于患者个体因素和现代再生技术的综合治疗方法可能是拔牙和修复的替代方法,尽管这种方法成本高昂且复杂。本文强调了精确诊断、综合治疗计划和与患者就成功机会和风险以及持续保留牙齿的优势进行坦诚沟通的必要性。
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引用次数: 0
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Swiss dental journal
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