Schweizer Monatsschrift fur Zahnmedizin = Revue mensuelle suisse d'odonto-stomatologie = Rivista mensile svizzera di odontologia e stomatologia最新文献

The aim of this randomized, controlled clinical study was to compare the short-term effects of nonsurgical periodontal therapy with the additional administration of systemic antibiotics (AB) and the same therapy with additional photodynamic therapy (PDT) in the treatment of patients with aggressive periodontitis (AP). Thirty-six patients with AP received full-mouth nonsurgical periodontal treatment (SRP) and were then randomly divided into two groups of 18 subjects each. Group AB received amoxicillin and metronidazole three times a day for 7 days. Group PDT received two applications of PDT on the day of SRP as well as at follow-up after 7 days. The following clinical parameters were measured at baseline and 3 months after therapy: plaque index (PLI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL). After 3 months, PD was significantly reduced in both groups (from 5.0±0.8 mm to 3.2±0.4 mm with AB, and 5.1±0.5 mm to 4.0±0.8 mm with PDT; both p<0.001), while AB revealed significantly lower values compared to PDT (p = 0.001). In both groups, GR was not significantly changed. CAL was significantly reduced in both groups (PDT: 5.7±0.8 mm to 4.7±1.1 mm; p=0.011; AB: 5.5±1.1 mm to 3.9±1.0 mm; p<0.001) and differed significantly between the groups (p=0.025). The number of residual pockets (PD ≥4 mm) and positive BOP was reduced by AB from 961 to 377, and by PDT from 628 to 394. Pockets with PD ≥7 mm were reduced by AB from 141 to 7, and by PDT from 137 to 61. After 3 months, both treatments led to statistically significant clinical improvements. The systemic administration of antibiotics, however, resulted in significantly higher reduction of PD and a lower number of deep pockets compared to PDT.

The therapy of traumatized front teeth with ankylosis and additional root resorption is a real challenge for the clinician. Due to the infraposition ankylosed teeth are useless and esthetically unsatisfactory. The progressive replacement resorption and the vertical growth inhibition render an intervention inevitable. In the following case report, the prophylaxis of the alveolar ridge is brought into focus. The treatment of two ankylosed teeth by decoronation, preservation of the alveolar ridge and an implant-supported supraconstruction will be presented. The additional histological assessment confirms the diagnosis and the choice of treatment.

Since the introduction of cone beam computed tomography (CBCT), this 3-dimensional diagnostic imaging technique has been established in a growing number of fields in dental medicine. It has become an important tool for both diagnosis and treatment planning, and is also able to support endodontic treatments. However, the higher effective dose of ionizing radiation compared to conventional 2-dimensional radiographs is not justifiable in every case. CBCT allows for a more precise diagnosis of periapical lesions, root fractures as well as external and internal resorptions. Concerning the utility of CBCT in treatment planning decisions, the gain of information through 3-dimensional imaging for any of these pathologies has to be evaluated carefully on an individual basis. Moreover, radioopaque materials such as root canal filling and posts often create artefacts, which may compromise diagnosis. The aim of this review is to summarize the possibilities and limits of CBCT imaging in endodontology as well as introduce guidelines for daily clinical practice. Furthermore, the article presents possible therapeutic advantages of preexisting CBCT scans for root canal treatments.

Objectives: Skiing and snow-boarding are winter sports with risk of dental trauma. The aim of the present study was to investigate the use of protective gear and the occurrence of dental trauma in amateur winter sports on ski slopes.

Materials and methods: A total of 500 skiers and snowboarders (345 skiers, 110 snow-boarders, and 45 who rode both) were interviewed using a standardized questionnaire during one winter season (from January to April 2008). Sustained injuries and use of protective gear (including mouthguards) were assessed.

Results: Of the 500 interviewed, eleven (9 m, 2 f; 2.2%) had sustained dental trauma while skiing or snowboarding. Frequent riders were most susceptible to dental trauma (p < 0.001). 165 (33%) have sustained a skiing or snow- boarding accident at least once, males more often than females (p = 0.031). Protective gear was used by 337 (67.4%), helmet, back and wrist protectors being worn most often. Snow-boarders were generally protected best (p < 0.001). All riders who had sustained an accident (n = 124; 75.1%) wore protective gear at the time of the interview (p = 0.009). Only two of eleven who had sustained dental trauma wear a mouthguard now for winter sports.

Conclusion: The results show that skiing and snowboarding pose only a small risk for dental trauma.

Wisdom tooth transplants offer youth the possibility of biologically fixed tooth replacement in cases of premolar agenesis or premature loss of a molar. In the present study, 57 transplants of third molars were reviewed and evaluated retrospectively on preoperative findings (root growth stages, extraction sites, indication for transplantation), on postoperative clinical findings (local gingivitis, periodontal probing values, tooth mobility, percussion sound and percussion pain) and on radiological findings (tertiary build-up of dentin, osseous periradicular conditions, progress of root growth). Only the transplants which healed with a vital pulp and in a periodontally healthy state were considered successful. Upper and lower wisdom teeth having 50% to 75% root growth progression were transplanted. The postoperative follow-up observation period averaged 26.4 months. The success of a wisdom tooth transplantation was not influenced by the root growth stage (p = 1), the extraction location of wisdom teeth (p = 0.45), or the feasibility for a transplantation (p = 0.56). Three teeth showed pulpal necrosis with apical periodontitis and were counted as failures. The success rate was rather high with 54 out of 57 transplants (94.7%), therefore wisdom tooth transplantations, with careful selection of a suitable graft and its gentle removal, can be described as a good predictable treatment.

The purpose of this study was to evaluate the present opinions and the knowledge of Swiss general dentists about current strategies to restore endodontically treated teeth. Between 2009 and 2011, a 17-item questionnaire was given to 95 general dentists at the beginning of continuing education courses related to this topic. The majority of dentists indicated that they restore more than 30 endodontically treated teeth per year. The decision for placing an intracanal post was mainly based on the amount of remaining tooth substance and the type of tooth (anterior tooth, premolar, molar, or abutment for fixed dental prostheses). Most respondents strove for a retention depth of at least two-thirds of the root length and a form-congruent fit between post and post space preparation. In terms of post type, metallic posts were predominantely used, while an increasing application of glass-fiber posts was registered. Regardless of the type of post, composite cements were the most commonly used luting materials. The prevailing strategies for the restoration of endodontically treated teeth are in part in accordance with the current literature. Disagreements with the literature are related to the post length, the desired post fit and the fact that metal screw posts are apparently still in use.

The present study reports on the surgical and prosthodontic rehabilitation of 46 patients, 31 male and 15 female, after resection of oral tumors. The treatment was carried out from 2004 to 2007 at the Department of Prosthodontics, University of Bern, with a follow-up time of 3 to 6 years. The average age at diagnosis was 54 years. 76% of all tumors were squamous cell carcinoma, followed by adenocarcinoma. Resection of the tumors including soft and/or hard tissues was performed in all patients. 80% of them additionally underwent radiotherapy and 40% chemotherapy. A full block resection of the mandible was perfomed in 23 patients, and in 10 patients, the tumor resection resulted in an oronasal communication. 29 patients underwent grafting procedures, mostly consisting of a free fibula flap transplant. To enhance the prosthetic treatment outcome and improve the prosthesis stability, a total of 114 implants were placed. However, 14 implants were not loaded because they failed during the healing period or the patient could not complete the final treatment with the prostheses. The survival rate of the implants reached 84.2% after 4 to 5 years. Many patients were only partially dentate before the tumors were detected, and further teeth had to be extracted in the course of the tumor therapy. Altogether, 31 jaws became or remained edentulous. Implants provide stability and may facilitate the adaptation to the denture, but their survival rate was compromised. Mostly, patients were fitted with removable prostheses with obturators in the maxilla and implant-supported complete dentures with bars in the mandible. Although sequelae of tumor resection are similar in many patients, the individual intermaxillary relations, facial morphology and functional capacity vary significantly. Thus, individual management is required for prosthetic rehabilitation.