Deutsche Stomatologie (Berlin, Germany : 1990)最新文献

As a preliminary communication, we introduce a surgical procedure not previously described--intraorally performed ventrocaudal transpositional plastic surgery of the coronoid process for the treatment of recurrent TMJ luxation. The aim is to provoke an early stretch reflex of the temporal muscle and tendons by surgically shifting its insertion when the mouth is opened to an extreme position. Physiologically, this limits the extent to which the mouth can be opened and counteracts luxation. We report on initial clinical results of the intraoral transposition of the coronoid process after on observational period of 9 months.

Resection affecting the continuity of the mandible and the mandible nerve leads to complete anaesthesia of the lower lip and mental area, furthermore to deformity and functional disturbance like uncontrolled salivation. In our long term follow up study on multimodal neurological investigation sensibility is reported to have uncomplete regenerated spontaneously often already after one year. Complete sensory, however, could not be found; the incomplete sensory return was to be measured in individually different degrees of hypaesthesia. Furthermore the axonal qualities of the mandible nerve show different regenerative potential: the receptor function for pressure and contact sensitivity could be demonstrated in the most of cases, whereas the heat- and painreceptor qualities could not be revealed in all cases.

By experimentally brushing 20 teeth vertically to the tooth axis under a pressure of 2 N only lesions in cementum or dentine could be obtained. There was no case in which enamel was damaged by our brushing experiments. Therefore, defects appearing clinically cannot be explained by wrong tooth brushing techniques. There were several parallel lesions (similar to a saw blade) to be found as well as confluent hard tissue losses. Both indicate the direction of the movement of the tooth brush. The smallest defect to be measured in coronal-apical direction was 2.25 mm, the biggest 6.7 mm. The depth of the defects ranged front 239.9 microns to 493.2 microns. A correlation between Vicker's hardness and substance abrasion could not be proved, nor was the clinical appearance of wedge-shaped defects to be achieved by means of our experimental device. The formation of enamel defects cannot be explained by mere mechanical abrasion due to tooth brushing. In our opinions the formation of wedge-shaped defects implies a multicausal process.

The ceramic system In-Ceram is a metal-free method to manufacture ceramic crowns and bridges. The metal framework is replaced by a sintered, glass infiltrated aluminium oxide substructure of high strength. Due to improved material properties the implementation of ceramic dental restorations allows a wider range of application. The paper presents own clinical experiences as well as recommendations concerning the dimensions of the aluminium oxide substructure.

In the present study the results of individual programmes of dental care conducted in a selected population of young adults were shown. The periodontal status was recorded using GPM/T, CPITN, QHI index criteria. In the period of 18 months there was no progression of gingivitis. The severity of gingivitis was clearly reduced, but the percentage distribution was not influenced. The results of the study indicate directions for prevention, diagnosis and therapy. In order to reduce the incidence of the diseases dental care should be concentrated on the motivation and instruction of oral hygiene, plaque control and removal of dental calculus. The findings of the study confirm that a prophylactic programme can prevent more severe gingivitis and marginal periodontitis.

Whether fluoridation of drinking water would have an influence on orthodontic extraction therapy and especially on selection of extraction objects was inquired. Treatment results of 256 patients of a town with fluoridation of drinking water (Chemnitz) who had extraction of teeth under their orthodontic treatment, were interpreted and compared with these of a district without fluoridation of drinking water (Berlin). Evident differences concerning extraction frequency of the various species of teeth were noticed.

Resulting from clinical observation the relations between acute and chronical pulpitis and pulpitis chronica clausa, regressive metamorphoses and pulpal biomorphose are examined by histological findings and the literature. The etiological, nosological and pathohistological differentiation of this process is discussed. With the rising up of endodontological therapy needs into the middle and higher age the chronical inflammatorical and biomorphological events are more important. Proposals for diagnostics, differentiation and in the role wainting up instead of a early therapy are made.

There is a controversial discussion according to treatment of the early loss of first permanent molar. The aim of this investigation was to study the change of periodontal conditions of the teeth neighbouring the gap. We investigated 33 patients with 55 gaps. The average time of first molar loss was 10.5 years. The position of neighbouring teeth was influenced by the early loss of the first molar. Oral hygiene and self cleaning of the periodontal tissues was of good quality in this region. The bleeding on probing was smaller in this region compared with control teeth. The pocket depth of the second molar was higher than that of the second premolar. The loss of alveolar bone detected by radiography was greater in the second molar compared with the second premolar and also in the distal periodontal site of the second molar and the mesial site of the second premolar controlled with sites neighbouring the gap.

The direct and indirect effect on the endodont after thermic treatment with the micro-plasma unit from EGIDE were examined in animal experiments. The EGIDE unit is considered by its producer to be an alternative for CO2 lasers. The histological evaluation showed that both the plasma-therapy of dentin and the exposed pulp lead to massive pathological changes of endodont and was inferior to traditional methods as the indirect pulpcapping.

The increasing morbidity of the psychosomatical eating disorders demands more attention by the general practioners. The origin of the anorexia nervosa and bulimia nervosa and the clinical picture are described. The consequences of the acid erosion at the teeth are shown with illustrations. The cooperation between the psychotherapist and the dentist has a positive influence on the long therapy of the patients.