Biological interaction, esthetics, handling, and loss rate of temporary luting cements - a clinical single-blind randomized controlled trial.

OBJECTIVES: To evaluate three temporary luting cements in terms of their restoration loss rates, biological interactions, esthetic properties, and handling characteristics. MATERIALS AND METHODS: 75 adults requiring fixed prosthodontics voluntarily participated in a single-blind, randomized controlled trial. After preparation, temporary restorations were luted with a randomly selected temporary luting cement (either Provicol QM Plus (PQP), Bifix Temp (BT), or Provicol QM Aesthetic (PQA)). Clinical examinations were performed one to two weeks after cementation. The following criteria were evaluated: tooth vitality, percussion, hypersensitivity, gingival bleeding, odor formation, esthetics, cement handling, removability, cleanability, and retention loss. Antagonistic teeth served as controls. Statistical analysis was performed using the paired t-test, one-way ANOVA, Pearson's chi-square and Fisher's exact test, where appropriate. RESULTS: The overall loss rate of temporary restorations was 16.0%, showing no cement-specific differences. Postoperative hypersensitivity occurred in 8% of cases regardless of cement type. Esthetic impairment was reported by 31% of the PQP-fixed restorations, compared with 4.0% and 4.2% of the BT and PQA-bonded restorations. Cement application was reported to be easy in 100% of cases, excess removal in 88-96%, depending on the cement used. CONCLUSIONS: The choice of luting material affects the esthetic appearance of a temporary restoration and should be considered, particularly in restorations in esthetically demanding areas. No significant differences between the cements were identified regarding biocompatibility, handling, and loss rate. CLINICAL RELEVANCE: Translucent cements can help to reduce color interferences, resulting in a more appealing appearance of the temporary restoration.

Sex hormones associated with temporomandibular pain on palpation in male adolescents-Results of the epidemiologic LIFE child study.

OBJECTIVE: This study aimed to investigate whether the sex steroid precursor hormone dehydroepiandrosterone sulphate (DHEA-S), sex hormone-binding globulin (SHBG) and testosterone (TT) are associated with temporomandibular (TM) pain on palpation in male adolescents. METHODS: Out of the LIFE Child study dataset containing 1022 children and adolescents aged 10-18 years (496 males, 48.5%), we used a subsample of 273 male adolescents (mean age: 13.8 ± 2.3 years) in advanced pubertal development (PD) to analyse the association between hormones and TM pain. The Tanner scale was applied to describe the stage of PD. Pain on palpation of the temporalis and masseter muscles and the TM joints (palpation pain) was assessed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Serum levels of sex hormones (DHEA-S, SHBG and TT) were determined using standardised laboratory analyses. Free TT was estimated from the ratio between TT and SHBG (free androgen index[FAI]). We calculated the risk of perceived positive palpation pain for male participants as a function of hormone levels (DHEA-S, FAI) taking into account age and body mass index (BMI). RESULTS: Among more developed (Tanner stage 4-5) male adolescents, 22.7% (n = 62) reported palpation pain in the TM region. In these participants, FAI levels were approximately half that of individuals without such pain (p < .01). DHEA-S levels were about 30% lower in the pain group (p < .01). In multivariable regression analyses, the odds ratio (OR) for pain on palpation decreased to 0.75 (95% confidence interval [CI]: 0.57-0.98) per 10 units of FAI level compared to those without pain, after controlling for the effects of age and adjusted BMI. We observed the same effect for this subgroup per unit of DHEA-S serum level (OR = 0.71; 95% CI: 0.53-0.94). CONCLUSION: At subclinical lower levels of serum free TT and DHEA-S, male adolescents are more likely to report pain on standardised palpation of the masticatory muscles and/or TM joints. This finding supports the hypothesis that sex hormones may influence pain reporting.

Material selection for tooth-supported single crowns-a survey among dentists in Germany.

OBJECTIVES: This study aimed to survey dentists in Germany to identify their favored materials for the fabrication of tooth-supported single crowns (SCs) depending on the location of the abutment teeth and the preparation margin. MATERIALS AND METHODS: The survey included questions regarding demographic characteristics of dentists/their dental practice and preferred restorative materials for the fabrication of SCs for abutment teeth 16, 11, 34, and 36 with either supra- or subgingival preparation margins. RESULTS: Between August 2019 and February 2020, 721 dentists participated in the survey; responses from 33 dentists were excluded from data analysis because the dentists did not work in Germany or provided less than one fixed dental prosthesis/month. Dentists favored ceramic materials independent of the location of the abutment tooth and preparation margin (56.6-92.2%). CAD/CAM resin composites or full metals were preferred by only a few participants. A significantly higher proportion of dentists recommended porcelain fused to metal for subgingival preparation margins than for supragingival margins (p < 0.001). Characteristics of dentists/dental practices influenced a single scenario (11 subgingival) that was dependent on the dentist's time since graduation. When asked to specify the ceramic materials, numerous participants wrote a free response (5.7-7.8%) or did not answer (0.7-4.8%). CONCLUSIONS: Dentists in Germany selected restorative materials for SCs depending on the clinical scenario. Since numerous dentists did not specify the ceramic materials, postgraduate information and education might help to extend expertise. CLINICAL RELEVANCE: The results of this survey provide insight into the favored materials of dentists for the fabrication of tooth-supported SCs.

Material preferences for tooth-supported 3-unit fixed dental prostheses: A survey of German dentists.

STATEMENT OF PROBLEM: Different material options are available for fixed dental prostheses (FDPs), but valid data on the favored materials of German dentists for 3-unit FDPs are lacking. It is unclear whether preferences depend on the individual characteristics of the dentists or their dental practices. PURPOSE: The purpose of this survey was to identify the preferred material selection of German dentists for the fabrication of tooth-supported 3-unit FDPs depending on the location of the abutment teeth and the individual characteristics of the dentist or the dental practice. MATERIAL AND METHODS: A survey was developed that included questions on the demographic characteristics (sex, area of expertise, age group, time since graduation, number of inhabitants, and the postal code of the dental practice or dental school) of the participating dentist and their preferred materials for the fabrication of tooth-supported 3-unit FDPs. Three clinical scenarios (anterior maxillary FDP, posterior maxillary FDP, posterior mandibular FDP) were presented. The dentists were allowed to select from predefined options or to give a free answer. For comparisons of characteristic associations, the number of inhabitants was chosen to represent the characteristics of the dental practice, and sex and time since graduation were selected to represent the characteristics of the dentist. Group comparisons were conducted with Chi-square tests (α=.05). RESULTS: A response of 721 dentists from all parts of Germany was received, and data from 688 dentists were included in the analyses. Ceramic was the most preferred material for the fabrication of 3-unit FDPs independent of the location of the abutment teeth with veneered zirconia as the favored option. Metal-ceramic was ranked second. The time since graduation ≤15 years was associated with a preference of ceramic over metal-ceramic for the anterior restoration (P<.001). CONCLUSIONS: Most participating dentists selected appropriate restorative materials depending on the individual clinical setting presented in the survey. For the anterior 3-unit FDP, time since graduation was associated with the preference for a restorative material. Some dentists selected lithium-X-silicate ceramics for situations beyond their recommended indication range.

[Oral health in dementia: Results of a telephone helpline]. / Mundgesundheit bei Demenz: Ergebnisse einer telefonischen Beratungsstelle.

BACKGROUND: The complexity of dental care and oral hygiene for people with dementia increases with increasing numbers of residual teeth. AIM: This study was carried out to determine whether the offer of a telephone helpline on oral health and dementia would be utilized. MATERIAL AND METHODS: Over a period of 1 year contacts received by a telephone helpline manned by three oral healthcare staff were collected and analyzed. RESULTS: From 01 June 2012 to 31 May 2013 a total of 355 callers (180 healthcare staff and 175 relatives) presented and discussed 2535 problems. The average duration of a call was 21 min. Almost one quarter of the callers were looking for mobile dental care services and 14.4 % were looking for a dentist specialized in caring for patients with dementia. Oral disease, oral care and conflicts between stakeholders on aspects of oral health were discussed. Of the healthcare staff three quarters asked about training to improve the oral health of people with dementia. CONCLUSION: The demand on the specialists of the helpline showed a substantial knowledge deficit of healthcare staff and relatives. The study confirmed a wide range of oral health issues of people with dementia. Knowledge on oral and denture hygiene and on oral disease could be introduced into primary training and continued professional education. In addition to the lack of knowledge, deficits also exist in the oral healthcare system for people with dementia. Politicians and healthcare stakeholders are encouraged to incorporate oral healthcare for people with dementia into strategies and dementia networks.

Intraoral Repair of Chipping Due to Cohesive Failure-Results of a Nationwide Survey Among Dentists in Germany.

PURPOSE: To survey the materials favored by dentists for intraoral repair of cohesive chipping. MATERIALS AND METHODS: From August 2019 to February 2020, dentists were surveyed to determine the frequency of cohesive chipping experienced within the last 3 months and to identify their preferred approaches for intraoral repair. RESULTS: Of the participants, 42.5% observed chipping (n = 506). Participants favored the application of roughening devices, silane, and composite resins. Self-etching glass-ceramic primers or hydrofluoric acid were used for ceramic etching. CONCLUSION: Dentists apply a variety of materials for intraoral repair of chipping, including materials that are not approved for intraoral use. Int J Prosthodont 2023;36:216-218. doi: 10.11607/ijp.7098.

What Counts for the Old and Oldest Old?-An Analysis of Patient Criteria for Choosing a Dentist-Part I: Awareness and Selection Criteria, Infrastructure, and Dental Office Equipment.

Utilization of a dentist is influenced by many factors. The aim of this study is to present the factors relating to how patients become aware of a dentist, according to which criteria they select the dentist, and which factors in the infrastructure, equipment of dental offices, and human interactions are important for patients. A telephone survey with 466 participants (female 59.9%) in three age groups (ag 1: 35−50 years, ag 2: 70−84 years, ag 3: >85 years) in three German cities was conducted. Data were analyzed with respect to age, gender, and place of residence. Hardly any differences in the selection of the dentist and the selection criteria applied were found between the sexes, the age groups, or the places of residence. Recommendation seems to be the major aspect regarding how patients become aware of or select their dentist (n = 278, 65.6%), while modern technologies, e.g., the internet, play a subordinate role (n = 31, 7.3%). The unimportance of modern technologies increases significantly with the increase in age. As age increases, factors such as infrastructure (e.g., elevator available (ANOVA p < 0.001; Bonferoni correction: significant differences between ag 1 and ag 2 p < 0.001, ag 1 and ag 3 p < 0.001, and ag 2 and ag 3 p = 0.009); accessibility by wheelchair (ANOVA p < 0.001; Bonferoni correction: significant differences between ag 1 and ag 2 p = 0.006; and ag 1 and ag 3 p < 0.001); etc.) and dental office equipment become significantly important and influence the choice of dentist, while the importance of good parking facilities significantly decreased with age (ANOVA p = 0.003; Bonferoni correction: significant differences between ag 1 and ag 3 p = 0.004, and ag 2 and ag 3 p = 0.023). With increasing age, e.g., the importance of a television in the waiting room (ANOVA p = 0.012; Bonferoni correction: significant differences between ag 1 and ag 3 p = 0.014; and ag 2 and ag 3 p = 0.011), a modern waiting room (ANOVA p < 0.001; Bonferoni correction: significant differences between ag 1 and ag 3 p < 0.001; and ag 2 and ag 3 p < 0.001) or the possibility to visualize the oral situation on a screen decreases significantly (ANOVA p < 0.001; Bonferoni correction: significant differences between ag 1 and ag 2 p < 0.001; ag 1 and ag 3 p < 0.001, and ag 2 and ag 3 p < 0.001). If dentists want to welcome and treat older people, they should adapt the accessibility, infrastructure and equipment of their practice to the needs of older people in order to be able to guarantee continuous lifelong dental care regardless of the need for assistance or care.

What Counts for the Old and Oldest Old?-An Analysis of Patient Criteria for Choosing a Dentist-Part II: Personal Characteristics and Soft Skills.

Soft skills include communication skills and personality traits that are important when choosing a dentist, but other factors within the dental office also seem to be important for patients. The aim of this study is to evaluate factors that are important to people in a dentist as well as characteristics of the ideal dentist and to evaluate possible age-, gender-, and residence of living specific differences. A telephone survey with participants aged 35 years or older (ag­age group: ag 1: 35−50 years, ag 2: 70−84 years, ag 3: >85 years) in three German cities was conducted. Data were analyzed with respect to gender and age. Most of the participants (n = 298, 64.2%), regardless of their own gender, age, or place of residence did not care about the gender of the dentist. In general, the price of the treatment does not play a role in choosing the ideal dentist. Women differ significantly from men in their choice of dentist (ANOVA p < 0.001 (preference of non-smoker), ANOVA p < 0.001 (preference, that the dentist does not smell of smoke, importance of appearance (ANOVA p < 0.001) and psycho-social skills, etc.). As age increases, professional experience and psycho-social competencies are rated as important. With the increase in age, the mean value of the desired years of professional experience increases without significant differences between age groups. The importance of advanced training (ANOVA p < 0.001; Bonferoni correction: significant difference between ag 1 and ag 2 p < 0.001, and ag 1 and ag 3 p < 0.001) decreases with age. Especially for participants aged 70 to 84 years, a relationship of trust is important. Between the places of residence, statistical differences for almost all surveyed items were found (e.g., importance that the dentist speaks the patients' native language ANOVA p < 0.001, Bonferoni correction: significant difference between Berlin and Leipzig, Berlin and Mainz, and Leipzig and Mainz (each p < 0.001), dentist has a specialization ANOVA p < 0.001, Bonferoni correction: significant difference between Berlin and Leipzig and Berlin and Mainz (each p < 0.001), etc.). Dentists should be trained to develop psycho-social skills to meet the special demands of the increasing older population.

The Influence of Coordinative Skills on the Oral Health of Children and Adolescents in Permanent Dentition.

Removing dental plaque by using a toothbrush is the most important measure for oral hygiene. The aim of the present study was to estimate the impact of the coordination skills of children and adolescents on their oral health (plaque level, DMF/T: decayed, missing, filled teeth). Within a prospective cohort study, 996 children (10 to 18 years) were examined. The results of three coordination tests from the Motorik Modul (MoMo) were included to evaluate the coordination skills. Other parameters taken into account were age, sex, orthodontic treatment and socioeconomic status (SES). Univariate and various multivariate analyses were performed to evaluate relationships. Better results in precision coordination tests were significantly related to a better oral hygiene (backward balancing: logistic regression OR 0.86, 95%CI: 0.73−0.99, p = 0.051, proportional odds model OR 0.86, 95%CI: 0.75−0.99, p = 0.037; one-leg-stand: logistic regression OR 0.78, 95%CI: 0.63−0.96, p = 0.018, proportional odds model OR 0.77, 95%CI: 0.64−0.92, p = 0.003). Higher scores on one-leg-stand were significantly related to a lower caries prevalence (logistic regression OR 0.81, 95%CI: 0.66−0.99, p = 0.037; Poisson regression exp(ß) 0.82, 95%CI: 0.74−0.91, p < 0.001). Coordination test under a time constraint (jumping side-to-side) showed no significant relation. Oral hygiene was poorer in younger children, boys and low SES. Caries prevalence increased with low SES and increasing age. The present results suggest that oral health is influenced by coordinative skills.

Cementation of Tooth-colored Restorations - A Survey among Dentists in Germany.

Purpose: To survey dentists in Germany regarding their preferred cementation regimen for fixed dental prostheses (FDPs) fabricated from various restorative materials. Materials and Methods: An online survey was developed for completion by dentists in Germany between 08/2019 and 02/2020. The questionnaire gathered information about the cementation regimen (conventional, including the acid-base cements zinc-oxide phosphate or any glass-ionomer cement; self-adhesive; adhesive; don't know) that the participant would preferably select for the insertion of single- or multi-unit FDPs fabricated from various restorative materials. Data were also collected on demographic and personal characteristics. Results: A total of 721 dentists completed the survey, and the data from 688 questionnaires were included in the analysis. Conventional cementation was the option of choice for restorations fabricated from alloy/porcelain-fusedto- metal among 91.0% of the participants and for restorations fabricated from polycrystalline ceramics among 42.9% of the participants. Adhesive cementation was preferred for restorations fabricated from feldspathic/leucitereinforced glass ceramics (77.9%), lithium-disilicate glass ceramics (67.5%), zirconia-reinforced lithium-silicate glass ceramics (42.0%), and CAD/CAM resin composites (63.8%). Uncertainties regarding the appropriate cementation protocol for restorations fabricated from CAD/CAM resin composites were reported by 15% of the participants. More than 20% of the participants selected a technique that is less or not at all recommended for the cementation of restorations fabricated from zirconia-reinforced lithium-silicate glass ceramic and CAD/CAM resin composites. Conclusion: The results of the survey suggest that dentists in Germany select the cementation regime depending on the restorative material. Some of the participating dentists selected cementation regimens that are less or not at all recommended for restorations fabricated from zirconia-reinforced lithium-silicate glass ceramic and CAD/CAM resin composites, or were not sure about the appropriate cementation protocol.

Relationship between deciduous molar hypomineralisation and parameters of bone metabolism in preschool children.

BACKGROUND: The aetiology of deciduous molar hypomineralisation (DMH) is still largely unknown. AIM: The aim of the study was to elucidate the occurrence of DMH as a function of the parameters of bone metabolism, as it is suspected that abnormalities in these parameters may affect the mineralisation of teeth. DESIGN: In a prospective cohort study, 958 children aged 1-6 years were examined. The inclusion criteria were: a blood sample to determine the parameters of bone metabolism; and documentation of enamel mineralisation using the European Academy of Paediatric Dentistry (EAPD) criteria. Multivariable methods were applied to analyse the incidence of DMH relative to the concentrations of serum calcium, phosphate, vitamin D, vitamin B12 and alkaline phosphatase, taking into account the effects of age, gender and height. RESULTS: The proportion of children diagnosed with DMH was 4.0% (38 of 958). A significant difference between DMH-affected and non-DMH-affected children was found only in the serum concentration of calcium (2.47 ± 0.08 mmol/l vs. 2.52 ± 0.10 mmol/l, respectively, P = 0.004). The risk of DMH significantly increased, by 1.63-fold (95% CI: 1.03-2.57), if the calcium level dropped by 0.1 mmol/l, regardless of age, gender or adjusted height. During the follow-up examination of 17 DMH-affected subjects, the calcium level remained consistently low 1 year later (t-test, P > 0.05). CONCLUSION: Children with DMH showed consistently subclinically lower serum calcium levels. No associations were found for other parameters.

Influence of overweight/obesity, socioeconomic status, and oral hygiene on caries in primary dentition.

AIM: The aim of the present study was to investigate possible influences of overweight (OW)/obesity on caries in primary dentition. Socioeconomic status (SES) and quality of oral hygiene were also considered. METHODS: In the present study, 1628 children between the ages of 6 months and 9 years were included. In addition to dental examinations regarding the decayed, missing, filled teeth (dmft) index in primary dentition and the evaluation of oral hygiene, the body mass index standard deviation score (BMI SDS) was determined, and SES was recorded. RESULTS: The presence of OW/obesity was associated with higher caries prevalence (P < 0.001). A lower SES and non-optimal oral hygiene were also associated with increased dmft. The Poisson regression also showed a significantly higher risk in the combination of a high SES and OW/obesity (ßlow-high  = 0.21, P = 0.01). The increase was evident in both good and poor oral hygiene. In contrast, there was no difference between the lower and middle social strata (ßlow-medium  = 0.03, P = 0.6). With increasing age, the BMI influence decreased (ßage: BMI SDS  = -0.06, P < 0.001). CONCLUSIONS: BMI, oral hygiene, and SES are important factors in caries prevalence. In the highest social class, however, increased body weight has an adverse effect regardless of oral hygiene.