Stainless steel crown versus multisurface amalgam restorations: an 8-year longitudinal clinical study.

Two alternative methods of restoring primary teeth that had multisurface lesions were examined in a clinical longitudinal study. In a paired comparison, stainless steel crowns proved far superior to multisurface amalgam restorations with respect to both lifespan and replacement rate. Stainless steel crowns are not only more acceptable to the patient and more cost effective, but also more acceptable to the dentist because of the comparatively simple procedures involved in restoring even severely affected primary molars.

Failure to detect any effect of amalgam restorations on peripheral blood lymphocyte populations.

Dental amalgam has been considered to have adverse side effects on the immune system. Reports have been contradictory, indicating both an increase and a decrease in peripheral blood lymphocyte counts associated with amalgam restorations. We investigated two groups of patients, one of which was treated with amalgam restorations for the first time. In the other group, all existing amalgam fillings were removed. Prior to and after treatment, we determined the absolute and relative numbers of granulocytes, lymphocytes, monocytes, T cells, B cells, cytotoxic T cells, helper T cells and natural killer cells. In addition, functional investigations of T cells were performed. We failed to find any effect of amalgam restorations on the immune system in terms of the parameters investigated.

[Mercury vapor emission from amalgam capsules during trituration and storage]. / Quecksilberdampfabgabe aus Amalgamkapseln während Trituration und Lagerung.

Inhalation of mercury vapor is a potential hazard when handling dental amalgam. To prove the safety of modern capsule systems, we tested 21 brands of dental amalgam. Mercury vapor emission was measured at different stages during handling: a) immediately after opening of a capsule package, b) cumulative emission over 24 h of storage of an open package, c) during trituration and d) for different methods of waste capsule treatment. Highly significant differences between capsule types were found for the measured parameters. Disposable capsules that could be reassembled showed the most favorable results.

[Effects of amalgam on cells of the immune system]. / Einfluss von Amalgam auf Zellen des Immunsystems.

Dental amalgam has been considered to have adverse side effects on the immune system. There are controversial reports, which indicate an increase as well as a decrease in peripheral blood lymphocyte counts due to amalgam fillings. We investigated 2 groups of patients: one group was treated with amalgam restorations for the first time. In the other group all previous amalgam fillings were removed. Before and after treatment we determined the absolute and relative numbers of granulocytes, lymphocytes, monocytes, T cells, B cells, suppressor T cells, helper T cells and NK cells. In addition, functional investigations of T cells were performed. In conclusion, we could not find any effect of amalgam restorations on the immune system regarding the investigated parameters.

[Reproducibility of measurements to assess the quality of dental restorations]. / Reproduzierbarkeit von Messungen zur Ergebnisqualität zahnärztlicher Füllungen.

Criteria for assessment of the quality of dental restorations should be highly reproducible. To prove reproducibility of a set of modified Ryge-criteria we assessed the quality of 468 fillings (157 amalgam, 155 cast restorations, 156 composites). Assessment was done double-blind by two investigators. The amount of agreement between the investigators ranged from 56.1% to 88.4% depending on the criteria used. The more positive the results of the assessment and the more objectifiable the criteria, the higher was the amount of agreement. For an objective assessment the reproducibility of the method seems to be unsatisfactory.

Dental fear and pain: effect on patient's perception of the dentist.

A questionnaire was developed including the Dental Anxiety Scale (DAS) and the Dental Beliefs Survey (DBS) as subscales to examine the epidemiology of dental fear and dental beliefs in Germany. The survey was administered before treatment to a sample of 474 dental patients. Of the respondents 56% were female. The mean age was 34.3 yr (SD 12.4 yr). The mean DAS score was 8.6 (SD 3.7). Mean DBS score ranged from 1.73 to 2.75 for single items. The correlation between DAS and DBS scores was highly significant (rs = 0.39, P less than 0.001). Absence or presence of dental pain revealed significant differences for DAS and DBS scores (P less than 0.001). Both tests are valid screening forms for the German linguistic context and easy to implement in daily dental routine.

[Interaction of dental treatment anxiety and oral health]. / Wechselwirkung zwischen Angst vor dem Zahnarzt und Mundgesundheit.

Measurements of oral health (PBI, DMFS), dental treatment anxiety (DAS) and frequency of dental utilization were taken in a sample of 474 dental patients. Regression analysis shows that DAS scores are significantly correlated with DS, but not with MS and FS. Dental anxiety has a negative impact on the frequency of dental utilization, which is a predictor variable of oral health status. These results permit the conclusion that our attention should be focussed on reducing dental treatment anxiety to improve oral health.

[Epidemiology and treatment need for caries and periodontal disease in handicapped children and youth]. / Epidemiologie und Behandlungsbedarf von Karies und Parodontalerkrankungen bei behinderten Kindern und Jugendlichen.

Epidemiological studies in a group of handicapped subjects from the area of Lower Frankonia revealed a surprisingly good oral health. The WHO objective for caries control (DMF-T in 3 to 12 years olds) for the year 2000 has already been reached. In spite of low average values the individual values demonstrated a marked polarisation (30% of subjects of one birth year had approx. 70% of caries, missing, or filled tooth surfaces). The degree of treatment is clearly above that of the normal population. By comparison data are also favorable for the prevalence of gingivitis and periodontitis. Nevertheless one forth of the 10 to 13 year olds and half of those older than 14 will not only need an improvement of their oral hygiene but also scaling to treat their periodontal disease. Subjects with multiple handicaps are affected more strongly and need additional intensive preventive care.

[The patient--his anxiety and his assessment of the dentist as variables in the compliance model]. / Der Patient: Seine Angst und seine Einschätzung des Zahnarztes als Variable im Compliance-Modell.

The publication concerns the relationship between the two variables "patient anxiety" and "assessment of the dentist by the patient". Two instruments were used: the German versions of the "Dental Anxiety Scale" and the "Dental Belief Survey". The answers of 383 patients, age 18 to 80 years, demonstrated that both tests are highly age dependent. There is no difference between males and females in either test in the overall population nor in the individual age categories. Patient anxiety and assessment of the dentist by the patient show a highly significant correlation.

[Enhancement of bite-wing radiographs by digital image processing]. / Moglichkeiten der digitalen Bildverarbeitung zur Informations-verstarkung in Bissflugelaufnahmen.

Extracted premolars with an initial approximal caries were subjected to radiographic and histological examination. Radiographs were taken with the rectangular technique as used for bite-wing radiographs. Digital image processing was found to enhance the image information so that the border of caries lesions as well as histological structures, Retzius lines and Hunter Schreger stripes, within the body of the lesions were well defined. This helps to distinguish initial caries from depressions in the tooth surface.