The system of prosthetic treatment for CLAP patients.

The prosthetic treatment of CLAP patients is usually done in three phases: an interceptive treatment during two stages of orthodontics, the definitive prosthetic treatment and usually the secondary treatment. In the interceptive phase we use clasp-retained partials; the definitive treatment is achieved mostly by telescope-retained partials. There is seldom an indication for Maryland-bridges or for dental implants.

[Periodontal aspects of removable partial dentures]. / Parodontale Gesichtspunkte bei der teilprothetischen Versorgung.

Periodontal pre-treatment of patients receiving partial dentures should involve three phases: initial therapy; periodontal surgery; home care. For periodontal surgery and/or prosthodontic treatment using precision materials, e.g. telescope retainers, the API (approximal plaque index) should not exceed 30%. To prevent further loss of gingival attachment due to iatrogenic irritation by the dentures preparation of abutments should consistently the para- or supragingival. In patients with few residual teeth telescope retainers, which can be cemented for definitive fit if indicated, are the treatment of choice.

[Periodontal aspects of care of partially edentulous jaws]. / Parodontale Aspekte bei der Versorgung des teilbezahnten Kiefers.

After an initial periodontal therapy to reduce bleeding a pocket depth and after reaching an AOI below 30% it is possible to make an apical reposition-flap. It is apt to supragingivalize the margins of restorations of fractured teeth or in case of subgingival lesions or preparation margins. In combination with a good recall-system thus the prognosis of periodontal treatment can be optimized.

[Bonded porcelain laminates--an alternative to anterior porcelain crowns]. / Die geklebte Porzellanschale--Eine Alternative zur Porzellan-frontzahnkrone.

The trend towards esthetic dentistry, which originates in the USA, has added new dimensions to the treatment of anterior teeth. One of it is the porcelain laminate technique. Using composites, extremely thin, manually prepared porcelain laminates with a thickness of 0.3 to 0.5 mm are bounded to the labial aspect of front teeth or laterals. On account of the low laminate thickness very little enamel preparation is needed. The residual enamel mass and the translucency of the ceramic material produce a natural appearance and optimal cosmetic results. This technique enables the dentist to restore the shape and color of esthetically compromised teeth.

[EEG changes in symptomatic headache caused by bruxism]. / EEG-Veränderungen bei symptomatischem Kopfschmerz durch Bruxismus.

EEG recordings were carried out on 36 patients with the verified diagnosis of bruxism and unilateral headache. Occlusal splints were applied in the long-term management of these patients. Initial EEG recordings showed pathological changes in 56% of the patients. The EEG recordings were repeated two and six weeks later in these patients and following improvement in the clinical symptomatology pathological EEG patterns were detected in only 22% of all cases. This decrease is of statistical significance.

[Nocturnal sleep studies of bruxism]. / Nachtschlafuntersuchungen bei Bruxismus.

Polygraphic recordings during two nights sleep in 7 selected outpatients prior to and following treatment of bruxism were carried out using EMG-, EEG and EOG-recordings to evaluate the activities of the masseter muscle and the different sleep stages. The results thus obtained were compared to those of an age-matched control group. Following treatment with occlusal splints the recordings were repeated eleven weeks later. The length and the amount of grinding and pressing activities were correlated with the total night sleep as well as with the different sleep stages. The highest incidence of muscle activity was found in stage two and during awakening. Furthermore muscle activities were observed immediately before the beginning of REM-sleep and in particular during the change from REM- to NREM-sleep and in sleep stage one. After treatment with occlusal splints there was a decrease of total muscle activity, thus indicating efficiency of the treatment.

Distribution of muscle activity during sleep in bruxism.

10 outpatients with bruxism were investigated by polygraphic recordings during night sleep. Electromyogram, electrooculogram and electroencephalogram derivations were used to evaluate the activities of masseter muscle and the different stages of sleep. The results of the bruxist group were compared to those of an age-matched control group. The amount and the length of pressing and grinding jaw movements were correlated with the sleep period time as well as with the different sleep stages. In comparison to the control group, a significant difference of muscle activity longer than 5 s was found, but there was no difference regarding activities of 3-5 s duration. The highest level of activity was found in sleep stage two and during awakening times. No difference was seen with regard to percentages of the sleep stages.