Abstract: Objectives This study aimed to evaluate the influence of vestibuloplasty on the clinical success and survival of dental implants in head and neck tumor patients. Materials and methods A retrospective single-center study was conducted. All patients received surgical therapy of a tumor in the head or neck and underwent surgical therapy and, if necessary, radiotherapy/radiochemotherapy. Patients with compromised soft tissue conditions received vestibuloplasty using a split thickness skin graft and an implant-retained splint. Implant survival and success and the influence of vestibuloplasty, gender, radiotherapy, and localizations were evaluated. Results A total of 247 dental implants in 49 patients (18 women and 31 men; mean age of 63.6 years) were evaluated. During the observation period, 6 implants were lost. The cumulative survival rate was 99.1% after 1 year and 3 years and 93.1% after 5 years for patients without vestibuloplasty, compared to a survival and success rate of 100% after 5 years in patients with vestibuloplasty. Additionally, patients with vestibuloplasty showed significantly lower peri-implant bone resorption rates after 5 years (mesial: p = 0.003; distal: p = 0.001). Conclusion This study demonstrates a high cumulative survival and success rate of dental implants after 5 years in head and neck tumor patients, irrespective of irradiation. Patients with vestibuloplasty showed a significantly higher rate of implant survival and significantly lower peri-implant bone resorption after 5 years. Clinical relevance Vestibuloplasty should always be considered and applied if required by the anatomical situations to achieve high implant survival/success rates in head and neck tumor patients

Abstract: This study aimed to investigate the effects of an oral health optimized diet on the composition of the supragingival oral plaque in a randomized controlled trial. Participants of the standard diet group (n = 5) had a diet high in processed carbohydrates and did not change their dietary behavior during the observation. The healthy diet group (n = 9) had to change the diet after 2 weeks from a diet high in processed carbohydrates to a diet low in carbohydrates, rich in omega-3 fatty acids, rich in vitamins C and D, antioxidants and fiber for 4 weeks. Saliva and supragingival plaque samples were taken at the end of week two and eight of the observation period to investigate the composition of microbiota in saliva and supragingival plaque. Data were subjected to an exploratory analysis to identify significant differences. Statistically significant differences were only found in the healthy diet group between the baseline (week 2) and the final sample (week 8) for specific species in plaque and saliva samples. A reduction of the total counts of Streptococcus mitis group, Granulicatella adiacens, Actinomyces spp., and Fusobacterium spp. was found in plaque samples of the healthy diet group. In saliva samples of the healthy diet group, the total counts of Actinomyces spp. and Capnocytophaga spp. decreased. A diet low in carbohydrates, rich in omega-3 fatty acids, rich in vitamins C and D, and rich in fiber reduced Streptococcus mitis group, Granulicatella adiacens, Actinomyces spp., and Fusobacterium spp. in the supragingival plaque

Abstract: Background: The success of periodontal therapy depends on the adherence of patients to professional recommendations. The aim of this study was to investigate the influence of a workshop in motivational interviewing (MI) on non-surgical periodontal treatment performed by dental students.Materials and Methods: In the experimental group patients with periodontitis were treated by students trained in MI, while in the control group patients were treated by students who had not been trained in MI. Clinical oral parameters were assessed by a blinded periodontist in addition to the evaluation of psychological questionnaires given before and after the non-surgical periodontal treatment (6 months). Conversations between patients and students were recorded and rated with the Motivational Treatment Integrity Code (MITI-d) by a blinded psychologist.Results: There were 73 patients in the MI group and 99 patients in the control group. The MI group showed significantly higher scores in the MITI-d analysis. Regression analysis showed that there were no significant differences between groups with regard to plaque level, gingival bleeding, pocket depth reduction or bleeding upon probing. However, patients in the MI-group showed significantly higher interdental cleaning self-efficacy than patients in the control group (MI = 19.57 ± 4.7; control = 17.38 ± 6.01; p = 0.016).Conclusion: Teaching MI to dental students resulted in a significant improvement in the self-efficacy of interdental cleaning in patients compared to a control group of non-trained students, but no improvement in other aspects of non-surgical periodontal therapy. The study also showed that an 8-h workshop with supervision significantly improved the MI-compliant conversations of dental students without requiring more conversation time

Abstract: Purpose To investigate the influence of teeth and dental restorations on the facial skeleton's gray value distributions in cone-beam computed tomography (CBCT). Methods Gray value selection for the upper and lower jaw segmentation was performed in 40 patients. In total, CBCT data of 20 maxillae and 20 mandibles, ten partial edentulous and ten fully edentulous in each jaw, respectively, were evaluated using two different gray value selection procedures: manual lower threshold selection and automated lower threshold selection. Two sample t tests, linear regression models, linear mixed models, and Pearson's correlation coefficients were computed to evaluate the influence of teeth, dental restorations, and threshold selection procedures on gray value distributions. Results Manual threshold selection resulted in significantly different gray values in the fully and partially edentulous mandible. (p = 0.015, difference 123). In automated threshold selection, only tendencies to different gray values in fully edentulous compared to partially edentulous jaws were observed (difference: 58-75). Significantly different gray values were evaluated for threshold selection approaches, independent of the dental situation of the analyzed jaw. No significant correlation between the number of teeth and gray values was assessed, but a trend towards higher gray values in patients with more teeth was noted. Conclusions Standard gray values derived from CT imaging do not apply for threshold-based bone segmentation in CBCT. Teeth influence gray values and segmentation results. Inaccurate bone segmentation may result in ill-fitting surgical guides produced on CBCT data and misinterpreting bone density, which is crucial for selecting surgical protocols

Abstract: Objective To assess the survival and technical complication rate of partial and full-arch all-ceramic implant-supported fixed dental prostheses (P-FDP/FA-FDP) and supporting implants. Materials and methods An electronic search through three databases (MEDLINE/Pubmed, Cochrane Library, Embase) was conducted to identify relevant clinical studies with an observation period of at least 12 months, including ≥15 patients. Reconstruction and implant survival rates, technical complications and confounding variables such as processed/installed materials, retention mode and location in the mouth were obtained. Failure and complication rates were analyzed using standard Poisson regression models to calculate 5-year survival and complication estimates. Results A total of five studies for the P-FDP group and seven studies for the FA-FDP group were included, throughout evaluating veneered zirconia reconstructions. In the P-FDP group, reconstructions were located in posterior regions. Meta-analysis indicated survival estimates on the reconstruction level of 98.3% and 97.7% for P- and FA-FDPs after 5 years. However, chipping of the veneering ceramic was frequent, resulting in estimated 5-year complication rates of 22.8% (P-FDPs) and 34.8% (FA-FDPs). Five-year survival estimates of implants supporting P-FDPs and FA-FDPs of 98.5% and 99.4% were calculated, respectively. Including a total of 540 FDPs, one screw-loosening and 11 de-cementations were reported. Confounding variables were not found to have a significant influence on survival and complication rates. Conclusions All-ceramic implant-supported P- and FA-FDPs comprising veneered zirconia frameworks showed high survival but clinically inacceptable fracture rates of the veneering ceramic. Their suitability with regard to this indication and a successful long-term outcome needs to be further evaluated

Abstract: Objective This review aimed at evaluating the survival and technical complication rates of all-ceramic implant-supported single crowns (SC). Material and Methods Three electronic databases were searched for clinical studies conducted at ≥ 15 patients examining implant-supported all-ceramic SCs over ≥ 12 months. Survival rates of implants and restorations plus technical complication rates of SCs were calculated and tested for statistical correlation with confounding variables. Statistical analysis was performed using a negative binomial distribution model to calculate 5- and 10-year survival and complication estimates. Results Forty-one included studies reported on implant-supported SCs made of veneered and monolithic high-strength oxide ceramics, monolithic, and veneered glass-based ceramics and of a monolithic resin-nano-ceramic (RNC). Survival estimates for SCs of 93% (95% CI: 86.6%-96.4%) after 5 years and 94.4% (95% CI: 91.1%-96.5%) after 10 years were calculated, corresponding values for implant survival were 95.3% (95% CI: 90.6%-97.7%) and 96.2% (95% CI: 95.1%-97.1%). Technical complication rates after 5/10 years were as follows: chipping 9.0% (95% CI: 5.4%-14.8%)/2.7% (95% CI: 2.1%-3.5%), framework fractures 1.9% (95% CI: 0.7%-4.9%)/1.2% (95% CI: 1%-1.5%), screw loosening 3.6% (95% CI: 1.6%-8.4%)/5.2% (95% CI: 3.6%-7.5%), and decementations with 1.1% (95% CI: 0.4%-2.8%) after 5 years. Some confounding variables influenced the above-mentioned estimates significantly. Conclusions All-ceramic implant-supported SCs showed--with the exception of a RNC material--high survival rates. However, failures and technical complications occurred which have to be considered when informing patients on the treatment with implant-supported all-ceramic SCs

Abstract: In this pilot study, a volumetric analysis of retromolar onlay bone grafts over a period of 12 months was conducted, using repeated CBCT imaging combined with automated image registration. Eleven patients being treated with 16 bone grafts taken from the retromolar area were examined by CBCT scanning prior to bone augmentation (T0), immediately after bone augmentation (T1) and after a healing time of 12 months after augmentation (T2). Graft volumes were measured at each time point after automated image registration of consecutive CBCT scans. The mean volume of the augmented site was 372.2 ± 179.4 mm3. Resorption relative to the original augmented volume was 43.7% ± 19.0% after 12 months. Three-dimensional graft resorption could be precisely depicted by the use of automated image registration for CBCT data over a period of 12 months and demonstrated extensive volumetric changes of bone grafts taken from the ascending ramus of the mandible. Graft resorption and continuous bony remodeling of the grafted site before and after implant insertion have to be carefully considered by the clinician