Dental education in Germany

In Germany, the dental curriculum is still based on dental licensing regulations (Approbations-/Prufungsordnung fur Zahnarzte) from 1955. Essential changes of the dental licensing regulations have not been made for over 50 years-unlike the medical licensing regulations in Germany. Teaching and learning concepts have, nevertheless, changed considerably in medical and dental education over time. The present study delivers an analysis about reform initiatives in dental education in Germany and introduces examples of innovative projects. To be able to establish long-term and broad reforms in dental education, new licensing regulations for dentists are required. This should create a contemporary framework for education, which assigns resources and enables occupational profile development at specific locations. Thereby, compatibility with the medical curriculum has to be guaranteed just as required adaptations of admission and curricular capacity regulations for dentistry

Standard and Limit Values of Mandibular Condylar and Incisal Movement Capacity

A clinical functional status was obtained and an instrumental analysis of functional movement patterns of the mandible using the ultrasonic Jaw Motion Analyzer (JMA, Zebris; Isny, Germany) was performed on 259 subjects (100 male, 159 female) who were part of an associated project of the representative population -based Study of Health in Pomerania (SHIP 0). Standardized bilateral arbitrary skin points based on anatomical skin references were assumed as posterior reference points in the joint area. The recorded movement patterns were evaluated for condylar movement capacity right and left upon mouth opening (COR and COL, in mm), the incisal right -lateral and left -lateral excursion capacity (IR and IL, in mm), the incisal opening capacity (10, in mm), and the maximum opening angle (OA, in degrees). For the determination of the standard and limit, the following means were determined with standard deviations and 5th and 95th percentiles: COR 14.52 +/- 4.188 (7.70, 21.40); COL 15.07 +/- 4.788 (7.60, 21.80); IR 8.92 +/- 2.403 (5.20, 13.00); IL -8,79 +/- 2.455 (4.80, 13.00); 10 44.34 +/- 7.388 (33.40; 56.10); OA 32.16 5.954 (21.40; 41.80). The values for men vs women for IR and for OW and in the age group below 40 years vs 40 years and above for IR were statistically significantly different. Interestingly, the interval between the 5th and 95th percentile in the group with a Helkimo clinical dysfunction index of 1 and approximately the same mean value was significantly greater than in the group with Helkimo 0. Based on this standard and limit values or ranges, individually measured values of functional mandibular movement can be compared and differentiated with respect to hypomobility/limitation ( 95th percentile). This serves to indicate the therapeutic direction for functional treatment to improve the jaw's movement capacity in terms of biomechanical optimization. Objective kinematic measurements can be used for additional documentation of the treatment progress during the treatment course

Variability and Reliability of Muscle Activity Measurements During Chewing

The objective of this study was to test masseter muscle activity and its variability and reliability in terms of repeatable measurements in fully dentate and healthy volunteers during habitual chewing and deliberate unilateral chewing. Three sessions were performed on three consecutive days, each time recording kinematic data and masseter muscle EMG activities through a series of defined jaw exercises, including maximum voluntary contraction, habitual chewing, and left and right unilateral chewing. Asymmetry index (Al) and deliberate chewing index (DCI) scores were used to evaluate the activities of the left and right masseter muscles, which were separately recorded during each of these chewing exercises. DCI scores were side -specific, including two sets of values for left and right unilateral chewing. Reproducibility testing of the values obtained for all parameters revealed good to excellent reproducibility of masseter muscle activity under standardized recording conditions across the consecutive study sessions, with intra-class correlation coefficients (ICCs) ranging from 0.68 to 0.93. Different individuals were found to utilize different strategies of bilateral masseter activation during both habitual chewing and deliberate unilateral chewing

A CAD-Based Workflow and Mechanical Characterization for Additive Manufacturing of Tailored Lattice Structures

Lattice structures are highly recommended for lightweight applications and cost reduction in additive manufacturing (AM). Currently, parts with lattice structures are still mainly used for illustrative purposes and rarely in industrial products. One important reason is that, due to their high dependency on macro- and micro-geometry, the mechanical properties of manufactured structures are difficult to predict. Thus, even and precise struts are needed. In this paper, a workflow for fabrication of lattice structures with strut-diameters from 150 µm to 400 µm on commercial laser beam melting (LBM) systems is presented. Based on a CAD-integrated user-interface for lattice design, a customized slicing algorithm determines database-aided suitable exposure parameters which ensure that the properties of the manufactured struts will just be as specified upon design. Subsequently, compression tests are performed in order to verify the established workflow. The developed tool enables designers to integrate AM-specific geometries into their components with little specific experience in AM.Mechanical Engineerin

Do we need real-time MRI for diagnosis of temporomandibular joint disorders?

Magnetic resonance imaging (MRI) has been approved as an appropriate radiological modality for temporomandibular joint (TMJ) diagnosis, whereas the results of international multicenter studies impressively show the limitations of static three-dimensional MRI. The state of the art for dynamic imaging of the TMJ in real-time are TrueFISP sequences in one sagittal plane. In order to support the diagnostics, a computer-assisted visualization procedure has been developed by the authors for both the static and dynamic MRI

Effects of occlusal modifications on the muscular activity of the masseter and anterior temporalis muscles

The aim of this study was to analyze the effect of occlusal modifications on the muscular activity of the masseter and anterior temporalis muscles. The study included 41 healthy dentate subjects who were examined in relation to the muscle activity of the masseter and anterior temporalis muscles recorded by surface electromyography (EMG) bilaterally in two different sessions. Occlusal plastic strips (thickness: 0.4 or 0.8 mm) were placed on different mandibular teeth to simulate different bite constellations (unilateral, bilateral transversal, and bilateral diagonal). Controlled by visual feedback, the subjects performed submaximum occlusion at 10% and 35% of maximum voluntary contraction (MVC). The activity ratios of the muscles were analyzed by two-way repeated measurement analysis of variance (ANOVA), and the reliability of muscle activity data was determined by intraclass correlation coefficient (ICC) analysis. The activity ratios of the masseter muscles were not significantly different under various biting conditions. In contrast, the anterior temporalis muscles showed significant differences (P < 0.001) between unilateral configurations and the other biting conditions (bilateral transversal or diagonal), in particular during biting at 10% MVC. In general, ICC values revealed low to moderate reliability of the measurements of muscle activity. Under controlled submaximum occlusal loading, the activity behavior of the masseter muscles remained stable, whereas the anterior temporalis muscles reacted differently to distinct occlusal biting configurations. The results support the assumption that the anterior temporalis muscles might operate as fine-tuning muscles when asymmetric bite force distributions occur, for instance during chewing, caused by food fragments between the teeth

4.3 Towards a global superstore of quality-assured modularized learning programmes

Our section's assignment entails exploration of the current challenges to develop criteria for quality assurance of dental e-learning material. Our work has involved comparison of current methods of assessment, the identification of best practice and the formulation of guidelines and criteria for producers and assessors. We anticipate the need for a standing international body responsible for the revision and refinement of guidelines and criteria and that might award a 'Seal of Approval'. © Blackwell Munksgaard, 2002