Comparison of Gingival Retraction Materials Using a New Gingival Sulcus Model

Purpose To investigate the pressure generated by different retraction materials using a novel gingival sulcus model. Materials and Methods A gingival sulcus model was made using a polymer frame filled with silicon. A pressure sensor and a sulcus‐fluid simulation were embedded into the silicon chamber to evaluate the pressure generated by different retraction materials. Six sizes of Ultrapak retraction cords (Ultradent, sizes #000 ‐ 3), 4 retraction pastes (Expazen, Expasyl, Acteon, Access Edge, Traxodent) and 2 retraction gels (Sulcus Blue, Racegel) were analyzed. The mean and median pressure, interquartile range, and standard deviation (SD) of n = 10 repeated measurements were calculated. Statistical analysis was conducted by Kruskal‐Wallis test for differences between the main groups of retraction materials, and Mann‐Whitney U‐test was performed to analyze differences between the single retraction materials. Results Pressure (mean ± SD) generated by retraction cords increased with increasing size (48.26 ± 11.29 kPa, size #000 to 149.27 ± 28.75 kPa for #3). There was a significant difference between sizes (p \u3c 0.01), except in #0 versus #1, and #2 versus #3. Retraction pastes generated pressures that ranged from 82.74 ± 29.29 kPa (Traxodent) to 524.35 ± 113.88 kPa (Expasyl). Retraction gels generated pressures from 38.96 ± 14.68 kPa (Racegel) to 95.15 ± 24.18 kPa (Sulcus Blue). Pressure generated by Expasyl was significantly higher than pressure generated by all other tested materials (p \u3c 0.001). Conclusion Pressure generated by retraction pastes and gels depends on the consistency of the retraction material, while pressure generated by retraction cords increased with increasing size of cords. Expasyl was found to generate the highest pressure compared to all other retraction materials

Oral Health and Dental Anxiety in a German Practice-based Sample

Objective Does dental anxiety have an effect on dental and periodontal health? Methods Survey data was collected from n = 200 adults (53 % females, average age 49 years) in a cross-sectional study. Dental anxiety was measured with the modified dental anxiety scale (MDAS, score 1–5, the greater the score, the greater the anxiety). Clinical parameters including probing depth (PD), clinical attachment level (CAL), plaque index (SLI), and bleeding on probing (BoP) as well as the DMFT index were recorded and statistically analyzed. Results Rating of dental anxiety was higher in women than in men (65 vs 35 %). Subjects with higher MDAS values visited the dentist less frequently (p = 0.001) and had more decay (DT 6.7 ± 4.2 vs 1.7 ± 2.4; p \u3c 0.001) but fewer filled teeth than subjects with lower ratings of dental anxiety (FT 7.1 ± 4.5 vs 9.8 ± 5.7; p = 0.042). There were no differences in PD or CAL between subjects with or without dental anxiety, while patients with higher MDAS value showed significantly more BoP (50 ± 19 vs 34 ± 20 %; p = 0.002) than patients with low MDAS scores (no or low dental anxiety). Conclusions Patients with higher ratings of dental anxiety had significantly more caries experience and gingivitis. Therefore, dental anxiety is associated with negative effect on dental and periodontal health. Clinical relevance Identifying patients with high dental anxiety and helping to manage this anxiety has important implications to improve oral health in adults. The MDAS appears to be an easy and efficient tool that can be used to identify patients with dental anxiety in dental practices

An Explorative Evaluation on the Influence of Filler Content of Polyetheretherketone (PEEK) on Adhesive Bond to Different Luting Resin Cements

Polyetheretherketone (PEEK) is considered one of the most innovative prosthetic materials of the last few decades. Its chemically inert behavior and high biocompatibility make it a promising material in many areas of dentistry. The aim of this study was to test whether PEEK with different TiO2 filler contents achieves comparable bond strength values when using different resin cements. N = 70 PEEK samples each with different TiO2 filler content (20 wt.% TiO2 vs. 5 wt.% TiO2 vs. no filler as a control group) were divided into seven groups and cemented with various conventional (ResiCem, RelyX Ultimate, Variolink Esthetic DC) and self-adhesive resin cements (RelyXUnicem 2, Bifix SE, Panavia SA Cement Plus, SpeedCem). The shear strength of the bond was assessed after 24 h and after 25,000 thermal loading cycles. Mann-Whitney U and Wilcoxon tests were used for statistical analysis (significance level: α = 0.05). PEEK without filler showed the highest mean shear strength (24.26 MPa using RelyX Ultimate), then high-filled PEEK (22.90 MPa using ResiCem) and low-filled PEEK (21.76 MPa using RelyX Ultimate). Conventional resin cements generally achieved slightly higher adhesive strengths than self-adhesive resin cements. It appears that the filler content does not affects the adhesive bond strengths

Einfluss der supraglottalen Strömungsrandbedingungen auf den Onset- und Offsetdruck der Stimmlippenschwingungen

Hintergrund: Die klinische Diagnose von Stimmstörungen ist fast ausschließlich auf die Analyse der Stimmlippenschwingungen und des akustischen Signals der Stimme fokussiert. Aus physikalischer Sicht ist der Prozess eine Fluid-Struktur-Akustik-Interaktion. Die zeitabhängige Luftströmung oberhalb der Glottis kann im Patienten nicht berücksichtigt werden. Aus diesem Grund ist der Einfluss der Strömungsrandbedingungen im supraglottalen Bereich aus heutiger Sicht nicht hinreichend geklärt.Material und Methoden: Aus diesem Grund wurde ein künstliches Modell des menschlichen Kehlkopfes entwickelt. Die künstlichen Stimmlippen bestehen aus Silikonkautschuk, die durch einen Luftstrom zu Schwingungen angeregt werden. Somit ist es möglich, den Einfluss der Strömungsrandbedingungen im supraglottalen Raum auf den gesamten Prozess der Fluid-Struktur-Akustik Interaktion zu untersuchen. Die Variation der Randbedingungen umfassen die laterale Aufweitung des supraglottalen Strömungskanals und das Einbringen der Taschenfalten. In der vorliegenden Arbeit wurde der Onset- und Offsetdruck der Stimmlippenschwingung bestimmt. Dazu wurde ein Drucksensor verwendet der subglottal fixiert war.Ergebnisse: Es zeigte sich eine Steigerung des Onset- und Offsetdrucks für größere laterale Durchmesser des supraglottalen Kanals. Ferner wurde generell ein niedrigerer Onset- als Offsetdruck beobachtet. Der niedrigste Onsetdruck ergab sich beim Einbringen von Taschenfalten. Geschwindigkeits- und Druckmessungen der Strömung zeigten, dass der Druck innerhalb der Ventrikel zwischen Stimmlippen und Taschenfalten aufgrund der hohen Geschwindigkeit im Freistrahl abfiel. Dadurch wurde ein niedrigerer Onsetdruck für den Beginn der Stimmlippenschwingung benötigt.Diskussion: Bailly und Kollegen beobachteten eine Unterdrückung der Stimmlippenschwingungen bei kleinen Öffnungen zwischen den Taschenfalten, die zu einer Druckerhöhung in den Ventrikeln aufgrund der Stauung des Freistrahls führte. Eine Anfachung konnte bei größerem Spalt beobachtet werden, was durch den oben beschriebenen Effekt erklärt wird

Aetiology, comorbidities and cofactors of chronic leg ulcers: retrospective evaluation of 1 000 patients from 10 specialised dermatological wound care centers in Germany

Numerous comorbidities and cofactors have been known to influence wound healing processes. In this multicentre study, clinical data of 1 000 patients with chronic leg ulcers from ten specialised dermatological wound care centers were analysed. The patient cohort comprised 567 females and 433 males with an average age of 69.9 years. The wounds persisted on average for 40.8months and had a mean size of 43.7 cm(2). Venous leg ulcers represented the most common entity accounting for 51.3% of all chronic wounds, followed by mixed-type ulcers in 12.9% and arterial ulcerations in 11.0% of the patients. Vasculitis was diagnosed in 4.5%, trauma in 3.2%, pyoderma gangrenosum in 2.8%, lymphoedema in 1.7%, neoplasia in 1.0% and delayed post-surgical wound healing in 0.6% of the included patients. In total, 70.5% of patients suffered from arterial hypertension, 45.2% were obese, 27.2% had non-insulin dependent diabetes, and 24.4% dyslipidaemia. Altogether 18.4% suffered from metabolic syndrome. Cofactors and comorbidities of patients with chronic leg ulcers have previously been studied but not in detail. Here, we were able to demonstrate the existence of several potentially relevant cofactors, comorbidities of their associations and geographical distributions, which should be routinely examined in patients with chronic leg ulcers and - if possible - treated

Incidence of infections due to third generation cephalosporin-resistant Enterobacteriaceae - a prospective multicentre cohort study in six German university hospitals

BackgroundInfections caused by third generation cephalosporin-resistant Enterobacteriaceae (3GCREB) are an increasing healthcare problem. We aim to describe the 3GCREB infection incidence and compare it to prevalence upon admission. In addition, we aim to describe infections caused by 3GCREB, which are also carbapenem resistant (CRE).MethodsIn 2014-2015, we performed prospective 3GCREB surveillance in clinically relevant patient specimens (screening specimens excluded). Infections counted as hospital-acquired (HAI) when the 3GCREB was detected after the third day following admission, otherwise as community-acquired infection (CAI).ResultsOf 578,420 hospitalized patients under surveillance, 3367 had a 3GCREB infection (0.58%). We observed a similar 3GCREB CAI and HAI incidence (0.28 and 0.31 per 100 patients, respectively). The most frequent pathogen was 3GCR E. coli, in CAI and HAI (0.15 and 0.12 per 100 patients). We observed a CRE CAI incidence of 0.006 and a HAI incidence of 0.008 per 100 patients (0.014 per 1000 patient days).ConclusionsComparing the known 3GCREB admission prevalence of the participating hospitals (9.5%) with the percentage of patients with a 3GCREB infection (0.58%), we conclude the prevalence of 3GCREB in university hospitals to be about 16 times higher than suggested when only patients with 3GCREB infections are considered. Moreover, we find the HAI and CAI incidence caused by CRE in Germany to be relatively low