Internal diseases encountered by dental students while treating dental patients during undergraduate training

Abstract Background The number of internal diseases, disorders and syndromes (IMDDSs) encountered in dental practice is increasing. Dentists report to feel ill prepared by their undergraduate dental training for the management of IMDDSs. To increase the effectiveness of internal medicine training at dental school it might be necessary to focus on IMDDs encountered by dental students. The aim of our study was to identify IMDDSs dental students come across while treating dental patients during the clinical years of their undergraduate training. Methods All dental patients treated between April and July 2015 by 116 dental students enrolled at the Medical Faculty of Hamburg University in the semesters 7 to 10 were anonymously analysed retrospectively with respect to age, gender, smoking habits, drinking habits, current or previous diseases, allergies, current medication, dental diagnoses, and dental treatment in the current semester. Identified IMDDSs were clustered and evaluated. Results The 116 dental students treated 511 patients with 559 IMDDSs with a median of one IMDDS per patient. The IMDDSs encountered most frequently could be assigned to the subspecialties cardiology, endocrinology/diabetology, and rheumatology. Arterial hypertension occurred most frequently in dental patients, followed by diabetes mellitus type 2, and chronic bronchitis. Conclusions We identified the spectrum of IMDDSs encountered by dental students in the clinical years of their undergraduate dental education. Further studies are needed to test the effects of learning internal medicine with an internal medicine course based on the IMDDSs encountered by dental students and including additional IMDDSs specific relevance for dentists

Nergiz I. the fit of tapered posts in root canals luted with zinc phosphate cement: a histological study

The fit of tapered posts in root canals luted with zinc phosphate cement Schmage, P; Ozcan, M; McMullan-Vogel, C; Nergiz, [ Summary Objectives. Stress transmission to the root through passive fitting dental posts is partly influenced by the thickness of the cement layer between the post and the prepared root canal surface as well as the fit of the post in the root canal. The objective of this study was to compare the cement gap between the post surfaces and the root canals using five prefabricated, tapered, unthreaded titanium posts of different manufacturers, without and with cement. Methods. Following the endodontic treatment with hand instruments of 100 intact anterior teeth, post spaces were prepared using opening drills of the corresponding size of post. Fifty posts were cemented with zinc phosphate cement into the roots for each system while another 50 posts were inserted into the canal without using the cement. After histological sectioning, the cement gap was measured at six sites for three times at the coronal, middle and apical regions between the root canal wall and the post surface under a light microscope before and after cementation. Results. Before cementation, the highest overall cement gap was observed with the Dr Mooser post system w (46 mm) and the lowest with the Velva post system w and Cylindro-Conical system w (30 mm). Significantly less (P!0.05) mean cement gap was observed with respect to the Erlangen post system w (41 mm), the Dr Mooser post system w (48 mm), the MP Pirec post system w (34 mm) and Velva post system w (33 mm) when compared with the Cylindro-Conical system w (62 mm). The Cylindro-Conical system w (79, 61 mm) and MP Pirec post system w (25, 24 mm) demonstrated no significant difference (PO0.001) compared with Velva-Post w (38, 20 mm) at the coronal and middle part, respectively (Mann-Whitney U-test, Boneferroni correction). Significant differences (P!0.001) were observed between the cement gap at the coronal and apical part for the Cylindro-Conical system w (79, 46 mm), Dr Mooser post system w (45, 56 mm) and MP Pirec post system w (25, 52 mm). After cementation, the highest cement gap at the coronal part was obtained with the Cylindro-Conical system w (79G21 mm) and the lowest with the MP Pirec post system w (25G9 mm). However, at the apical end, the MP Pirec post system w (52G89 mm) and Dr Mooser post system w (56G16 mm) revealed the highest gap. Significance. Form-congruence between the preparation drill and the post systems exhibited differences. The most consistent cement gap either at the coronal, middle or apical parts of the root canals was obtained with the Erlangen post system w

Microtensile bond strengths of short surface-coated intraradicular posts

Actual endodontic and reconstructive concepts require posts. In this trail short posts with a coronal retentive head received tribochemical-surface coating (Tbc). The microtensile-bond-strengths (mu TBS) of the new short posts with and without additional coating were compared with the conventional posts concerning post and luting material. Root canals of 120 freshly extracted human anterior-teeth were endodontically treated to ISO size 80/length 6 mm and randomly divided into 3 groups (n = 40): Root canals of each group were prepared using respective drills of the post-system for the conventional posts (I), the new short posts without coating ((II), prototyp) and with coating (III). Posts of two materials (titanium and FRC) were inserted using two composites (RelyX-Unicem (RX), DentinBuild-Evo (DB)). After Thermocycling (5 degrees/55 degrees C, 5000x) push-out-testing was performed for the coronal (CR), medium (MR) and apical (AR) region-of-the-post. Statistical analysis was performed (ANOVA, Bonferroni correction, alpha = 0.05). Highest values of mu TBS were found for the short, coated posts (III) luted with DB at the (CR) (FRC:11.8 +/- 7.5 N/mmc, Ti:13.7 +/- 7.9N/mmc). Yet, conventional posts without coating (I) ranged on the same level at (CR) (FRC/DB:10.8 +/- 3.1N/mmc, Ti/DB:8.7 +/- 5.1N/mmc). mu TBS decreased not significantly apically within all groups. mu TBS of (II) were lower compared to (I) + (III) (p > 0.05). Posts luted with RX showed similar mu TBS regardless of the area of the post-type as well as the post-material (p > 0.05). Yet, overall post types as well as post segments turned out to be significant factors (p < 0.05, 4-way ANOVA). Short, coated posts of Ti as well as FRC revealed at least similar mu TBS to those of the conventional posts luted with both investigated composites cements

Cleaning Effectiveness of Implant Prophylaxis Instruments

Purpose: The aim of this study was to evaluate the cleaning effectiveness of implant prophylaxis instruments on polished and acid-etched implant surfaces. Materials and Methods: Biofilm layers of Streptococcus mutans were grown on a total of 80 titanium disks; 40 disks were polished and 40 were acid-etched. Five disks of each surface were cleaned using each of seven implant prophylaxis instruments: (1) manual plastic curette, (2) manual carbon fiber-reinforced plastic (CFRP) curette, (3) sonic-driven prophylaxis brush, (4) rotating rubber cup with prophylaxis paste, (5) sonic-driven polyether ether ketone (PEEK) plastic tip, (6) ultrasonic-driven PEEK plastic tip, and (7) air polishing with amino acid (glycine) powder. Ten disks (five of each surface type) served as controls. After cleaning, the surfaces with remaining bacteria were assessed by light microscopy. Statistical analyses of the results were performed with one-way and two-way analyses of variance with Bonferroni-Dunn multiple comparisons post hoc analysis (alpha = .05). Results: The cleaning effectiveness of the plastic curette was significantly lower than those of all machine-driven instruments on the polished surface. Significantly lower cleaning effectiveness occurred with the CFRP curette compared to the prophylaxis brush and to both oscillating PEEK plastic tips on the polished surface. The rubber cup provided less cleaning effectiveness compared to the ultrasonic PEEK plastic tip and air polishing on the acid-etched surface. Superior results, with less than 4% of the biofilm remaining, were obtained for both oscillating PEEK plastic tips and air polishing on both implant surfaces. The cleaning ability of the prophylaxis brush, rubber cup, and ultrasonic PEEK plastic tip differed significantly between both surface structures. Conclusions: Cleaning effectiveness, ie, less than 4% of the biofilm remaining, was not observed with all tested implant prophylaxis instruments. The cleaning ability of the devices depended on the implant surface structure

A paradigm shift in mechanical biofilm management? Subgingival air polishing: a new way to improve mechanical biofilm management in the dental practice

In the past few years indications for the use of the air polishing technology have been expanded from supragingival use (airflow) to subgingival air polishing (perioflow) by the development of new low-abrasive glycine-based powders and devices with a subgingival nozzle. Several studies on the subgingival use of air polishing have been completed. On 7 June 2012, during the Europerio 7 Congress in Vienna, a consensus conference on mechanical biofilm management took place aiming to review the current evidence from the literature on the clinical relevance of the subgingival use of air polishing and to make practical recommendations for the clinician. Bernita Bush (Bern), Prof Johannes Einwag (Stuttgart), Prof Thomas Flemmig (Seattle), Carmen Lanoway (Munich), Prof Ursula Platzer (Hamburg), Prof Petra Schmage (Hamburg), Brigitte Schoeneich (Zurich), Prof Anton Sculean (Bern), Dr Clemens Walter (Basel), and Prof Jan Wennström (Gothenburg) discussed under the moderation of Klaus-Dieter Bastendorf and Christian Becker (both ADIC Association for Dental Infection Control) the available clinical studies to reach a consensus on available clinical evidence. This paper summarizes the main conclusions of the consensus conference and points to the clinical relevance of the findings for the dental practitioner

Interaction of Systemic Morbidity and Oral Health in Ambulatory Patients in Need of Home Care (InSEMaP) : an observational study at the sector boundary between dental and general practice care in Germany

Introduction: Older people in need of home care are at risk of declining oral health as their visits to dentists are becoming less frequent due to restricted mobility. There is increasing evidence that poor oral health and systemic diseases are closely associated, for example, in cardiological, metabolic or neurodegenerative conditions. Thus, Interaction of Systemic Morbidity and Oral Health in Ambulatory Patients in Need of Home Care (InSEMaP) is investigating the need, provision and utilisation of oral healthcare, systemic morbidity and clinical status of the oral cavity in older people. Methods and analysis: InSEMaP consists of four subprojects (SP), all involving the target population of older people in need of home care. In SP1 part a, a sample is surveyed using a self-report questionnaire. In SP1 part b, stakeholders (general practitioners, dentists, medical assistants, family and professional caregivers) are interviewed regarding barriers and facilitators using focus groups and personal interviews. In SP2, a retrospective cohort study, health insurance claims data are examined to investigate the utilisation of oral healthcare, its association with systemic morbidity and healthcare costs. In SP3, a clinical observational study will assess the oral health of participants by a dentist’s visit at home. SP4 synthesises the results of SP1, SP2 and SP3 to develop integrated clinical pathways, identifying strategies to uphold oral healthcare in older people. In assessing and evaluating the process of oral healthcare, and its associated systemic morbidity, InSEMaP aims to improve general healthcare across the sector boundary of dental and general practitioner care.PeerReviewe

Interaction of Systemic Morbidity and Oral Health in Ambulatory Patients in Need of Home Care (InSEMaP): an observational study at the sector boundary between dental and general practice care in Germany

Introduction Older people in need of home care are at risk of declining oral health as their visits to dentists are becoming less frequent due to restricted mobility. There is increasing evidence that poor oral health and systemic diseases are closely associated, for example, in cardiological, metabolic or neurodegenerative conditions. Thus, Interaction of Systemic Morbidity and Oral Health in Ambulatory Patients in Need of Home Care (InSEMaP) is investigating the need, provision and utilisation of oral healthcare, systemic morbidity and clinical status of the oral cavity in older people.Methods and analysis InSEMaP consists of four subprojects (SP), all involving the target population of older people in need of home care. In SP1 part a, a sample is surveyed using a self-report questionnaire. In SP1 part b, stakeholders (general practitioners, dentists, medical assistants, family and professional caregivers) are interviewed regarding barriers and facilitators using focus groups and personal interviews. In SP2, a retrospective cohort study, health insurance claims data are examined to investigate the utilisation of oral healthcare, its association with systemic morbidity and healthcare costs. In SP3, a clinical observational study will assess the oral health of participants by a dentist’s visit at home. SP4 synthesises the results of SP1, SP2 and SP3 to develop integrated clinical pathways, identifying strategies to uphold oral healthcare in older people. In assessing and evaluating the process of oral healthcare, and its associated systemic morbidity, InSEMaP aims to improve general healthcare across the sector boundary of dental and general practitioner care.Ethics and dissemination Ethics approval was obtained from the Institutional Review Board of the Hamburg Medical Chamber (approval number: 2021-100715-BO-ff). The results of this study will be disseminated through conference presentations and publications in peer-reviewed journals. An expert advisory board to support the InSEMaP study group will be established.Trial registration number German Clinical Trials Register: DRKS00027020

Recommendations on the clinical application of air polishing for the management of peri-implant mucositis and peri-implantitis

Air polishing was introduced as an alternative approach for the supra- and submucosal biofilm management at dental implants. An international expert meeting involving competent clinicians and researchers took place during the EUROPERIO 8 conference in London, UK, on 4 June 2015. Prior to this meeting a comprehensive systematic review dealing with the efficacy of air polishing in the treatment of peri-implant mucositis and peri-implantitis was prepared and served as a basis for the group discussions. This paper summarizes the consensus statements and practical recommendations on the clinical application of air polishing for the management of peri-implant mucositis and peri-implantitis