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Objectives: The aim of this study was to examine the occlusion of anterior teeth in individuals with shortened dental arch (SDA). Material and methods: In a case–control clinical study, 41 individuals with SDA and 41 individuals with complete dental arch (CDA) participated. The CDA control group was matched for age and gender. Testing for occlusal contacts of anterior maxillary teeth was conducted by biting on foil strips (8 µm) with subjectively normal bite force (NBF) and maximal bite force (MBF). The data was analyzed on individual and tooth levels. Results: The median rates of anterior maxillary teeth with occlusal contacts were 0.67 (NBF) and 0.83 (MBF) in the SDA group and 0.50 (NBF) and 0.83 (MBF) in the CDA group. Within both groups, the contact rates were significantly higher in MBF. The group difference with NBF was significant. A generalized linear model showed that the odds of an anterior maxillary tooth to have an occlusal contact were greater in the SDA both for NBF with an odds ratio (OR) 2.277 and MBF with an OR 1.691. Conclusions: The findings suggest effective compensatory mechanisms relative to the occlusal function in individuals with SDA. Clinical relevance: The study delivers further evidence regarding the SDA concept as a viable option in the management of posterior tooth loss. [ABSTRACT FROM AUTHOR]

Objectives: The aim was to evaluate the impact of diabetes on the outcome of periodontal treatment based on massive data analyses. Materials and methods: Data originated from the database of a major German National Health Insurance. Patients who underwent periodontal treatment were allocated to four groups according to their medical condition: type 1 diabetes (D1), type 2 diabetes with the intake of oral anti-diabetics (D2M), type 2 diabetes without the intake of oral anti-diabetics (D2), and a control group without diabetes (ND). Four-year Kaplan-Meier survival analyses on the patient level and multivariate regression analyses were conducted for tooth extraction. Results: Of 415,718 patients, 4139 matched the criteria for D1, 22,430 for D2M, and 23,576 for D2. At 4 years, the cumulative survival rate (no extraction) was 51.7% in the D1 group, 54.0% in the D2M group, and 57.7% in the D2 group. The ND control group had a significantly higher survival rate of 65.9% (P < 0.0001). In the multivariate analyses, both diabetes types were significantly associated with further tooth loss after periodontal treatment. Conclusions: The diagnosis of diabetes type 1 or 2 seems to be associated with a higher risk of tooth loss after periodontal treatment. Clinical relevance: The long-term prognosis of teeth in diabetes patients should be judged carefully. [ABSTRACT FROM AUTHOR]

Objectives: Posterior metal ceramic crowns are still widely used as a standard treatment. The aim of this study was to obtain long-term data on their clinical performance.Material and Methods: Ten private practitioners participated in this prospective practice-based study. Patients were provided with two crowns each. Two groups were formed. The single crown group comprised 95 patients with 190 crowns. The retainer crown group comprised 138 patients with fixed dental prostheses and 276 retainer crowns.Results: For the primary outcome "loss of tooth or crown," 20-year survival rates of 78.8% in the single crown group and 67.8% in the retainer crown group were found. Veneering ceramic defects occurred rather frequently, resulting in respective 20-year technical success rates of 74.2% for single crowns and 62.9% for retainer crowns. However, veneering ceramic defects causing crown losses were very rare events.Conclusions: The results contribute to our knowledge on long-term outcomes of treatments with metal ceramic crowns and show high survival and success rates over 20 years.Clinical relevance: Posterior metal ceramic crowns are a highly reliable option in private practice settings. [ABSTRACT FROM AUTHOR]

Objectives: There is only sparse knowledge concerning the outcomes of treatments with posterior permanent restorations in general practice settings. This study aimed at evaluating outcomes based on a large dataset by using a novel approach on a tooth surface basis. Materials and methods: The study based on routine data from a major German national health insurance company. Respective treatment fee codes allowed for tracking the clinical courses on a tooth surface level. The study intervention was defined as the placement of a restoration on an interproximal or occlusal posterior tooth surface regardless of its actual extension and material on which no information was available. All surfaces restored between January 1st, 2010 and December 31st, 2013 were included. Kaplan-Meier survival analyses were conducted to estimate four-year survival. The primary outcome was a restorative re-intervention on the same tooth surface. Separate analyses were performed for the secondary outcomes 'crowning' and 'extraction'. Results: Over ten million interproximal surfaces and eight million occlusal surfaces in nine million posterior teeth had been restored. At 4 years, the cumulative survival rates concerning the primary outcome 're-intervention' for mesial surfaces (81.4%; CI 81.3-81.5%) and distal surfaces (81.2%; CI 81.1-81.2%) differed significantly from those for occlusal surfaces (77.0%; CI 76.9-77.0%). Restored surfaces in premolars showed significantly higher survival rates compared to molars. Four-year survival rates for the secondary outcome 'crowning' were 91.9% (CI 91.8-91.9%) for mesial surfaces, 92.1% (CI 92.1-92.2%) for distal surfaces and 93.3% (CI 93.2-93.3%) for occlusal surfaces. The respective rates for the secondary outcome 'extraction' were 94.5% (CI 94.5-94.5%) for mesial surfaces, 94.8% (CI 94.7-94.8%) for distal surfaces and 95.4% (CI 95.4-95.5%) for occlusal surfaces. Conclusions: Re-interventions after restorative treatment play a significant role in general practice settings. Surface-related survival rates of restorations reveal a need for improvement. Clinical relevance: This study allows the estimation of the probability of re-interventions after restoring posterior tooth surfaces. It is based on several million cases from general practises under the terms and conditions of a national health insurance system. [ABSTRACT FROM AUTHOR]

Objectives: Being a secondary outcome in a multicenter randomized controlled trial, the present analysis focused on interdental spacing in the shortened dental arch (SDA). The aim was to evaluate changes in interdental spacing in dependence of two different treatments after an observation period of up to 5 years. Material and methods: Patients were either treated with a partial removable dental prosthesis (PRDP) for molar replacement (PRDP group) or according to the SDA concept aiming at a premolar occlusion (SDA group) in a randomized manner. Interdental spacing in the anterior region was measured with gauges and categorized as '0' (<0.1 mm), '1' (<0.5 mm), '2' (0.5-1 mm), and '3' (>1 mm). The statistical analysis was performed with analysis of variance models followed by linear contrast. Results: Ninety-one patients (SDA n = 41, PRDP n = 50) were included. Changes of interdental spacing were detected in 70.7 % of all cases. A significant difference between the mean score changes was found in the mandible comparing the PRDP group and the SDA group. The respective mean score changes from baseline to 5 years were 0.23 ( SD 0.49) for the PRDP group and 0.02 ( SD 0.30) for the SDA group ( p = 0.023). Conclusions: Major interdental spacing could be observed in neither of the groups. The SDA concept resulted in a slightly better outcome. Clinical relevance: When deciding whether to replace missing molars, the present results give further support to the SDA concept. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this multi-center, randomized controlled trial was to assess the impact of missing posterior support on the risk for temporomandibular disorder (TMD) pain by comparing patients with either shortened dental arches (SDA) or molar replacement by removable dental prostheses (RDP). Methods: A sample of 215 patients with bilateral molar loss in at least one jaw was consecutively recruited in 14 prosthodontic departments of dental schools in Germany. Of the initial sample, 152 patients (mean age: 59.7 years; 53.9 % female) received randomly allocated interventions (SDA: n = 71; RDP: n = 81). Presence of TMD pain was assessed using patients' self-reports and was verified by physical examination and by pain intensity, as the mean of current pain, worst pain, and average pain in the last 6 months, with 10-point ordinal rating scales. Assessments were performed before treatment and at follow-ups until 60 months after treatment. Impact of interventions on TMD risk and pain intensity was computed by applying logistic and linear random-intercept models. Results: Tooth replacement (RDP) did not significantly change the risk for self-reported (odds ratio [OR]: 1.1; confidence interval [CI]: 0.4 to 3.4) or clinically verified (OR: 0.7; CI: 0.1 to 4.3) TMD pain compared to no tooth replacement (SDA). Mean characteristic pain intensity was virtually identical in both groups (Coeff: 0.01; CI: −0.30 to 0.32). Conclusion: Retaining or preservation of an SDA is not a major risk factor for TMD pain over the course of 5 years when compared to molar replacement with RPDs. Clinical relevance: Seemingly, missing molars do not have to be replaced in order to prevent TMD pain. [ABSTRACT FROM AUTHOR]

Objectives: The use of fast-setting impression materials with different viscosities for the one-stage impression technique demands precise working times when mixing. We examined the effect of varying working time on impression precision in a randomized clinical trial. Materials and methods: Focusing on tooth 46, three impressions were made from each of 96 volunteers, using either a polyether (PE: Impregum Penta H/L DuoSoft Quick, 3 M ESPE) or an addition-curing silicone (AS: Aquasil Ultra LV, Dentsply/DeTrey), one with the manufacturer's recommended working time (used as a reference) and two with altered working times. All stages of the impression-taking were subject to randomization. The three-dimensional precision of the non-standard working time impressions was digitally analyzed compared to the reference impression. Statistical analysis was performed using multivariate models. Results: The mean difference in the position of the lower right first molar (vs. the reference impression) ranged from ±12 μm for PE to +19 and -14 μm for AS. Significantly higher mean values (+62 to −40 μm) were found for AS compared to PE (+21 to −26 μm) in the area of the distal adjacent tooth. Conclusions: Fast-set impression materials offer high precision when used for single tooth restorations as part of a one-stage impression technique, even when the working time (mixing plus application of the light- and heavy-body components) diverges significantly from the manufacturer's recommended protocol. Clinical relevance: Best accuracy was achieved with machine-mixed heavy-body/light-body polyether. Both materials examined met the clinical requirements regarding precision when the teeth were completely syringed with light material. [ABSTRACT FROM AUTHOR]