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There is a paucity of evidence on injuries sustained by farriers and hoof care practitioners, two professions exposed to unique occupational hazards. The aim of this study was to collect and examine data on occupational head/face and dental injuries among farriers and hoof care practitioners in a nationwide survey in Switzerland.Data on occupational head/face and dental injuries were gathered in a questionnaire-based, voluntary survey, which was mailed to all farriers and hoof care practitioners in Switzerland. The statistical analysis comprised multiple regressions with a nested design (α = 0.05).The survey included 278 respondents (response rate of 78.1%). Head/face injuries were more frequently reported by farriers than hoof care practitioners (60.6% and 20.7%, respectively). Among full-time workers, farriers had a higher chance of an occupational head/face injury compared with hoof care practitioners (p = .007). The rate of dental injuries, mainly related to a horse kick, was 11.1% and 1.9% among farriers and hoof care practitioners, respectively. Negligence in wearing mandatory eye protection was reported by 37.5% of respondents.Farriery and hoof care management entail a significant risk of occupational head/face and dental injuries. Preventive safety measures-eye protection in particular-and knowledge in dental first aid should be promoted among farriers and hoof care practitioners to decrease the frequency and severity of work-related injuries.

Lifting heavy weights almost automatically elicits teeth clenching, which, if performed regularly, may lead to chronic trauma. This study assessed self-reported injuries to oral tissues in athletes and bodybuilders caused by resistance training and determined the association between self-reported trauma, performance level and the duration of practicing resistance training. A standardized questionnaire was used to gather information about the respondents (age and gender), their performance level (hobby versus competition athlete), experience with oral tissue trauma, the use of mouthguards, and dietary habits. From a total of 363 females and 239 males, 221 (36.7%) classified themselves as competition athletes and 381 (63.3%) as hobby athletes. Nearly 34.6% (n = 202) of the participants declared distress in their orofacial region during practice. Female hobby athletes reported 2.5 times more mouth-teeth-jaw problems than female competition athletes (p0.001). Females showed themselves slightly more susceptible to mouth-teeth-jaw problems with resistance training than males (odds ratio [OR] = 1.45, p = 0.076). Negative oral effects were found to be 2.1 (p = 0.003) times higher for those who had been practicing for 10 years or more. It was concluded that a higher number of years of resistance training increased self-reported oral tissue trauma in the current cohort. Females were more likely to report orofacial problems than males.

Evidence on the risk of injury at concerts is scant. The aim of this study was to collect data on general and dental injuries incurred by concertgoers in Switzerland and to investigate whether the frequency of accidents was related to music genre, gender and consumption of alcohol.A questionnaire-based, cross-sectional study comprising 451 concertgoers in Switzerland was conducted on the timeframe January 2019 to February 2021. The survey gathered data on general and dental injuries, alcohol consumption and drug use. The statistical analysis included Fisher's exact tests, chi-squared tests, rank sum tests and logistic regressions (α = .05).There were 28.8% of respondents who reported an injury incurred at a concert. Contusion was the most prevalent injury, accounting for 33.8% of all injuries. Legs were the most commonly injured body part (34.6%). Injuries to their mouth/lips/teeth were reported by 17.7% of respondents. Dental injuries, accounting for 4.6% of all reported injuries, comprised four tooth fractures, one lateral luxation and one avulsion. The risk of injury while attending punk rock concerts was 8.6 times higher than for pop concerts (p .001). In comparison with pop concerts, metal and rock concerts had an increased risk of injury by factors of 5.1 and 2.3, respectively (p ≤ .029). Neither gender nor drug use had a significant effect on the injury risk (p ≥ .3). Heavy alcohol consumption (5 standard glasses) increased the risk of injury by a factor of 2.3 (p = .028).This study suggests that concert attendees at rock, metal and punk concerts face an increased risk of injury, which is likely due to the frequency of aggressive dance styles such as moshing. Heavy alcohol consumption leads to a greater risk of injury at concerts.

Purpose: The aim of this in vitro study was to evaluate the temperature development of a novel, electropolished drill design during conventional and guided implant osteotomy in comparison to conventional drills under standardized conditions. Materials and methods: Single and sequential 12-mm-deep drilling protocols (guided and unguided) with a conventional (control groups) and novel drill (test groups) were performed in artificial bone blocks under external irrigation. Each drilling protocol was repeated 30 times with drill diameters of 2.2, 2.8, 3.5, and 4.2 mm. Temperature changes were recorded by an infrared camera, and the accumulated thermal energy was calculated. For group comparison, a one-way analysis of variance (ANOVA) and Tukey post hoc test were used with a level of significance set to = .05. Results: The highest temperatures were measured up to 77.9°C for small-diameter drills in the control and test groups. The 3.5-mm and 4.2-mm novel drills showed significantly lower heat generation during guided and unguided osteotomy preparation for single and sequential drilling. The accumulated thermal energy during guided osteotomy preparation was significantly lower with the electropolished drills. Conclusion: The drill design has an important impact on heat development during osteotomy, which was most pronounced for guided osteotomy with conventional drills and for small-diameter osteotomies.

BACKGROUND/AIM Dental photographs are a valid means for documentation of dental luxation injuries. The aim of the study was to evaluate the utility of two photographs from different perspectives in the assessment of dental luxation injuries compared to one perspective only. MATERIALS AND METHODS Photographs of simulated dental luxation injuries were shown to experts in dental traumatology and other dentists who had to estimate the displacement in the vertical and horizontal dimensions. The overall error of estimation as a result of both vertical displacement and horizontal displacement was calculated and statistically analyzed. RESULTS The mean overall error of estimation was 0.43 mm and 0.75 mm for experts and dentists, respectively. If two (frontal and occlusal) perspectives were available, the overall error was lower than when only one perspective was available (p

Objectives This study aimed to assess whether the emergency service of a major Swiss dental institution faced different demands (patient volume, treatment needs, dental care characteristics) during a lockdown, issued to mitigate the COVID-19 pandemic, compared with the weeks before and after. Materials and methods Data of patients receiving urgent care at a university center for dental medicine (Basel, Switzerland) during the 6-week lockdown, pre-lockdown, and post-lockdown periods were retrospectively evaluated. Statistical analysis involved tests for equal proportions and logistic regression models. The level of significance was set at α=0.05. Results The study comprised 3109 dental emergency visits in the period from February 2 to June 5, 2020. Daily caseloads increased during lockdown. Abscesses, orthodontic emergencies, and surgical follow-ups were more common during lockdown, whereas the number of dento-alveolar injuries declined (≤0.048). Urgent dental care provision involved intraoral radiographs more frequently in the pre-lockdown period compared with the following weeks (pppp=0.004). Conclusions The lockdown significantly impacted the dental emergency service in terms of patients’ diagnoses, treatment needs, and the characteristics of the urgent care that was delivered. Clinical relevance Access to essential dental care must be monitored and safeguarded throughout the COVID-19 pandemic and beyond as deferred care entails risks for serious sequelae and persons with comorbidities may change their dental care-seeking behavior.

The use of tooth-colored composite resin materials in dentistry is increasing. As composite restorations appear similar to the natural tooth structure, their detection is becoming more challenging. The aim of this study was to compare five diagnostic methods for detection of dental restorations and to create reliable postmortem dental records for forensic purposes. A conventional examination method without a direct light source (CONV), with a dental loupe light (DL), Galilean loupes with a direct light source (GDL), a fluorescence-inducing device (FIT), and intraoral radiographs (RX) were compared. Dentists specializing in conservative dentistry or oral surgery and dentistry students participated. Regarding sensitivity, specificity, positive predictive value, and negative predictive value, FIT and RX showed significantly higher results than CONV, DL, and GDL. RX and FIT showed comparable results in identifying composite restorations but depending on their location. The combination of both methods may lead to even better results. In conclusion fluorescence-inducing devices show good results in identifying composite restorations and therefore should be considered as a standard tool in forensic examinations. Another advantage is their small size, low cost, and mobility. Good illumination and magnification devices are recommended to enhance performance during conventional examinations. Involving dentists specialized in conservative dentistry could contribute to dental identification.

The aim of this study was to evaluate functional and esthetic clinical outcomes and patient satisfaction with narrow-diameter implants in comparison to standard-diameter implants in the anterior zone of the maxilla in a follow-up examination after 1 to 6 years.The study was designed as a retrospective cohort study investigation including 27 patients receiving a 3.3-mm diameter single implant (NDI, n = 14) or a standard-diameter 4.1-mm single implant in the anterior zone of the maxilla (SDI, n = 16). Descriptive and analytical statistics were performed comparing both groups with regard to clinical examination including esthetic outcome, sulcus fluid flow-rate , crown esthetics, patients' satisfaction on visual analog scales, occurrence of biologic or technical complication, probing pocket depths (Fisher exact test), pink esthetic score (PES) and Periotest (Mann-Whitney U test). The level of significance was set at α = .05.The mean observation period was 4.8 years after crown insertion in the NDI group, and 4.9 years in the SDI group. Significant differences were observed for Periotest values in favor of the 4.1-mm implants (P = .014). No differences were found with regards to esthetics (PES; P = .27) or sulcus fluid flow-rate (P = 0.73) and probing pocket depths (P = .35). Overall patient satisfaction was high for both groups with visual analog scale scores of 9.3 ± 1.1 for NDI and 9.4 ± 1.0 for SDI (P = .39).Clinical outcome with narrow-diameter implants was comparable to standard-diameter implants in the anterior zone of the maxilla with similar esthetic assessments and patients' satisfaction.

Background/aim Skiing is a sport with a medium risk of injuries, and injuries are increasingly common among professional alpine skiers. Examples of other medium-risk sports are for example handball, basketball, and karate. The aim of this study was to assess the frequency of dental trauma in professional alpine skiing and to determine whether the frequency of dental injuries is associated with a skier's performance level, alpine skiing discipline, and/or years of skiing experience. Material and methods A questionnaire consisting of 17 questions was distributed to professional male ski racers to gather information about their skiing discipline (category), performance level, and injuries, particularly dental trauma. Results A total of 161 out of 190 skiers returned the survey, with a response rate of 84.2%. Of these, 134 (83.2%) had suffered alpine ski racing-related injuries during their career and 38 (23.6%) reported skiing-related dental trauma-most commonly crown fractures (65.8%, n = 25), which mainly involved the maxillary or mandibular incisors (76.0%, n = 28). Ski racers with higher performance levels were more likely to experience dental injuries, but the difference in the frequency of dental trauma between participants in the speed versus technical category was not significant. Likewise, the number of years of ski racing experience did not impact the frequency of dental injuries. The participants rarely wore custom-made mouthguards (6.8%, n = 11). None of those who reported dental injuries were wearing a custom-made mouthguard when the injury occured. They preferred to wear chin guards, over-the-counter mouthguards, or no mouthguards. Conclusion Professional alpine ski racing has a medium risk of dental trauma, which further increases with skier performance level. The participating skiers rarely wore custom-made mouthguards.

Zahnunfälle gehören zum sportlichen Alltag. Vor allem Kontaktsportarten sind mit erhöhtem Risiko verbunden. Mithilfe eines Zahnschutzes können orale und periorale Verletzungen weniger intensiv ausfallen oder ganz vermieden werden. Jedoch: Nur ein professioneller, individuell angefertigter Multilayer-Zahnschutz kann allen Ansprüchen genügen und dem Sportler einen optimalen Schutz gegen mögliche Verletzungen bieten.

Clinical Relevance A well-polished cement surface increases the viability and spreading of gingival fibroblasts. The tested resin composite cements did not reveal any cytotoxic effects. SUMMARY Objective: This in vitro study aimed to investigate the effect of cement type and roughness on the viability and cell morphology of human gingival fibroblasts (HGF-1). Methods and Materials: Discs of three adhesive (Panavia V5 [PV5], Multilink Automix [MLA], RelyX Ultimate [RUL] and three self-adhesive (Panavia SA plus [PSA], SpeedCem plus [SCP], RelyX Unicem [RUN]) resin composite cements were prepared with three different roughnesses using silica paper grit P180, P400, or P2500. The cement specimens were characterized by surface roughness and energy-dispersive X-ray spectroscopic mapping. A viability assay was performed after 24 hours of incubation of HGF-1 cells on cement specimens. Cell morphology was examined with scanning electron microscopy. Results: The roughness of the specimens did not differ significantly among the different resin composite cements. Mean Ra values for the three surface treatments were 1.62 ± 0.34 μm for P180, 0.79 ± 0.20 μm for P400, and 0.17 ± 0.08 μm for P2500. HGF-1 viability was significantly influenced by the cement material and the specimens’ roughness, with the highest viability for PSA ≥ RUN = MLA ≥ SCP = PV5 > RUL (p P180 (p Conclusion: The composition of resin composite cements significantly affects the cell viability of HGF-1. Smooth resin composite cement surfaces with an Ra of 0.2–0.8 μm accelerate flat cell spreading and formation of filopodia.

This case series retrospectively investigated the one-year surgical outcome of regenerative peri-implantitis therapy using a hydroxyapatite (HA) bone substitute material in combination with enamel matrix derivate (EMD) and collagen membrane for guided bone regeneration (GBR). Data-sheets of patients were screened to detect patients who received identical regenerative peri implantitis-therapy with surface decontamination and GBR applying HA, EMD and a collagen membrane under broad- spectrum antibiotic regime. For inclusion, information on pre- and postoperative clinical and radiographic parameters (probing pocket depth (PPD), bleeding on probing (BOP), suppuration (SUPP) and the radiological bone level (RBL)) had to be available for statistical analysis. Data of a total of 11 patients (20 implants) were extracted out of 202 (336). All implants were still in function after one year. Bone defects decreased by an average of 1.3 mm mesially and 0.9 mm distally, respectively. Mean PPD was reduced from 4.9 mm to 2.7 mm. BOP decreased from 90% to 20%. Suppuration decreased from 65% to 0%. Based on the success criteria applied, 15 of the 20 (75%) implants included were considered as successfully treated after 1 year. Regenerative peri-implantitis therapy according to the presented concept showed promising clinical and radiographic outcomes after one year. To estimate the beneficial effects of the combined use of HA, EMD and collagen membranes, further long term investigations with a control group are needed.

This position statement represents a consensus of an expert committee convened by the European Society of Endodontology (ESE) on the endodontic management of traumatized permanent teeth. A recent comprehensive review with detailed background information provides the basis for this position statement (Krastl et al. 2021, International Endodontic Journal, https://doi.org/10.1111/iej.13508). The statement is based on current scientific evidence as well as the expertise of the committee. Complementing the recently revised guidelines of the International Association of Dental Traumatology, this position statement aims to provide clinical guidance for the choice of the appropriate endodontic approach for traumatized permanent teeth. Given the dynamic nature of research in this area, this position statement will be updated at appropriate intervals.

Purpose The purpose of this study was to evaluate whether fully digitally guided implant surgery may be performed with sufficient accuracy based on printing virtually designed templates after matching a surface scan with the magnetic resonance imaging (MRI) dataset mimicking edentulous cases based on cadaver maxillae of pigs. Materials and methods The palatal mucosa of five young pig cadavers was scanned with an intraoral scanner. High-resolution MRI of the jaws was performed, and the images were exported as DICOM files and uploaded into software for implant planning. Six implant osteotomies were virtually planned in each jaw. The intraoral surface scans were fused with the volumetric MRI data based on the palatal soft tissue, and virtual templates for guided implant surgery were created and exported as STL files. These were printed and the templates were used to perform flapless guided osteotomy, with the templates fitting on the soft tissue of the jaws alone. Cone beam computed tomography (CBCT) of the jaws was performed after osteotomy. These data were fused with the virtually planned osteotomies, and the 3D crestal, apical, and axial deviations between the virtually planned and physically performed osteotomies were determined. Results Matching the surface scans with the mucosa was possible in three cases automatically; additional manual corrections were necessary in two cases. Thirty osteotomies were performed by applying the printed mucosa-supported templates. The mean angular deviation between the planned and realized cavities was 3.29 degrees (0.3 to 11.1 degrees; SD = 2.5 degrees), the mean 3D apical deviation was 1.3 mm (0.22 to 3.98 mm; SD = 0.94 mm), and the mean crestal deviation was 1.76 mm (0.39 to 3.79 mm; SD = 0.88 mm). Conclusion MRI in combination with the presented workflow may be used in edentulous cases for guided implant surgery. Further studies are needed to prove the promising accuracy of this alternative approach in clinical trials.

Garden trampolines are very popular in Switzerland. Most trampoline related accidents result in fractures and soft tissue injuries of the extremities. While these types of injuries have been well investigated in numerous studies, there has been no study on dental injuries on trampolines. The aim of the present study was to investigate dental accidents on garden trampolines in Switzerland and to analyze possible influencing factors. Data collection was carried out by analyzing aerial photographs and a questionnairebased survey. Out of 1212 questionnaires sent out, 637 could be included in the study. The data were evaluated in terms of accident, type of trampoline (inground or onground), and whether a safety net was present. A total of 105 trampoline accidents (16.5%) occurred, of which 23 were dental injuries (23.2%). 39.1% (n=9) were tooth fractures, 30.4% (n=7) were concussions, 17.4% (n=4) were avulsions, and 13.0% (n=3) were dislocation injuries. Teeth were predominantly impacted on the trampoline frame (26.2%, n=6) or on a person's own knee (26%, n=6). Dental accidents occurred 3.6 times more frequently when the trampoline was used by more than one person at a time. Dental accidents occurred 2.4 times more frequently on inground trampolines than on onground trampolines. Statistically, only the diameter of the trampoline had an influence on the frequency of accidents: Larger trampolines led more frequently to accidents. The present study showed that trampolining poses a risk of dental injury like other sports such as kick scooter or skiing. It is therefore important to increase parental and public awareness regarding the potential dangers of trampoline use.

The aim of the present study was to gain a better understanding of the significance, use and prevalence of digital as well as analog learning and teaching aids within dentistry studies at the University Center of Dental Medicine Basel (UZB) regarding sociodemographic aspects. A questionnaire was distributed among the three upper years of dental students at the UZB in the autumn semester before the corona pandemic. The results showed that all students use digital devices. The most often used devices in connection with academic studies were portable devices such as laptops or smartphones. It is to mention that students younger than 25 years used smartphones more often as learning aids than their older classmates. The devices were used on average 57 % of the total daily use time for study purposes, whereas private usage time decreased with age and progression of studies. In order to acquire theoretical knowledge, analog and digital formats were equally important. Digital learning aids were mainly used as digitalized lecture notes or for internet research. Advantages were especially seen in timesaving and organizational aspects. The analog learning aids were appreciated for their better learning and less tiring effect. The high prevalence and usage of mobile internet connectable devices as well as the high availability of the internet may indicate a tendency toward mobile learning.

Nasal surface anesthesia is a simple, non-invasive method with a not yet fully understood effect on oral tissues. Should it prove to be successful in dental medicine, it could replace or at least complement the more invasive injection anesthesia, especially in children after dental trauma. The local anesthetic Tenaphin (tetracaine hydrochloride and naphazoline nitrate) was applied to 105 patients prior to ear, nose and throat medical diagnosis or therapy. After different exposure times, the influence on the oral tissues in the anterior region was examined by a dentist in the context of a pilot study. The effect of the mucosal anesthesia increased in the canine and anterior region the further mesial the tooth was located and the longer the application time was. In the buccal and palatinal area the effect increased from apical to incisal. The pulps of the central incisors and the canines were better anesthetized than those of the lateral incisors. Nasal surface anesthesia has the potential to replace the more invasive injection anesthesia in the anterior region of the upper jaw or to complement it. Dosage and exposure time will have to be investigated in more detail.

The prevalence of dental trauma among children and adults is high. Most luxated teeth need splinting. The Titanium Trauma Splint (TTS) is a widely used appliance with good performance properties. Esthetics is increasingly important for most patients. Splints placed on the front teeth have a clearly visible impact on patients' appearance and, thus, on their quality of life during splint therapy. Therefore, the aim of the present study was to evaluate the esthetic preferences of adult patients with regard to different splint color and surface finish characteristics. TTS appliances were fabricated in four different colors (silver, gold, green and violet) and two different surface finishes (matt or polished) to yield a total of eight variants. The finished splints were applied to the teeth of a human model, photographed by a professional photographer, and printed as posters. Adults aged between 18 and 79 years were asked to complete a written survey containing items regarding their TTS color and surface preferences based on the posters with photographs as well as questions about previous tooth bleaching treatments, the importance of having esthetic teeth in general, and the prioritization of esthetic versus function-driven dentistry. Over 80% of participants preferred the silver matt splint over the other variants. Neither gender nor age nor other parameters had a significant influence on the choice of splint color or surface. Women placed greater importance on esthetic rather than function-driven treatment.

Confrontations between police officers and citizens have become almost commonplace in today's world. The propensity for violence towards police officers is an ongoing topic. Statistics show a clear increase in violent crimes of this nature. The aim of the present study was to evaluate police officers' risk of injury including orofacial involvement in the line of duty. One hundred and sixty-eight members of a regional police corps in northwestern Switzerland were interviewed with the help of an online questionnaire. The data were kept completely anonymous. Survey questions related to police officers' life on and off the job and focused on serious line-of-duty injuries (LODIs) that led to a loss of work time. LODIs resulting in work absences were not uncommon: 60.9% had been injured in the line of duty. During their free time, the officers showed a moderate risk-taking behavior (mean 50, IQR 30-67.2) and a slightly higher level of perceived risk of being injured while on duty (mean 59.1, SD 20). Most line-of-duty injuries occurred during the first 15 years of service. Among the injured police officers, the level of perceived threat of violence while on duty (mean 40, IQR 20-60) was higher than their non-injured colleagues (mean 50, IQR 21.2-60). The most commonly injured body parts were the hands (20.8%), head (14.9%) and knees (11.3%). Dental injuries were reported in only one case (0.6%). Greater work experience seems to improve the reactions and protective behavior of this occupational group in dangerous situations. Albeit the risk of being injured is high among police officers, dental trauma and orofacial involvement occurs rarely.

Von obsolet in der Kariesdiagnostik bis obligat bei der Herdabklarung vor Strahlentherapie – die Einsatzhaufigkeit der DVT in der Abklarung pathologischer Veranderungen an Zahnen variiert sehr stark. Unerwarteterweise wird die DVT nicht nur diagnostisch, sondern auch zu therapeutischen Masnahmen an Zahnen eingesetzt. Das topmoderne Thema der Guided Endodontics greift diesen Aspekt auf. Immer wieder Gegenstand zahnarztlicher Unsicherheit sind die externen und internen Resorptionen. Die entsprechenden Unterkapitel bringen Klarheit uber die diagnostisch verwertbaren Unterschiede. Das Kapitel zeigt wo und unter welchen Umstanden die DVT in der Diagnostik und Therapie am Zahn selbst indiziert ist und welche Befunde erhoben beziehungsweise auch ausgeschlossen werden konnen. Abseits der radiologischen Diagnostik werden – wie in allen anderen Kapiteln dieses Buches auch – viele in dem Zusammenhang wichtige klinische Informationen vermittelt.

Unfalle mit Beteiligung der Zahne sind vor allem bei Kindern und jungen Erwachsenen haufig und betreffen meist die Zahne im anterioren Oberkiefer. In diesem Kapitel wird dargestellt wie Diagnostik und Therapie erfolgen sollten und welche Rolle die Digitale Volumentomographie (DVT) beim Zahntrauma spielt. Wahrend eine DVT bei Kronenfrakturen und Zahndislokationen nur selten zum Einsatz kommen wird, kann sie bei Wurzel- oder Kronen-Wurzel-Frakturen durchaus entscheidende Hinweise zur Diagnostik und Therapie sowie auch fur die Einschatzung der Prognose des verletzten Zahnes liefern. Die DVT ist jedoch keine Routinebildgebung nach einem Zahntrauma. Etwas haufiger ist die DVT indiziert bei der Abklarung von Alveolarfortsatzfrakturen mit en bloc beweglichen Zahnen.

Antibiotics can be used in oral surgery. The effective benefits are offset by the dangers of resistance and sensitization, which requires a strict indication. There are controversial views regarding indication, dosage and, above all, duration and timing of antibiotic medication in oral surgery.

When dental trauma occurs, initial management on the day of injury has a determining influence on healing and thus on the prognosis of the affected teeth. Improper, delayed, and/or inconsistent treatment often has far-reaching consequences that cannot be reversed later, even with great effort, especially in children and adolescents. In most cases, it is unrealistic or impossible for the patient to get to a specialized dental trauma facility in time. Therefore, it is every dental practitioner's duty to provide adequate initial diagnosis and treatment of dental trauma at their dental practice, even if they do not have routine experience in this area. This article serves as a guide to the initial management of dental trauma. It utilizes a three-tiered approach to illustrate which initial management measures are absolutely essential (MUSTS), which should ideally be performed (SHOULDS), and which are not top priorities but can be performed (CANS) if the necessary time, training and experience, and equipment and facilities are available. For further treatment, dental practitioners should realistically assess the limits of their ability to treat complex dental trauma cases and, if necessary, they should refer the patient to a specialist or specialized treatment center. (Quintessence Int 2020;51:763-774; doi: 10.3290/j.qi.a45103; modified from a previously published article (in German) Quintessenz 2019;70(9):990-1002).

Halitosis is a widespread condition presenting several social and psychological implications, leading to a reduction in the quality of life of an individual. Halitosis, per definition, defines an unpleasant smell of the exhaled air, independent of its etiology. It can have a long-term prevalence or be transient, making it difficult to establish this symptom's epidemiology. Oral malodor can be attributed to a high local concentration of intraoral microbial populations, particularly those of the tongue's biofilm, as well as the biofilms associated with teeth and periodontal tissue. Frequently, the treatment options rely on improving oral health via tongue cleaning, detecting periodontal diseases, insufficient dental restorations, alternating diets, and/or alleviating local factors. Different methods targeting specific bacteria species have been designed to improve this condition. The aim here is to underline the correlation between oral biofilms and halitosis, describing prime bacteria species influencing oral malodor and addressing new concepts to ameliorate this condition.

The pulp plays a key role in the treatment of traumatic dental injuries (TDIs) and is strongly associated with the outcome, particularly in severe cases. A correct pulp diagnosis is essential as it forms the basis for developing the appropriate management strategy. However, many TDIs are complex, and their treatment requires a profound knowledge of the physiological and pathological responses of the affected tissues. This comprehensive review will look at the dentine–pulp complex and its interaction with the surrounding tissues following TDIs. The literature up to 2020 was reviewed based on several searches on PubMed and the Cochrane Library using relevant terms. In addition to the recently revised guidelines of the International Association of Dental Traumatology, this article aims to provide background information with a focus on endodontic aspects and to gather evidence on which a clinician can make decisions on the choice of the appropriate endodontic approach for traumatized permanent teeth.

Halitosis is often caused by a change in the oral biofilm, primarily located on the surface of the tongue. A suction tongue cleaner enables professional cleaning of the tongue. The aim of this study was to investigate the acceptance and efficiency of a suction tongue-cleaning device in adults in comparison to a conventional manual tongue cleaner in an office (professional) setting. Both were tested simultaneously on 100 individuals with a split-mouth (i. e. half-tongue) design, between the ages of 19 to 31, at the University Center for Dental Medicine Basel UZB. To evaluate the efficiency of the cleaning, photos were taken before and after the cleaning and later assessed by using a modified coating tongue index by Winkel (WTCI). Both cleaning devices significantly reduced the coating on the tongue (p0.001). In 58 cases, the side cleaned with the suction tongue cleaner resulted to be cleaner in comparison to the side which was cleaned manually. There were no significant differences in acceptance on a visual analogue scale (VAS, 0-10 cm) between the devices (p = 0.259). However, 53 subjects favored the manual method in comparison to 36 who favored the suction device. The remaining 11 did not convey any preference for either. Both devices triggered an equally frequent gag stimulus. With 95%, the majority of the patients who had this treatment would undergo it a second time. In conclusion, both cleaning devices resulted in a significant reduction of tongue coating, and the usage in general can be highly recommended. While it does not matter which one is used, the suction tongue-cleaning device offers a good alternative to manual tongue-cleaning devices in dental clinics and can be considered a viable adjunct for in-office use.

OBJECTIVES To compare the stability of a screw-retained connection in a novel two-piece zirconia implant to a conventional titanium-based connection in an in vitro chewing simulation including artificial ageing. MATERIAL AND METHODS Incisor (I) and molar (M) shaped monolithic zirconia crowns were screw-retained on either two-piece zirconia (test) or two-piece titanium (control) implants resulting in 4 groups of 8 samples (titanium implants with incisor-shaped crowns (T-I), titanium implants with molar-shaped crowns (T-M), zirconia implants with incisor-shaped crowns (Z-I) and zirconia implants with molar-shaped crowns (Z-M). These were subjected to artificial ageing by thermal cycling (TC: 2 × 3000 × 5°C/55°C cycles of 2 min) and mechanical loading (ML: 1.2 × 106 cycles of 50 N, f = 1 Hz). Surviving samples additionally underwent a fracture force test. Kaplan-Meier plots were drawn, and two-way ANOVA was calculated taking anatomical localisation and material variables as factors. RESULTS The mean corresponding survival times were lower for T-M (0.86 × 106 ± 0.31 × 106 cycles) and Z-I (0.84 × 106 ± 0.21 × 106 cycles) compared to T-I (1.14 × 106 ± 0.10 × 106 cycles) and Z-M (1.20 × 106 ± 0.10 × 106 cycles). In one-way ANOVAs for survival time dependent on either location or material, no statistically significant differences could be found (location: p = .31; material: p = .62) in one-way ANOVAs. The interaction of location and material showed significant differences (F = 21.3, p

BACKGROUND/AIM Accurate removal of composite bonded titanium trauma splints (TTS) can be challenging. The aim of this study was to evaluate a Fluorescence-aided Identification Technique (FIT) compared with a conventional light source (CT) for removal of trauma splints regarding loss of tooth substance, residual composite, and time taken. MATERIALS AND METHODS Twenty maxillary models with six bovine teeth (13 - 23) were fabricated. An optical three-dimensional impression was taken and a TTS was applied from 12 to 22 with two bonding sites on every tooth under standardized conditions using an etch-and-rinse adhesive and resin composite. Two operators removed 10 splints each (5x FIT and 5x CT). For FIT, a 405 nm light-emitting headlamp was used. Time was recorded. A post-operative scan was superimposed on the pre-operative scan using OraCheck software. A qualitative and quantitative analysis of tooth defects and composite remnants was performed by two operators and statistically analyzed. RESULTS Compared with the CT, FIT led to significantly fewer and smaller enamel defects (mean volume: -0.04 mm3 vs -0.33 mm3 ) (P

In the hectic daily life, spending our leisure time outdoor in the mountains becomes more and more popular. Although information describing dental injuries in various sports is available, data specifically on dental trauma and other dental problems in alpine sports are lacking. Data of 1,128 alpinists were generated by using a standardized questionnaire. The questions focused on the frequency of head and dental injuries and other dental problems. The participating alpinists have been recruited through the network of alpine clubs and an outdoor equipment supplier. Injuries were most frequently caused by a fall while doing alpine sports (14.7%, = 154). Of the participants, 8.2% (n = 93) suffered from a facial injury: 16% (n = 15) of these had a dental trauma. Other dental problems such as barodontalgia were more common than dental traumas. A sensation of pressure or pain was noticed in 13% (n = 135) of the participants at least once. Of all the participants who suffered pain, 54.1% reported one or several previous restorations. Pain medication was beneficial in 92.1%. Dental traumas are rare while doing alpine sports but not negligible because of its requirement of lifelong therapy and incurs substantial treatment costs. An intraoral pain of a usually asymptomatic tissue occurred, in this sample of participants, nearly as often as in pilots and divers. Pain killer is an efficient tool for the alpinists to reduce the pain until they reach a lower altitude.

Recent evidence suggests that salivary cytokines provide information about both oral conditions and systemic diseases. This review summarizes evidence for the use of salivary cytokines as biomarkers for oral and systemic diseases. We included studies in adults and children with a focus on the latter, due to the importance of non-invasive diagnostic methods in the paediatric age group. A systematic review was performed using Medline and Web of Science covering the period of January 1996 to December 2019 according to the preferred reporting items for systematic reviews. Thirty-four studies were included in the final analysis, for a total of 2407 patients and healthy controls. Pro-inflammatory cytokines including interleukin (IL)-1β, IL-2, IL-6 and tumor necrosis factor (TNF)-α were associated with the severity of oral mucosal tissue damage in patients with cancer, and IL-1β may be an early marker of graft-versus-host disease. Salivary interferon-γ levels were correlated with oral complications and the presence of the underlying disease in HIV-infected individuals, and salivary cytokine patterns may be useful for diagnosing tuberculosis. In summary, current data illustrate that salivary cytokines are associated with oral inflammation, making them potential biomarkers for disease diagnosis and treatment efficacy. Because of the simplicity of saliva collection, this method may be useful in pediatric studies and in resource-limited settings.

Zusammenfassung. Etwa jedes zweite europäische Kind erleidet heute einen Zahnunfall. Die Verletzungen reichen von einfachen oder komplexeren Zahnfrakturen über diverse Arten von Dislokationsverletzungen bis hin zu Avulsionen. Während im Milchgebiss maximal ein temporärer Zahnerhalt bis zum physiologischen Zahnwechsel angestrebt wird, fehlen nach schweren Zahnverletzungen oder unfallbedingten Zahnverlusten die entsprechenden Behandlungsmöglichkeiten, die erst Erwachsenen zur Verfügung stehen. Grund ist das noch nicht abgeschlossene Kieferwachstum mit eventuellem Durchbruch weiterer bleibender Zähne, was einen Zahnersatz mit Brücken oder gar Implantaten verbietet. Daher sind richtiges Verhalten unmittelbar nach einem Zahnunfall und eine professionelle zahnärztliche Erstbehandlung essenziell für die Prognose nach einem Zahntrauma.

In the following, legal cases under the Swiss legal system practice concerning dental practice in Switzerland in the fields of criminal, liability and administrative law of the last 20 years will be examined. The objective is to raise awareness of the legal consequences of dental malpractices on the basis of real cases and to make specific suggestions for improvement, which can ultimately contribute to improving the quality of dental practice.Relevant legal cases in the fields of criminal, liability and administrative law were collected with the help of electronic data bases and cantonal courts.The results consist of nineteen court decisions, which in essence concern the withdrawal of professional licenses, prohibition from practice, bodily injury offenses and forgery of certificates. In fifteen of these nineteen cases, the dentist is found guilty by at least one court, in two of them the concerned is acquitted by all the courts mentioned, and in another two, the dentist is convicted for working without an appropriate license.It amounts to the fact that dentists should be fully aware of the legal system and communicate transparently. Moreover, it would be appropriate for patients to stand up for their rights but not to take inappropriate legal action. Furthermore, the Swiss legal system could help to reduce the number of unlawfully issued professional licenses by establishing an intercantonal database.

Background/aims Judo is a popular martial art with a high risk of injury. Notwithstanding this risk, mouthguards were not allowed until June 2018. The aim of this study was to measure the prevalence of traumatic injuries in judo with a particular focus on dental and lip injuries. A further aim was to assess the influences of increased overjet and wearing fixed orthodontic appliances. Material and methods Judokas (n = 382) from two judo clubs in Bern, Switzerland, were interviewed with a standardized questionnaire. Results About two thirds had suffered at least one traumatic injury with a high number of limb injuries (n = 1054), followed by face injuries (n = 855) and spine, torso, occiput or neck injuries (n = 84). Among the face injuries, 562 lip injuries were recorded. A significantly higher number of lip injuries were found for judokas who wore fixed orthodontic appliances compared to judokas who never wore such appliances. Forty-seven dental trauma incidents during judo were recorded. During both judo and leisure time, 161 dental trauma incidents were recorded. Individuals with lip incompetence and increased overjet showed the highest number of dental injuries ( x ¯ = 0.815; SD = 0.622), which differed in statistically significant ways from the number of dental injuries in individuals with lip incompetence and normal or reduced overjet ( x ¯ = 0.278; SD = 0.461). For individuals with no lip incompetence, no difference between the sub-group with an increased overjet and the sub-group with a normal or reduced overjet could be found. Nobody in the study population was wearing a mouthguard, and the acceptance of mouthguards was low (9.7%). Conclusion It is important to increase the awareness of the recent authorization of mouthguards and to promote their acceptance among judokas. The combination of increased overjet and lip incompetence was more relevant for the dental trauma risk than an increased overjet alone.

Background Oral malodor is a very discomforting condition deriving from the presence of volatile sulfur compounds in the expired air. In halitosis of intraoral etiology, the volatile sulfur compounds are metabolic products of the oral microorganisms within the biofilm coating the tongue dorsum as well as other tissues in the oral cavity. The aim of this study was to characterize and compare the microbial composition of tongue biofilm in volunteers suffering from halitosis and healthy volunteers by means of both the culture method and culture‐independent cloning technique. Results A high bacterial variety (more than 80 different species) was detected using the combination of both methods. A distinct bacterial composition was revealed in the halitosis‐associated biofilms compared with the health‐associated biofilms. Actinomyces graevenitzii was shown to be significantly associated with the halitosis condition. The culture method identified 47 species, included Veillonella rogosae, never isolated from the tongue biofilm of halitosis patients so far. In the healthy condition, the culture‐dependent method showed that the most frequent species were Streptococcus parasanguinis among the aerobes and Veillonella spp. among the anaerobes. The culture‐independent cloning method detected more than 50 species. Streptococci, in particular S. mitis/oralis, S. pseudopneumoniae, and S. infantis as well as Prevotella spp., were found most frequently in halitosis patients. Streptococcus salivarius and Rothia mucilaginosa were found more frequently in the healthy condition. Conclusions The combination of the culture‐dependent and culture‐independent cloning techniques allowed for a widespread analysis of the tongue biofilm in halitosis patients. The results can support further pharmacological research for new antimicrobial agents and halitosis therapy strategies., Oral malodor is a discomforting condition deriving from the presence of volatile sulfur compounds in the expired air. The study characterized and compared the microbial composition of tongue biofilm in volunteers suffering from halitosis and healthy volunteers by means of both the culture method and culture‐independent cloning technique, revealing a distinct bacterial composition of halitosis‐associated biofilms compared with the health‐associated biofilms and a high bacterial diversity within the halitosis‐associated biofilms.