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The Study of Health in Pomerania (SHIP), a population-based study from a rural state in northeastern Germany with a relatively poor life expectancy, supplemented its comprehensive examination program in 2008 with whole-body MR imaging at 1.5 T (SHIP-MR). We reviewed more than 100 publications that used the SHIP-MR data and analyzed which sequences already produced fruitful scientific outputs and which manuscripts have been referenced frequently. Upon reviewing the publications about imaging sequences, those that used T1-weighted structured imaging of the brain and a gradient-echo sequence for R2* mapping obtained the highest scientific output; regarding specific body parts examined, most scientific publications focused on MR sequences involving the brain and the (upper) abdomen. We conclude that population-based MR imaging in cohort studies should define more precise goals when allocating imaging time. In addition, quality control measures might include recording the number and impact of published work, preferably on a bi-annual basis and starting 2 years after initiation of the study. Structured teaching courses may enhance the desired output in areas that appear underrepresented.

Purpose To evaluate the efficacy of manual and machine-aided cleaning to remove matured plaque from removable partial dentures (RPD). Materials and methods A total of 32 patients with bilateral free-end saddle RPDs were included. The plaque was stained, and the RPD was photographed on all sides. One saddle was randomly allocated to manual cleaning, while the other was allocated to no cleaning. The patient manually cleaned the saddle by applying a denture brush and gel. The whole RPD was then cleaned with the aide of a machine using a rotating needle device. After each step, plaque dyeing and photographing were repeated. The plaque proportions (% pixel) were measured using special software. For statistical analysis, mixed models were used to adjust for baseline covariates, including plaque and surfaces, and to cover all time points. Results The mean plaque area without cleaning at the fitting surface was higher than at the buccal/lingual surfaces (32.8% [95% CI: 28.1% to 36.4%] vs 15.3% [13.1% to 17.4%], respectively). Manual cleaning was not substantially better than no cleaning (4.6% [-0.1% to 9.2%] for the difference at fitting surfaces; disclaiming a substantial difference of > 10%; the difference found was even smaller at buccal/lingual surfaces). Machine-aided cleaning was substantially better than manual cleaning (16.1% [12.0% to 20.2%] for the difference at fitting surfaces and 7.3% [4.6% to 10.0%] at buccal/lingual surfaces). The combination of manual and machine-aided cleaning was not better than machine-aided cleaning alone (-0.2% [-2.6% to 2.1%] difference at fitting surface). Conclusion Manual cleaning is insufficient in removing matured denture plaque. Machine-aided cleaning is clearly superior to manual cleaning, especially at fitting surfaces.

Objectives Stability values of mini-implants (MIs) are ambiguous. Survival data for MIs as supplementary abutments in reduced dentitions are not available. The aim of this explorative research was to estimate the 3-year stability and survival of strategic MIs after immediate and delayed loading by existing removable partial dentures (RPDs). Material and methods In a university and three dental practices, patients with unfavorable tooth distributions received supplementary MIs with diameters of 1.8, 2.1, and 2.4 mm. The participants were randomly allocated to group A (if the insertion torque ≥ 35 Ncm: immediate loading by housings; otherwise, immediate loading by RPD soft relining was performed) or delayed loading group B. Periotest values (PTVs) and resonance frequency analysis (RFA) values were longitudinally compared using mixed models. Results A total of 112 maxillary and 120 mandibular MIs were placed under 79 RPDs (31 maxillae). The 1st and 3rd quartile of the PTVs ranged between 1.7 and 7.8, and the RFA values ranged between 30 and 46 with nonrelevant group differences. The 3-year survival rates were 92% in group A versus 95% in group B and 99% in the mandible (one failure) versus 87% in the maxilla (eleven failures among four participants). Conclusions Within the limitations of explorative analyses, there were no relevant differences between immediate and delayed loading regarding survival or stability of strategic MIs. Clinical relevance The stability values for MIs are lower than for conventional implants. The MI failure rate in the maxilla is higher than in the mandible with cluster failure participants. Clinical trial registration German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS-ID: DRKS00007589, www.germanctr.de), January 15, 2015.

The purpose of this study was to evaluate and compare the effects of the immediate and delayed loading of strategic mini-implants (MIs) on the satisfaction of patients with removable partial dentures (RPDs). In this multi-center randomized clinical trial, strategic MIs were inserted under 79 RPDs in 76 participants. Two questionnaires, one for the upper jaw and one for the lower jaw, were given before surgical intervention and 2 weeks, 4 months, 4.5 months, 1 year, 2 years, and 3 years after implant insertion. To estimate the loading effect (immediate vs. delayed) in terms of the odds ratio, an ordinal logistic regression model was used. The Wilcoxon matched-pairs signed-rank test, which was corrected for clusters in the patient population, was used to evaluate changes in patient satisfaction. After 4 months, a statistically significant difference in favor of the immediate loading group was recognized in terms of the overall satisfaction score. The patient satisfaction scores recorded after 4.5 months and 1, 2, and 3 years showed substantial improvements compared with the scores recorded before implant insertion in both groups. At the item level, substantial improvements were noted in the following domains: general satisfaction, RPD retention, stability, support, eating, speaking, and aesthetics. Strategic MIs improved the satisfaction of patients with RPDs during the medium-term follow-up period. An earlier improvement in the satisfaction of patients with RPDs was seen after immediate loading of the MIs as compared with delayed loading. Inserting MIs under existing RPDs can improve patients’ satisfaction with their RPDs in several domains.

Inserting a dental implant in a strategic position under a removable partial denture (RPD) can upgrade the RPD design by changing a mainly tissue-supported RPD to an implant-tissue-supported RPD or an implant-tooth-tissue-supported RPD with better retention, support, and stability. CASE PRESENTATION: The patient (female, 77-year-old) was unsatisfied with her maxillary and mandibular clasp-retained removable dentures (RDs). Medical, social, and systemic health evaluations revealed that the patient was healthy. Dental history, intraoral and extraoral examinations, functional screening, and esthetic analyses revealed that the patient had a reduced vertical dimension, resulting in pseudo-class III malocclusion and angular cheilitis. Strategic implants were used to improve the retention, support, and stability of the new RDs. The maxillary canine 23 (World Dental Federation notation) and maxillary premolar 24 were used to retain the maxillary conical crown attachments. Three strategic mini-implants were inserted in the positions of teeth 12, 13, and 14 to support and retain the maxillary RPD. Two locators above the standard implants (33 and 43) were used to support and retain the mandibular overdenture. An improvement in the oral health-related quality of life and patient satisfaction with respect to the maxillary and mandibular RDs was observed immediately after using the new RDs. This improvement did not diminish after a year. CONCLUSION: Herein, using strategic implants to support the maxillary RPD and two standard implants under the mandibular overdenture improved the oral health-related quality of life and patient satisfaction with respect to the maxillary and mandibular prostheses in terms of the retention, stability, support, eating ability, speaking ability, appearance, and cleanability.

The journal of evidence based dental practice 23(1S), 101794 (2023). doi:10.1016/j.jebdp.2022.101794 special issue: "Dental patient-reported outcomes 2022 Dental PROs / Edited by Fang Hua", Published by Elsevier, Amsterdam [u.a.]

Background The psychometric properties of self-administered instruments for measuring patient satisfaction with removable dentures should be tested before inviting patients to express their opinions. This study aimed to evaluate the validity and reliability of new instruments in the Arabic language that measure patient satisfaction with all types of removable dentures. Methods A three-step methodology was used to translate and test the instruments. In step one, the instruments were translated from tested German instruments to develop the pilot questionnaires. In step two, the face validity of the pilot questionnaires was tested through three rounds of interviews. There were 15, 13, and 15 participants per round, respectively. At the end of every round, the results of the interviews were discussed with an expert panel. The expert panel confirmed the form and the type of questionnaires’ adjustments before a new round of interviews began. At the end of step two, the final form of the questionnaires was reached. In step three, 235 questionnaires were distributed to 133 participants to estimate the construct validity of the upper jaw and the lower jaw questionnaires. After one week, the participants were asked to complete the questionnaires again. A total of 102 questionnaires were returned and used to assess the instruments’ reliability. Factor analysis was used to assess the construct validity. The intraclass correlation coefficient and Cronbach’s alpha were used to estimate the reliability and suitability of the items in the indexes. Results The result of step one was two pilot questionnaires. The pilot questionnaires were adjusted in step two. At the end of step two, the questionnaires proved to have good face validity. Factor analyses in step three revealed that only one factor could be retained. The one-factor model explained 60.95% and 63.06 of the total variance of the upper jaw and lower jaw questionnaires, respectively. The items in every questionnaire shared the same cluster and could be summed to form an upper jaw index and lower jaw index that reflected patient satisfaction with removable dentures. Cronbach’s alpha values indicated excellent internal consistency and reliability for the upper jaw questionnaire (α = 0.91) and the lower jaw questionnaire (α = 0.92). Intraclass correlation coefficient values ranged from 0.72 to 0.95, which can be considered “moderate” to “excellent”. Conclusions The Arabic version of questionnaires and indexes assessing patient satisfaction with upper and lower removable dentures are reliable and valid self-administered instruments.

Objectives To compare oral health-related quality of life (OHRQoL) in patients with either molar replacement by partial removable dental prostheses (PRDP) or with restored shortened dental arches (SDA) over a period of 10 years. Methods In this multi-center RCT, a consecutive sample of 215 patients with bilateral molar loss in at least one jaw was initially recruited in 14 prosthodontic departments. Of those patients, 150 could be randomly allocated to the treatment groups (SDA: n = 71; PRDP: n = 79), received the allocated treatment, and were available for follow-up assessments. OHRQoL was assessed using the 49-item version of the Oral Health Impact Profile (OHIP) before treatment (baseline) and at follow-ups after treatment (4–8 weeks and 6, 12, 24, 36, 48, 60, 96, and 120 months). To investigate the course of OHRQoL over time, we longitudinally modelled treatment and time effects using mixed-effects models. Results OHRQoL substantially improved from baseline to first follow-up in both groups indicated by a mean decrease in OHIP scores of 20.0 points (95%-CI: 12.5–27.5). When compared to the SDA group, OHRQoL in the PRDP group was not significantly different (−0.6 OHIP points; 95%-CI: −7.1 to 5.9) during the study period when assuming a constant time effect. OHRQoL remained stable over the 10 years with a statistically insignificant time effect (p = 0.848). Conclusions For patients requesting prosthodontic treatment for their lost molars, treatments with SDA or PRDP improve clinically relevantly OHRQoL and maintain it over a period of 10 years with no option being superior to the other. Clinical significance Since there was no significant difference between the two treatment options over the observation period of 10 years, and since results have stayed stable over time, patients can be informed that both treatment concepts are equivalent concerning OHRQoL.

Background A shortened dental arch (SDA) is an established treatment concept for patients with missing molars. However, little is known regarding long-term course of oral health-related quality of life (OHRQoL) in patients with SDA and the benefits from replacement of missing molars. Aim Purpose of this multi-center randomized clinical trial was to assess OHRQoL over a period of 15 years in patients with molar replacement by a removable partial denture (RPD) compared to patients with a restored SDA without molar replacement. Design Patients at least 35 years of age with all molars missing in one jaw and at least the canine and one premolar present on each side were included. Patients received either a precision attachment-retained, RPD for replacement of missing molars (N=79), or the dental arch ended with the second premolar (SDA) that had to be present or replaced by a cantilever fixed dental prosthesis (N=71). Follow-up examinations continued for 15 years. OHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP). OHIP summary and dimension scores were longitudinally modeled in the statistical analyses to assess course of OHRQoL over time applying an intention-to-treat approach. In addition, scores for the OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact were analyzed. Results After an initial improvement in OHRQoL indicated by a mean decrease of 20.0 OHIP points with an effect size of 0.61 in the entire study population, OHRQoL stayed relatively constant over the entire follow-up period. Assuming a constant time and treatment effects over the study period, OHRQoL did not differ statistically significant between the two treatments (0.4 OHIP points; 95%-CI: −7.1 to 6.2). OHRQoL after treatment did not change notably over 15 years and was statistically nonsignificant as well (p=0.872). Similar findings were observed in all four OHRQoL dimensions. Conclusions In patients, missing all molars in one jaw OHRQoL improved providing RPD or restoring SDA to a clinically relevant degree. Treatment-related improvement remained mostly stable over a period of at least 15 years. Therefore, patients can be informed that both treatment concepts are equivalent concerning long-term OHRQoL. Accordingly, patients’ preferences regarding treatment options should be granted priority in treatment decision making with the SDA treatment option being the default.

Journal of oral rehabilitation 48(6), 738-744 (2021). doi:10.1111/joor.13167, Published by Wiley-Blackwell, Oxford [u.a.]

PURPOSE The aim of this investigation was to compare the chewing efficiency after immediate and delayed loading of mini-implants that served as supplementary support for removable partial dentures (RPDs). MATERIALS AND METHODS In this four-center randomized trial, patients who had RPDs in arches with unfavorable tooth distributions, ie, no canine and at most two posterior teeth in one or both quadrants, received strategic mini-implants with ball abutments. The mini-implants in group A were loaded immediately either by housings with O-rings (insertion torque ≥ 35 Ncm) or by soft relining material (insertion torque < 35 Ncm). In group B, the RPDs were only hollowed over the balls. After 4 months, the soft relined RPDs and all RPDs of group B received the housings. Masticatory efficiency was evaluated with a validated mixing ability test of two-colored chewing gum before surgery and 14 days, 4 months (before housing pickup), 4.5 months, and 12 months after surgery. The circular variance of hue was the measure of mixing. RESULTS From 76 participants with 79 RPDs, 38 each were randomly allocated to group A or B. In group A, the housings in six participants were picked up immediately, and the remaining RPDs were primarily soft relined. There was a significant group difference only after 4 months. The mixing ability was better after immediate loading than after delayed loading (P < .0001). In group B, the chewing efficiency was notably deteriorated after the RPDs were hollowed over the ball abutments. However, immediately after all housings were picked up, the chewing efficiency in both groups was substantially improved, and the variance of hue values after 1 year were very similar in the groups. CONCLUSION The chewing performance can be improved by inserting supplementary mini-implants under existing RPDs with unfavorable tooth support. This improvement occurred faster by immediate loading than by delayed loading.

Journal of prosthodontic research 64(4), 498-505 (2020). doi:10.1016/j.jpor.2020.01.005, Published by Elsevier, Amsterdam [u.a.]

Aim Evidence for reducing Helicobacter (H.) pylori by periodontal therapy comes from small studies in China, limiting generalizability. To estimate the association between periodontal disease and anti-H. pylori IgG titer levels in a European country, we used population-based data from the Study of Health in Pomerania. Materials and methods For pocket depth as the primary exposure, we restricted the age range to participants younger than 60 years (n = 2,481) to avoid selection bias due to edentulism in this cross-sectional study. For the full age range up to 81 years, we chose the number of missing teeth (n = 3,705). Results The association between pocket depth and the outcome was weak. Given the ceiling effect for the number of missing teeth (ordinal logistic regression; odds ratio of the interquartile range effect = 1.6; 95% CI: 1.3-1.9; p-value for linearity = 0.005), we checked whether wearing removable dental prosthesis was associated with higher anti-H. pylori IgG titer levels (odds ratio = 1.3; 95% CI: 1.1-1.5). Conclusions Tooth loss and wearing removable dental prosthesis were weakly to moderately associated with higher anti-H. pylori IgG titer levels in the general population of a European country.

Journal of prosthodontic research 62(3), 313-316 (2018). doi:10.1016/j.jpor.2017.12.003, Published by Elsevier, Amstedam [u.a.]

PURPOSE To evaluate changes in distribution of teeth and in prosthodontic tooth replacement during an 11-year period in an adult population. MATERIALS AND METHODS Information on prosthetic status was collected from 4,288 participants aged 20 to 81 years at baseline in the Study of Health in Pomerania (SHIP-0) and from 2,244 participants aged 30 to 92 years who reappeared in the 11-year follow-up (SHIP-2). The tooth distribution per arch was classified into one of the six following classes: class 0 (edentulous), class 1 (one to three remaining teeth), class 2 (extended tooth-bounded space or extreme shortened dental arch), class 3 (small anterior space), class 4 (small posterior space with one or more missing premolars), or class 5 (functional dentition). RESULTS Longitudinally, the most pronounced change in class was the transition from class 1 to class 0 (maxilla: 54.5%, mandible: 58.3%). The percent change from other higher classes to lower classes ranged between 10% and 40%. In the same age groups of 40 to 79 years, the number of edentate arches was cut in half, with a corresponding increase in functional dentitions. The proportion of unrestored arches decreased in all classes. Double crown-retained partial removable dental prostheses (PRDPs) showed the highest increase (a 15% to 20% increase) at the expense of acrylic PRDPs in classes 1 and 2. In small spaces, the proportion of fixed dental prostheses (FDPs) also increased by 15% to 20%. Seven participants of SHIP-0 (0.16%) and 56 participants of SHIP-2 (2.5%) had dental implants. CONCLUSION Similar age groups showed improvement in oral conditions. The proportion of higher-end restorations (FDPs and double crown-retained PRDPs), including the frequency of dental implants, increased.

Journal of dental research : JDR 97(2), 163-170 (2018). doi:10.1177/0022034517736063, Published by Sage, Thousand Oaks, Calif.

Objectives This multi-centre randomized controlled trial was conducted to investigate, whether the masticatory performance of elderly edentulous patients is improved by placement of a single implant in the midline of the edentulous mandible, and whether improvements differ with respect to the loading protocol, i.e., implant is loaded either directly or three months later after second stage surgery. Methods Edentulous seniors aged 60–89 years were screened according to inclusion and exclusion criteria and 163 underwent implant placement. Of those, 158 were randomly assigned either to the direct loading group A (n = 81) or the conventional loading group B (n = 77). Chewing efficacy was obtained before treatment, one month after implant placement during the submerged healing phase (only group B) and 1 and 4 months after implant loading. Results The masticatory performance increased over time in both groups. Four months after loading, a significant increase was observed for both groups compared to the baseline data without implant (p ≤ 0.05). However, between the two groups, chewing efficiency did not differ significantly at any point in time (p > 0.05). Conclusions A single midline implant in the edentulous mandible increases masticatory performance significantly, independently from the loading protocol. Clinical significance A single midline implant in the edentulous mandible increases masticatory performance. The loading protocol has no influence.

Mini dental implants (MDI) were once thought of as transitional implants for treatment in selected clinical situations. Their reduced diameter makes them a very attractive option for patients with poor tolerance to maxillary and mandibular prostheses. Using the method of finite element analysis, a series of different designed MDI prototypes have been investigated. The prototypes differed in the geometry of implant body and/or design of implant head. The load transfer of the implant prototypes to the idealised alveolar bone has been regarded and the prototypes have been compared to each other and to a number of standard commercial implants. The prototype models have been virtually placed in the idealised bone with a cortical thickness of 1.5 mm and loaded laterally 30° from the implant's long axis. The condition of immediate loading was assumed for the numerical analyses through defining a contact interface between the implant and bone bed. The numerical analysis in this study showed that the design of the investigated prototype MDI of group 3 (mini-ball head) is the most advantageous design.

Purpose: The aim of this study was to evaluate the reliability and agreement of a new computerized planimetric method (CPM) for the measurement and assessment of plaque on all types of removable dental prostheses (RDPs). Materials and Methods: From a database containing 780 images taken following a standardized method for 65 RDPs, 55 images were randomly selected for image analysis. Adobe Photoshop software was used according to standard operating procedure (SOP) by one main examiner two times in different sessions, and one time by three additional examiners. To estimate the intra- and interexaminer reliability, intraclass correlation coefficient ICC(2,1) were used. Three parameters were used to estimate agreement: standard error of measurement (SEM), smallest detectable change at the 95% confidence level (SDC95%), and limits of agreement (LoA) according to the Bland-Altman method. Results: In all steps of the image analysis, both intra- and interexaminer reliability were excellent, with ICC(2,1) values > 0.85 at the 95% confidence level. The intra- and interexaminer values for both the SEMagreement and SDC95% were ≤ 6% and ≤ 17%, respectively. The Bland-Altman analysis revealed a satisfactory level of agreement. Conclusion: This study shows excellent inter- and intraexaminer reproducibility, a satisfactory level of examiner agreement, and acceptable measurement error. Furthermore, the method can be used with all types of RDPs. The CPM is more suitable for clinical research because of its objectivity, reliability, high level of standardization, and ability to detect and quantify small changes in plaque.

Objective This study evaluates the mandibular lingual foramina (LF) using computed tomographic imaging data from a large Central European cohort, focusing on the most relevant anatomical parameters. We aimed to examine whether there are differences in key parameters between ethnic groups, or based on age and gender. Additionally, we analyze the potential effect of tooth loss on the LF and discuss risk management options before and during surgery. Methods 460 CT scans of adults (273 females and 186 males) were examined. The number, the location and the diameter of the median and lateral LF were assessed for each patient. The data was analyzed statistically, whereby a p-value lower than 0.05 was considered as significant. Results Median and lateral LF were present in 95,9%, and 38,9% of patients, respectively. Male patients had a greater number of LF than females. While the majority of median LF (62%) was located above the mental spine, the majority of lateral LF was located below (84%). The diameter of lateral LF (1,15 mm ± 0,33) was smaller than for median LF (1,22 mm ± 0,35), as well the lateral canals (4,8 mm ± 1,28) were shorter than the median canals (5,32 mm ± 1,74). Lateral LF were equidistant to the symphysis (13,89 ± 3,63 mm) on either side. Critical diameter size >1 mm was found in about 2/3 of our cases. The distance from the foramen to the residual ridge was ∼7 mm less in edentulous patients compared to dentulous patients. Conclusion The median LF is a near-obligatory structure of the mandible, while the lateral LF is a frequently encountered structure. Age does not seem to affect the frequency of LF. Edentulous patients did not show differences regarding the presence of the LF, but their vertical osseous dimension was diminished by 7 mm and they may, therefore, be at an increased risk of adverse surgical incidents. The main findings of this study relate to the substantial variability in the anatomy and location of the LF and confirm with previous studies. As the LF can be reliably detected using CT/CBCT, the use of three-dimensional-imaging is recommended prior to conducting oral surgery. Careful pre-operative planning and accurate anatomical information may help to avoid surgical complications. To ascertain the potential significance of ethnicity on LF, more data need to be collected using standardized methodologies. A definitive conclusion on the impact of ethnicity on LF thus cannot currently be drawn based on the results of our study and those available from the published medical literature.

OBJECTIVES The knowledge about the influence of dental treatment on health-related quality of life (HRQoL) is still limited. The aim of this multicenter randomized controlled clinical trial was to assess the effect of stabilizing an existing complete denture, by means of a single mandibular implant, on HRQoL. Furthermore, the impact of the loading protocol, i.e., immediate or delayed loading, in edentulous patients was evaluated. METHODS One hundred fifty-eight participants aged 60-89 years were randomly assigned to study group A (immediate loading; n = 81) and to group B (delayed loading; n = 78). All participants received a single midline implant in the mandible. The implants were either immediately loaded (group A) or after a closed healing period of 3 months (group B) by connecting the existing mandibular complete dentures to ball attachments. HRQoL was assessed with the Short Form-36 questionnaire of health (SF-36) at baseline, 4 months, and 24 months after implant loading. RESULTS Improvement of HRQoL by means of a single implant-retained mandibular overdenture could not be demonstrated after 4 and 24 months of implant loading. Furthermore, the application of two different loading protocols did not influence HRQoL ratings of study participants. CONCLUSION The loading protocol is not a factor, influencing HRQoL in patients treated by a single midline implant in the edentulous mandible. CLINICAL RELEVANCE A single midline implant in the edentulous mandible, stabilizing a mandibular complete denture, cannot be recommended for improving HRQoL.

Aim The aim of this study was to determine the prospective association between sex steroid concentrations with periodontal progression and incident tooth loss in men and women. Methods We used data from 1465 women and 1838 men (age 20-81 years) with completed five-year-follow-up from the Study-of-Health-in-Pomerania, a population-based longitudinal cohort. Serum levels of total testosterone (TT) and other sex steroids were measured. Mean clinical attachment loss (CAL) and the number of teeth were assessed. Generalized regression models were implemented for cross-sectional and longitudinal analyses, adjusting for age, education, smoking, waist circumference, diabetes, physical activity, blood sampling time and time between baseline and follow-up. Results Fully adjusted models revealed no consistent associations between TT and mean CAL, neither in cross-sectional [men: s = -0.0004 (-0.023;0.022), p = 0.97; women: s = -0.033 (-0.057; -0.009), p = 0.006] nor in longitudinal analyses [men: s = -0.033 (-0.100;0.034), p = 0.33; women: s = -0.023 (-0.086;0.040), p = 0.47]. For tooth loss, neither cross-sectional nor longitudinal associations with any of the sex steroid concentrations were found. Conclusions No consistent associations of sexual steroids with periodontal progression or tooth loss were found. Further cohort studies are necessary to evaluate possible associations between endocrinological parameters, like supra- or subphysiologic testosterone concentrations, and periodontal progression or tooth loss.

PURPOSE To demonstrate how data collected using the computerized planimetric method (CPM) can be analyzed by providing an example in which the amount of plaque accumulation and the efficacy of the rotating needles device (RND) in cleaning specific parts of partial removable dental prostheses (PRDPs) were estimated. MATERIALS AND METHODS Thirty-four participants wearing a total of 41 double-crown-retained PRDPs with veneered secondary crowns were included in this study. The PRDPs underwent the following steps: preparing the PRDP for photography, photography of the PRDP, cleaning the PRDP with the RND, and re-photography. One trained examiner used a tested CPM to analyze 98 images (49 before/49 after). Each participant was considered as a statistical unit; thus, if the participant had two PRDPs, one was randomly selected for analysis. Reliability was tested using intraclass correlation coefficients (ICCs[1, 2]), and nonparametric Wilcoxon signed rank test was used for all comparisons. RESULTS The intraclass correlation coefficients (images before/after) for both the base and veneer were > 0.9. Wilcoxon signed rank test P value was < .001 for the comparison of plaque accumulation on the base and veneer, estimating the RND's efficacy on both PRDP parts (before/after) and comparing the RND's efficacy on the base and the RND's efficacy on the veneer. CONCLUSIONS There are different ways to analyze data collected via CPM; thus, it is advisable to provide an explanation for the choice of modeling. Plaque accumulation was significantly greater on the double-crown veneer than on the base. The RND efficacy in cleaning the veneer and the base is significant, but more substantial in cleaning the base.

Purpose This study aimed to compare the long-term outcomes of two different nonimplant treatments in the bilateral shortened dental arch (SDA). Materials and methods In a multicenter randomized controlled clinical trial, patients with complete molar loss in one arch were assigned to one of two different nonimplant treatments. In the partial removable dental prosthesis (PRDP) group, patients were provided with a distal-extension prosthesis retained with precision attachments. In the SDA group, patients were treated according to the SDA concept by preserving or restoring a premolar occlusion. Results Of the 152 treated patients, 82 reached the 10-year examination independent of their dental or prosthetic status. In the intention-to-treat analysis, the survival rates for tooth loss at 10 years were 0.44 (95% confidence interval [CI]: 0.30 to 0.56) in the PRDP group and 0.52 (95% CI: 0.37 to 0.65) in the SDA group. For tooth loss in the study arch, the survival rates were 0.67 (95% CI: 0.52 to 0.78) in the PRDP group and 0.60 (95% CI: 0.45 to 0.73) in the SDA group. The number of teeth lost was higher than expected. In a multivariate analysis using a multiple Cox regression model, the covariates age (unit: 1 year, Hazard Ratio [HR]: 1.033, P = .03) and DMFT value (unit: 1 tooth, HR: 1.121, P = .03) were significant for time to first tooth loss in the study arch. Conclusion The results suggest an overestimation of the influence of the prosthetic management of the bilateral SDA. In treatment decisions, patient preferences should be considered with appropriate weight.

To develop and test self-administered satisfaction questionnaires for patients with removable dental prostheses (RDPs) in the German language.A three-phase methodology was used. A pilot questionnaire was developed in phase one. At the end of phase two, the final version of the questionnaires were reached. In phase three, 192 questionnaires were distributed to evaluate the psychometric properties of the final version of the questionnaires. Construct validity, content validity from the patients' perspective, and questionnaire reliability were estimated.At the end of phase two, the final versions of the questionnaires were defined as instruments with good face validity. At the end of phase three, content validity from the patients' perspective was assessed and found to be good. Exploratory factor analysis identified a one-factor model for each questionnaire. Consequently, each questionnaire was summed to create a single index. Internal consistency of the indexes was assessed using Cronbach's α and found to be excellent (α 0.9). A high repeatability of all the items was identified through a test-retest. Intra-class correlation coefficient (ICC) values ranged from 0.80 to 0.99.The questionnaires and indexes are valid and highly reliable instruments, and can be used to measure patient satisfaction with RDPs.

Purpose: The aim of this multicenter single mandibular implant study was to compare the clinical outcome of an immediately loaded implant placed in the midline of an edentulous mandible with the clinical outcome when closed healing and delayed loading is chosen. Here, the patient recruitment period and the main reasons for exclusion were analyzed. Materials and Methods: Patient recruitment was performed at nine German universities. Rather conservative inclusion and exclusion criteria, including denture satisfaction, denture status, a psychologic symptom checklist, and a defined bone height in the posterior mandible, had to be fulfilled. It was initially calculated that 230 persons would have to be screened within 13 months to include 180 persons in the trial. Results: Within 13 months (December 2012 to December 2013), 201 patients were screened for possible inclusion in the trial and 148 met the inclusion criteria. Finally, after the recruitment period was extended by 2.5 months, 224 patients were screened and 169 were included. Of those screened, 55 (24.6%) did not meet the inclusion criteria and were excluded. Another 4 patients (1.8%) were excluded based on their psychologic symptom checklist score, while 5 others (2.8%) showed signs of noncompliance. A further 8 patients (4.4%) decided not to participate and withdrew their informed consent, and another 3 (1.3%) were no longer available after screening. Another 2 patients were excluded due to medical contraindications and 1 due to an insufficient mandibular denture. In 34 cases (15.2%), the residual bone height did not comply with McGarry type II or III. Conclusion: Within the limitations of this patient recruitment period, it can be concluded that residual bone height is the most important factor when considering elderly edentulous patients for implant therapy. The psychologic symptom checklist score was less important.

Summary In a multicentre randomised trial (German Research Association, grants DFG WA 831/2-1 to 2-6, WO 677/2-1.1 to 2-2.1.; controlled-trials.com ISRCTN97265367), patients with complete molar loss in one jaw received either a partial removable dental prosthesis (PRDP) with precision attachments or treatment according to the SDA concept aiming at pre-molar occlusion. The objective of this current analysis was to evaluate the influence of different treatments on periodontal health. Linear mixed regression models were fitted to quantify the differences between the treatment groups. The assessment at 5 years encompassed 59 patients (PRDP group) and 46 patients (SDA group). For the distal measuring sites of the posterior-most teeth of the study jaw, significant differences were found for the plaque index according to Silness and Loe, vertical clinical attachment loss (CAL-V), probing pocket depth (PPD) and bleeding on probing. These differences were small and showed a slightly more unfavourable course in the PRDP group. With CAL-V and PPD, significant differences were also found for the study jaw as a whole. For CAL-V, the estimated group differences over 5 years amounted to 0·27 mm (95% CI 0·05; 0·48; P = 0·016) for the study jaw and 0·25 mm (95% CI 0·05; 0·45; P = 0·014) for the distal sites of the posterior-most teeth. The respective values for PPD were 0·22 mm (95% CI 0·03; 0·41; P = 0·023) and 0·32 mm (95% CI 0·13; 0·5; P = 0·001). It can be concluded that even in a well-maintained patient group statistically significant although minor detrimental effects of PRDPs on periodontal health are measurable.

To investigate whether there are differences in patients' denture satisfaction when an implant placed in the midline of the edentulous mandible is loaded either immediately or three months later, after second-stage surgery. One hundred and fifty-eight edentulous patients received a single implant in the midline of the mandible. After randomisation, it was loaded either immediately after implant placement (N = 81, group A) or three months later, after a submerged healing phase and a second-stage surgery (N = 77, group B). Patients' denture satisfaction aspects were assessed, using visual analogue scales (VAS), before treatment, one month after implant placement during the submerged healing phase (only group B) and one and four months after implant loading. The statistical analysis was performed using the Wilcoxon signed-rank and rank-sum tests. One month after loading, a significant improvement in comfort, function and stability of the mandibular denture could be observed in both groups (P ≤ 0·05). A slight but not significant improvement was found between one and four months after loading. Patients with second-stage surgery and delayed loading rated the stability and fit of the mandibular denture as significantly better than patients who had immediate loading. A single implant in the edentulous mandible significantly increased patients' denture satisfaction. After four months, stability and fit of the mandibular denture were considered better when a delayed loading protocol had been followed. A single mandibular implant in the edentulous mandible significantly increases patients' denture satisfaction, regardless of the loading protocol.

Background A dentition of at least 20 teeth is associated with sufficient masticatory efficiency and is a stated health goal of the World Health Organisation. We examined whether subjects with missing, unreplaced teeth had an increased mortality risk. Methods We used data prospectively collected from those participants in the population-based Study of Health in Pomerania who had fewer than 20 remaining teeth, resulting in a sample of 1803 participants with a median age of 64years. Of those, 188 subjects had 9 or more unreplaced teeth. During a median follow-up period of 9.9years, 362 subjects died, 128 of whom of cardiovascular causes. Results We found that having 9 or more unreplaced teeth was related to all-cause mortality (rate ratio 1.53, 95% CI: 1.11–2.10; adjusted for variables according to causal diagrams: remaining teeth, age, sex, education, income, marital status, partnership, and oral health behaviour) and cardiovascular mortality (rate ratio 1.94, 95% CI: 1.15–3.25). When adjusting not only for the variables according to causal diagrams but also for smoking, alcohol consumption, physical activity, obesity, hypertension, diabetes, and dyslipidemia, the rate ratio was 1.43 (95% CI: 1.05–1.96) for all-cause mortality and 1.88 (95% CI: 1.10–3.21) for cardiovascular mortality. Conclusions A reduced, unrestored dentition is associated with increased mortality risk. Thus, clinicians and dietitians have a responsibility to consider individual chewing ability in nutritional recommendations.

Gerodontology 2013; doi: 10.1111/ger.12066 Clinical response of edentulous people treated with mini dental implants in nine dental practices Objectives: To analyse implant survival, prosthetic aftercare and quality of life (QoL) after stabilisation of complete dentures with mini-implants. Background: Many edentulous patients refuse implant therapy due to the expenses and fear of surgery. Studies on minimally invasive and low-cost mini-implants remain rare. Materials and methods: A total of 133 participating patients from nine private practices were evaluated via patient records, questionnaires and clinical examinations. Complications, maintenance, QoL questions and the German short version of the oral health impact profile (OHIP-G14) were analysed. Results: After 7 to 61 months, 15 of 336 maxillary implants and 11 of 402 mandibular implants had to be removed. In addition, four mandibular implants experienced fracture. The difference between the 4year survival rates of 94.3% for the maxilla and 95.7% for the mandible was not statistically significant (p = 0.581). All original 144 overdentures remained functional. The prosthetic interventions were typically limited to repairs of acrylic base fractures (about one in five patients), changes of plastic O-rings and relining procedures. The participants showed OHIP-G14 scores (median = 2) that were comparable with those of patients with overdentures retained by conventional implants. Conclusions: Mini-implant survival was similar to that of regular-diameter implants. Although some prosthetic aftercare was necessary, none of the overdentures had to be replaced. Prospective studies comparing conventional and mini-implants are warranted.

This study sought to evaluate platform-switched implants for immediate placement. A total of 136 implants were placed in 58 patients using either an immediate or delayed implant protocol. Bone level changes of the implants were measured mesially and distally and statistically analyzed with linear mixed models. No implant was lost. There was no significant difference between immediate and delayed implants in approximal bone level changes during the first year (95% confidence interval: -0.10 to -0.01 for immediate versus -0.14 to -0.07 for delayed implants). Subsequent bone resorption was negligible in both groups.

Permanent cementations of zirconia-ceramic restorations may conflict with the rationale for retrievability of implant-supported restorations. The aim of this study was to test the hypothesis that retrievable, tooth-implant supported FDPs made of veneered zirconia ceramic cores are a viable treatment alternative.Restorations of patients in private practice and dental clinic were evaluated by reviewing patient records retrospectively and performing a final clinical examination. Permanently cemented copings protected the tooth abutments. The zirconia-ceramic restorations were semi-permanently cemented to the copings and the implant abutments using acrylic-urethane cement. In addition to Kaplan-Meier analyses for complications, the effect of age, gender, signs of bruxism, jaw and number of units on complications was estimated using Cox regression analyses (significance p0.05).The follow-up period for 23 patients (nine with signs of bruxism) with four anterior and 27 posterior zirconia-ceramic restorations (3-12 units) ranged from 12.7-47.9 months. Core fractures of two posterior prostheses in patients with signs of bruxism yielded a 40-month survival rate of 93.5%. There were 10 cohesive chippings within the veneering porcelain for seven patients (six patients with signs of bruxism), which resulted in 40-month chipping rates of 5.6% among non-bruxers and 100% among patients with signs of bruxism. The hazard ratio for signs of bruxism was 20 (95% confidence interval: 2.1-188.3, p = 0.009).Retrievable, tooth-implant supported restorations made of zirconia-ceramics should be used with caution because of some core fractures and a considerable number of minor veneer fractures. The fracture risk was very high among patients with signs of bruxism. Due to the low number of occasions for intentional retrievals, a recommendation to use semi-permanently cemented, all-ceramic FDPs would still be premature.

Background Acceptable short-term survival rates (>90 %) of mini-implants (diameter

This randomized clinical trial compares immediate and delayed loading of single implants to support mandibular overdentures. The aim of this preliminary analysis is to test the hypothesis whether patients with immediate loading will experience less pain and discomfort through the intervention than patients with delayed loading. Edentulous patients in nine German dental schools received a midline implant with a length of 11 mm. Implants with a minimum insertion torque of 30 Ncm and an implant stability quotient of ≥60 were randomly allocated to group A for immediate loading using ball attachments or to group B for delayed loading after 3 months. Patients completed questionnaires with 100-mm visual analogue scales about the items pain, pain during chewing, swelling, bleeding, and perception of the intervention at the day of surgery and 1, 2, 3, and 7 days, thereafter. Groups were compared by Wilcoxon–Mann–Whitney tests (P ≤ 0.05). The questionnaires of 81 patients in group A and 74 patients in group B were completed. The medians for pain and discomfort were moderate (

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.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.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).Major interdental spacing could be observed in neither of the groups. The SDA concept resulted in a slightly better outcome.When deciding whether to replace missing molars, the present results give further support to the SDA concept.

Previous investigations have confirmed that every fifth dental patient suffers from clinically significant depressive symptoms. However, the putative impact of depressive symptoms on the prosthetic status has not been addressed in these studies. The objective of this study was to investigate the association between depressive symptoms and prosthetic status based on data from the Study of Health in Pomerania (SHIP-0).Data from 2,135 participants aged 30 to 59 years were analyzed. A classification (six classes regarding the number and position of missing teeth per jaw) was used to identify the degree of prosthetic status (no/suboptimal/optimal tooth replacement). The presence of depressive symptoms was assessed with a modified version of von Zerssen's complaints scale. Screening for lifetime diagnoses of mental disorders was performed with the Composite International Diagnostic-Screener (CID-S). Multivariable logistic regressions including several confounders were calculated.A significant protective dose-response effect of depressive symptoms on prosthetic status was found only in men for the lower jaw [0-1 depressive symptoms: odds ratio (OR) = 3.84, 95 % confidence interval (CI, 1.65-8.92), p0.01; 2-3: OR = 2.87 (CI, 1.22-6.74), p0.05; reference, ≥8; adjusted for age, school education, smoking status, household income, marital status, living without a partner, risky alcohol consumption, obesity, diabetes, and physical activity]. There was no such association in women or for the upper jaw. The analyses using the CID-S confirmed these results.In the lower jaw, men with depressive symptoms had a better prosthetic status than men without depressive symptoms suggesting a higher level of concern regarding their personal health.If dentists might have an opportunity to identify men with depressive symptoms they can provide a wide range of treatment options that may enhance patients' self-esteem and contribute to the patient' well-being. Furthermore, depressive symptoms could indicate a discrepancy between self-perception of the dental health and the actual status which influence the dentists' treatment decision making.

The study was designed to provide clinical outcome data for two treatments of the shortened dental arch (SDA). In a multicenter randomized controlled clinical trial, patients with complete molar loss in one jaw were provided with either a partial removable dental prosthesis (PRDP) retained with precision attachments or treated according to the SDA concept preserving or restoring a premolar occlusion. No implants were placed. The primary outcome was tooth loss. Of 152 treated patients, 132 patients reached the 5-year examination. Over 5 years, 38 patients experienced tooth loss. For the primary outcome tooth loss, the Kaplan–Meier survival rates at 5 years were 0.74 (95 % CI 0.64, 0.84) in the PRDP group and 0.74 (95 % CI 0.63, 0.85) in the SDA group. For tooth loss in the study jaw, the survival rates at 5 years were 0.88 (95 % CI 0.80, 0.95) in the PRDP group and 0.84 (95 % CI 0.74, 0.93) in the SDA group. The differences were not significant. No Cox regression models of appropriate fit explaining tooth loss on the patient level could be found. The overall treatment goals of a sustainable oral rehabilitation and the avoidance of further tooth loss over longer periods were not reliably achievable. The influence of the type of prosthetic treatment on tooth loss might have been overestimated. Regarding our results, the patient’s view will gain even more importance in the clinical decision between removable and fixed restorations in SDAs.

The scientific evidence concerning prosthodontic care for the shortened dental arch (SDA) is sparse. This randomized multicenter study aimed to compare two common treatment options: removable partial dental prostheses (RPDPs) for molar replacement vs. no replacement (SDA). One of the hypotheses was that the follow-up treatment differs between patients with RPDPs and patients with SDAs during the 5-year follow-up period. Two hundred and fifteen patients with complete molar loss in one jaw were included in the study. Molars were either replaced by RPDPs or not replaced according to the SDA concept. A mean number of 4.2 (RPDP) and 2.8 (SDA) treatments for biological or technical reasons occurred during the 5-year observation time per patient. Concerning the biological aspect, no significant differences between the groups could be shown, whereas treatment arising from technical reasons was significantly more frequent for the RPDP group. When the severity of treatment was analyzed, a change over time was evident. When, at baseline, only follow-up treatment with minimal effort is required, over time there is a continuous increase to moderate and extensive effort observed for both groups ( Controlled-trials.com number ISRCTN97265367).

Summary In a cross-sectional analysis of data from the Study of Health in Pomerania (SHIP 0), temporomandibular disorders (TMD) were the strongest predictors for tinnitus beside headache. The aim of this study was to investigate whether signs and symptoms of TMD can be identified as risk factors for developing tinnitus. The SHIP 1 is a population-based 5-year longitudinal study intended to systematically describe the prevalence of and risk factors for diseases common in the population of Pomerania in northern Germany. A total of 3300 subjects (76% response) were reevaluated after 5 years for tinnitus and signs and symptoms of TMD using the same questionnaires and examination tools as baseline. To estimate the relative risk (RR) appropriately, a modified Poisson regression was used. After exclusion of prevalent cases with diagnosed tinnitus, 3134 subjects were analysed. Among the 191 exposed subjects with palpation pain in the temporomandibular joint (TMJ), 24 subjects (12·6%) received diagnosed tinnitus after 5 years, whereas among the 2643 unexposed subjects 142 subjects (5·8%) received tinnitus yielding a risk difference of 7·7% (95% confidence interval [CI]: 3·0%–12·5%) and a risk ratio of 2·60 (95% CI: 1·7–3·9). The risk ratio was 2·4 (95% CI: 1·6–3·7) after adjustment for gender, age, school education and frequent headache. Pain on palpation of the TMJ, however, did not worsen the prognosis for tinnitus in prevalent tinnitus cases (RR = 0·8, P = 0·288). Signs of TMD are a risk factor for the development of tinnitus.

Mundt T, Polzer I, Samietz S, Grabe HJ, Doren M, Schwarz S, Kocher T, Biffar R, Schwahn C. Gender-dependent associations between socioeconomic status and tooth loss in working age people in the Study of Health in Pomerania (SHIP), Germany. Community Dent Oral Epidemiol 2011; 39: 398–408. © 2011 John Wiley & Sons A/ S Abstract – Objectives: Individual impact and the effect magnitude of socioeconomic key indicators (income, education and occupation) and of gender on oral health are ambiguous. In primary analyses of cross-sectional data among participants of the Study of Health in Pomerania (north-east Germany), women with low school education and low income were at highest risk for missing teeth, whereas being single was a risk indicator for missing teeth in men. Using the 5-year follow-up of this study, we aimed at verifying these findings and at investigating the gender-dependent impact of key socioeconomic indicators on tooth loss. Methods: The longitudinal data originate from 1971 subjects (1062 women) aged 25–59 enrolled from 1997 to 2001 and again from 2002 to 2006. The effects of marital status, household income, school education and occupational prestige for tooth loss were examined by gender using negative binomial regression analyses. Results: Low education and low income were moderately [relative risks (RR) between 1.6 and 2.0] associated with tooth loss among both women and men, whereas occupational prestige was not. After multiple imputations of missing data, less-educated women with lower income exhibited the highest risk of tooth loss [RR = 3.1; 95% confidence interval (CI) = 1.7–5.5 for

– Objectives: To analyse the possible effects of the socioeconomic status (SES) on the prosthetic replacement of missing teeth in working-age people and to explore the role of potential confounders. Methods: Cross-sectional data were collected from 2310 German adults aged 30–59 years. The relationship between each of the three SES indicators (education, income, and occupational status) and dental prostheses were examined by multinomial logistic regression analyses. For that, partially dentate participants with suboptimal and no replacement of missing teeth were compared with partially dentate participants having optimal replacement. Potential confounders (age, sex, dental status, social network and social support) were entered if their inclusion in the model led to ≥10% change in the coefficient of interest. Results: Social network and social support did not meet the criterion for confounding. In the maxilla, having no replacement was positively associated with lower categories for each of the three SES indicators [Odds ratios (OR) between 1.6 and 2.1; 95% confidence intervals (CI) between 1.1 and 3.4]. Low occupational status was the single predictor for suboptimal dental prostheses (OR = 3.2; 95% CI: 1.6–6.2). In the mandible, occupational status showed no association with the prosthetic status, whereas low educational level and low household income were determinants for having no replacement (OR = 1.9 and 1.9, 95% CI: 1.0–3.5 and 1.1–3.0, respectively). Low household income was the single determinant for suboptimal replacement of missing teeth (OR = 2.4, 95% CI = 1.1–5.2). Conclusion: The findings may indicate the relevance of the financing of prosthodontic treatment. The strong association between various forms of upper dentures and occupational prestige can be seen as key contributing concept to how individuals′ characteristics affect the outcome in prosthodontic care.

Purpose: To evaluate changes in marginal bone levels around maxillary and mandibular mini-implants stabilizing complete dentures and to explore possible risk factors associated with bone loss. Materials and Methods: All eligible patients from nine private dental practices were invited to participate. Panoramic radiographs were obtained postoperatively and at the follow-up examination. The changes in bone level were estimated with linear mixed models that included the factors sex, age, jaw, region (anterior versus posterior), smoking habits, and loading concept. Results: Of the 180 invited patients, 133 participated in the follow-up (response rate: 73.9%). Of 336 mini-implants in 54 maxillas and 402 mini-implants in 95 mandibles, 15 maxillary implants and 11 mandibular implants were lost after insertion, and 4 mandibular implants fractured. Radiographic evaluations in 11 participants were not possible. The mean marginal bone loss at the remaining 634 mini-implants in 122 patients was 0.8 mm in the maxilla and 0.5 mm in the mandible over a mean observation time of 2.2 ± 1.0 years. This difference in univariate estimation lost significance after adjusting for the other variables. Implants in former smokers showed more bone loss than implants in participants who had never smoked. Implants that were loaded 3 to 4 months after placement (delayed loading) showed more marginal bone loss than immediately loaded implants. No statistically significant differences were found between men and women, different age groups, or anterior and posterior implants. Conclusion: Mean marginal bone loss around mini-implants used to stabilize complete dentures was insignificantly higher in the maxilla than in the mandible after a mean observation period of 2.3 years. These values are comparable with marginal bone loss around standard-diameter implants. A previous smoking habit and delayed loading after implant placement with a low insertion torque were shown to be possible risk factors for bone loss.

Objectives. The aim was to develop an instrument for quality control in dental practices. We compared the number of teeth of subjects of the Study of Health in Pomerania (SHIP-0) with those from patients of dental practices. Methods. Patients from seven dental practices (n=1,497) were randomly sampled by age strata and gender for a period of two years. Dental status derived from patient files was transformed into practice profiles using age-specific number of teeth as a parameter. Practice profiles were compared with a nomogram, which was based on the age-specific number of teeth of 3,990 SHIP-0 participants regularly visiting the dentist. Further, negative binomial regression models were evaluated to model associations between the number of teeth with age and dental practices, including interactions. Results. The practice profiles ranged between the 45th and 95th quantile curves of the reference population SHIP-0. The rate ratios (RR) for the number of missing teeth ranged from 0.37 to 0.67 (p<0.001) between the different dental practices, indicating lower risk for higher numbers of missing teeth in comparison to SHIP-0. Conclusions. This study showed considerable differences between dental practices and the reference population of SHIP-0 regarding the pattern of tooth loss and confirms the value of nomograms to compare age-specific numbers of teeth between patients of dental practices and a population-based-study as a tool for quality control. For further analyses, the socioeconomic status of patients and relevant risk factors will be used to adjust for structural differences in order to improve the validity of the comparisons.

Aim To examine associations of pre-diabetes and well-controlled diabetes with periodontitis. Materials and Methods The Study of Health in Pomerania (SHIP)-Trend is a cross-sectional survey in North-Eastern Germany including 3086 participants (49.4% men; age 20–82 years). Clinical attachment loss (CAL) and periodontal probing depth (PPD) were assessed applying a random half-mouth protocol. The number of teeth was determined. Pre-diabetes comprised impaired fasting glucose and impaired glucose tolerance. Previously known diabetes was defined as well controlled if glycated haemoglobin (HbA1c) was

SUMMARY Introduction The aim of this study was to examine the clinical performance of this method, and determine which temporary cement was the most appropriate. Methods Dental fixtures (Tiolox implants GmbH, Germany) were implanted and crown and bridgework applied in a private practice between 1998 and 2003. Copings made of pure gold or titanium were permanently cemented onto the prepared teeth. The bridges were attached with either conventional temporary cements (Zinc oxide/ calcium hydroxide based) or acrylic/urethane cement (IMProv) both to the copings and to the implant abutments. Complications were evaluated by a retrospective review in January 2006. Results A total of 47 patients (response: 81%) with 65 fixed partial dentures could be evaluated. Removal and re-attaching without damage of the dentures was undertaken for the following reasons: for follow-up examinations ( n = 31), colour corrections ( n = 15), cleaning of the dentures ( n = 12), treatment of peri-implantitis ( n = 2), repair following ceramic fractures ( n = 5), implant failure ( n = 1), tooth extractions ( n = 2), root canal treatments ( n = 2), occlusal corrections ( n = 2), or in the case of abutment loosening ( n = 4). Accidental detachments with conventional temporary cements occurred more frequently and more rapidly than with IMProv (15% versus 88.7% survival rate after four years). Conclusions This method for dental implant supported fixed partial dentures is successful and efficient.