International Poster Journal of Dentistry and Oral Medicine, 1/2024
Poster 2577, Language: English, GermanDaume, Linda / Hanisch, Marcel / Bucklitsch, Anja / Kleinheinz, Johannes
In order to achieve a functional and, from an aesthetic point of view, optimal treatment result, various things have to be taken into account in cleft patients: comprehensive interdisciplinary cooperation, favourable tooth positions and intermaxillary relationships, and appropriate peri-implant soft tissue management. Nevertheless, difficult conditions, e.g., narrow interdental gaps, often persist despite extensive pretreatment over many years from a preimplantological point of view. The present case report shows a patient with a left-sided cleft. At the age of 21, the patient could be treated implantologically with a single-tooth implant in region 22. The success prognosis of implants in the cleft jaw region is comparable to implants placed after trauma. Sufficient bone supply is absolutely essential for this.
Keywords: cleft, implant
International Poster Journal of Dentistry and Oral Medicine, 1/2024
Poster 2525, Language: English, GermanOelerich, Ole / Kleinheinz, Johannes / Bohner, Lauren / Hanisch, Marcel
Objective: This case report and systematic review aimed to answer whether patients with osteogenesis imperfecta (OI) can be prosthetically treated with implants. Osteogenesis imperfecta is a rare genetic disease characterized by a type I collagen defect leading to bone fragility and connective tissue disorders.
Case Report: A 64-year-old female patient with OI type 1 presented for the first time to a specialty consultation for rare diseases with oral involvement in May 2019. The patient had received alendronic acid (p.o.) for many years to treat OI. At the consultation time, she was fitted with maxillary and mandibular complete dentures, and the complete mandibular denture had inadequate support. Implants were planned to stabilize the prosthesis. Under local anaesthesia, two tissue-level implants (Straumann Standard Plus®, Basel, Switzerland, SLActive 3.3 mm × 10 mm) were placed in regions 32 and 44. After a healing period of three months, uncovery took place, and the prosthetic restoration with locators could be performed two weeks later. Since implant placement, the patient has attended regular check-ups for one year and has shown no signs of drug-associated osteonecrosis or peri-implant infection.
Methods: Because of the paucity of studies on implants in individuals with OI, a systematic review was performed. The search queries were based on the Population Intervention Comparison Outcome (PICO) procedure with the question, "Can people with osteogenesis imperfecta (P) be successfully treated and prosthetically restored (O) with dental implants (I)?"
Results: The primary outcome was implant survival. Supporting data were analysed descriptively. Twelve studies were finally included. Twenty-three patients were treated with a total of 116 implants, with 5.0 (±3.8) implants placed per patient. Bone augmentation was performed before or during implant placement in 30 implants (25.8%). A sinus lift was performed before the placement of 19 implants (28.8%). In 18 patients, implants were placed in a two-stage procedure. In four patients, 14 implants (12.1%) were immediately loaded. Implant survival was 94.0%, with a mean follow-up of 59.1 months (±36.1). A total of seven implants were lost in four different patients. Three implants (2.6%) were lost before loading, and two implant fractures (1.7%) were described.
Conclusion: The available data show the loss of only seven implants, with two of these implants lost due to implant fractures not attributable to the patient. With the limitations of this review and based on the available data, implants have a high survival rate (94.0%) in patients with osteogenesis imperfecta. Therefore, implants may be a viable treatment option for replacing missing teeth in patients with OI and should be considered in treatment planning after a detailed individual risk assessment.
Keywords: Osteogenesis imperfecta, implants, rare disease, case report, systematic review
International Poster Journal of Dentistry and Oral Medicine, 1/2024
Poster 2575, Language: English, GermanDaume, Linda / van der Bijl, Nils / Joanning, Theresa / Oelerich, Ole / Kleinheinz, Johannes
Das Simpson-Golabi-Behmel Syndrom ist eine x-chromosomal rezessiv-vererbte Überwachstumserkrankung, die durch Makrosomie, mentale Defizite, einen großen Kopf, prominente Schädelnähte, Mittelgesichtsdefizite, Hypertelorismus, eine breite Nase, einen breiten Mund, Makroglossie, Zahnfehlstellungen, einen stark gewölbten Gaumen sowie Anomalien des Bewegungsapparats und der Gliedmaßen gekennzeichnet ist. Das männliche Geschlecht ist häufiger betroffen, bisher wurden lediglich ca. 200 Fälle beschrieben. Der vorgestellte Fall eines 2-jährigen Patienten zeigte ein flaches Gesichtsprofil, eine Makroglossie, eine tiefe Zungenlage mit mit angestrengtem Mundschluss, ein großer Ober- und Unterkiefer sowie Schmelzbildungsstörungen an den Milchmolaren. Eine präventive, interdisziplinäre Betreuung des Patienten bezüglich seiner Mundgesundheit sowie der Gebiss- und Sprachentwicklung wird empfohlen.
Keywords: Simpson-Golabi-Behmel Syndrom, seltenen Erkrankungen mit oralen Symptomen
Quintessenz Zahnmedizin, 6/2023
ImplantologiePages 494-499, Language: GermanJung, Susanne / Kleinheinz, Johannes
Im (zahn)ärztlichen Praxisalltag kommt dem Aufklärungsgespräch und dem Einholen der Einwilligung vor Medikamentengabe oder einem operativen Eingriff nicht immer das Gewicht zu, das die Gesetzgebung und die gute klinische Praxis verlangen. Die medikolegalen Konsequenzen einer ungenügenden Aufklärung können drastisch sein und sind nicht allen Behandlern vollumfänglich bewusst. Die Streitfälle, die auch auf einer ungenügenden Aufklärung basieren, nehmen in den jeweiligen Statistiken einen bemerkenswerten Anteil ein. Aufklärung, Einwilligung und die entsprechende Dokumentation dienen nicht nur der Rechtssicherheit, sondern sind wesentliche Pfeiler eines belastbaren Behandlungsvertrags.
Manuskripteingang: 15.03.2023, Manuskriptannahme: 25.04.2023
Keywords: Aufklärung, „Informed consent“, Einwilligung, Rechtswirksamkeit
International Poster Journal of Dentistry and Oral Medicine, 4/2023
Poster 2580, Language: German, EnglishJaber, Mona / Hanisch, Marcel / Sielker, Sonja / Kleinheinz, Johannes / Bohner, Lauren
CBCT devices offer a scanning protocol mode with a partial rotation arc of 180o, followed by a 360o image reconstruction through algorithms. This scan mode is associated with a low number of basis images and subsequent reduced image quality.
However, it does not influence the appearance of artefacts, and it offers a reliable alternative for assessing peri-implant bone.
Although the appearance of dental implant artefacts is well documented in literature, metal artefacts are usually determined by grey values or contrast-noise-ratio, but fewer studies have reported the influence of artefacts on diagnostic image quality.
Keywords: CBCT, partial rotation arc of 180 degrees, followed by a 360 degree, peri-implant bone, artefacts, diagnostic image quality
International Poster Journal of Dentistry and Oral Medicine, 4/2023
Poster 2573, Language: German, EnglishDaume, Linda / Kreis, Constance / Jaber, Mona / Kleinheinz, Johannes
A 6-year-old patient with proven cutaneous lichen ruber showed reticular striae on the inner surface of the upper lip and hyperpigmentation of the attached gingiva. Oral lichen planus (OLP) is very rare in children, with a prevalence in adults of 0.5-2% of the general population and < 2-3% of the total being children. Because the patient was asymptomatic, no therapy was given, and regular follow-up was recommended. Although OLP is considered rare in children, clinicians should consider lichen planus as a possible differential diagnosis in the presence of a non-wipeable white lesion.
Keywords: oral lichen planus, oral mucosal diseases, children
International Poster Journal of Dentistry and Oral Medicine, 4/2023
Poster 2574, Language: German, EnglishDaume, Linda / Wurche, Caroline / Köckerling, Nils / Kleinheinz, Johannes
Hyperparathyroidism leads to the development of a brown tumour in 2-3% of cases, which can manifest anywhere in the skeleton. Increased parathyroid hormone results in increased osteoclast activation and increased calcium and phosphate. Bone resorption outweighs new bone formation. As a result, giant cell-containing tissue forms, replacing physiologic bone structure and forming radiologically detectable osteolysis.
In the present case report, a 65-year-old female patient presented with a hard, nondisplaceable, mildly pressure-dolent swelling in region 32-44. CT scan revealed a diffuse osteolytic sclerotic process extending to the mandibular base. The diagnosis was confirmed by bone biopsy. Histologically typical are multinucleated giant cells, spindle cells and haemorrhage foci organized by the release of hemosiderin, hence the name "brown tumours". Differential diagnosis includes other giant cell-containing lesions such as: central giant cell granuloma or aneurysmal bone cyst. Therefore, additional laboratory parameters must be used to establish the diagnosis. The cause of primary hyperparathyroidism, as in the described case report, is a parathyroid adenoma in 80% of cases.
The therapy consisted of the removal of the parathyroid gland. This also resulted in regression of the bony lesion, so that it did not require further surgical treatment.
Keywords: Brown tumour, hyperparathyroidism
Team-Journal, 4/2023
KOMPETENZ PLUSPages 194-201, Language: GermanKleinheinz, Johannes / Daume, Linda
Mundschleimhautveränderungen treten in der Bevölkerung relativ häufig auf. Weniger Beachtung finden diese Veränderungen allerdings bei Kindern und Jugendlichen. Selten sind diese Veränderungen ein Thema für Vorträge und Veröffentlichungen, in der alltäglichen Praxis jedoch stellen sie für den Behandler eine große Herausforderung dar. Fragen, die oftmals bei der Betrachtung bei Kindern und Jugendlichen gestellt werden, sind: Gibt es grundsätzliche Unterschiede beim Auftreten von Mundschleimhautveränderungen zwischen Kindern/Jugendlichen und Erwachsenen? Gibt es Unterschiede bei folgenden Kriterien: Spektrum, Prävalenz, Ätiologie, Dignität, Lokalisation? Gibt es Unterschiede in der Therapie?
Team-Journal, 4/2023
INTERDISZIPLINÄRPages 208-213, Language: GermanDaume, Linda / van der Bijl, Nils / Kleinheinz, Johannes
Unter Gingivahyperplasie wird im Allgemeinen die lokale oder generalisierte Gewebevermehrung oder auch Wucherung der keratinisierten Gingiva über das physiologische Maß hinaus bezeichnet. Ihr liegt pathohistologisch eine Zunahme der Fibroblastenzahl mit gesteigerter Synthese von extrazellulärem Kollagen zugrunde. Die Ursachen sind häufig multifaktoriell und können von genetischen Erkrankungen wie der hereditären gingivalen Fibromatose, erworbenen Mangelzuständen wie Skorbut (Vitamin C-Mangel) oder auch durch Formen der Leukämie verursacht werden.
International Poster Journal of Dentistry and Oral Medicine, 3/2023
Poster 2572, Language: English, GermanDaume, Linda / Sharaf, Yasser / Poggenpohl, Laura / Kleinheinz, Johannes
The removal of impacted and displaced teeth is one of the most common procedures in dentoalveolar surgery. Up to 80% of the population have at least one wisdom tooth impacted in the jaw. In the present case report, highly displaced tooth nucleus 28 was removed via a maxillary sinus window using a piezotome because of its close positional relationship to the roots of tooth 27 and to the maxillary sinus. Piezosurgery has been proven to reduce the risk to neighbouring soft tissue structures such as Schneider's membrane. To protect and preserve the mucosa of the maxillary sinus, a bone window was prepared and refixed with sutures after tooth removal. Consequently, the particular surgical technique should always be selected on a patient-specific basis.
Keywords: wisdom tooth removal, piezotome