Poster 2578, Language: English, GermanDaume, Linda / Hanisch, Marcel / Bucklitsch, Anja / Kleinheinz, Johannes
In autoimmune diseases, such as oral lichen ruber planus, a sufficient prosthetic restoration without dental implants is often not possible. Due to the extreme vulnerability of the oral mucosa, the indication for an implant restoration should be considered, especially for tegument relief. Interdisciplinary planning between prosthodontist and surgeon is necessary to realize an individual, mucosa-relieving treatment for the patient. Implants in patients with immunodeficiencies are therefore justified when strictly indicated and can lead to a rehabilitation of the physiological masticatory function, an increased quality of life, and a positive influence on the general state of health.
Keywords: Oral lichen planus, implant, oral mucosal diseases
Poster 2592, Language: English, GermanOelerich, Ole / Hanisch, Marcel / Kleinheinz, Johannes / Bohner, Lauren
A Prospective Clinical Study Presented with a Case StudyThis case series reports the rehabilitation of the anterior maxilla using immediate implant placement and provisional restoration in combination with preservation of the alveolar foramen. Four patients presented to the Department of Oral and Maxillofacial Surgery with a non-preservable maxillary incisor following dental trauma. Treatment planning was performed digitally using Co-DiagnostiX software. The treatment protocol included atraumatic extraction followed by immediate implant placement and provisional restoration with an implant-supported single crown. In all cases, the non-salvageable tooth was carefully extracted and a dental implant (2 BLT, 2 BLX, Straumann) was placed using a flapless approach. Augmentation was performed with a combination of autogenous and xenogenous material, and the soft tissue was augmented with a connective tissue graft. After surgery, intraoral scans were taken and a CAD-CAM provisional crown was fabricated and placed on the same day as surgery. The final ceramic crown was placed after three to six months. The soft tissue profile was compared by superimposing the baseline intraoral scans (before and immediately after surgery) with the follow-up scans. Six months after surgery, soft tissue changes were considered minimal compared to baseline.
Keywords: Dental implants, immediacy, digital planning, soft tissue
Poster 2524, Language: German, EnglishDaume, Linda / Becker, Alexander / Joanning, Theresa / Köckerling, Nils / Kleinheinz, Johannes
In autoimmune diseases such as oral lichen planus or mucosal pemphigoid, a sufficient prosthetic restoration without dental implants is often not feasible. Interdisciplinary planning between the prosthodontist and surgeon is necessary to realize an individual, mucosa-relieving treatment for the patient.
Implants in patients with immunodeficiencies are therefore justified when strictly indicated and can lead to a rehabilitation of the physiological masticatory function, an increased quality of life, and a positive influence on the general state of health.
Keywords: Dental implant, oral diseases, oral lichen planus, mucous membrane pemphigoid
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
Simpson-Golabi-Behmel syndrome is an x-linked recessive overgrowth disorder characterized by macrosomia, mental deficits, a large head, prominent cranial sutures, midface deficits, hypertelorism, a broad nose, a wide mouth, macroglossia, dental malocclusions, a strongly arched palate, and musculoskeletal and limb abnormalities. The male sex is more commonly affected, with only about 200 cases being described. The presented case of a 2-year-old patient showed a flat facial profile, macroglossia, a deep tongue position with forced mouth closure, a large upper and lower jaw, and enamel formation disturbances at the primary molars. Preventive, interdisciplinary care of the patient regarding his oral health as well as dentition and speech development are recommended.
Keywords: Simpson-Golabi-Behmel syndrome, rare diseases associated with oral symptoms
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