Poster 2525, Language: English, GermanOelerich, Ole / Kleinheinz, Johannes / Bohner, Lauren / Hanisch, Marcel
Ziel dieser systematischen Übersichtsarbeit war es, die Frage zu beantworten, ob Patienten mit Osteogenesis imperfecta (OI) prothetisch mit Implantaten versorgt werden können. Osteogenesis imperfecta ist eine seltene genetische Erkrankung, die durch einen Defekt des Kollagens Typ I gekennzeichnet ist und zu Knochenbrüchigkeit und Bindegewebsstörungen führt.
Fallbericht: Eine 64-jährige Patientin mit OI Typ 1 stellte sich im Mai 2019 zum ersten Mal in einer Spezialsprechstunde für seltene Erkrankungen mit oraler Beteiligung vor. Unter Lokalanästhesie und perioperativer Langzeitantibiose wurden in den Regionen 32 und 44 zwei Bereiche identifiziert, in denen die Insertion von zwei Tissue-Level Implantaten ohne Augmentation möglich war. Seit der Implantation hat die Patientin ein Jahr lang regelmäßig Kontrolluntersuchungen wahrgenommen und keine Anzeichen einer medikamentenassoziierten Osteonekrose oder einer periimplantären Infektion gezeigt. Auch die Taschensondierungstiefen sind stabil geblieben.
Aufgrund der unzureichenden Studienlage zu Implantaten bei Personen mit OI wurde eine systematische Übersichtsarbeit angefertigt. Die Einschlusskriterien waren die Diagnose einer Osteogenesis imperfecta und die Verwendung von Implantaten für die prothetische Versorgung. Die Suchanfragen basierten auf dem "Population Intervention Comparison Outcome" (PICO) Verfahren mit der Fragestellung: „Können Menschen mit Osteogenesis imperfecta (P) erfolgreich mit Zahnimplantaten (I) behandelt und prothetisch versorgt werden (O)?“. Die Überlebensrate der Implantate lag bei 94,0 %, mit einer mittleren Nachbeobachtungszeit von 59,1 Monaten (±36,1). Insgesamt gingen sieben Implantate bei vier verschiedenen Patienten verloren.
Daher können Implantate eine praktikable Behandlungsoption für den Ersatz fehlender Zähne bei Patientenmit OI sein und sollten bei der Behandlungsplanung nach einer ausführlichen individuellen Risikoeinschätzung berücksichtigt werden.
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
Poster 2577, Language: English, GermanDaume, Linda / Hanisch, Marcel / Bucklitsch, Anja / Kleinheinz, Johannes
Um ein funktionelles und in ästhetischer Hinsicht optimales Behandlungsergebnis zu erreichen, sind bei Spaltpatienten verschiedene Dinge zu beachten: eine umfassende interdisziplinäre Zusammenarbeit, günstige Zahnstellungen und intermaxilläre Beziehungen sowie ein entsprechendes periimplantäres Weichgewebsmanagement. Dennoch bleiben häufig trotz umfangreicher langjähriger Vorbehandlungen in präimplantologischer Hinsicht schwierige Verhältnisse, z. B. beengte Schaltlücken, bestehen. Der vorliegende Fallbericht zeigt einen Patienten mit linksseitiger LKG-Spalte. Im Alter von 21 Jahren konnte der Patient implantologisch mit einem Einzelzahnimplantat in regio 22 versorgt werden. Die Erfolgsprognose von Implantaten im Kieferspaltbereich ist vergleichbar mit Implantaten die nach Trauma inseriert wurden. Ein ausreichendes Knochenangebot ist dafür zwingend erforderlich.
Keywords: Spalte, Implantat
Poster 2591, Language: English, GermanOelerich, Ole / Poggenpohl, Laura / Remki, Christina / Wolowski, Anne
Background: Especially in the anterior region, late implantation can lead to unsatisfactory aesthetic soft tissue results. This case report is intended to demonstrate a possibility to achieve aesthetic soft tissue contours and emergence profiles even in late implantations.
Case report: In February 2022, a then 27-year-old courier cyclist presented to the Interdisciplinary Ambulance Centre of the Department of Oral and Maxillofacial Surgery Münster after a fall. Teeth 11 and 21 were avulsed (non-recoverable); tooth 22 had a complicated crown-root fracture and was also not worth preserving. For insurance reasons, the implantation could not take place until 5 months after the accident. In the meantime, the patient was treated with a deep-drawn splint designed for maximum papilla preservation. Three Straumann implants BL 3.3 mm (10/12/12 mm) were placed in region 11, 21, and 22. After another three months, the implants were uncovered and the emergence profiles were designed with PMMA crowns. Over a period of three months, the PMMA crowns were successively adjusted in the subgingival area to ensure the most aesthetic soft tissue contouring possible. For the definitive restoration, individualised zirconium abutments on a titanium adhesive base were fabricated and restored with fully veneered zirconium crowns. Due to the long shaping phase with PMMA crowns, highly aesthetic results could be achieved even though implant placement took place only 5 months after the accident.
Discussion: Several studies have already addressed the shaping of implant crowns (including temporaries) and the transfer of the emergence profile to the definitive model in order to achieve aesthetic results. The case presented takes up several of these approaches to achieve aesthetic results here with delayed implant placement and restoration.
Keywords: dental implants, missing teeth, soft tissue, prosthodontics, ceramic crowns
Poster AwardPoster 2595, Language: EnglishSindagi, Swabhaanu Manoj / Raj, Kruthi Bipin / Paramashivaiah, Ashwini / Mehta, Deepak
Objectives: The objectives of this in-vitro study were to evaluate dentin tubule occlusion caused by PredictaTM Bioactive Desensitizer, a methacrylate-free, nanohydroxyapatite-based desensitizer, and the effects of phytic acid pretreatment.
Materials and Methods: Occlusal surfaces were prepared from 55 caries-free human premolars extracted as part of orthodontic treatment with informed consent. The teeth were stored in 0.5% thymol solution at 4°C and then randomly allocated to 6 groups, each consisting of 10 samples except the control group. Using a low speed diamond saw, 2mm thick dentin discs were cut. The central area (5mm) was defined as the experimental area and polished with 600 and 1000 grit silicon carbide. These polished samples were immersed in 17% EDTA for 40 minutes to open up the dentin tubules. Groups A, B, C, D, and E (n=10 each) were treated with PredictaTM Bioactive Desensitizer. Samples of Group D and E were pretreated with 1% phytic acid with and without wash, respectively; Group F (n=5) was left immersed in artificial saliva as a control. Micromorphological analysis using a scanning electron microscope was performed to assess tubular occlusion. A blinded reviewer independently scored the level of tubule occlusion. Means were compared using one-way analysis of variance (ANOVA).
Results: The mean occlusion scores computed from micromorphological analysis using scanning electron microscope showed that: Group E > Group D > Group C = Group B > Group A > Group F.
Conclusion: The tubule occlusion efficacy of Predicta Bioactive Desensitizer seems to be more effective with 1% phytic acid pretreatment than without.
Keywords: dentin, phytic acid, dentin sensitivity, smear layer, desensitizers, SEM, bioactive
Poster 2598, Language: EnglishRaj, Kruthi Bipin / Sindagi, Swabhaanu Manoj / Paramashivaiah, Ashwini / Mehta, Deepak
A Pre-clinical Evaluation of a Clinical PossibilityObjective: The objective of this preclinical study was to evaluate a predictable technique that combines layering and injection moulding for easy, efficient and consistent polychromatic anterior restorations.
Materials and Methods: This preclinical study was conducted on a Nissin Jaw Model with push-type typodont. Thirty maxillary anterior typodonts were prepared using diamond abrasives to simulate multiple diastemata and divided into equal groups. Group A was restored using the traditional injection moulding technique and Group B was restored using the experimental technique, which combines the histological layering technique with the traditional injection moulding technique.
Unprepared typodonts were used as a laboratory wax up for consistency and reproducibility. Stents were prepared using a clear, vinyl polysiloxane impression material. Samples of Group A were restored with G-ænial Universal Flo after adhesive protocol. For Group B, after adhesive protocol, packable composite (Shades A3, A2, A1, CT) was used to create internal anatomical features such as mamelons, incisal halo, and cervical high value areas, following which G-ænial Universal Flo was injected to mimic the enamel layer.
Standardised finishing and polishing protocols were followed for both groups. An aesthetic evaluation was performed by blinded evaluators using the FDI World Dental Federation clinical criteria for direct restorations. The parameters considered were surface luster, translucency, and aesthetic anatomical form.
Results: The surface luster of both groups was comparable; Group B received better scores for translucency and aesthetic anatomical form.
Conclusion: This preclinical study demonstrated that layering followed by injection moulding resulted in predictable, aesthetic, polychromatic, life-like restorations.
Keywords: adhesives, composite resins, dental bonding, aesthetics, injection moulding, layering
Poster 2599, Language: EnglishParamashivaiah, Ashwini / Kottur, Shubhankar S / Sindagi, Swabhaanu Manoj / Raj, Kruthi Bipin / Mehta, Deepak
Objective: This clinical case series reports a non-invasive treatment of complex transposition using injection moulding to obtain a predictable aesthetic outcome.
Material and Methods: A 25-year-old female and a 29-year-old female reported with a request to improve the aesthetic appearance. Clinical examination revealed transposition of maxillary canines in place of a central and lateral incisor, respectively. The proposed treatment in both cases was injection moulding due to its non-invasive nature. A wax-up was made to replicate ideal tooth morphology. A silicone key of the wax-up was obtained using a clear polyvinyl siloxane impression material. A fine needle diamond was used to drill the holes in the key to facilitate injection of composite resin. After prophylaxis, the procedure was started sequentially for both cases. The teeth were isolated with teflon tape and adhesive protocol was followed. Next, the silicone key was positioned onto the teeth and composite was injected. G-ænial Universal Injectable, shade A1 was selected for the procedure. Next, it was light cured through the transparent silicone. Finishing and polishing were performedincluding surface textures to obtain a natural and life-like appearance.
Results: The injection moulding technique provided an easy, non-invasive and predictable approach to plan restorations in challenging scenarios with complex morphology.
Conclusions: This treatment approach provided excellent function and aesthetics with advantages including minimal tooth structure loss and cost effectiveness.
Keywords: composite resins, adhesive, aesthetics, injection moulding, transposition, layering
Poster 2600, Language: EnglishSinghal, Ridhima / Yadav, Anjali / Anand, Deepti / Tewari, Shikha
Introduction: Excessive gingival display (EGD) is commonly referred to as gummy smile, which is an aesthetic concern for an individual. Lip repositioning is a simple procedure to treat this problem. The procedure restricts the muscle pull of elevator lip muscles, thereby reducing gingival display while smiling. This is a safe and predictable procedure with minimal risk and side effects.
Objectives: Reduction of EGD using surgical lip repositioning
Methodology: A 20-year-old female patient reported to the Department of Periodontology, PGIDS Rohtak with a chief complaint of gummy smile. Clinical examination revealed 5-6mm of maxillary gingival display. The maxillary anterior teeth had smaller crown height with adequate attached gingiva, and vestibular depth was present. Crown lengthening and lip repositioning surgery was performed.
Result: Gingival display at baseline was 5-6mm, which was reduced and stable at 1st month, 3rd month, and 6th month postoperatively.
Conclusion: Lip repositioning procedure is an effective way of reducing excessive gingival display and appears to be a promising alternative treatment option for gummy smile.
Keywords: dental aesthetics, gingiva, crown lengthening
Poster AwardPoster 2603, Language: EnglishDwivedi, Ruby / Mehrotra, Divya / Chandra, Shaleen / Pandey, Rahul / Anthony, Ekta
The limitations associated with reconstruction of critical-sized bony defects arising from maxillofacial trauma has averted researchers towards bone tissue engineering employing scaffolds prepared from biomaterials having osteogenic potential. In this study we have developed a novel 3-D scaffold with BMP-2 for reconstruction in critical-sized bone defects and compared its regenerative properties with β-TCP and PCL/HA scaffolds in vivo (rabbit model).
Material and methods: Novel Chitosan-gelatin nanohydroxyapatite (nHaP) scaffold reinforced with PCL-nHaP nanofibres was developed. Physical characteristics were evaluated through SEM analysis. Sterilized scaffolds- Novel Graft + BMP2 (G), Polycaprolactone /HA (P) and βTCP (B) were placed in surgically created critical-sized defects in rabbit bone and analysed at an interval of 2, 4, and 6 weeks post implantation. Bone formation was evaluated through Micro CT and histomorphometry.
Results: SEM analysis revealed smooth and bead-free continuous PCL-nHaP fibers with specific peaks of HaP on X-Ray diffraction. The scaffold was highly porous, exhibiting long, smooth partially interconnected polygonal pores. Micro CT images revealed a substantial amount of bone formation in Group G followed by Group P and Group B. The HE stained sections revealed appreciable bone formation at the vicinity of the novel graft.
Conclusion: The novel Chitosan-gelatin nHaP graft reinforced with PCL-nHaP nanofibres is a tested bone substitute for critical-sized bone defects. Its superior physical properties as compared to other commercial bone substitutes, adequate cell attachment and growth, and better neo-osteogenesis and bone healing may contribute topersonalised rehabilitation of maxillofacial trauma patients in the near future.
Keywords: biomaterial, bone tissue engineering, critical size defects, PCL nanofibres, chitosan, nano-hydroxyapatite, scaffold
Poster 2605, Language: EnglishDevi, Priya / Khan, Eram / John, Sharon / Sharma, Kriti / Selvam, Ramya / Gupta, Shalini
Traumatic neuroma is an exuberant, but non-neoplastic, proliferation of peripheral nerves that occurs after any trauma or surgery. The lesion develops most commonly in the jaws or in the soft tissues of the mental foramen area, lower lip and tongue. This case report discusses a case of traumatic neuroma present extra- orally in the cheek that occurred following an injury. It also gives a brief overview on the relevant demographic, clinical, radiographic, histologic, immunohistochemical, and treatment aspects of traumatic neuromas.
Keywords: amputation neuroma, traumatic neuroma, mandible