TY - JOUR A1 - Schmitter, Marc A1 - Bömicke, Wolfgang A1 - Behnisch, Rouven A1 - Lorenzo Bermejo, Justo A1 - Waldecker, Moritz A1 - Rammelsberg, Peter A1 - Ohlmann, Brigitte T1 - Ceramic crowns and sleep bruxism: first results from a randomized trial JF - Journal of Clinical Medicine N2 - Background: This randomized clinical trial was conducted to assess whether sleep bruxism (SB) is associated with an increased rate of technical complications (ceramic defects) in lithium disilicate (LiDi) or zirconia (Z) molar single crowns (SCs). Methods: Adult patients were classified as affected or unaffected by SB based on structured questionnaires, clinical signs, and overnight portable electromyography (BruxOff) and block randomized into four groups according to SB status and crown material (LiDi or Z): LiDi-SB (n = 29), LiDi-no SB (n = 24), Z-SB (n = 23), and Z-no SB (n = 27). Differences in technical complications (main outcome) and survival and success rates (secondary outcomes) one year after crown cementation were assessed using Fisher’s exact test with significance level α = 0.05. Results: No technical complications occurred. Restoration survival rates were 100% in the LiDi-SB and LiDi-no SB groups, 95.7% in the Z-SB group, and 96.3% in the Z-no SB group (p > 0.999). Success rates were 96.6% in the LiDi-SB group, 95.8% in the LiDi-no SB group (p > 0.999), 91.3% in the Z-SB group, and 96.3% in the Z-no SB group (p ≥ 0.588). Conclusions: With a limited observation time and sample size, no effect of SB on technical complication, survival, and success rates of molar LiDi and Z SCs was detected. KW - bruxism KW - cad-cam KW - ceramics KW - clinical studies/trials KW - prosthetic dentistry/prosthodontics KW - clinical outcomes Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-301480 SN - 2077-0383 VL - 12 IS - 1 ER - TY - JOUR A1 - Schneider, Sonja Jasmin Maria A1 - Höhne, Christian A1 - Schneider, Martin A1 - Schmitter, Marc T1 - Photoacoustic tomography versus cone-beam computed tomography versus micro-computed tomography: Accuracy of 3D reconstructions of human teeth JF - PloS One N2 - Objectives In this in-vitro study, teeth were imaged using photoacoustic tomography (PAT), cone-beam computed tomography (CBCT), and micro-computed tomography (μ-CT). The study had aim: to identify the best wavelength for PAT images to determine the accuracy of the three imaging methods, and to determine whether PAT images of teeth can achieve acceptable reconstruction quality. Methods Nineteen human mandibular single-rooted incisors were extracted from patients with trauma or periodontitis. To determine the best wavelength for acquiring photoacoustic images, all 19 teeth were scanned in vitro with PAT, using different laser wavelengths between 680 and 960 nm. The images were analyzed using image analysis software. To assess the accuracy of PAT and compare it with the accuracy of CBCT, each tooth was also scanned in vitro using CBCT and the reference standard technique of μ-CT. Subsequently, three different three-dimensional models, one for each imaging technique, were created for each tooth. Finally, the three different three-dimensional models acquired for the same tooth were matched and analyzed regarding volume and surface. Results The highest quality tooth images were achieved using the 680 nm wavelength, which showed the best contrast ratio. The full geometry of the dental root (μ-CT compared with PAT) could be visualized with relative standard deviations of 0.12 mm for the surface and −7.33 mm3 for the volume (n = 19). The full geometry of the dental root (μ-CT compared with CBCT) could be visualized with relative standard deviations of 0.06 mm for the surface and −14.56 mm3 for the volume (n = 19). The difference between the PAT–μ-CT group and CBCT–μ-CT group regarding the total average of the root surface area was not significant (p>0.06). Conclusion Images, which were acquired using PAT at 680nm showed the best contrast ration, enabling the identification of dentin, cementum and the dental pulp. No significant differences were found between the PAT–μ-CT group and CBCT–μ-CT group regarding the total average of the RSA and the total volume. Thus, three-dimensional reconstructions based on in-vitro PAT are already of acceptable reconstruction quality. KW - teeth KW - imaging techniques KW - computer software KW - incisors KW - in vivo imaging KW - caries KW - magnetic resonance imaging KW - tomography Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-301437 VL - 17 IS - 12 ER - TY - JOUR A1 - Winter, Anna A1 - Schulz, Stefan M. A1 - Schmitter, Marc A1 - Brands, Roman C. A1 - Straub, Anton A1 - Kübler, Alexander A1 - Borgmann, Anna A1 - Hartmann, Stefan T1 - Oral-health-related quality of life in patients with medication-related osteonecrosis of the jaw: a prospective clinical study JF - International Journal of Environmental Research and Public Health N2 - Medication-related osteonecrosis of the jaw (MRONJ) represents an adverse side effect of antiresorptive and antiangiogenic medications. It is associated with impaired quality of life, oral health, and oral function and can be classified into various stages. The purpose of this prospective clinical study is to evaluate the impact of stages I and II MRONJ on oral-health-related quality of life (OHRQoL) and related parameters. Patients’ OHRQoL, satisfaction with life, oral discomfort, and oral health were assessed using the German version of the Oral Health Impact Profile (OHIP-G49), visual analog scales (VAS), and Satisfaction with Life Scale (SWLS) at baseline (T0), 10 days (T1), and 3 months after treatment (T2) in 36 patients. Data were analyzed using Kolmogorov–Smirnov test, two-way mixed ANOVAs, and follow-up Mann–Whitney U tests. The impact of treatment effects on the original seven OHIP domain structures and the recently introduced four-dimensional OHIP structure were evaluated using linear regression analysis. Thirty-six patients received surgical MRONJ treatment. Before treatment, patients’ perceived OHRQoL, oral discomfort, oral health, and satisfaction with life were negatively affected by MRONJ. Surgical treatment significantly improved OHRQoL and related parameters (all p ≤ 0.012). This improvement was greater in patients with higher impairment at T0. OHRQoL and oral restrictions were still impaired after treatment in patients who needed prosthetic treatment. The four-dimensional structure revealed valuable information beyond the standard seven OHIP domains. Increased awareness of MRONJ risks and an interdisciplinary treatment approach for MRONJ patients are needed. KW - oral-health-related quality of life KW - satisfaction with life KW - oral health KW - medication-related osteonecrosis of the jaw KW - treatment benefit KW - OHIP-49 KW - SWLS Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-288141 SN - 1660-4601 VL - 19 IS - 18 ER - TY - JOUR A1 - Ohlmann, Brigitte A1 - Waldecker, Moritz A1 - Leckel, Michael A1 - Bömicke, Wolfgang A1 - Behnisch, Rouven A1 - Rammelsberg, Peter A1 - Schmitter, Marc T1 - Correlations between sleep bruxism and temporomandibular disorders JF - Journal of Clinical Medicine N2 - The aim of this study was to identify correlations between sleep bruxism (SB) and temporomandibular disorders (TMD) as diagnosed by means of the research diagnostic criteria for temporomandibular disorders (RDC/TMD). Sleep bruxism was diagnosed on the basis of I) validated questionnaires, II) clinical symptoms, and III) electromyographic/electrocardiographic data. A total of 110 subjects were included in the study. Fifty-eight patients were identified as bruxers and 52 as nonbruxers. A psychosocial assessment was also performed. An RDC/TMD group-I diagnosis (myofascial pain) was made for 10 out of 58 bruxers, whereas none of the nonbruxers received a diagnosis of this type. No significant differences were found between bruxers and nonbruxers with regard to RDC/TMD group-II (disc displacement) and group-III (arthralgia, arthritis, arthrosis) diagnoses. Somatization was significantly more common among bruxers than nonbruxers. Multivariate logistic regression analysis revealed that somatization was the only factor significantly correlated with the diagnosis of myofascial pain. The results of this study indicate a correlation between myofascial pain, as diagnosed using the RDC/TMD, and somatization. It seems that somatization is a stronger predictor of an RDC/TMD diagnosis of myofascial pain than sleep bruxism is. KW - sleep bruxism KW - TMD KW - electromyographic/electrocardiographic data Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-200662 SN - 2077-0383 VL - 9 IS - 2 ER - TY - JOUR A1 - Höhne, Christian A1 - Schwarzbauer, Raphael A1 - Schmitter, Marc T1 - Introduction of a new teaching concept for crown preparation with 3D printed teeth JF - European Journal of Dental Education N2 - Introduction For both students and teachers, it is challenging to learn and teach a correct crown preparation. The purpose of this study was the design, feasibility and evaluation of a 3D printed tooth model with internal preparation for dental education in crown preparation and to analyse the quality of the prepared printed teeth in comparison with prepared standard model teeth. Materials and methods A printable tooth was designed and printed by a stereolithographic printer. 38 fourth‐year dental students in the first clinical course in prosthodontics were trained in a voluntary course using printed teeth. Different aspects of the printed tooth were evaluated by a questionnaire using German school grades (1 best to 5 worst). The quality of the preparation with the printed teeth and standard training teeth was also rated in an evaluation form done by an expert group consisting of five experienced dentists. Results The workflow was feasible and cost‐effective for the production of the teeth. The overall rating of the printed tooth was Ø 2.0 ± 0.34 in the questionnaire completed by the students. The students rated the printed tooth model (Ø 2.1 ± 0.85) as significantly better than the standard model tooth (Ø 3.3 ± 0.77; P = .000). The students reported great benefits in the use of this model tooth, for example valuable replacement of a standard model and real teeth, direct control of material loss. The quality of the preparation was evaluated by the expert group as significantly better with an overall mean grade of Ø 2.6 ± 0.37 for the printed teeth compared to Ø 2.9 ± 0.42 for the standard model teeth (P = .000). Conclusions The feasibility of this teaching concept was confirmed. The students favoured to work on the innovative 3D‐teeth with internal preparation, emphasising the usefulness of this technique in dental education. The expert group confirmed also the significant training effect of this tooth model in contrast to a standard model tooth. KW - 3D printing KW - additive manufacturing KW - clinical practice KW - dental education KW - printed tooth KW - student training Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-218133 VL - 24 IS - 3 SP - 526 EP - 534 ER - TY - JOUR A1 - Şen, Sinan A1 - Orhan, Gül A1 - Sertel, Serkan A1 - Schmitter, Marc A1 - Schindler, Hans J. A1 - Lux, Christopher J. A1 - Giannakopoulos, Nikolaos Nikitas T1 - Comparison of acupuncture on specific and non‐specific points for the treatment of painful temporomandibular disorders: A randomised controlled trial JF - Journal of Oral Rehabilitation N2 - Background and Objective The aim of this single‐centre, two‐arm, parallel‐group, double‐blinded, randomised controlled trial was to investigate the disputed specific effectiveness of acupuncture by comparing acupuncture on specific and non‐specific points among patients with non‐chronic, painful TMDs. Methods Following predefined eligibility criteria, 49 consecutive patients of both sexes were recruited to the study. All subjects were diagnosed with a non‐chronic (Graded Chronic Pain Scale grade <3) painful TMD, as assessed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Patients were randomly assigned to group A (acupuncture on specific points) or group B (acupuncture on non‐specific points) after the initial examination (T0). Both acupuncture treatment sessions were conducted by a trained dentist once a week for four weeks. The examination was repeated five weeks (T5) after T0 by one calibrated examiner who was unaware of the study groups. Characteristic pain intensity (CPI) was evaluated as the main outcome criterion and compared between times and treatment groups by means of non‐parametric tests (significance level set at P = .05). Secondary outcomes comprised the maximum corrected active mouth‐opening without pain (MAO); patients’ expectations regarding acupuncture treatment and pain development; depressivity; and oral health‐related quality of life (OHRQoL). Results A total of 41 patients (38 female) successfully completed the study (mean age: 40.17 ± 16.61). The two groups did not differ significantly at any time in terms of age and CPI. However, CPI was significantly (P < .05) lower at T5 than at T0 for both groups (29.66 and 30.35% lower in group A and group B, respectively). An increase in MAO was observed at T5 for both groups but was significant for group B only (P = .016). All patients had positive expectations of acupuncture therapy, and the two groups did not differ significantly at T5 with regard to the extent to which their expectations had been fulfilled by the treatment (P = .717). Comparison of T0 and T5 showed a statistically significant reduction of depressivity for group A (P = .0205), but no significant change for group B (P = .329). At T5, OHRQoL had improved significantly for both groups (group A, P = .018; group B, P < .001) compared with at T0. Conclusions Acupuncture on both specific and non‐specific points reduces the non‐dysfunctional pain of TMD patients. The effect of acupuncture on painful TMD cannot be attributed to the specific point selection. KW - acupuncture KW - effectiveness KW - oro‐facial pain KW - randomised controlled trial KW - temporomandibular disorders Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-215419 VL - 47 IS - 7 SP - 783 EP - 795 ER - TY - JOUR A1 - Höhne, Christian A1 - Dickhaut, Nora A1 - Schmitter, Marc T1 - Introduction of a new teaching concept for dentin post preparation with 3D printed teeth JF - European Journal of Dental Education N2 - Introduction The preparation for dentin posts is difficult and hard to learn. There are currently no reproducible simulation models to train this clinical procedure. The purpose of this study was the design, feasibility and evaluation of a three‐dimensional (3D) printed tooth model for the pre‐clinical teaching of students. Materials and methods A printable tooth was designed and printed by a stereolithographic printer. A total of 48 fourth‐year dental students in the first clinical course in prosthodontics were trained in a voluntary hands‐on course on 4 similar printed teeth. The students used standard model teeth and real‐teeth models during their education. They had experience in caries removement and root canal treatment on real patients. Root perforations were counted for every attempt. The different benefits of the 3D printed tooth were evaluated by a questionnaire using German school grades from 1 (best) to 6 (worst). Results The overall rating of the printed tooth was Ø1.9 ± 0.3. The item “suitable exercise option” was rated Ø2.0 ± 0.8, and the teeth were “easy to use” Ø1.9 ± 0.9. The item “realistic approach to dentin post preparation” was rated Ø2.1 ± 0.8, and the teeth showed the “shortcomings at a root perforation” Ø1.5 ± 0.6. The students reported to have much more motivation and enthusiasm to improve their skills with the printed teeth Ø2.1 ± 0.9. They had a strong desire to include these teeth in their pre‐clinical education before the first patient treatment Ø1.6 ± 0.8. The success rate of the dentin post preparation was significantly better for the second 25% (P = .047) and fourth 48% (P = .04) attempt. Conclusions The feasibility of this teaching concept was confirmed. The students had the possibility to learn a correct dentin post preparation on a printed tooth model. The learning effect with this tooth model was rated as good to very good by the questionnaire. KW - 3D printing KW - additive manufacturing KW - CAD KW - CAM KW - clinical practice KW - dental education KW - dentin post KW - printed tooth KW - rapid prototyping KW - stereolithography KW - student training Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-215586 VL - 24 IS - 3 SP - 499 EP - 506 ER - TY - JOUR A1 - Türp, Jens C. A1 - Schlenker, Anna A1 - Schröder, Johannes A1 - Essig, Marco A1 - Schmitter, Marc T1 - Disk displacement, eccentric condylar position, osteoarthrosis - misnomers for variations of normality? Results and interpretations from an MRI study in two age cohorts JF - BMC Oral Health N2 - Background Clinical decision-making and prognostic statements in individuals with manifest or suspected temporomandibular disorders (TMDs) may involve assessment of (a) the position of articular disc relative to the mandibular condyle, (b) the location of the condyle relative to the temporal joint surfaces, and (c) the depth of the glenoid fossa of the temporomandibular joints (TMJs). The aim of this study was twofold: (1) Determination of the prevalence of these variables in two representative population-based birth cohorts. (2) Reinterpretation of the clinical significance of the findings. Methods From existing magnetic resonance imaging (MRI) scans of the TMJs that had been taken in 2005 and 2006 from 72 subjects born between 1930 and 1932 and between 1950 and 1952, respectively, the condylar position at closed jaw was calculated as percentage displacement of the condyle from absolute centricity. By using the criteria introduced by Orsini et al. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 86:489-97, 1998), a textbook-like disc position at closed jaw was distinguished from an anterior location. TMJ morphology of the temporal joint surfaces was assessed at open jaw by measuring the depth of the glenoid fossa, using the method proposed by Muto et al. (J Oral Maxillofac Surg 52:1269-72, 1994). Frequency distributions were recorded for the condylar and disc positions at closed jaw. Student’s t-test with independent samples was used as test of significance to detect differences of condylar positions between the age cohorts (1930 vs. 1950) and the sexes. The significance levels were set at 5%. First, the results from the measurement of the age cohorts were compared without differentiation of sexes, i.e., age cohort 1930–1932 versus age cohort 1950–1952. Subsequently, the age cohorts were compared by sex, i.e., men in cohort 1930–1932 versus men in cohort 1950–1952, and women in cohort 1930–1932 women men in cohort 1950–1952. Results In both cohorts, condylar position was characterized by great variability. About 50% of the condyles were located centrically, while the other half was either in an anterior or in a posterior position. In both female cohorts, a posterior position predominated, whereas a centric position prevailed among men. Around 75% of the discs were positioned textbook-like, while the remaining forth was located anteriorly. Age had no statistically significant influence on condylar or on disc position. Conversely, comparison between the age groups revealed a statistically significant decrease of the depth of the glenoid fossa in both older cohorts. This age-dependent changes may be interpreted as flattening of the temporal joint surfaces. Conclusions We call for a re-interpretation of imaging findings because they may insinuate pathology which usually is not present. Instead, anterior or posterior positions of the mandibular condyle as well as an anterior location of the articular disc should be construed as a variation of normalcy. Likewise, flattening of articular surfaces of the TMJs may be considered as normal adaptive responses to increased loading, rather than pathological degenerative changes. KW - Image interpretation KW - Medicalization KW - Osteoarthritis KW - Overdiagnosis KW - Temporomandibular joint disc KW - Mandibular condyle KW - Medical overuse KW - Osteoarthrosis KW - Temporomandibular disorders KW - Terminology Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-164710 VL - 16 IS - 124 ER -