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Notes: Background: In this study, risk determinants were determined for periodontal disease in the representative population sample (n=3146) of the Study of Health in Pomerania.Methods: After examining the net random sample (response 69%) and exclusion of edentulous cases and those with missing values, 2595 subjects remained. Using a multivariate, fully adjusted logistic regression, different definitions of “periodontally diseased/healthy” were examined as the dependent variable (extent of attachment loss (AL〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE629:ges" location="ges.gif"/〉4 mm, combined AL and tooth loss). The independent variables used were sociodemographic factors (age, gender, income, education), medical factors (systemic diseases, drugs), behavioral factors (regular dental checkup, smoking), and oral factors (presence of supragingival calculus and plaque).Results: The following risk determinants were found for AL: male gender, presence of supragingival plaque and calculus, smoking, low educational level. For the combination of AL and tooth loss, risk determinants were female gender, supragingival plaque, smoking, and low educational level. Consumption of antiallergic medications and regular dental checkups proved to be protective. Smoking was the most influential risk determinant. These parameters explained approximately 43–55% of the variation.Conclusion: These results concur with those of the literature. In order to explain disease status further, host-response and microbiological factors must also be examined.

Notes: Aim: Benchmarking is a means of setting goals or targets. On an oral health level, it denotes retaining more teeth and/or improving the quality of life. The goal of this pilot investigation was to assess whether the data generated by a population-based study (SHIP 0) can be used as a benchmark data set to characterize different practice profiles.Material and Methods: The data collected in the population-based study SHIP (n=4310) in eastern Germany were used to generate nomograms of tooth loss, attachment loss, and probing depth. The nomograms included twelve 5-year age strata (20–79 years) presented as quartiles, and additional percentiles of the dental parameters for each age group. Cross-sectional data from a conventional dental office (n=186) and from a periodontology unit (n=130, Greifswald) in the study region as well as longitudinal data set of a another periodontology unit (n=135, Kiel) were utilized in order to verify whether the given practice profile was accurately reflected by the nomogram.Results: In terms of tooth loss, the data from the conventional dental office agree with the median from the nomogram. For attachment loss and probing depth, some age groups yielded slight but not uniform deviations from the median. Cross-sectional data from the periodontology unit Greifswald showed attachment loss higher than the median in younger but not in older age groups. The probing depth was uniformly less than the median and tended toward the 25th percentile with increasing age. The longitudinal data of the Unit of Periodontology in Kiel showed a pronounced trend towards higher percentiles of residual teeth, meaning that the patients retained more teeth.Conclusion: The profile of the Pomeranian dental office does not deviate noticeably from the population-based nomograms. The higher attachment loss of the Unit of Periodontology in Greifswald in younger age strata clearly reflects their selection because of periodontal disease; the combination of higher attachment loss and decreased probing depth may reflect the success of the treatment. The tendency of attachment loss towards the median with increasing age may indicate that the Unit of Periodontology in Greifswald does not fulfill its function as a special care unit in the older subjects. The longitudinal data set of the Unit of Periodontology in Kiel impressively reflects the potential of population-based data sets as a means for benchmarking. Thus, nomograms can help to determine the practice profile, potentially yielding benefits for the dentist, health insurance company, or – as in the case of the special care unit – public health research.

Notes: Background/aims: In a dummy-head trial, we assessed how effectively untrained operators were able to learn scaling with curettes and power-driven instruments.Methods: Two untrained operator groups (n = 11 each) received six 2-h lessons during a 10-week period following a training program. Subgingival scaling was performed with curettes (GRA) and a power-driven system (PP). At 6 test days each subject had to instrument 10 test teeth. The percentage of debrided area was assessed with an image analysis program. Learning success was measured as a percentage of debrided root area and scaling time. Furthermore, the effectivity was related to difficulty in anatomical situations and access to root surfaces. Statistical analysis was carried out with SPSS.Results: At baseline, effectivity was 63.1% (GRA) vs. 52.3% (PP). Between weeks 9 and 11, operators reached a plateau for group GRA at 84.7% and group PP at 81.3%. Scaling time did not differ between the two groups. Debridement of teeth with complex root shapes that were hard to access was less effective with the power-driven system.Conclusion: Independent of the instrument used, untrained operators were only able to debride root surfaces at low levels of efficacy. With systematical training, effective scaling with the power- driven system was as easy to learn as with hand instruments. On root surfaces with complicated shape and anatomy or difficult accessibility, the power-driven system works significantly less effectively.

Notes: Background: In an in vitro study, the surface wear on cervical restorations and adjacent enamel and root cementum caused by different tooth-cleaning methods in simulated long-term therapy was investigated.Methods: Cervical restorations of amalgam (Oralloy®), modified composite resin (Dyract®), glass-ionomer cement (ChemFill Superior®), and composite (Tetric®) were instrumented by POL (polishing), CUR+POL (curette and polishing), US+POL (ultrasonic device with polishing) and the polishing agents Cleanic® and Proxyt® in a computer-controlled test bench. Treatment time corresponding to a real-time period of 5 or 10 years. Substance loss from instrumented surfaces was measured with a digital gauge. A three-way anova was used in the statistical evaluation.Results: The results showed that POL led to slight substance loss, which was greater using Cleanic® (27 μm) than Proxyt® (5 μm). CUR+POL produced a significantly greater substance loss than did US+POL, with 186 μm versus 35 μm on glass-ionomer cement, respectively, and 123 μm versus 18 μm, respectively, on root cementum, followed by composite (111 μm versus 27 μm, respectively), polyacid modified composite resin/compomer (89 μm versus 36 μm), amalgam (75 μm versus 19 μm), and enamel (32 μm versus 23 μm).Conclusions: As opposed to the use of US+POL or POL, substance loss on cervical restorations and especially root cementum must be expected to result from tooth-cleaning during long-term maintenance treatment using CUR+POL.

Notes: Background, aims: In a manikin study we recently assessed how effectively student operators were able to learn scaling with curettes (GRA) and power-driven instruments (PP). Calculating the debrided root area effectiveness was low in both groups without systematic training or without a motivational program. After 10 weeks (20 h) of training, operators reached a high effectiveness of 84.7% (GRA) and 81.6% (PP). The purpose of the present study was to evaluate the clinical outcome of nonsurgical treatment as performed by these student operators.Methods: In a clinical trial, 19 students trained in the use of Gracey curettes for 10 weeks (=20 h) (GRA10) and Periopolisher® system for 1 week (=2 h) (PP1), and 20 students trained in the use of Gracey curettes for 1 week (GRA1) and the Periopolisher for 10 weeks (PP10) treated one patient each in a split-mouth design. At baseline and 6 months, we recorded probing depth (PD), probing attachment level (PAL) and bleeding on probing (BOP) by computer-assisted probing. Statistical analysis was carried out for moderate (category B) and deep sites (category C). Groups were compared using Student's t-tests (p〈0.05).Results: Category B sites showed a PD reduction of 1.2/1.0 mm (GRA10/GRA1) and 1.1 mm (PP10/PP1). PAL gain was 0.5/0.3 mm (GRA10/GRA1) and 0.4/0.2 mm (PP10/PP1). In category C sites, PD reduction was 2.1/2.3 mm (GRA10/GRA1) and 2.0 mm (PP10/PP1) with a PAL gain of 0.6/0.9 mm (GRA10/GRA1) and 0.4 mm (PP10/PP1). BOP was significantly lower in all groups.Conclusion: The results show that student operators who had received a systematical training on manikins and had attained different effectiveness results were able to treat periodontally diseased patients successfully using both Gracey and Periopolisher instruments.

Notes: summary  The literature has documented a controversial discussion on the possible relationship of otogenous symptoms and craniomandibular dysfunction since the 1920s. Therefore, an investigation was conducted which consisted of two parts: a case study with population-based controls and a cross-sectional study. The aim of the first study was to screen a group of patients suffering from acute or chronic tinnitus for temporomandibular disorders (TMD) in comparison with a population-based group of volunteers without tinnitus. To this end, 30 patients (13 females and 17 males, age 18–71 years) suffering from acute hearing loss associated with tinnitus, isolated acute tinnitus, and chronically transient tinnitus were examined for symptoms of craniomandibular dysfunction. The results were compared with those of clinical functional analysis from 1907 subjects selected representatively and according to age distribution from the epidemiological ‘Study of Health in Pomerania’ (SHIP); the occurrence of tinnitus was ruled out in these control subjects. Statistical analysis was performed with Chi-square and Mann–Whitney U-tests. Sixty per cent of the tinnitus patients and 36·5% of the control subjects exhibited more than two symptoms of TMD (P = 0·004). Tinnitus patients had significantly more muscle palpation pain (P 〈 0·001), temporomandibular joint (TMJ) palpation pain (P 〈 0·001), and pain upon mouth opening (P 〈 0·001) than the general population group. No statistical differences were found in TMJ sounds, limitation of mandibular movement, or hypermobility of the TMJ. Furthermore, 4228 subjects of the population group examined in the epidemiological study were screened for co-factors of tinnitus with the help of a multivariate logistic regression model which was adjusted for gender, age, and a variety of anamnestic and examined data. Increased odds ratios (OR) were found for tenderness of the masticatory muscles (OR = 1·6 for one to three painful muscles and OR = 2·53 for four or more painful muscles), TMJ tenderness to dorsal cranial compression (OR = 2·99), listlessness (OR = 2·0) and frequent headache (OR = 1·84) A relationship between tinnitus and TMD was established in both examinations. Tinnitus patients seem to suffer especially from myofascial and TMJ pain. A screening for TMD should be included in the diagnostic survey for tinnitus patients.

Notes: Objective:  The purpose of this study was to assess periodontal destruction following experimentally induced marginal periodontitis in rats by ligatures over a 60-day observation period. The extent to which the physiological movement of teeth influenced the effect of the ligatures was also examined. In addition, two methods for measuring bone loss in the defleshed jaw were compared.Methods:  Thirty-five male Sprague-Dawley rats (SD) were divided into five groups. Marginal periodontitis was induced by ligatures on the second maxillary molars. Rats were killed after 15, 30, and 60 days. Rats in the control group were killed on day 1 and day 60. Bone loss was determined with two different methods on the buccal and palatinal surfaces of the defleshed jaw. In the first method, the distance of the cementoenamel junction (CEJ) from the alveolar bone crest (ABC) was measured at different sites; in the second method, the area of the exposed root surface of the molars was measured.Results:  Comparison of the control groups from day 1 and day 60 using both measuring methods showed significant differences in bone loss. In the area where the ligature was located, test rats exhibited significantly greater bone loss than control rats. Comparison of control rats from day 1 with test rats from day 15 showed that the increase in bone loss between the groups within the area of the ligature was significantly greater than outside it. The age-dependent bone loss increases over the entire observation period of 60 days. The ligature-induced bone loss increased most from day 1 to day 15; on days 30 and 60, slighter increases in bone loss were observed.Conclusions:  The application of this model can only be recommended for short (≤15 days) observation periods. The distance method should be preferred to the area method.