Publications (6)12.36 Total impact
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Article: Complications and survival rates of teeth after dental trauma over a 5-year period.
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ABSTRACT: OBJECTIVES: The purpose of this study was to evaluate whether the current guidelines of the International Association of Dental Traumatology (IADT) for emergency care of traumatised teeth result in lower complication rates. MATERIALS AND METHODS: Therapeutic strategies of 361 dental injuries in 291 patients treated at a university dental hospital over a 5-year period were investigated by evaluating the patients' records. Adherence to the guidelines of the IADT (Flores et al. Dent Traumatol 17:1-4, 2001; 49-52, 2001; 97-102, 2001; 145-148, 2001; and 193-196, 2001; Flores et al. Dent Traumatol 23:66-71, 2007; 130-136, 2007; and 196-202, 2007) was evaluated. Complications were also recorded according to the patients' records and analysed relative to the treatment and injury pattern. During follow-up visits, the teeth were inspected regarding pulp vitality and overall function of the injured tooth. The Kaplan-Meier survival analysis of pulps and teeth was performed for different injury categories. RESULTS: The majority of injuries (322/361; 89.2 %) were treated according to the guidelines. When IADT guidelines were followed, complication rates were significantly lower than for cases treated without adherence to the guidelines. The most frequent complication was the loss of restoration, followed by pulp necrosis, abnormal mobility, and tooth loss. The overall survival analysis showed that in the permanent dentition, the loss of pulp vitality and tooth occurs within the first 6 months but may also occur later. CONCLUSIONS: The results of this study indicate that traumatised teeth that were treated according to the recommendations had a lower complication rate. In addition, the majority of pulp necrosis and tooth losses in the permanent dentition occurred within the first 6 months after trauma. These results indicate that early follow-up visits are essential to promptly treat complications. CLINICAL RELEVANCE: Adherence to the IADT guidelines for treatment of dental trauma may lead to more favourable outcomes when compared to cases treated without compliance to the guidelines.Clinical Oral Investigations 08/2012; · 2.36 Impact Factor -
Article: Traumatic dental injuries at a German University Clinic 2004-2008.
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ABSTRACT: AIM: This study was designed to analyse the distribution and treatment management of patients who presented at a German university dental emergency department for trauma in a 5-year period. MATERIALS/METHODS: Clinical and radiographical baseline data and recall of patients presenting from 2004 to 2008 for dental trauma were evaluated with regard to age, gender, type of injury and treatment strategies. In addition, trauma management as performed was compared with the guidelines of the International Association of Dental Traumatology (IADT). RESULTS: A total of 361 teeth in 219 patients from 1 to 68 years were treated with 1.7 injured teeth per incident and patient. Over 75% of the patients were < 14 years. In 23% of all incidents, primary teeth were affected with a male-to-female ratio of 2.1:1. Luxation injuries were predominant in the deciduous dentition. The domestic environment was the most common trauma location (44%), followed by nursery schools (36%) and outdoors during recreational activities (20%) mainly caused by falls (72%). In 76% of all dental injuries, permanent teeth were involved; 65% of patients were men; and 35%, women (1.8:1). With permanent teeth, enamel-dentine fracture without pulp involvement was most common. Falls (38%), accidental contacts (21%) and sports accidents (18%) caused the most injuries. The majority of teeth were treated in concordance with the guidelines (89%). CONCLUSIONS: The distribution of traumatic injuries is similar to other national and international data with regard to gender, age and in relation to injury type, location and causes. International and national healthcare associations and teachers in under- and postgraduate education should put effort on increasing the awareness of the guidelines.Dental Traumatology 05/2012; · 1.20 Impact Factor -
Article: Diagnostic performance of the universal visual scoring system (UniViSS) on occlusal surfaces.
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ABSTRACT: Aim of this investigation was to evaluate the validity and reproducibility of the universal visual scoring systems (UniViSS) on occlusal surfaces in vitro. The validity study included 65 third molars. Following to reach a UniViSS consensus diagnosis for each surface, all teeth were histologically prepared and evaluated according to the newly developed caries-extension-index (CE-index). The reproducibility study consisted of 149 molars. These teeth were examined by two dentists and four students without any calibration training. In result, the CE-index provided the exact caries depth for each UniViSS criterion, which could further be associated with a distinct preventive or treatment strategy. The mean intra-/inter-examiner weighted Kappa values amounted to 0.685/0.551 (UniViSS/severity) and 0.628/0.542 (UniViSS/discoloration). The cumulative Logit-model underlined that UniViSS/severity criteria were more frequently reproduced in comparison to the UniViSS/discoloration criteria. In conclusion, this study on the diagnostic performance of UniViSS showed encouraging results and give valuable hints for future studies.Clinical Oral Investigations 03/2010; 15(2):215-23. · 2.36 Impact Factor -
Article: Development, methodology and potential of the new Universal Visual Scoring System (UniViSS) for caries detection and diagnosis.
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ABSTRACT: Given the limitations of adjunct caries detection and diagnostic tools, e.g., imperfect validity and reproducibility, as well as the difficulties in controlling all possible confounding factors, the need for an objective visual caries detection and diagnosis system has become evident. Our work has therefore aimed at systematizing caries lesions with the Universal Visual Scoring System (UniViSS) for occlusal and smooth surface lesions, which can be used for primary and permanent teeth, as well as under clinical, epidemiological, public health and laboratory conditions. Besides the description of the development and methodology of UniViSS, it is shown that UniViSS allows an accurate and reproducible classification of caries lesions on occlusal surfaces.International Journal of Environmental Research and Public Health 09/2009; 6(9):2500-9. · 1.61 Impact Factor -
Article: Reproducibility of DIAGNOdent 2095 and DIAGNOdent Pen measurements: results from an in vitro study on occlusal sites.
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ABSTRACT: The aim of this in vitro study was to investigate the intra- and interdevice reproducibility of the DIAGNOdent 2095 (DD2095) and the new DIAGNOdent Pen (DDPen) on non-cavitated occlusal caries sites. Altogether, 241 sites on 90 molars were inspected twice with both devices and by four examiners. The intra/interdevice reproducibilities were assessed by means of the intraclass correlation coefficient (ICC) as well as by the range of the 95% limits of agreement of Bland & Altman. Additionally, a linear mixed-effects model was fitted with fixed effects for the visual scores and the devices used and random effects for occlusal sites and examiners within each measurement site. In result, the following values were determined for the intradevice reproducibility: DD2095: ICC 0.89, range 42.3; and DDPen: ICC 0.88, range 49.3. The interdevice reproducibility was found to be in the same order of magnitude (ICC 0.82, range 53.7). The comparison between both devices indicated significantly lower mean values for the DDPen. The estimates of the linear model show that there is a high variation between the sites that cannot be explained by the fixed effects. In conclusion, both devices showed an imperfect reproducibility, which indicate the usage as adjunct tool only in clinical practice.European Journal Of Oral Sciences 07/2007; 115(3):206-11. · 1.88 Impact Factor -
Article: The intra/inter-examiner reproducibility of the new DIAGNOdent Pen on occlusal sites.
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ABSTRACT: This in vitro study on occlusal sites aimed to assess the intra/inter-examiner reproducibility of the new DIAGNOdent Pen (KaVo, Biberach, Germany) and to prove the assumption that its handling is easy to learn by dental students. Two hundred and forty-one sites of 90 occlusal non-cavitated molar surfaces were investigated twice by 2 dentists and 2 undergraduate students with the DIAGNOdent Pen according to manufacturer's instructions. Intra/inter-examiner reproducibility was assessed calculating intra-class correlation coefficients (ICCs) and the range of the 95% limits of agreement by Bland and Altman. Intra-examiner reproducibility revealed excellent ICCs (0.84-0.92); but the range amounted to 41.2-59.1, which indicate a wide measuring range. The inter-examiner reproducibility using all measurements had to be proved as excellent (ICC 0.84); the range was found in the same order of magnitude as mentioned above (53.2). When measurements were categorised according to treatment related cut-offs a good inter-examiner reproducibility was detected in the interval of <30 (ICC 0.70); an excellent ICC were registered for the interval >30 (ICC 0.51). For both intervals the range values (<30: range 32.3 and >30: range 67.7) exceeded a deviation limit of +/-20%. Both students tended to measure slightly more precise compared to the dentists. This study revealed a wide measuring range of DIAGNOdent Pen readings. Since there were no differences between dentists and students it can be used as adjunct tool by undergraduates as well. Nevertheless, based on the registered reproducibility the DIAGNOdent Pen should be used additionally to visual inspection and dental radiographs.Journal of Dentistry 06/2007; 35(6):509-12. · 2.95 Impact Factor
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Institutions
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2012
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Ludwig-Maximilian-University of Munich
- Department of Operative Dentistry and Periodontology
München, Bavaria, Germany
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