Michael H Walter

Technische Universität Dresden, Dresden, Saxony, Germany

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Publications (84)105.05 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: Fast-setting impression materials may be prone to inaccuracies due to accidental divergence from the recommended mixing protocol. This prospective randomized clinical trial aimed to assess three-dimensional (3D) deviations in the reproduction of subgingival tooth surfaces and to determine the effect of either following or purposely diverging from the recommended mixing procedure for a fast-setting addition-curing silicone (AS) and fast-setting polyether (PE). Materials and Methods: After three impressions each were taken from 96 participants, sawcut gypsum casts were fabricated with a standardized procedure and then optically digitized. Data were assessed with a computer-aided 3D analysis. Results: For AS impressions, multivariate analysis of variance revealed a significant influence of the individual tooth and the degree to which the recommended mixing protocol was violated. For PE impressions, the ambient air temperature and individual tooth showed significant effects, while divergence from the recommended mixing protocol was not of significance. Conclusions: The fast-setting PE material was not affected by changes in the recommended mixing protocol. For the two fast-setting materials examined, no divergences from the recommended mixing protocol of less than 2 minutes led to failures in the reproduction of the subgingival tooth surfaces.
    The International journal of prosthodontics. 07/2014; 27(4):366-375.
  • Michael Raedel, Susanne R. Rehm, Michael H. Walter
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    ABSTRACT: Aims: On 1st January 2005 the subsidy of prosthetic treatment for members of the German public health insurance system changed by law from a percentage subsidy on therapy to a diagnosis based fixed-subsidy system. The aim of this study was to measure the influence of this change on the spectrum of prosthetic therapy- options at a university clinic. Methods: All prosthetic therapy carried out between July 1st 2005 and June 30th 2006 (study group) and between July 1st 2003 and June 30th 2004 (control group) was documented and analysed. The data were gathered using the digital patient record system of the clinic. The study was approved by the responsible ethical board. The data were analysed using descriptive statistical methods. Differences between the two groups were assessed using the t-Test. The study group comprised of 379 cases, the control group comprised 475 cases. The analysed clientele is not representative for the German population due to the specific characteristics of university clinic patients. Results: A decrease of more than 20% over all in the number of cases treated was detected. The number of crowns decreased from 666 (63.4%) in the control group to 455 (58.0%) in the study group. The number of bridges decreased from 141 (13.4%) in the control group to 95 (12.1%) in the study group. The number of cast metal partial dentures increased from 35 (3.3%) to 55 (7.0%). The comparison of the average cost showed an increase in almost all classified categories. Conclusions: A shift of the spectrum in prosthetic treatment could be shown. It can be stated that the change in the reimbursement system had slight influences on the spectrum of prosthetic therapy- options that were performed.
    Annual Congress of the European Association of Dental Public Health, Gothenburg, Sweden; 06/2014
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    1st 05/2014; Asgard Verlasservice., ISBN: 978-3-943-74490-3
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    ABSTRACT: Objectives Data on posterior alveolar ridge resorption (PARR) in patients with two implant supported mandibular overdentures is very heterogeneous. The aim of this prospective study was to observe the PARR after ten years for a study population treated with a titanium bar retained overdenture on two IMZ-implants.Material and methodsThe data pool consisted of digital and digitized conventional panoramic radiographs taken prior to implant placement and at follow up appointments. Digital measurements were carried out following an established procedure (“Tuebingen method” by Gomez-Roman). For each patient a linear regression was calculated resulting in a relative area related PARR-value per year. A simplified geometrical scenario was used for the estimation of absolute bone height losses.ResultsData of 23 patients was available. The mean observation period was 9.4 years (±2.4 years). An average area related PARR-rate of 1.02% per year was observed with high individual differences ranging from 0.15% and 2.63% per year. The estimated average ten year vertical bone loss in the chewing center was 1.5 mm.Conclusions Posterior bone resorption was found to be in the range previously reported for different implant restorations and therefore does not represent a particular problem of two implant bar retained overdentures. The results strengthen the two implant concept.
    Clinical Oral Implants Research 04/2014; · 3.43 Impact Factor
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    ABSTRACT: In a multicentre randomised trial (German Research Association, grants DFG WA 831/2-1 to 2-6, WO 677/2-1.1 to 2-2.1.; controlled-trials.com ISRCTN97265367), patients with complete molar loss in one jaw received either a partial removable dental prosthesis (PRDP) with precision attachments or treatment according to the SDA concept aiming at pre-molar occlusion. The objective of this current analysis was to evaluate the influence of different treatments on periodontal health. Linear mixed regression models were fitted to quantify the differences between the treatment groups. The assessment at 5 years encompassed 59 patients (PRDP group) and 46 patients (SDA group). For the distal measuring sites of the posterior-most teeth of the study jaw, significant differences were found for the plaque index according to Silness and Löe, vertical clinical attachment loss (CAL-V), probing pocket depth (PPD) and bleeding on probing. These differences were small and showed a slightly more unfavourable course in the PRDP group. With CAL-V and PPD, significant differences were also found for the study jaw as a whole. For CAL-V, the estimated group differences over 5 years amounted to 0·27 mm (95% CI 0·05; 0·48; P = 0·016) for the study jaw and 0·25 mm (95% CI 0·05; 0·45; P = 0·014) for the distal sites of the posterior-most teeth. The respective values for PPD were 0·22 mm (95% CI 0·03; 0·41; P = 0·023) and 0·32 mm (95% CI 0·13; 0·5; P = 0·001). It can be concluded that even in a well-maintained patient group statistically significant although minor detrimental effects of PRDPs on periodontal health are measurable.
    Journal of Oral Rehabilitation 03/2014; · 2.34 Impact Factor
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    ABSTRACT: The aim of this multi-center, randomized controlled trial was to assess the impact of missing posterior support on the risk for temporomandibular disorder (TMD) pain by comparing patients with either shortened dental arches (SDA) or molar replacement by removable dental prostheses (RDP). A sample of 215 patients with bilateral molar loss in at least one jaw was consecutively recruited in 14 prosthodontic departments of dental schools in Germany. Of the initial sample, 152 patients (mean age: 59.7 years; 53.9 % female) received randomly allocated interventions (SDA: n = 71; RDP: n = 81). Presence of TMD pain was assessed using patients' self-reports and was verified by physical examination and by pain intensity, as the mean of current pain, worst pain, and average pain in the last 6 months, with 10-point ordinal rating scales. Assessments were performed before treatment and at follow-ups until 60 months after treatment. Impact of interventions on TMD risk and pain intensity was computed by applying logistic and linear random-intercept models. Tooth replacement (RDP) did not significantly change the risk for self-reported (odds ratio [OR]: 1.1; confidence interval [CI]: 0.4 to 3.4) or clinically verified (OR: 0.7; CI: 0.1 to 4.3) TMD pain compared to no tooth replacement (SDA). Mean characteristic pain intensity was virtually identical in both groups (Coeff: 0.01; CI: -0.30 to 0.32). Retaining or preservation of an SDA is not a major risk factor for TMD pain over the course of 5 years when compared to molar replacement with RPDs. Seemingly, missing molars do not have to be replaced in order to prevent TMD pain.
    Clinical Oral Investigations 01/2014; · 2.20 Impact Factor
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    ABSTRACT: This article is part of a randomized clinical trial on different treatments in the shortened dental arch (SDA). It focused on the abutment tooth prognosis with cantilevered fixed dental prostheses (CFDPs). Sixty-two patients with a bilaterally SDA up to the first or second premolar in the mandible or maxilla were evaluated. In 57 of 124 quadrants, second premolars were replaced by a CFDP (cantilever group). In the remaining 67 quadrants, a natural second premolar was present and thus no need for a CFDP was given (non-cantilever group). Patients were recalled annually up to 5 years. The mean observation period was 56.3 months (min. 3.0, max. 76.2, SD 16.1). Kaplan-Meier survival rates concerning tooth loss and tooth fracture were 93.9%/94.0% in the cantilever group and 91.9%/92.8% in the non-cantilever group. Differences between both groups were not significant. The survival rate concerning loss of retention of CFDP retainers was 92.1% in the cantilever group. After 5 years of clinical service, CFDPs for the replacement of the second premolar showed no negative impact on the abutment tooth prognosis. Clinical Significance: Cantilevered fixed dental prostheses present a viable treatment option in the shortened dental arch without compromising the medium-term abutment tooth prognosis.
    Journal of dentistry 01/2014; · 3.20 Impact Factor
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    ABSTRACT: OBJECTIVES: Although the shortened dental arch (SDA) concept is a widely accepted strategy to avoid overtreatment, little is known on its impact on oral health-related quality of life (OHRQoL). This multicenter randomized controlled trial aimed to investigate the OHRQoL for removable partial dental prostheses (RPDP) with molar replacement versus the SDA concept. MATERIAL AND METHODS: In both groups, missing anterior teeth were replaced with fixed dental prosthesis. Two hundred fifteen patients with bilateral molar loss in at least one jaw were included. The Oral Health Impact Profile (OHIP-49) was completed before; 6 weeks (baseline), 6 months, and 12 months after treatment; and thereafter annually until 5 years. RESULTS: Of the initial cohort, 81 patients were assigned to the RPDP group and 71 to the SDA group (age, 34 to 86 years). Before treatment, the median OHIP score was similar in both groups (RPDP, 38.0; SDA, 40.0; n.s.). Results indicate marked improvements in OHRQoL in both groups between pretreatment and baseline (RPDP, 27.0; SDA, 19.0; p ≤ 0.0001) which continued in the RPDP group until the 1-year follow-up (p = 0.0002). These significant reductions in OHIP scores are reflected in its subscales. No further differences were seen within and between groups during the remainder observation period. CONCLUSION: Both treatments show a significant improvement in OHRQoL which continued in the RPDP group until the 1-year follow-up. No significant differences were seen between groups. CLINICAL RELEVANCE: For improving OHRQoL, it is not necessary to replace missing molars with a RPDP.
    Clinical Oral Investigations 05/2013; · 2.20 Impact Factor
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    ABSTRACT: Metal ceramic restorations are widely used in prosthodontics, but long-term data on their clinical performance in private practice settings based on prospective trials are sparse. This clinical trial was designed to provide realistic long-term survival rates for different outcomes related to tooth loss, crown loss, and metal ceramic defect. Ninety-five participants were provided with 190 noble metal ceramic single crowns and 138 participants with 276 fixed dental prosthesis retainer crowns on vital posterior teeth. Follow-up examinations were scheduled 2 weeks after insertion, annually up to 8 years, and after 10 years. Kaplan-Meier survival analyses, Mantel-Cox logrank tests, and Cox regression analyses were conducted. Because of variations in the time of the last examinations, the maximum observation period was 12.1 years. For the primary outcome 'loss of crown or tooth', the Kaplan-Meier survival rate was 94.3% ±1.8% (standard error) at 8.0 years (last outcome event) for single crowns and 94.4% ±1.5% at 11.0 years for fixed dental prosthesis retainer crowns. The difference between the survival functions was not significant (P>.05). For the secondary outcome 'metal ceramic defect', the survival rate was 88.8% ±3.2% at 11.0 years for single crowns and 81.7% ±3.5% at 11.0 years for fixed dental prosthesis retainer crowns. In Cox regression models, the only significant covariates for the outcome event 'metal ceramic defect' were bruxism in the medical history (single crowns) and signs and symptoms of bruxism (fixed dental prosthesis retainer crowns) with hazard ratios of 3.065 (95% CI 1.063 - 8.832) and 2.554 (95% CI 1.307 - 4.992). Metal ceramic crowns provided in private practice settings show good longevity. Bruxism appears to indicate a risk for metal ceramic defects.
    The Journal of prosthetic dentistry 03/2013; 109(3):149-55. · 1.22 Impact Factor
  • Annemarie Michel, Michael Rädel, Michael Walter
    Deutscher Kongress für Versorgungsforschung, Dresden; 09/2012
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    ABSTRACT: OBJECTIVES: The use of fast-setting impression materials with different viscosities for the one-stage impression technique demands precise working times when mixing. We examined the effect of varying working time on impression precision in a randomized clinical trial. MATERIALS AND METHODS: Focusing on tooth 46, three impressions were made from each of 96 volunteers, using either a polyether (PE: Impregum Penta H/L DuoSoft Quick, 3 M ESPE) or an addition-curing silicone (AS: Aquasil Ultra LV, Dentsply/DeTrey), one with the manufacturer's recommended working time (used as a reference) and two with altered working times. All stages of the impression-taking were subject to randomization. The three-dimensional precision of the non-standard working time impressions was digitally analyzed compared to the reference impression. Statistical analysis was performed using multivariate models. RESULTS: The mean difference in the position of the lower right first molar (vs. the reference impression) ranged from ±12 μm for PE to +19 and -14 μm for AS. Significantly higher mean values (+62 to -40 μm) were found for AS compared to PE (+21 to -26 μm) in the area of the distal adjacent tooth. CONCLUSIONS: Fast-set impression materials offer high precision when used for single tooth restorations as part of a one-stage impression technique, even when the working time (mixing plus application of the light- and heavy-body components) diverges significantly from the manufacturer's recommended protocol. CLINICAL RELEVANCE: Best accuracy was achieved with machine-mixed heavy-body/light-body polyether. Both materials examined met the clinical requirements regarding precision when the teeth were completely syringed with light material.
    Clinical Oral Investigations 08/2012; · 2.20 Impact Factor
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    ABSTRACT: The scientific evidence concerning prosthodontic care for the shortened dental arch (SDA) is sparse. This randomized multicenter study aimed to compare two common treatment options: removable partial dental prostheses (RPDPs) for molar replacement vs. no replacement (SDA). One of the hypotheses was that the follow-up treatment differs between patients with RPDPs and patients with SDAs during the 5-year follow-up period. Two hundred and fifteen patients with complete molar loss in one jaw were included in the study. Molars were either replaced by RPDPs or not replaced according to the SDA concept. A mean number of 4.2 (RPDP) and 2.8 (SDA) treatments for biological or technical reasons occurred during the 5-year observation time per patient. Concerning the biological aspect, no significant differences between the groups could be shown, whereas treatment arising from technical reasons was significantly more frequent for the RPDP group. When the severity of treatment was analyzed, a change over time was evident. When, at baseline, only follow-up treatment with minimal effort is required, over time there is a continuous increase to moderate and extensive effort observed for both groups (Controlled-trials.com number ISRCTN97265367).
    Journal of dental research 07/2012; 91(7 Suppl):65S-71S. · 3.46 Impact Factor
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    ABSTRACT: OBJECTIVES: The study was designed to provide clinical outcome data for two treatments of the shortened dental arch (SDA). MATERIAL AND METHODS: In a multicenter randomized controlled clinical trial, patients with complete molar loss in one jaw were provided with either a partial removable dental prosthesis (PRDP) retained with precision attachments or treated according to the SDA concept preserving or restoring a premolar occlusion. No implants were placed. The primary outcome was tooth loss. RESULTS: Of 152 treated patients, 132 patients reached the 5-year examination. Over 5 years, 38 patients experienced tooth loss. For the primary outcome tooth loss, the Kaplan-Meier survival rates at 5 years were 0.74 (95 % CI 0.64, 0.84) in the PRDP group and 0.74 (95 % CI 0.63, 0.85) in the SDA group. For tooth loss in the study jaw, the survival rates at 5 years were 0.88 (95 % CI 0.80, 0.95) in the PRDP group and 0.84 (95 % CI 0.74, 0.93) in the SDA group. The differences were not significant. No Cox regression models of appropriate fit explaining tooth loss on the patient level could be found. CONCLUSIONS: The overall treatment goals of a sustainable oral rehabilitation and the avoidance of further tooth loss over longer periods were not reliably achievable. The influence of the type of prosthetic treatment on tooth loss might have been overestimated. CLINICAL RELEVANCE: Regarding our results, the patient's view will gain even more importance in the clinical decision between removable and fixed restorations in SDAs.
    Clinical Oral Investigations 06/2012; · 2.20 Impact Factor
  • Stephan Jacoby, Michael Rädel, Michael H. Walter
    Deutsche zahnärztliche Zeitschrift 01/2012; Dtsch Zahnärztl Z(67):32-39.
  • 01/2012: pages 978-86;
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    ABSTRACT: The study aim was to identify predictors of impaired oral health-related quality of life (OHRQoL). Employees of five companies were offered a clinical full-mouth examination. Oral health-related quality of life was measured with the German version of the Oral Health Impact Profile (OHIP) and summarized as additive scores (OHIP-ADD) and as prevalence of negative impacts (OHIP-SC). Two logistic regression models were developed for the odds of increased scores of the target variables OHIP-ADD and OHIP-SC. The target variables were dichotomized, and for the OHIP-ADD, the cut-off point for having impaired OHRQoL was heuristically defined as OHIP-ADD > 34. For the OHIP-SC, the corresponding threshold was OHIP-SC > 0. In the model for the OHIP-ADD, female gender, impaired aesthetics, few posterior occluding pairs, and painful masticatory muscles proved to be significant independent variables. For the OHIP-SC, female gender, impaired aesthetics, painful masticatory muscles, joint sounds, missing mandibular teeth, and carious teeth were significant. This cross-sectional study showed that within the models for both OHIP-ADD and OHIP-SC the high-risk person for impaired OHRQoL is a woman with impaired aesthetics and painful masticatory muscles.
    European Journal Of Oral Sciences 12/2011; 119(6):481-8. · 1.42 Impact Factor
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    ABSTRACT: Despite the success in preventing oral diseases, the prevalence of tooth loss in the German population remains high and increases with age. Today, the advances in prosthetic dentistry allow necessary tooth replacement following preventive strategies-after considering benefits and risks. Modern treatment options improve the overall prognosis of the stomatognathic system and the quality of life of the affected patients significantly. Hereby, adverse iatrogenic effects can be minimized or even completely avoided by extending the traditional treatment spectrum, e.g., using adhesively fixed restorations and implant-supported restorations, and refraining from placing restorations that are unnecessary from the medical point of view. Generally, patients benefit greatly from prosthetic treatment and the achieved health gain is remarkably high. It encompasses not only the recovery of the impaired oral functions but also extends to the whole human organism, including nutrition, digestion, musculoskeletal system, as well as mental and social well-being.
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 08/2011; 54(9):1102-9. · 0.72 Impact Factor
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    ABSTRACT: Trotz aller Erfolge in der Prävention von Zahnerkrankungen hat der Zahnverlust auch heute noch eine hohe Prävalenz in der deutschen Bevölkerung, die mit zunehmendem Lebensalter kontinuierlich steigt. Der medizinische Fortschritt in der prothetischen Zahnmedizin ermöglicht heute den notwendigen Ersatz fehlender Zähne mit präventionsorientierten Strategien unter konsequenter Gegenüberstellung von Nutzen und Risiken. Hier verbessern moderne Therapiemittel die Gesamtprognose des Kauorgans und die Lebensqualität der betroffenen Patienten deutlich. Die iatrogene Schädigung wird dabei so gering wie möglich gehalten. Iatrogene Schädigungen werden vor allem durch die Erweiterung des konventionellen prothetischen Behandlungsspektrums mittels adhäsiv befestigter und implantatgetragener Therapiemittel sowie durch den Verzicht auf medizinisch nicht erforderlichen Zahnersatz minimiert oder sogar vermieden. Der Gesundheitsgewinn durch zahnärztlich-prothetische Therapiemittel ist für die betroffenen Patienten in der Regel außerordentlich hoch und beinhaltet nicht nur die Wiederherstellung der durch Zahnverlust eingeschränkten orofazialen Funktionen, sondern erstreckt sich auf den gesamten menschlichen Organismus. Dabei sind vor allem Ernährung, Verdauung, Bewegungsapparat und psychisches und soziales Wohlbefinden zu nennen. Despite the success in preventing oral diseases, the prevalence of tooth loss in the German population remains high and increases with age. Today, the advances in prosthetic dentistry allow necessary tooth replacement following preventive strategies—after considering benefits and risks. Modern treatment options improve the overall prognosis of the stomatognathic system and the quality of life of the affected patients significantly. Hereby, adverse iatrogenic effects can be minimized or even completely avoided by extending the traditional treatment spectrum, e.g., using adhesively fixed restorations and implant-supported restorations, and refraining from placing restorations that are unnecessary from the medical point of view. Generally, patients benefit greatly from prosthetic treatment and the achieved health gain is remarkably high. It encompasses not only the recovery of the impaired oral functions but also extends to the whole human organism, including nutrition, digestion, musculoskeletal system, as well as mental and social well-being. SchlüsselwörterGesundheit–Implantate–Lebensqualität–Prothetik–Zahnersatz KeywordsHealth–Implants–Quality of life–Prosthetic dentistry–Tooth replacement
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 01/2011; 54(9):1102-1109. · 0.72 Impact Factor
  • Deutsche zahnärztliche Zeitschrift 01/2011; Dtsch Zahnärztl Z(66):647-53.
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    ABSTRACT: This article presents an overview of the recently published first two parts of the Memorandum III "Methods for Health Services Research" discussed and approved by the member societies of the German Network Health Services Research [Deutsches Netzwerk Versorgungsforschung e.V.]. Part one of this memorandum covers methodical principles and minimum standards for the subject areas of health services research "Epidemiological Methods for Health Services Research", "Methods for Organisational Health Services Research" and "Methods for Quality of Life Research", the second part the topics "Methods of Health Economic Evaluation" and "Registries for the Health Services Research". The Memorandum is addressed to health services researchers and to reviewers who are planning, conducting, publishing studies as well as evaluating research proposals and publications. Assurance of quality and increase of the health services research are the aims of the Memorandum III. According to the advanced knowledge in health services research the Memorandum needs regular updates. Therefore the Memorandum has to be understood as "work in progress".
    Medizinische Klinik 12/2010; 105(12):924-9. · 0.34 Impact Factor

Publication Stats

588 Citations
105.05 Total Impact Points

Institutions

  • 1999–2014
    • Technische Universität Dresden
      • • Medizinische Fakultät Carl Gustav Carus
      • • Abteilung Kinderzahnheilkunde
      • • Poliklinik für Zahnärztliche Prothetik
      Dresden, Saxony, Germany
  • 1995–2014
    • Carl Gustav Carus-Institut
      Pforzheim, Baden-Württemberg, Germany
  • 2013
    • Universitätsklinikum Dresden
      Dresden, Saxony, Germany
  • 2012–2013
    • RWTH Aachen University
      • Department of Prosthodontics and Dental Materials
      Aachen, North Rhine-Westphalia, Germany
  • 2009–2011
    • Christian-Albrechts-Universität zu Kiel
      Kiel, Schleswig-Holstein, Germany
  • 2010
    • Universität Ulm
      • Clinic for Prosthetic Dentistry
      Ulm, Baden-Wuerttemberg, Germany
  • 2004
    • University of Alberta
      • School of Dentistry
      Edmonton, Alberta, Canada
  • 1991
    • Deutsche Gesellschaft für Zahn-, Mund- und Kieferheilkunde
      Berlín, Berlin, Germany