University Hospital Regensburg

Older people need a specialized preoperative risk assessment to reliably identify those highly vulnerable risk patients who are in danger of a poor postoperative outcome. In this way these vulnerable risk patients can be separated from those who have successfully and healthily aged and therefore still show a high resilience even in old age. Careful planning of the perioperative management with integration of all disciplines and professions involved can ensure a safe perioperative treatment even for high-risk patients. The corresponding possibilities are presented in this article. The perioperative geriatric anesthesiological treatment pathway must be individually adapted and conceived to specifically address the risks of those patients who are particularly in danger of functional decline and complications.

Purpose This study aims to analyze the epidemiology, incidence, and treatment of tibial plateau fractures in Germany from 2019 to 2022. The focus is on understanding demographic trends, clinical presentations, and surgical management strategies for this severe injury. Methods A retrospective cohort study was conducted using data from the German Institute for the Hospital Remuneration System (InEK) from 2019 to 2022. Cases were identified using the International Classification of Diseases 10th Revision (ICD-10) codes related to tibial plateau fractures, and documented surgical procedures were categorized using OPS codes. The Patient Clinical Complexity Level (PCCL) was used to assess the severity of cases. Results A total of 79,158 cases of tibial plateau fractures were recorded during the study period, with an incidence of 22.4–25.3 per 100,000 inhabitants. Women were more frequently affected, accounting for 61.5% ± 1.1% of cases annually. The average hospital stay was 9.2 ± 0.1 days, and 76.5% ± 0.5% of patients were categorized at PCCL 0. Most fractures were multifragmentary 68.8% ± 1.3%, and the predominant documented treatment method was open reduction and internal fixation with plate osteosynthesis 63.5% ± 2.8%. 23.6% ± 2.2% of cases required bone grafting, with a preference for allografts. Conclusions Tibial plateau fractures represent a significant and stable burden in Germany, with an incidence ranging from 22.4 to 25.3 per 100,000 inhabitants. Women accounted for 61.5% ± 1.1% of cases, highlighting a gender-related predisposition. The mean hospital stay remained stable at 9.2 ± 0.1 days. The study underscores the need for tailored treatment strategies and highlights the importance of preventive measures, particularly for the elderly population, in order to reduce the incidence of these fractures. Future research should focus on improving surgical techniques and postoperative care to enhance patient outcomes and potentially reduce hospital stay durations.

Background: Patients who undergo extracorporeal cardiopulmonary resuscitation (ECPR) are at risk of left ventricular distention and complications. There is emerging evidence that concurrent mechanical left ventricular (LV) unloading (e.g. an intra-aortic balloon pump, or microaxial left ventricular assist device) may improve survival. Despite this, there are no large, well-conducted studies investigating the impact of LV unloading on outcomes in ECPR. Methods: We queried the Extracorporeal Life Support Organisation (ELSO) registry between 2020 and 2023, and used an emulated target trial framework to investigate the association between concurrent mechanical left ventricular unloading and outcomes in patients receiving ECPR. We imputed missing data using multiple imputation with chained equations, and identified potential confounders implicated in the causal pathway between ECPR and survival time up to 90 days (primary outcome). We used propensity score-matching to adjust for potential confounders, and analysed the primary outcome using a Cox proportional hazards model. We then emulated further target trials based on the inclusion criteria of prior ECPR RCTs to assess whether concurrent unloading was associated with better outcomes based on these criteria. Secondary outcomes included complications from ECPR as classified by ELSO, and survival with favourable functional outcome defined as a Cerebral Performance Category (CPC) 1-2. Results: Of the 3,215 patients included in our analysis, we matched 621 pairs of patients who did and did not receive LV unloading. There were no significant differences in survival time between both groups (HR 0.92, 95%-CI 0.79-1.08), nor survival with favourable functional outcomes (OR 1.15, 95%-CI 0.67-1.99). This was concordant across several sensitivity analyses. Of note, LV unloading was associated with a higher rate of renal (OR 1.55, 95%-CI 1.16-2.07) and cardiovascular (OR 1.60, 95%-CI 1.14-2.26) complications. LV unloading was also associated with central nervous system bleeding (OR 1.75, 95%-CI 1.03-2.96), arrhythmias (OR 1.56, 95%-CI 1.04-2.36), and haemolysis (OR 1.85, 95%-CI 1.10-3.09). Conclusions: Left ventricular unloading was not associated with improved survival in the context of ECPR and may increase complication rates. Randomised data are required to confirm these findings.

Background The relationship between obesity and osteoporosis has been widely studied. Studies have shown that relative fat mass (RFM) can be used to predict obesity. However, its relationship with bone mineral density (BMD) is unclear. The aim of this study was to investigate the relationship between RFM and lumbar BMD. Methods We used data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018. Multiple linear regression models were applied to examine the relationship between RFM and lumbar BMD. We used smoothed curve fitting and threshold effect analysis to check for non-linear trends. Subgroup analyses were performed to explore differences in various populations. The Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic potential of body mass index (BMI), weight-adjusted waist circumference index (WWI), waist circumference (WC), and RFM for OP. Results A total of 10636 participants were included. Multiple linear regression showed a significant negative link between RFM and lumbar BMD. In subgroup studies and smoothed curve fitting, RFM was consistently associated with lower BMD across subgroups. ROC curve indicate that RFM is more sensitive than BMI, WWI and WC in diagnosing OP capacity. Conclusion RFM is negatively associated with lumbar BMD in US adults. This suggests that RFM contributes to the study of low BMD.

Introduction The global dietary supplements (DS) market is expanding, numerous adults regularly consume DS. Potential interactions with prescribed medications raise concerns, but communication about DS intake during medical consultations remains limited. This study explores general practitioners’ (GPs) perceptions of communication on DS during periodic health examinations (PHEs). Methods We conducted a cross-sectional online survey among 162 German GPs between May and August 2021. The pseudonymized web-based questionnaire assessed DS-related was carried out to analyze quantitative data. Results In total, 162 general practitioners (GPs) participated in the survey, aged 50.2 years (±11.1). While 64.8% of GPs considered DS to be an important topic, 38.8% rarely or never (<25% of conducted PHE) addressed DS during PHEs. Personal DS use (Cramers’ V = 0.407; P < .001) and considering DS an important topic (Cramers’ V = 0.231; P = .016) were associated with more frequent discussions about DS. Time constraints (24.9%), competing priorities (21.4%), and uncertainty about DS (20.5%) were identified to be the main barriers. Suggestions for improving communication included offering more reliable information and including DS in the medication plan. Conclusion This is the first study addressing communication about DS in Germany. Despite recognizing the relevance of DS, GPs’ communication practices remain limited due to time constraints and competing priorities. Integrating DS in the PHE could identify potential interactions with medication, strengthen patient-doctor-relationship, and satisfy patients’ needs for individualized counseling. Implementation of standardized DS documentation in medication plans and the provision of evidence-based information resources may improve patient safety and fulfill GPs informational needs.

Zusammenfassung Die Durchführung der flexiblen Rhinolaryngoskopie ist eine häufig angewendete HNO-ärztliche Untersuchungsmethode. Sie erfolgt regelhaft mit wiederverwendbaren Endoskopiesystemen. Seit 2019 stehen alternativ flexible Einweg-Rhinolaryngoskope verschiedener Hersteller mit und ohne Arbeitskanal auf dem deutschen Markt zur Verfügung. In den letzten Jahren gelten deutlich gestiegene hygienische Anforderungen und Vorgaben für die Aufarbeitung wiederverwendbarer Endoskope. Diese Arbeit evaluiert anhand von Fragebögen die Benutzerzufriedenheit des Einweg-Endoskopiesystems mit Arbeitskanal der Firma Ambu innerhalb einer bizentrisch durchgeführten Beobachtungsstudie. Der Gesamteindruck des Endoskopie-Einwegsystems mit Arbeitskanal wurde in der Hälfte der Fälle mit „sehr gut“ bewertet. Bildqualität und Handhabung wurden vorwiegend mit „gut“ bis „sehr gut“ beurteilt. Die parallele Bedienung von Instrumenten durch den Arbeitskanal stellt eine Herausforderung dar. Einweg-Rhinolaryngoskopiesysteme bieten eine hervorragende Handhabung, Bildqualität und Anwenderzufriedenheit. Im Hinblick auf Kontaminationsrisiken und Komplikationsraten bieten sie eine hohe Sicherheit. Die Einhaltung aktueller Hygienerichtlinien kann zu steigenden Kosten in der Wiederaufbereitung von Endoskopie-Mehrwegsystemen führen und Einweg-Endoskope zukünftig attraktiver machen. In Kombination mit einem integrierten Arbeitskanal können Endoskopie-Einwegsysteme aus hygienischen Betrachtungen einen echten Mehrwert gegenüber den Mehrwegsystemen bieten.

Background The tumor microenvironment is crucial for prognosis and response to immunotherapy in several tumor entities. Methods In a multicenter retrospective study, a total of 86 tumor samples from patients with metastatic melanoma were evaluated for baseline expression of indoleamine 2,3-dioxygenase (IDO) and programmed death ligand 1 (PD-L1). Expression patterns of IDO and PD-L1 on tumor cells and antigen-presenting cells (APCs) as determined by immunohistochemical (IHC) staining of paraffin-embedded tissue sections were correlated with response to ipilimumab and overall survival (OS). Statistical analysis was performed using the Spearman correlation, the Mann-Whitney test and Kaplan-Meier estimator. Results IDO expression in tumor cells or APCs was not predictive for treatment response. The median OS was 26 months in IDO-positive and IDO-negative patients, regardless of IDO expression in tumor cells or APCs. A correlation of IHC expression scores of IDO and PD-L1 could not be documented. Conclusion The exact role of IDO in creating an immunosuppressive tumor environment and its reversal needs to be further elucidated.

Cancer-associated thrombosis (CAT) remains a critical concern in hematology and oncology, contributing significantly to morbidity and mortality. The interplay between malignancy and hemostasis has been extensively studied, yet it continues to present clinical challenges and opportunities for advancement in prevention, treatment, and management. This special issue of Haemostaseologie—Progress in Haemostasis—Disorders of Thrombosis and Hemostasis in Cancer brings together seven review articles that explore diverse aspects of CAT, shedding light on current practices and emerging trends. Publication History Article published online: 07 May 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Graft-versus-Host disease (GvHD) ensues as the most common non-relapse complication after allogeneic hematopoietic cell transplantation (allo-HCT). A pivotal goal in GvHD management revolves around quelling inflammation. Phagocytic clearance of inflammatory cells contributes substantially to termination of inflammatory processes. Nevertheless, the precise functions of phagocytosis in GvHD remain largely unclear. In this study, we identified the "don't eat me"-signal CD47 as a promising target for therapeutic interventions aimed at eradicating alloreactive T-cells subsequent to allo-HCT. Analysis of global data sets revealed a remarkable upregulation of CD47 expression on T-cells residing in the ileum of patients with inflamed intestine. Building on this finding, we examined CD47 levels in the gastrointestinal tract (GIT) following allo-HCT. Our work not only confirmed upregulated CD47 expression in the GIT of GvHD patients, but also identified CD47 on T-cells in the ileum of GvHD mice after allo-HCT. Additionally, we found that activated donor T-cells suppress antibody-dependent cellular phagocytosis (ADCP) via CD47 signaling in vitro. Application of anti-CD47 antibodies significantly invigorated the impaired ADCP of activated T-cells. Administering anti-CD47 antibodies to mice elevated phagocytosis of T-cells in the GIT, induced immunosuppressive responses and improved survival. Finally, transplantation of CD47 deficient donor T-cells significantly improved clinical GvHD score with improved survival after allo-HCT. Collectively, our findings illuminate CD47 upregulation as pivotal mechanism in GvHD patients, leading to impaired phagocytic clearance of alloreactive T-cells. This study proposes that anti-CD47 treatment could rectify the compromised phagocytosis of alloreactive T-cells, thereby aiding in the resolution of inflammation after allo-HCT.

Purpose Patients receiving CD20-directed therapies are known to insufficiently develop neutralizing antibody titers against SARS-COV-2 after two vaccinations. We investigated the impact of a third and fourth vaccination, possibly deriving predictive factors. Methods In a monocentric, prospective, non-interventional observational study patients who had received at least one administration of a monoclonal CD20 antibody (mCD20Ab) within 9 months prior to vaccination were included to receive mRNA-based third vaccination. SARS-COV-2 IgG titer was determined before and four weeks after immunisation. Patients without adequate humoral immune response proceeded to a fourth vaccination. Furthermore, tolerability and prespecified potentially influencing factors such as age, baseline lymphocyte counts and others were analysed. Results Twenty-four patients were included and vaccination was well tolerated. Quantitative analysis of humoral response four weeks after third vaccination revealed a significant increase which, however, did not translate into a clinically relevant seroconversion rate. In the subgroup analysis, patients older than 65 years and mCD20Ab therapy longer than 6 months ago benefited. All evaluable patients on mCD20Ab monotherapy (n = 7) showed an immediate or delayed immune response after third vaccination, while all non-responders (n = 7) were on combination therapy. Clinical parameters such as lymphocyte count, immunoglobulin status and others did not appear to have any influence. Conclusion An interval of at least 6 months after the last mCD20Ab administration and mCD20Ab monotherapy appears to be favorable for humoral immune response to third vaccination. Furthermore, patients can be reassured that delayed immune responses are possible. Future studies should therefore also investigate seroconversion at later time points.

Background PD‐1 or BRAF + MEK inhibition is considered the current gold standard in adjuvant melanoma therapy. Little is known if, after the recurrence of the disease and surgery, a second course of adjuvant therapy might be beneficial. Methods A multicenter, retrospective study investigating a second course of adjuvant therapy after recurrence and surgery in stage III–IV melanoma patients. Patients received nivolumab (NIV), pembrolizumab (PEM) or dabrafenib plus trametinib (D + T) between 01/2017 and 10/2021. The primary endpoint was 12‐month recurrence‐free survival (RFS2). Further analyses included descriptive and correlative statistics. Results Sixty‐six patients from 22 centers in Germany, Austria and Switzerland were included. Thirty‐two patients received D + T as second‐course adjuvant therapy, 9 patients received PEM and 25 patients received NIV. Recurrence‐free survival for the second‐course adjuvant treatment (RFS2) was assessed after 12 and 24 months and showed a superiority of adjuvant BRAF + MEK over PD‐1 therapy (12‐months RFS2: 90.6% vs. 70.6%, HR 4.226 [95% CI 1.154–15.48]; p = 0.030; 24‐months RFS2 71.9% vs. 52.9%, HR 3.154 [95% CI 1.374–7.242]; p = 0.007). There was no significant decrease in OS with either BRAF + MEK or PD‐1 treatment (12‐months OS: 100% both, 24‐months OS: 100% vs. 93.8%). Furthermore, therapy sequences were investigated. For better comparability, only BRAF V600 mutated patients were assessed: RFS2 was significantly better for patients with a class switch from PD‐1 to BRAF + MEK compared to BRAF + MEK to PD‐1 (HR 4.401 (1.04–18.63), p = 0.044). No new safety signals were detected. Conclusion In the investigated cohort, a second course of adjuvant melanoma treatment is feasible and provides similar RFS compared to an initial course of adjuvant therapy using BRAF + MEK inhibitors; however, RFS2 is reduced for PD‐1 antibodies. In addition, both treatments were convincing with a 24‐month OS of almost 100%. Switching from adjuvant PD‐1 to BRAF + MEK treatment provided better overall RFS compared to switching from adjuvant BRAF + MEK to PD‐1 treatment.

Zusammenfassung Die initiale Einschätzung des Neugeborenen nach der Geburt kann in Deutschland Richtlinien-konform durch eine Ärzt:in oder eine Hebamme erfolgen. Es ist jedoch unklar, wer die U1-Untersuchung mit welcher Qualifikation derzeit tatsächlich durchführt. Ziel der Studie war es, zu untersuchen, welche Professionen derzeit in den größten Geburtskliniken Deutschla die Erstuntersuchungen der Neugeborenen tatsächlich durchführt. Alle Geburtskliniken, die 2021 über 2000 Geburten aufwiesen, sowie alle universitären Geburtskliniken wurden gebeten, einen webbasierten Fragebogen zu beantworten. Für die Gruppenvergleiche wurde ein Chi-Quadrattest durchgeführt. 77 von 111 kontaktierten Geburtskliniken beantworteten den Fragebogen. Insgesamt führen in den größten deutschen Geburtskliniken fünf verschiedene Professionen die Erhebung der Apgar-Scores und die U1-Untersuchung bei gesunden Neugeborenen durch. Hebammen erheben in 92% der Geburtskliniken regelhaft die Apgar-Scores. U1- Untersuchungen werden zwar ebenfalls an den meisten Häusern regelhaft unter Beteiligung von Hebammen durchgeführt (74%), aber an signifikant (p≤0,001) weniger Häusern als die Erhebung der Apgar Scores. Universitäre und nicht-universitäre Geburtskliniken unterscheiden sich nicht signifikant in der regelhaften Durchführung von Apgar Scores (93,9% vs. 90,9%, p=0,623) und U1-Untersuchungen (72,7% vs. 75%, p=0,822) durch Hebammen. Hebammen sind an deutschen Geburtskliniken mit großem Abstand die dominante Berufsgruppe, wenn es um die Durchführung der Erstuntersuchungen von Neugeborenen geht. Damit sollten sie in Zukunft auch erste Ansprechpartner bei Maßnahmen der Qualitätssicherung/- verbesserung für die Erstuntersuchung sein.

Background Simulator-based training (SBT) transforms medical education from traditional methods to technology-driven simulations for safer, complex scenario learning. This study examines perceptions, benefits, drawbacks, and challenges of such training, focusing on ultrasound simulations among medical students and physicians. Methods The study surveyed 343 participants: 154 third-year medical students, 97 practical-year students, and 92 physicians across various specialties. A digital questionnaire was used to analyze their views on SBT, featuring main- and sub-items evaluated through a Likert scale and dichotomous questions. Results Widespread exposure to SBT was evident, notably in ultrasound simulator usage, where over 60% of all respondent groups reported prior experience. Significant disparities in acceptance and assessment between students and physicians were noted, particularly highlighting inconsistent integration into mandatory education and a marked deficit in physicians’ training (p < 0.001). All groups acknowledged the relevance of SBT for developing practical skills and patient safety. The interest in ultrasound simulator use showed variability across specialties (p < 0.001). While ultrasound pathology training was highly valued, doubts about simulators replacing hands-on patient experience persisted. Conclusions Our study highlights the necessity for enhanced integration of SBT within medical curricula. It highlights the significance of adaptive teaching methodologies and singles out ultrasound simulator training as essential for practical skill development. Future research should concentrate on creating comprehensive customized teaching strategies to elevate the quality of patient care.

Objectives: To evaluate the patient-reported impact of retinitis pigmentosa (RP) in a large patient cohort to identify relevant disease-related disadvantages as key aspects for the improvement of ophthalmic and social care. Methods: Consecutive patients with molecularly confirmed RP older than 18 years of age were identified in two tertiary care centers in Germany. Patients were contacted to participate in an anonymized patient query regarding the impact of RP on their vocational training, professional career, and social, familial, and personal life, as well as their experience with ophthalmologic care. Results: Out of 241 contacted patients, 162 responded (67.2%; 52.5% female, 67.3% younger than 50 years of age). While the impact of RP on vocational training was limited, professional careers were frequently disrupted with early retirement rates of 39.8% (≥40 years of age) to 50% (≥50 years of age). Most respondents felt restricted in their participation in public life (66.3%). One-fifth complained about financial restrictions; however, one-third of this number did not obtain financial help. A negative impact on familial life (21.4%) was less frequently reported compared to personal impairments, especially anxiety (74.5%) and depression (24.2%). Most respondents considered their ophthalmic care as adequate; however, a delayed diagnosis (≥two years: 28.6%) and initial misdiagnosis (24.0%) were frequent. Insufficient psychological support was the major complaint about professional care. Conclusions: RP affects the lives of patients in multiple aspects. Ophthalmic and social care providers should focus on the acceleration of the diagnostic process, as well as easy access to financial assistance and psychological support, as key areas for improvement. Improvements in these areas are expected to reduce challenges for patients. They should have an impact on rehabilitation, participation in public life, and quality of life.

Background Emergence of periodic leg movements (PLM) on adaptive servo‐ventilation (ASV) is well known in patients with chronic heart failure and reduced ejection fraction (HFrEF), but its clinical significance remains unclear. We investigated the effect of ASV on the emergence of PLM with arousal (PLMA) in HFrEF patients with obstructive or central sleep apnea (OSA or CSA) and determined whether emergent PLMA modifies the effect of ASV on fatigue and sleepiness. Methods Sixty stable HFrEF patients (ASV n = 29, control n = 31) with moderate to severe OSA or CSA were included. Polysomnography (PSG) was obtained at baseline and after 12 weeks. Results In HFrEF patients with OSA and CSA, ASV significantly increased PLMA‐Index compared to control. ASV was associated with a significant reduction in Epworth sleepiness scale (ESS) and fatigue severity scale (FSS) in patients without emergent PLMA (52%) compared to those with emergent PLMA (48%; delta ESS: −3 (−3; 0) vs. 2 (−2; 4) p = 0.027; delta FSS: −1.3 (−2.1; 0.1) vs. −0.3 (−1.1; 1.7) p = 0.031) and compared to controls (0 (−1; 1) p = 0.039); (0.1 (−0.9; 0.4) p = 0.034). Conclusion ASV treatment increases PLMA in some HFrEF patients with OSA or CSA. On ASV treatment, patients reported only improved sleepiness and fatigue if no PLMA emerged.

Background In palliative care, alternative routes for drug application besides the oral and intravenous administration are frequently necessary. Up-to-date, very little is known about the familiarity, use and perceived relevance of inhalative medications for symptom control among palliative care practitioners. Methods We conducted an anonymous online survey among palliative care physicians throughout Germany between 09/2021 and 04/2022. The questionnaire covered participants’ sociodemographics, as well as familiarity, perceived relevance and prescription practices regarding 21 nebulised drugs. Analysis was performed using methods of descriptive statistics. Results 108 fully completed questionnaires were analysed. Most of the participants were employed in palliative care for 5 + years. The administration of normal saline, mucoactive drugs, bronchodilators and steroids via nebulisation was a widely known and frequently used technique among the participants, as evidenced by its regular use in clinical routine. About 50% of the participants reported to know epinephrine and tranexamic acid for anti-oedematous or haemostyptic effects, respectively. Both drugs were considered “relevant” by more than 60% of the prescribers. Only a minority of participants reported to know and use nebulised opioids, iloprost, several antibiotics, heparin, ketamine and lidocaine. Conclusions Our survey shows that nebulised drugs are prescribed and considered relevant in palliative care. However, for several of the mentioned medications only limited data is available regarding use and effectivity. There is also uncertainty to what extent the existing data may be transferable into routine palliative care setting. Therefore, more evidence should be generated. Trial registration Not applicable.

Introduction PET imaging is a key diagnostic procedure in clinical routine worldwide. While public figures on PET volume are available in many countries, until now these numbers were not publicly known for Germany. Methods On behalf of the PET committee of the German Society of Nuclear Medicine, we conducted a comprehensive survey among PET centers in Germany to collect data on PET imaging, including the total PET volume and indication groups. Results National total PET volume in 2021 was 154,400 scans (94% PET/CT, 6% PET/MRI). PET volume in 2021 normalized to total population was lower in Germany (1,857 scans per 1 million inhabitants) when compared to public figures from France (10,182 scans), Belgium (9,866 scans), or Italy (4,312 scans). PET volume in Germany demonstrated significant growth 2017 to 2021 (+ 48%). Top three indication fields were oncological (re)staging (76%), theranostic (13%), and neurology (4%). The top three indications were lung cancer (31%), prostate cancer (16%), and lymphoma/leukemia (12%). The top three radiotracers used were [¹⁸F]FDG (75%), PSMA radioligands (17%), and somatostatin-receptor radioligands (8%). Conclusions Clinical adoption of PET imaging in Germany is behind compared to Italy, France, and Belgium. However, newly established outpatient reimbursement seems to contribute to recent growth in PET volume. We observe considerable shift towards theranostic applications.

Background The COVID-19 pandemic significantly disrupted healthcare systems, particularly affecting vulnerable populations such as children and individuals with special needs, causing delays and reductions in routine dental services. The aim of this study was to evaluate level of access and identify determinants of access to oral healthcare for children aged 0–13 during COVID-19 restrictions. Methods Mixed-methods research design was adopted. This cross-sectional study included 270 children aged 0 to 13 years who visited Ege University Pediatric Dental Clinics between August 2021 and February 2022. Interviewer-administered questionnaires collected information about sociodemographic and economic characteristics, as well as dental service utilization during the pandemic. “Access” to receive oral health care to address existing dental problems is defined separately for each application to the institution. Statistical analyses were conducted using IBM SPSS Statistics 23, with Pearson’s Chi-Square, Fisher’s Exact, and Binary Logistic Regression tests applied to examine variable relationships. A 95% confidence interval and a significance level of p < 0.05 were adopted, with model fit assessed using the Hosmer-Lemeshow test and Nagelkerke R². Qualitative data from 16 in-depth interviews were analysed using thematic analysis to explore the barriers to accessing oral healthcare during the COVID-19 pandemic. Results During the pandemic, 62.3% of dental institutions’ applications had limited access to care. Parental education, employment status, and household income significantly affected access (p < 0.005). Multiple logistic regression revealed that applying to university clinics (OR = 4.78; 95% CI 2.24–10.21) and private institutions (OR = 4.33; 95% CI 2.30–8.17) led to higher access rates when compared to public dental centres. The father’s regular employment (OR = 3.39; 95% CI 1.37–8.34) and the child’s previous dental contacts (OR = 2.37; 95% CI 1.21–4.62) increased the likelihood of accessing oral healthcare. The risk of contracting infections and income loss were pandemic related barriers. The most common barriers were those concerning the availability of services at public dental clinics. Children with disabilities faced further barriers due to the risk of infection, difficulty reaching institutions, and unmet dental needs for treatment under general anaesthesia. Conclusion Higher socioeconomic status and past contact with dentists had a positive effect on oral healthcare access. Dental services provided by public institutions had a lower level of access. The COVID-19 pandemic highlighted oral healthcare inequalities, particularly for those children with disabilities in Türkiye. Policymakers should strengthen public health crisis plans in order to improve children’s oral healthcare access.