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Patients Singleton–Merten syndrome is an extremely rare autosomal dominant condition with less than 10 reported cases in the literature. It is characterized by abnormal aortic calcifications and dental abnormalities. The goal of this case report is to discuss the abnormal oral clinical features and the modified treatment protocol that was used in order to achieve osseointegration of dental implants in a patient having abnormal bone density and bone turnover associated with Singleton–Merten Syndrome. Discussion Following extraction of the remaining teeth, titanium implants (Friadent GmbH, Mannheim, Germany and Straumann ® , Basel, Switzerland) were placed in the upper and lower jaw of the patient. The upper jaw which was treated with dental implants, received a bar supported implant retained prosthesis and the lower jaw an implant retained telescopic prosthesis. The patient was regularly followed up for the past 13 years during which, clinical and radiological evaluation of osseointegration was undertaken. All the loaded implants showed clinical and radiographic evidence of osseointegration. With a follow up of 13 years after insertion of the first implant, the patient reported functioning well with no complications. Conclusion The treatment with dental implants in the extremely rare Singleton–Merten syndrome patients is a reasonable treatment option to rehabilitate maxillofacial aesthetics and establish normal function of the jaws.

Statement of problem While a considerable body of literature deals with the comparison between visual and instrumental tooth color determination, in most of these studies either the number of color specimens or the number of examiners is too small to allow for a general statement about such a subjective method as visual color determination. Furthermore, perceptual aspects like perceptible or acceptable color differences are often not considered. Purpose The purpose of this study was to investigate the precision of a spectrophotometer in tooth shade determination compared with visual color matching using a shade guide in vitro. Moreover, the influence of different illuminants as well as of sex and professional experience of the examiners on visual color matching was analyzed. Material and methods Fifty examiners (13 men, 37 women; without dyschromatopsia), grouped by professional experience, determined the shades of 10 prosthetic teeth with the Vitapan classical shade guide under 4 illuminants (daylight, halogen, fluorescent [5000 K], fluorescent [nonspecific ceiling light]) and with a spectrophotometer (Shadepilot). Reproducibility (precision) of color determination was characterized by the average of the highest percentages of interexaminer agreement for each specimen. Additionally, color differences (ΔE) were calculated based on CIELab values. Results The mean reproducibility of the spectrophotometer was 92.2%, while for visual examination it was 43.7%. The corresponding differences in CIELab color space amounted to ΔE instr =2.6 and ΔE vis =5.2. Illuminants and professional experience showed a significant influence, while sex did not. Conclusion While the spectrophotometer provided higher reproducibility, considering the color differences, the results obtained by visual inspection were still satisfactory. The differences due to type of illuminant, degree of experience, and sex of the examiners are of little practical relevance.