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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.

Gerichtliche Sachverstandigengutachten werden notwendig, wenn im Streit steht, ob beispielsweise eine medizinische Behandlung ordnungsgemas verlaufen ist oder nicht. Eine Schlusselfunktion nimmt dabei der vom Gericht zu erlassende Beweisbeschluss ein. Es zeigt sich immer wieder, dass dieses Thema nicht unproblematisch ist. Daher soll versucht werden, einige Aspekte und Probleme bei der Begutachtung zu beleuchten, die sich aus der Abfassung des Beweisbeschlusses ergeben konnen bzw. sich vermeiden liesen.

Purpose In recent years, the growing readiness on the part of dental patients to take legal action has resulted in an increasing number of medical liability lawsuits. The aim of this retrospective analysis was to highlight aspects of these lawsuits of special significance, to subject them to both qualitative and quantitative analysis, and to show how conflicts can be avoided. Materials and methods Forty relevant court decisions from the year 1984 onwards were found in online databases and through direct inquiries at the courts. These were supplemented by 21 reports prepared by experts at the University of Muenster, Department of Dental Medicine, commissioned by courts in connection with ongoing lawsuits. Analysis was initially based on formal aspects of the cases and reports. It was later supplemented by differentiated assignment of the questions addressed by the courts to the expert consultants. The principles underlying the judgments as to the liability arising from the terms of the contract were also assigned to the expert consultants in a differentiated manner. Results The results revealed marked differences in the frequency of liability-prone aspects of treatment. While the majority of judgments referred to the obligation to take due care during the preparatory and treatment phases, infringement of the obligations to provide information and to keep records played more than a minor role. Moreover, 90% of all cases represented combined charges covering various aspects, including those related to consequential failings. Discussion and conclusion The detailed qualitative analysis of the grounds quoted and of the lines of reasoning can therefore be summed up in clearly defined recommendations aimed at helping the clinician avoid conflicts by observing the judicial requirements.— Reprinted with permission of Quintessence Publishing.

Dem Wortlaut des mir gestellten Themas nach konnte man hinter den Richtlinien durchaus Qualitatskriterien vermuten, wie denn eine zahnarztliche Behandlung im Detail auszusehen habe. Geht man die Richtlinien fur eine ausreichende, zweckmasige und wirtschaftliche vertragszahnarztliche Versorgung vom 25.10.1988 (BAnz Nr. 230, S. 1), zuletzt geandert durch Bekanntmachung v. 15.9.2000 (BAnz 2001, Nr. 58, S. 495) durch, so entdeckt man indessen sehr schnell, dass solche Ausfuhrungsstandards kaum in ihnen enthalten sind, und die, die man findet, sind tatsachlich teilweise uberholt. Das irritiert insbesondere angesichts der Tatsache, dass sogleich zu Beginn der Richtlinien davon die Rede ist, dass die vertragszahnarztliche Versorgung nach dem wissenschaftlich anerkannten Stand der medizinischen Erkenntnisse ausgerichtet sei.

Die berufsrechtlichen Rahmenbedingungen fur die zahnarztliche Tatigkeit entwickeln sich zur Zeit in eine wenig erfreuliche Richtung. Das ohnehin in den letzten Jahren rapide in seiner Bedeutung gestiegene Berufshaftpflichtrecht droht ebenfalls diesem Trend zu unterliegen. Die Diskussion um zahnarztliche Materialien halt an. Kontroverse Standpunkte zur Bio-(un)vertraglichkeit und zum Teil obskure Meinungen zur haftungsrecht- lichen Verantwortlichkeit vermengen sich zu einem undurchdringlichen Nebel und tragen Orientierungs- und Ratlosigkeit in die Zahnarzteschaft. Wissenschaftlich gut untersuchte und bewahrte Werkstoffe werden als Wurzel alien Ubels inkriminiert, wahrend neue Materialien, die noch langst nicht entsprechend erforscht sind, als besonders vertraglich und biokompatibel propagiert werden. Die Verunsicherung bei allen Beteiligten hat ein unertragliches Ausmas erreicht. Wer hoffte, das mit Inkrafttreten des neuen Medizinproduktegesetzes eine europaweit einheitliche Regelung geschaffen wurde, die fur sachlich klare und rechtlich verlasliche Verhaltnisse bei der Anwendung zahnarztlicher Werkstoffe sorgt, der sieht sich enttauscht. Das Gesetz besteht in erheblichen Teilen aus Verordnungsermachtigungen, die erst die eigentliche Regelung erbringen werden bzw. sollen. Ansonsten enthalt es uber Seiten zum Teil qualende, dem Verstandnis alles andere als forderliche Begriffsbestimmungen bzw.sollen.