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Introduction: The number of mentally altered patients a dentist meets in practice is increasing and interaction with them can be very challenging. As a baseline for an interventional study, we want to assess the attitude of dental students and identify areas of improvement in patient communication. This work compares the attitude of dental students towards people suffering from dementia to the attitudes of trained medical caregivers and the general population. Our aim is to use the results to assess the need for training in communicating with mentally altered patients. Materials and Methods: Fourth‐year dental students attended two lectures on dementia given by a psychiatrist as part of the geriatric dentistry lecture and were questioned afterwards using the Dementia Attitude Scale. In 2016 and 2017, 73 students at the University of Greifswald were interviewed. The response rate was 84%. Using a factor analysis, the Dementia Attitude Scale's validated questions were interpreted and compared with data from nursing staff from Switzerland and the USA. Results: The factor analysis of the data showed the same two‐factor loadings as the comparative groups, and that dental students' attitude is more comparable to the general population than to medically trained nursing staff. Conclusion: Given the results, we conclude that the implementation of a communication module can serve in improving the attitude of dental students towards patients with dementia. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of manual and machine-aided cleaning to remove matured plaque from removable partial dentures (RPDs). Materials and Methods: A total of 32 patients with bilateral free-end saddle RPDs were included. The plaque was stained, and the RPD was photographed on all sides. One saddle was randomly allocated to manual cleaning, while the other was allocated to no cleaning. The patient manually cleaned the saddle by applying a denture brush and gel. The whole RPD was then cleaned with the aid of a machine using a rotating needle device. After each step, plaque dyeing and photography were repeated. The plaque proportions (% pixel) were measured using special software. For statistical analysis, mixed models were used to adjust for baseline covariates, including plaque and surfaces, and to cover all time points. Results: The mean plaque area without cleaning at the fitting surface was higher than at the buccal/lingual surfaces (32.8% [95% CI: 28.1% to 36.4%] vs 15.3% [13.1% to 17.4%], respectively). Manual cleaning was not substantially better than no cleaning (4.6% [-0.1% to 9.2%] for the difference at the fitting surface [showing a substantial difference of < 10%]), and the difference found was even smaller at the buccal/lingual surfaces. Machine-aided cleaning was substantially better than manual cleaning (16.1% [12.0% to 20.2%] for the difference at the fitting surface and 7.3% [4.6% to 10.0%] at buccal/lingual surfaces). The combination of manual and machine-aided cleaning was not better than machine-aided cleaning alone (-0.2% [-2.6% to 2.1%] difference at the fitting surface). Conclusion: Manual cleaning is insufficient in removing matured denture plaque. Machine-aided cleaning is superior to manual cleaning, especially at fitting surfaces. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to compare the shaping ability of four multi-file systems and one single-file system in simulated S-shaped canals. Materials and methods: Fifty S-shaped canals in resin blocks (Endo Training Bloc S-shape, Dentsply Sirona, Salzburg, Austria) were prepared to an apical size of 25.06 using ProTaper Next (Dentsply Sirona, Ballaigues, Switzerland), HyFlex CM (Coltène/Whaledent, Langenau, Germany), F6 SkyTaper (Komet, Lemgo, Germany), BioRace (FKG Dentaire, La-Chaux-des-Fonds, Switzerland) and Mtwo (VDW, Munich, Germany) systems (n = 10 canals/group). Canal transportation was assessed by comparing the pre-instrumentation and post-instrumentation images under a stereomicroscope. Material removal was measured using a digital template and image analysis software. Deformation of instruments and preparation time were also recorded. The data were statistically analysed by considering the clinical relevance and the ability to maintain the S-shaped form. Results: Canals prepared with HyFlex CM, ProTaper Next and F6 SkyTaper remained better centred compared with those enlarged with the BioRace and Mtwo systems, which removed statistically significantly greater amounts of resin from the inner side of both curvatures (P < 0.05). F6 SkyTaper and BioRace were the two fastest systems (P < 0.001). No instrument fractures occurred during canal preparation. About 78% of all HyFlex CM files were suitable for reuse. Conclusion: Under the conditions of this study, all five nickel-titanium systems were safe to use. The heat-treated systems HyFlex CM and ProTaper Next maintained the original canal curvature better than instruments made of conventional nickel-titanium. Less tapered instruments at the sequence's beginning had a positive effect on the systems' centring ability. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this investigation was to compare the chewing efficiency after immediate and delayed loading of mini-implants that served as supplementary support for removable partial dentures (RPDs). Materials and Methods: In this four-center randomized trial, patients who had RPDs in arches with unfavorable tooth distributions, ie, no canine and at most two posterior teeth in one or both quadrants, received strategic mini-implants with ball abutments. The mini-implants in group A were loaded immediately either by housings with O-rings (insertion torque ≥ 35 Ncm) or by soft relining material (insertion torque < 35 Ncm). In group B, the RPDs were only hollowed over the balls. After 4 months, the soft relined RPDs and all RPDs of group B received the housings. Masticatory efficiency was evaluated with a validated mixing ability test of two-colored chewing gum before surgery and 14 days, 4 months (before housing pickup), 4.5 months, and 12 months after surgery. The circular variance of hue was the measure of mixing. Results: From 76 participants with 79 RPDs, 38 each were randomly allocated to group A or B. In group A, the housings in six participants were picked up immediately, and the remaining RPDs were primarily soft relined. There was a significant group difference only after 4 months. The mixing ability was better after immediate loading than after delayed loading (P < .0001). In group B, the chewing efficiency was notably deteriorated after the RPDs were hollowed over the ball abutments. However, immediately after all housings were picked up, the chewing efficiency in both groups was substantially improved, and the variance of hue values after 1 year were very similar in the groups. Conclusion: The chewing performance can be improved by inserting supplementary mini-implants under existing RPDs with unfavorable tooth support. This improvement occurred faster by immediate loading than by delayed loading. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate changes in distribution of teeth and in prosthodontic tooth replacement during an 11-year period in an adult population.Materials and Methods: Information on prosthetic status was collected from 4,288 participants aged 20 to 81 years at baseline in the Study of Health in Pomerania (SHIP-0) and from 2,244 participants aged 30 to 92 years who reappeared in the 11-year follow-up (SHIP-2). The tooth distribution per arch was classified into one of the six following classes: class 0 (edentulous), class 1 (one to three remaining teeth), class 2 (extended tooth-bounded space or extreme shortened dental arch), class 3 (small anterior space), class 4 (small posterior space with one or more missing premolars), or class 5 (functional dentition).Results: Longitudinally, the most pronounced change in class was the transition from class 1 to class 0 (maxilla: 54.5%, mandible: 58.3%). The percent change from other higher classes to lower classes ranged between 10% and 40%. In the same age groups of 40 to 79 years, the number of edentate arches was cut in half, with a corresponding increase in functional dentitions. The proportion of unrestored arches decreased in all classes. Double crown-retained partial removable dental prostheses (PRDPs) showed the highest increase (a 15% to 20% increase) at the expense of acrylic PRDPs in classes 1 and 2. In small spaces, the proportion of fixed dental prostheses (FDPs) also increased by 15% to 20%. Seven participants of SHIP-0 (0.16%) and 56 participants of SHIP-2 (2.5%) had dental implants.Conclusion: Similar age groups showed improvement in oral conditions. The proportion of higher-end restorations (FDPs and double crown-retained PRDPs), including the frequency of dental implants, increased. [ABSTRACT FROM AUTHOR]

Introduction: We investigated the relationship between periodontal treatment and pre-clinical Alzheimer’s disease (AD). Methods: In this quasi-experimental design, 177 periodontally treated patients from the “Greifswald Approach to Individualized Medicine” cohort, which used the same protocols as the population-based Study of Health in Pomerania TREND (SHIPTREND), and 409 untreated subjects from SHIP-TREND were analyzed. Subjects were younger than 60 years at the magnetic resonance imaging examination, with a median observation period of 7.3 years. Imaging markers for brain atrophy in late-onset AD and brain aging were used as the outcomes. Results:Robust to sensitivity analyses, periodontal treatment had a favorable effect on AD-related brain atrophy (–0.41; 95% confidence interval: –0.70 to –0.12; P = .0051), which corresponds to a shift from the 50th to the 37th percentile of the outcome distribution. For brain aging, the treatment effect was uncertain. Conclusion: Periodontitis is related to pre-clinical AD in our population. [ABSTRACT FROM AUTHOR]