Biomedical subjects
Publications and source records attributed to H Erpenstein.
Failure-time analysis of Dicor single crown restorations: Statistical methods of survival-analysis according to Kaplan-Meier were applied to investigate the effects of the fracture of 159 Dicor-restorations in 82 patients in a private dental office. After 33 months of service 77% (+/- 15%; 95% Conf. Int. for the mean) of the crowns were still under risk. Fractures were very high in molar crowns.
A prophylactically oriented concept of periodontal treatment is inconceivable without purpose-trained personnel. This fact led to the new profession of dental hygienist, being introduced into many countries more than 15 years ago. In Germany, attempts were made to close the gap with the profession of dental assistant (ZMF). This model has, however, proved a failure because--besides the advanced training curriculum not being sufficiently specialized--the demand for dental assistants is far greater than the supply. Many dentists, therefore, employ assistants with relevant training in the form of updating courses. Apart from the fact that this frequently results in legal misgivings, it also fails to meet the demand. For this reason, it is absolutely essential that personnel structures be adapted nationwide to a prophylactically oriented concept of periodontal treatment. Account is being taken of experience already gained abroad, as well as current opportunities for training and advanced training in Germany, including the legal principles valid in this country.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The inter-relationships between the periodontal situation of a patient and a prosthetic appliance should be regarded in particular from the aspect of oral hygiene. Creating or maintaining a high standard of oral hygiene is thus the joint objective characterizing cooperation between the periodontist and the prosthodontist. The tasks falling to the prosthodontist during initial therapy are: removal and temporary replacement of restorations that are not conducive to good oral hygiene, temporary replacement of teeth with hopeless prognoses, and temporary prosthetic planning in conjunction with the periodontist. In the phase of surgical periodontal treatment, the creation of new attachments should be accompanied by morphologic corrections; these are essential to the oral hygiene of patients with prosthetic appliances. The prosthodontist has therefore to advise the periodontist on what corrections are desirable and where. This applies firstly to gingival corrections at abutment teeth and secondly to mucosal corrections on the edentulous alveolar ridge. On conclusion of the periodontal treatment, the prosthodontist will have to come to terms with three problems: the indication for prosthetic treatment, the decision between fixed bridges and removable partial dentures, and the periodontal problem zones occurring with crowns and bridgework. The indications for prosthetic treatment can now be more restricted, following recent findings on oral function with shortened dental arches. When deciding between fixed bridges and removable partial dentures, it is the oral hygiene aspect that is decisive. In existing or threatened free-end situations preference should be given to bridgework. This can be implemented with: cantilever bridges, bridges abutted at each end by the distal movement of a premolar, and bridges abutted at each end by hemisectioning of a periodontally damaged molar. With crowns and bridges, prospects for oral hygiene are determined by the following: the position of the crown margin, the contour of the crown in the marginal area, and the contour of the under-surface of the pontic. If optimum prospects for oral hygiene have been created by good coordination between the periodontist and the prosthodontist, the prognosis in the maintenance phase is considerably improved.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The problems of periodontal and prosthetic treatment are demonstrated with a typical case of oral erosive lichen planus with gingival involvement. The results attained suggest that oral lichen can be improved by optimum plaque control and periodontal treatment. Prosthetic treatment should be based on bridgework and not on removable partial dentures owing to the isomorphous irritant effect that characterizes lichen planus. Once the plaque situation is firmly under control, even teeth with advanced destruction of the supporting tissues may be used as abutments. In the event of all molars being absent, cantilever bridges should be fitted. In this case it is not essential to replace all the molars provided that the masticatory function is subjectively adequate.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Over a period of 1-7 (average 2.9) years, 34 hemisectioned molars were examined clinically and radiographically. All patients were kept on a 3-6 month recall system. The indications for hemisectioning were periodontal in 9 cases and endodontic in 20 cases. In 4 cases extensive carious destruction, and in 1 case an external granuloma led to hemisectioning. Mainly mandibular molars were treated (27). Root resectioning was carried out on only 7 maxillary molars, 22 of the treated teeth were used as distal abutments for small fixed bridges. For a further 3 the same was planned. The remaining treated teeth were singly crowned. Of the 34 treated molars, 7 were considered failures, 6 for endodontic reasons (apical periodontitis) and only 1 for periodontal reasons. No correlation between failure and the length of the follow-up period was found. With 17 of the 34 molars a significant reduction in periodontal pocket depths was recorded between commencement of treatment and the final examination. No difference in periodontal pocket depth or in the height of the alveolar crest was found between hemisectioned and non-hemisectioned surfaces. The mobility of hemisectioned molars was difficult to judge because 22 of the 31 crowned teeth were used as abutments for bridges. 17 of the 22 bridges were firm, 4 showed mobility of 1 degree, and 1 mobility of 11 degrees. Of the singly crowned teeth, only 1 exhibited mobility of 111 degrees. This study indicates that the prognosis for hemisectioned teeth is favourable. Failures were primarily endodontic in origin rather than periodontal. Periodontal damage can be kept to a minimum by regularly reviewing oral hygiene standards. Treated teeth may be used as abutments for small bridges if attention is paid to achieving optimal articulation.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Various X-ray techniques (panorama views and intraoral plates) were contrasted and evaluated for diagnostic use in periodontal lesions. In addition the Status X-unilateral technique (Durner, Meyer) was compared to intraoral right angle roentgen states (Updergrave) in the examination of 20 patients.
After 8 years' use of the periodontal status, recommendations for alterations to it are put forward for discussion, based on our own experience and on the evaluation of 218 analysed parodontal statuses. The headings "previous history", "function" and "diagnosis" are discussed in greater detail. Because of the significance of plaques as aetiological factors, it is recommended that a headling of plaque diagnosis should be added to the status.
Caries incidence and gingival irritation were studied in 245 teeth with partial crowns of 62 patients of a dental practice after an average 3.24 years of wearing such crowns. At the beginning of the treatment, the group of patients tested showed an average caries incidence with a DMFT index of 14.9 +/- 4.0. In the follow-up, the mean value of the simplified OH index was 1.16 +/- 0.34. None of the partial crowns had to be re-cemented because of insufficient retention in the period covered by this study. Secondary marginal caries developed in only 0.4%, primary caires in 6.1% of the teeth with partial crowns. Marginal inflammation was significantly more frequent in teeth with partial crowns than in teeth without crowns. When evaluating the individual sections of the crowns, the highest degree of inflaterproximal region.
Muco-periosteal pedicle flaps, free mucosal transplants as well as a combination of these two methods may be used for treating gingival recessions. The method selected and the therapeutical success depend on whether or not the interdental gingiva is also affected. From this viewpoint, three different types of recessions can be distinguished. Type I recessions with intact interdental gingiva on both sides can successfully be treated by all methods. In type II recessions with partial loss of the interdental gingiva on one side, free transplants as well as their combination with sliding flaps show the best results. Recessions at two adjacent teeth with loss of the interdental gingiva (type III) can only be treated with free mucosal transplants. Prognosis of successful treatment diminished from type I to type III.