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author:("siebold, Dirk")
1.  Comparison of clinical and dental panoramic findings: a practice-based crossover study 
BMC Oral Health  2013;13:48.
Aim was to compare clinical findings with x-ray findings using dental panoramic radiography (DPR). In addition, type and frequency of secondary findings in x-rays were investigated.
Patients were selected on the basis of available DPRs (not older than 12 months). No therapeutic measures were permitted between the DPR and the clinical findings. The clinical findings were carried out by several investigators who had no knowledge of the purpose of the study. A calibrated investigator established the x-ray findings, independently and without prior knowledge of the clinical findings. The evaluation parameters for each tooth were: missing, healthy, carious, restorative or prosthetically sufficient or insufficient treatment. Type and frequency of additional findings in the DPR were documented, e.g. quality of a root canal filling and apical changes.
Findings of 275 patients were available. Comparison showed a correspondence between clinical and radiographic finding in 93.6% of all teeth (n = 7,789). The differences were not significant (p > 0.05). Regarding carious as well as insufficiently restored or prosthetically treated teeth, respectively there were significant differences between the two methods (p < 0.05). The DPRs showed additional findings: root fillings in 259 teeth and 145 teeth with periapical changes.
With reference to the assessment of teeth, there was no difference between the two methods. However, in the evaluation of carious as well as teeth with insufficiently restorative or prosthetic treatment, there was a clear discrepancy between the two methods. Therefore, it would have been possible to have dispensed with x-rays. Nevertheless, additional x-ray findings were found.
PMCID: PMC4015768  PMID: 24066660
Dental findings; Radiographic findings; Dental panoramic radiography (DPR); Clinical examination
2.  Effects of easy-to-perform procedures to reduce bacterial colonization with Streptococcus mutans and Staphylococcus aureus on toothbrushes 
It is well known that dental caries and periodontitis are the consequence of bacterial colonization and biofilm formation on the enamel surface. The continuous presence of bacterial biofilms on the tooth surface results in demineralization of the tooth enamel and induces an inflammatory reaction of the surrounding gums (gingivitis). The retention and survival of microorganisms on toothbrushes pose a threat of recontamination especially for certain patients at risk for systemic infections originating from the oral cavity, e.g., after T-cell depleted bone marrow transplantation. Thus, the effects of different decolonization schemes on bacterial colonization of toothbrushes were analyzed, in order to demonstrate their applicability to reduce the likelihood of (auto-)reinfections.
Toothbrushes were intentionally contaminated with standardized suspensions of Streptococcus mutans or Staphylococcus aureus. Afterwards, the toothbrushes were exposed to rinsing under distilled water, rinsing and drying for 24 h, 0.2% chlorhexidine-based decolonization, or ultraviolet (UV) radiation. The remaining colony forming units were compared with freshly contaminated positive controls. Each experiment was nine-fold repeated. Bi-factorial variance analysis was performed; significance was accepted at P < 0.05.
All tested procedures led to a significant reduction of bacteral colonization irrespective of the toothbrush model, the brush head type, or the acitivity state. Chlorhexidine-based decolonization was shown to be superior to rinsing and slightly superior to rinsing and drying for 24 h, while UV radiation was similarly effective as chlorhexidine. UV radiation was slightly less prone to species-dependent limitations of its decolonizing effects by bristle thickness of toothbrushes than chlorhexidin.
Reduction of bacterial colonization of toothbrushes might reduce the risk of maintaining bacterial infections of the upper respiratory tract. Accordingly, respective procedures are advisable, particularly as they are cheap and easy to perform.
PMCID: PMC3832098  PMID: 24265940
bacterial colonization; decolonization; oral hygiene; Staphylococcus aureus; Streptococcus mutans; toothbrush
3.  Pathophysiology of Barodontalgia: A Case Report and Review of the Literature 
Case Reports in Dentistry  2012;2012:453415.
Changes in ambient pressure occur during flying, diving, or hyperbaric oxygen therapy and can cause different types of pathophysiological conditions and pain including toothache (barodontalgia). We report the case of a patient with severe pain in the region of his mandibular left first molar, which had been satisfactorily restored with a conservative restoration. Pain occurred during an airplane flight and persisted after landing. Radiology revealed a periapical radiolucency in the region of the distal root apex. Pain relief was achieved only after endodontic treatment. On the basis of this paper, we investigated the aetiology and management of barodontalgia. Dentists should advise patients to avoid exposure to pressure changes until all necessary surgical, conservative, and prosthetic procedures have been completed. The influence of pressure divergences should be noted at any time. Under changed environment pressures may be the changing perception of pathologies.
PMCID: PMC3518957  PMID: 23243520
4.  In Vitro Effects of External Pressure Changes on the Sealing Ability under Simulated Diving Conditions 
ISRN Dentistry  2012;2012:418609.
Aim. To measure and validate the permeability of pressure changes in correlation to different root filling techniques. Methods. Eighty extracted single-rooted teeth were randomly assigned to one of eight groups of ten teeth. Following standardized instrumentation and irrigation, root canal fillings were performed using either cold lateral condensation, a warm carrier-based gutta-percha obturation technique, a warm carrier-based Resilon, or warm gutta-percha compaction with the downpack/backfill technique. After insertion of a pressure sensor within the pulp chamber ten teeth of each group then underwent simulated dives with pressure measurement and the other ten a dye penetration test during simulated dives to 5.0 bar. Differences were analyzed statistically (P < 0.05) using one-way analysis of variance (ANOVA). Results. When the warm carrier-based gutta-percha obturation technique and vertical gutta-percha obturation techniques were used, there was significant lower intrapulpal pressure to experimental chamber pressure (P > 0.05). When cold lateral condensation or carrier-based Resilon as used, pressure was sometimes almost completely equalized. Conclusions. Warm gutta-percha obturation techniques provide a largely pressure-tight seal whereas the Resilon obturation technique and cold lateral condensation appear to be unsuitable to pressure changes.
PMCID: PMC3478745  PMID: 23119172
6.  Oral health status of patients with acute coronary syndrome – a case control study 
BMC Oral Health  2012;12:17.
The aim of this investigation was to assess the state of oral health of patients with acute coronary syndrome (ACS) and to compare this with that of a provably healthy control group (H).
33 patients who were receiving treatment as inpatients following acute myocardial infarction or unstable angina pectoris took part in the study (ACS-group). A healthy control group (H-group) made up of blood donors, was formed following matching for age, gender, and smoking habit with the study patient group.
The dental investigation consisted of the dental status (DMF-T), a plaque-Index (PI), an assessment of gingival inflammation (GI) and periodontal situation (Periodontal Screening Index: PSR®/PSI), and attachment loss (AL). Statistical evaluation: t-test, Mann–Whitney-test and chi- squared test (level of significance p < 0.05).
The mean DMF-T of the ACS-group (18.7 ± 6.8) and the H-group (19.4 ± 5.1) showed no difference (p = 0.7). Although, in the ACS-group the average loss of teeth (M-T: 8.4 ± 5.2) was higher than in the H-group (M-T: 5.8 ± 6.6) the difference was not significant (p = 0.2). Whereas with the PI no difference between the two groups was found (p = 0.9), the ACS-group showed significantly more signs of inflammation (GI) than the H-group (p = 0.045). In the case of PSR®/PSI, there was no difference between the two groups (p = 0.7). With regard to AL, no difference was revealed between ACS- and H-group (p = 0.2).
Although, the state of oral health of the ACS-group differed only insignificantly from that of control, patients with ACS showed more signs of gingival inflammation and a higher loss of teeth.
PMCID: PMC3444382  PMID: 22727119
Oral health; Oral hygiene; Gingival inflammation; Periodontitis; Acute coronary syndrome; Acute myocardial infarction; Unstable angina pectoris
7.  Association between carotid area calcifications and periodontal risk: a cross sectional study of panoramic radiographic findings 
The aim was to investigate the extent to which it is possible to diagnose suspected carotid calcification from dental panoramic radiography (PR) and to establish an association to periodontal risk.
824 PRs from one dental practice were investigated. Parameters considered were gender, age, bone loss - age index, tooth loss, periodontal risk and suspected carotid calcification (left, right, both sides). Periodontal risk was classified: low risk (under 4 missing teeth, bone loss - age index under 0.5), moderate risk (5 to 8 missing teeth and/or bone loss - age index 0.5 to 1.0) and high risk (more than 9 missing teeth and or bone loss - age index greater than 1.0).
Of 824 patients, 349 were male (42.4%) and 475 female (57.6%); the mean age was 48.32 ± 16.52 years. In 9.0% (n = 74) of PRs, suspected carotid calcification was diagnosed (right: 5.5%, left: 2.3%, both sides: 1.2%). The mean tooth loss was 4.16 ± 5.39 teeth. In the case of 282 patients (34.2%), there was a low, in 335 patients (40.7%) a moderate, and in 207 patients (25.1%) a high periodontal risk. There was a significant correlation found between number of cases of suspected carotid calcification and periodontal risk, tooth loss and age (p = 0.0001). However, only age showed a significant association (OR: 4.9; CI: 2.4-9.8; p < 0.0001) in contrast to periodontal risk (OR 1.4; CI: 0.9-2.4).
PR can provides indication of carotid calcification as a secondary (chance) finding. In addition, periodontal risk may be correlated with positive findings of carotid calcification.
PMCID: PMC3224751  PMID: 22070470
8.  Long-term effects of tongue piercing — a case control study 
Clinical Oral Investigations  2011;16(1):231-237.
The aim of this study was to evaluate tooth and periodontal damage in subjects wearing a tongue piercing (TP) in comparison to matched control subjects without tongue piercing. Members of the German Federal Armed Forces who had TP (group TP) and a matched control group (group C) volunteered to take part in the study. The time in situ, localization and material of TP were documented. Dental examinations included DMF-T, oral hygiene, enamel fissures (EF), enamel cracks (EC) and recessions. Statistical analysis was determined by χ2 test and the t test. Both groups had 46 male subjects (mean age 22.1 years). The piercings had been in situ for 3.8 ± 3.1 years. Subjects in the TP group had a total of 1,260 teeth. Twenty-nine subjects had 115 teeth (9.1%) with EF (67% lingual). In group C (1,243 teeth), 30 subjects had 60 teeth with EF (4.8%, 78% vestibular) (p < 0.01). Thirty-eight subjects belonging to group TP had EC in 186 teeth (15%). In group C, 26 subjects with 56 teeth (4.5%) were affected by EC (p < 0.001). Twenty-seven subjects in group TP had 97 teeth (7.7%) with recessions. Lingual surfaces of anterior teeth in the lower jaw were affected most frequently (74%). In group C, 8 subjects had 19 teeth (1.5%) with recessions (65% vestibular). Differences between the two groups were statistically significant (p < 0.001). Tongue piercing is correlated with an increased occurrence of enamel fissures, enamel cracks and lingual recessions. Patients need better information on the potential complications associated with tongue piercing.
PMCID: PMC3259306  PMID: 21271349
Tongue piercing; Enamel fissures; Enamel cracks; Lingual recessions; Case control study
9.  Initial periodontal screening and radiographic findings - A comparison of two methods to evaluate the periodontal situation 
BMC Oral Health  2011;11:3.
The periodontal screening index (PSI) is an element of the initial dental examination. The PSI provides information on the periodontal situation and allows a first estimation of the treatment required. The dental panoramic tomography (DPT) indicates the proximal bone loss, thus also allowing conclusions on the periodontal situation. In this study, the results of both methods in determining the periodontal situation are compared.
The clinical examination covered DMF-T, QHI, and PSI scores at four proximal sites per tooth; the examining dentist was unaware of the radiographic finding. Based on the PSI scores, the findings were diagnosed as follows: score 0 - 2 "no periodontitis", score 3 and 4 "periodontitis". Independent of the locality and time of the clinical evaluation, two dentists examined the DPTs of the subjects. The results were classified as follows: no bone loss = "no periodontitis", and bone loss = "periodontitis".
112 male subjects (age 18 to 58, Ø 37.7 ± 8 years) were examined. Regarding the PSI, 17 subjects were diagnosed "no periodontitis" and 95 subjects "periodontitis". According to the evaluation of the DPTs, 70 subjects were diagnosed "no periodontitis" and 42 "periodontitis". A comparison of both methods revealed that the diagnosis "no periodontitis" corresponded in 17 cases and "periodontitis" in 42 cases (53%). In 47% (53 cases) the results were not congruent. The difference between both methods was statistically significant (p < 0.001; kappa = 0.194).
The present study shows that the initial assessment of the periodontal situation significantly depends on the method of evaluation.
PMCID: PMC3025926  PMID: 21235747

Results 1-9 (9)