Andreas Zenthöfer

Comparison of the Easyshade Compact and Advance in vitro and in vivo

ObjectiveThe objective of this study was to evaluate the repeatability, inter-examiner and inter-device reliability, and accuracy of the new VITA Easyshade Advance (ES-A) spectrophotometer in comparison with the Easyshade Compact (ES-C).MethodsFor the in vitro study, six porcelain disks of random shade mixtures were fabricated from VITA ceramic powders. To analyze the repeatability of the ES-C and ES-A, readings were obtained by one examiner for one porcelain disk and one shade tab (VITA 3D-Master). Measurements were repeated by two examiners to evaluate inter-examiner reliability. To assess accuracy, porcelain disks and shade tabs were measured with the ES-C and ES-A and by means of a spectroradiometer (SR). ∆E values between the shade tabs and disks were calculated. Differences between devices were evaluated by use of univariate analysis. Reliability and accuracy of both devices were also tested in a clinical setting. The intra-class correlation coefficient (ICC) was calculated for all assessments of reliability.ResultsGood agreement was observed for replicate measurements (ICC > 0.9), for inter-examiner reliability of the ES-A and ES-C (ICC > 0.9), and for inter-device agreement (ICC > 0.9). Univariate analysis revealed that ∆E values for the spectrophotometers were consistent (p = 0.783); spectroradiometrically measured ∆E was comparable, but the mean value was smaller than that for the spectrophotometers (p = 0.004). Clinical inter-device agreement was acceptable to high (ICC > 0.777). The accuracy of the ES-A was higher than that of the ES-C (p = 0.001).ConclusionWithin the limitations of the experiment, the spectrophotometers tested enabled reliable and accurate measurement. In the clinical setting, however, the ES-A seems more accurate.Clinical relevanceES-C and ES-A can be valuable tools for the determination of tooth colors. Because of their good reliability, they should especially be used for the assessment of tooth color changes over time.

Improving oral health of institutionalized older people with diagnosed dementia

Objective: Previous research has revealed poor oral hygiene and health among older people suffering from dementia. To evaluate the oral health and denture hygiene of older people with and without dementia, six months after carer have followed a dental education programme. Method: Ninety-three older people living in four long-term care homes in south-western Germany were included in this longitudinal cohort study. All participants were allocated into two groups on basis of the medical dementia diagnosis extracted from the medical records in the care documentation: suffering from dementia (n = 33) or not (n = 60). For each participant plaque control record, gingival bleeding index (GBI), community periodontal index of treatment needs (CPITN), and denture hygiene index (DHI) were assessed at baseline and six months after carer have followed a dental education programme, and after use of ultrasonic devices for denture cleaning. Differences between all target variables from baseline to follow-up, and between participants with and without dementia, were evaluated by bivariate and multivariate testing. Results: In bivariate testing, participants with dementia had a significantly lower DHI (p < 0.001), a lower GBI (p < 0.05), and a lower CPITN (p < 0.01) at follow-up. In participants without dementia, only for DHI (p < 0.001) a significant improvement was observed. In multivariate analyses, the significant association could not be reproduced (p > 0.05). Conclusions: Use of ultrasonic baths can be a successful means for improving denture hygiene among older people in long-term care with and without dementia. Education for carer in order to improve oral hygiene, however, seems to be of minor significance and to be more effective for people with dementia.

Determinants of oral health‐related quality of life of the institutionalized elderly

Diminished oral health of the institutionalized elderly has frequently been reported. This is not only of significance with regard to nutrition and general health, but it can also affect oral health‐related quality of life. This paper evaluates the effects of oral and general conditions on oral health‐related quality of life for the institutionalized elderly, as measured by the Geriatric Oral Health Assessment Index (GOHAI).

Increasing dependency of older people in nursing homes is associated with need for dental treatments.

To determine relationships between the need for dental treatments of institutionalized elderly people and cognitive impairment and the general level of care needed. Two hundred and sixty-eight residents of long-term care facilities in Germany were included in this study. Age, sex, diseases, number of frequently taken drugs, and location of the long-term care facility of the participants were recorded. For each participant, the need for care was assessed by use of the Barthel index (BI). Cognitive impairment was evaluated by use of the mini-mental state examination (MMSE). To assess dental treatment needs, the revised oral assessment guide (ROAG) was applied for different oral health conditions, which were rated “healthy” or “treatment needed”. Spearman correlations were performed to evaluate associations between BI and MMSE and dental treatment needs. Statistical analysis revealed significant associations of BI (P<0.001) and MMSE (P=0.015) with the ROAG score. Increasing dependency and decreasing cognitive ability worsen oral health and increase the need for dental treatment.

Selecting VITA classical shades with the VITA 3D-master shade guide.

PURPOSE Although the VITA 3D-Master (3D) shade guide offers improved shade-matching performance, many dental materials are only available in VITA Classical (VC) shades. This study aimed to clarify whether it is possible to convert 3D shades determined by observers into VC shades (indirect method) without adding a clinically significant error in comparison with direct shade determination using the VC shade guide. MATERIALS AND METHODS Forty ceramic specimens were fabricated. L*a*b* values were recorded using a spectroradiometer. Sixty participants (35 dentists, 15 technicians, and 10 students) were recruited and asked to determine the shades of specimens using the VC and 3D shade guides under standardized conditions. Conversion tables were constructed by allocating the closest VC shade tab to every matched 3D shade and by use of an optimization algorithm (indirect methods). Differences between ΔE values for VC matches and for the indirect methods were evaluated using t tests. RESULTS A mean ΔE (SD) of 4.34 (2.00) for VC and 4.22 (2.21) for 3D was observed (P = .040). Compared with direct shade matching using VC, the indirect method with the optimized tables resulted in a mean ΔE of 4.32 (1.96), which was not significantly different (P = .586). CONCLUSIONS Within the limitations of this study, the conversion tables were suitable for the determination of tooth color using the 3D shade guide followed by conversion into VC shades without adding a clinically significant error.

Determination of VITA Classical shades with the 3D-Master shade guide

Abstract Objectives. Because of its good matching performance the VITA 3D-Master shade guide (3D) is frequently used for determination of tooth color. Numerous composites/ceramics are, however, available in VITA Classical (VC) shades only. The objective of this study was to investigate the possibility of performing a shade match with 3D Master and converting this result via a table in a VC shade (indirect method) without this resulting in an apparent inferior shade matching in comparison with direct shade matching with the VC. Methods. Experiments were performed with an artificial, computer-generated tooth color space. Conversion tables were generated by calculating the color difference (ΔE) between a 3D shade and the closest VC shade (simple conversion table) and with the aid of optimization procedures. Statistical differences between the direct and indirect methods and between the indirect methods were assessed by use of a U-test. Results. Median ΔE was 2.38 for direct matching with the VC and 2.86 for indirect matching by use of a simple conversion table (p < 0.01). Optimized tables performed slightly better (median ΔE = 2.81). Conclusions. Within the limitations of the study, it is usually possible to determine tooth color with the 3D and convert it, via a table, into a VC shade without adding a clinically apparent error to the direct shade match with the VC.

Carers’ education improves oral health of older people suffering from dementia – results of an intervention study

Aim The aim of this study was to evaluate the effectiveness of carers’ education on improvements in oral health and denture hygiene of care-dependent and cognitively impaired older people in nursing homes compared to those without intervention. Methods A total of 219 seniors living in 14 nursing homes in southwest Germany (intervention: n=144; control: n=75) were enrolled in this study. For each participant, Plaque Control Record (PCR), Gingival Bleeding Index (GBI), Denture Hygiene Index (DHI) and Community Periodontal Index of Treatment Needs (CPITN) were assessed at baseline and six months following the interventions. In addition, demographic parameters such as age, sex, chronic diseases, permanent medications, level of dependency and cognitive state were recorded. In the intervention homes, education for caregivers was provided and ultrasound baths for denture cleaning were implemented. Changes in the dental target variables PCR, GBI, CPITN and DHI during the six-month study period were compared between subjects in the intervention and the control groups as well as between subjects with and without dementia. Additionally, multivariate models were compiled for each dental index to evaluate possible confounders. Results In the intervention group, PCR and DHI significantly improved during the study period (P<0.001). Oral health and denture hygiene improved likewise in subjects with and without dementia. In the control group, no significant improvements were observed (P>0.05). Conclusion Carers’ education improves oral health of people in nursing homes over a clinically relevant period of time. Implementation of ultrasound baths is a simple and effective measure to improve denture hygiene of both institutionalized elderly people and seniors with dementia and in severe need of care. From a clinical standpoint, it is noteworthy that the respective interventions can be easily implemented in everyday care routine.

Estimating costs for shade matching and shade corrections of fixed partial dentures for dental technicians in Germany: a pilot investigation.

Abstract Aims. To evaluate the additional operating expenses caused by shade matching by dental technicians in the dental practice and by color changes of fixed partial dentures. Methods. A questionnaire was handed out to visitors of the 2010 ADT dental technician congress in Germany. Thirty-one completed questionnaires were evaluated. Results. Mean costs caused by shade matching and shade correction per month were 1269

Comparison of incidence of complications and aesthetic performance for posterior metal-free polymer crowns and metal–ceramic crowns: Results from a randomized clinical trial

(SD = 1278

Kommunikationstraining MultiTANDEMplus – Ein Beitrag zur Verbesserung der Kommunikation zwischen Pflegenden und Ärzten

; n = 25) and per unit of FPD 9.32