The aim of this retrospective study was to evaluate the dental treatments received under general anesthesia (GA) in pre-school children and school children with special healthcare needs (n = 263) compared with healthy controls (n = 62). In order to analyze the impact of pre-existing cofactors on oral health, children were divided into the following groups: heart disease, cancer, syndromic disease, and other diseases as well as in- and outpatient healthy children. Caries experience (dmf-t/DMF-T) before GA (impulse 1), waiting time, and dental treatment under GA (impulse 2) were determined. Pre-school children showed a higher caries experience (mean ± standard deviation; 8.3 ± 4.8) compared to schoolchildren (6.9 ± 4.3). Predominantly, early childhood caries (ECC) of type 1 were detected. From all groups with special healthcare needs, children with cancer revealed the highest Significant Caries Index (17.0 ± 2.0), followed by other diseases (14.6 ± 2.6), syndromic disease (14.3 ± 1.8), and heart disease (13.8 ± 2.7). Overall, 2607 dental procedures were performed under GA with a mean of 8.0 ± 6.5 dental measures per child. Within the limitations of this study, the data exhibited independent of pre-existing cofactors and age high caries risk in all patient groups showing a high need for treatment.

Background: The aim of this clinical study was to compare the occlusal caries detection (OCD) performance of the intraoral scanners (IOSs) Trios 4 (TIO, 3Shape) and Emerald S (EME, Planmeca) and the Diagnocam (DIA, KaVo) with the established visual (WHO) examination (VIS, reference method). Methods: Between 08/2022 and 02/2023, 60 children (mean age 9.6 ± 2.5 years) were examined as part of their regular dental checkups. OCD was performed at the tooth level, separately for primary and permanent unrestored teeth. Furthermore, two thresholds were analyzed: sound versus overall caries (pooled data of enamel and dentin caries, TH1) and pooled data of sound and enamel caries versus dentin caries (TH2). Results: The best agreement with the reference method (reliability) in both dentitions was obtained for DIA (ĸ = 0.829/ĸ = 0.846; primary/permanent teeth), followed by EME (ĸ = 0.827/ĸ = 0.837) and TIO (ĸ = 0.714/ĸ = 0.680). Similar results were shown for the diagnostic quality (sensitivity, specificity and area under the curve of the receiver operating characteristic curve), with higher values for TH1 than for TH2. Both IOSs and the DIA showed worse results than the reference method VIS. Conclusions: Currently, IOS should be used as an additional caries detection tool, especially for visualization, and cannot be recommended as a basic tool for diagnosis or invasive/noninvasive therapy decisions in OCD.

Purpose: The aim of this retrospective study was to analyse the dental and medical parameters, including peri- and postoperative management and complications, of patients with special healthcare needs receiving dental treatment in a tertiary care hospital setting. Methods: A total of 154 patients (mean age 7.8 ± 4.1 years) who received dental treatment under general anaesthesia or analgosedation at the Department of Paediatric Dentistry of the XXX University in XXXXXXX between 2021 and 2023 were divided into the following diseases: metabolic disease, nervous system disorder, congenital heart disease, tumour disease, gastroenterological disease, genetic syndrome, pulmonology disease and coagulopathy. Caries experience (dmf-t/DMF-T), type of anaesthesia and pre- and perioperative parameters were recorded. Results: Regardless of disease, all children showed higher caries experience in the primary dentition compared to permanent dentition (mean ± standard deviation; 6.44 ± 4.85/2.01 ± 3.87). Most of the children suffered from genetic syndrome, followed by congenital heart and metabolic disease. Dental treatment was mostly performed under general anaesthesia. 92.2% of those patients were intubated orotracheally and 66.9% received antiemetics. The complication rate was lower than 3%. Conclusions: Data show that special healthcare needs patients regardless of kind of disease are highly affected by caries and require dental treatment. Most dental restorations were performed under general anaesthesia. Regardless of disease and type of anaesthesia, the complication rate was low, which underlines the high clinical relevance of adequate dental care under general anaesthesia for this vulnerable patient group.

Epidemiologisch gesehen ist mehr als die Hälfte aller Jugendlichen von einem Zahntrauma betroffen. Dabei sind in der Mehrzahl der Fälle vor allem die Frontzähne betroffen. Unter einem Frontzahntrauma versteht man eine Verletzung der Frontzähne (Schneidezähne) und/oder der benachbarten Strukturen (Zähne, Knochen, Weichteile) durch äußere Gewalteinwirkungen. Ursachen eines Frontzahntraumas können beispielsweise ein Sturz, ein Schlag oder ein Unfall sein [1]. Die entstandenen Unfallverletzungen stellen für den behandelnden Zahnarzt eine große Aufgabe und Herausforderung dar. Hinsichtlich der Therapie steht neben der vorausschauenden Behandlung, welche vor allem vom Entwicklungsstand des Gebisses abhängt, die Sofortbehandlung im Vordergrund. Hierbei sind Sachkenntnisse aus den Bereichen Endodontie, Parodontologie und Oralchirurgie von Bedeutung, da sich aus anfänglich harmlos aussehenden Unfallverletzungen durchaus die Notwendigkeit langfristiger Nachbehandlungen bis ins Erwachsenenalter ergeben kann. Erschwerend kommt hinzu, dass das Zahntrauma nicht zu den Vorkommnissen der zahnärztlichen Routine im Praxisalltag gehört und der Behandler meist unvorbereitet eine sowohl schnelle als auch kompetente diagnostische Entscheidung treffen muss.

Insgesamt ist in Deutschland eine Verbesserung der Mundgesundheit bei Schulanfängern festzustellen. Der Anteil an Kindern mit kariesfreien Milchzähnen stieg im Zeitraum 1994/95 bis 2009: Während in den Jahren 1994/95 zwischen 20 und 45,9% der Kinder in den verschiedenen Bundesländern naturgesunde Milchzähne aufwiesen, so lagen die entsprechenden Werte 2009 zwischen 42,7 und 62,3%. Damit waren im Jahr 2009 in der Gruppe der 6 – 7-Jährigen durchschnittlich 53,9% Milchgebisse kariesfrei.