The aim of this pilot study was to investigate the effects of four weeks of an oral health optimized diet on periodontal clinical parameters in a randomized controlled trial. The experimental group (n = 10) had to change to a diet low in carbohydrates, rich in Omega-3 fatty acids, and rich in vitamins C and D, antioxidants and fiber for four weeks. Participants of the control group (n = 5) did not change their dietary behavior. Plaque index, gingival bleeding, probing depths, and bleeding upon probing were assessed by a dentist with a pressure-sensitive periodontal probe. Measurements were performed after one and two weeks without a dietary change (baseline), followed by a two week transitional period, and finally performed weekly for four weeks. Despite constant plaque values in both groups, all inflammatory parameters decreased in the experimental group to approximately half that of the baseline values (GI: 1.10 ± 0.51 to 0.54 ± 0.30; BOP: 53.57 to 24.17 %; PISA: 638 mm2 to 284 mm2). This reduction was significantly different compared to that of the control group. A diet low in carbohydrates, rich in Omega-3 fatty acids, rich in vitamins C and D, and rich in fibers can significantly reduce gingival and periodontal inflammation. German Clinical Trials Register; https://www.germanctr.de (DRKS00006301). Registered on 2015-02-21.

Objective: This review aimed at evaluating the survival and technical complication rates of all‐ceramic implant‐supported single crowns (SC).Material and Methods: Three electronic databases were searched for clinical studies conducted at ≥ 15 patients examining implant‐supported all‐ceramic SCs over ≥ 12 months. Survival rates of implants and restorations plus technical complication rates of SCs were calculated and tested for statistical correlation with confounding variables. Statistical analysis was performed using a negative binomial distribution model to calculate 5‐ and 10‐year survival and complication estimates.Results: Forty‐one included studies reported on implant‐supported SCs made of veneered and monolithic high‐strength oxide ceramics, monolithic, and veneered glass‐based ceramics and of a monolithic resin‐nano‐ceramic (RNC). Survival estimates for SCs of 93% (95% CI: 86.6%–96.4%) after 5 years and 94.4% (95% CI: 91.1%–96.5%) after 10 years were calculated, corresponding values for implant survival were 95.3% (95% CI: 90.6%–97.7%) and 96.2% (95% CI: 95.1%–97.1%). Technical complication rates after 5/10 years were as follows: chipping 9.0% (95% CI: 5.4%–14.8%)/2.7% (95% CI: 2.1%–3.5%), framework fractures 1.9% (95% CI: 0.7%–4.9%)/1.2% (95% CI: 1%–1.5%), screw loosening 3.6% (95% CI: 1.6%–8.4%)/5.2% (95% CI: 3.6%–7.5%), and decementations with 1.1% (95% CI: 0.4%–2.8%) after 5 years. Some confounding variables influenced the above‐mentioned estimates significantly.Conclusions: All‐ceramic implant‐supported SCs showed—with the exception of a RNC material—high survival rates. However, failures and technical complications occurred which have to be considered when informing patients on the treatment with implant‐supported all‐ceramic SCs.

Objective: To assess the survival and technical complication rate of partial and full‐arch all‐ceramic implant‐supported fixed dental prostheses (P‐FDP/FA‐FDP) and supporting implants.Materials and methods: An electronic search through three databases (MEDLINE/Pubmed, Cochrane Library, Embase) was conducted to identify relevant clinical studies with an observation period of at least 12 months, including ≥15 patients. Reconstruction and implant survival rates, technical complications and confounding variables such as processed/installed materials, retention mode and location in the mouth were obtained. Failure and complication rates were analyzed using standard Poisson regression models to calculate 5‐year survival and complication estimates.Results: A total of five studies for the P‐FDP group and seven studies for the FA‐FDP group were included, throughout evaluating veneered zirconia reconstructions. In the P‐FDP group, reconstructions were located in posterior regions. Meta‐analysis indicated survival estimates on the reconstruction level of 98.3% and 97.7% for P‐ and FA‐FDPs after 5 years. However, chipping of the veneering ceramic was frequent, resulting in estimated 5‐year complication rates of 22.8% (P‐FDPs) and 34.8% (FA‐FDPs). Five‐year survival estimates of implants supporting P‐FDPs and FA‐FDPs of 98.5% and 99.4% were calculated, respectively. Including a total of 540 FDPs, one screw‐loosening and 11 de‐cementations were reported. Confounding variables were not found to have a significant influence on survival and complication rates.Conclusions: All‐ceramic implant‐supported P‐ and FA‐FDPs comprising veneered zirconia frameworks showed high survival but clinically inacceptable fracture rates of the veneering ceramic. Their suitability with regard to this indication and a successful long‐term outcome needs to be further evaluated.

Many preventive approaches in dentistry aim to improve oral health through behavioural instruction or intervention concerning oral health behaviour. However, it is still unknown which factors have the highest impact on oral health behaviours, such as toothbrushing or regular dental check-ups. Various external and internal individual factors such as education, experience with dentists or influence by parents could be relevant. Therefore, the present observational study investigated the influence of these factors on self-reported oral heath behaviour. One hundred and seventy participants completed standardized questionnaires about dental anxiety (Dental Anxiety Scale (DAS), and dental self-efficacy perceptions (dSEP)). They also answered newly composed questionnaires on oral hygiene behaviours and attitudes, current and childhood dental experiences as well as parental oral hygiene education and care. Four independent factors, namely attitude towards oral hygiene, attitude towards one’s teeth, sense of care and self-inspection of one’s teeth were extracted from these questionnaires by rotating factor analysis. The results of the questionnaires were correlated by means of linear regressions. Dental anxiety was related to current negative emotions when visiting a dentist and negative dental-related experiences during childhood. High DAS scores, infantile and current negative experiences showed significant negative correlations with the attitude towards oral hygiene and one’s teeth. Dental anxiety and current negative dental experiences reduced participants’ dental self-efficacy perceptions as well as the self-inspection of one’s teeth. While parental care positively influenced the attitude towards one’s teeth, dental self-efficacy perceptions significantly correlated with attitude towards oral hygiene, self-inspection of one’s teeth and parental care. Dental anxiety, dental experiences, parents’ care for their children’s oral hygiene and dental self-efficacy perceptions influence the attitude towards oral hygiene and one’s own oral cavity as well as the autonomous control of one’s own dental health. Therefore, oral hygiene instruction and the development of patient-centred preventive approaches should consider these factors.

Enterococcus faecalis is a microorganism that can be found in the oral cavity, especially in secondary endodontic infections, with a prevalence ranging from 24–70%. The increase in the ability to form biofilms in the presence of subinhibitory antibiotic concentrations is a phenomenon that is observed for a wide variety of bacterial pathogens and is associated with increased resistance. In this study, therefore, six E. faecalis isolates from an endodontic environment and two control strains were exposed to subinhibitory concentrations of Penicillin G, Amoxicillin, Doxycycline, Fosfomycin, Tetracycline and Vancomycin and examined for their biofilm formation abilities. The minimum inhibitory concentration (MIC) was determined for all E. faecalis isolates. A culture of the isolate was mixed with a serial dilution series of the respective antibiotic, incubated overnight and the biofilm formation was analyzed using a microtiter plate assay. All isolates were able to form biofilms in the absence of an antibiotic. A significant increase in biofilm formation of up to more than 50% was found in the isolates exposed to subinhibitory concentrations of various antibiotics. Most isolates showed a significant increase in Fosfomycin (7/8), Doxycycline (6/8) and Tetracycline (6/8). Three endodontic isolates showed a significant increase in five of the antibiotics examined at the same time. On exposure to Vancomycin, three endodontic isolates and the two control strains showed an increase. The increase in the ability to form biofilms extended over a concentration range from 1/2 to 1/64 of the MIC concentration. Antibiotics may reach certain niches in the oral cavity at subinhibitory concentrations only. This can increase the biofilm formation by enterococci, and in turn lead to decreased susceptibility of these taxa to antibiotics.

Mid-term data on zirconia oral implants is very rare. Therefore, the aim of this prospective clinical investigation was to evaluate the survival rate and the marginal bone loss of a one-piece zirconia implant after five years. Patient-reported outcomes were also recorded. Zirconia implants to support single crowns (SC) or a 3-unit fixed dental prosthesis (FDP) were placed and subsequently restored. After the insertion of the implants, at prosthetic delivery, and after five years, standardized radiographs were taken to evaluate marginal bone loss (MBL). For bone tissue evaluation, linear mixed models with random intercepts were fitted. Twenty-seven patients received one implant for an SC and 13 patients received two implants for a 3-unit FDP. Three patients each lost one implant for an SC before prosthetic delivery. Thirty-five patients were seen after five years, and no further implant was lost. The cumulative five-year implant survival rate was 94.3%. The MBL from implant installation up to five years was 0.81 mm. The MBL from implant installation to prosthetic delivery was statistically significant (p < 0.001). Patients perceived a significant improvement in function, esthetics, sense, speech, and self-esteem from pretreatment up to the five-year follow-up. The present findings substantiate the clinical applicability of this implant system.