Research

In addition to the use of caries- or periodontitis-inhibiting agents, such as toothpastes and mouth rinses, sustainable prevention concepts also include the teaching of sufficient oral hygiene strategies. By observing oral hygiene habits, we improve our understanding of this type of habitual activity and pattern. Furthermore, we determine the effectiveness of oral hygiene education in childhood and adolescence. The overarching aim of our work is to develop new strategies to change habitual patterns, with a particular focus on motological and cognitive aspects, in order to maintain oral health from childhood and into old age. In addition to the general population, people with a high need for prevention, such as people with a serious underlying disease that has an impact on oral health, but also people with manual impairments, benefit greatly from these research activities.

The bond between dental materials such as composite-based or all-ceramic materials and the dental hard tissue (enamel/dentin) is highly complex and is subject to a wide variety of intraoral (in vivo) influences, which we simulate in vitro using appropriate established test setups. As part of our research activities, we investigate the effect of various parameters on the bonding zone between the above-mentioned materials and/or to the tooth structure. Our main focus is on establishing studies whose results can be transferred directly from the in vitro ("laboratory situation") to the in vivo situation ("oral cavity").

 

The following procedures are carried out in our materials testing laboratory and in close cooperation with other Institutes and Clinical Departments of the MHH to test material-specific parameters:

 

• Microtensile tests of adhesively bonded materials using the "Microtensile Bond Strength" method
• Simulation of intraoral degradation of the adhesive bond due to alternating thermal stress
• Light microscopic fracture analyses
• Scanning electron microscopic analyses
• Transmission electron microscopic analyses of the hybrid layer
• Edge analyses by means of dye penetration
• Wear simulations under erosive, abrasive or erosive-abrasive conditions

 

In clinical studies, we examine restorative materials with regard to their intraoral long-term stability using established evaluation criteria such as the modified Ryge criteria. All clinical studies conducted in-house are carried out by certified investigators in accordance with the Declaration of Helsinki and the principles of "Good Clinical Practice".

Children with congenital heart defects are at risk of oral pathogenic changes, such as caries and gingivitis, due to various factors. Untreated carious processes in particular are to be seen as a risk factorwith regard to possible infective endocarditis. In collaboration with the Clinical Department of Pediatric Cardiology, saliva analyses will be carried out on children with heart disease. The samples will be analyzed for proteomes, microbiomes and metabolomes. The aim is to show what influence these parameters have on oral health.

The potential loss of an anterior tooth or anterior tooth trauma can not only have aesthetic and functional consequences for the often still young patient, but can also have psychological effects and entail financial costs. Adequate treatment is particularly important for growing children in order to minimize the risk of future jaw growth disorders. Long-term therapeutic success is therefore influenced directly at the accident site by the actions of the person affected and the individual primary treatment of the dentist consulted by the patient. The working group is investigating the level of knowledge about anterior tooth trauma in the primary and mixed dentition among practicing dentists and students.

Some rare systemic diseases manifest themselves in the teeth or the periodontium. Since in these cases not only individual teeth often show changes, but all teeth are affected, this entails extensive treatment. The scientific guideline "Treatment of rare, genetic diseases of the teeth" (AWMF registry number 083 - 048) aims to characterize some of these diseases and develop evidence-based recommendations for their treatment.

Hypophosphatasia is one of these rare diseases. If the disease begins in childhood or adolescence, long-term enzyme replacement therapy can be used to treat the bone manifestations of the disease. This treatment also appears to have beneficial effects on tooth development. Teeth formed under this enzyme replacement therapy are to be examined and described in comparison with corresponding teeth in healthy subjects.

By participating in the S3 guideline "Fissure and pit sealing" (AWMF register number 083-002) and in the S3+ guideline group "Child abuse, maltreatment and neglect with the involvement of youth welfare and education (child protection guideline)" (AWMF register number 027 - 069), scientifically based recommendations are to be developed and updated.

Restorative dental treatment can be carried out under anesthesia in patients who are unable to cooperate with the treatment or can only cooperate to a limited extent. If there are risks that require perioperative or postoperative monitoring, such treatments can only be carried out in an inpatient environment. As tooth-preserving treatments are time-consuming, they cannot be billed to cover costs under the current conditions. The aim is to enable cost-covering billing of the services provided to the cost bearers.

With the introduction of the new dental licensing regulations (ZApprO) , the subject of pediatric dentistry is gaining in scope and importance. In the area of teaching research, the question of the extent to which the Objective Structured Clinical Examination (OSCE) can be integrated into a nationwide assessment process is being investigated.

• Biocompatibility of dental materials

All dental plastics release molecules such as (co)monomers, initiators and accelerators of the polymerization reaction into the oral cavity after polymerization (material hardening). We investigate how cells of oral origin react to these organic ingredients in conventional cell cultures and tissue culture models. Our aim is to understand how cellular effects triggered by dental materials lead to the activation of different cellular responses, such as redox modulation, genotoxicity, cell death or cellular senescence, how inflammatory cellular processes are affected and which redox-sensitive cellular factors are involved. The identification and clarification of these mechanisms of action will provide important data for the assessment of clinical risks and for the development of biocompatible alternatives to the plastic-modified biomaterials currently used in clinical practice.

• Oral stem cells

Mesenchymal stem cells are the stem cells of connective tissue and are responsible in the organism for the regeneration of damaged tissue and the maintenance of tissue homeostasis. We work with stem cells of oral origin. Once the cells have been harvested, they are processed and preserved in cryogenic liquid nitrogen and undergo extensive quality controls. The cells are used in cell culture procedures to analyze their ability to differentiate into cell types that play a role in tooth formation and/or the regeneration of periodontal defects and to investigate the influence of oxidative stress induced by dental materials. This provides us with a basis for understanding the molecular processes involved in wound healing, which is important for planning strategies for the regeneration of oral tissue.

 

 

 

• Statistical advice, study designs and case number calculations, especially for clinical studies in the field of dentistry

Clinical studies are an essential basis for medical progress and enable systematic knowledge to be gained that goes beyond the experience gained from treating individual patients. The choice of the right study design on the one hand and study-related case number planning on the other are of crucial importance. A particular challenge in studies in the field of dentistry is posed by multiple observations at patient level, be it through the collection of tooth-specific factors or treatments on more than one tooth per patient.

• Expanding the range of methods used in clinical studies in the field of dentistry and improving Communications of study results

Clinical studies can draw on a broad, general range of methods. However, innovative approaches in dental research, such as the increased consideration of prognostic and predictive factors, the use of new target variables such as the microbiome, or the increased consideration of questions from the field of health services research, make it necessary to expand the usual spectrum in the field of dentistry.

The use of digital measurement and data collection methods is also leading to an increasing amount of data in dentistry research. This requires new ways of visualizing data and presenting results. Improving the Communications of study results - also through suitable illustration of theoretical-statistical measures - is therefore another focus.