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With the increasing use of dental implants in patients undergoing extensive mandibular reconstructions, it is crucial to understand how soft tissues react in different implantation contexts. The aim was to compare the behavior of the soft tissues surrounding zirconia implants to that of the soft tissues surrounding natural teeth in terms of cytokine levels in patients who had undergone various microvascular flap procedures for jaw reconstruction. Due to anatomical deviations after flap surgery, such as thick skin paddles, the possibility of fixed implant dentures in patients with bony flaps is rare. Therefore, these patients are often treated with removable dentures. In this prospective observational study ten patients with a total of six fibula flaps and four deep circumflex iliac artery (DCIA) flaps underwent reconstruction in the lower and upper jaws using vascularized bone flaps, and were treated with a total of 41 zirconia implants. The cytokine levels in the crevicular fluid were analyzed in terms of the interleukin-1 beta (IL-1b) and matrix metalloproteinase-8 (MMP-8) levels up to one-year follow-up. The implant survival and success rates were also investigated up to one year. No significant differences in IL-1b were found between natural teeth and ceramic implants. After six months, MMP-8 levels of the natural teeth of a patient treated with DCIA flaps were once significantly lower when compared to the ceramic implants inserted into fibula flaps ( p  = 0.001). The overall survival and success rates were 100 and 76.83%, respectively. For the fibula group, the survival and success rates were 100 and 72.55%, respectively, and for the DCIA group, they were 100 and 81.12%. Zirconia implants and natural teeth showed comparable cytokine levels in the crevicular fluid. Nevertheless, implant treatment with extensive microvascular jaw reconstructions affected the success rates in the present study.

Background Local anaesthesia plays a key role in many aspects of a dentist’s work. The required skills to perform anaesthesia successfully are acquired at university. To take advantage of the possibilities for new teaching formats, a blended learning concept for the local anaesthesia course was developed. The aim of the study was to compare the effectiveness of face-to-face, blended and e-learning in teaching in local anaesthesia by assessing students’ knowledge gain, performance of practical skills and satisfaction with the course. Methods All participants ( n  = 37) were randomly allocated into three groups. After acquiring the theoretical background in the blended learning, e-learning or lecture groups, a test to assess knowledge gain was performed. The performance of the practical skills was assessed in a small-group seminar. Student attitudes were evaluated with a questionnaire. Results The blended group showed significantly better results (mean = 17, SD =1.5) in theoretical knowledge gain than the other two groups (e-learning group: mean = 14.7, SD = 2.2; lecture group: mean = 14.8, SD =2.3). When comparing the results of the clinical skills assessment, there was no significant difference among all three groups ( p  > 0.017). The participants confirmed a high overall satisfaction with the course, in particular with the blended learning approach. Conclusion This study indicates that blended learning improves the learning outcome for theoretical knowledge in teaching local anaesthesia more than either face-to-face learning or e-learning alone. Furthermore, the blended learning approach is highly appreciated by the students. For acquiring practical skills, this study shows that blended learning is as effective as other teaching methods.

Objectives Against the background of digitalization, practicing on 3-D models for dental education has become more important. To improve the surgical skills of dental students, this study aimed to develop a 3-D-printed model for osteotomy of a partially retained lower wisdom tooth and evaluate surgical skills of students with practical experience acquired through phantom exercises compared to students who acquired experience only by assisting oral surgeons. Materials and methods We developed a 3-D model that allows dental students to perform an osteotomy of a partially retained real wisdom tooth in region 48. The model was evaluated by oral surgeons (OS; n  = 5), students with phantom experience (PE; n  = 26), and students with experience with clinical assistance (CE; n  = 29). Additionally, student performance was rated. Results The OS, PE, and CE groups all evaluated the model as suitable for student courses, except for the gingiva mask. The CE group developed slightly better. In the exercise, the PE group showed better incision results, while the CE group was slightly better in the preparation of the working field. Conclusions The osteotomy model is suitable for hands-on courses for dental students, but the gingiva should be improved. However, phantom exercise cannot replace clinical experience. Clinical relevance To improve education, knowledge and self confidence of students in dental school.

Unattached surface probes are commonly used with the O2C analysis system (LEA Medizintechnik, Germany) to monitor microvascular free flap perfusion. This study compared attached and unattached surface probes for extraoral free flaps. The study included 34 patients who underwent extraoral microvascular head and neck reconstruction between 2020 and 2022. Flap perfusion was monitored postoperatively using the O2C analysis system at 0, 12, 24, 36, and 48 h, with an attached surface probe at 3 mm tissue depth and an unattached surface probe at 2 mm and 8 mm tissue depths. Clinical complications, technical errors, and perfusion measurement values were compared. No clinical complications (attachment suture infections) or technical errors (probe detachment) occurred. Flap blood flow values of the probes were partially different (3 mm vs. 2 and 8 mm: p < 0.001; p = 0.308) and moderately correlated (3 mm with 2 and 8 mm: r = 0.670, p < 0.001; r = 0.638, p < 0.001). Hemoglobin concentration and oxygen saturation values were generally different (3 mm vs. 2 and 8 mm: all p < 0.001) and variably correlated (3 mm with 2 and 8 mm: r = 0.756, r = 0.645; r = 0.633, r = 0.307; all p < 0.001). Both probes are comparable in terms of technical feasibility and patient safety, with flap perfusion values dependent on tissue measurement depth.

Background Good communication between patients and practitioners is essential, especially during dental procedures, as these treatments are often associated with increased nervousness and anxiety. The aim of this study was to investigate, implement and evaluate a concept for communication skills training by using targeted training in combination with simulation patients in dental education. Methods Students ( n  = 34) were assigned to four small groups receiving targeted training consisting of two parts. A lecture about the theoretical basics of communication skills and two practical sessions with simulation patients. During this training, one of the students performed the conversation with the patient. Immediately after self-assessment was obtained, the simulation patient, the remaining students and the lecturer provided feedback. Additionally, anonymous surveys were administered to the students at the beginning of the semester, immediately after the training and at the end of the course. Results The students rated the learning of communication skills as important for later professional life at all times. After targeted training followed by subsequent use in simulated patients, there was a significant improvement in communication skills ( p  < 0.001). The number of open-ended questions asked to patients after attending the course significantly increased ( p  = 0.0245). The communication training was considered useful, especially in small groups. Conclusion The implementation of targeted training with subsequent use in simulated patients significantly contributed to the students’ improvement in communication skills. The concept offers a good opportunity to better prepare students for interaction with patients, both in their studies and in their upcoming professional lives.

When attempting to estimate the impacts of future climate change it is important to reflect on information gathered during the past. Understanding historical trends may also aid in the assessment of likely future agricultural and horticultural changes. The timing of agricultural activities, such as grape harvest dates, is known to be influenced by climate and weather. However, fewer studies have been carried out on grapevine yield and quality. In this paper an analysis is undertaken of long-term data from the period 1805-2010 on grapevine yield (hl/ha) and must sugar content (°Oe) and their relation to temperature. Monthly mean temperatures were obtained for the same time period. Multiple regression was used to relate the viticulture variables to temperature, and long-term trends were calculated. Overall, the observed trends over time are compatible with results from other long term studies. The findings confirm a relationship between yield, must sugar content and temperature data; increased temperatures were associated with higher yields and higher must sugar content. However, the potential increase in yield is currently limited by legislation, while must sugar content is likely to further increase with rising temperatures.

Background The aim of this systematic review was to evaluate whether laser Doppler flowmetry (LDF) as a diagnostic tool is effective in detecting gingival inflammation. Methods This review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered at the International Prospective Register of Systematic Reviews (PROSPERO) (registration number CRD42025633576). Two authors independently performed searches in PubMed, Embase, the Cochrane Library, and Scopus. Results In total, 1317 studies were identified, of which 10 met the inclusion criteria after full-text screening. All studies compared perfusion with a healthy control group, seven included a gingivitis group, five included patients with periodontitis, and none included patients with peri-implant disease. Higher blood flow values were found in patients with chronic gingivitis compared to healthy controls, while patients with experimental gingivitis showed no significant difference. Blood flow values in patients with periodontitis showed controversial results. Conclusions LDF shows potential utility in detecting chronic gingival inflammation and altered perfusion patterns between healthy individuals and those with gingival or periodontal inflammation. However, reliably grading perfusion across disease stages and distinguishing between acute gingivitis and chronic periodontitis remains challenging. Notably, there is a lack of data regarding the use of LDF in peri-implant tissues, representing a significant gap in current research. At present, established clinical parameters such as probing depth and bleeding on probing (BOP), remain the gold standard in routine periodontal diagnostics.

Background Teledentistry has the potential to enhance access to dental care and interprofessional communication. However, its implementation depends strongly on practitioners’ acceptance and understanding. Therefore, this study aimed to assess dentists’ awareness, knowledge, and acceptance of teledentistry and to examine how professional experience, anticipated frequency of use, and practice size influence their attitudes. Furthermore, the interest in a dedicated teledentistry centre was evaluated. Methods A cross-sectional survey was conducted among 362 dentists. A 16-item questionnaire was distributed via SoSci Survey and in paper form. Statistical analysis included chi-square and Fisher-Freeman-Halton exact tests ( P < .05). Results Of the 362 dentists invited, 187 completed the survey, yielding a response rate of 52%. More than 70% of participants were familiar with the term teledentistry, yet only one quarter demonstrated a comprehensive understanding of its scope. About one third (32%) had previously used teledentistry in clinical practice. A large majority (71%) considered the establishment of a regional teledentistry centre beneficial, for improving communication with specialists and managing referrals, although their expectations regarding acceptable response times varied considerably between one day and one week. Interest in teledentistry showed no significant association with years of professional experience ( P = .76) or the number of dentists in a practice ( P = .598) but correlated significantly with the frequency of relevant clinical cases ( P < .01, Cramér’s V = 0.449). Main concerns included diagnostic limitations without in-person contact and data privacy. Conclusions The study highlights a generally positive attitude toward teledentistry. The findings provide substantial support for the proposed initiative to establish a teledentistry centre, operating on the premise of the store-and-forward method. Familiarity with the concept and clinical demand influence acceptance more than professional experience or the number of practicing dentists in a dental office.

Background The Oxygen-2-see (O2C) analysis system can measure flap perfusion, which is a prerequisite for flap viability, and it is therefore commonly used in flap monitoring for microvascular head and neck reconstruction. However, in the context of predefined threshold values for perfusion parameters indicating vascular flap compromise, it is unclear whether blood hemoglobin and hematocrit levels are confounding variables. The aim of this study was to investigate the influence of blood hemoglobin and hematocrit levels on flap perfusion parameters. Methods Perfusion parameters (i.e., flap blood flow, hemoglobin concentration, and hemoglobin oxygen saturation) measured intraoperatively and postoperatively with the O2C analysis system at 8- and 2-mm tissue depths were retrospectively analyzed in 125 patients reconstructed with a radial free forearm flap (RFFF), an anterolateral thigh flap (ALTF), or a fibula free flap (FFF) between 2011 and 2020. Associations between perfusion parameters and blood hemoglobin and hematocrit levels were analyzed using Spearman correlation coefficient and multiple linear regression models. Results Postoperative hemoglobin concentration at a 2-mm tissue depth was associated with blood hemoglobin and hematocrit levels in RFFFs ( r  = 0.259, p  = 0.031; and r  = 0.268, p  = 0.026; respectively). Both associations persisted in multivariable regression analysis ( p  = 0.040 and p  = 0.036). No other associations between perfusion parameters and blood hemoglobin and hematocrit levels were observed for RFFFs, ALTFs or FFFs (all p  > 0.05). Conclusions For the perfusion parameters flap blood flow and hemoglobin oxygen saturation no association with blood hemoglobin or hematocrit levels was observed. This underlines the validity of absolute threshold levels for indicating vascular flap compromise in the context of flap monitoring with the O2C analysis system.

Background The sandwich principle is an educational concept that regularly alternates between collective and individual learning phases within one learning unit. Applying sandwich principle to lectures has proven to be more effective for learning outcomes than classical lectures. Supposedly, this teaching format also leads to a beneficial knowledge transfer when applied to other teaching formats. Therefore, the aim of this study was to investigate the effect of the sandwich principle on instructional videos and how its use was evaluated by students. Methods Participants ( n  = 51) were randomly allocated into two groups. Both groups were given a test to assess the baseline level of knowledge. Afterwards, the control group watched the normal instructional video on cleft lips and palates, while the sandwich group watched the same video modified according to the sandwich principle. The participants then had to answer 30 single-choice questions to assess their knowledge gain and evaluate the instructional video. Long-term retention of the knowledge was tested again 6 months later using the same test questions. The unpaired t-test and ANOVA were used to compare the results. Results Comparison of the pre-test and post-test results of both groups showed significantly increased test scores ( p  < 0.0001). Regarding long-term retention, the mean test scores were still significantly higher in both groups than before watching the video ( p  < 0.0001). For all test results, there was no significant difference between the groups ( p  > 0.05). The evaluation showed that the students highly appreciated the modified video and found the interruptions for repetition of previously learned knowledge useful. Conclusion The hypothesis that the modification of instructional videos according to the sandwich principle would lead to an improved learning outcome could not be proved subjectively or objectively. Nevertheless, the teaching format was highly appreciated by the students and may have increased their motivation to learn with instructional videos.