In order to provide you with even better service in the future, we are continuously working on improving the skills and expertise of our doctors and the clinic in the discipline of maxilla-facial surgery. Therefore we are actively participating in research, including but not limited to the following areas:
Malocclusion / Oral Surgery board Medicon
A maxillary advancement plate has been developed (Le Fort I-Prof Nolte see publications) by Medicon Instruments, that allows the surgeon to use fewer osteosynthesis plates for the fixation of the upper jaw. Furthermore, the fixation of the displaced maxilla using this method makes it no longer necessary to remove the osteosynthesis material. There is no longer need for a follow-up surgery to remove the metal.
Dental trauma guidelines
Our clinic focuses on trauma of the teeth at a young age. Prof. Nolte worked as a coordinator of the German Society of Oral and Maxillofacial Surgery (DGMKG) and the German Society of Dental, Oral and Maxillofacial Surgery (DGZMK ) and numerous professional authors of other specialist treatment facilities guideline for: treatment of dental trauma in the permanent dentition. The creation of an S2K guideline is currently in process with the involvement of all dental companies operating in Germany (see http://www.awmf.org/leitlinien/detail/anmeldung/1/ll/083-004.html).
We also looked into the field of gustatory sweating. The attached links (ZM online, "Help I'm sweating" textbook of dermatology and scientific published work maxillofacial surgery) show our activity in this area. In our studies, we have shown that the injection of botulinum toxin with dosages we tested can block the gustatory sweating for up to two years.For more information please refer to our page about botulinum toxin and also refer to the list of publications and http://www.zm-online.de/m5a.htm?/zm/11_03/pages2/titel1.htm, http://www.transpiration.de/?gclid=CMu4pfziu60CFQaGDgod91sECA
Minimally invasive bone augmentation / HgSO
Another focus of our clinic is the further development of minimally invasive techniques of bone formation. At various symposiums, we held lectured, describing this technique which minimizes the intervention by simultaneously maximizing the success rate of bone formation.More information can be found under Bone formation.
In our clinic, tooth transplantation is a frequently performed procedure. Unfortunately, the knowledge on the subject is not very common among colleagues, thus often leading to confusion with the patient. The autogenous tooth transplantation, which we are examining intensively in our own research projects, have a high potential for replacement of teeth in the juvenile and adult set of teeth. Especially in young patients, with proper indication, we can utilize this method with excellent results and success rates higher than 90%. However, the time window in which the patient is seeking consultation is very crucial.For example, a lost upper upper incisor in children aged 6 to 8 years can be excellently replaced by transplanting lower deciduous tooth (baby tooth transplantation). For this purpose, an existing lower deciduous tooth is used in place of a lost upper front tooth. This method has the advantage that the resulting tooth gap of the upper permanent maxillary incisor will be co-developed both aesthetically and functionally in an appropriate way. Later, at the age of 16-18 years, an implantation can be performed at that spot, without the need for bone grafting.
For more information please also read the PDF Autogenous tooth transplantation: new perspectives.
For traumatic tooth loss in 12-14 year olds, however, teeth can be replaced using the patient’s own tooth, with excellent cure rates of up to 100% (premolar transplantation). In this age group, the resulting tooth gap of the donor tooth can be closed by our orthodontics colleagues very easily. The advantage of this method is the elimination of the need for subsequent implants. Therefore there is no need for implanting any foreign material into the anterior maxilla. The dentist then constructs the crown of the premolar using plastic adhesive technology resulting in outstanding aesthetic results. Furthermore this method ensures excellent bone growth behavior, that currently no endosseous implant can provide.
In addition to this specific indication of the just decribed premolar transplantation, a molar transplantation of wisdom teeth can be administered at the age of 14-18 years. With this method, usually damaged back teeth (molars) are replaced with healthy caries-free third molars. This method is actually the origin of the development of tooth transplantation and is carried out with great success worldwide, especially in Scandinavian and Asian countries.
As conclusion this means, that tooth transplantation of milk teeth, transitional dentition and adult set of teeth have excellent survival rates of well over 80%, assuming the proper indications have been met, such as careful attention of the corresponding time slot for the transplanted teeth.
Therefore it is vital to consult with your dentist as soon as possible after your child’s tooth loss in order to ensure proper further therapeutic planning to explore the possibilities of milk tooth-, premolar-, and molar transplantation to ensure tooth preservation and bone growth of the jaw.
The results can be found in the accompanying scientific material:
- Autogenous tooth transplantation technique with great potential by Dr. Markus Thoma http://www.bzb-online.de/okt09/58_59.pdf
- Autogenous tooth transplantation- new perspectives Dirk Nolte and Robert Linsenmann and Karin Huth (see Publications).
- Autogenous tooth transplantation: current evidence base for the daily practice of Dirk Nolte et al (see Publications)
- Autogenous tooth transplantation: an evidence-based systematic review by Karsten Hinrichs (http://www-brs.ub.ruhr-uni-bochum.de/netahtml/HSS/Diss/HinrichsKarsten/)
- Autogenous tooth transplantation: a systematic, evidence-based review by Dirk Nolte et al (see Publications)
- Autogenous milk tooth transplantation by Dirk Nolte et al (see Publications)
Immediately after surgery
4.5 years after surgery
The x-ray images above show an already-effective transplantation of a not yet fully developed lower wisdom tooth in place of another lower molar tooth. As you can see from the pictures, after 4.5 years, the tooth shows a complete maturation of the root tips, which indicates the preservation of vitality. An orthodontist may integrate such a tooth into the further treatment using orthodontic braces.