Destination Hamburg

Hamburg - Gateway to the world & always worth a visit

Actually, people are going as far to call Hamburg “the most beautiful city of the world”. That is for sure the slightly understating sounding self-image that Hamburgers (don’t think about food!) have of their city.

Hamburg is a cosmopolitan host, open to change, refreshing by day and exciting by night. The pulsating hub of a region which primarily stands for vastness and nature, yet also has a lot more to offer. Hanseatic Brick Gothic, grand merchant’s mansions, royal country estates and manicured parks all make up the charm of northern Germany. They attest to the civic pride in maritime traditions, economic successes, entrepreneurial spirit and typically northern German style – but certainly not stagnation.

Special Offer: Visit Hamburg and save up to 50€

Although – due to the current circumstances – the City of Hamburg will not serve as a stage for this year’s EAPD Congress, we hope to welcome you back soon.
Since we are very happy to have you as guests in our wonderful city, the Hamburg Tourism Board offers a special treat for your travel preparations.

All facts at a glance

Hamburg – recipe for the best city in the world:

For further details regarding Hamburg, please visit the official website of Hamburg

Link: https://www.hamburg-travel.com

Sondos Albadri (United Kingdom)

Sondos is a Professor and Honorary consultant in Paediatric Dentistry at the University of Liverpool. She is the Vice Dean for Research and postgraduate studies and the academic lead for Paediatric Dentistry.

Sondos graduated from Jordan University of Science and Technology in 1997 with a BDS and completed her PhD from Queens University Belfast. After completing specialist training, she joined the University of Liverpool in 2008 where she completed her consultant training in Paediatric Dentistry. She was appointed as a senior lecturer and honorary consultant in Paediatric Dentistry in 2011 and promoted to a Professor in November 2018.

Sondos developed the Doctorate programme in paediatric dentistry, the programme follow the UK Specialist training curriculum combining research and clinical training.

Sondos’s research is focused on child centred care. She has research collaborations in Dental Trauma, Stem cell and regeneration and clinical trials. Sondos has published and co-authored over 40 peer-reviewed publications. She has been a reviewer for a number of Dental Journals and publishers. Sondos is the associate editor of the International Journal of Paediatric Dentistry and has been the chair of the British Society of Paediatric dentistry conference abstracts and prizes committee since 2015.
Sondos has been providing CPD courses in Paediatric Dentistry and Dental Trauma, to general practitioners, specialist trainees and consultants for many years. She jointly developed an international course for Endodontics in children attended by consultants and specialists

Sondos is the academic representative on the Royal College of Surgeons of Edinburgh Speciality Advisory Board in Paediatric Dentistry, and the intercollegiate body, which advise on Paediatric specialist training (Specialty Advisory Committee. She is a member of the examiners’ board for the tri-collegiate membership examination in Paediatric Dentistry. Sondos has held several external examiner positions for undergraduate, postgraduates and PhD programmes

Undergraduate Education in the UK

The majority of children in the UK access routine dental care and treatment at their General Dental Practitioners, therefore the undergraduate curriculum needs to ensure that dentists have the knowledge and abilities to manage children to the level of “safe beginner” as described by the General Dental council.

This presentation will discuss:

Current teaching of paediatric dentistry in the UK
Current expectations from graduates, regarding providing dental care to children
Current guidelines on referral to specialist paediatric dentistry services within the National Health Service

Amre Shahwan (Ireland)

Professor Amre Shahwan
Consultant Paediatric Clinical Neurophysiologist & Epileptologist
Temple Street Children’s University hospital
Dublin Ireland

Professor Amre Shahwan is Consultant Paediatric Clinical Neurophysiologist and Epileptologist at Temple Street Children’s University Hospital, Dublin, Ireland since September 2008. After training initially in paediatric neurology, paediatric epilepsy, adult epilepsy and clinical neurophysiology (EEG) in Ireland, he specialised further in more complex paediatric EEG and complex paediatric epilepsy at the Royal Children’s Hospital in Melbourne, Australia. In his current role, he specialises in paediatric EEG, video EEG telemetry and complex paediatric epilepsy diagnosis and management. He is Honorary Associate Clinical Professor at the Royal College of Surgeons in Ireland with avid passion for teaching and education.

Epilepsy – What should we know as paediatric dentists
This presentation will address several aspects of epilepsy which paediatric dentists should be (or would like to be) aware of. There is a relatively new system for classification of seizures and epilepsy which the epilepsy community itself is only beginning to become familiar with. Old terminology is being replaced with new terminology and new abbreviations which I hope to make easy for you to remember and recognise with ease after this presentation. There are some practical aspects of epilepsy and drug therapy paediatric dentists may encounter during clinic or surgery (including significant side effects which may impact on dental health but also on dental therapies/surgeries). There are different modalities for treatment of epilepsy other than antiepileptic drugs including diets and electronic devices you may come in contact with and may have some effect-impact on certain investigations and therapies you may be carrying out. If a child has an epileptic seizure whilst in your care in clinic, are you comfortable dealing with it? Do you need to have specific measures in place where you work to be ready for such situation?
I aim to address all the above points in this presentation which is planned to demystify, clarify, inform, update and install confidence in paediatric dentistry colleagues when dealing with patients/children with epilepsy. If this summary excites you or indeed provokes certain concerns or questions in your mind, please have these ready! I will happily address these on the day.

David Manton (Netherlands)

Prof. David John Manton BDSc MDSc PhD FRACDS FICD FADI FPFA
Elsdon Storey Chair of Child Dental Health
Chair, Postgraduate Research and Education Committee
Head, Growth and Development Section

David has spent more than 30 years in private practice and academia and is currently the Elsdon Storey Chair of Child Dental Health and a visiting consultant at RCH. He is involved in several collaborative and postgraduate research projects in both paediatric dentistry and orthodontics. Graduated BDSc (Melb) in 1984 and worked in general practice until 1991 when he undertook an MDSc in Paediatric Dentistry. He was dental advisor to the Australian Federal Government from 1994 – 1996 and won the KG Sutherland Prize of the RACDS in 2007. He is on the editorial boards of the European Archives on Paediatric Dentistry and the International Journal of Paediatric Dentistry, and the advisory panel (board) of the European Caries Research Association (ORCA).

Over the past 15 years David has spoken throughout Australia, Asia and Europe and has wide ranging experience in laboratory and clinical trials of CPP-ACP, Minimum Intervention Dentistry, the definition, detection, and treatment of carious lesions, developmental defects of enamel and the use of calcium silicates in endodontics. He has published more than 100 manuscripts in peer-reviewed journals and has been cited more than 3000 times since 2014.

Summary
Developmental defects of enamel (DDE) are a prevalent condition affecting both the primary and permanent dentitions – and one of the most prevalent is MIH. A mean prevalence of around 15% has been reported for MIH, with around one third of affected teeth being affected severely. MIH affected teeth can be sensitive, suffer from post-eruptive breakdown (PEB) and have poor restorative outcomes. Therefore, repair or remineralisation of the hypomineralised lesion has the potential to ameliorate these problems. However, when trying to preserve enamel integrity, several issues can influence mineral gain of affected enamel, such as individual caries risk and compliance, lesion surface layer thickness, increased protein content and rapid PEB. Due to the high prevalence of MIH worldwide and its influence on caries risk and treatment burden, MIH presents a challenge to oral health care systems; so minimisation of treatment burden is imperative.

Learning objectives
To understand the possibility of remineralising hypomineralised enamel
To understand the limiting factors for remineralising hypomineralised enamel
To understand the methods that may improve remineralisation potential

Gabriel Krastl (Germany)

Dr. Gabriel Krastl received his degree in dentistry from the University of Tübingen, Germany in 1998 and has been a staff member and research associate until 2005. From 2005 to 2014 he was a senior research associate at the Clinic of Periodontology, Endodontology and Cariology in Basel, Switzerland. 2006 he co-founded the interdisciplinary Center of Dental Traumatology at the Basel University. Since 2014 Gabriel Krastl is Professor and chair of the Department of Conservative Dentistry and Periodontology at the University Hospital of Würzburg, Germany and directs the Center of Dental Traumatology which he founded in 2015.
He published more than 100 papers mostly in the field of endodontology and dental traumatology and serves as a reviewer in several scientific journals.

Saving the Unsavable: Interdisciplinary treatment options for fractured, necrotic immature teeth

Prof. Dr. Gabriel Krastl

Teeth with deep subgingival tooth fractures are usually deemed non-restorable. When tooth preservation is nonetheless essential, all treatment modalities have to be considered. Surgical crown lengthening can be performed to expose the root and allow restorative treatment. However, the reduction of alveolar bone may be associated with unfavorable gingival architecture and poor aesthetic results in the anterior region.

Orthodontic extrusion (forced eruption) may be a suitable alternative to transpose the lesion to a more coronal position. Surgical extrusion, also referred to as intra-alveolar transplantation, was introduced as a faster alternative to orthodontic extrusion. Since the tooth is first extracted, deep root injuries can be diagnosed more easily compared with orthodontic extrusion. Prognosis after surgical extrusion was shown to be favourable, however the level of evidence is rather low. To minimize the risk of resorption associated with surgical extrusion, minimally invasive extraction procedures are advantageous.

Although the treatment of crown-root fractures is one of the most technically demanding procedures in dental traumatology and is frequently considered as a long-term temporary restoration, tooth conservation up to the age at which implants can be placed may be regarded as a success. However, in many cases even long-term tooth preservation of teeth with deep subgingival fractures seems feasible.

Learning Objectives

Discuss the clinical problems associated with deep subgingival margins particularly in immature teeth
Demonstrate how endodontic and restorative treatment can be carried out in difficult cases
Demonstrate the use of atraumatic extraction systems to reduce the trauma to the PDL during tooth extraction

Christian Kirschneck (Germany)

Priv.-Doz. Dr. Dr. Christian Kirschneck
Chief Senior Physician, Department of Orthodontics, University Hospital Regensburg

Education and Qualifications
Graduation from the University of Regensburg in both Dentistry and Molecular Medicine with distinction, Ph.D. in both subjects with the rating “summa cum laude”
2017 Specialist in Orthodontics
2017 Habilitation and Venia legendi for Dentistry at the University of Regensburg

Academic Appointments
2018 Senior Physician, Department of Orthodontics, University Hospital Regensburg (Head: Prof. Dr. Dr. Peter Proff)
since 2018 Member of the Editorial Board of the scientific journal “Annals of Anatomy”
since 2019 Vice President of the Association for Basic Research (AfG) of the German Dental Society (DGZMK)
since 2019 Chief Senior Physician, Department of Orthodontics, University Hospital Regensburg (Head: Prof. Dr. Dr. Peter Proff)

Focus of Scientific and Clinical Activities
Biological-molecular basic research on orthodontic tooth movement
Clinical and epidemiological research on various topics
Author of numerous scientific publications and book contributions (inter alia on molar incisor hypomineralisation, relapse/retention and craniomandibular dysfunctions in orthodontic context)
Management of orthodontic relapse and retention
Adult orthodontics

Extraction and space management – the orthodontic solution
Extraction therapy and orthodontic space closure represent a valid treatment approach for molars affected by molar incisor hypomineralisation (MIH), which also offers certain advantages over prosthetic-restorative therapy, given favourable factors for orthodontic treatment success and a certain severity of hypomineralization with poor long-term prognosis. The decision to extract MIH-affected first molars, however, should not be made by the paediatric dentist or orthodontist alone, but always in conjunction after comprehensive interdisciplinary diagnosis and joint treatment planning, taking into account general, local and secondary factors. Extraction therapy needs to consider not only the MIH pathology itself, but the entire dental and orthodontic status of the patient in question to achieve maximum patient benefit and the individually optimal treatment with minimal adverse effects. For the success of orthodontic extraction therapy in MIH, choosing the optimal time for molar extraction (between 8 and 11.5 years of age), depending on the jaw (upper or lower) as well as the presence or absence of additional dental crowding, is essential. An early referral of children affected by MIH to the orthodontist and an orthodontic examination in the early mixed dentition is recommended to allow for correct timing of orthodontic extraction therapy and space closure in patients, which would benefit from this treatment approach. In this talk the extraction of MIH-affected molars and subsequent orthodontic space closure is discussed as possible treatment option in patients with severe MIH as well as corresponding prerequisites, timing and treatment strategy.

Ivana Radovic (Serbia)

Ivana Radović, DDS, MSc, PhD
Associate Professor
Clinic for paediatric and preventive dentistry
Vice-dean for Research
School of Dental Medicine
University of Belgrade, Serbia

Ivana Radovic works as an Associate Professor at the Clinic for paediatric and preventive dentistry, School of Dental Medicine, University of Belgrade, Serbia, where she graduated in 2001 and received a Master’s degree in 2005 (topic: Bond strength, microleakage and SEM investigation of self-etching adhesive systems). She defended her PhD thesis at the University of Siena in 2009 (title: Different aspects related to luting fiber posts). Dr. Radovic specialized in preventive and paediatric dentistry at the School of Dental Medicine, University of Belgrade in 2007. She co-authored several textbooks. Dr. Radovic published numerous articles mostly in the field of adhesive dentistry in international scientific journals, and gave many invited lectures. Dr Radovic is also a reviewer for several leading international scientific journals. Since 2018 she also works at the position of Vice-Dean for Research at School of Dental Medicine, University of Belgrade.

Bread and butter of prevention in practice
Prevention is the cornerstone of every pediatric dentistry practice. In order to enable the maximum effect of preventive measures to take place in a child, the implementation of preventive measures should start during pregnancy, whenever this is possible.
During the first years of life the responsibility of maintaining oral health lies predominantly on child’s parents/caregivers, who need to be fully aware of the importance of their role. Nevertheless, at-home care is not an independent entity, but an activity that needs to be continuously supported by professional guidance, motivation and education, as well as by professional monitoring and intervention when needed. We can expect the best at-home care to be administered by parents/caregivers that are oral health literate and eager to make every effort so that dentition in their child remains both functional and estheticaly pleasing.
In line with the evidence-based dental approach, clinical recommendations should be integrated with the individual approach to the child, with the expert judgment of the dentist, as well as with the child’s needs and preferences. It is very important to pay attention to the collection of data relating to the child’s risks (hygiene, nutrition) and needs (absence of pain and discomfort, functioning, self-esteem) as a basis for adapting preventive care to be based on individual needs.
Dentists should be motivated to build relationships with children that will encourage them to gradually take full responsibility for their own oral health and prevent disease, rather than depend on the dentist to cure problems when they occur.

Monty Duggal (Singapore)

Prof Duggal obtained his dental degree and MDS in Paediatric Dentistry from India. He then immigrated to the United Kingdom and obtained his FDSRCS from the Royal College of Surgeons of England and his PhD from University of Leeds. He was appointed Professor and Chair of Child Dental Health at Leeds Dental Institute in 1999 where he oversaw a large postgraduate programme in Paediatric Dentistry which has international acclaim. In January 2017 he was appointed as Professor and Head of Paediatric Dentistry in Faculty of Dentistry, National University of Singapore. Currently he is the Vice Dean and Faculty Research Director of the National University Centre for Oral Health, Singapore (NUCOHS). He has served in various senior positions, and was President of the European Academy of Paediatric Dentistry from 2014-2016 and has been on the board of EAPD for last 10 years. Professor Duggal has published over 160 research papers in international journals and is author of “Restorative Techniques in Paediatric Dentistry, which has been published in 7 languages and has sold over 16,000 copies worldwide. He is also a co-author of a textbook on Dental Traumatology and has Co-Edited “Paediatric Dentistry” by Oxford, now in its 5th edition and is the most widely followed textbook in Paediatric dentistry in the world. More recently he authored “Paediatric Dentistry at a Glance”, published by Blackwell Willey. He has administered research grants totaling over seven million pounds and is an internationally recognised researcher and clinician with main research interest is Cariology and Translation Research in Clinical Paediatric Dentistry, including dental traumatology and regenerative endodontics and auto-transplantation. Apart from Paediatric Dentistry his main interest is playing and watching cricket and any time spare from work and family is devoted to this important activity

Replacing the unsavable – An Interdisciplinary approach to achieve biological long-term outcomes for children and adolescents
Complex and severe trauma to the dento-alveolar structures in children can carry a life-long legacy of dental disability. Such injuries can cause irreversible damage to not only teeth, but also supporting structures such as bone making achieving long term aesthetic outcomes challenging. We have developed a multidisciplinary approach for the management of anterior teeth with poor prognosis or those that are lost as a result of dental trauma. This involves bone management at the affected site followed by autotransplantation (AT). Since the inception of this programme we have placed over 260 transplants using the multidisciplinary team comprising of both paediatric dentistry and orthodontic expertise. In this talk the speaker will aim to provide an overview of interdisciplinary treatment planning involving paediatric dentistry, orthodontics and other specialities with the goal of providing children with a long term sustainable, and biological outcome. Methods to enhance the prognosis, such as the use of surgical templates and 3D printed tooth replicas for use in surgery to reduce the damage to the PDL of the donor tooth will be discussed. The technique and clinical protocol of autotransplantation will be presented, and importantly its clinical application will be demonstrated with discussion of several clinical cases with diverse, and some complex indications to highlight the versatility of this technique. Long term outcomes of up to 15 years and prognostic indicators for successful outcome will also be highlighted.

Richard Steffen (Switzerland)

Dr. Richard Steffen WBA KZM SSO finished dental school at Basel University in 1985, made his doctor degree in 1987 and specialist training in paediatric dentistry fulfilled 1991. Since 1991 he is working in his private paediatric dentistry office and since 1998 as a senior lecturer and scientific member of paediatric dentistry department University of Zürich. Sommer 2018 he started as an Assist. Prof./Oberarzt at the Center Dental Medicin in Basel.
2008 he founded and is co-owner of Medcem GmbH. Since 2003 he is member of the scientific board of Swiss Paediatric Dental Society (SVK / ASP). From 2008 to 2014 he was delegate of Switzerland in EAPD (European Academy of Paediatric Dentistry). Currently he is member oft the Board EAPD and head of the organizing committee EAPD Lugano 2018.
His research and clinical interests are in the fields of MTA / Hydraulic Silicate Cements, Endodontics, Regenerative Endodontics, Sedation esp. with Nitrous Oxide, Stomatology Oral Pathology, Paediatric Dentistry, Traumatology. He also is responsible for the Swiss SVK / ASP education program in sedation. He has written more than 40 publications (most in German) and several chapters in books.
The education platform for stomatology and oral pathology in children and adolescents, www.stomatopedia.com has been initiated by RS.

Summary
The term molar incisal hypomineralization (MIH) describes the clinical picture of more or less strongly hypomineralized first permanent molars and permanent anterior teeth. These sometimes hypersensitive teeth can only be treated with complete pain control. With the knowledge of the connections of this hypersensitivity, the correct behaviour management (BM), an adequate anaesthesia technique, exactly matched to the MIH premedication and compassion for our patients, it should be possible to treat most of the teeth affected by MIH under practice conditions. If the correct analgesic is used, pain control can also be performed on chronically inflammatory MIH molars (pain protocol, pain algorithms). Sedation with a mixture of nitrous oxide and oxygen allows the in-depth application of BM techniques. As a last solution, the dentist has the option of a rehabilitation under general anaesthesia.

Hani Nazzal (United Kingdom)

Dr. Hani Nazzal
Senior Consultant, Paediatric Dentistry, Hamad Medical Corporation and visiting lecturer, paediatric department, school of dentistry, University of Leeds
BDS, MFD RCS (Ireland), PhD Paediatric Dentistry, FRCD (Canada) Paediatric Dentistry, MPaed Dent RCS (Glasgow), FDS Paed Dent (Glasgow).

Dr. Hani completed three years clinical training in Paediatric Dentistry at the University of Leeds in 2008 after which he obtained a Fellowship in Paediatric Dentistry from the Royal College of Dentists in Canada in the same year. He then worked as a Senior Dental Officer in Paediatric Dentistry at Bradford and Airedale Salaried Dental Services between 2008 and 2012. He became a member and then a fellow of the Royal College of Physicians and Surgeons of Glasgow (Paediatric Dentistry) in 2015 and 2016. He worked as an academic Paediatric Dentist consultant at University of Leeds in 2017. In 2018, Dr Hani was appointed as a senior consultant in Paediatric Dentistry at Hamad Medical Corporation.

Academically, he obtained a PhD in paediatric Dentistry from the University of Leeds, School of Dentistry in 2008. In 2012, he was appointed as a NIHR Clinical Lecturer in the paediatric dentistry Department where he was involved in undergraduate and postgraduate education. Dr Hani is also the founding president of the Arabian Academy of Paediatric Dentistry.

His research interests are in the field of fluoride anticariogenic effect; slow releasing fluoride device, dental plaque, regenerative endodontics and the use of laser Doppler flowmetry. Hani has multiple publications and co-authored several book chapters in addition to presenting in several UK national and international conferences. In addition, Dr Hani is currently an associate editor of the Paediatric Dentistry and Orthodontic sections of Dental Traumatology Journal.

Title:The preservation and regeneration of the traumatised dental pulp: A clinical guidance.

Abstract: Preservation of the vitality of the dental pulp is an essential component in the successful management of traumatised teeth. This is extremely important in the case of immature teeth with incomplete root formation, thin dentinal walls and compromised crown root ratios. Preservation of the pulp insures continuation of root development and hence improving the tooth’s long-term prognosis. Despite our best efforts, pulpal necrosis is one of the possible sequalae of managing traumatised teeth. In immature teeth, root canal treatment using traditional endodontic techniques lacks the potential in promoting continuation of root development. Therefore, pulpal regeneration has been hailed as the best approach in managing these cases. This lecture focus on presenting available techniques and material used in preserving and regenerating the dental pulp within the available evidence.

Objectives:

1) To discuss the available techniques and materials used in preserving the traumatised dental pulp within available evidence.

2) To discuss the evidence and available guidelines of regenerative/revitalisation endodontic technique.

Lars Andersson (Sweden)

DDS, PhD DrOdont, Senior Professor Oral & Maxillofacial Surgery

Dr Andersson completed undergraduate and research training at the Karolinska Institute in Stockholm, Sweden and subsequently became Specialist in Oral and Maxillofacial Surgery in 1981. He defended his doctoral thesis in 1988 on experimental and clinical studies on root resorption after replantation of teeth. He was appointed Docent at Karolinska Institute, Stockholm, Sweden in 1990. As consultant Oral Maxillofacial Surgeon in the 1980s and 90s, he gained extensive clinical experience. His main expertise is in trauma, orthognatic and implant surgery. He belongs to the first-generation implant surgeons and directed an implant training program in the 1990s in which implant surgeons from all continents of the world were trained. He chaired a national specialist training program in Oral and Maxillofacial Surgery in Sweden. During the period 2002-2017 he was Professor in Oral and Maxillofacial Surgery at Kuwait University in Kuwait and from 2017 Senior Professor in Oral Maxillofacial Surgery at Malmö University, Sweden. He has published numerous articles and letters and more than hundred research articles in international Medline indexed scientific journals. Dr Andersson has been textbook editor of five textbooks and chapter author in several textbooks. He was Editor-in-Chief of the internationally renowned scientific journal, Dental Traumatology from 2007-2015 and was President of the International Association of Dental Traumatology 2011-2014.

Satellite Symposium in Dental Trauma – Currently accepted treatment protocols

Periodontal injuries after dental trauma – risk and consequences of ankylosis and how manage this complication

The periodontal ligament is often damaged by dental trauma. Compression, tearing, drying or storage in non-physiologic conditions are examples of this. Root resorption is often seen after serious traumatic dental injuries such as tooth avulsions and intrusions. While infection related root resorption today can be prevented or treated, ankylosis is the most serious complication resulting in progressive replacement resorption of the root by bone and eventually causing loss of the tooth. Moreover, inhibition of growth and development of the alveolar process is seen in young growing patients following ankylosis. However, also this complication can be managed today. The lecture will present how ankylosis will develop, explain its progression and consequences and how we can understand and manage such situations today. The recent shift in paradigm from “save the tooth” to “preserve the bone” will be presented.

Eija Salmela (Finland)

I have worked as a university lecturer in Pediatric Dentistry at the University of Helsinki and as a pediatric dentist at the Hospital for Children and Adolescents in Helsinki, Finland since 2012. I got specialist degree in Pediatric Dentistry in February 2019.

I finished the doctoral degree under supervision of Professor Satu Alaluusua at the University of Helsinki in 2011. During my postgraduate studies, I did in vitro research on the effects of organic environmental toxicants on hard tissue formation in developing tooth. In recent years I have participated in Professor Alaluusua’s research projects studying etiological factors of molar incisor hypomineralisation. Currently I have been working in a project concentrating in inherited diseases of dental hard tissues.

MIH and possible associations with childhood illnesses and antibiotics

Molar incisor hypomineralization (MIH) is a common condition with a worldwide prevalence reported to vary between 2.4% and 40.2%. In MIH, demarcated dental enamel hypomineralization defects are found in first permanent molars (FPMs) and frequently also in permanent incisors. The clinical severity of enamel defects ranges from small, demarcated areas with a mild change in color to large, severe lesions with post-eruptive enamel breakdown. Hypomineralized enamel lesions may cause increased treatment-need and discomfort to the patient.

The origin of MIH is systemic, but studies have shown that there might be a genetic influence as well. However, the etiology is still unclear, even though several etiological factors have been suspected. These include e.g. birth complications, common childhood illnesses, antibiotics and environmental contaminants.

Enamel of FPMs starts to mineralize around birth and the enamel formation is completed at about three years. Therefore, medical problems during the early childhood have been proposed as possible etiological factors. Several studies have reported associations between early childhood fever, respiratory disease, pneumonia, acute otitis media and MIH. There are also studies that have not found significant associations.

The use of antibiotics as an etiological factor has also been studied and significant associations have been reported in part of them. The literature is however sparse, and the level of evidence is very low. In addition, because antimicrobial drugs are used against for certain illnesses, it is difficult to determine which one, the illness itself or the antibiotic used for the illness, may have a greater impact for the risk of MIH, or is there a combined effect. In some experimental in vivo and in vitro studies, amoxicillin has disturbed enamel matrix formation and mineralization, leading to quantitative and qualitative defects in enamel. Findings from experimental studies may support the hypothesis of antibiotics as an etiologic factor for MIH, but any straightforward conclusions to humans cannot be made.

Learning Objectives:

-Even though early childhood diseases might be associated with MIH, the level of evidence is still low.

-The role of antibiotics is uncertain but possible. The literature is sparse, and the level of evidence is very low.

-It seems that the etiology of MIH is multifactorial.

-More well-designed prospective studies are needed to clarify the etiology.

Bart van Meerbeek (Leuven, Netherlands)

Bart van Meerbeek
Professor in Dental Biomaterials Science
KU Leuven – BIOMAT, Department of Oral Health Sciences I Restorative Dentistry – UZ Leuven
bart.vanmeerbeek@kuleuven.be

Bart Van Meerbeek obtained his DDS in 1988 and his PhD in 1993 at KU Leuven (University of Leuven) in Belgium. He continued his research activity abroad for one year at the University of Texas Health Science Center at San Antonio, Texas, and later also at the University of Missouri-Kansas City. In 1995, he became Assistant Professor (‘Docent’) at KU Leuven and since then teaches Dental Biomaterials Science. In 1998 and 2002, he was promoted respectively to Associate Professor (‘Hoofddocent’) and Professor (‘Hoogleraar’), and in 2005 to Full Professor (‘Gewoon Hoogleraar’). His primary research interest involves studies related to the broad field of Adhesive Dentistry, including fundamental as well as clinical research regarding dental adhesive technology in particular. Newer research lines deal with Dental Ceramics, Cariogenicity & Biocompatibility of Dental Materials, Bioactive Materials and Pulp-preservation Material Technology. His research work has been published in more than 400 peer-reviewed journals and has been honoured with awards such as the 1996 triennial Robert Stock Award for best PhD dissertation in Biomedical Sciences, Albert Joachim Award in 1997, Award in Biomedical Sciences of the Research Council of KU Leuven in 1998, IADR Young Research Award in 2000, SmithKline Beecham Award in 2001, Academy of Operative Dentistry Buonocore Memorial Lecturer in 2003, CED-IADR (Continental European Division of IADR) Robert Frank Lecturer in 2008, 2014 IADR/AADR William J. Gies Award for the best 2014 JDR paper in the Biomaterials & Bioengineering Research category, and the 2015 IADR Wilmer Souder Award (IADR Distinguished Scientist award for Dental Materials). In 2003, he became holder of the Toshio Nakao Chair for Adhesive Dentistry. He was President of the Pan-European Federation of IADR in 2006-2007 and is currently serving as Secretary of the Continental European Division of IADR or CED-IADR. Recently in September 2019 (Madrid), he was elected as President Elect of CED-IADR to become CED-IADR president in September 2020 with the task to organize the 2021 CED-IADR/NOF Oral Health congress in Brussels (September 16-18, 2021). Since 2004, he is Editor-in-Chief of the Journal of Adhesive Dentistry.

What’s new in adhesive (paediatric) dentistry?
This lecture aims to provide an update on modern adhesive technology to directly restore teeth. An overview of the current state of the art regarding dental adhesive technology and their adhesion performance to enamel and dentin will be presented. The most recent generation of ‘universal’ adhesives enable the dentist to choose for either an ‘etch-and-rinse’ or ‘self-etch’ bonding approach. A next research challenge is to develop adhesive technology that additionally provides bioactivity. This can be diverse in terms of anti-microbial, anti-enzymatic and/or re-mineralization potential. Special attention will be given to potential differences in bonding to deciduous versus permanent tooth tissue, as well as some new self-adhesive restorative material developments will be addressed.

Tim Watson (London, UK)

Prof Tim Watson BSc BDS PhD FDSRCS
King’s College
Faculty of Dentistry, Oral & Craniofacial Sciences
Guy’s Hospital, London

Tim Watson is Professor of Biomaterials and Restorative Dentistry and Honorary Consultant in Restorative Dentistry at King’s College, in the Faculty of Dental, Oral & Craniofacial Sciences at Guy’s Hospital, London. Much of his research has been based on the microscopic imaging of new operative techniques and adhesive restorative materials, with extensive publications in the fields of microscopy, dental materials and operative dentistry. Twenty-five PhD students have graduated under his supervision over the last 25 years. He lectures worldwide and has attracted over £6M in research grants from Government, Charity and Industrial sources. He worked in the same private practice at weekends for over 30 years.

Interactions of Materials & Carious Dental Tissues
This talk will look at the intraoperative assessment and management of dental caries. The restorative dilemmas facing clinicians are more complex now than ever, as we have materials that can have a range of effects: from being simple sealers – to prevent bacterial ingress and proliferation, to bioactive materials with anti-bacterial properties and remineralising properties. Furthermore, one mustn’t forget that the pulp – dentine complex is a vital living organ and can respond by healing, with the laying down of reparative dentine, especially in the presence of therapeutic agents.

This talk will look at ways of determining the extent of dentine caries, using sound observational techniques backed up by microscopical imaging and bacteriological studies. The dynamics of the caries affected tooth complex and its interactions with materials in laboratory and clinical caries management experiments has shown that there are changes in the depths of a cavity with time. This may stall the carious process and also preserve pulp vitality.

What is new?
Discussions on the interaction of bioactive materials with caries-affected tissues.

Learning objectives

Re-evaluate how much decayed tissue needs to be removed during cavity preparation.
Appreciate the interactions between caries affected tissue and modern restorative materials.

Sylvie Babajko (France)

Diploma and field competence
Master of Molecular and Cellular Pharmacology, University of Paris 6, France (1990)
PhD on IGF system (Inserm U142 Paris), University of Paris 6, France (1993)
Permanent position at INSERM (CR2) (Inserm U142 Paris) (1995)
Authorization for research direction (HDR), University of Paris 6, France (1998)
Research work on IGF system in cell proliferation and tumorigenesis (1990-2003)
Research work on mRNA decay (cnrs UPR 2167 Gif/Yvette) (2003-2004)
Research on development of mineralized tissues (since 2004)
Group leader on gene – environment relationships and hypomineralyzing pathologies (since 2010)
Director of Research at Inserm (Inserm U1138 Paris) (2016)
Head of the Molecular Oral Pathophysiology Laboratory (since 2018)

Expertises
Local: Conseil du Centre de Recherche des Cordeliers, Conseil UFR Science du Vivant Université Paris-
Diderot, Conseil scientifique de l’UFR Odontologie Université Paris-Diderot
National: Membre du groupe de travail sur les perturbateurs endocriniens à l’ANSES (2017-2020),
Membre du groupe de travail sur les agénésies transverses à Santé Publique France (2019), Comité d’interface Inserm-Odontologie (depuis 2008), Conseil d’administration de la Société Française
d’Endocrinologie (2019-2021), Commission scientifique spécialisée n°6 de l’Inserm (2008-2012),
Comité d’évaluation à l’ANR SV1 (2013-2015)
International: Member of the International Association

Are endocrine disruptors responsible for hypomineralisations in human teeth?

Sylvie Babajko, director of research at the French National Institute of Health and Medical Research (INSERM)

Centre de recherche des Cordeliers – INSERM – Université de Paris – France

Our environment is considerably changing during last decades and, many recent data show the relationships between our lifestyle, exposure to multiple pollutants and development of chronic diseases. Among environmental pollutants, hundreds of them present endocrine disrupting activities, they are called endocrine disruptors (EDs). They are able to interact directly with the steroid and thyroid hormone receptors, to modulate steroid hormone synthesis and / or their circulating levels. They are thus able to disrupt the homeostasis and development of target organs, especially during fetal and perinatal life when they are particularly active. This window of time corresponds to dental development; any disturbance of amelogenesis may cause irreversible enamel defects. Molar Incisor Hypomineralisation (MIH) retained our attention because the prevalence of this enamel pathology is higher nowadays than thirty years ago suggesting an environmental causal factor, and because selective teeth are affected, permanent first molar and incisors, the first mineralizing teeth, suggesting a time-window causality. Despite its etiology is still unclear, probably multifactorial, EDs appeared as interesting enamel disruptor candidates to investigate. Our experimental results show the impact of several EDs, including bisphenol A, alone or in combination with other EDs, on the quality of enamel. The defects of rodent enamel exposed to these molecules share many structural and biochemical similarities with those of children with MIH.

We are currently progressing in characterization of the different types of hypomineralizations caused by environmental toxicants, and in ED mechanisms of actions in dental cells to demonstrate their effects. In the future, dental defects reflecting the history of exposure to toxicants could be taken into account in the follow-up of children, future adults likely to develop pathologies related to lifestyles and exposure to multiple environmental pollutants.

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