Dr. Hans Ulrich Brauer, M.A. Oral Surgeon Master of Integrated Practice in Dentistry Implantology, Periodontology Private Practice Brotstr. 2 D-79341 Kenzingen Germany
Abstract: BACKGROUND: Dental litigation has a key role for the autonomy of the dental profession. We conducted a study among legal dental expert witnesses in order to reflect the present situation and reveal the potential for professional development. METHODS: A questionnaire was distributed among 161 participants of the Karlsruhe training for legal dental experts between 2004 and 2009. They were asked to describe and to reflect on the present situation of dental litigation in Germany. RESULTS: 83 questionnaires were returned (51.6%). The main reason to become a legal dental expert was to "support the profession". 68 participants (85.0%) think that civil action resulting from dental treatment will become more frequent. The quality of dental expert opinions is considered to be in need of improvement. Strategies to optimise dental expert opinions and to deal with the potential growing number of claims are developed. CONCLUSION: Basic and advanced training for dental expert witnesses assures the quality of dental expert opinions and also provides a chance for the further development of the dental profession.
Abstract: Supernumerary teeth are frequently found as incidental findings on x-rays. Generally, they are surgically removed as they can be responsible for complications such as lack of space, eruption disorders, retention, disturbed root development and cystic complications. On the basis of the typical position of supernumerary teeth it is shown in a case series that the dental cone beam computed tomography provides a suitable diagnostic tool for exact preoperative localization of supernumerary teeth in all three dimensions.
Abstract: The writing of dental expert opinions concerning planning reports and malpractice claims called by the Association of Statutory Health Insurance Dentists (KZV) is a responsible and challenging task. To make his decision, the dental expert witness has to take into account the current guidelines of the Federal Joint Committee, current evidence-based dentistry, the patient's interest, and finally the dentist's viewpoint. In this paper a list of features is presented which helps the dental expert to create a structured written dental expert opinion of good quality.
Abstract: Supernumerary teeth are an infrequent developmental alteration that can appear in any area of the dental arches and which are often associated with several syndromes such as cleidocranial dysplasia or Gardner syndrome. Multiple supernumerary teeth in individuals with no other associated diseases or syndromes are very uncommon.
Abstract: Keratocystic odontogenic tumour (KCOT): a case report and review of literature. According to the 2005 WHO classification of head neck tumours the parakeratinized form of the odontogenic keratocyst (primordial cyst) is listed as a form of benign odontogenic tumours and is classified as keratocystic odontogenic tumour (KCOT). This case report describes an osteolytic process in the mandibular angle which stood in connection with the right lower third molar in a 14-year-old patient. In the report the surgical regimen as well as KCOT as an entity is discussed.
Abstract: The rare solitary bone cyst which is also referred to as simple, traumatic or juvenile bone cyst, is a pseudocyst with an expansive growth and non-neoplastic osteolysis. It has one chamber, is filled with serous fluid or air and is often located in the mandibular body and usually discovered as an incidental finding in the panoramic radiograph. This case report of a 13-year-old patient illustrates two typical applications of the cone beam computed tomography (CBCT). It is useful for the radiological evaluation of unspecified osseous findings (in this case a solitary bone cyst) and also for the exact localization of supernumerary teeth. With the cone beam computed tomography a diagnostic tool is available that provides a radiological-based diagnosis and permits exact localization and extension in all three dimensions. Thus, CBCT is appropriate for precise preoperative planning and therefore minimizes surgical risks.
Abstract: Whether an indication exists to remove a third molar is determined by the corresponding guideline of the German Society of Dental, Oral and Craniomandibular Sciences (Deutsche Gesellschaft für Zahn-, Mund- und Kieferheilkunde, DGZMK). This guideline is clinically proven and gives both the referring dentist or the surgeon and the patient an acceptable amount of manoeuvring space, adequate for everyday clinical situations. Having received appropriate information targeted to the specifics of the individual case that specifically addresses the typical risks, the patient will give his or her informed consent to the surgical procedure. For forensic reasons, the content of the informational session with the patient must be correctly documented. Following an exploration of the patient history, clinical inspection and appropriate radiological diagnostics, the procedure itself will be carefully planned and conscientiously performed, and appropriate follow-up measures will be instituted.
Abstract: Surgical exposure of impacted maxillary canines: a review of literature. 1 - 2 of the population have impacted maxillary canines. These young patients often are in need of a combined orthodontic and surgical therapy. This review presents the recent literature concerning both the surgical interventions and the important preoperative diagnostics.
Abstract: Third molar removal is a frequent surgical procedure. Common complications associated with third molar surgery are well-recognized and frequently explained to patients during the process of informed consent. The general dental practitioner, as well as the oral and maxillofacial surgeon, must be familiar with all possible complications. This systematic review serves as a reminder of the unusual complications of this routine procedure.
Abstract: Qualified dental expert opinions play an essential role for the dental profession. In 1996, the Institute of Continuing Professional Development Karlsruhe initiated an advanced training program for legal dental experts. It is based on an approved concept and contains 5 weekend seminars. During that time case reports and their workups are presented by experienced legal dental experts; recent cases are reprocessed and discussed in small groups under supervision. In between seminars the participants can communicate in online meetings and can use a variety of tools in the virtual lecture hall. During the last seminar the participants present their own case workups in the plenum. In the virtual alumni lecture hall further online exchange continues. Additionally, upgrade seminars are offered on a yearly basis where recent topics of interest are discussed.
Abstract: Lawsuits concerning dental litigation are increasing. The court puts the dental expert in charge to clarify the court order. The question does arise what is a good expert opinion. The following paper describes the quality standard of dental expert opinions. A checklist is presented for the better expert opinion. By this checklist the dental expert could reflect his work and the quality of dental expert opinions could be made transparent.
