Fracture of the implant abutment screws is a complication which can render an implant useless. The prevalence of abutment screw fracture does not exceed 2,5% after 10 years. Causes are loosening of implant abutment screw, too few, too short or too narrow implants, implants not inserted perpendicular to the occlusal plane, improper suprastructure, too long free-ending parts of the suprastructure, improper occlusion concept, premature occlusal contacts, parafunctions, inadequate skills of the dentist, and fabrication failures. Methods of removing a fractured implant abutment screw piece are, among others, the use of a self-made screwdriver and the use of a service set available for the specific implant system.

In a study involving a group of 907 randomly selected Dutch individuals, satisfaction about one’s physical appearance and satisfaction about the appearance of one’s teeth were assessed. Furthermore, the relationship between body esteem and happiness was explored. Three quarters of the respondents were satisfied about their physical appearance, while 70% was satisfied about the appearance of their teeth. Women and people with a non-Dutch background were significantly less likely to be satisfied about their physical appearance than men and those with a Dutch background. Individuals 30 years old and younger were more likely to be satisfied about their teeth than those who were older. Almost two third of the respondents (64%) reported that the appearance of their teeth contributed positively to their happiness. Women and people with a non-Dutch background were most likely to indicate that the appearance of their teeth contributed to their happiness. Satisfaction about general physical appearance and appearance of the teeth were significantly associated with happiness. Prospective studies are needed to examine to what extent esthetically motivated dental treatments make people happy and enhance their general well-being.

In 1987, the Dutch Society of Periodontology (NVvP) made it possible for dentists to be recognized as specialists in periodontology. This recognition lasts for 5 years after which, on the basis of an evaluation of the Consilium Parodontologicum of the NVvP, continuation of the recognition for another period of 5 years is possible. The Academic Centre for Dentistry at the University of Amsterdam and the University Medical Centre St. Radboud at Nijmegen University provide a 3 year full time specialisation programme in periodontology. These programmes are approved by the European Federation of Periodontology. After successful completion of one of these programmes, recognition as Periodontist by the Dutch Society of Periodontology can be requested. Possible recognition is based on an extensive evaluation during a one day site visit in the practice by the Consilium Parodontologicum.

In order to determine whether the quantity of bacteria in saliva and the degree of periodontal infection influence the speed of de novo plaque formation in periodontitis patients, 23 patients rinsed with 10 ml sterile saline. All teeth were then supragingivally and professionally cleaned, after which the patients were not allowed to undertake any form of oral hygienics for 24 hours. After this period, the rinsing procedure was repeated and the amount of de novo plaque was assessed. Three months after the initial periodontal therapy was completed the experiment was repeated. Both before and after treatment, the periodontal parameters were evaluated. The results showed that the quantity of the de novo plaque in healthy areas was less than in infected areas. In order to determine the influence of the quantity of bacteria in the saliva, only the areas which were already healthy before the treatment and the same areas after treatment were inspected. It was concluded that the degree of periodontal infection was the most important parameter for the degree of de novo plaque formation, but that the quantity of bacteria in the saliva also played a role.

In dentistry 3 aspects may lead to an improvement in the quality of life: pain reduction, aesthetic adjustments, and improvement of masticatory performance. Only the improvement of masticatory performance can be assessed objectively. Although orthodontists often claim that they improve masticatory performance, they seldom initiate treatment on the basis of functional limitations. Patients also often express the expectation that orthodontic treatment will improve their oral functions. Chewing is dependent on various anatomical, physiological and physical factors. The combination of all of these factors can reduce food particles to a greater or lesser extent. The magnitude of food reduction is known as masticatory performance. The masticatory performance is related to quality of life since it influences food selection, the quality of digestion, and the experience or enjoyment of eating. The smaller food particles are the easier will be the subsequent enzymatic food digestion during the later phases of digestion. Because it is clear, in the opinion of the authors, that malocclusions cause functional limitations, they conclude that orthodontists should integrate functional goals in their treatments in order to improve the quality of life of their patients.

Dysgnathia complex is a rare disorder characterized by a hypoplastic or absent mandible (micro- or agnathia), a limited mouth opening (trismus), a small tongue (microglossia) and ear anomalies. Since 1961 only 21 cases of isolated dysgnathia complex are reported in literature. Diagnosis of this disorder is difficult due to the general unfamiliarity of the disorder as well as the less apparent disparity with other known developmental syndromes of the head and neck area. A case of a female recently diagnosed with dysgnatia complex is discussed.

In general health care, use is increasingly being made, in diagnostics, of ionizing radiation sources. In accordance with a European law, the Dutch Ministry of Health, Welfare and Sports has set up a medical radiation information system (IMS). This internet digital information system provides insight into the yearly amount of radiation which the population receives as a result of the various diagnostic techniques. The use of dental x-rays also contributes to the amount of radiation. This system is intended to increase radiation consciousness and encourage the responsible use of ionizing radiation in health care.