Dental Tribune Indian Edition

14 Dental Tribune Indian Edition - January 2013 Product designer Shirin Fani has developed an interactive toothbrushing device for children. (DTI/Photo courtesy of Shirin Fani) Dental implants provide a predic- table means for replacing missing teeth. Increasingly, the demand for implant treatment involves not only the restoration of function, but also achievement of an aesthetically ple- asing prosthesis that blends imper- ceptibly with the rest of the natural dentition. Both surgical and restorative fac- tors contribute and interact to achie- ve an aesthetic treatment outcome. Surgically, the clinician is mainly able to influence the hard and soft- tissue architecture of the edentulous space, which in turn provides the soft-tissue frame for the prosthetic reconstruction. A detailed evaluation of the site is required as a first step. Sites that are compromised by loss of bone and soft-tissue height may be difficult or impossible to reconstruct to the original pristine form. Limitations of treatment and the risk of adverse aesthetic outcomes need to be re- cognised, and communicated to the patient before the commencement of treatment. A number of surgical factors are under the control of the clinician. Positioning the implant in the cor- rect restorative position is a critical determinant of aesthetic outcome. Malpositioned implants may be as- sociated with adverse soft-tissue outcomes, including loss of papil- lae and recession of the midfacial mucosa. Facial malposition can be a risk with immediate implants placed into extraction sockets. When multi- ple adjacent teeth need replacement with implants, the relative position, dimensions and number of implants are important surgical considerations. Adjacent implants if placed too close together risk loss of the bone between the implants, which in turn may cau- se flattening or a crater between the papilla. This can have very negative aesthetic implications. As a general rule, adjacent im- plants should be avoided. Clinicians should also be aware of the dimen- sional changes that take place when multiple adjacent teeth are removed. It is often necessary to replace the missing soft tissue by addition of pink porcelain to the cervical regions of the prosthesis. Ongoing modelling of the alveolar bone may cause flattening of the rid- ge and thinning of the mucosa over time. Clinicians should attempt to reconstruct the natural morphology of the ridge and mimic the appearan- ce of a root eminence by grafting the external surface of the bone with bone substitutes that have a slow turnover rate. When adverse aesthetic outcomes occur, options for treatment depend upon the aetiology of the recession. Recession caused by inflammation or thin mucosa in an otherwise pro- perly placed implant can usually be corrected with soft tissue (connective tissue) grafts. With mucosal recession caused by facial malposition of implants, soft- tissue grafting methods have limited success. In severe malposition cases, the only practical solution is to remove the implant, reconstruct the ridge and insert a replacement implant in an op- timal axial position. In summary, achieving acceptable aesthetic outcomes with implants de- pends upon proper evaluation of the site and technically proficient pla- cement of the implant with adjuncti- ve augmentation procedures. When adverse outcomes occur, treatment options are limited. The adage that “prevention is better than cure” holds true for implants and adverse aesthe- tic outcomes.DT “I wanted to create a whole new experience of toothbrushing” An interview with designer Shirin Fani, Iran, about the Tooth Hero Children usually don’t like brushing their teeth. However, a new oral hygiene set, called the Tooth Hero, will encourage children to do so in a playful and interactive way. Shi- rin Fani, the inventor of the device hopes that the brush set will render the process of toothbrushing more entertaining for children and there- by more effective. The designer was born in Teheran, Iran, and studied industrial design in Austria. DT In- ternational editor Claudia Duschek spoke with her about the unusual device, for which she received this year’s national James Dyson Award, an international student design com- petition run in 18 countries. Claudia Duschek: What was your intention behind developing a dental tool for children? Shirin Fani: I graduated in June this year from the University of Ap- plied Arts in Vienna. For my diploma project, I wanted to design something for children in order to make their lives healthier in a smart way. I star- ted to spend a lot of time with them and found out that children don’t like brushing their teeth and when they do, they don’t do it correctly. Pa- rents usually have to do a follow-up brushing to ensure that their children’s teeth have been cleaned properly. How can this be achieved with the Tooth Hero? There are some common methods for encouraging children to brush their teeth, like toothpastes with dif- ferent flavours, toothbrushes with images of comic heroes, and brushing timers, etc. With my project, howe- ver, I wanted to create a whole new experience of toothbrushing. Instead of them buying Batman, Spiderman or Hello Kitty toothbrushes, I wanted them to learn more about the microor- ganisms that cause cavities and tried to make those bacteria visible for the children to identify them as enemies they can fight. This is why I came up with the idea of a brushing game in the form of an interactive brushing guide. Could you please explain the design and function of your innovative device? The Tooth Hero consists of a mul- tifunctional brush set with three parts, including a pH meter, an ultra- sonic toothbrush and an ultrasonic tongue cleaner, and comes with a projector. As acidic pH levels caused by some foods make one’s tooth enamel vulnerable, the pH meter measures whether it’s the right time to brush. When it turns green, the pH value in the child’s mouth indicates that he or she should brush but when it turns red, then he or she still has to wait. Furthermore, always having an aci- dic pH level can be a sign of caries and a visit to the dentist is recom- mended. The projector is the fun part. With a brushing game that can be downloaded from the Internet, it shows the bacteria depicted as co- loured dots on any surface in the bathroom. The tip of the toothbrush communicates the brushing pattern through sensors. The game is not fi- nished until all the dots have disap- peared and all the teeth have been brushed. Did you consult dental and educa- tional staff for advice on designing the device? Yes, of course. I read a lot and talked to dentists and parents about the Tooth Hero concept. I even ac- companied some children to their dentist. I showed a number of den- tists the prototype and discussed the project and its approach with them a great deal. How has your project been received so far? The brush set was tested by children from the start of the project. I received feedback from children throughout, from the very first idea of the product until the finished protot- ype. For them, using the Tooth Hero meant winning a game, which they lo- ved. The device gives children the op- portunity to be the heroes of their te- eth by fighting the bacteria that live in their mouth. In this manner, brushing rules can be taught; for instance, high brushing pressure can result in losing points in the game. What are your plans now? Are you going to develop more dental design products and market your idea? I found it fun to design for children. Winning the award was a step towards converting my con- cept into a real product. I haven’t introduced the project to any com- pany yet because I only finished the project at the end of June but I’m planning to approach some compa- nies because I absolutely believe in this project and its potential to be a real product and new trend in oral care for children.DT “The device gives children the oppor- tunity to be the heroes of their teeth...” Surgical factors that influence the aesthetic treatment outcome Dr Stephen Chen Australia Trends & Applications Dr Stephen Chen maintains a pri- vate practice in Melbourne in Au- stralia. He can be contacted schen@ balwynperio.com.au Contact Info