Dental Tribune Indian Edition

6 Dental Tribune Indian Edition - April 2013World News We have a behavioural assessment questionnaire requiring less than five minutes to complete, which dentists can request from our website. How does an economic downturn affect dental-practice fraud? Difficult economic times create more of these desperate people I men tioned earlier, which creates more fraud. We did notice a much larger incidence of fraud in the Detroit area after the auto industry downsizing a few years ago. What are the first critical steps a dental practice owner should take if he or she suspects internal fraud is occurring? Unfortunately, intuitive steps are not always the right ones at this point. Dentists try to conduct their own in vestigation, bring their CPA into the office, or call the police. Doing any of these will likely alert a perceptive thief to your suspicions. The overarching objective is not to telegraph your suspicion to the su spect. When fraudsters think they are about to be discovered, their strong urge is to destroy evidence. This inva riably causes collateral damage. De struction might consist of wiping the computer’s hard drive and destroying all backup media. In one spectacular case, the victims did not engage us but began their own (clumsy) investigation. The thief, once alerted, burned down the office! This is really the point where ex pert guidance is needed. We have an “immediate action checklist” for den tists who suspect fraud in their office. They can request the checklist from our website. Our investigative process is comple tely stealthy. I promise never to send a nerdylooking investigator to your office. This helps ensure that eviden ce is protected, and also that working relationships are not destroyed in the event that suspicions are groundless. What is the most unusual fraud case you have encountered? About once a month we see so mething innovative. The alteration of receivable balances after the server crash is one I think of—we suspect that the thief caused the server to crash. By placing a magnet inside one of our lab computers, we could repli cate the crash quite easily. Is there specific insurance owners can buy to protect their business against loss to fraud? Is such insu- rance worth getting? This insurance is either included in the basic insurance package that offi ces already have or an “employee di shonesty” rider can be added. I don’t have cost details, but understand that it is quite inexpensive. Based on what I said about the probability of fraud in offices, I think everyone should have this coverage. How much of a problem is exter- nal fraud involving customers, ven- dors, suppliers or other business re- lationships compared with internal fraud? It certainly happens. We see a fair amount of identity theft from people trying to make use of someone else’s insurance coverage or to obtain pre scription medication. However, the financial and other damage that this type of activity normally causes pales in comparison to the damage caused by embezzlement. Thank you very much for this in- terview.DT DTI TOKYO, Japan: A team of Japanese researchers has demonstrated that hydrogen sulphide, one of the main causes of bad breath, could be a key component in developing future me dical therapies. In a recent study con ducted at the Nippon Dental Univer sity in Tokyo, they reported that stem cells isolated from dental pulp tran sformed into liver cells after being incubated with the characteristically foul smelling gas for at least three days. While dental pulp stem cells have been found to have the ability to tran sform into a number of different cells, including muscle and blood cells, this is the first time that researchers have claimed to have produced a huge number of cells that were able to store glycogen and collect urea—the two main functions of the liver. They said that although more research might be needed on the possible carcinogenic effects of the method, results indicate that it produced cells with little po tential to differentiate, hence limiting the risk of developing tumours after transplantation. “Hydrogen sulphide did not cause apoptotic changes in the cells,” they stated in the report. Common methods of producing hepatic cells for human transplanta tion include the use of foetal bovine serum, which is heavily regulated worldwide. The researchers however extracted stem cells for their study from patients undergoing regular to oth extractions. These were then divi ded into two groups, of which one was incubated with hydrogen sulphide and the other with a different medium. Commonly associated with the smell of rotten eggs, hydrogen sulphi de is produced in small amounts by the human body for signalling and other biological functions. In the oral cavity, where it is considered highly toxic to tissue, it is produced by forms of bacteria that do not require oxygen to grow. It is estimated that between 20 and 50 percent of people in developed countries suffer from halitosis, the main sideeffect of this process.DT Microscope picture of normal human liver. (DTI/Photo Convit) Bad breath gas used to make liver cells from teeth The ability to examine the cra niofacial anatomy with help of th reedimensional images obtained through Cone Beam Computerized Tomography (CBCT) has been prai sed as the new gold standard in oral surgery. Dental Tribune recently had the opportunity to speak with Prof. Stefan Haßfeld from the University of Dortmund’s Department of Oral and CranioMaxillofacial Surgery in Germany about the technology and its future potential at the FDI An nual World Dental Congress in Hong Kong. Dental Tribune: Prof. Haßfeld, in your opinion, has CBCT become a standard in dentistry? Prof. Stefan Haßfeld: CBCT has been available in dentistry for over a decade and since then has been established as a standard for many indications. Despite this deve lopment, I doubt that the technology will make traditional imaging ob solete any time soon. Instead, it will be used as an aid in more complex treatments. One of the areas in which CBCT is used is implant treatment planning. What are the other main areas of application? Nowadays, the technology is wi dely used in complex oral and ma xillofacial surgery procedures. For example, we regularly examine large cysts and deeply impacted third mo lars with CBCT. Its use can also be of benefit for the diagnosis of maxillary sinus di seases, as well as in traumatology or the correction of anomalies and dysgnathias. What potential does the technology offer regarding the improvement of treatment outcomes? In contrast to traditional imaging, CBCT allows the human autonomy and pathology to be assessed in de tail in 3D space. This can be extre mely helpful for treatment planning and the assessment of regions that present a surgical risk, like adja cent nerves, teeth or blood vessels. In many cases, we expect a signifi cant reduction in operative risks and an improvement in surgical plan ning. According to the industry, the radia- tion dose for patients is significantly lower with CBCT. Do you agree with this statement? I would have to disagree, since compared with traditional imaging, CBCT usually has a higher radiation dose. However, it also yields comple tely different information. By taking a high number of single images from different angles, CBCT can provide lower radiation doses only in a few exceptional cases. Is this the only drawback compared with traditional imaging techni- ques? As CBCT has another field of indi cations, comparison with traditional imaging techniques is not appro priate. However, there are indeed some shortcomings, like higher ra diation doses and costs, as well as a lower resolution compared with den tal film. What role will CBCT play in dental practices in the future? CBCT will take root in dental practices, particularly in those with emphasis on surgery, when it comes to certain complex treatment issues. For all the mentioned reasons, tradi tional imaging methods will not di sappear. A panoramic Xray image, for example, provides an excellent over view of the entire jaw arch for cli nically oriented examinations, with only little effort and at a small radia tion dose. Dental film still offers the highest resolution for viewing details. Rather, the establishment of CBCT for dental imaging offers us additio nal options for daily practice. Thank you very much for this inter- view. .DT Traditional imaging will not disappear with CBCT An interview with Prof. Stefan Haßfeld, Germany Prof. Stefan Haßfeld ← DT page 5