DENTAL TRIBUNE The World’s Dental Newspaper · South Asia Edition Published in India Digital Aesthetic Digital Aesthetic Dentistry: 6-Step Workflow Integrates Multiple Systems, Gadgets, and Tools Robotic implant Boston University Dental School- the first US dental school to implement robotic implant surgeries ” Page 02 www.dental-tribune.in 10/19 Gingival cells Study identifies gingival cells that can protect against periodontitis ” Page 04 ” Page 05 Slow Dentistry Slow Dentistry- a concept to empower dental patients and also reduce work stress among dentists ” Page 06 AIIMS & Union Health Ministry launch ‘eDantSeva’ web & app to reach out to over 1 billion people by Dental Tribune South Asia New Delhi, India: The All India Institute of Medical Sciences (AIIMS), and Union Health ministry have launched ‘eDantSeva‘ website and mobile application - that will reach out to more than one billion people with just one click. On the 7th of October 2019, the All India Institute of Medical Sciences, in collaboration with the Union Health Ministry launched a unique digital platform ‘e-DantSeva‘ the first-ever website and mobile application on oral health awareness. - gathered scientific Union Health Minister Harsh Vardhan said the digital platform will provide oral health information from resources authentic and help people to get timely advice for managing their dental emergencies and various oral health problems. The ‘eDantSeva‘ website and mobile application will reach out to more than one billion people with just one click, he added. ‘e-DantSeva‘ contains information about the National Oral Health Programme, a detailed list of all the dental facility and colleges, Information, Education and Communication (IEC) material and a unique feature called ‘Symptom Checker‘. the eDantSeva aims to sensitize people about the significance of maintaining optimum oral health and equips them with the tools and knowledge to do so, including awareness on the nearest oral health service facility (contains GPRS and satellite images of the facility for easier access to the people). Dr Harsh Vardhan also released booklet and voice-over on oral health a Braille AIIMS & Union Health Ministry launch ‚eDantSeva‘ Website & App to reach out to over 1 billion people (Photo: National Portal of India (india. gov.in); Wikimedia/Magnus Maske; Flickr/ Russavia) education for visually impaired. “Oral health is indispensable for the wellbeing and good quality of life. Poor oral health affects growth negatively in all aspects of human development,“ he said The objectives of e-DantSeva include: • in Improvement the determinants of oral health e.g. healthy diet, oral hygiene improvement to reduce disparity in oral health accessibility in rural & urban population. and etc. • Reduce morbidity from oral diseases by strengthening oral health services at Sub district/district hospital to start with. • Integrate oral health promotion preventive services with general health and care system and other sectors that influence oral health; namely various National Health Programs. • Promotion of Public Private Partnerships (PPP) for achieving public health goals. Email : nohpindia@gmail. com – is available for any questions people may have about their dental health and the choices that are available to address specific conditions. The current initiatives in the domain of Oral Health include: • Initiation of the Pit and Fissure Sealant Pilot Project in 2017 in collaboration with 12 dental colleges and institutes with a target to seal 53,750 permanent molars in children 6-14 years of age to prevent dental caries. • Approval of AIIMS, New Delhi for the set up of the National Referral and Research for Higher Dental Institute Studies (NaRRIDS), an apex Institute for oral health research and tertiary care. • • Conduction of Regional and National Review Meetings and Workshops for the purpose of training and capacity building of State Nodal Officers Development of training manuals on oral health for para-dental staff, including oral health manuals for school teachers and healthcare workers Set up of Tobacco in dental Cessation Centers colleges across the country through a collaboration with the Dental Council of India. • • Development of IEC/ to generate BCC materials awareness oral health, on including posters, pamphlets, television radio jingle and games for children. commercial, • Celebration of World Oral Health Day on 20th March across the country. • Initiation of a Pilot Project on Oral Health Care of Pregnant Women in collaboration with the Dental Department at VMMC &Safdarjung Hospital • Drafting of a National Oral Health Policy for India • Engagement of stakeholders for phasing down on dental amalgam in India under the Minamata Convention
2 News 10/19 Digital Aesthetic Dentistry: 6-Step Workflow Integrates Multiple Systems, Gadgets, and Tools The second step is to collect the intraoral data using a 3Shape Trios intraoral scanner. (Fig 8) Use the scanned data and design a digital wax-up using the new SKIN concept, introduced by Paulo Kano. (As mentioned earlier, this process has been completely digitized by Florin Cofar et al through the ‘RAW’ concept.) Use the 3Shape Software to create two sets of digital wax-ups – one for the upper 6 anteriors and another for the upper 10 teeth till the second premolars using the tooth shapes available in the 3Shape library. (Fig 9- 12). The 3 D wax-up can also be done using the Exocad software. Step 3: 3D Printing of the Digital Wax-up. Next, we 3-D print the digital wax-ups (Anycubic Photon 3D Printer). (Fig 13-14) 3 D printing can be done, besides Photon, in any DLP /SLA printer. Step 4: Create a Silicone Index using 3D printed models. Next, you create a silicone index - an impression of a wax-up. If you have created a digital wax-up, as done in this case, then 3D print the digital wax-up first and then take its impression. A silicone index is designed for transferring the information of a wax-up into the mouth during treatment. The silicone index prepared from the 3D printed models (Fig 14- 15) carries the provisionalization material (Luxatemp) into the patient’s mouth to create two sets of mock- ups. Step a provisionalization material intraorally in the Silicone Index. One silicone index carries the (Luxatemp) provisionalization material the upper 6 anterior teeth, whereas the other carries Luxatemp (A1 shade) for the upper 10 teeth till the second premolars. (A2 shade) Carry for 5: We create two mock-ups (Fig 16-17) and the patient gets to Digital Aesthetic Dentistry: 6-Step Workflow Integrates Multiple Systems - DSD, New SKIN and RAW. (Photograph: Dr Aslam Inamdar) by Dr Aslam Inamdar With so many new tools and systems populating the digital dentistry and smile design space, a beginner often finds himself confused about the different terminologies and the clinical steps used. Dr Aslam Inamdar simplifies the digital workflow and clinical procedures into 6 easy steps for anybody to understand. the the aesthetic dentist Introduction: One of the biggest challenges we have in clinical dentistry is to meet the expectations of esthetically demanding patients, for which it becomes imperative for to understand his patient’s needs as well as desires. Also, we need tools that enhance our diagnostic vision and make it easier for us to communicate the treatment steps with our team objectively and clearly. The need is to employ user-friendly systems & create standardized workflows that can guide the team through the aesthetic rehabilitation process. The ultimate aim is to address the functional and biological issues and therapeutically generate aesthetic outcomes that are predictable & consistent. for the foundation Digital Smile Design (DSD), a novel concept designed by Dr Christian Coachman, collects digital images of the patient’s smile and provides essential tools to create a 3D diagnostic wax-up. High-quality digital images - static and dynamic, make of DSD the documentation, communication and analysis of data the most critical components of contemporary esthetic rehabilitation. Moreover, they create a set of standardised guidelines templates for diagnosis and treatment planning. We also need good videos documenting the patient‘s phonetics. and - The DSD protocol is also a fantastic communication tool to enable the patients to see the treatment outcomes beforehand. Test drive – a powerful DSD tool enables the patients not only to see and compare the end result with the pre-op situation but also experience it in real life. A test drive adds transparency, builds trust and increases the treatment acceptance rate. Another concept that we describe here is called the ‘New SKIN’ designed by Paulo Kano. The New SKIN concept uses natural anatomical shapes of the teeth to give a natural appearance. Originally it was a combination of digital and manual workflows. Later it was completely digitized by Florin Cofar et al through the ‘RAW’ concept. Now, all these workflows are clinically known as Natural Restoration workflows. This case shows how we create two test drives (mock- ups), both of which have DSD planning in common, but differ in their morphology based on the tooth shapes selected from the 3Shape digital library. Case presentation: A 27-year-old male presented with a short and small upper right lateral incisor (12), and worn-out central incisors (11/21). Below is a 6- step workflow that covers the digital planning and clinical execution until he gets a test drive to wear. Step 1: Photographs and Treatment Planning using the DSD Software (Fig 1 - 6). First, we need a full set of high-resolution photographs to analyse and diagnose the smile. Also, good videos documenting the patient‘s phonetics. these images We use to plan the treatment and also to guide the team through all the subsequent steps of smile design and esthetic rehabilitation. Next, we start with the Digital Smile Design process to create a treatment plan. Out of all the images taken above, three photographs viz. frontal, 12 o‘clock position, and occlusal – are essential for this step. We have to verify the harmony among these three images as shown in Fig. 7. We do the DSD 2D planning using the keynote on a Mac/ powerpoint/ DSD app or any similar app. This 2D planning creates the foundation for the subsequent 3D steps. Step 2: Intraoral Scanner and Digital Wax-ups using the New SKIN / RAW concepts
3 News compare them with the baseline situation (pre-op images). Step 6: Test-drive the mockup in the patient’s mouth Allow the patient to wear and experience the test-drive. Evaluate his satisfaction with the new appearance, function, and speech with the intraoral test- drive. (Fig 18- 23) Take your patient‘s approval for the subsequent steps of smile design. Conclusion: What after the patient approval? Next, as per DSD planning, the necessary we carry out orthodontic, periodontic, implant procedures or any other treatment. This is followed by restorative treatment where we create final restorations in monolithic materials using the same teeth shape and morphology as approved by the patient in the test drive. This leaves no room for surprises in the end, as we begin the procedure with the end in mind !! In Digital Aesthetic Dentistry, the right mix and the optimum use of advanced technologies – DSD, New SKIN concept, RAW, Intraoral scanner, Digital library, 3D wax-up software, 3D printer - can give excellent results in esthetic rehabilitations. 10/19 International, 2013 Volume 7: 18- 21. Issue 4, 3. Coachman C, Calamita MA, Sesma N. Dynamic Documentation of the Smile and the 2D/3D Digital Smile Design Process. Int J Periodontics Restorative Dent. 2017; 37 (2):183- 193. 4. The Anatomical Shell Technique: Mimicking Nature— Paulo Kano; Luiz Narciso Baratieri et al. Quintessence of Dental Technology 2014: Vol 37 References: 1. An Improve The Anatomical Shell Approach Technique: to Esthetic Predictability of CAD/CAM Restorations. Paulo Kano et al. Quintessence of Dental Technology 2013: Vol 362. the 2. Improving aesthetics in CAD/CAM dentistry – Anatomic Shell Technique (AST) Paulo Kano, Cristiano Xavier, Jonathan Ferencz et al. Cosmetic Dentistry Fig-1 Fig-6 Fig-10 Fig-19 Fig-2 Fig-11 Fig-15 Fig-20 Fig-3 Fig-7 Fig-12 Fig-16 Fig-21 Fig-4 Fig-8 Fig-13 Fig-17 Fig-22 Fig-5 Fig-9 Fig-14 Fig-18 Fig-23 Author: Dr Aslam Inamdar Dr. Aslam journey Inamdar’s and professional his state of the art practice in Mumbai is a rich blend of the most contemporary and advanced domains of dentistry in the right mix. After graduating from Nair Hospital Dental College, Mumbai he started with Dr. Inamdar’s Dental Studio – his award winning dental clinic located in South Mumbai. First, he took training in Digital Smile Design (DSD) from Dr. Christian Coachman, and then worked as a co- trainer for DSD with Dr. Rajiv Verma. Next, Dr. Aslam completed his Mastership in Clinical from Stony Brooks School of Dental Implantology Medicine (New York, USA) along with Online Externship in Dental Implantology from Dentalxp, Atlanta, USA. He is a consulting implantologist to many clinics in Mumbai. Dr. Aslam continued his journey in digital dentistry by getting extensively trained in CAD- CAM dentistry from Florin Cofar and master Paulo Kano. Very recently, Dr. Aslam received his Diplomat in New SKIN & Magic Make Up from Romania. Dr. Aslam is known as the Digital Dentist of India with his state of the art practice focusing on Digital Smile Design, extensive use of Intra- oral scanner, 3D Printer and CAD CAM Technology.
4 News 10/19 Boston University Dental School- the first US dental school to implement robotic implant surgeries by Dental Tribune South Asia the for dental The Henry M. Goldman School of Dental Medicine (GSDM) at Boston University has become the first U.S. dental school to use surgical robotic devices implant surgeries. Yomi, robot-assisted surgical device, developed by Miami-based healthcare start-up Neocis is the first (and to date, implant surgery only) dental device the clearance from the U.S. Food and Drug Administration; and now, the Henry M. Goldman School of Dental Medicine (GSDM) has become the first U.S. dental school to acquire and install the Yomi surgical robotic devices for dental implant surgeries. to have received Yomi will provide an excellent opportunity for the predoctoral students and the postdoctoral residents of the dental school to learn how the accuracy and precision of this state-of-the-art robotic technology can impact dental-school level will help in building comfort and skill from the ground up and that Yomi may become a new standard of care for dental implants. rigorous GSDM, with assistance from Neocis technicians, completed installing and calibrating the robotic devices in September 2019. GSDM faculty members underwent two-day training in the last week of September 2019, with additional two-day sessions planned in the next few months. Once the training is complete, the GSDM faculty members will not only implement the Yomi system on their patients but will also start instructing the predoctoral students postdoctoral residents on this technology. training and All predoctoral students at GSDM currently have the opportunity to place dental implants using guided surgery, and soon they will be able to use the first robot-assisted dental surgical system in the U.S. Goldman School of Dental Medicine, Boston becomes the first US Dental School to acquire and implement Yomi Robotic System for dental implant surgery by Neocis (Photo: www.neocis.com) and significantly improve dental implant surgical outcomes and patient care. assistant dean Dr Alexander Bendayan, GSDM’s of digital development & clinical training, believes that Yomi is truly revolutionary and will significantly improve the way dental implant surgeries are done at the Henry M. Goldman School of Dental Medicine, and also that it will help to establish new standards of care for the profession. In the Yomi protocol, the implant surgeon first creates a virtual plan for the implant placement using 3D scans taken of the patient’s mouth. The system then guides the surgeon in the precise implementation of that plan, giving real-time feedback via haptic technology to guide him through the process. Yomi is flexible enough to adjust to accommodate dynamically any mid-procedure changes. The implant surgeon controls the handpiece at all times, and Yomi augments his ‚feel‘. So, essentially, Yomi complements, rather than overriding your clinical expertise. Dr Alon Mozes, co-founder and CEO of Neocis, and a member of the Dean’s Advisory Board at GSDM said that embedding this advanced technology at the Ad Ad THE FIRST AND UNIQUE DENTAL IMPLANT IN THE WORLD MANUFACTURED THROUGH DIRECT LASER METAL FORMING TECHNIQUE BY MICROFUSION OF TITANIUM PARTICLES SURFACE l SPONGY l TRIDIMENSIONAL l ISOELASTIC CAVITIES l INTERCONNECTED l 2-200 µm Cleared! ACTIVE POROUS SURFACE l THICKNESS TO 250 µm l DESIGNED TO PROMOTE BONE GROWTH MORE THAN 15 YEARS OF EXPERIENCE BY DOCTORS ALL AROUND THE WORLD OVER 250.000 UNITS SOLD WORLDWIDE References available upon request ONE STEP BEYOND LifeCare Devices Private Limited 210 Udyog Mandir 1, 2nd Floor, 7-C Bhagoji Keer Marg, Mahim West, Mumbai - 400 016 Phone: +91 22 6146 4725 / 27 E-mail: firstname.lastname@example.org
6 Clinical 10/19 Slow Dentistry- a concept to empower dental patients and also reduce work stress among dentists A total of 2503 respondents gave valid responses, which showed that dental professionals working in the UK exhibit high levels of stress and burnout and low well-being. General dental practitioners (GDPs) seem to be the most affected group. Issues relating to regulation and fear of litigation appear to be the most stressful aspects of being a dentist. from The findings this online survey build upon the existing research findings and show that dentistry is, indeed, a stressful profession. The changing landscape of dentistry, over the years, seem to have shifted the sources of this stress. The researchers felt that the interventions should address these stressors and make changes in the working conditions of dentists. The paper individual solutions recommended that instead of solely focusing (e.g. on stress management), future interventions should also seek global solutions (e.g. modifying the working environment). The concept of Slow Dentistry aims to bring in a shift towards a slower pace of care, which would not only ensure patient safety but also minimise the triggers that create stress among the practitioners. “The four cornerstones are easily identifiable and are a means to allow patients to influence their safety and well-being at the dentist. We encourage everyone to insist on having the time to explain and understand, the time to ensure that anaesthetic is effective and to take note of all aspects of hygiene,” said Dr Miguel Stanley, a co-founder of Slow Dentistry. “While we may assume this is all happening— and, in many cases, it is—the cornerstones of Slow Dentistry encourage patients to take some control over their appointments,” he commented. “Having created a large client base through my passion and love for dentistry, I found myself overwhelmed and unable to cope with the growing patient list. It soon became evident to me that time was what I needed, and what is essential to provide the best care for my patients,” said Dr Rhona Eskander, one of the global ambassadors for Slow Dentistry. The study A survey of stress, burnout and well-being in UK dentists was published in the British Dental Journal on 11th January 2019. Ad Slow Dentistry has encouraged dental professionals to adopt a slower pace in their dental practices to ensure patient safety and to reduce work-related stress. (Photo: Joseph Shohmelian from Pixabay) by Dental Tribune International LUCERNE, Switzerland: A group of international clinicians have developed this concept of Slow Dentistry to overcome the work pressure or stress seen among dental professionals to perform and achieve instant results. The concept of slow dentistry is built upon four universal key principles designed to empower the patients to be confident about their safety, well-being and comfort, and also help them understand the dental treatments better. The nature of work and working conditions in dental surgery have turned dentistry into a stressful profession. With the dramatic changes that have taken place in the profession in recent years, and the changes that are expected to happen in the coming years, it has become critical that we establish the this would have on impact on the well-being of dental professionals. A study was conducted to determine the levels of stress and burnout among dental professionals in the UK and how this relates to their well-being. The study also made an attempt to identify the sources of work- related stress that the dentists self-reported in their practice. survey An online that covered the work stress, burnout and well-being among dentists - was administered the members of the British Dental Association (BDA), and also the non-members. to Relax your patients and make them feel more comfortable during dental procedures Matrx Nitrous Oxide and Oxygen Conscious Sedation Systems There are many good reasons to use nitrous oxide sedation in your dental practice: • Safe - N2O/O2 has been used globally for over 100 years • Relieves patient anxiety and discomfort • Patients remain awake, yet more relaxed, making it an excellent patient management tool • Improves patient experience, resulting in return visits Matrx is made in the USA 210 Udyog Mandir 1 7-C Bhagoji Keer Road Mahim West, Mumbai 400016 India Phone: +91 22 61 46 47 48 Email: email@example.com www.lifecare.in
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7 News 7/19 LifeCare Devices Private Limited210 Udyog Mandir 1, 7-C Bhagoji Keer Marg, Mahim West, Mumbai – 400 016.Phone: +91 22 6146 4725 / 27 | E-mail email@example.comYour distributor:INDICATIONS:► Oral surgery► Implantology► Plastic surgery► Bone grafts► Sinus lifts► Wound closure► Soft tissue surgery► Socket preservation► Regenerative medicine► Dermatology► Orthopedics► AestheticsDuo Quattro Centrifuge‘’Strictly physiologic!and6 Protocols:Position 1: A-PRF + : 1300 rpm / 14 min Position 2 : i-PRF : 700 rpm / 3 minPosition 3 : i-PRF M : 700 rpm / 4 minPosition 4 : i-PRF + : 700 rpm / 5 minPosition 5 : A-PRF Liquid : 1300 rpm / 5 minPosition 6 : Custom : 1300 rpm / 3 minPosition 7 : Manual : Free settings+tubes(Red) 10ml To Obtain: - PRF Clots - PRF Membranes - PRF Plugstubes(Purple / Lavindine) 13mlFor injectable PRF, only for:- Aesthetics- OrthopaedicsBlood CollectorsBlood collectors are used to draw blood.tubes(Green) 10mlFor Liquid PRF, for:- Sticky Bone- Large Membranes- Intra oral Injections(Pre-Op. Flap Injection / Papilla / TMG / Endo)S-« PRF Box » allow you to get the membranes always hydrated and of constant thickness, but also to recover the exsudate rich in proteins: Vitronectin and Fibronectin. You can also produce ‘‘plugs’’ of PRF.PRF box with a crusher in Teflon, with compartments of differentsizes to easily create large membranes and sticky bone.