DENTAL TRIBUNE The World’s Dental Newspaper · South Asia Edition Published in India www.dental-tribune.in 01/20 Saliva and Oral Cancer Human Papilloma Virus in salivary exosomes may help in the early detection of mouth & throat cancer ” Page 03 Vitamin D in Periodontitis Study finds modest association between periodontitis and low levels of vitamin D ” Page 04 Tech in Education Dental students embrace new learning technology that helps them build their skills & knowledge Smile and Self-esteem Survey reveals the impact of a good smile and healthy teeth on self- confidence and well- being ” Page 07 ” Page 05 Mahesh Chaudhary: Master dental technician who touched, transformed and inspired many lives. by Rajeev Chitguppi, Dental Tribune South Asia Dental Tribune South Asia pays its heartfelt tribute to the master dental technician, ceramist par excellence, a great mentor and human being, Mr Mahesh Chaudhary, after his untimely demise on 6th Jan 2020. Three clinicians who had had a close association with him - Drs. Akshita Mehrotra, Rainy Surana and Ali Tunkiwala share their experiences on how it was like working with him and learning from him. Mr Mahesh Chaudhary was a master dental technician with a vast experience of more than 30 years in the dental industry. He graduated from Government Dental College, Mumbai and completed his post-graduation from the Manchester School of Dental Technology in 1986. in Post his degree at Manchester, he worked with various dental laboratories the United Kingdom. In the year 1989, he founded Ceramic Dental Studio in Mumbai, India. He trained thousands of technicians and dentists across India- who are now gainfully employed and some of them even have started their own outfits catering to the dental industry. He to trained individuals from novices competent professionals. He will be known for his relentless pursuit of improvement in techniques and practices. Three clinicians pay their tribute to the master dental technician. “Sometimes, when one person is absent, the whole world seems depopulated.“ I remember the first time I met him in his lab. I had just moved back from Los Angeles and had no faith that I would be able to do the same quality of work that was done back in the US. Everything changed from that day, 4 years ago, when I met Sir! Sir was a perfectionist and a very frank and truthful one. He would call a spade a spade- so a bad impression was a bad impression and had to be redone by the dentist. We, unfortunately, are not in a country where a dentist can be wrong, and that would make it extremely difficult for all dentists to follow his high standards of quality. I Sir was tough and expected the best only. remember repeating final impressions 5 times, till I got all the margins and other structures recorded with 100 % perfection. But that was sir. Soon, those 5 repeat attempts became 3, and the 2 and then 1. And I only have sir to thank for it. In these 4 years of visiting the lab regularly, I have more appreciation technicians. And learning to do my own lab work, has made me a much better dentist today! for Sir would understand the passion for perfection. There was once a single unit Veneer case, and I wanted to layer and stain, glaze it myself in Sir’s lab. I remember redoing the veneer fabrication 7 times- that means 7 attempts of pressing, layering, staining and glazing. All this while, Sir encouraging me that I would be able to do it better the next time around. I feel there are many talented ceramists in this country that may be able to do good work, but none like Mahesh Sir, who would do it so selflessly. He had, in a similar - by Dr Akshita Mehrotra (Prosthodontist, Mumbai with more than 20 years of association with Mr Chaudhary) The new year 2020 began with full of promise and enthusiasm but brought shocking news on 6th of January. Mahesh Chaudhary, the ceramist, somebody with whom I had discussed cases just one day ago, had suddenly passed away. I couldn’t believe what I had heard. The person with whom there was a daily conversation regarding various patients, was suddenly no more. It was really mind-numbing! Sometimes, when one person is absent, the whole world seems depopulated. We as a dental community have not only lost a good ceramist but also somebody who was full of energy and enthusiasm and always ready to help others. My association with him goes back more than twenty years. Approximately in 1997- 98. I had walked into his office and introduced myself as a PG student from GDC, Mumbai. At that time, he was already a very established dental technician, one of the few who was well himself known for doing advanced ceramic work. I was nervous and scared as he was known not to suffer fools easily. I had a full mouth rehabilitation case to be completed and presented in the upcoming prosthodontic conference. Mahesh Chaudhary introduced and welcomed me warmly. He listened to me patiently and guided and mentored me on the finer technical aspects of ceramic prosthetic work. Over the next month, the case was completed to our satisfaction, presented and was well appreciated. This was the start of a professional relationship that lasted more than 20 years until his unexpected demise. Over the years, I came to know Mahesh as a true professional and great ceramist who cared foremost about good dentistry and produced superb results in a committed time span. He was not only an expert technician but also had good knowledge about the biological aspects of clinical dentistry. With authority, he could constructively criticize and with a passion he would work to produce superb results. Though known for his straight-talking, over the years I have seen him help many unconditionally, whether it be PG students or young dentists, and was always open to suggestions to better and improve on his work. The highest tribute to the dead is not grief but gratitude. I am a better prosthodontist and clinician for having worked with Mahesh Chaudhary. Mahesh, with so many beautiful smiles created by us over the years, I will miss collaborating with you in my future cases. May the winds of heaven blow softly and whisper in your ear. How much we respect and miss you and wish that you were here “A perfectionist and a frank person who called a spade a spade“ - by Dr Rainy Surana (whom Mr Mahesh Chaudhary called his most favourite student) Mahesh sir was someone whose reputation preceded him.
2 News manner, mentored thousands of dentists and technicians over his 30+ years of practice. After Sir’s a beautiful untimely demise, I felt lost. And I came across article about mentorship. About how important it is and how wrong we get the concept. “We write a ton about importance of mentors. the Yet, commercial, artificial and transient nature to mentorship. We select a mentor based on an individual challenge or circumstance. True mentorship, though, is deeper, and it‘s something that chooses you. It‘s a relationship, deep and lifelong -- even generational.” there‘s a I had never realized that until Sir. Thank you, Mahesh Sir, I will be eternally grateful. “A salute to Mahesh Chaudhary - he was way ahead of his time“ by Dr Ali Tunkiwala (Renowned Prosthodontist & Implantologist) I distinctly remember as if it happened just yesterday; we were doing our post-graduation in GDC Mumbai in 1996. As part of our university requirement, we had to do a thesis that required a lot of lab support. Mahesh (Chaudhary), from Ceramic Dental Studio, was the default choice to go to. When I first met him, he immediately made me comfortable and came across as a very jovial and helpful person with the correct dose of sarcasm and humour that made you laugh all the time when you were with him. He had a lot of interesting stories about everyone he worked with and there was never a dull moment with him around. information He was a storehouse of vital lab that forms the basis of all that we were learning. He generously shared his entire lab infrastructure for the purpose of education and allowed us unhindered access. I developed a great rapport with him and continued working with him as I started my own practice. Times were tough initially and he always used to say, „Don‘t worry about money to be paid to me, do good work and pay me when you have some“. He provided some real state of the artwork in the field of metal-ceramics and was way ahead of his time as far as lab protocols were concerned. There were not many labs in our city at that time, and Mahesh stood out amongst the best of best. He was the first lab who taught me how good work should be produced by setting up the case well clinically. At such a young age to lose him is a big loss for the dental fraternity. He will be remembered for all the good he did; not only for the clinicians but more so for the lab personnel. He commanded respect and today the dental lab fraternity reaps the benefit of the hard work put in by amazing human beings like Mahesh. He had a lot more to offer to humanity and has gone too soon. We pay our tributes to him and pray that his soul will rest in peace! His memories will be cherished with a smile on my face and with eternal gratitude in my heart for all that he has done for so many of us. Gone too soon! Known for his frank views, this one is in Mr Mahesh Choudhary‘s own words: (September 2018) It‘s was in the month of September 1985 I left the country in pursuit of knowledge and learning... now 33 years on am still doing the same!! Learning never ends!! Over these years I‘ve realized the technician in India suffers because of lack of exposure to the right products and correct techniques!! and companies We are essentially influenced their by technicians whose sole goal is to sell... never to impart knowledge. It‘s one thing I‘ve always held against them and hence been very unpopular amongst them. 01/20 The dental laboratory, in the present times, is only governed by the price and speed of delivery. Every laboratory today likes to boast of their incorporation of digital technology which they have bought purely by monkey see monkey do philosophy. Most of these labs don‘t even own a vacuum investor nor do they know how to make individual dies models. More than 90% of the work done in this country is done without dies. Laboratories are using cheap unknown Chinese brands. Some of the better materials in our business are neither popular or nor available. It‘s a sad state of affairs!!! for Thank you, Mr Mahesh Chaudhary, touching, transforming and inspiring so many lives. May your soul Rest In Peace! Figure 1 Mahesh Chaudhary in 1999 and in 2019 Figure 2 Mahesh Chaudhary immersed in his work Figure 3 Lab work Figure 4 During a training event in Lucknow (2017) Ad 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: firstname.lastname@example.org www.lifecare.in
3 News 01/20 Novel technology may improve early detection of mouth and throat cancer by Dental Tribune International DURHAM, N.C., U.S./ BIRMINGHAM, U.K.: Cancers that occur in the back of the mouth or in the upper throat are often diagnosed only when they are advanced as they are difficult to spot in their early stages. Acoustofluidics is a novel, non-invasive method that analyses saliva for the presence of papillomavirus (HPV)-16, which happens to be the pathogenic strain linked with oropharyngeal cancers (OPC). This new technique has demonstrated a high success rate in detecting OPC in whole saliva in almost half of the patients tested and in human the majority of confirmed OPC patients. evaluate studies to that had Earlier attempted the detection of human papilloma viral (HPV) DNA in the whole saliva as a diagnostic measure for HPV-associated oropharyngeal cancer (HPV-OPC) were not really successful. Researchers in the current study hypothesized that the membrane-bound extracellular vesicles that are believed to play a role in various types of cancers, are packaged with HPV-associated biomarkers. They hypothesized that efficient enrichment of salivary exosomes through isolation can enhance salivary exosomes, Ad In a new study, researchers were able to successfully detect human papillomavirus from salivary exosomes isolated by integrating acoustics and microfluidics. (Image: UCLA) diagnostic performance for HPV-OPC. and prognostic “OPC has an approximate incidence of 115,000 cases per year worldwide and is one of the fastest rising cancers in Western countries due to increasing HPV- related incidence, especially in younger patients,” explained co-author Dr Tony Jun Huang, William Bevan distinguished professor mechanical engineering and mechanical science at Duke University in North Carolina. of distinct “Considering these factors, the successful detection of HPV from salivary exosomes isolated by our acoustofluidic platform offers advantages, including early detection, risk assessment, screening,” Huang added. The technique may also be instrumental in helping predict which patients will respond well to radiation therapy and in improving progression-free survival. physicians and Exosomes, the membrane- extracellular vesicles, bound are believed to play a role in intercellular communication and are associated with several types of cancers. In the study, the researchers analysed saliva samples from ten HPV-positive OPC patients using a tiny acoustofluidic chip developed to isolate salivary exosomes. They removed the unwanted particles leaving based on their size, exosome-rich concentrated that helped detect samples tumour-specific biomarkers. The technique identified the tumour biomarker HPV-16 DNA in 80% of the cases when coupled with droplet digital polymerase chain reaction. “The acoustofluidic separation technique provides fast, biocompatible, high- a yield, high-purity, label-free method for exosome isolation from saliva,” said co-author Prof. David T.W. Wong, associate dean for research and director of the Center for Oral/Head and Neck Oncology Research at the University of California, Los Angeles (UCLA). The researchers believe that the technology can also be used to analyze other biofluids, including blood, urine, and plasma. these “With features, industry the acoustofluidic technology has the potential to significantly exceed current standards, address unmet needs in the field, help expedite exosome-related biomedical research, and aid in the discovery of new exosomal biomarkers,” Huang commented. The study is an international collaboration between Duke University, UCLA the Birmingham. University “The results are a testament to the power of interdisciplinary international research collaboration,” said Prof. Hisham Mehanna, director of the Institute of Head and Neck Studies and Education at the University of Birmingham. and of and
4 News 01/20 Study suggests relationship between periodontitis and vitamin D also been shown to reduce the risk of fractures. Chronic periodontitis is an inflammatory condition of the periodontium caused by microbial biofilms forming on the teeth. Bacterial products influence the host immune response and result in the destruction of the tooth-supporting tissues such as alveolar bone. Periodontal disease has several associated risk factors and indicators. Since there is conflicting evidence regarding the association between vitamin D and periodontal disease, a study was needed to establish a relation between the two. from the University of Manitoba in Canada conducted cross-sectional study, in which they examined data collected between 2007 and 2009 from respondents to the Canadian Health Measures Survey. They determined the Vitamin D levels by measuring the concentrations of plasma 25-hydroxyvitamin D (25(OH) D), a metabolite produced once vitamin D has been metabolized Researchers a by the liver. The periodontal status was defined through the gingival index and clinical loss of attachment. After such as accounting for independent additional variables smoking, the research team found that there was modest evidence for an association between low concentrations of 25(OH)D and periodontal disease. follow-up are “Prospective studies with likely longer required to fully elucidate what effect, if any, vitamin D levels have on the progression of periodontal disease,” the study’s authors wrote. An earlier study showed that vitamin D deficiency, paired with periodontitis, may have an influence on Type 2 diabetes. However, sufficient vitamin D levels may have the potential to decrease inflammation and have an impact on the oral microbes that are related to periodontal disease. Ad A new study has found an association between low levels of vitamin D, which is produced through sun exposure, and the presence of periodontal disease. (Image: FotoHelin/Shutterstock) by Dental Tribune International that OTTAWA, Ontario, Canada: There is sufficient scientific evidence shows why vitamin D is essential to the body’s proper functioning. The vitamin is helpful for maintaining healthy bones and teeth and can assist in regulating insulin levels and managing diabetes treatment. Now, a new study has found an association between low levels of vitamin D and periodontal disease. Vitamin D is a fat-soluble regulates that vitamin calcium absorption from the gastrointestinal tract, helps to maintain the plasma calcium concentration bone mineralization. Literature has shown positive associations between vitamin D levels and bone mineral density. Vitamin D supplementation has significant and PRINT EVENTS EDUCATION DIGITAL SERVICES Dental Tribune International The World's Dental Marketplace www.dental-tribune.com
6 News 01/20 Researchers call for thoughtful waste management in dentistry Researchers believe that dental practices should take steps to properly manage and reduce plastic, mercury, lead and silver waste, the most common pollutants produced by the dental industry. (Image: PHOTO FUN/Shutterstock) by Dental Tribune International the researchers participants’ CAMBRIDGE, Mass., U.S.: Harvard University’s recent Worldwide Week had from Harvard School of Dental (HSDM) drawing Medicine the attention to the correlation between environmental health and oral health through the lens of health equity. The team of researchers believes that dentistry has a profound impact on our planet’s environmental health, which, in turn, affects oral health. The link between dental health and the environment makes it crucial for us to manage dental waste effectively. To accomplish endodontics, the goals of restorative dentistry, prosthodontics and others, dentists use a variety of materials and equipment, many of which, including heavy metals and biomedical waste — present a potential challenge to the environment. the The surprising team of researchers, led by Dr Donna Hackley, an instructor in oral health policy and epidemiology at HSDM, a found source of food, water and air pollution - the international dental community. In a recent summary of their research, the team cited plastic, mercury, lead and silver waste among the most common pollutants produced by the dental industry. “These pollutants threaten the health of organisms and humans, especially the developing young, as well as the stability of various economies,” Hackley said. example, According to the researchers, plastic waste is a particularly common type of dental waste. For toothbrushes, toothpaste tubes and toothpaste are frequently used dental products typically made of or contain plastic and are difficult to recycle. Dental Tribune has recently reported on the impact International that are that plastic toothbrushes have on the environment and noted that they often get into our forests, rivers and oceans. 23 and “Toothpaste “Globally, billion toothbrushes their wrappings are discarded every year, and in the U.S. alone, the number of discarded toothbrushes is enough to circle the earth four times,” the team reported. tubes are also not recyclable, as they typically contain an interior layer of aluminium. The toothpaste itself contains harmful plastic trillion microbeads, microbeads are released into aquatic environments daily from the U.S., enough to cover over 300 tennis courts.” and 8 threat Mercury, lead and silver to our also pose a environment. ever-changing According to Hackley, patient chairs can generate up to 4.5 g of mercury daily and this may pose a serious threat if the mercury is improperly disposed Additionally, of. products consisting of silver and lead are found in radiographic materials, including films and developer solutions, and are of particular concern in countries that cannot properly manage dental waste disposal. To tackle the issue of waste dentistry, management in Hackley and her team are encouraging dental offices to estimate the total amount of domestic and medical waste they produce and to determine ways to reduce it. As more and newer, environmentally friendly products available, Hackley hopes that dental offices will find alternatives to common plastic products. become “The international dental commit community must reducing to preventing and dental waste. Any adverse environmental impact resulting from our professional activities disproportionately affects the most vulnerable populations globally. This is about equity. Thoughtful waste management is no longer just a nice idea, but a moral and ethical imperative to protect the environment and every organism living in it,” Hackley concluded. A preliminary waste audit from conducted by students the university revealed that primary sources of waste in the preclinical include gloves, disposable gowns, masks, paper and paper towels. laboratory As health practitioners, dentists should be concerned with promoting not only oral health and overall well-being of people but also that of the environment. A proactive approach is the need of the hour, which will allow this profession to succeed in an era of increased public environmental concern. It has become a legal obligation too, plus a moral and ethical obligation to provide dental services that benefit the public at minimal expense to the environment.
7 News 01/20 Survey reveals the impact of a good smile and healthy teeth on self-confidence and well-being by Dental Tribune International BLOOMFIELD, Conn., U.S: A new study published by Cigna, a worldwide health services organization, helps confirm the connection between oral health and confidence. It shows that people who reported as having “excellent” oral health had higher self-confidence than those who reported, “fair to poor oral health.” The study also shows that the insecurities about smiles and oral health have had a direct impact on employment opportunities for many of the people included in the study. The had survey 1000 respondents 1000 U.S. citizens aged 18 years and above in such a way that the sample composition approximated the population of U.S. adults with regard to gender, age and census region. The questionnaire asked the respondents to respond to questions on how they rated their self-confidence, the impact of the smile and oral health on employment, the convenience A health care organization has investigated oral health and its impact on confidence, employment and social connections and whether dental coverage has a direct impact on mental well-being. (Image: pixelheadphoto digitalskillet/Shutterstock) and stress of going to the dentist, and their perceptions of others’ smiles and oral health. The survey showed that, of those who were completely satisfied with their smile, 93% rated their self-confidence as excellent or very good. However, 15% reported being “not at all or not very satisfied,” and 16% said their smile impairs their self-confidence. In the study, researchers also noted that adults who have routine dental care two or more times per year reported significantly higher rates of self- confidence than people who go less than once a year or not at all. As oral health affects many impact aspects of life, the employment was of the smile and oral health on also investigated. More than 21% of people surveyed reported feeling less confident about job interviews because of their smile or the state of their oral health, and 12% believed their smile or oral health condition held them Ad back from getting a job or getting a promotion. According to Cigna, self-esteem, the study was conducted among consumers not only to better understand oral health’s impact on confidence, employability and stress but also to examine its impact on the ability to make and maintain meaningful social connections. The overall goal of this study was to develop insights on whether or not having dental coverage has a direct impact on mental well- being. Speaking to Dental Tribune International, Cigna’s Chief Dental Officer Dr Cary Sun said, “Cigna Dental Health Connect is the embodiment of our clinical approach to improving whole-person health through innovative dental solutions. We are committed to expanding on this clinical model which today includes chronic condition support, dental care reminders for high-risk customers, on-site dental care, and safe opioid prescribing.” preventive Ad NOW OFFERING SPECIAL 20% DISCOUNT Belmont leads the way with totally new generation of dental treatment centre. (*Exclusive of Taxes. Terms and Conditions apply.) Exclusive Distributor in India: LifeCare Devices Private Limited T: (022) 6146 4725, 6146 4727. E: email@example.com l Mumbai l Delhi l Bangalore l Kolkatta l Chennai l Pune l Ahmedabad l Madurai l Hyderabad l Chandigarh l Lucknow l Jaipur l Vijayawada
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