DT Pakistan No. 2, 2019

News / Clinical Implantology / News

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PUBLISHED IN PAKISTAN

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Page 2

Comparison of guided
and non-guided implant
placement accuracy ...

The fully digital
Pro Arch protocol

Dental treatment
service worsens
in rural areas ...

NEWS

MARCH, 2019 - Issue No. 02 Vol.6

CLINICAL IMPLANTOLOGY

Page 6

CLINICAL IMPLANTOLOGY

Page 8

IDS reaffirms its
leading position as
global dental trade fair
DT International Report

C

COLOGNE, GERMANY The International Dental
Show (IDS), which took
place in Cologne from 12 to 16 March,
fulfilled the high expectations of the
global industry and once again
underlined its position as the leading
trade fair. With 2,327 companies from
64 countries participating, this year's
event welcomed 20 more exhibitors
compared with two years ago, as well

as 160,000 trade visitors from 166
countries. The overall number of
visitors rose by 3.2 per cent (about
5,000 more people) and the number
of foreign trade visitors by 6.0 per
cent.
Gerald Böse, CEO of Koelnmesse,
which stages the show, said: "IDS is
a trade fair in a class of its own and
always sets new benchmarks. It
manages to surpass the already
excellent results of the previous event
every time." Both visitors and
exhibitors are impressed by
IDS: it is only here that one
encounters supply and
demand of such an extent,
quality and level of
internationality. "IDS is the
undisputed leading global

Image: PTV News

Dr Inayatullah
Padhiar receives
Sitara-e-Imtiaz

DT Pakistan Report

K

ARACHI - Dr Inayatullah Padhiar
was honoured with Sitara-e-Imtiaz
in recognition of his services
rendered to dentistry in Pakistan. The
prestigious civil award was conferred by
the President of Islamic Republic of
Pakistan, Dr Arif Alvi, in the ceremony
held at President House on March 23rd
2019.
Dr Inayat's academic journey and
professional career make an inspirational
story not only for his countrymen but for
any and every person associated with dental
profession, and academic and medical
writing.
After graduating with Bachelors in Dental
Surgery from Liaquat University of Medical
and Health Sciences in 1974, he began to
show eager and active participation in
organized dentistry in the country. He had
Continued on Page 15

The 2019 International Dental Show exceeded the results of the previous
event and the organisers attained their goals of greater internationality
and higher quality in supply and demand, boosting the satisfaction of both
exhibitors and attendees. (Photograph: Dental Tribune International)
trade fair for the dental industry," he
continued.
The official figures confirm the high
level of internationality at IDS: 73
per cent of the exhibitors and 62 per
cent of the visitors came from 166
foreign countries, including Argentina,
Australia, Brazil, Canada, Chile,
Egypt, Japan, Korea, New Zealand,
South Africa and the US. Regarding

the 6 per cent increase in foreign
visitors, IDS 2019 recorded significant
growth in the number of visitors from
Asia (+23.1 per cent), eastern Europe
(+19.6 per cent), Africa (+17.0 per
cent), Central and South America
(+14.6 per cent) and North America
(+5.3 per cent) specifically.
An independent visitors' survey
Continued on Page 15

WORLD ORAL HEALTH DAY19

3.6 million smiles spread across Pakistan!
DT Pakistan Report

K

ARACHI - The World
Oral Health Day 2019
campaign concluded
successfully, resulting in 3.6
million bright smiles! In Pakistan,
the campaign was organized by
Dental News in collaboration with
World dental Federation (FDI) and
Pakistan Dental Association
(PDA), in close association with
Shield Pakistan, which sponsored
the CSR activity. Dental Tribune
International (Pakistan) was the
official media partner for the events
conducted under the aegis of
WOHD. The movement for oral
care awareness probed and
penetrated many diverse
population groups. Various
programs aimed at oral care
consciousness were conducted as
part of their WOHD'19 campaign.
The official theme of the 2019
World Oral Health Day (WOHD)

Image: DT Pakistan

campaign was, 'Say Ahh: Act on
Mouth Health'. The scheme for
this year was to 'motivate people
to take action about their mouth
health.'
To realize these objectives,
several resources were deployed
to awaken and foster the sense of
care for oral health among masses.
Through different contests and

polls people were educated on the
various facts and concerns
regarding oral care; efforts were
contributed toward raising
awareness about the weightiness
of mouth problems in order to push
the masses to consider the status
of their oral health. People were
encouraged to immediately report
Continued on Page 14

[2] => Dt pages.FH10

NEWS

2 DENTAL TRIBUNE Pakistan Edition March 2019
Photo: DT Pakistan

Dr Tariq Bhutta
elected new
PMDC president
DT Pakistan Report

SLAMABAD - On March
31, first meeting of the newlyconstituted Council
constituted
under the 2019
Ordinance was
held to elect the
president and
vice president.
Pakistan
Medical and Dental Council has
elected new president and vice
president after running on ad-hoc
basis for 13 months. The 17member new council notified by
Ministry of National Health
Services, Regulations and
Coordination has elected Dr Tariq
Bhutta as new president while Dr
Amer Zaman as Vice President of
the council.
Officials said that Dr Tariq
Bhutta secured 11 votes for the
slot of president, while his
opponent Dr Shoaib Hassan Shah
got 5 votes. Meanwhile, on the
post of VP, Dr Amer Zaman
secured 10 votes, while his
opponent Dr Shabir Lehri received
six votes. Dr Syed Shoaib Hassan
Shah, Dr Tariq Bhutta, Dr Shabir
Lehri and Dr Amer Zaman Khan
and contested in the polls for the
position of president and vice
president of the PMDC.
Elections were conducted at
PMDC headquarters. An official
said that president and vice
president of the council are elected
under section 4 (3) of the PMDC
Ordinance 2019.
Dr Shabir Lehri earlier served
as president of PMDC before the
council was dissolved by the
former chief justice Saqib Nisar.
The former CJP in January 2018
had dissolved the 35-member
council and formed a 9-member
ad-hoc council headed by former
Supreme Court judge, Justice
Continued on Page 15

Editor Clinical Research
Dr. Inayatullah Padhiar
Editors Research & Public Health
Prof. Dr. Ayyaz Ali Khan
Editor - Online
Haseeb Uddin

Dental treatment service worsens
in rural areas: PDA press conf
DT Pakistan Report

ARACHI - The Pakistan
Dental Association (PDA)
has warned that the situation
concerning the availability of dentists
in small towns and the rural areas of
the country has become so dismal
that fatal oral diseases among their
populace could spread like an
epidemic if the due corrective
measures are not taken on an
emergency basis.
The PDA issued this health alert
recently following a press conference
at the Press Club held by officials on
the eve of World Oral Health Day
which is globally celebrated every
year on 20th March. General
Secretary, PDA, Prof Nasir Ali Khan,
Senior Vice-President, PDA, Dr
Anwar Saeed, and Dr Asif Arain were
also present on this occasion.
"In Karachi, one dentist is available
for every 5,000 people on average.
The situation is similar in other big
cities like Lahore and Islamabad.
However, when we go to the relatively
faraway district of Tharparkar, not a
single dentist is available for a section
of the population as big as 200,000
people," said Dr Mahmood Shah,
President, PDA, while speaking to
the press.
Dr Shah said that the situation of
availability of dental treatment
services in the rural and far-flung
areas of the country had been getting
worse with each passing year instead
of improving owing to the utterly
indifferent attitude of the relevant
public health authorities.
He informed that the dentist-

population ratio in Pakistan had been
alarmingly uneven across the country
as it fluctuates heavily between urban
and rural areas as these statistics fall
much lower than the standards of
public health services set by the
concerned global agencies like the
Wo r l d H e a l t h O rg a n i z a t i o n .
"One of the means to rectify this
situation is by the opening of dental
colleges in the small towns of the
country as these institutions of dental
education should not be just confined
to the big cities," said the PDA
President.
He said that another way of tackling
the situation could be done via the
proper activation of rural health
centres of the provincial governments.
Dental surgeons should be recruited
for placing them at these RHCs for
the provision of much-needed dental
health services to the villagers.
Dr Shah added that such measures
had to be taken to extend the dental
care services across the country as
oral cancer had become the second
most recurring form of cancerous
disease in Pakistan after lung cancer.
He said that various forms of
chewable tobacco and other hazardous
chewing material like Gutka,
Mainpuri, betel nuts, Supari, were
being consumed in the society
unchecked as this social epidemic is
equally affecting large cities, city
suburbs, small towns, and rural areas.
Dr Shah stressed that early
screening and diagnosis of a case of
oral cancer could ensure its complete
treatment as otherwise, it could prove
Continued on Page 14

Prof Charlotte of King Abdullah
University visits KCD
DT Pakistan Report

Publisher/CEO
Syed Hashim A. Hasan
hashim@dental-tribune.com.pk

ESHAWAR - Professor Dr Charlottee A. E. Houser of the King
Abdullah University of Science and Technology (KAUST), Jeddah,
Kindom of Saudi Arabia paid her second visit to Khyber College
of Dentistry (KCD) this month.
She delivered a lecture on "Peptides for Regenerating Life: Use of Peptide
Biomaterial for Injectable Therapies and 3D Tissue Printing."
Image: DT Pakistan
MoU has been signed between Khyber College of Dentistry and King
Abdullah University, Saudi Arabia, as they share a common goal to advance science and technology through bold
and collaborative research and education, while addressing challenges of national, regional, and global significance.

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Dental Tribune Pakistan.

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[3] => Dt pages.FH10

[4] => Dt pages.FH10

NEWS

4 DENTAL TRIBUNE Pakistan Edition March 2019

PMDC requests doctors to halt
practice if without license
DT Pakistan Report

Image: DT Pakistan

SLAMABAD - The Pakistan
Medical and Dental Council
has asked doctors to avoid
private practice or work in public
or private sector hospitals
without a valid council license.
According to an official of the
PMDC, without a valid council
registration, no doctor is eligible
to practice in the country, and
they have been clearly warned
through a public notice that the
council will take strict action
against doctors having invalid
council registration. He said that
no medical certificate,
prescription, or advice would be
considered valid unless obtained
from a medical or dental
practitioner having valid
registration.
He said that it had been
observed that doctors and dentists
were practicing without having
a valid license as per the Pakistan
Registration of Medical and
Dental Practitioners Regulations,
2008. The council through a
public notice warned them that
after one month of issuance of
this notice, names of the doctors
with invalid registration would
be published in the newspapers
for strict action.

SBDC shines at 7th
International Students
Dental Conference
DT Pakistan Report

S
Under the law, no person,
other than a registered medical
or dental practitioner can
practice medicine or dentistry.
If any person who acts in
contravention of the provisions
of sub-section (I) will be
punishable with imprisonment
for a term which may extend
to two years but will not be less
than six months or with fine.
The amount for the fine may
extend to Rs200000 but will
not be less than Rs100000. He
added as per law, any medical
practitioner or a dentist
possessing any recognized
medical or dental qualification
whose name was maintained
on the register of the council
can work or start practice as
doctors in the country. He said
that as per PMDC regulations,
only those names would be
retained on the register, who

have paid the dues of the
council and only these names
will be considered to have valid
registration.
He said that through its public
notice, all medical and dental
practitioners, specialists and
faculty with expired or invalid
registration had been asked to
get their PMDC registration
renewed within two months.
Those who fail to comply will
be met with the council who
will take strict action to exercise
its powers conferred under the
PMDC ordinance of 1962.
He said that the council has
planned to take strict action
against the doctors having
invalid council registration. He
added that the Pakistan Medical
and Dental Council would
ensure the countrywide renewal
and registration process of
doctors.

HARJAH - The 7th International Students
Dental Conference was held at the
University of Sharjah from February 10th
to 11th. The theme for the
event was 'to inspire the
dentists of tomorrow,
nations are united today',
and was specifically
organized for dental
students and junior dentists.
Alongside scientific &
social programs, a variety
of workshops were also
offered at the conference;
various competitions were held as well.
One such segment was the Jeopardy Quiz, which
took place between two contesting teams. The
'Alpha Group' included two house officers from
Sardar Begum Dental College (SBDC), Dr
Muhammad Asif and Dr Siddiq Yousufi, and a
candidate from University of Sharjah, Dr Nadine
Al-Wazzan. Team Alpha won the quiz with an
impressive score.
Dr Siddiq Yousafi of SBDC scored another
achievement at the international conference by
claiming 1st position in poster competition. The
topic of his poster presentation was 'Use of
Antibiotics in teaching dental hospitals of
Peshawar, Pakistan. How justified are we?' Coinvestigators for the research project included Dr
Yasir Israr and Dr Shaina Zaman. The project was
supervised by Dr Syed Imran Gilani, Assist. Prof.
Community and Preventive Dentistry.

Ministry to push for Health Tax in budget against tobacco products
DT Pakistan Report

Image: DT Pakistan

SLAMABAD - The
Ministry of National
Health Services,
Regulations and Coordination
will urge the government to
include the "Health Tax" in
the upcoming budget for the
fiscal year 2019-20 to cut the
rising tobacco consumption
and increase the revenue,
reported officials. A senior
official of the ministry stated
that they would soon forward
a " H e a l t h Ta x 2 0 1 9 "
summary to the relevant
government departments,
suggesting additional taxes
on tobacco products and
beverages to discourage their
consumption.
Earlier in February this
year, the Federal Cabinet
rejected the proposal of the
Health Ministry for the
imposition of 'sin tax' on
consumption of tobacco and
beverages owing to the legal
and administrative lacunae in
the enforcement of the

levy.Under the "Health Tax,"
the ministry had proposed
imposing an additional Rs10
on each cigarette pack, while
Rs10 for 250ml beverage
bottle.
The official said that the
Federal Board of Revenue
(FBR) opposed the
imposition of the health levy
as it would only increase
taxation on multinational

companies that are already
paying "heavy taxes."
A special audit report on
the causes of the decline in
tax collection of the tobacco
sector has revealed that the
cigarette manufacturing
industry was involved in tax
evasion of Rs33 billion, and
recommended the withdrawal
of the third tier of the taxation
system for the tobacco

industry, which has resulted
in the annual loss.
It suggested the government
to increase the Federal Excise
Duty (FED) on an annual
basis to comply with the
World Health Organization
(WHO) rules, as this will also
result in higher revenues for
the government. According
to the WHO, a minimum of
70% of the retail price is an

excise tax, but in Pakistan,
45.79% of retail price is an
excise tax.The economic cost
of smoking in Pakistan
amounts to Rs143.208 billion
annually, and it includes
direct expenses related to
healthcare expenditures and
indirect costs related to lost
productivity due to early
mortality and morbidity, as
told by a report.
The report also revealed
that every year more than
160,100 people die in
Pakistan of tobacco-caused
diseases and still more than
125,000 children (10-14 years
old) and 14,737,000 adults
(15+ years old) continue to
use tobacco each day. The
health ministry official said
that keeping in view all this
economic and health loss;
they have been trying to
convince the Federal Cabinet,
FBR and other relevant
departments for the
imposition of the "Health
Tax" in the upcoming budget.

[5] => Dt pages.FH10

[6] => Dt pages.FH10

CLINICAL IMPLANTOLOGY

6 DENTAL TRIBUNE Pakistan Edition March 2019

The fully digital Pro Arch protocol
By Cuadrado de Vicente, Becerra,
Cuadrado Canals

T

he Straumann Pro Arch
concept involves different
treatment solutions for the
fully edentulous patient. The objective
is to provide a predictable,
reproducible and simple treatment that
restores patients oral health and
consequently improves their quality
of life dramatically. The possibility of
immediate, same-day rehabilitation
by means of temporary fixed
prostheses offers maximum treatment
quality and satisfaction for both
the dental team and patient. The
objective of the treatment with
an immediately loaded fixed prosthesis
on implants is to improve the patients
quality of life by providing
function, aesthetics and health until

Fig. 1

Fig. 2

Fig. 6

Fig. 7

Fig. 11

Fig. 17

reproducible results, with the use of
the intra-oral scanner as the principal
element. Our protocols include the
use of certain elements (adequate
implant system, Osstell, etc.) and
action protocols for scanning, surgical
and prosthetic procedures and
laboratory operations, including the
production and maintenance of the
provisional prosthesis.
In this case report, we present the
i2 Standard protocol. This can be
applied to patients requiring the
removal of terminal dentition. In
summary, this involves selected
extractions, implant placement, intraoral digital impressions, and the design
and production of the temporary fixed
prosthesis in PMMA, with placement
in the patient on the same day.
It is important to note that our fully

Fig. 3

Fig. 8

Fig. 12

Fig. 18

osseointegration is established.
Owing to the fully digital workflow,
which starts with the use of an intraoral scanner, the work team is able to
offer a treatment of extreme precision
in a simple way. This marks the
beginning of a completely digital
treatment right up to the final
prosthesis. This could be considered
as a new form of implantology in
which the different elements of
treatment are optimised to obtain a
spectacular result.
With this objective in mind, at i2
Implantología, we have developed a
number of solutions and protocols
covering the different clinical
situations in fully edentulous patients
and based on classical implantology
principles to obtain predictable and

periodontist. A panoramic radiograph
and dental CT scan were taken to
evaluate the bone availability,
disposition and density (Figs. 1 & 2).
After the different treatment options
were discussed, and in view of the
patients overall dental, social and
financial situation, an implant
treatment with a same-day fixed
temporary restoration was the first
choice for both the dental team and
the patient.
Treatment planning
The goal was to load the implants
immediately with a fixed screwed
temporary prosthesis. To achieve this,
the strategic extraction of some dental
elements was planned, with the
temporary preservation of those key
elements that, in the intra-oral
scanning, determined the patients

Fig. 13

Fig. 19

digital protocol to reach the final
prosthesis is based, if needed, on the
production of subsequent different
temporary prostheses until
osseointegration is established. We
will modify the initial design (and
produce further temporaries) always
according to a fully digital approach,
in order to obtain the final mock
temporary prosthesis that fulfils the
functional and aesthetic parameters in
the patient. The information provided
by this final mock temporary will be
copied on to the final prosthetic design.
A trained dental team, clinic and
laboratory are mandatory.
Initial situation
A 68-year-old patient with no
medically relevant history and
hopeless dentition was referred by his

Fig. 14

Fig. 20

occlusion and occlusion (Fig. 3).
The surgery was performed under
local anaesthesia and with patient
monitoring by an anaesthesiologist
using conscious intravenous sedation
with midazolam and pulse oximetry
monitoring. Removing failing teeth
was the first task, keeping in place
those teeth with less mobility and in
strategic positions to maintain
antagonist contacts, and trying to keep
the same preoperative bite (Fig. 4).
Extraction sockets were fully
debrided with a bur to remove all of
the granulomatous tissue. Gingival
trimming was also performed on those
gingival parts with deep pockets.
Cleaning with hydrogen peroxide and
saline was the final step, obtaining
fresh places for the implants.
Keeping in mind the bone anatomy,

Fig. 4

Fig. 5

Fig. 9

Fig. 10

Fig. 15

Fig. 21

aesthetics, vertical dimension of
occlusion and prosthetic arch. We
decided to perform minimally invasive
surgery, where possible, with a flapless
technique to avoid any mobile tissue
that could affect intra-oral scanning.
The placement of six Straumann Bone
Level Tapered, Roxolid, SLActive
implants with screw-retained
abutments (SRAs) was planned for
the restoration.
Surgical procedure
Before starting the surgery, an initial
study model scan was obtained with
the intra-oral scanner and sent to the
laboratory as the patients original file
(File 1). This file contained all of the
information concerning the patients
preoperative situation, including teeth,
aesthetics, vertical dimension of

Fig. 16

Fig. 22

availability and expected density, the
final implant locations were selected
and the implant beds were prepared
at 800 rpm with continuous saline
irrigation. The implant beds have to
be prepared such that parallelism is
maintained between all the implants.
When placing tilted and/or nonparallel implants, the preparation angle
should be either 17° or 30° to match
the available SRA custom angulation.
Accordingly, the dentist is constantly
striving for the least divergent implant
preparation, drilling at 0, 17 or 30°.
The Pro Arch guide is very useful for
this purpose.
Furthermore, undersized drilling
with continuous bone density
assessment according to the operators
Continued on Page 12

[7] => Dt pages.FH10

[8] => Dt pages.FH10

CLINICAL IMPLANTOLOGY

8 DENTAL TRIBUNE Pakistan Edition March 2019

Comparison of guided and non-guided implant
placement accuracy  In vitro study with 3-D printing
By Dr Lukasz Zadrozny et al.

T

he procedure of implantation
is becoming an increasingly
popular method for replacing
teeth. The critical factor in the
achievement of a therapeutic and
aesthetic long-term effect is the
accuracy and precision of implant
placement, being the support for the
future prosthetic work. Thanks to
modern digital technologies, it is
possible to plan the implantation
virtually. Evaluation of this plan by
3-D printing in a subsequent step
allows the creation of implant guides.
Using the guides, which provide
precise information on implant
placement and insertion depth and
angle, allows the maintenance of all
the parameters included in the
planning stage, lowering the risk of
a mistake during implantation. Using
3-D printing allows the fabrication of
both implant guides and study models
that accurately represent patients true
clinical conditions. This makes it
possible to compare the precision of
procedures under the in vitro
conditions, which are safe and
representative of actual requirements.
During the implantation, clinical
conditions very often hinder precise
orientation in the operating field, thus
the precision of implant positioning

is lower. According to the literature,
both more and less experienced
clinicians face this problem.
Introducing virtual planning based on
CBCT is highly useful while
preparing for the procedure; however,
what allows the fully controlled
preparation of the implantation site
is the transfer of its result to the guide
imposing the positioning. The
virtually created implant guide can
be printed using a 3-D printer,
sterilised and then used in the
procedure. The use of the guide affects
the precision of the procedure and
shortens its time.
Aim of the study
The aim of the study is to prepare
3-D models for the analysis of the
precision of implant procedures
performed on the basis of digital
planning, conducted with and without
the use of implant guides.
Methodology Based on the CBCT
examination of the patient, who
underwent implantation in the
mandible, a 3-D model corresponding
to the actual bone and mucosal
conditions before implantation was
created in DDS-Pro software
(www.dds-pro.com.pl). It was then
reprinted 20 times. The print was
produced with selective laser sintering
technology using polyamide powder

Fig. 1b: Virtual planning of
implant positioning.

Fig. 1a: Virtual planning of
implant positioning.

Fig. 3: A model with the guide
and implants after the
implantation. The guide was
stabilised with two posts.

in the TPM Elite P3600 SLS System
printer (Solveere). It yielded ten
identical pairs of mandibular models.
Virtual planning (DDS-Pro; Fig. 1)
of implant positioning and placement
(TSIII, OSSTEM IMPLANT) and the
implant guide, printed in 3-D with Jet
technology (ProJet MP 3000 printer,
3-D Systems), with stock sleeves for
three implants with regular platforms
previously used clinically (sterilised),
were used to intro-duce implants into
every second printed model, using
the OsstemGuide KIT (Taper). The
drilling speed was set at 1,200 rpm.
Water cooling was not used.
Osteotomies were performed
according to the manufacturers
instructions. Other models were used
for implantation based on the planning
performed, but without additional help
(no guide), using the same implant
kit and under the same conditions. As
the test was conducted in vitro, TSIII
training implants with dimensions of
4 × 10 mm were used. It was assumed
that all ten procedures performed
would yield the same results.
Findings
The use of 3-D printed models
allows implantation under conditions
spatially corresponding to those of a
clinical situation. However, the
models printed in this study were

Fig. 4: The material
was deposited on the
drill attached to the
extension.

Fig. 5: Drill attached to the extension
passing through the reduction sleeve.
The extension allows the drill to be
guided correctly without touching the
template on the adjacent tooth with
the contra-angle handpiece.

hard. The material cut during
osteotomy preparation was deposited
on the drill and the implant thread,
making it difficult to perform fulldepth insertion. More torque was
required to insert the implant than is
clinically used. It was observed that,
when an osteotomy was prepared in
the vicinity of a preserved tooth, there
was a need to use the drill extension
in order to avoid leaning the contraangle handpiece on the guide or tooth.
Because this tool is missing in the
OsstemGuide KIT (Taper), one must
have an additional implant kit when
using it clinically. The use of the guide
shortens the implantation time,
compared with the same procedure
performed with no help of a guide.
In the following stage of the project,
the models will be optically scanned
and undergo comparative analysis in
terms of repeatability, accuracy and
compliance with the planned virtual
goal.
Editorial note: The study is being
carried out as a part of a project in
the field of scientific developmental
research aimed at the development of
young scientists and students enrolled
in PhD studies, financed as part of
the scientific activity of the Medical
University of Warsaw in Poland.
- Dental Tribune International

Fig. 2: Exemplary pair of models before
the procedure: on the left, without the
guide, and on the right, with the guide.

Fig. 6: Models after performing the
procedures with the use of the guide.
The same axes of the implants
inserted are visible.

[9] => Dt pages.FH10

NEWS

March 2019 Pakistan Edition DENTAL TRIBUNE 9

Annual Publishers Meeting:
DTI looks towards the future
By Brendan Day

C

OLOGNE, GERMANY - In
the lead-up to the 38th
International Dental Show
(IDS), Dental Tribune International
(DTI) held its 15th Annual Publishers'
Meeting over 10 and 11 March in
Cologne. This year's gathering saw 75
members of the DTI network from all
over the globe in attendance to discuss
the latest developments and projects
the company is undertaking.
Among the highlights of the meeting
was the official introduction of Dental
Tr i b u n e A l g e r i a , t h e n e w e s t
international licence partner. Led by
Dr Ouahes Aziouez, the new partner
will produce Dental Tribune Algerian
Edition, a quarterly publication that
will focus on the latest developments
in dentistry within the Maghreb region.
Its first issue will be formally launched
at IDS and will be available for viewing
at the DTI Media Lounge in Hall 4.1
at Booth D060-F061.

The Annual Publishers' Meeting also
provided an opportunity for an exciting
announcement about DTI's upcoming
expansion into the Scandinavian dental
media market. Though the details are
still being finalised, new Dental Tribune
editions for the region will be launched
soon, according to DTI President and
CEO Torsten Oemus. "We look forward
to welcoming our Scandinavian friends
into the fold here at DTI and expanding
our international presence," he said.
Oemus also spoke about one of the
newest additions to the DTI portfolio,
Smyle magazine. With its flagship
German-language edition currently
delivered to over 60,000 dental practices
in Germany, Smyle is to be expanded
to include an international Englishlanguage version later this year. "By
introducing an international edition of
Smyle, we will be able to highlight the
latest global trends in well-being, health,
beauty and more," said Oemus.

This year's gathering saw licence partners from all over the globe in
attendance to discuss the latest developments and projects the company is
undertaking. (Photograph: Tom Carvalho, DTI)
An update on the status of the
highly anticipated DDS.WORLD was
also provided at the meeting by
Joachim Tabler and Martin Troppa,
departing and incoming
DDS.WORLD managers,
respectively. A full-service digital
marketplace for products, news, elearning and practice management,
DDS.WORLD is targeted at all
participants in the dental industry. It
offers a web shop and an associated
search facility, practice management
and inventory management systems,
direct customer communication tools
and much more. Attendees were

New study shows cancer-linked genetic
changes in electronic cigarette users

L

OS ANGELES, U.S. Despite their thriving
market, electronic
cigarettes may not be a
harmless alternative to smoking
after all. A recent study has
shown that e-cigarette users
develop some of the same
cancer-related molecular
changes in their oral tissue as
cigarette smokers, adding to
growing public health concern.
In the study, researchers at
the University of Southern
California (USC) analyzed
gene expression in the oral
epithelial cells of 42 e-cigarette
users, 24 cigarette smokers and
27 nonsmokers to test for gene
alteration, as certain alterations
in gene expression can lead to
cancer. Both smokers and
vapers displayed abnormal
expression, or deregulation, in
a large number of genes linked
to cancer development. About
26 percent of the deregulated
genes in e-cigarette users were
identical to those found in
smokers. Some deregulated
genes found in e-cigarette
users, but not in smokers, are
associated with lung cancer,
esophageal cancer, bladder
cancer, ovarian cancer and
leukemia.
"The existing data show that
e-cig vapor is not merely 'water

informed that DDS.WORLD will
initially be launched in select pilot
markets-Greece, Serbia and Polandand will provide all-in-one solutions
for running a dental practice.
Alyson Buchenau, Business
Development and Marketing Manager
at DTI, thanked those in attendance
and emphasised the importance of
cooperation. "The DTI network
currently reaches 785,000 dental
professionals worldwide via our print
and digital portfolio," she said. "If we
work together, our audience will
continue to grow." - Dental Tribune
International

Dental, medical and
nursing students work
together in new study

N

EW YORK, U.S. - With dental caries being
the most common chronic childhood disease,
it is imperative that health care professionals
across all sectors work closely together. In a new study,
led by the New York University (NYU) Rory Meyers
College of Nursing, dental, medical and nursing students
worked together in order to help improve
interprofessional skills and collaboration between
primary care and dental providers.

A recent study has suggested that molecular changes seen
in e-cigarette users may serve as an early warning of a
process that may eventually lead to cancer. (Photograph:
Andrey_Popov/Shutterstock)
vapor' as some people believe,"
said senior author Dr. Ahmad
Besaratinia, Associate
Professor of Research
Preventive Medicine at the
Keck School of Medicine of
USC. "Although the
concentrations of most
carcinogenic compounds in ecig products are much lower
than those in cigarette smoke,
there is no safe level of
exposure to carcinogens."
Besaratinia noted that the
molecular changes seen in the
study are not cancer, or even
pre-cancer, but rather an early
warning of a process that could
potentially lead to cancer if left
untreated. The scientists are
planning to replicate the study
with a larger group of subjects

and explore the mechanisms
that cause gene deregulation.
They are also launching
another study in which smokers
will switch to e-cigarettes to
see whether any changes occur
in gene regulation after the
switch. "For the most part, the
participants are as curious as
we are to know whether these
products are safe," said
Besaratinia.
T h e s t u d y, t i t l e d
"Deregulation of biologically
significant genes and associated
molecular pathways in the oral
epithelium of electronic
cigarette users," was published
online in the first February
2019 issue of the International
Journal of Molecular Sciences.
- Dental Tribune International

In a recent study, dental, medical and nursing students
worked together to help test the success of
interprofessional collaboration in child oral health.
(Photograph: Andrey_Popov/Shutterstock)
"Collaborative, workplace-ready students are valuable
assets to any clinical team. Our goal is for team-based,
whole person care to become the norm for promoting
children's oral health and preventing cavities," said Dr.
Erin Hartnett, Program Director of Oral Health Nursing
Education and Practice (OHNEP) at NYU Meyers and
the study's lead author.
As part of the interprofessional experience, family
nurse practitioner, medical and dental students worked
as a team to assess patients. Together, they reviewed
patients' charts, looked at patients' medical and dental
Continued on Page 15

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NEWS

10 DENTAL TRIBUNE Pakistan Edition March 2019

Human immune system contributes to
dental caries and damage to dental fillings

O R O N T O ,
within five to seven years,
CANADA - The
costing Canadians an
question as to why
estimated CA$3 billion a
the human immune system
year.
partly works against the
Ours is the first basic study
body, for example in
to show that neutrophils can
autoimmune diseases, is still
break down resin composites
not sufficiently researched.
and demineralize tooth
Usually, it is the conjunctive
dentin, said Russel Gitalis,
tissue that is affected. Researchers from the University of Toronto have found that a masters student at the
However, a recent study by the human immune system plays a role in the occurrence of university and first author of
r e s e a r c h e r s f r o m t h e dental caries. (Photograph: Sergii Kuchugurnyi/Shutterstock) the paper. This suggests that
University of Toronto has
neutrophils could contribute
shown the first evidence that the bodys cavity, the body sends out neutrophils to tooth decay and recurrent caries.
own defense system could be a major to attack. However, as the neutrophils
While the study provides the first
contributor to dental caries and filling track down and destroy the invading direct evidence that an immune
failure.
bacteria, they may cause destruction response may contribute to dental
No one would believe that our to the localized environment as well. caries, it also opens up new
immune system would play a part in
On their own, neutrophils are possibilities for research. We can
creating cavities, said lead author Dr. incapable of causing damage to the develop new methods to prevent
Yoav Finer, an associate professor in teeth. Finer explained: They dont immune-mediated destruction of
the Faculty of Dentistry at the have acid, so they cant do much to teeth, said co-author Prof. Michael
university. Now we have evidence. mineralized tooth structures. Glogauer, from the Faculty of
The study demonstrated that the However, if neutrophils engage in Dentistry at the university.
decay of dentin and fillings is caused attack, the acids produced by oral
The findings may also one day lead
not only by bacteriaas has been the bacteria demineralize the tooth. That to new standards for testing filling
common understanding of scientists is when enzymes from both the materials, said Finer, who argues that
for decadesbut through the unique immune cells and their targets, the materials need to face trial within the
activity of oral immune cells known bacteria, rapidly degrade teeth and can collaborative destruction laboratory
as neutrophils, which potentially cause collateral damage to resin to pass muster. We need to test
enhance the effects of bacteria. composite fillings.
interactions with the body and
Recognized as important in
Corroborating the findings of bacteria, he added.
combating inflammation in all parts previous studies conducted by the
The study, titled Human neutrophils
of the body, the neutrophil is a type group, the research also explained why degrade methacrylate resin composites
of short-lived innate immune system so many patients who have composite and tooth dentin, was published on
cell that enters the oral cavity from fillings as a result of caries treatment April 1, 2019, in Volume 88 of Acta
the gingivae around the roots of the face high rates of recurrence of the Biomaterialia. - Dental Tribune
teeth. When bacteria invade the oral disease. Most composite fillings fail International

Plant cellulose might provide new bone
material to be used for dental implants

ANCOUVER, BRITISH COLUMBIA,
CANADA - Owing to the potential complications
associated with autografts, there is a need for
synthetic bone tissue scaffolds. Researchers from the
University of British Columbia (UBC) and McMaster
University have developed a new implant material, a
foamlike substance, for bone regeneration. The researchers
are confident that the material can be used in dental
implantology in the future.
The new material is made from chemically cross-linked
plant cellulose nanocrystals to form a strong but
lightweight aerogel that can compress or expand as
needed to completely fill bone cavities.
"Most bone grafts or implants are made of hard, brittle
ceramic that doesn't always conform to the shape of the
hole, and those gaps can lead to poor growth of the bone
and implant failure," said lead author Daniel Osorio, a
doctoral student in chemical engineering at McMaster.
"We created this cellulose nanocrystal aerogel as a more
effective alternative to these synthetic materials."
For their research, the team tested their material in two
groups of rats, with the first group receiving the aerogel
implants and the second group receiving none. Results
showed that the group with implants experienced 33
percent more bone regeneration at the three-week mark
and 50 percent more bone growth at the 12-week mark,
compared with the controls.

Researchers have developed a new bone regeneration
material, derived from plant cellulose, which may be
used for dental implants in the future. (Photograph:
Clare Kiernan, UBC)
"These findings show for the first time in a laboratory
setting that a cellulose nanocrystal aerogel can support
new bone growth," said co-author Dr. Emily Cranston,
an associate professor in the Department of Chemical
and Biological Engineering and President's Excellence
Chair in Forest Bioproducts at UBC. Cranston is also an
adjunct professor in the Department of Chemical
Engineering at McMaster. She explained that the implant
should break down into nontoxic components in the body
as the bone starts to heal.
Continued on page 15

Scientists find link
between mouthwash use
and raised blood pressure

OUSTON, U.S. - A
balanced oral microbiome
can contribute to good
cardiovascular health by converting
dietary nitrate into nitric oxide
(NO), a signaling molecule that
helps maintain normal blood
pressure. Now, a new study has
suggested that chlorhexidine, an
antiseptic substance found in
mouthwash, may kill NO-producing
bacteria and raise systolic blood
pressure.

A recent study has suggested that
proper management of the tongue
microbiome might improve resting
systolic blood pressure. (Photograph:
Gecko Studio/Shutterstock)
The researchers used 16S rRNA
gene sequencing and analysis to
examine whether using
chlorhexidine antiseptic mouthwash
twice a day for one week would
change the oral bacterial
communities and blood pressure
levels in 26 healthy individuals.
They collected samples of the
participants' saliva and tongue
scrapings and measured their blood
pressure at baseline as well as seven,
ten and 14 days later.
The results indicated that using
chlorhexidine twice a day was
associated with a significant
increase in systolic blood pressure
and that recovery from use resulted
in an enhancement in nitratereducing bacteria on the tongue.
Individuals with relatively high
levels of bacterial nitrite reductases
had lower resting systolic blood
pressure.
"The demonstration that the
presence of NO-producing bacteria
in the oral cavity can help maintain
normal blood pressure gives us
another target to help the more than
100 million Americans living with
high blood pressure," said lead
researcher Dr. Nathan S. Bryan, an
adjunct professor in the Department
of Molecular and Human Genetics
at the Baylor College of Medicine
in Houston. "Two out of three
patients prescribed high blood
pressure medication do not have
their blood pressure adequately
managed," he added. "None of the
[current] drugs for management of
hypertension are targeted towards
these NO-producing bacteria."
According to Bryan, owing to the
Continued on page 14

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NEWS

12 DENTAL TRIBUNE Pakistan Edition March 2019

Facial transplant surgery improves speech in
patient with severe facial trauma, study finds

N

EW YORK, U.S. - Facial
transplantation is one of
the most extensive facial
reconstructive surgeries available.
The procedure involves the partial
or total replacement of nerves,
muscles and skeletal structures of
the face, head and neck using
donor tissue. A new case study by
New York University's Steinhardt
School of Culture, Education, and
Human Development has found
that facial transplant surgery in a
patient who had experienced
severe facial trauma improved
speech production.
"Our findings provide a window
into the complex recovery process
following major facial
reconstruction and serve as an
important foundation from which
we can begin to understand how
facial transplant can improve
speech production preoperatively
to postoperatively," said Dr. Maria
I. Grigos, lead author of the study
and associate professor at the
university. "Among the many
remarkable patterns observed, we
found that the patient displayed
more flexible control of facial
movement as he adapted to the
transplanted structures."
Using optical tracking, a form

F

REIBURG, GERMANY - A recent
study has shown that a plant-based
wholefood diet enriched with omega3 fatty acid and vitamin D is able to reduce
gingival inflammation naturally. Based on
the findings of this trial, the researchers

Researchers from New York Universitys Steinhardt School of
Culture, Education, and Human Development have found that
facial transplant surgery contributes to improved speech production.
(Photograph: Azret Ayubov/Shutterstock)
of motion tracking technology,
Grigos and her team were able to
examine firsthand how the facial
transplant procedure altered
movement of the face and
contributed to improved speech
production. The researchers
compared data from the case study
patient-a male victim who had
suffered third- and fourth-degree
burns and major soft-tissue loss
in a fire-against data on four
healthy adult men (controls).
The patient's speech production
and facial movements were

The fully digital Pro ...
Continued from page 6

Plant-based diet could
help reduce gingivitis

own experience is mandatory to achieve
the highest insertion torque, taking
account of the biological bone situation
and the mechanical properties of
Roxolid. In this case, six implants
(Straumann BLT, Regular Neck,
Roxolid, SLActive, four of ? 4.1 mm
and two of ? 4.8 mm) were placed with
the handpiece at 45 N cm, with a final
manual setting and monitoring of the
insertion torque (Figs. 5 & 6). Careful
orientation of the Loxim orientation
marks is mandatory to maintain the
desired parallelism of the SRA
prosthetic screws.
After final implant seating, BLT Type
54 SmartPegs from Osstell were placed
on each implant, and the ISQ level was
measured and recorded at implant
connection level. Values between 75
and 85 out of 100 were obtained,
confirming the immediate loading
possibility on all the implants (Figs. 7
& 8).
SRAs were connected to all of the
implants: two 17º Type A angulated
SRAs were placed on the anterior
implants to correct the angulation for
immediate prosthetic rehabilitation.
Straight SRAs were placed on the
remaining implants (Fig. 9). New ISQ
levels were measured at abutment level
using the convenient BLT Type 25

examined once before the
procedure and four times in the
13 months after the procedure.
Movements of the patient's lips
and jaws, as well as the
intelligibility of his speech, were
compared pre- to posttransplantation and then tracked
across the recovery period.
The study found that his speech
intelligibility varied across the
study period and was restored to
control status by seven months
post-transplant. Jaw displacement
Continued on Page 14

SmartPegs. It is important to record the
ISQ level at implant and abutment level
in the surgery so that the values can be
extrapolated in future Osstell readings
at SRA level.
To obtain the final intra-oral surface
scan, original Straumann SRA scan
bodies were connected to the SRAs
under visual control (Fig. 10). A new
intra-oral scan was taken to record the
patients current oral situation, showing
the scan bodies and the preserved
strategic teeth. This file (File 2) was
also sent to the laboratory (Figs. 11 &
12). When the laboratory confirmed
receipt of both files, the preserved teeth
were extracted and healing caps placed
on the abutments, completing the
surgery.
Prosthetic procedures
On receipt of the scan body file (File
2), the laboratory imported it into
3Shapes Dental System and created a
virtual model, matching the virtual SRA
scan bodies from Straumanns original
library with the intra-oral SRA scan
bodies (Figs. 13 & 14). A working file
was created for designing the temporary
prosthetic emergence profile for the
SRA.
To perform the design of the
temporary full-arch prosthesis and
maintain (or modify) the vertical
dimension of occlusion and occlusion,
the patients pre-preparation study

A new study has suggested that gingivitis
is profoundly affected by diet. (Photograph:
9dream studio/Shutterstock)
recommended that dental professionals ought
to assess dietary behaviour in patients with
gingivitis and provide dietary
recommendations in addition to periodontal
therapy.
For the trial, 30 patients with gingivitis
were randomised to an experimental and a
control group stratified by their plaque
values, which were taken at baseline and
the end of the study. The experimental group
changed to a diet low in processed
carbohydrates and animal proteins, and rich
in omega-3 fatty acid, vitamin C, vitamin
D, antioxidants, plant nitrates and fibre for
four weeks, whereas the control group
Continued on Page 14

model scan file (File 1) was imported
as a pre-preparation scan (blue) and
merged with the implant file scan (File
2), using the preserved teeth present
on both scans. The software allowed
us to mark the same points on the
preserved teeth on both files, the study
model scan and the implant scan (both
contained the preserved teeth). Thus,
the laboratory was able to work on a
single file containing both Files 1 and
2, merged by means of the preserved
teeth. Designing the temporary
prosthesis is an easy task using the
image of the patients own teeth as a
mock to be copied (Fig. 15). Any design
modification can easily be done (Figs.
16 & 17).
Finally, the designed temporary was
sent to the milling unit and produced
on a convenient PMMA disc (Telio
CAD, Ivoclar Vivadent), resulting in a
perfect full-arch bridge about 2 hours
later. In this case, using SRAs, a
monolithic Telio CAD bridge was
produced without any Variobases
(Straumann) for the SRAs. Final
temporary production steps included
characterisation and polishing (Fig. 18).
Returning to the patient, the healing
caps were removed (Fig. 19), and the
prosthesis was placed, allowing for a
passive fit on the abutments, with an
initial handpiece tightening of each
SRA screw to 5 N cm. After the seating

was checked, the torque of each SRA
screw was increased, also with the
handpiece, to 35 N cm (Fig. 20). The
occlusion was checked and contacts
were inspected (Fig. 21). The screw
holes were sealed with PTFE and a
temporary filling material. A panoramic
X-ray was taken, and SRA screw
positions were evaluated to confirm the
perfect temporary bridge fit (Fig. 22).
The patient was discharged on 500 mg
of amoxicillin every 8 hours and 25
mg of dexketoprofen every 12 hours
for one week. Oral hygiene and diet
instructions were given, and a oneweek follow-up appointment was
scheduled.
Treatment outcomes
Bearing in mind that this is a
one-day treatment, the overall treatment
time per jaw is about 34 hours from
the beginning to the end of the
procedure. With this minimally invasive
protocol, postoperative pain, swelling
and discomfort are minimal. Patients
are able to recover their health and
social life immediately, without the
psychological and social impairment
associated with longer classical
procedures.
Editorial note: This article was
published in CAD/CAM - international
magazine of digital dentistry No.
04/2018.
- Dental Tribune International

[13] => Dt pages.FH10

[14] => Dt pages.FH10

14 DENTAL TRIBUNE Pakistan Edition March 2019

3.6 million smiles spread ...
Continued from front page

any dental or oral problem, or even visit
a dentist for a routine checkup.
On March 20th, Dental News, with
sponsor Shield, erected kiosks at 50
dental colleges/hospitals/healthcare
centers, in 16 different cities across
Pakistan. Here the dental OPDs ran all
day, free of cost, on WOHD, to maximize
dental care benefit for the masses. The
visiting patients were dealt with
compassionately, they were keenly
educated about their oral health by the
dental professionals present at the camp,
and screened for any dental or oral
ailment, and were provided the needed
treatment. Correct brushing techniques
were demonstrated and basic oral
hygiene guidelines were shared. Free
samples were also be provided to the
visitors. The Pakistani dental community
rose as one to contribute passionately to
the selfless cause of restoring the smiles
of adults and children alike.
An outreach programme was also
carried out by Liaquatian's Welfare
Society (LWS) BDS Chapter at Matyari
School, in the Hyderabad district, Sindh,
for underprivileged students and staff.
To mark the day, poster competitions
on various oral care subjects were
especially conducted in dental institutes
on WOHD. This academic activity was
organized by institutes namely Multan
Medical and Dental College, Multan;
Bibi Asfa Dental College, Larkana;
Liaquat College of Medicine and
Dentistry, SIOHS, Jinnah University,
Karachi; HBS Dental College,
Islamabad; and Peshawar Dental
College, Peshawar.
Several institutes organized seminars
for their students, trainees and faculties
on this day. These seminars dealt with
topics ranging from community dentistry
to treatment and management. Among
colleges to hold seminars were Baqai
Dental College, Karachi; Bibi Asfa
Dental College, Larkana; Liaquat
College of Medicine and Dentistry,
Karachi; HBS Dental College,
Islamabad; Peshawar Dental College,
Peshawar; and CMH Dental Hospital,
Lahore.
'Walk a Cause' oral health awareness
marches were organized by several
partner institutes to amplify the effect
of the campaign. Institutes to hold
awareness marches included Bibi Asfa
Dental College, Larkana; Karachi
Medical and Dental College, Karachi;
HBS Dental College, Islamabad; Bhatai
Dental College, Mirpurkhas; Bolan
Dental College, Quetta; Dental Section,
Liaquat University of Medical and
Health Sciences, Jamshoroo; Peshawar
Dental College, Peshawar.
The aforementioned activities scored
a physical reach of 20,000 individuals!
Dental News commenced its engagement
campaign well ahead of World Oral
Health Day. It kept the general public
engaged; as well as involved individuals
from the dental fraternity that stepped
forward to passionately participate in

this movement toward creating healthier
smiles.
Content comprising facts, tips and
tricks, and general knowledge about the
mouth and all that is within, was shared
on social media. Posts with a dash of
humour were also published to attract
greater attention. These educational posts
were consistently made on three different
social media platform.
As part of its WOHD campaign, DN
invited its followers and subscribers to
send in their queries in regards to their
oral health. These questions were
answered by a Dr Hira M. Khan in a
'Live Q&A Session' that was aired on
Facebook page.
Quiz posts were posted on social media
platforms asking people basic oral
hygiene/oral care questions with the
intention of bringing their attention to
oral health matters that are elementary,
yet either forgotten or barely thought of.
Common questions about brushing
techniques, oral hygiene routine and
timetable, and oral care tools are being
asked to raise concern among masses.
The intention is it to transform the
cultivated concern and thoughts into
action.
To educate people about the
significance of a beautiful and healthy
smile, a "Smile & Win" selfie
competition was also launched, wherein
the participants were required to click a
picture, smiling brightly, with a Shield
toothbrush and toothpaste in their hands;
the picture then had to be posted on the
participant's social media.
One winner was selected, via lucky
draw, from the participants of each
competition. The winners received
exciting gift hampers at the end of the
WOHD campaign.
The dental community was also stirred
to partake in the campaign via
contributing motivational blogs and
messages targeting the masses. Video
messages of several renowned dental
surgeons of Pakistan were recorded with
educational content based on this year's
WOHD theme. Apart from the celebrated
dentists of our country, which included
the President of Islamic Republic of
Pakistan, Dr Arif Alvi- a dentist and one
of the chief architect of WOHD;
President PDA; and several heads of
institutions, WOHD public service
messages were received from many other
dental practitioners, teachers, students,
and its followers on social media.
The digital campaign bagged 3.6
Million impressions!
Dental News, with the combined
efforts of all the contributors, including
DTI Pakistan, was able to realize the
goals and objectives of WOHD'19
campaign, which were mainly targeted
toward creating oral care awareness
among masses, and ensuring their
wellbeing. Our impressive scores and
substantial statistics speak clearly of our
success and achievement of the desired
mark in 'Oral Care Awareness'.
The well-tailored campaign that was
as per the guidelines of the FDI received
tremendous recognition and engagement.

The three groups of target audiences
were effectually addressed; children and
adults through 'school outreach
programmes' and 'awareness &
engagement campaigns' for
parents/adults via social media and dental
camps; thirdly, the government and
policy makers were stimulated through
'Walk a Cause' marches.
World Oral Health Day (WOHD) is a
far-reaching global oral health campaign.
It is a platform for the public, oral health
community, and policymakers to help
reduce the overall oral disease burden.
Dental News and DTI Pakistan will
continue to strive for the recognition of
oral health as a vital part of overall
wellbeing, and remain committed
to working towards better oral health
for all.

Dental treatment service ...
Continued from page 2

fatal for the patient if the case was not
timely referred to a qualified dental
surgeon.
"It is my recommendation that if a
mouth ulcer persists for more than two
weeks, then it should be properly
examined by a qualified dental surgeon
on an urgent basis," he said.
The PDA President stated that apart
from oral cancer, other dental ailments
were easily preventable as that required
adoption of good oral hygiene practices
since the days of early childhood.
"Brushing of teeth is compulsory using
any toothpaste containing fluoride. That
is the most fundamental oral hygiene
practice, which should be adopted by all
on a daily basis as a norm of their routine
life," he quoted.
He further stated that amongst children,
the most common oral health ailment
was of tooth decay or dental caries
whereas among the adults the common
dental problem was of gum or
periodontal disease.
Dr Shah said that both of these
common oral health issues could
effectively be prevented by adopting
good hygiene practices. Brushing one's
teeth twice daily is a compulsory practice
for everyone, he said.
"Lastly I would suggest that one should
not hesitate and readily visit a qualified
dental surgeon if any of these common
dental issues arise as proper,
recommended, and timely treatment of
these ailments could prevent further
complications related to oral health," he
concluded.

Scientists find link ...
Continued from page 10

widespread nature of the molecule, oral
bacteria may have other profound effects
on human health besides regulating blood
pressure. "We know one cannot be well
without an adequate amount of NO
circulating throughout the body. Yet, the
very first thing over 200 million
Americans do each day is use an
antiseptic mouthwash, which destroys
the 'good bacteria' that help to create
the NO. These once thought good
habits may be doing more harm than

Fig. 7: Gentle extraction preserving the
vestibular lamina

good," he said.
The study, titled "Frequency of tongue
cleaning impacts the human tongue
microbiome composition and
enterosalivary circulation of nitrate,"
was published online on March 1, 2019,
in Frontiers in Cellular and Infection
Microbiology. - Dental Tribune
International

Facial transplant surgery ...
Continued from page 12

and lip aperture in the vertical plane
significantly increased over time for
nonspeech and speech tasks. Changes
in horizontal lip movements over time
were minimal. Jaw and lip movement
variability fluctuated over time and was
greater than that of the controls by 13
months post-transplant.
"The remarkable changes that we
captured in this patient reflect the
multiple processes involved in the
reintegration of neuromuscular control
and in the learning of new strategies
over the recovery period. Such
adaptability is a positive indicator that
treatment to improve speech production
can be effective post-facial transplant
surgery," continued Grigos.
The study, titled "Changes in
articulatory control pre- and post-facial
transplant: A case report," was published
in the February 2019 issue of the Journal
of Speech, Language, and Hearing
R e s e a r c h . - D e n t a l Tr i b u n e
International

Plant-based diet could ...
Continued from page 12

remained on their western diet. All
participants stopped using dental floss
and other interdental cleaners during the
trial period. Periodontal parameters, such
as subgingival plaque values and gingival
bleeding, after the procedure were
assessed by a blinded dentist.
The findings indicated that, although
there were no differences regarding the
participants' plaque values, the
experimental group experienced a
significant reduction in gingival bleeding.
Apart from the potential benefit for oral
health, a substantial increase in vitamin
D values and weight loss was also
evident.
"Study results clearly demonstrate the
possibility to naturally reduce gingivitis
by an optimised diet that also promotes
general health. According to this, dental
teams should address dietary habits and
give adequate recommendations in the
treatment of gingivitis, since it might be
a side effect of a pro-inflammatory
western diet," said lead author Dr Johan
Wölber, a dentist and research assistant
in the Department of Operative Dentistry
and Periodontology of the Centre for
Dental Medicine at the University of
Freiburg Medical Centre.
The study, titled "The influence of an
anti-inflammatory diet on gingivitis. A
randomized controlled trial", was
published online on 2 April 2019 in the
Journal of Clinical Periodontology ahead
of inclusion in an issue. - Dental Tribune
International

[15] => Dt pages.FH10

March 2019 Pakistan Edition DENTAL TRIBUNE 15

Americans find natural
teeth worth saving,
according to survey

C

HICAGO, U.S.- A recent
study conducted by the
American Association of
Endodontists (AAE) has found that
Americans believe there is much
worth saving. Beyond material
possessions, such as scrapbooks,
the survey explored what
Americans most want to save about
their body.

A survey by the American
Association of Endodontists has
found that natural teeth are
considered something worth
saving. (Photograph:Q-stock/
Shutterstock)
The AAE survey found that
younger people value saving their
natural teeth at least as much as
any other aspect of their body.
Twenty-four percent of millennials
ranked teeth as the most important
part of their body they would save
or maintain. In comparison, 37
percent of baby boomers would
prefer to save their eyesight.
We tend to take our bodies for
granted, so its great to learn
younger people understand the
importance of dental health, said
AAE President Dr. Patrick Taylor.
Endodontists take pride in using
advanced training, specialized
techniques and superior
technologies to perform root canal
treatment and help everyone keep
their natural teeth.
According to the survey, which
was conducted online among 800
adults from Jan. 28 through Feb.
4, 2019, the top reasons people
value saving their natural teeth are
because its healthier and it
gives you a better appearance.
Interestingly, 61 percent of the
female respondents feel strongly
that saving their natural teeth helps
them feel better about themselves,
compared with 51 percent of the
male respondents. - Dental Tribune
International

My therapist was like,
What brings joy to
your heart? And I was
like, I like to see teeth.
I guess maybe I should
have been a dentist.
~Tiffany Haddish

IDS reaffirms its leading ...

and the dental community are
admirable.

reported that the largest groups of
visitors came from the dental industry.
Schools and universities were strongly
represented too. Almost 80 per cent
of those who completed the survey
stated they were satisfied or highly
satisfied with the range of exhibition
offerings. More than 93 per cent said
that they would recommend visiting
IDS, and 70 per cent of the
respondents were already planning to
visit the next IDS, in 2021.
Dr Markus Heibach, Executive
Director of the Association of the
German Dental Industry, which is
involved in organising the event, was
also pleased with the outcome of the
trade fair: "The high level of
satisfaction of our trade visitors and
exhibitors is for us impressive
confirmation of our efforts to make
our guests' stay as pleasant and
successful as possible by offering
them a cosmopolitan, hospitable and
perfect service."
IDS offered the ideal business
platform, especially for new
companies on the dental market
seeking to establish themselves with
high-quality innovations, such as those
for improved digital workflows and
additive production, new prophylactic
formulas and filling materials,
pioneering intra-oral scanners and
implant designs, as well as flexible
workflows for management of the
laboratory.
The 39th IDS is scheduled to take
place from 9 to 13 March 2021.
- Dental Tribune International

Dr Tariq Bhutta elected ...

Continued from front page

Dr Inayatullah Padhiar ...
Continued from front page

immense interest in the academic field
as well. In 1983, Dr Padhiar worked
as editor-in-chief for PDA Newsletter.
He remained a major contributor in
Pakistan Dental Association
Congresses that took place throughout
the country in all major cities. In 1987
he became an editor for Journal of the
Pakistan Dental Association as well.
Dr Padhiar is greatly respected for
initiating Monthly Clinical Education
Program at Liaquat National Hospital,
Karachi, which continued till 1992.
In 2012, Dr Padhiar was rewarded
with lifetime achievement award from
Pakistan Dental Association.
Currently, Dr Padhiar owns his private
practice; he is an editor for Journal of
Pakistan Dental Association (JPDA),
and a senior teacher at Fatima Jinnah
Dental College. His professionalism,
skill and compassion has earned him
immense respect and appreciation
among his colleagues, students and
patients.
On receiving the Sitara-e-Imtiaz,
the publisher, editors and all staff
members of Dental Tribune Pakistan
offer their heartiest congratulations
to Dr Inayat Padhiar and his family.
His noble contributions to dentistry

Continued from page 2

Shakirulllah Jan. Meanwhile, the
government was tasked to form new
ordinance of the PMDC. President
Dr Arif Alvi had approved new
ordinance of PMDC in January and
new 17-members council was formed.
The previous council had remained
at loggerheads with private medical
colleges association over the students
fee structure and registration of some
the colleges.
The ministry earlier this month
notified all 17-members of the council.
Names of the council members
included Dr Tariq Iqbal Bhutta, Prof
Shoaib Hassan Shah, Ali Raza, Prof
Aamer Zaman Khan, Prof Amer Bilal,
Prof Khalid Usman, Prof Umer
Farooq, Prof Saeed Sadiq Hamid, Dr
Sulman Jaffar, Prof Muslim Khan,
Prof Zafarullah Chaudhry, Maj Gen
Prof Saleem Ahmed Khan, Dr Shehla
Baqi, Dr Kartar Dawani, Dr Mehmood
Haider, Dr Shabir Lehri, Prof Nadeem
Samad Sheikh and Prof Mirza Khan.
New PMDC has 12 representatives
from civil society, provincial and
federal governments, public and
private educational institutions,
president of College of Physicians
and Surgeons Pakistan (CPSP) and
Surgeon General of Armed Forces
Medical Service.
The PMDC is a statutory regulatory
authority that maintains the official
register of medical and dental
practitioners in Pakistan. Its main
function is to "establish a uniform
minimum standard of basic and higher
qualifications in medicine and
dentistry throughout the country". The
council also sets the education
standards for medical and dental
institutions in Pakistan along with the
Higher Education Commission
Pakistan.
The council is mandated to form
strategies and utilise financial
resources, accreditation of medical
programmes and recognition and
registration of medical and dental
educational institutions.
Despite of approval of the ordinance
government still has to approve it
from the parliament in upcoming
months to complete the legislation
process.

Dental, medical and nursing ...
Continued from page 9

history, performed oral assessments,
applied fluoride varnish, and educated
children and parents. Students also
learned to identify the connection
between oral health and overall health,
covering areas such as how certain
diseases or medications can affect oral
health. According to the study's
authors, the overall goal was to
increase the oral health knowledge
and skills of nondental primary care
providers while boosting dental

students' knowledge about the link
between oral and systemic health.
According to the study, a total of
162 family nurse practitioner, dental
and medical students participated in
this interprofessional experience, and
the students completed surveys before
and after their participation to evaluate
whether their interprofessional
competencies had changed. Results
of the study showed that all students
had significantly improved
interprofessional competency scores
after the team-based experience. This
included improvements in important
factors for working with other
professionals, such as communication,
collaboration, conflict management,
team functioning and using a patientcentered approach.
"Our findings suggest that a teambased, clinical approach can be an
effective strategy to help health
professional students develop
interprofessional competencies," said
co-author Dr. Judith Haber, Ursula
Springer Leadership Professor in
Nursing at NYU Meyers and
Executive Director of OHNEP.
The study, titled "The impact of an
interprofessional pediatric oral health
clerkship on advancing
interprofessional education
outcomes," was published online on
April 22, 2019, in the Journal of
Dental Education ahead of inclusion
in an issue. - Dental Tribune
International

Plant cellulose might ...
Continued from page 10

The innovation can potentially fill
a niche in the $2 billion bone graft
market in North America, said study
co-author Dr. Kathryn Grandfield,
who supervised the work. She is an
assistant professor both in the
Department of Materials Science and
Engineering and at the McMaster
School of Biomedical Engineering.
"We can see this aerogel being used
for a number of applications,
including dental implants and spinal
and joint replacement surgeries," said
Grandfield. "And it will be
economical, because the raw material,
the nanocellulose, is already being
produced in commercial quantities."
According to the researchers, it will
be some time before the aerogel
makes it out of the laboratory and
into the operating room. "This
s u m m e r, w e w i l l s t u d y t h e
mechanisms between the bone and
implant that lead to bone growth,"
said Grandfield. "We'll also look at
how the implant degrades using
advanced microscopes. After that,
more biological testing will be
required before it is ready for clinical
trials."
The study, titled "Cross-linked
cellulose nanocrystal aerogels as
viable bone tissue scaffolds," was
published on March 15, 2019, in
Volume 87 of Acta Biomaterialia.
- Dental Tribune International

[16] => Dt pages.FH10

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[cover] => DT Pakistan No. 2, 2019

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Table of contents

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News / Clinical Implantology / News

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