Digital dentistry is reshaping oral care / Researchers use clinical audit in dental implant treatment to improve record keeping / Study identifies new bacterial species involved in dental caries formation / Midline diastema closure with direct composites
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[1] =>
The World‘s Dental Newspaper
South Asia Edition
Published in India
www.dental-tribune.com
CLINIC AUDIT
Vol. 1, No. 7
CARIES RESEARCH
MIDLINE DIASTEMA
Researchers use clinical audit in dental
implant treatment to improve record
keeping
Study identifies new bacterial
species involved in dental caries
formation
Midline diastema closure with direct
composites
Page 04
Page 05
Page 06
Digital dentistry is reshaping oral care
Dentistry is on the brink of a
new era where how we offer services will be fundamentally and irreversibly changed. Technology
will be the primary driver of this
change, reshaping how professionals work. We must embrace
this change and accelerate technology with confidence.
Digital technology is already
being embraced in dentistry, and I
believe dentistry’s future is entirely digital. However, having
good digital technology alone
does not make one a good dentist.
One must be a good dentist first,
and digital technology will only
simplify the work, ease our efforts,
and make our workflows productive. We should use technology for
good and make our dentistry better.
The first International Digital Dentistry Congress was a great success. (All photos: IDDC)
By Dr. Deepak Muchhala
Dr. Deepak Muchhala, the Organizing Chairman, writes about the
resounding success of the very
first International Digital Dentistry
Congress, held on 10-11 June 2023
in Mumbai.
Digital dentistry has transformed the way dental care is delivered. It has revolutionized imaging, treatment planning, restoration fabrication, patient communication, and collaboration among
dental professionals. With its precise and efficient workflow, digital
dentistry offers enhanced diag-
www.dental-tribune.com
nostic
capabilities,
improved
treatment outcomes, and a more
seamless patient experience.
As technology continues to
evolve, we at IDA realize that the
future of digital dentistry holds
even greater possibilities for advancement.
shared goals, and that’s how it
makes our resolution even stronger. To take our nation and dentistry to the next level and be Atmanirbhar, it becomes crucial to
tap the energy of our young dentists in research and develop products and equipment made in
India.”
Over the two days, the congress featured 88 national and foreign speakers, 54 Scientific Sessions, and over 4688 delegates.
Speakers at this event displayed
their scientific expertise, putting
India on the world map. It was undoubtedly an extraordinary occasion.
Realizing this dream, the Indian Dental Association partnered
with the Digital Dentistry Society
– International, the leading scientific body in the subject of Digital
Dentistry, to collaborate for the
first International Digital Dentistry
Congress on the 10-11 June 2023
at the Jasmine Hall at the Jio World
Convention center in Mumbai.
Dr. Ashok Dhoble, the Honorary Secretary General of Indian
Dental Association said in his
speech, “Speakers for the event
have been selected for their passion for their work. The desire for a
common goal to change dentistry
helps us bring you all together and
realize these dreams – individually
or as a group. We all need each
other for the fulfillment of our
Inauguration of IDDC.
While many fear AI, computers, and machines will take over
our jobs, I believe that jobs and
work will not reduce. Instead, we
must change our thinking and
skillsets to remain relevant in the
game.
“Digital technology is
already being embraced
in dentistry, and I believe
dentistry’s future is
entirely digital.”
[2] =>
NEWS
2
Dental Tribune South Asia Edition | 07/2023
Inaugural Ceremony of the International Digital Dentistry Congress, graced by Shri
Narayan Rane - Hon. Minister, Micro, Small & Medium Enterprises.
Lamp lighting during the inauguration ceremony.
Dr. Ashok Dhoble, Hon Secretary General, IDA, addressing the gathering.
Some important launches were announced during the conference.
Officials & speakers from Digital Dentistry Society – International who attended the conference
Dr. Jaafar Mouhyi, President of Digital Dentistry Society (DDS)
Dr. Giuseppe Luongo, one of the founders of DDS
Dr. Henriette Lerner, Past President of DDS
Dr. Katalyn Nagy has done a lot of work on oral cancer
Dr. Fabrizia Luongo
Dr. Francesco Mangano, President Elect of Digital
Dentistry Society (DDS)
[3] =>
NEWS
3
Dental Tribune South Asia Edition | 07/2023
Huge crowd at the registration counter.
Stalls showcasing digital dentistry products and servces.
Artificial intelligence in dentistry covered by Dr. Rajeev Chitguppi.
Dr. Komal Majumdar speaking on digital dentistry workflows.
Dr. Moez Khakiani.
Dr. Udatta Kher.
Dr. Harshwardhan Arya.
Dr. Deepak Muchchala, the Conference Organizing Chairman, IDDC 2023.
[4] =>
NEWS
4
Dental Tribune South Asia Edition | 07/2022
Researchers use clinical audit in
dental implant treatment to
improve record keeping
IMPRINT
INTERNATIONAL
HEADQUARTERS
PUBLISHER AND CHIEF EXECUTIVE OFFICER: Torsten OEMUS
CHIEF CONTENT OFFICER:
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in this issue is copyrighted by Dental
Tribune International GmbH. Such
material must be published with the
permission of Dental Tribune International GmbH. Dental Tribune is a
trademark of Dental Tribune International GmbH.
The study showed how a good clinical audit can identify inadequacies and shortcomings of clinical practice and helps to design corrective
interventions to improve healthcare service. (Photo: Canva)
By Dr. Rajeev Chitguppi,
Dental Tribune South Asia
KUALA LUMPUR, Malaysia: Dental
implants have revolutionized the
replacement of missing teeth by
creating ideal outcomes with regards to aesthetics and function,
however it is not without successful record keeping that surely
makes them excel. We should always attempt for sustained enhancement with regards to the
success rates of dental implants
and standard of healthcare delivery. By performing a clinical audit,
researchers led by principal investigator Dr Tanay Vijaykumar Chaubal from the School of Dentistry,
International Medical University,
Kuala Lumpur, Malaysia have identified the inadequacies and shortcomings of clinical practice in relation to implant dentistry. Subsequently, intervention can be executed to stimulate enhancement
in providing superior healthcare
service.
According to the researchers, a
clinical audit is an exercise intending to upgrade quality, essentially
enhancing patient care and results
through a systematic analysis of
care against specific standards. It
is frequently considered as part of
continuing professional development and, in some circumstances,
is a compulsory requirement for
specialist education and registration. During the audit process, inadequacies in current practice
against set standards are underscored, and improvements are executed for superior service delivery and results. Identifying shortcomings is paramount if quality in
care is to be tackled.
The study screened 534 dental
implant records via an electronic
practice management software
system (Open Dental) from January 2015 to December 2019. Each
dental implant record was further
assessed using a detailed audit
checklist consisting of 53 parameters with respect to presurgical,
surgical and prosthetic procedures of dental implant treatment
based on the surgical and prosthetic safety checklist for dental
implants by Bidra AS. The absence
or presence of a recording of each
parameter was investigated. If the
parameter was not recorded, it
was scored as 1; if the parameter
was recorded, it was scored as 2.
The audit disclosed high precision of record keeping in gender
(100%), age (99.6%), cone beam
computerized tomography (CBCT)
(97.8%), written consent (95.1%),
dental implant placement site
(94%), implant diameter (93.6%),
and implant length (93.4%).
There was inferior precision of
record keeping in intraoperative
radiograph with guide pin to check
angulation (19.7%), periodontal
disease (17.4%), postoperative
chlorhexidine (17.2%), smoking
(15%), clean-up of residual cement
for a cement-retained prosthesis
(14.4%), time of placement (11.4%),
preoperative antibiotics (7.9%),
preoperative chlorhexidine mouth
rinse (7.3%), disinfection of abutment and restoration (3.9%), hydration of bone graft particles
(3.6%), preoperative analgesics
(1.9%), loading protocol (1.8%),
countersink drill for dense bone
(0.9%), and ice pack (0%).
“The poorest recorded parameter was the advice of ice pack
(0%), its usage may be incorporated during delivery of post-operative instructions, yet it is often
neglected in the backdrop of
post-operative instructions given
to each patient. Numerous factors
like time- consuming documentation and lack of reinforcement
could contribute to this inadequate recording of the parameter,”
principal investigator Dr Tanay Vijaykumar Chaubal, a faculty in division of restorative dentistry at
the university, said in a press release.
A multi-disciplinary approach
is required to replace missing
teeth with dental implants to restore oral function and aesthetics.
The part of patients’ records is essential to successfully disseminate
information within the team. Although the appropriateness of
dental care is not illustrated by superior records, these records enable dental practitioners to assess
the case and contemplate en-
hancements, which inferior records do not. “In the present study,
the significance of displaying and
maintaining precise dental records is highlighted as these dental records are key for superior
standard patient care and at the
same time perform as a protective
shield as a consequence of a malpractice claim at legal court,” Dr.
Chaubal stated.
“Many clinical audits
have been performed in
dentistry, but I believe
this is the first audit
project on dental
implants that utilizes a
comprehensive checklist
which could effectively
improve patient
treatment outcomes” —
Dr. Tanay Vijaykumar
Chaubal, International
Medical University,
Malaysia
“Enhancement could be attained if
recognition of the value and benefits of keeping records is increased amidst the dental practitioners,” Dr. Chaubal stated.
The study, titled “Clinical audit on
the quality of record keeping of
dental implant treatment performed by dental professionals”
was published online as early access in March 2023 in the Journal
of Osseointegration.
Dr. Tanay Vijaykumar Chaubal.
(Image: International Medical
University, Malaysia)
All rights reserved. © 2023 Dental
Tribune International GmbH. Reproduction in any manner in any language, in whole or in part, without the
prior written permission of Dental
Tribune International GmbH is expressly prohibited.
Dental Tribune International GmbH
makes every effort to report clinical
information and manufacturers’ product news accurately but cannot assume responsibility for the validity of
product claims or for typographical
errors. The publisher also does not
assume responsibility for product
names, claims or statements made
by advertisers. Opinions expressed
by authors are their own and may
not reflect those of Dental Tribune
International GmbH
DENTAL TRIBUNE SOUTH ASIA
EDITION
PUBLISHER
Ruumi J. DARUWALLA
CHIEF EDITOR
Dr. Meera VERMA
CLINICAL EDITOR
Dr. Dilip DESHPANDE
RESEARCH EDITOR
Dr. Shobha DESHPANDE
ASSOCIATE EDITOR
Dr. GN ANANDAKRISHNA
EXECUTIVE EDITOR
Dr. Rajeev CHITGUPPI
ASSISTANT EXECUTIVE EDITORS
Dr. Riddhi D. TELISARA
DESIGNER
Anil LAHANE
PRINTER
Mehernosh MISTRY
Burzin MISTRY
Ampersand, Mumbai, India
[5] =>
NEWS
5
Dental Tribune South Asia Edition | 07/2023
Study identifies new bacterial
species involved in dental caries formation
plementary expertise of many
groups and individual investigators and trainees,” said co-author
Prof. Kimon Divaris from the University of North Carolina at Chapel
Hill.
The researchers are now planning to further investigate how
S. sputigena ends up in the aerobic
environment of the tooth surface.
“This phenomenon in which a bacterium from one type of environment moves into a new environment and interacts with the bacteria living there, building these remarkable superstructures, should
be of broad interest to microbiologists,” Prof. Koo concluded.
The study, titled “Selenomonas sputigena acts as a pathobiont mediating spatial structure
and biofilm virulence in early
childhood caries”, was published
online on 22 May 2023 in Nature
Communications.
A large study in children has demonstrated a highly complex microbial interaction in dental plaque.
(Image: Evgeniy Kalinovskiy/Shutterstock)
By Iveta Ramonaite,
Dental Tribune International
PHILADELPHIA, US: It was previously believed that Streptococcus
mutans was the main microorganism responsible for dental caries.
However, in a recent study, researchers have discovered that another bacterial species, Selenomonas sputigena, plays a major role
in dental caries development. The
unique insights gained in the
study could help in the development of new strategies for caries
prevention.
In the study, the researchers
analysed samples of plaque from
the teeth of 300 children aged 3 to
5 years, half of whom had caries.
They then validated their findings
on a further set of 116 plaque samples from 3- to 5-year-olds. They
found that, although S. sputigena
does not cause caries on its own,
S. sputigena interacts with S. mutans in a manner that enhances its
cariogenic power.
“This was an unexpected finding that gives us new insights into
the development of caries, highlights potential future targets for
cavity prevention, and reveals
novel mechanisms of bacterial
biofilm formation that may be relevant in other clinical contexts,”
said senior author Prof. Hyun Michel Koo, a founding director of
the Center for Innovation and Precision Dentistry at the University
of Pennsylvania School of Dental
Medicine.
School of Global Public Health.
“This was a perfect example of col-
laborative science that couldn’t
have been done without the com-
Advertisement
The researchers explained that
S. mutans metabolises sugars to
produce glucans to protect the
biofilm
bacteria
and
that
S. sputigena can become trapped
in the glucans. Once this occurs,
S. sputigena grows rapidly, forming honeycomb-shaped superstructures that further encapsulate and protect S. mutans, thus increasing acid production within
the plaque.
The study was a collaboration
between the University of Pennsylvania School of Dental Medicine and the University of North
Carolina at Chapel Hill Adams
School of Dentistry and Gillings
Research has discovered that Selenomonas sputigena interacts with
Streptococcus mutans in caries formation. (Image: © 2023 Cho et al.,
licensed under CC BY 4.0)
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| Customer Service : +91 99304 50170
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[6] =>
NEWS
6
Dental Tribune South Asia Edition | 07/2023
Midline diastema closure with direct
composites
By Dr. Usha Dadlani,
Dental Tribune South Asia
A report published in the Journal
of American Dental Association
estimates that around 1.6% to
25.4% of adults from various age
groups and populations have midline diastema. Various treatment
options, like orthodontics, direct
composites, and indirect veneers,
are in use for midline diastema
correction. Direct composites
offer an advantage over other options due to their shortened treatment time. One of the major ad-
vantages of direct composites
over indirect veneers is their
non-invasive nature. This case series discusses various techniques
for diastema closure with direct
composites.
Introduction
In this article, a case of midline diastema in a 24-year-old male patient that was closed in a single appointment with direct composite
build-up is discussed in detail. This
case report presents a step-bystep approach toward composite
build-up under rubber dam isolation. Z350 Filtek from 3M was used
with a universal bonding agent.
Conclusion:
The success of these restorations
depends on following the protocols for bonding and its integration with the surrounding soft tissues. Direct composites if handled
well, by a skilled clinician, offer the
best modality to transform the
smile in a single visit with minimally invasive protocols.
Evaluation and mock up
1
About
Dr. Usha Dadlani is an aesthetic &
restorative dentist par excellence
practicing at Koparkhairne,
Navi Mumbai, after
completing her BDS from
YMT Dental College, Navi
Mumbai (2007). Her
other areas of interest
include implant dentistry
and dental photography.
She has received the ISOI
Fellowship from the Indian
Society of Oral Implantologists (2019). Winner of Famdent
Awards for Aesthetic Dentistry
(2019 & 2022). Dr. Usha runs her
aesthetic dentistry courses across
India
Fig. 1
Pre-op showing midline diastema.
2
Fig. 2
Shade was evaluated with the
“Button
technique”.
Various
shades of composite to be used
are applied in a button or disk
shape on the tooth and light cured.
The shade that is the most
inconspicuous is selected. In this
case, A3.5 Body for cervical region
and A3 Body for middle and incisal
thirds is selected. A point to be
noted here is to select the shade
before any procedure or rubber
dam to avoid any discrepancy due
to dehydration.
Fig. 3
A monochrome photograph helps
evaluate the Value. A3 Enamel was
chosen for this case.
3
4
5
6
Fig. 4
Increasing the contrast and
reducing the brightness of a
photo.
Fig. 5
Quick intra-oral mock-up was
performed without etching or
bonding. Care was taken to divide
the space equally between the two
central incisors and the same was
confirmed by measuring with
vernier calliper. This can also be
done with the chosen shades of
composite to roughly evaluate the
selected shade.
It is also
recommended to check occlusion
at this point and remove any
static/dynamic interferences.
Fig. 6
Once verified, a putty index was
made with A-Silicon to record the
palatal surface. graph helps
evaluate
the
internal
characteristics.
There
were
hypoplastic lines for example, in
this case.
[7] =>
NEWS
Dental Tribune South Asia Edition | 07/2023
7
Bonding and palatal shell
Fig. 7
After thorough prophylaxis, the
concerned site was isolated with
rubber dam and further retraction
of gingiva was achieved with the
help of floss ties. A good retracted
area gives good access and
visibility for the restoration and
hence the desired emergence
profile.
7
8
Fig. 8
37% Phosphoric acid was used to
etch the enamel for 20 seconds
and thoroughly washed after that.
Fig. 9
A single Bond Universal from 3M
was used as the adhesive. The
bond was applied and the excess
was removed with a fresh
applicator tip and light cured.
9
10
Fig. 10
The silicon index is then used to
build the palatal shell which will
serve as the base to further layer
composite.
Fig. 11
A3 Enamel was used in this step.
Fig. 12
The sectional matrix for posterior
teeth was used in a vertical
direction and stabilized with
wedge.
11
12
Contact build-up and stains
Fig. 13
The proximal wall was first built on
right central incisor taking support
from the matrix band. The desired
contour is achieved on right central incisor.
Fig. 14
Band and wedge is then stabilized
for the left central incisor.
13
14
Fig. 15
And the proximal contour Is built
for the left central.
Fig. 16
Contact point is achieved at the
desired level. The main body is
built with blending the A3.5 and
A3 Body shades.
Fig. 17
Finally, white opaquer is used to
mimic the hypoplastic lines and
light cured.
15
17
16
[8] =>
NEWS
8
Dental Tribune South Asia Edition | 07/2023
Final layering and polishing
Fig. 18
Final Enamel layer is contoured
with A3 Enamel and light cured.
Fig. 19
A water soluble medium is applied
and light cured under that to
eliminate the Oxygen Inhibited
Layer.
18
19
Fig. 20
Gross finishing was performed
before removing the rubber dam.
Fig. 21
The Line angles are defined first
with the help of pencil marking
and then fine-tuned with the help
of fine finishing burs.
Fig. 22
And final polish was achieved with
the help of Soflex Disks and Spirals
from 3M.
20
21
22
Bonding and palatal shell
Fig. 23
Seven days post op shows the
smooth finish and polish which
integrated
well
with
the
surrounding soft tissues. The
healthy papilla filled the interdental
space leaving no black triangle.
23
24
Fig. 24
The white opaquer used just under
the enamel layer blended well with
the rest of the hypoplastic lines
even after rehydration.
Fig. 25
Defining line angles and their
perfect contour helps establish an
aesthetic shape and hence a
pleasing end-result.
Fig. 26
Defining line angles and their
perfect contour helps establish an
aesthetic shape and hence a
pleasing end-result.
25
26
Fig. 27
The textures were well replicated
and gave the life-like appeal to
final restoration.
Fig. 28
The textures were well replicated
and gave the life-like appeal to
final restoration.
27
28
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[toc_titles] => Digital dentistry is reshaping oral care
/ Researchers use clinical audit in dental implant treatment to improve record keeping
/ Study identifies new bacterial species involved in dental caries formation
/ Midline diastema closure with direct composites
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