DT Middle East & Africa Edition No. 5, 2024
CAPP and DentAlliance announce partnership to support dental education
/ News
/ Industry
/ Conservative and necessary: How occlusion can affect a single-tooth replacement
/ Dr. Galip Gürel conducts his signature APT (Aesthetic Pre-evaluative Temporary) Veneers Course at CAPP in Dubai
/ “The future of dentistry lies in predictive, personalized, and data-driven care” Interview with Prof. Falk Schwendicke
/ The transformative power of AI in dentistry
/ “No success happens without proper awareness and education to parents.” Interview with Dr Rafi f Tayara
/ “Everyone has a role to play in tackling antimicrobial resistance”: What’s yours? Interview with Dr Wendy Thompson
/ Motivating your team
/ New study shows bacteria love some restorative materials more than others
/ News
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[1] =>
LY
N
O
S
AL
N
IO
SS
FE
O
PR
TA
L
EN
D
PUBLISHED IN DUBAI
ENDO TRIBUNE
From mentorship to mastery:
Prof. Damiano Pasqualini on
advancing endodontics
www.dental-tribune.me
LAB TRIBUNE
Current and future regenerative
possibilities: A review of
3D bioprinting applications
Insertion A
IMPLANT TRIBUNE
Interview with Prof. Marco Tallarico:
“Digital technologies should assist
clinicians without replacing..."
Insertion B
Vol. 15, No. 5
ORTHO TRIBUNE
HYGIENE TRIBUNE
Interview with Dr Isabel Flores
Allen: “Virtual planning lets us create precise treatment plans..."
Major contributors revitalise WHO
global strategy for oral health
Insertion D
Insertion E
Insertion C
CAPP and DentAlliance
announce partnership
to support dental
education
By Dental Tribune MEA
CAPP is pleased to announce a new partnership with
DentAlliance, a global strategic alliance formed in 2020 by
four leading dental institutions: the Adams School of Dentistry at the University of North Carolina at Chapel Hill, the
Faculty of Dentistry, Oral & Craniofacial Sciences at King’s
College London, the Melbourne Dental School at the
University of Melbourne, and the Faculty of Dentistry
at the National University of Singapore.
► Page 02
AD
#whdentalwerk
video.wh.com
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your dealer
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that speeds up MY daily operation.”
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Convenient in its handling. Outstanding in its results. With the shortest cycle
time in its class and the Quick Connect System, the Assistina One is a top
maintenance solution – designed for top dental professionals.
20230619_AD_Dental Tribune_MEA_420x285mm_draft.indd 2
20.06.2023 07:48:01
[2] =>
NEWS
02
Dental Tribune Middle East & Africa Edition | 05/2024
This collaboration is aimed at
expanding the Continuing Professional Development (CPD) efforts of
both organizations, supporting
dental professionals around the
world.
As part of the partnership, DentAlliance will contribute to the scientific
programme of CAPP’s annual CAD/
CAM Digital & Oral Facial Aesthetics
International Dental ConfEx. This
event brings together practitioners,
researchers, and industry experts to
discuss developments in digital and
aesthetic dentistry. By working together, CAPP and DentAlliance aim to
broaden the scope of the scientific
programme and promote knowledge
exchange in the field.
Beyond the conference, DentAlliance will also collaborate with
CAPP on online educational efforts,
including webinars and interactive
digital sessions. These events are intended to provide dental professionals with opportunities to stay
updated on new techniques, technologies, and research in their field.
In addition, DentAlliance will assist CAPP in gathering insights from
dental professionals through surveys designed to capture emerging
trends and areas of need. These
(Image: DentAlliance)
findings will help guide the development of educational content that is
relevant and useful for the global
dental community.
This partnership reflects the
shared commitment of CAPP and
DentAlliance to advancing dental
education and CPD on an interna-
tional scale. Dental professionals
can expect further opportunities for
learning and professional development through CAPP events and we-
binars, informed by the expertise
and resources of both organizations.
AD
SAVETHEDATE
14-15 NOVEMBER 2025
www.cappmea.com
Tel. /WhatsApp: +971 50 279 3711
IMPRINT
INTERNATIONAL
HEADQUARTERS
PUBLISHER AND CHIEF EXECUTIVE OFFICER:
Torsten Oemus
CHIEF CONTENT OFFICER:
Claudia Duschek
Dental Tribune International GmbH
Holbeinstr. 29, 04229 Leipzig, Germany
Tel.: +49 341 4847 4302
Fax: +49 341 4847 4173
General requests: info@dental-tribune.com
Sales requests:
mediasales@dental-tribune.com
www.dental-tribune.com
Material from Dental Tribune International GmbH that
has been reprinted or translated and reprinted in this
issue is copyrighted by Dental Tribune International
GmbH. Such material must be published with the per-
|
Email: events@cappmea.com
mission of Dental Tribune International GmbH. Dental
Tribune is a trademark of Dental Tribune International
GmbH.
All rights reserved. © 2024 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 respon-
sibility 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
MEA PUBLISHER:
Dr. Dobrina MOLLOVA
SALES:
Tzvetan DEYANOV
Petar MOLLOV
DENTAL TRIBUNE MEA
Onyx Tower 2, Office P204, Dubai, UAE
Mob.: +971 55 112 8581
www.dental-tribune.com
General requests:
dtmea@dental-tribune.me
[3] =>
NEWS
Dental Tribune Middle East & Africa Edition | 05/2024
Winners Announced for the I Love
My Dentist (ILMD) Award 2024
By CAPP Events & Training
The I Love My Dentist (ILMD)
Award 2024 concluded with 3,500
votes cast by patients, celebrating
95 dentists from 27 countries for
their outstanding care and expertise. Congratulations to our incredible winners!
Celebrating excellence in
Dentistry
The I Love My Dentist Award,
part of the larger Aesthetic Dentistry MENA Awards, highlights
dentists who go above and beyond
to deliver the highest standards of
care. Patients were invited to nominate and vote for dentists who
excel not only in technical skill but
also in their dedication to improving patient well-being.
"We are proud to shine a light
on the dentists who have earned
the trust and admiration of their
patients, and we look forward to
celebrating their accomplishments
at the upcoming Grand Gala
Awards Ceremony."
Grand Gala Awards Ceremony – 15 November 2024
The celebration of these outstanding professionals will be at
the Gala Grand Awards Ceremony
on 15 November 2024, at the Madinat Jumeirah Convention Centre,
Dubai. The event promises to be a
night of recognition, celebration,
and networking with the best
minds in dentistry.
The ILMD Awards 2024 mark
another successful year in highlighting the invaluable role that
dentists play in transforming lives
through oral health and aesthetic
dentistry.
For more information about the
Grand Gala Awards Ceremony:
www.dentistr yawards.cappmea.
com/grand-gala/
Special Thanks to sponsors
We extend our deepest gratitude to our sponsors for their generous support in making the ILMD
Awards 2024 a tremendous success. A heartfelt thank you to:
•
Oral-B
•
New Al Farwaniya Surgicals &
Medical Equipment LLC
•
Flaesh
•
Scorpios International LLC
•
Philips Sonicare
Your invaluable contributions
have helped us celebrate and recognize excellence in the field of
dentistry.
About the ILMD Award
The ILMD Award continues to
recognize excellence in dentistry,
including clinical expertise, innovation, and patient-centered care.
Through public voting, the award
honors dental professionals who
make a lasting impact on the lives
of their patients.
03
[4] =>
04
INDUSTRY
Dental Tribune Middle East & Africa Edition | 05/2024
Maximum lubrication with minimum
consumption
By W&H
W&H reprocessing devices
Maintenance devices are indispensable when it comes to ensuring dental transmission instruments work properly, maintain
their value, and have a long service
life. The W&H Assistina Twin and
Assistina One impress with their
thorough and comprehensive lubrication of the gear parts and
cleaning of the spray channels, as
well as their environmentally
friendly Care Set.
The Assistina Twin from W&H is
unique among maintenance devices with its innovative dual-chamber system and record-time lubrication. The Assistina One is geared
towards the needs of users in dental practices and was designed to
further simplify the maintenance
process and make it more efficient.
Both devices use an innovative
nebulisation technique: Finely
atomised oil loosens and removes
contamination from the internal
gear parts under high pressure,
without setting them in motion.
“Automatic lubrication via Assistina
ensures the proper lubrication of
handpieces with the correct
amount of oil. In addition, unlike
manual lubrication, it offers the
possibility of cleaning the spray
channel. The correct amount of oil
guarantees not only the perfect
maintenance of transmission instruments but also reduces possible damage to other devices, such
as sterilizers, caused by excess oil.
Finally, an excess of oil can create
spots on pouches after sterilization, potentially affecting sterilization retention”, explains Alberto
Borghi the advantages of reprocessing with W&H devices.
The W&H Assistina Twin and Assistina One impress with their thorough and comprehensive lubrication of the gear parts and cleaning of the spray channels.
(Image: W&H)
Laboratory tests on oils showed that the Assistina Care Set oil MD-302 leads to a
significantly lower abrasion of the gear parts compared to the most common
competitor products. (Image: W&H)
The one and only oil
Laboratory tests on oils showed
that the Assistina Care Set oil MD302 leads to a reduced friction rate
and significantly lower abrasion of
the gear parts compared to the
most common competitor products. The abrasion of the gear parts
can be reduced from 28% up to
77%. The use of W&H reprocessing
devices can therefore lead to resource conservation, given that the
handpieces demonstrate prolonged service life and sustain their
value over time.
Environmentally friendly and
sustainable
The Assistina Care Set oil yields
as much as 20 oil spray cans MD400. Thus, more than 2,800 transmission instruments can be maintained. The W&H reprocessing devices automatically dispense the
exact amount of W&H Service Oil
and W&H Activefluid needed.
Made in Austria with durable,
high-quality materials, they also
have a small ecological footprint of
production. All these features make
W&H reprocessing devices a highly
economical solution, enabling dentists to save money, time, and
waste. “Both Assistina One and
Twin pay off their investment within
a year due to the fact that their consumables cost less than oil cans.
We recommend considering your
clinic size when choosing, and in
just one year, the Assistina proves
to be the financially savvy alternative”, explains Alberto Borghi, W&H
product manager for sterilization,
hygiene, and maintenance.
W&H
Ignaz-Glaser-Straße 53
5111 Bürmoos
Tel: +43 6274 6236-239
office.at@wh.com
http://www.wh.com/de_global
The Assistina Care Set oil yields as much as 20 oil spray cans MD-400. Thus, more than 2,800 transmission instruments can
be maintained. (Image: W&H)
[5] =>
Fixed & Removable
Prosthodontics
MClinDent
OBTAIN MCLINDENT FROM A GLOBAL TOP 5 UNIVERSITY FOR DENTISTRY
START JAN 2025, APPLICATION DEADLINE 20 NOV 2024
ONLINE DISTANCE LEARNING & DUBAI FACE-TO-FACE HANDS-ON TRAINING
DEL IVER E D & AWA R DE D BY
MA RKET ING PA RT NE R
www.cappmea.com/fixedremovableprosthodontics
+971 558844272
[6] =>
INDUSTRY
06
Dental Tribune Middle East & Africa Edition | 05/2024
Piezoelectric levers for third molar
extraction
By mectron
Mectron now introduces the
first piezoelectric lever to facilitate
the luxation manoeuvre and sometimes even third molar root extraction, especially when ankylosed.
This occurs when the manual
force the operator exerts on the
handpiece is added to the hammering action (typical of the Mectron PIEZOSURGERY) which propagates from the lever into the deep
periodontium.
Additionally, proper use of the
piezoelectric lever can significantly
reduce operating time.
The efficiency of these levers
was evaluated in a randomised,
controlled study, comparing them
to manual levers, where they
showed the following benefits:
•
better visibility
•
maximum intraoperative control
•
faster third molar extraction
For more information contact
MECTRON S.P.A.
Via Loreto, 16/A
16042 Carasco (GE), Italy
Tel. +30 0185 35361
mectron@mectron.com
www.mectron.com
(Image: mectron)
Composan LCM & Composan LCM
flow – Light-curing micro-hybrid
composites
By Promedica
Composan LCM is a universal
light-curing micro-hybrid composite suitable for fillings in the anterior & posterior area and for the
inlay technique. Its high filler content and well-balanced resin matrix
guarantee minimal abrasion, low
polymerisation shrinkage, as well
as high compressive and transverse
strength.
Perfect aesthetic results
Composan LCM convinces with
its great colour stability, excellent
polishing properties, perfect adap-
tation to the natural tooth colour
and its toothlike brilliance.
Therefore, fillings made of
Composan LCM meet the highest
aesthetic requirements of dentists
and patients.
and reinforces the bonding layer.
Due to its elastic properties the
material is also highly stress absorbing. Its low viscosity ensures
good wetting capability and highly
aesthetic results.
Also available as a flowable
version
Composan LCM flow is suitable
for various indications like minimally invasive preparation, fillings
of Class III to V, extended fissure
sealing etc. Moreover, it is ideal for
linings under composites due to its
easy application and perfect adaption to the cavity walls / tooth substance. Composan LCM flow levels
out irregularities of the cavity floor
For more information contact
Promedica Dental Material GmbH
Domagkstrasse 31
24537 Neumünster
Germany
Tel: +49 43 21/5 41 73
www.promedica.de
(Image: Promedica)
AD
Kaltpolymerisierendes provisorisches Kronenund Brückenmaterial, Paste-Paste-System
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Visit www.promedica.de to see all our products
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eMail
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Internet www.promedica.de
[7] =>
INDUSTRY
Dental Tribune Middle East & Africa Edition | 05/2024
07
Introducing the updated ClearSmile
Aligner portal: A game changer for case
management
By Middle East Dental Lab
We are excited to announce the launch of our
updated ClearSmile Aligner Portal, designed to
make case management faster, simpler, and
more efficient, allowing you to focus on delivering the best possible care to your patients.
What’s new?
The updated portal brings a range of new
features aimed at streamlining your workflow
and enhancing the treatment process.
1. Faster case submission: Submitting cases
has never been easier. The revamped portal
allows for faster and more intuitive digital
impression submissions, ensuring that your
cases get started with minimal delay. The
new interface is user-friendly, reducing the
time spent on administrative tasks.
2. Streamlined communication: We understand how crucial effective communication
is for successful orthodontic treatments. The
ClearSmile Aligner Portal now features
built-in messaging tools, enabling you to
communicate directly with the lab team.
This ensures faster responses and a more
collaborative approach to managing each
case.
3. Enhanced user interface: The portal has
been redesigned with a modern, user-friendly interface that improves navigation and usability. You’ll find it easier to
manage cases, review treatment plans, and
access patient information. Everything is
neatly organized, allowing you to focus on
patient care rather than administrative tasks.
4. Comprehensive case history: The updated
portal stores all your past and current cases
in one place, enabling you to review completed cases quickly, compare treatment
outcomes, or reference previous cases for
new patients.
Why the Upgrade?
The ClearSmile Aligner Portal was upgraded
to give you more control over the treatment process while simplifying your workflow. By improving communication and reducing administrative
tasks, the portal helps you deliver outstanding
results more efficiently.
Get Started Today
If you’re already using ClearSmile Aligners,
we encourage you to explore the new features
and see how they can improve your case management. If you’re new to ClearSmile, now is the
perfect time to start. The upgraded portal will
help you manage aligner treatments seamlessly,
giving you the tools to provide top-quality care
for your patients.
The updated ClearSmile Aligner Portal is here
to enhance your workflow and support successful patient outcomes. If you have any questions
or need assistance with the new portal, our team
is ready to help. Let's take ClearSmile to the next
level, together.
For more information contact
Middle East Dental Laboratory
White Crown Tower, Office 1901
Sheikh Zayed Road
info@mdentlab.com
AD
[8] =>
INDUSTRY
08
Dental Tribune Middle East & Africa Edition | 05/2024
Leading the world of
the Multifi lament Surgical Sutures
By HuFriedyGroup
Silk
Silk is one of the most common
sutures used in today’s surgery
world. Silk suture is a natural,
non-absorbable, multifilament suture material that has been widely
used for wound ligation and closure.
It was the most common natural suture, used in the biomedical
industry during the past 100 years.
During the last decades. A range of
synthetic sutures has dominated
the market; however, silk is still
popular in oral and maxillofacial
surgery. HFG Silk suture is a braided
surgical suture composed of an organic protein called fibroin, beeswax coated to create a unique surface and signified that silk suture
facilitate easy passage through tissues and exhibit a good knotting
strength and secure knot placement. The tread is dyed black for
better visibility in tissue, and you
will find it in more than 65 different
SKUs, in a thread diameter range
btw 2/0 up to 6/0 and pre-cut
lengths such as 45, 55 and 75 cm.
How can you secure an effective completion of any surgical procedure? Simply by using the qualitative HFG sutures.
Polyester
Did you know that Polyester sutures are an ideal alternative to Silk
sutures in case you prefer to avoid
a potential post-operative negative
effect caused by the application of
Silk sutures and at the same time
get an excellent stability with a
great flexibility?
Polyester suture is a sterile
non-absorbable surgical material
composed
of
Poly-ethyleneterephthalate. Is a synthetic material that reduces significantly the
inflammatory reaction at the
wound site and limits the bacterial
plate on their surface. HFG Polyester sutures are coated with a thin
layer of Beeswax and available in
green color for better visibility
during the surgery. Among its characteristics are very high tensile
strength, maximum security in approximation of tissues under stress
conditions, minimal tissue reactivity and easy handling with optimal
knot security due to the braided
surface. HFG Polyester assortment
is extended to 25 SKUs, btw 3/0 and
6/0 USP thread diameter and different pre-cut lengths from 45 to
75 cm.
PGLA & PGLA Rapid
Are you searching for a suture
which is there when you need it and
gone when you don’t need it anymore? HFG PGLA and PGLA RAPID
is the best solution for you and
your patients.
HFG PGLA suture is a braided,
multifilament, synthetic absorbable surgical suture composed of a
copolymer made from 90% glycolide and 10% L-lactide. It’s provided coated with Poly (glycolideco-lactide) (30/70) and calcium
stearate and is also available undyed and dyed as violet. Progressive loss of tensile strength and
eventual absorption of PGLA occurs by means of hydrolysis, where
the polymer degrades to glycolic
and lactic acids which are subsequently absorbed and metabolized
from the human body. PGLA retains approximately 50% of the
tensile strength at the end of the
3rd post implantation week and the
absorption of the suture is essentially complete between 56 to 70
days.
HFG PGLA RAPID suture has the
same composition as the PGLA and
the characteristic rapid loss of
strength occurs due to the lower
molecular weight that the normal
PGLA suture, this is the reason why
the thread is only undyed available.
PGLA RAPID retains approximately
50% of the original tensile strength
at the 5th post implantation day
and all the original tensile strength
is lost by approximately 10 to 14
days. Total absorption is completed
essentially by 42 days.
Some of the main features of
the PGLA and PGLA RAPID suture
are excellent tissue support with a
minimal tissue reaction, excellent
handling properties and high flexibility and high knot security.
Sources:
https://www.vetsurgeryonline.com/non-absorbable-sutures/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356909/
https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/poliglecaprone
All company and product names are trademarks of Hu-Friedy Mfg. Co., LLC, its affiliates or related companies, unless otherwise noted.
(Image: HuFriedyGroup)
Follow us on
@HuFriedyGroupMiddleEast
@HuFriedyGroupEurope
@HuFriedyGroup Europe
Charalampos Amanatidis
Senior Product Manager Sutures
EMEA
Hu-Friedy Mfg. Co., LLC.
European Headquarters
Astropark - Lyoner Str. 9
60528 Frankfurt am Main, Germany
Tel.: +49 (0)69 24753640
Fax: +49 (0)69 25577015
Free Call: 0080048374339
[9] =>
TAPER
CUT
ROUND
BODY
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EXTRA
REVERSE
CUTTING
ALL THE SUTURES
YOU NEED
POLYPROPYLENE,
POLYAMIDE
SILK
PGCL
PTFE
POLYESTER
PGA, PGLA,
PGLA RAPID
In HuFriedyGroup portfolio you can find
the ideal suture for each of your surgical procedures.
With our combinations of high quality needles
and biologically inert threads, you will find the one
that suits your surgical needs.
Hu-Friedy Mfg. Co., LLC. • European Headquarters • Lyoner Str. 9 • 60528 Frankfurt am Main, Germany • HuFriedyGroup.eu
All company and product names are trademarks of Hu-Friedy Mfg. Co. LLC, its affiliates or related companies, unless otherwise noted.
©2022 Hu-Friedy Mfg. Co., LLC All rights reserved. HFL-771/1222
For more information on HuFriedyGroup products
call at 00800 48 37 43 39 or visit HuFriedyGroup.eu
[10] =>
INDUSTRY
10
Dental Tribune Middle East & Africa Edition | 05/2024
Osstem Implant secured EU-MDR
certification for 156 items including
Surgical KIT
By Osstem Implant
Osstem Implant announced
that it secured EU Medical Device
Regulation (MDR) certification for
156 items of implant surgical kits
and tools. On August 30, Frank
Juettner, CEO of TÜV Rheinland
Korea, a global testing and certification organization visited Osstem
Implant Headquarters and presented the certificate to CEO
Haesung Kim in person. Both devices use an innovative nebulisation technique: Finely atomised oil
loosens and removes contamination from the internal gear parts
under high pressure, without setting them in motion. “Automatic lubrication via Assistina.
Osstem Implant has made a
successful transition from MDD
certification to MDR certification
for its 122 Taper KIT, 123 Straight
KIT, OneGuide KIT, One CAS KIT
and secured MDR certification for
its
new
products
including
OneGuide KIT(short) and One485
KIT. The company explained that it
made a significant improvement in
its production and quality management processes to achieve MDR
certification.
“Our surgical kits, which incorporate our unique technologies,
such as the 122 Taper KIT and OneGuide KIT, are our flagship products. Therefore, local customers are
encouraged to familiarize themselves with the kits through master
courses and hands-on lectures
provided at our subsidiaries in Europe,” Osstem Implant stated.
“With the acquisition of the EU
MDR certification, we expect to see
a growth in trust among local dental professionals in our company,
which operates 10 overseas subsid-
(From left to right in the photo) Son Hee-kwon, Director of the Regulatory Affairs Department at Osstem Implant; Kim Hae-sung, CEO of Osstem Implant; Frank Juettner,
CEO of TÜV Rheinland Korea; Nah Hana, Team Leader of the Medical Devices Team at TÜV Rheinland Korea. (Photos: Osstem Implant)
iaries in Europe,” Osstem Implant
hosted six hands-on sessions focused on implant placement using
the 122 Taper KIT on the first day of
EAO 2024, Europe’s largest dental
congress, which took place in
Milan, Italy, in October. In addition,
Osstem Implant will share clinical
know-how on the use of OneGuide
and OneGuide KIT with European
dentists through large-scale forums and hands-on sessions over
two consecutive days during the
three-day event.
MDR, which is a strengthened
certification system replacing the
(From left to right in the photo) OneCAS KIT, OneGuide KIT, and 122 Taper KIT, all certified under EU MDR.
MDD (Medical Device Directive),
came into effect in May 2021. According to a survey on 475 medical
device manufacturers operating in
EU countries conducted by MedTech Europe, a non-profit organization, in April 2022, over 50% of
respondents planned to reduce
their product portfolios. Among
them, 33% indicated that they intended to give up securing MDR
certification and discontinue their
products. MedTech Europe also analyzed that, as of 2022, more than
85% of over 500,000 medical device manufacturers worldwide that
had received MDD or AIMDD certification had not obtained MDR certification.
According to a recent survey by
The European Association of Medical Devices Notified Bodies (TEAM
NB) composed of 35 European
medical devices certification bodies including TÜV Rheinland, the
share of MDR certification issued
among the applications submitted
last year was only 33.5% as of the
end of 2023. As significant investment in research, production, and
quality management is required to
meet the strict and rigorous MDR
review standards, MDR certification serves as a high entry barrier
for small companies that lack the
necessary human and material infrastructure.
Osstem Implant, which marked
annual revenue of US$ 902 million
(based on the exchange rate as of
March 21, 2024), invests 11% of its
revenue in R&D. The company has
22 research institutes and around
1,000 research personnel in the
areas of implant, orthodontics, materials, and equipment. Osstem Implant produces 18.3 million sets of
implants annually at a single factory, holding the No. 1 position in
terms of implant sales. It plans to
complete the MDR certification for
its main implant products by the
first half of 2025 and aims to obtain
MDR certification for dental materials, including bone graft materials, by 2026.
[11] =>
[12] =>
GENERAL DENTISTRY
12
Dental Tribune Middle East & Africa Edition | 05/2024
Conservative and necessary:
How occlusion can affect
a single-tooth replacement
1
2
3
Fig. 1: Pre-op retracted facial view of the fractured composite restoration on tooth #11 with the teeth in maximum intercuspation. Fig. 2: Teeth in protrusive excursion, showing excessive wear on the tooth (# 41)
opposing tooth #11, indicating hyperfunction and increased functional stress on the restored area. Fig. 3: Incisal view showing that tooth #41 was the arch form’s most facially positioned mandibular incisor.
By Dr Robert A. Lowe, US
Introduction
As has been stated by Dr Harold
M. Shavell, “Occlusion and morphology are the common denominators of all dentistry.”1 A single
tooth or restoration can profoundly
affect a patient’s function and comfort if it is not properly integrated
into the patient’s natural occlusal
function. It is unfortunate that
“modern” dentistry has such a
“conformative” approach under the
guise of being conservative or
avoiding overtreatment. With the
“one-toothat-a-time” or “if it’s not
broken, don’t fix it” approach, are
we really doing our best to help patients keep their teeth for the rest
of their lives? How many teeth, as
Dr Shavell would say, have been
sacrificed on the altar of false conservatism? These are questions we
all wrestle with every day in private
practice. One thing that is important to remember is that the muscles always win! Without proper integration into a non-interfering occlusal scheme, the best restorative
effort will ultimately fail regardless
of the material used. The following
is a case report that illustrates
these premises while addressing a
single-tooth restorative failure. 2,3
A Class IV composite failure:
Case history and restorative plan
The patient presented with a
fractured Class IV mesial–incisal
composite restoration on tooth #11
(Fig. 1). It had been repaired three
times during the past year and had
fractured again. Was this due to
poor technique, maybe inferior
materials? More than likely, it was
due to occlusion. Aside from the
amount of composite on the facial
surface that extended beyond the
fractured area, most of the palatal
surface of the tooth was worn
through to the dentine due to hyperfunction in protrusive and lateral excursion over many years,
creating a functional and aesthetic
dilemma for the patient. A “conser-
vative” approach may
have been to bond
the tooth again with
composite and hope
for the best. However,
this may not have
been the best longterm approach considering the functional stress in this
area, even with the
best tooth alignment.
4
5
After all, how conservative is it to continuFig. 4: Shade taking prior to restoration. Fig. 5: Tooth #41 orthodontically prepared on the facial aspect to create space so that restoration
of that surface could correct the facial position of the tooth in the occlusion.
ally assault the tooth
with rotary instrumentation to keep fixing a composite that
continues to fracture?
What about the
alignment of the opposing teeth? It could
be observed that excessive wear was present on the incisal
edges of teeth #31
and 41 (Fig. 2). From
the incisal view, ex6
7
tensive wear was seen
on all mandibular incisal edges due to occlusal disease—which
is often seen yet left
untreated (Fig. 3).
Tooth #41 was also facially positioned so
that in protrusive excursion it engaged
the palatal surface of
tooth #11 prematurely, placing additional stress on both
8
9
the palatal surface
and incisal edge of
Fig. 6: Lingual aspect of tooth #41 being built up in composite to reposition the incisal edge of the tooth lingually into a more favourable
alignment. Fig. 7: Uveneer template placed on the facial surface of tooth #41 in proper alignment with the adjacent teeth. Fig. 8: Tooth #41
tooth #11 before coushown
from the facial aspect after restoration of the facial surface and the incisal edge. Fig. 9: Incisal view of the direct composite restopling with the remainration of tooth #41, showing the incisal edge alignment compared with the pre-op situation (Fig. 3).
der of the maxillary
anterior segment. This
demonstrates
that
posite resin was chosen as a more
lost enamel and reinforce the retreatment plan was to restore tooth
addressing these issues restorconservative and less costly option
maining tooth structure. The deci#41 in such a way that the position
atively involves more than just fixfor tooth #41, but the patient was
sion was made to restore tooth #11
of the tooth facially and its incisal
ing a chipped composite restotold that it may require a ceramic
with a ceramic crown and tooth #41
edge would not engage the palatal
ration.
restoration later.
with a direct composite restoration.
surface of tooth #11 prematurely
Orthodontics to correct tooth
For tooth #11, an aesthetic match
and then to restore the palatal suralignment was discussed with the
to tooth #21 could be better
face and incisal–facial fractured
patient, but the patient did not deachieved in layered ceramic. Comarea with ceramic to replace the
sire this option. An alternative
► Page 13
[13] =>
GENERAL DENTISTRY
13
Dental Tribune Middle East & Africa Edition | 05/2024
◄ Page 12
10
11a
11b
Fig. 10: Inferior view of tooth #11 after preparation and with the teeth in maximum intercuspation. Note how the restoration of tooth #41 was needed to position the incisal edge and facial surface in a more lingual
position to allow for the space required to restore the palatal surface of tooth #11 at the proper thickness while maintaining the natural palatal concavity determined in part by occlusal excursive patterns. Figs. 11a
& b: Incisal view (a) and facial view of the completed preparation of tooth #11 (b).
12
13
14
Fig. 12: Using a super-pulsed diode laser to remove the excess tissue incisal to the top cord. Fig. 13: Incisal view of the retracted preparation after the gingivoplasty had been completed. Fig. 14: Retracted facial
view of tooth #11 after provisionalisation with the teeth in maximum intercuspation.
15
16
17
Fig. 15: Retracted facial view of the ceramic crown on tooth #11 after cementation with the teeth separated. Fig. 16: Palatal view of the ceramic crown on tooth #11, showing replication of the palatal concavity with
supragingival margin placement. Fig. 17: Six-month post-op retracted facial view of the restored teeth #11 and 41 with the teeth in maximum intercuspation. Aesthetic and functional harmony had been achieved.
First operative procedure: Direct composite veneer of tooth #41
The shade was chosen preoperatively and photographed for the
ceramist for colour matching, using
a digital camera with a function
that isolates the tooth shade from
the rest of the oral cavity (EyeSpecial C-II, SHOFU; Fig. 4). Next,
the facial surface of tooth #41 was
prepared orthodontically to move
the facial surface and incisal edge
lingually (Fig. 5). After preparation,
the bevelled facial surface of tooth
#41 had a knife-edged cervical
margin about 2 mm supragingivally. This long bevel would allow
for a more aesthetic blend of composite and tooth structure while
leaving the emergence profile of
the natural tooth untouched.
Prior to placement of composite, the enamel surface was etched
with phosphoric acid (Ultra-Etch,
Ultradent Products) for 15 seconds,
thoroughly rinsed and then airdried. A universal bonding resin
(Peak Universal Bond, Ultradent
Products) was applied to the tooth
surface, air thinned to evaporate
the solvent and then lightpolymerised for 20 seconds (VALO
Grand, Ultradent Products). An initial increment of composite (Mosaic universal composite, Ultradent
Products) was used to build up the
incisal one-third of the tooth to
move the tip lingually (Fig. 6). A
Uveneer template (Ultradent Prod-
“It is important to always consider that the restoration
of a single tooth can affect the occlusion [...].”
ucts) was chosen to properly restore the facial anatomy and contour of tooth #41 in composite, it
being extremely difficult to contour
properly freehand because of its
small size. The template was filled
with the chosen shade of composite and placed on the facial surface
of the tooth in proper alignment
with the adjacent teeth, and the
composite was light-polymerised
(Fig. 7). The template was then removed, some minor incisal adjustments made and the restoration
polished (Figs. 8 & 9).
Second operative procedure:
Ceramic restoration of tooth #11
Tooth #11 was prepared for a
ceramic crown. It is important to
stress that the preparation of the
palatal surface is critical. It must be
prepared for 1.0–1.5 mm of reduction following the curvature of the
unprepared palatal surface (maxillary palatal concavity). This is so
that the restoration can follow the
natural palatal curvature at the appropriate thickness of restorative
material for strength. Remember,
the maxillary palatal concavity is
determined by the angle of the eminence and the envelope of function, both occlusal determinants
that must be followed when restoring maxillary anterior teeth. Once
the preparation has been completed (Figs. 10, 11a & b), the master impression can be taken.
A two-cord technique for indirect impression making
A two-cord impression technique is an extremely predictable
way to capture quality master impressions for complete and partial
coverage restorations with either intra-sulcular or equi-sulcular margins
(at the free gingival margin).4 If desired, both cords may be soaked in a
haemostatic solution (e.g. ViscoStat
Clear, Ultradent Products) and excess
removed with a 5 × 5 cm gauze
sponge prior to placement.
First, a #00 retraction cord
(e.g. Ultrapak, Ultradent Products)
is placed at the base of the gingival
sulcus around each preparation,
starting from the lingual aspect,
around the proximal to the facial
aspect, then back through the opposite proximal area to the lingual
starting point. The excess at both
lingual ends is trimmed, and the
opposing ends of the cord are
tucked into the lingual gingival sulcus so that they butt against one
another but do not overlap. Once
the first retraction cord has been
properly placed and prior to placement of the second retraction cord,
any minor marginal correction can
be done to the preparation using a
coarse or fine diamond instrument
of the appropriate diameter. Next,
using a cotton pledget, the preparation is wiped with a 2% chlorhexidine
antibacterial
solution
(e.g. Consepsis, Ultradent Products) to make sure the surface is
clean and free of preparation debris from the diamond instrument.
Then, a #1 cord (e.g. Ultrapak) is
placed on top of the #00 cord in the
same manner.
When ready (usually after both
cords are in place and the fit of the
impression tray has been verified),
the #1 cord is partially pulled out of
the sulcus on the facial aspect of
each preparation using an explorer,
and the amount of retraction (and
lack of moisture or blood contamination) is evaluated. Remember,
the master impression must capture not only the entire restorative
margin but also 0.5 mm of the
tooth or root surface apical to the
margin. If the marginal gingiva adjacent to the restorative margin rebounds to contact the tooth or
margin after the top cord has been
pulled, a small piece of a largerdiameter cord (#2 cord; e.g. Ultrapak) is placed into the affected area
for an additional minute and then
removed. This added retraction
should be sufficient to create a
space between the tooth surface
and the inner dimension of the gingival sulcus. The goal of retraction
is to create a moat (a space into
which to inject a light-bodied impression material) around the castle (the tooth preparation).
A super-pulsed diode laser as
an adjunct to cord packing
If any portion of the circumferential gingival tissue is not sufficiently retracted from the emergence profile of the tooth or preparation after placement of the #1 re► Page 14
[14] =>
GENERAL DENTISTRY
14
Dental Tribune Middle East & Africa Edition | 05/2024
◄ Page 13
traction cord, a diode laser can be
used to perform a minor gingivoplasty on the overlapping gingival
tissue above the top cord so that it
is visible prior to its removal. This is
common in interproximal areas
where the gingival tissue (papilla)
may be slightly enlarged. It is not
recommended to hope that the
heavy-bodied impression material
will push the tissue out of the way
to let the light-bodied impression
material access the gingival sulcus.
In this case, after placement of
the #1 retraction cord, there was
excess tissue in the facial area of
the preparation that may have interfered with the light-bodied impression material flowing subgingivally. A super-pulsed diode laser
(Gemini, Ultradent Products) was
used to meticulously remove the
excess tissue incisal to the cord
without damaging the cord
(Figs. 12 & 13). The retraction cord
was entirely visible before removal,
allowing unimpeded access for the
light-bodied impression material
to flow into the retracted area.
When the cord is removed, an
impression of the margin and
0.5mm of the tooth or root surface
apical to the margin is virtually assured. To capture a precise master
impression, light-bodied impression material should be injected
not only around the prepared tooth
but also over all the occlusal and incisal surfaces so that the stone
models can be accurately articulated. After injection of the
light-bodied impression material,
the impression tray with the
heavy-bodied impression material
is placed in the mouth according to
the manufacturer’s recommendations.
anterior coupling and the envelope
of function (Fig. 14). It is much more
than just a temporary replacement!
After removal of the provisional restoration and of any remaining provisional cement, the restoration was
tried in, the proximal contacts and
occlusion were adjusted and then it
was polished as necessary. Next, the
preparation was disinfected with
Consepsis.
The laboratory had etched the
definitive restoration, so the etched
surface was treated with a silane coupling agent before cementation according to the manufacturer’s instructions. The restoration was then
luted using a dual-polymerised resin
cement (PermaFlo DC Translucent,
Ultradent Products; Figs. 15–17).
Delivery of the ceramic restoration
The provisional restoration is important in order to judge the aesthetic considerations and evaluate
the functional occlusion, protrusion,
Conclusion
It is important to always consider that the restoration of a single
tooth can affect the occlusion in a
profound way. The reverse is also
true: not considering the occlusion
can affect a single restoration in
both contour and longevity. It is always recommended to consider
these issues prior to any restorative
endeavour.
Editorial note: This article originally appeared in Oral Health Magazine, and an edited version is provided here with permission from
Newcom Media.
This article was published in cosmetic dentistry beauty & science, Vol.
18, Issue 1/2024.
Please scan this QR code for the
list of references.
Dr Robert
A. Lowe
graduated
magna cum
laude from the then Loyola University School of Dentistry in Chicago
in the US in 1982. He maintains a
private practice in Charlotte in North
Carolina in the US and publishes and
lectures internationally on aesthetic
and restorative dentistry. Dr Lowe
can be reached at boblowedds@
aol.com.
Dr. Galip Gürel conducts his signature
APT (Aesthetic Pre-evaluative
Temporary) Veneers Course at CAPP
in Dubai
By CAPP Events & Training
CAPP hosted Dr. Galip Gürel’s
renowned
hands-on
training
course “Veneers in the APT (Aesthetic Pre-evaluative Temporary)
Concept – Advanced Smile Design
Masterclass” at the CAPP Training
Center in Dubai, a key milestone in
CAPP’s commitment to advancing
dental education in the UAE and
beyond. Recognized globally as
one of the foremost leaders in aesthetic dentistry, Dr. Gürel brought
his extensive expertise to Dubai,
providing a unique opportunity for
participants to learn from a true innovator in the field.
Over the course of two intensive days, participants divided into
Dr. Gürel’s groundbreaking Aesthetic Pre-evaluative Temporary
(APT) concept. This approach allows for comprehensive aesthetic
planning by simulating the end result in temporary veneers, offering
patients a preview of their new
smiles before the final placement.
Attendees were guided through
every detail of the APT technique,
along with advanced methods in
veneer preparation, application,
and finishing, all under the meticulous guidance of Dr. Gürel.
The course took place at the
state-of-the-art CAPP Training
Institute in Dubai, where delegates
engaged in practical learning using
seven models mounted on phantom heads to master intricate aesthetic techniques.
The event attracted dental
professionals from 14 different
countries eager to enhance their
aesthetic dentistry skills, with a
course that seamlessly blended
theoretical insights and practical
exercises. From initial diagnostics
and smile design to the final
touches that ensure optimal aesthetics and function, participants
left with a comprehensive toolkit to
elevate their practice in aesthetic
dentistry.
Dr. Galip Gürel’s expertise and
dedication were met with enthusiasm from participants, who benefited greatly from his hands-on
guidance and insights into advanced aesthetic dentistry techniques. This intensive course was
made possible through the support
of key sponsors, whose contributions were instrumental in enhancing the learning experience for all
attendees. With this event, CAPP
reaffirms its commitment to providing top-tier dental education
and looks forward to future collaborations that further elevate standards in aesthetic dentistry.
Stay tuned for another course
in 2025 with Dr. Galip Gürel in Dubai
in partnership with CAPP.
[15] =>
EVENT
Dental Tribune Middle East & Africa Edition | 05/2024
(Images: CAPP Events & Training)
15
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[20] =>
INTERVIEW
20
Dental Tribune Middle East & Africa Edition | 05/2024
“The future of dentistry lies in predictive,
personalized, and data-driven care”
Interview with Prof. Falk Schwendicke
By Dental Tribune MEA
As anticipation builds for the
upcoming 37th Dental ConfEx in
Dubai this November, let’s turn our
attention to Prof. Falk Schwendicke.
A leading figure in digital health
and dental diagnostics, Prof.
Schwendicke will present his lecture titled "Artificial Intelligence in
Dentistry: Are we there yet?" His innovative work on AI-based applications in dental diagnostics, image
analysis, and treatment planning
has positioned him at the forefront
of data-driven dentistry. Prof.
Schwendicke’s insights into the future of AI in dental care promise to
be a highlight of the event, offering
a glimpse into the transformative
potential of AI in the field.
things like your iPhone, passport
automation, and even self-driving
cars. After outlining the fundamentals, I’ll dive into the current applications in dental image analysis,
such as radiographs, scans, and
photos, particularly in practices focused on aesthetics, smile design,
and complex rehabilitation, where
planning on 3D and 2D images is
crucial.
Additionally, I will cover how AI
applies to speech, text, and numerical data. Large foundational models like ChatGPT or predictive models can help in patient communication, administration, and dental logistics. Attendees will gain an
understanding of AI’s potential impacts across a broad spectrum of
dental practice processes.
Prof. Schwendicke, your lecture at the 37th Dental ConfEx in
Dubai is titled "Artificial Intelligence in Dentistry: Are we there
yet?" What can delegates expect
to learn from your presentation,
and how do you see AI reshaping
the future of dental diagnostics
and treatment?
In my presentation, I will first
explain how AI technology works,
as there’s a lot of talking around it,
but many people don’t really understand its mechanics. This is important because the same technology behind AI in dentistry powers
You’ve had a remarkable career in dental diagnostics, preventive care, and health economics. How did AI become a
central focus of your work, and
what initially drew you to this
area of research?
It's quite a funny story. I was involved in a health services research
project, developing an atlas for
Germany's dental density and service provisions for the government.
During that time, I had a statistically inclined staff member, and
when machine learning first
emerged in fields like dermatology
tion between me and my colleague,
Joachim, back in 2017-18. We entered an accelerator program that
was designed to help researchers
spin off companies, and by 2020,
we founded dentalXrai GmbH,
though we knew very little about
running a business at the time. It
was an adventure, and we probably
made a lot of mistakes along the
way.
In 2022, we were fortunate that
Align Technology acquired our
company, and today, our software
is used in thousands of practices
across Europe. It has had a meaningful impact, bringing AI-driven
image analysis to many dental professionals.
Prof. Falk Schwendicke is a renowned expert in digital health and dental diagnostics, known for his pioneering work in applying artificial intelligence (AI) to dental
care, image analysis, and treatment planning. (Photo: Prof. Falk Schwendicke)
and ophthalmology, I came across
one of those papers and thought,
"Could we do this with our radiographs?" I showed it to my colleague, and he said, "Yes, we can."
That moment led us to join an
accelerator program at Berlin University, where I was a professor at
that time. Eventually, we founded a
company, and today I find myself
chairing numerous initiatives at the
World Health Organization, ISO,
FDI, and others. It was all a bit of an
accident, but we happened to be
the first to apply AI in dentistry in
academia.
One of the key points in your
lecture is discussing the limitations and risks of AI in dentistry.
What are some of the current
barriers preventing widespread
AI integration into dental practice?
There are two main challenges.
First, the AI systems we have today
are relatively young with many limitations—most are just a year or
two old—so there are concerns
about their generalizability, robustness, and the transparency of
the data they use. These are areas
we are actively working on, for instance, with the WHO ITU Focus
Group AI for Health, to improve the
reliability and accessibility of AI
systems.
The second challenge lies
within dental practices. Many dentists lack the necessary digital literacy to implement these tools. This
is where events like the 37th Int’l
Dental ConfEx become vital, as
they help bridge this gap. Additionally, in dentistry, we face significant
issues with data interoperability.
Our datasets aren’t standardized
and often exist in silos, making it
difficult to integrate AI systems
with existing practice management
software. These are the two major
hurdles slowing progress—not
stopping it, just slowing it.
Your involvement with dentalXrai GmbH has been pivotal in
advancing AI-driven image analysis in dentistry. Could you share
the story behind this spin-off
and its impact on the field?
As I mentioned earlier, this all
began with a research collabora-
The concept of P4 dentistry—
predictive, preventive, personalized, and participatory—is intriguing. How do you see AI playing a role in the broader adoption of this model in everyday
dental care?
AI is one tool that will drive the
adoption of P4 dentistry. While AI
won’t be the central focus, it will
enable more predictive and personalized care, provided we can access the right data. Our current
datasets in dentistry are too small
to support the large models we use
in other fields, such as ChatGPT. To
truly harness AI, we need larger,
more diverse data pools. This
means opening up the various data
silos in dentistry and thinking
about federated learning, where
we can collaborate across organizations to build better models.
Finally, looking forward, how
do you envision AI transforming
dentistry over the next decade?
Are we on the brink of a major
shift, or do you think the transition will be more gradual?
I think we’re already seeing
some of the transformations. In
image diagnostics, AI will soon become the standard. Within the next
five to ten years, I believe most
dentists in high-income countries
will rely on AI to assess images.
We’re also seeing scanners becoming central to patient documentation, where AI overlays help create
a “digital twin” of the patient.
In addition to diagnostic tools,
AI will help shift dentistry toward
more predictive, individualized
care—the P4 model. Another major
trend is conversational AI. In the
near future, we’ll see dental assistants, admin staff, and even dentists interacting with AI through
natural speech. Tasks like booking
appointments, rescheduling, charting, and even patient education will
be automated. This will revolutionize how we run practices, making
things more efficient and improving patient care.
Thank you.
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[22] =>
GENERAL DENTISTRY
22
Dental Tribune Middle East & Africa Edition | 05/2024
The transformative
power of AI in dentistry
By Eric Kukucka, Canada
Introduction
When we think of artificial intelligence (AI), our minds often conjure
up images of sentient humanoid robots from iconic science fiction films
like 2001: A Space Odyssey and Blade
Runner. More recently, films like Her
have explored the concept of AI
agents possessing consciousness.
However, today’s discussion delves
into the use of AI in dentistry, where
practical applications are changing
the landscape of oral healthcare.
Defining AI in dentistry
Before we dive deeper into the
profound impacts of AI in dentistry,
let us establish a working definition.
In practical terms, AI is a field of computing in which advanced algorithms
access extensive data sets to solve
problems in ways reminiscent of
human cognition. IBM aptly characterises AI as the utilisation of computers and machines to emulate
human problem-solving and decision-making capabilities.
AI in everyday life
Many people are unaware that
they interact with AI on a daily basis.
If you have ever used voice-activated
virtual assistants such as Apple’s Siri,
Amazon’s Alexa or Google Assistant
or received personalised recommendations on platforms like Netflix,
YouTube or Spotify, you have already
experienced the influence of AI. Beyond these personal interactions, AI
plays a pivotal role in various aspects
of our professional lives.
For instance, AI is the driving
force behind automated speech recognition and closed captioning, enhancing accessibility for individuals
with hearing impairments. In the
realm of online customer service,
AI-powered chatbots efficiently assist users on e-commerce websites,
making
shopping
experiences
smoother and more efficient. Moreover, AI excels in image categorisation and analysis, a capability we
AI 2.0 (3Shape) edentulous scan.
often encounter in apps like Apple
Photos or during medical image assessments at healthcare facilities.
The evolution of AI
The recent surge in AI’s prominence can be attributed to several
factors. One crucial factor is the exponential growth in computational
power, computers continuously becoming more potent and capable of
handling complex AI tasks. Another
pivotal development is the unprecedented access to massive data sets,
consisting of millions of documents
and images. Additionally, the emergence of deep learning networks has
revolutionised AI by allowing it to
process vast amounts of information, often derived from extensive
online data sources.
Traditionally, software developers created specific algorithms tailored to solving well-defined problems. However, deep learning, a subset of machine learning, which is it-
AI can be used to improve patient scheduling software.
self a subset of AI, introduced a
dynamic approach. Deep learning
models are adept at handling substantial data sets and can learn the
unique characteristics of various
document types, such as images, essays or strings of computer code.
These models then generate new,
original content that closely resembles the examples they have encountered, all with minimal human intervention.
Dr Rune Fisker, senior vice president of product strategy at the dental scanning and software company
3Shape, has underscored the significance of deep learning in AI’s advancement. He noted that deep
learning demands less development
effort compared with traditional approaches while delivering significantly higher performance. The societal and other implications of this are
profound, as it will make computers
considerably more intelligent.
The implications for dentistry
But what does this mean for the
field of dentistry? The potential applications of AI in dentistry are vast
and transformative. While AI is not a
panacea, ignoring its potential would
be a missed opportunity. AI is poised
to become the next evolution in the
dental profession, much like how
digital technology revolutionised
dentistry by surpassing the limitations of analogue methods.
In our everyday lives, AI enhances our efficiency, effectiveness
and predictability. In North American oral healthcare, these qualities
translate into increased profit margins. Dr Fisker envisions AI-powered
(computer-aided) denture design as
not only technically feasible but also
inevitable. The impact of AI extends
to various aspects of dental care, including imaging, diagnostics and
eventually design.
3Shape’s current intra-oral scanning technology, called AI 2.0, uses
AI to help identify edentulous soft
tissue and delineate between soft
tissue, teeth and other artefacts in
the mouth. Conventional intra-oral
scans naturally capture everything
within range of the scanner’s beam,
including unhelpful images of soft
tissue irrelevant to the final diagnosis
or design of the final prosthesis.
Using AI and deep learning, modern
3Shape scanners can intelligently
differentiate between soft tissue and
other, more important, intra-oral information. 3Shape’s scanning software automatically and instantly deletes this soft-tissue information,
producing a cleaner, more useful
final digital record of a patient’s intra-oral situation.
Before the company’s AI-powered technology was developed,
technicians and clinicians needed to
manually annotate the unwanted
soft tissue and tongue on the initial
scanning output. Over time, 3Shape
accumulated a very large set of these
accurately annotated scans, which it
then used to train its deep learning
algorithm, effectively teaching it to
do the identification work human annotators had performed previously.
AI in dental imaging and diagnostics
One of the most promising applications of AI in dentistry is in dental imaging and diagnostics. Traditional dental radiographs have long
been indispensable tools for diagnosis and treatment planning. However,
AI is poised to take this essential aspect of dental care to new heights.
Several companies are currently
developing AI tools capable of automatically detecting dental conditions by analysing dental radiographs. Pearl, an American company,
gained clearance from the US Food
and Drug Administration for its
groundbreaking software in this
area. Pearl’s AI-powered Second
Opinion software has surpassed
human accuracy in detecting signs of
pathologies and common dental
conditions in radiographs. It even excels at identifying issues that may be
challenging for human dentists, such
as incipient caries or early signs of
periapical radiolucency. Pearl’s approach is akin to providing dentists
with a second set of eyes. This paradigm shift in dental diagnostics augments the capabilities of dental professionals, offering them invaluable
insights that may have been overlooked owing to human fatigue or
error.
Enhancing patient care and efficiency
AI’s influence extends beyond
diagnostics; it has the potential to
optimise patient care and streamline
dental practices. Efficient patient
scheduling is vital for maximising
chair time utilisation, reducing patient waiting times and optimising
resource allocation. AI can determine optimal staffing levels based
on expected patient loads, minimising over- or understaffing issues. It
AI can assist in the design of surgical guides for implant placement.
► Page 23
[23] =>
GENERAL DENTISTRY
23
Dental Tribune Middle East & Africa Edition | 05/2024
◄ Page 22
can analyse patient histories to
schedule appointments effectively,
ensuring that facilities are neither
under-utilised nor overbooked. Algorithms can calculate appointment
duration, accommodate patient
preferences for appointment times
and healthcare providers, monitor
real-time patient flow and adjust appointment schedules accordingly.
Moreover, AI can send automated
reminders to patients, enabling
them to reschedule or cancel appointments online, thereby reducing
no-shows. By historically predicting
which patients are more likely to miss
appointments, facilities can proactively overbook or send reminders to
improve attendance rates.
The future of AI in dentistry
The future of AI in dentistry holds
immense promise. AI will be seamlessly integrated into practice management software, providing second
opinions and aiding in treatment
planning. Advancements in CBCT
technology will offer unparalleled insights into anatomical structures, improving surgical interventions and
implant placement.
Furthermore, AI will revolutionise the design of digital dentures, automating processes that were once
performed manually. Currently, CAD
technicians manually mark characteristic points and the outer boundaries of dentures. With AI, these processes can be automated using deep
learning and extensive data sets.
While this intervention may not revolutionise dentistry, it will significantly reduce the time required in
denture laboratories, making the design process more efficient.
Dr Fisker envisions a future in
which patients can instantly view accurately generated digital simulations of their final dentures and laboratories can produce 3D-printed
dentures within hours. In this future,
AI will substantially reduce barriers
to access, enhancing the patient experience. This outcome is not just
theoretically feasible; it is highly
likely to become a reality in the foreseeable future.
AI-powered Second Opinion software (Pearl; hellopearl.com).
Editorial note: This article was published in AI dentistry—international
magazine of artificial intelligence in dentistry vol. 1, issue 1/2024 Preview edition.
Eric Kukucka
graduated
with a diploma
of denturism
from George Brown College in Toronto in Canada. He is vice president
of clinical removable prosthetics and
design technologies at dental service
organisation Aspen Dental Management, where he is responsible for the
ef cacy involved in the delivery of
care concerning removable prosthodontics. He is an active researcher,
educator, author and key opinion
leader who has helped develop
protocols, processes and materials
used by practising clinicians around
the world. In 2019, Kukucka became
the 32nd person in the world to
be certified as a global instructor
of Dr Jiro Abe’s Suction Effective
Mandibular Complete Dentures
methodology. He collaborated on
the development of monolithic
milled digital denture technology with Ivoclar and of intra-oral
scanning strategies for digitising
dentures. He co-developed the
reference denture scanning strategy
with 3Shape and in 2021 became
the first denturist appointed to its
global corporate advisory board.
He is also a member of SprintRay’s
clinical advisory board and a faculty
member of the Digital Dentistry
Institute. Kukucka co-authored The
Digital Removable Metamorphosis
(Quintessence Publishing, 2024).
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The role of AI in denture design
To delve deeper into the potential of AI in denture design, it is crucial
to understand the underlying principles. Mathematical equations and
discrete anatomical landmarks already exist to delineate essential
denture design factors such as tooth
position, tooth size, tooth shape and
gingival contours. AI has the potential to automate a significant portion
of the design process by relying on
established philosophies, principles,
physics, anatomy and physiology
that have been instrumental in dentistry for decades.
Conclusion
In conclusion, AI in dentistry empowers us to be more predictable,
effective and precise in our practice.
Rather than completely automating
our workflows, it is essential to leverage AI as a powerful tool while dedicating time to validating AI-generated recommendations. This approach not only saves time but also
enhances the quality of patient care,
ultimately improving the lives of
both patients and dental professionals.
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06.05.24 12:27
[24] =>
INTERVIEW
24
Dental Tribune Middle East & Africa Edition | 05/2024
“No success happens without proper
awareness and education to parents.”
Interview with Dr Rafif Tayara
By Dental Tribune MEA
As anticipation builds for the
upcoming Pediatric Dentistry Symposium in Dubai on 15 November,
let's take a moment to shine a spotlight on one of the esteemed
speakers, Dr. Rafif Tayara. A consultant pediatric dentist focusing on a
holistic approach and innovative
treatments, and as well as a book
author, Dr. Tayara will be presenting her lecture on 'Rethinking Pediatric Dentistry: Novel Peptide Technology and Guided Enamel Regeneration.' Her cutting-edge approach to treating early childhood
caries with non-invasive, peptide-based technology promises to
be a game-changer in pediatric
dentistry and a highlight of the
event.
You’ve had an impressive career working in both private and
hospital-based settings across
different regions. What inspired
you to specialize in pediatric
dentistry, and how has that
shaped your approach to treating young patients?
What inspired me to specialize
in pediatric dentistry was an internship at Sainte-Justine Children’s
Hospital in Montreal, Quebec, Canada, which became a pivotal moment in my career. During my time
there, I saw firsthand the unique
combination of psychological insight and medical expertise needed
to treat young patients effectively.
I realized that pediatric dentistry is
about much more than clinical
skills—it’s about understanding
and addressing the emotional
needs of children. That experience
sparked my passion for the field
and continues to shape my approach to treatment.
Since then, I’ve had the privilege of working in both hospital-based and private practice settings across different countries.
These experiences have reinforced
my belief that while pediatric dental residency provides a strong
foundation, true mastery comes
from continuous learning and daily
interactions with patients. I’m committed to staying up to date with
advancements in materials, techniques, and approaches because
our field is always evolving, and so
must we, to provide the best care
possible.
My studies at Saint-Joseph University in Beirut and the University
of Montreal gave me a diverse, international perspective, enriching
my understanding of pediatric care
across different cultural contexts.
This, along with my clinical experiences, has shaped the pediatric
dentist I am today.
Your lecture at the upcoming
conference focuses on peptidebased technology for guided
enamel regeneration. Could you
explain how this innovation is
changing the way we treat early
carious lesions in children, and
why it’s such a significant advancement in pediatric dentistry?
This technique represents a
major shift from traditional methods. With peptide-based technology, such as Curodont Repair, we
can immediately treat initial caries,
especially in cases like erupting
teeth or early childhood caries
(ECC). Unlike conventional approaches that often require drilling
and filling, this method is non-inva(Photos: Dr Rafif Taraya)
sive, drill-free, and painless, which
makes it far more comfortable for
young patients.
Traditional methods frequently
necessitate conscious sedation or
even general anesthesia, particularly in cases of severe decay. In
contrast, guided enamel regeneration allows us to treat caries without resorting to these measures,
ensuring better patient compliance. For children who may otherwise face anxiety or fear around
dental treatments, this technique
offers a more positive, stress-free
experience. It's a significant advancement because it not only arrests early caries but also regenerates the enamel, simplifying treatment and improving outcomes for
both clinicians and patients.
Treating children holistically
while achieving optimal clinical
outcomes can be challenging.
How do you balance preserving
natural tooth structure with correcting oral habits and promoting overall oral health in your
treatments?
It’s definitely one of the most
challenging aspects of pediatric
dentistry. We're not only striving
for clinical success but also managing the psychological needs of the
child, along with the expectations
of parents or caregivers. It involves
leadership and teamwork, but ultimately, it comes down to develop-
ing a treatment plan based on a
comprehensive approach. Rather
than focusing solely on the caries
status, we look at the child’s overall
health, lifestyle habits, diet, breathing and sleep patterns, as well as
their family and social context. By
doing this, we treat the root causes
of the disease, not just its symptoms.
You’ve mentioned that early
intervention is key to preventing
the progression of carious lesions. Can you share a memorable case where peptide-based
technology played a critical role
in improving a young patient’s
oral health?
One case that stands out involved a 4-year-old patient who
was referred to my practice for
early childhood caries. The mother
had recently seen another dentist,
who recommended fillings under
general anesthesia. Upon evaluating the child, we noticed
mouth-breathing, a highly cariogenic diet, and early lesions on the
buccal surfaces of the upper incisors and molars.
In our modern days, children
often consume up to five times the
recommended daily sugar intake,
primarily through unnecessary
sources such as juice boxes, fizzy
► Page 25
[25] =>
INTERVIEW
25
Dental Tribune Middle East & Africa Edition | 05/2024
◄ Page 24
drinks, and flavored milk. Crackers
and biscuits have also been identified as the leading cause of early
childhood caries, particularly when
children snack frequently throughout the day. In this case, the child’s
diet was a major contributing factor, with frequent sugary snacks
and drinks.
By addressing the underlying
causes—treating
the
mouthbreathing, modifying the diet, and
applying peptide-based technology to the early lesions—we were
able to stabilize the caries without
the need for general anesthesia.
This approach not only improved
the child’s oral health but also fostered a positive attitude towards
dental visits, ensuring long-term
success. It’s a clear example of how
early intervention and modern
techniques can significantly improve outcomes, especially when
combined with lifestyle changes
like healthier snacking habits.
Parental involvement is crucial in ensuring long-term success in pediatric dental care.
How do you work with parents to
educate and empower them in
maintaining their children’s oral
health at home?
No success is possible without
proper education for parents, caregivers, schools, and the wider community. Early childhood caries is a
community disease, and our approach always starts with education. During a child’s first dental
visit, we spend significant time asking questions about diet, airway
health, breathing patterns, lifestyle
habits, and family and social circumstances. This helps us understand the root cause of the disease.
Educating parents about the
connection between oral health,
maternal health during pregnancy,
and overall health and sleep patterns of their child is crucial. This
approach not only guarantees
treatment success but also helps
prevent relapse.
Lastly, your recently published book helps prepare pre-
school-aged children for
their first dental visit. What
inspired you to write it, and
how do you see it helping
young children and their
families overcome dental
anxiety and prevent early
childhood caries?
In my 19 years as a dentist,
one thing has remained constant: children often borrow
their parents' mental health.
Many times, a child dreads the
dental visit because their parent is subconsciously transferring their own anxiety from
past experiences. This was a
recurring challenge in my
practice, and it impacted the
success of my visits.
I wrote my book, Danny
and Sarah Go to Dr. Smile, with
the intention of creating a detailed, sensory-rich narrative
of a child’s first dental visit. It
walks them through everything they might encounter,
from the clinic space to the
dental chair, the instruments,
and each step of the visit.
Reading this book with
parents before the appointment offers children a positive, unbiased perspective on
the dental trip. We’ve observed a significantly higher
success rate for first-time dental visits when the book is read
repeatedly beforehand. It's
available in English and Arabic
on Amazon AE, Amazon UK,
Mumzworld, Noon, Virgin
Megastores, and bookstores
across the UAE, as well as on
my website, www.rafiftayara.
com.
For more information on a
holistic approach to pediatric
dentistry, follow me on social
media @doctortayara.
Thank you
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[26] =>
INTERVIEW
26
Dental Tribune Middle East & Africa Edition | 05/2024
“Everyone has a role to play in tackling
antimicrobial resistance”: What’s yours?
Interview with Dr Wendy Thompson
By Iveta Ramonaite, Dental
Tribune International
fection after multiple antibiotic
treatments for various injuries. Her
experience highlights the dangers
of repeated antibiotic exposure.
Antimicrobial resistance (AMR)
is an increasingly critical global
health issue. According to the
World Health Organization (WHO),
bacterial AMR was directly responsible for 1.27 million deaths and
contributed to 4.95 million deaths
globally in 2019. In this interview,
Dental Tribune International speaks
with Dr Wendy Thompson, who is a
dentist and chair of FDI’s Preventing AMR and Infections Task Team.
Dr Thompson shares insights on
the vital role antibiotics play in
modern dental practices, the dangers of overprescribing and the urgent need for stewardship within
the dental community. She also
discusses the importance of preventive care, the responsibilities of
dental professionals and the upcoming UN General Assembly
meeting on AMR.
Dr Thompson, you are one of
the leading advocates for the
safe and responsible use of antibiotics. Could you start by explaining the importance of antibiotics in dentistry and why it is
crucial to use them only when
needed?
Antibiotics are life-saving drugs
when people really need them, and
they must work effectively when
required. They underpin modern
medicine: without effective antibiotics, many procedures would simply be unsafe. Our modern way of
life relies heavily on antibiotics, and
we are already seeing life expectancies being reduced globally
owing to antibiotic resistance. Dental infections can lead to sepsis,
which is a significant concern.
Therefore, ensuring that antibiotics
work is crucial for patient safety.
Dentists are high prescribers of
antibiotics, and misuse contributes
to antibiotic resistance. Dentists
have a vital responsibility to use antibiotics only when absolutely necessary. We are equipped and
trained to treat dental infections
early, identifying potential problems before they become infections through routine check-ups
Dr Wendy Thompson is a clinical senior lecturer in primary dental care at the University of Manchester in the UK. (Image: Wendy Thompson)
and preventive care. By nipping issues in the bud, we can prevent infections and thus reduce the need
for antibiotics, keeping them effective for life-threatening situations,
both dental and otherwise.
Globally, dentists are responsible for about 10% of antibiotic prescribing, and studies have shown
that a significant proportion of
these prescriptions are unnecessary. For example, studies in the US
show that up to 80% of antibiotics
prescribed by dentists are not necessarily needed. The situation can
be even more pronounced in developing countries, where the impact of antibiotic resistance can be
disproportionately severe. Infections do not respect boundaries, so
this is a global issue. The adverse
outcomes of antibiotics, such as
anaphylaxis and Clostridioides difficile infections, highlight the need
for judicious use of these drugs.
Repeated exposure to antibiotics promotes antibiotic resistance. Could you explain why
this could be dangerous?
Repeated exposure to antibiotics is dangerous because each time
you take an antibiotic, it kills susceptible bacteria, but some bacteria will always survive because they
are not affected by that particular
antibiotic. This can lead to overgrowth of resistant bacteria or
fungi, such as thrush, which thrive
when the susceptible bacteria are
eliminated. For instance, C. difficile
can colonise the gut after antibiotics clear out other bacteria, producing toxins that can cause severe
illness or death. Similarly, if a patient with methicillin-resistant
Staphylococcus aureus (MRSA) is
given antibiotics, the susceptible
bacteria are cleared out, leaving
the resistant ones to proliferate,
potentially leading to life-threatening infections.
WHO emphasises patient advocacy to explain AMR to the public. People often do not realise the
true cause of death in cases where
resistance has played a significant
role. Vanessa Carter’s story is a poignant example of AMR. Her facial
prosthesis failed due to a MRSA in-
“People often do not realise the true cause of death in
cases where resistance has played a significant role.”
You are the lead author of
FDI’s white paper on dental antibiotics. What role does the dental team play in AMR, and how
can they be better supported in
tackling the issue?
The dental team’s role in tackling antibiotic resistance involves
three key areas from WHO’s national action plan: raising awareness, preventing and controlling
infections, and antibiotic stewardship. Firstly, raising awareness is
crucial not only within our professional circles but also among the
general population. All dental team
members, including receptionists,
should be knowledgeable about
antibiotic resistance. They should
be able to explain why antibiotics
may not be the best solution and
the risks involved, thus seeking to
keep patients safe.
Secondly, preventing and controlling infections is about more
than just disinfection and decontamination. Dental infections are
common globally, and preventing
them through good oral hygiene,
dietary advice and timely dental
care is vital. By treating issues early,
we can avoid the need for antibiotics. During the COVID-19 pandemic, dentistry proved effective in
infection control, showing that we
are well equipped to handle such
challenges.
Lastly, antibiotic stewardship
means prescribing antibiotics only
when strictly necessary. This requires access to time and resources
for proper dental procedures
rather than resorting to antibiotics
as a quick fix. WHO has guidelines
for dental conditions that may
need antibiotics, such as dental abscesses and noma—a neglected
tropical disease that starts as gingivitis. Each country should tailor
these guidelines to their specific
context to balance risks and benefits effectively.
To make FDI’s white paper more
accessible, we produced an interactive online course and a pledge
committing to these principles for
national dental associations to
sign. We are currently analysing
feedback from these associations
to improve our approach further
and will be presenting the results in
the coming months.
Last September, the UN General Assembly helld its second
high-level meeting on AMR, providing world leaders with the opportunity to address the threat
of AMR to global health. Could
you tell us a bit about the significance of this event and how it
contributed to reducing the
spread of infections that are resistant to antimicrobial medicines?
The UN General Assembly’s involvement in AMR highlights its
global importance. This is only the
fourth health issue that the UN
General Assembly has taken up,
after HIV/Aids, Ebola and non-communicable diseases. The first highlevel meeting on AMR in 2016 recognised the severe threat AMR
poses to human health, animal
health and the environment.
The 2024 high-level meeting
updated the global action plan on
AMR, emphasising a One Health
approach that integrates human,
animal and environmental health.
This collaboration between WHO,
the World Organisation for Animal
Health, the UN’s Food and Agriculture Organization and the UN Environment Programme aims to address AMR comprehensively. Ensuring that oral health is included in
this agenda is crucial, as dental infections and antibiotic use play a
significant role in AMR.
How is FDI preparing for this
meeting to ensure that oral
health is included in the antimicrobial stewardship agenda?
FDI is working with various
partners, including the World Medical Association and the World
Health Professions Alliance, to ensure that oral health is part of the
AMR agenda. We have had discussions with WHO to determine how
best to contribute to this effort. At
the UN high-level meeting, we will
advocate for universal access to
oral healthcare as a crucial component of AMR prevention and control.
We will also highlight the effectiveness of dental infection prevention and control measures and the
need for proper guidelines to reduce unnecessary antibiotic use.
Educating the public and healthcare professionals about the appropriate use of antibiotics in dental care is essential to combat AMR.
By raising awareness and promoting best practices, we can play a
significant role in reducing the
spread of resistant infections.
Everyone has a role to play in
tackling AMR. We must all work together to keep antibiotics effective
for future generations.
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GENERAL DENTISTRY
28
Dental Tribune Middle East & Africa Edition | 05/2024
Motivating your team
By Jerko Bozikovic, Belgium
In training sessions, managers,
dentists, leaders often ask me how
they can motivate their team and
keep them motivated. This is a
million-dollar question, since so
many leaders struggle to keep their
staff motivated, connected and engaged. Over my more than 22 years
of experience as a trainer and coach
and having held the role of manager
of a team myself, I have gained a
number of insights in this regard and
I share some of the most pertinent in
this article.
Teams are a combination of
individuals
Everybody wants to be heard, to
be seen and to be respected, and
these are key elements to consider
in relation to motivation. On one
hand, people want to be authentic
and unique, and on the other hand,
they want to blend in with others,
with a group. It is this constant dynamic of finding a balance that we
need to work with. As a team, we
want everybody to be aligned, but
we need to consider that everybody
is an individual, so a one-size-fits-all
approach does not work, even
though sometimes it might feel that
this is what society expects from
people. So how can you cherish the
individuality in your team?
Every team member has their
own talents, qualities and value, and
as a manager, you want to start recognising what these are and to start
nurturing these qualities and talents. You will find that some staff
members are aware of their own
abilities and are waiting for opportunities to fully express and use
them, but some are not at all aware
of their own capabilities, and this is
where you as a manager can step
into a coaching role to try to empower them and create awareness
of their talents in order to hopefully
start giving them the confidence to
be the best version of themselves. If
all team members are able do to
this, then TEAM (Together Everyone
Achieves More)—a wordplay that I
love, will come into place.
Communication is key
In my 22 years of experience
working with companies and teams
as a trainer and coach, I have often
heard from employees leaving the
company that a lack of (clear) communication is one of their top three
reasons for doing so.
Be clear in communicating your
expectations and obtain a commitment to these from your employees.
Ensure communication is a two-way
process by involving your team in
making decisions about the future
direction of the dental practice.
Establishing clear communication includes creating an open feedback culture. How has that been
rolled out in your practice? Are there
regular feedback moments during
the day/week/month with your
staff? Does feedback include good
points, compliments as well as
points of improvements? This feedback can be given in an informal
way, in between patients, for example, or at the start or end of the
working day, as well as in a formal
way individually or in a group during
meetings.
Regarding meetings, do you
have a clearly set-out meeting
structure? The other day I was working on team communication with a
practice in Belgium, and one of the
major takeaways for management
was that they had no structured
meeting culture, so feedback was
given sometimes and sometimes
not. Decisions were shared sometimes and sometimes not. Half of
the staff were aware of certain information, decisions and changes, and
the other half not.
The staff thus decided to establish different meeting structures
with different time frames: meetings
in smaller groups, depending on
roles and responsibilities, on a more
regular basis, and then entire staff
meetings on a monthly basis. They
decided not to book patients during
the timings of these meetings in
Maslow's hierarchy of needs. (Image: Plateresca/Shutterstock.com)
order to be completely focused. The
encouraging thing about that team
communication day was that it was
the team members who asked to set
up more meetings, and the orthodontists and management staff listened.
How you motivate your team
matters
How do you motivate your
team? This question is one I love to
ask during training and coaching
sessions. I ask people to write down
all the things they do, or their clinic
does, to motivate their team. Actually, you might want to do this exercise as well quickly. The answers we
normally get—and maybe you will
give similar ones—are things like:
•
offering good working hours;
•
providing an adequate salary;
•
respecting employees;
•
listening to employees;
•
giving employees the flexibility
to choose their holiday dates;
•
giving employees nice work
clothing;
•
arranging team-building activities;
•
celebrating birthdays and big
holidays, such as with the giving of Christmas gifts;
•
communicating a clear vision
of the direction the clinic is
evolving in;
•
being open to feedback;
•
empowering employees by
giving them responsibilities
and autonomy; and
•
offering employees training.
Do you have any others?
Now let me introduce you to the
motivation–hygiene theory. Frederick
Herzberg et al. developed this theory and published it in the book
Motivation to Work. Influenced by
Maslow’s hierarchy of needs,
Herzberg et al. concluded that satisfaction and dissatisfaction could not
be measured reliably on the same
continuum and conducted a series
of studies in which they attempted
to determine what factors in work
environments cause satisfaction or
dissatisfaction.
On the basis of their findings,
they grouped these factors into motivators and hygienic factors. Motivators are aspects that are intrinsic
to the work itself, fulfilling needs
concerning achievement and recognition, for example, and really
motivate people, keep their focus
and energy high, create a good
work atmosphere and increase job
satisfaction. Hygienic factors are
basic needs that must be met at
work to enable people to do their
jobs. These are assumed to be obligatory and are extrinsic to the work
itself, such as salary and work environment. When fulfilled, they can
“Coming together is the beginning, keeping together is
progress, working together is success”—Henry Ford
Herzberg’s motivation–hygiene theory with examples.
(Image: Skyline Graphics/Shutterstock.com)
prevent dissatisfaction, but do not
necessarily increase satisfaction.
Consider the categorisation of
some of the examples listed earlier
regarding whether they are motivators or hygienic factors:
•
Good working hours: Is this a
motivator or a hygienic factor?
Most people take good working hours for granted, but poor
working hours are a cause of
demotivation.
•
Adequate salary: Is this a motivator or a hygienic factor?
Most people expect to have an
adequate salary, so poor remuneration may make them feel
unappreciated and taken advantage of, leading to a lack of
motivation.
•
Respect: Is this a motivator or a
hygienic factor? For most people, it is usual to be respected,
but if they are not treated with
respect, then that is a cause of
demotivation.
•
Celebrating birthdays and big
holidays: Is this a motivator or a
hygienic factor? For most people, it is a motivator, a plus that
goes beyond what is expected
at work.
•
Being open to feedback: Is this a
motivator or a hygienic factor?
For most people, it is normal
for a workplace to have an
open feedback culture with
clear communication, but a
lack in this regard is a cause of
demotivation.
•
Giving responsibilities: Is this a
motivator or a hygienic factor?
For most people, it is a motivator in that they perceive this as
demonstrating particular trust
in them and giving them opportunities to grow and learn.
As you can see—and I suggest
you do this exercise with your list of
what you believe are motivators—
what we all thought were motivators are only partly motivators, and
often the majority are hygienic factors.
I remember a client who owned
a wonderful restaurant telling me in
a training session that every year
she invested in new work uniforms
for her staff. She would select the
best materials and have the staff’s
names embroidered on the uniforms. She spent quite a large
amount on doing this and was upset
that the staff did not appear to be
grateful and more motivated when
they received their new uniforms. I
asked her why she felt they should
be more motivated in their work because of these new uniforms and
who wanted to have these nice uniforms in the first place. She wanted
the staff to have these uniforms and
thought it was important. For her
staff, these were just an outfit they
needed to wear every day at work
but not something that made them
feel appreciated or offered them
additional value in the workplace.
In another example, employees
had to park their cars in an unlit
parking area, so when it was dark in
the mornings or the evenings, they
felt quite unsafe. This influenced
their energy and motivation negatively. Therefore, management decided to install large light fixtures to
illuminate the parking area and thus
create a feeling of safety for the employees. Management was then disappointed that the team’s motivation was not improved by this.
Why was this so? When hygienic
factors are not fulfilled, this is always
a source of demotivation. Because
employees expect these factors to
be in place, when a lack in this regard is addressed, employees take it
for granted. If the baseline represents zero, then a lack in hygienic
factors will reduce motivation to
below zero. Solving this lack will just
bring motivation back to zero. If you
want to go above zero, you need to
employ motivators, such as providing growth opportunities, celebrating achievements, offering teambuilding activities, giving recognition and creating unexpected moments.
Do you need to make some
changes to how you approach motivating your team? I hope that you
will now be able to reflect on
whether you are solving hygienic
factor issues or adding motivators. I
wish you all the best in this journey
of moving towards true motivators,
and both are important but have a
different approach and different
outcome.
Editorial note: This article was first
published in aligners international
magazine of aligner orthodontics,
Vol. 3, Issue 1/2024.
Jerko
Bozikovic is
a specialist in
communication skills, emotional intelligence, time
and stress management, leadership, and change management. He
is fascinated by human behaviour
and finds working with people on
personal development to be a daily
challenge and blessing. He speaks
seven languages and has offered his
training courses in four languages
since 2001. He embraces and embodies the motto “Love the life you
live; live the life you love”. He can be
contacted via LinkedIn.
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NEWS
30
Dental Tribune Middle East & Africa Edition | 05/2024
(Photo: Freepik)
New study shows bacteria
love some restorative materials
more than others
By Dental Tribune
International
Although various synthetic materials have achieved near-perfect
results in dental restorations, they
cannot completely replicate natural
tooth structure, often resulting in
clinical failure due to secondary caries and periodontal disease. Two
major contributing issues are the
formation of biofilm and bacterial
adhesion to restorative materials.
Using single-strain bacterial adhesion models, researchers in Japan
have investigated the influence of
dental material type and surface
properties on bacterial adhesion.
The findings suggest that the chemical composition of the material
plays a crucial role in bacterial adhesion, potentially more than surface
roughness or surface energy.
The study investigated three
grades of yttria-stabilised zirconia
and a CAD/CAM composite resin.
Bovine dentine served as the control. The surface roughness of all
materials was maintained at a highly
polished level. The materials were
tested against the strains of five
bacterial species: Porphyromonas
gingivalis (implicated in periodontal
disease), Streptococcus oralis, Streptococcus sanguinis, Streptococcus
gordonii (all three early-colonising
bacteria) and Streptococcus mutans
(associated with dental caries).
The results showed that there
were no significant differences in
surface roughness among the
highly polished samples. Surface
wettability varied, but no correlation was found between surface energy and bacterial adhesion. The yttria content in the zirconia did not
significantly affect bacterial adhesion. However, the composite resin
exhibited higher bacterial adhesion
compared with zirconia, attributed
to its higher carbon, oxygen and silicon contents.
Bacterial adhesion patterns differed among the materials. For
P. gingivalis, the control group
showed the highest adhesion and
the composite resin the lowest.
For S. oralis, S. sanguinis and
S. gordonii, the highest adhesion was
observed on the control and composite resin surfaces, followed by the
zirconia samples. For S. mutans, the
control group showed significantly
higher adhesion compared with the
experimental groups. The researchers noted that “the results clearly
show that the material type strongly
affects bacterial adhesion during
the first hour of incubation, which is
an important factor for clinical use”.
This study confirms that dental
material type significantly influences bacterial adhesion, even
when surface roughness is controlled. The composite resin, despite its polished surface, showed
higher bacterial adhesion, similar
to the control with a rougher surface. Considering both mechanical
and biological properties when selecting materials for dental restorations is key, according to the researchers.
They recommended further research, including co-culturing
models and long-term studies, to
fully understand the biocompatibility and clinical performance of
these materials. “Given the complexity of the physicochemical
properties of different materials,
we suggest that biological indicators related to bacterial adhesion
should be explored for optimal
clinical outcomes,” wrote the researchers. Employing bioactive
agents and superhydrophobic surfaces in restorative materials may
offer future solutions for reducing
bacterial adhesion and improving
clinical outcomes.
Editorial note: The study, titled
“Does dental material type influence
bacterial adhesion under the same
polishing conditions? Direct observation using a fluorescent staining technique: An in vitro study”, was published online on 1 June 2024 in Dental
Materials Journal, ahead of inclusion
in an issue.
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32
Dental Tribune Middle East & Africa Edition | 05/2024
Study evaluates whether
AI can craft a universally
aesthetically pleasing restoration
By Anisha Hall Hoppe, Dental
Tribune International
Digital smile design (DSD) programs have become instrumental
in dental treatment, enabling dentists and patients to plan treatments in harmony with the entire
face. A recent innovation in DSD is
the integration of artificial intelligence (AI). A study in Turkey has
compared aesthetic preferences
among dental professionals, dentistry students and laypeople regarding smile designs created
manually and using AI, considering
factors such as sex, professional experience and specialty. The findings offer insights into the potential
of AI in DSD.
For the study, four cases representing major smile design groupings were selected. They were chosen based on relationships between the trichion, glabella, subnasale and menton, these being
crucial for smile designs, employing the concept of “facial flow”,
which refers to the direction of facial structures. Case 1 showed a facial flow towards the right side,
case 2 showed a facial flow towards
the left side, the nose and chin
pointed in different directions in
case 3, and case 4 was a symmetrical face.
Two smile designs were created
for each case using Smile Designer
App: one via AI mode and another
manually. The app utilises the Microsoft Face API, a robust AI tool
with facial recognition capabilities.
The API identifies 68 facial landmarks essential for determining the
patient’s facial type and appropriate tooth sizes, ensuring a precise
and personalised treatment plan.
To gather perceptions on these
designs, an online survey was conducted. The 807 participants were
classified into three occupational
groups—dentists, dentistry students and other professionals (laypeople)—and were asked about
their professional knowledge, expertise in smile design and usage
of a smile design program, in the
case of dentists. They were then
asked to choose whether they
found the AI-created or the manually created design more attractive
for each case.
The socio-demographic breakdown showed that the majority of
the dentists had 0–4 years of experience and were general practitioners. Almost half the laypeople
and over half the dentistry students
were familiar with aesthetic smile
design. Age, education and clinical
experience did not influence aesthetic preferences.
For cases 1–3, both dentists
who used smile design programs
and those who did not favoured
the manually created designs.
However, for case 4, dentists who
used a smile design program preferred the manually created design,
whereas those who did not preferred the AI-generated design. For
case 3, orthodontists notably favoured the AI-generated design.
The authors suggested that this
might have been due to their familiarity with AI values or experience
with treatments based on the landmarks used.
Aesthetic preferences varied
significantly between all three occupational groups for cases 1–3,
but notably not for case 4. The authors suggested that dentists’ aesthetic perception may be different
from that of laypeople in complex
cases. There were significant differences between dentists and both
dental students and laypeople for
certain cases. The survey revealed
an overall perceptual gap between
dentists and laypeople, however,
for symmetrical faces, AI-generated designs were acceptable to
both dentists and laypeople, suggesting a potential time-saving
tool for clinicians in such cases.
The challenge of incorporating
AI lies in recognising that faces and
smiles are not always symmetrical.
Studies have found a link between
facial symmetry and perceived
beauty, but crucial landmarks used
in smile designs on asymmetrical
faces still need research for using
AI. AI relies on mathematical models to create symmetrical smiles.
However, because facial flow takes
into account human perception, it
allows for more natural smile designs for both symmetrical and
asymmetrical faces. While AIdriven DSD works well for symmetrical faces, manual techniques may
be better for asymmetrical cases.
Given AI’s infancy in healthcare,
there is potential for misinterpretations owing to algorithmic constraints. The authors thus recommended ongoing research to optimise AI in DSD and understand
aesthetic perception.
Editorial note: The study, titled
“Evaluating the facial esthetic outcomes of digital smile designs generated by artificial intelligence and dental professionals”, was published online on 6 August 2023 in Applied Sciences.
Botulinum toxin in dentistry:
Study shows trends in applications
By Dental Tribune
International
The use of botulinum toxin (BT),
commonly referred to as Botox, is
gaining traction in the dental field,
offering both therapeutic and cosmetic benefits. Although initially
known for its cosmetic applications, BT has evolved into a versatile tool in dentistry, addressing a
range of oral health issues. A recent
study from India has reviewed its
current applications, and its findings reflect a broader trend towards holistic patient care.
Current applications in dentistry
BT is primarily known for cosmetic treatments such as facial and
jawline contouring as well as wrinkle reduction, but the drug is now
also commonly used in dental care
to treat a number of oral conditions. The study from India highlighted a notable increase in BT
treatments among dental professionals.
For example, the authors highlighted that BT is used to treat
bruxism and temporomandibular
disorder (TMD) by relaxing the
masseter muscles, reducing clenching and grinding and leading to
significant improvements in pain
relief and jaw function. For bruxism
and TMD patients who have not responded well to typical therapeutic
alternatives, BT injections can provide a minimally invasive therapy
that helps suppress soft-tissue activation, lessen muscle tonicity and
significantly diminish the severity
of symptoms.
Moreover, the authors reported
that BT can support favourable
outcomes for dental implants for
this same reason. A primary cause
of implant failure is the lack of osseointegration, sometimes resulting from strong masticatory forces
in patients with abnormal masticatory habits.
BT injections also have application in surgery for oral and maxillofacial fractures, alleviating tension
in hyperactive muscles of the periodontal apparatus during periodontal procedures. Additionally,
the authors noted that intraoperative BT injections reduce muscular
activity, lowering tension and promoting better healing at the surgical site.
The study also reported the use
of BT to reduce the appearance of
excessive gingival display by relaxing the upper lip muscles and to
address a number of conditions involving the salivary glands and trismus.
“In situations where the patient
is unresponsive to, or in conjunction with, less intrusive therapy
methods, BT has unquestionably
been demonstrated to offer substantial utility in the care of the patient,” the researchers concluded.
“However, the dentist in practice
must make sure that the procedure
falls within his or her area of expertise and that he or she is qualified
to handle any possible side effects,
in addition to administering it,”
they cautioned.
Market trends
According to iData Research,
the global market for BT A, the
most commonly used type of BT for
medical and cosmetic treatments,
was valued at nearly US$6.6 billion
(€6.1 billion)* in 2022. It is projected
to grow at a compound annual
growth rate of 6.5%, reaching approximately US$10.2 billion by
2029. This growth is mainly being
driven by the increasing popularity
and acceptance of minimally invasive cosmetic procedures, such as
injectable fillers.
Guidelines and regulations
The legal framework for BT
treatments varies worldwide, influenced by regional regulations and
professional guidelines. In the US,
state dental boards regulate use,
and requirements differ significantly from one state to another. In
Texas, for example, only oral and
maxillofacial surgeons are allowed
to employ BT for both therapeutic
and cosmetic use. In California, the
use of BT by general dentists is limited to dental treatment purposes
only. Only oral surgeons who hold
an elective facial cosmetic surgery
permit can provide these services
solely for cosmetic purposes. According to the American Academy
of Facial Esthetics, approximately 7
to 8% of dentists in North America
are currently providing BT treatment to patients for cosmetic reasons, and this number is steadily increasing.
In many European countries,
the administration of BT by general
dentists is permitted, provided
they meet stringent training and
regulatory requirements. In Germany, dentists are authorised to
perform only treatments that fall
within the scope of dentistry. Specifically, this means that dentists
may administer treatments
with BT only if they do not extend beyond the vermilion border
of the lips. Similar regulations are in
place in Australia, for example.
As BT treatments become increasingly integrated into dental
practice, understanding the legal
and practical aspects is crucial for
practitioners. With its broad therapeutic and cosmetic applications,
BT offers a valuable addition to
dental care, promoting a holistic
approach to patient well-being.
Editorial note: The study, titled
Botox: Current and emerging trends
for dental practitioners in esthetic
dentistry, was published online on 8
July 2024 in Cureus.
* Calculated on the OANDA platform on 29 March 2023.
[33] =>
NEWS
33
Dental Tribune Middle East & Africa Edition | 05/2024
Dental teams could help detect
undiagnosed diabetes in patients
By Dental Tribune
International
Diabetes is one of the most
common chronic conditions in Europe and is strongly associated
with periodontitis. An estimated
one in three people with diabetes
are undiagnosed, totalling more
than one million undiagnosed patients in the UK alone. Seeking to
help improve diagnosis of Type 2
diabetes in such patients, researchers in the UK are working on a new
study, called INDICATE-2, to validate routine diabetes screening
during oral health check-ups.
The study, being conducted by
researchers at the University of Birmingham, has received funding
from Haleon, a global consumer
health company, and the support
of the UK’s National Institute for
Health and Care Research (NIHR)
Birmingham Biomedical Research
Centre.
“This exciting collaboration
with Haleon will allow us to determine the actual prevalence of prediabetes and Type 2 diabetes within
a larger, more representative population sample and assess the feasibility of scaling this approach nationally. It will explore the patient
journey and identify barriers or
challenges in the care pathway,”
co-researcher Dr Zehra Yonel, a
clinical lecturer in periodontics in
the School of Dentistry at the University of Birmingham, said in a
press release.
In a 2023 study, the Birmingham researchers collaborated with
others from the universities of
Leicester and Oxford in the UK and
the University of Greifswald in Germany to develop the Diabetes Risk
Assessment in Dentistry Score
(DDS), a tool designed to help
identify prediabetes and diabetes
in dental settings. The DDS was recently used in a pilot study, which
was funded by NIHR and Diabetes
UK and conducted across 13 dental
practices with 805 participants. For
participants whose DDS scores indicated that they may have prediabetes or diabetes, the haemoglobin A1c finger prick test was administered, and the trial found that
nearly 15% of the participants who
considered themselves healthy exceeded the UK’s prediabetes or diabetes threshold score on this test.
Based on this pilot study, INDICATE-2 will work with 50 dental
practices across England and Scotland to screen more than 10,000
patients and develop a care pathway that could help dental services
detect people with undiagnosed
diabetes in the UK and refer them
for treatment. Co-lead researcher
for INDICATE-2 Dr Iain Chapple,
professor of periodontics at the
University of Birmingham’s School
of Dentistry, said: “This funding
from Haleon is very exciting, as it
will enable us to validate the two-
step model on patients routinely
attending dental practices across
the UK and test onward referral
pathways of high-risk patients to
their family doctors for diagnosis
and treatment.”
Dr Jason Wong, MBE, chief dental officer for England, said: “It is vi-
tally important that medical and
dental care pathways become
more joined up, to put patients at
the centre of all we do. INDICATE-2
is a great example of a study aimed
to try and define one such pathway.”
Adam Sisson, head of research
and development in oral health at
Haleon, concluded: “We are delighted to be collaborating with the
University of Birmingham and NIHR
to help support this important scientific research. We hope the findings will underpin a new care path-
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way aimed at proactively identifying and treating more people with
diabetes by leveraging the expertise of oral health professionals.
The study will also help to draw further attention to the links between
our oral and systemic health.”
[34] =>
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[page] => 26
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[toc_titles] => CAPP and DentAlliance announce partnership to support dental education
/ News
/ Industry
/ Conservative and necessary: How occlusion can affect a single-tooth replacement
/ Dr. Galip Gürel conducts his signature APT (Aesthetic Pre-evaluative Temporary) Veneers Course at CAPP in Dubai
/ “The future of dentistry lies in predictive, personalized, and data-driven care” Interview with Prof. Falk Schwendicke
/ The transformative power of AI in dentistry
/ “No success happens without proper awareness and education to parents.” Interview with Dr Rafi f Tayara
/ “Everyone has a role to play in tackling antimicrobial resistance”: What’s yours? Interview with Dr Wendy Thompson
/ Motivating your team
/ New study shows bacteria love some restorative materials more than others
/ News
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