DT South Asia No. 5, 2024

“Our book on AI in dentistry is regarded as a premier global resource“— Dr Rohan Jagtap / Ortho-Resto Continuum—An Interdisciplinary Approach: Case Report / Bringing Dr Jordi Manauta‘s LAYERS to India / Interview: “The term ‘regeneration’ is very misleading”

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Table of contents

The World‘s Dental Newspaper
South Asia Edition
Published in India

www.dental-tribune.com

CASE REPORT

Ortho-Resto Continuum—An Interdisciplinary Approach

LAYERS

Bringing Dr Jordi
LAYERS to India

Vol. 2, No. 5

Manauta‘s

Page 03

REGENERATION

The term
misleading

Page 04

‘regeneration’

very

Page 08

“Our book on AI in dentistry is regarded as a
premier global resource“— Dr Rohan Jagtap

Dr Rohan Jagtap— the author of the book “Artificial Intelligence in Dentistry”—
interviewed by Dr Amisha Parekh, University of Mississippi Medical Center

By Dr Amisha Parekh
Dr Jagtap is the Director of
the Dept of Oral & Maxillofacial
Radiology. He is also the Assistant Professor in the Dept of
Care Planning and Restorative
Sciences at the School of Dentistry, University of Mississippi
Medical Centre, USA.
Your career path has been
truly remarkable. What motivated you to specialise in the
field of Oral Maxillofacial Radiology?
I never envisaged myself as a
dentist, but in India, familial influence shapes career decisions.
My father greatly influenced my
path; he inspired me to pursue
the dental field, leading me to
establish my career in dentistry.
A field where I’ve flourished for
16 years, specialising in Oral and
Maxillofacial Radiology, and
writing the world’s first book on
Artificial Intelligence in Dentistry.
Similarly, specialisation wasn’t

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initially on my radar, yet my fascination with technology and the
remarkable impact of CBCT imaging on dentistry captured my
interest. The advent of 3D imaging has revolutionised our approach
to
dental
care.
Dr Aniket Jadhav, an Oral and
Maxillofacial Radiologist at the
Virginia Commonwealth University School of Dentistry, played a
pivotal role in steering me towards the field of radiology.
These factors collectively motivated me to pursue a career in
Oral and Maxillofacial Radiology.
What inspired you to delve
into the subject of Artificial Intelligence in Dentistry?
Artificial Intelligence (AI) represents a significant advancement in dentistry, with the potential to revolutionise the field
in ways previously unseen. My
enduring fascination with cutting-edge dental technologies
and connection with Dr Kaan
Orhan has led me to recognise
the importance of integrating AI
into the dental field.
I think integrating AI in dentistry promises transformative
benefits across various aspects
of patient care and practice
management. AI offers the potential to enhance precision in
diagnostics and treatment planning through advanced machine
learning algorithms, leading to
improved patient outcomes. The
significant collaboration among
experts from dentistry, com-

puter science, and engineering
fosters innovation in AI-driven
solutions tailored to the specific
needs of oral care.
Diagnostic tools powered by
AI can revolutionise the diagnosis and monitoring of dental
conditions, empowering dentists to make informed decisions
and streamline treatment plans.
Additionally, AI has the capacity
to democratise access to dental
services by overcoming geographical
barriers
through
tele-dentistry platforms, thus
improving oral health outcomes
for underserved populations
and narrowing the gap between
supply and demand for dental
services. AI can improve accuracy in diagnostics, treatment
planning, and surgical procedures, leading to superior patient outcomes.
In summary, AI in dentistry
offers transformative capabilities that promise to enhance
precision, and diagnostic capabilities, streamline workflows,
spur innovation, and improve access to care. My inclination to
new technology, background in
radiology, and interest in the
field of clinical research have
greatly inspired me to start my
work in the field of Artificial Intelligence.
You’ve authored a book on
Artificial Intelligence in Dentistry. Could you provide some
key insights into how AI is being
applied in dentistry today?
Our book on “AI in Dentistry”
is regarded as a premier global
resource, showcasing the diverse applications of AI across
various dental specialities. It
highlights AI’s role in automatically detecting and segmenting
anatomical structures in dental
radiographs, such as teeth, maxillofacial bones, and other structures like the maxillary sinus and
mandibular canal, aiding dentists in quicker and more accurate diagnosis and treatment
planning.
In dentistry, AI assists in detecting alveolar bone loss, eval-

uating periodontal disease progression, identifying periapical
lesions and predicting various
endodontic conditions. AI has
made significant advancements
in the detection and prediction
of various aspects of endodontics, including identifying periapical lesions, crown and root
fractures, root and canal morphology, working length determination and detecting second
mesio-buccal canals.
It also aids in detecting impacted teeth, cystic lesions, and
oral cancers and predicting surgical outcomes.
Prosthodontics benefits from
AI in CAD/CAM technology, implant surgery template designing, aesthetic dentistry, and
shade matching. AI helps in designing occlusal surfaces for
crowns, determining emergence
profiles in dental implantology,
and creating framework designs
for removable partial dentures.
AI models detect dental
plaque, categorise fissure sealants and assist in the identification of deciduous and permanent
teeth,
supernumerary
teeth, and assessing ectopic
eruption. Machine learning algorithms predict early childhood
caries.
Orthodontics utilises AI for
landmark detection, cephalometric analyses, diagnosis, treatment planning, growth assessment and airway assessment. AIdriven software aids in developing personalised treatment
plans, assessing individual risk
factors and facilitating remote
consultations via tele-dentistry
platforms.
Administratively, AI optimises dental practice management, including scheduling algorithms and virtual assistants
handling patient inquiries. Overall, AI enhances diagnostics,
treatment planning, patient care
and practice management in
dentistry, with the potential for
further innovation.
or

Are there any novel AI tools
technologies that have

proved to be promising in enhancing diagnostics and treatment planning?
In the realm of dental AI, several companies like Velmeni, Diagnocat, CranioCatch, Pearl,
Overjet and VideaHealth are
leading the charge with innovative applications. Deep learning
algorithms, especially convolutional neural networks (CNNs),
excel in analysing various dental
images, including intraoral photographs, yielding precise diagnostics by identifying and classifying dental conditions and abnormalities.
Augmented Reality (AR) systems offer real-time guidance
during procedures by overlaying
virtual information onto real-world views. Natural Language Processing (NLP) techniques extract valuable insights
from electronic health records
(EHRs) and clinical notes, aiding
in diagnoses and treatment
planning. Virtual Reality (VR)
training simulators revolutionise
dental education by providing
immersive environments for
practising surgical procedures in
a safe setting. These simulators
offer feedback and performance
metrics, refining dentists’ skills
and clinical proficiency.
In your opinion, what are
the main challenges associated
with integrating AI into dental
practice?
Implementing AI in dentistry
comes with several challenges:
• Data Quality and Privacy of
Patient
Data:
Securing
high-quality, diverse datasets
for training AI models is crucial, but privacy concerns,
data silos and variability in
imaging techniques pose obstacles in accessing suitable
dental datasets.
• Liability: Attributing liability
for AI-generated therapeutic
recommendations is complex
and the reproducibility and
robustness of AI research results are often insufficient.
• Interoperability and Integration: The lack of interopera-

[2] =>

INTERVIEW

•

Dental Tribune South Asia Edition | 05/2024

bility among various digital
systems used in dental practices hampers the adoption
and effectiveness of AI solutions.
Regulatory and Ethical Considerations: Regulatory and
ethical concerns regarding
patient privacy, informed
consent, liability and professional responsibility need to
be addressed when deploying AI in dentistry.
Clinical Validation and Evidence-Based
Practice:
Demonstrating the effectiveness and clinical utility of AI
algorithms requires rigorous
validation in real-world clinical settings, necessitating
collaboration among researchers, clinicians and industry partners.
Education and Training: Dental professionals need education and training to effectively utilise AI in practice. Integrating AI into dental
school curricula and offering
hands-on training opportunities are essential.
Cost and Resource Constraints: Developing AI algorithms incurs upfront costs
for development, hardware,
software, and staffing. Ongoing expenses for maintenance, upgrades and data
management can strain resources.

Given your extensive knowledge and experience, what advice would you offer to dental
professionals interested in integrating AI into their practices
but uncertain about where to
start?
I would say, start by reading
my book, Artificial Intelligence in
Dentistry! It is the most valuable
resource available worldwide,
comprising 19 chapters and
spanning 365 pages, with extensive contributions from clinicians, specialists, engineers and
scientists holding a combined
500 years of experience from
around the globe. Each chapter
includes
thorough,
evidence-based data, bridging the
gap between theoretical knowledge and practical implementation. The book critically examines the benefits, drawbacks,
and limitations of AI in dental
health, offering a well-rounded
perspective. Additionally, it
guides readers through the
medico-legal aspects of AI, ensuring responsible navigation of
this groundbreaking field. It provides a forward-looking exploration of AI’s potential and future
applications in dentistry, paving
the way for a new era in oral
healthcare. This unique resource
empowers readers to stay at the
forefront of innovation and embrace the AI revolution in dentistry, preparing them well for
the future of dental practice.
I would also say that dental
practitioners need to educate
themselves about AI. They need
to keep up-to-date with the latest developments and advancements in AI technologies rele-

vant to dentistry. I guest lecture
globally to educate dentists and
specialists on this field. Practitioners can also follow reputable
journals, conferences and industry publications to stay informed
about new research findings and
attend workshops and seminars
to deepen their understanding
of AI tools and applications.
• Continuous Education: Dental practitioners should stay
updated on AI developments
relevant to dentistry through
online courses, webinars, and
guest lectures, like those I
provide worldwide.
• Information Sources: Following reputable journals, conferences and industry publications keeps practitioners
informed about the latest research in AI and its applications in dentistry.
• Hands-on Learning: Workshops, seminars, and product
demonstrations from AI companies provide valuable opportunities for practitioners
to gain a deeper understanding of AI tools and applications.
• Identifying Opportunities:
Reflecting on specific practice
challenges where AI could
offer solutions helps practitioners recognise the potential benefits of AI integration.
• Ethical Considerations: Adhering to ethical principles
and patient privacy standards
is paramount when incorporating AI into dental practices. Involving patients in AI
discussions ensures transparency and patient-centred
care.
• Starting Small: Beginning
with small-scale AI implementations allows practitioners to gradually familiarise themselves with AI technologies and their impact on
patient care.
In your opinion, how can
dental practitioners and institutions stay updated on the latest
advancements in AI in dentistry? Are there any reliable resources or organisations that
you recommend?
Dental practitioners can read
the white paper published by the
American Dental Association titled Dentistry Overview of Artificial and Augmented Intelligence
Uses in Dentistry. I had the opportunity to lead three major
sections in this paper: Radiology,
Pathology and Endodontics.
( h t t p s : // w w w. a d a . o r g /-/
media/project/ada-organizat i o n /a d a /a d a - o r g / f i l e s /r e sources/practice/dental-standards/ada_1106_2022.pdf)
Joining dental professional
associations and societies like
the ADA, IADR and AAOMR provides access to resources, publications, conferences, and workshops focused on AI in dentistry.
Subscribing to peer-reviewed
scientific journals that publish
research on AI in dentistry helps
practitioners stay current with
the latest advancements and

clinical applications. Taking advantage of online courses, webinars and continuing education
programmes tailored to AI in
dentistry, offered by educational
institutions, professional organisations and industry partners,
enhances practitioners’ knowledge and skills. Attending conferences, symposia and workshops dedicated to dental technology and innovation provides
opportunities to learn about the
latest advancements in AI, network with experts and explore
collaboration opportunities. Engaging with research institutions
and academic centres specialising in dental informatics and AIdriven healthcare technologies
provides insights into ongoing
projects and emerging trends in
the field.
Are there any potential ethical considerations that dentists
and researchers should keep in
mind when adopting AI in patient care?
• Patient Privacy and Confidentiality: Ensuring strict adherence to data privacy and
security measures throughout the AI process, from data
collection to analysis, is paramount.
• Informed
Consent
and
Transparency:
Patients
should be fully informed
about how their data will be
used in AI applications and
should provide explicit consent.
• Bias and Fairness: Monitoring and mitigating biases in
AI algorithms to prevent unfair treatment of certain patient groups is essential.
• Clinical Interpretability and
Accountability: Developing
transparent and interpretable
AI models ensures that clinicians understand and can
trust the recommendations
made by these systems.
• Professional Judgement and
Autonomy: Dentists must retain control over clinical decisions, using AI as a support
tool rather than a replacement for professional judgement.
• Continued Monitoring and
Evaluation: Regular monitoring, evaluation and improvement of AI systems are necessary to maintain their safety,
effectiveness and fairness
over time.
As an educator, how do you
see AI impacting dental education and enhancing the learning
experience for students? Are
there any steps that institutions
should take to prepare for this
transformation?
AI has the potential to profoundly impact dental education
by enhancing the learning experience for students in various
ways. AI-driven adaptive learning platforms can analyse students’ performance, preferences
and learning styles to tailor educational content and experiences to individual needs.
AI-powered simulations and vir-

tual reality (VR) environments
offer immersive and interactive
learning experiences for dental
students, allowing them to practise clinical procedures, treatment planning and patient interactions in a safe and controlled
setting. These technologies provide hands-on training opportunities that complement traditional classroom instruction and
clinical rotations, helping students develop clinical proficiency and confidence. AI algorithms can assist students in diagnostic interpretation and
treatment planning by analysing
patient data, clinical images and
case histories to generate differential diagnoses and evidence-based recommendations.
To prepare for the integration of AI into dental education,
institutions should consider taking the following steps:
• Invest in faculty development
and training programmes to
familiarise educators with AI
technologies and their applications in dental education.
• Integrate AI-related topics,
such as machine learning,
data analytics and digital
health, into the dental curriculum to ensure that students
are equipped with the knowledge and skills needed to
leverage AI in clinical practice.
• Collaborate with AI companies and research institutions
to pilot AI-driven educational
initiatives and evaluate their
effectiveness.
• Establish guidelines and best
practices for the ethical use of
AI in dental education, emphasising principles of transparency, fairness and accountability.
• Foster a culture of innovation
and experimentation within
the institution, encouraging
faculty and students to explore creative uses of AI in
teaching and learning.
Have you heard of any misconceptions or myths surrounding AI in dentistry, and
how would you debunk them?
Addressing misconceptions
surrounding AI in dentistry is
crucial for fostering informed
understanding so that professionals can make sound decisions about its integration, ultimately benefiting patient care
and outcomes. Here are some
common myths and their debunking:
• “AI will replace dentists”: AI
serves as a decision support
tool, augmenting dentists’ expertise rather than replacing
it. Dentists retain the final authority over diagnosis and
treatment decisions.
• “AI is only for large dental institutions or academic centres”: AI technologies are increasingly accessible and applicable to practices of all
sizes, offering cloud-based
solutions and software-as-aservice options.
• “AI algorithms are always accurate”: AI algorithms can be
prone to errors and limita-

tions, including biases in training data. Dental professionals
must critically evaluate AI results and exercise clinical
judgement.
• “AI will lead to job loss among
dental professionals”: AI integration is unlikely to cause
widespread job loss; instead,
it can create new opportunities, streamline workflows and
enhance efficiency within
dental practices.
• “AI in dentistry is not secure
and poses risks to patient
data”: Regulatory frameworks
like HIPAA and GDPR, along
with encryption and access
controls, help mitigate security risks associated with AI in
dentistry.
Lastly, considering the rapid
advancements in technology
and AI, what do you envision as
the future of dentistry and oral
and maxillofacial radiology?
The future of dentistry and
oral and maxillofacial radiology
(OMFR) is set for remarkable
changes, thanks to advancements in technology and artificial intelligence (AI). Innovations
in imaging techniques, such as
CBCT, MDCT and MRI, are enhancing the ability of OMFR professionals to thoroughly assess
dental and craniofacial structures. New methods like 3D
printing and virtual reality are
revolutionising patient education, treatment simulations, and
surgical planning.
Personalised treatment plans
based on patient data are becoming more common, allowing
for customised strategies and
better monitoring of disease
progression and treatment responses. Moving forward, collaboration across disciplines and
ongoing education will be crucial for effectively using AI technologies. Dental education programmes are beginning to include AI topics and continuing
education is promoting innovation and best practices in AIdriven imaging.
The AI future also leads to robotic dentistry. An autonomous
surgical robot could carry out
dental treatment tasks more accurately and effectively than a
human dentist, and in the near
future, clinically viable dental robots may be available.
By embracing these advancements and staying at the
cutting edge of technology, dentists and OMFR practitioners can
improve patient care and drive
the evolution of their field.

[3] =>

NEWS

Dental Tribune South Asia Edition | 05/2024

Ortho-Resto Continuum—An
Interdisciplinary Approach: Case Report
health was good, with probing
depths not exceeding 2 mm and
periapical radiographs showed
adequate bone levels. The temporomandibular joints were normal, with no history of dysfunction. A fleshy frenum was present in the midline, and the maxillary incisors were slender in
shape, with inadequate heightto-width ratios.

By Dr Priya Titus Singh
This case report aims to
demonstrate the decision-making and planning involved in
treating a case of midline diastema and how an interdisciplinary approach contributes significantly to achieving optimal results for the patient.
Aesthetic Dentistry is no longer a luxury. In today’s age of social media, everyone desires a
beautiful smile, as it influences
confidence and thus impacts
one’s prospects for success in
any field. From a dental perspective, achieving this requires a
thorough assessment of dynamic facial soft tissues, skeletal
structure, teeth, and their relationship with the lips and gingiva. Numerous parameters
contribute to an aesthetic smile,
including the facial and dental
midline, gingival zenith, tooth
size, golden proportions such as
tooth-to-tooth proportion and
tooth height-to-width ratio,
tooth position, tooth shape, incisal embrasures, papilla height,
contact areas, axial inclinations
and the shade of the maxillary
teeth. The treatment plan we
propose also depends on patient factors like time, budget
and the patient’s motivation and
expectations.
A diastema is a space between adjacent teeth with no
contact between them. A midline diastema may detract from
the aesthetics of a smile, as the
dark space creates a visual gap.
Possible causes of a midline diastema may include a wide dental arch, disproportionate tooth
size or shape, a congenitally
missing tooth, previously extracted mesiodens, or an active
or hypertrophic gingival frenum.
It is essential to differentiate a diastema from pathological tooth
migration due to poor periodontal health. Factors like parafunctional habits, occlusal trauma,
mouth breathing, tongue thrusting, and thumb sucking also
need to be considered.
A 28-year-old male patient
presented at the dental practice
with concerns about gaps between his upper and lower anterior teeth.

Analysis of the diagnostic
models showed that the spaces
in the anterior teeth exceeded
the amount of orthodontic retraction required in the upper
arch. For the lower arch, the
spaces could be managed solely
with orthodontics. Prior to orthodontic treatment, the patient
would need a habit-breaking appliance to prevent recurrence. Finally, the shapes of the teeth
would need to be modified restoratively with lithium disilicate
veneers or direct composites.

The case report demonstrates an interdisciplinary approach with orthodontics and restorative dentistry to achieve optimum results
in the management of midline diastema. (Image: Dr Priya Titus Singh)

After thoroughly considering
the patient’s aesthetic concerns,
time constraints and budget, we
developed the following treatment plan:

Fig. 1: Pre op in occlusion.

Fig. 4: Pre op in Maxillary Arch.

Fig. 2: Pre op in occlusion.

Fig. 5: Mandibular Arch.

Fig. 3: Pre op in occlusion.

Fig. 6: Post-orthodontic treatment completion.

Clinical Examination:
The midline diastema measurThe midline diastema measured 2 mm, with smaller diastemata present between central
and lateral incisors and canines.
The patient exhibited increased
proclination in both the maxillary and mandibular arches and
had a habit of tongue thrusting
during swallowing. Periodontal

[4] =>

NEWS

Dental Tribune South Asia Edition | 05/2024

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Fig. 7: Maxillary incisors brackets debonded.

Fig. 8: Maxillary incisors brackets debonded.

Fig. 13: Composite button.

Fig. 14: Palatal Shell layering using putty index.

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Fig. 9: Maxillary incisors brackets debonded.

Fig. 15: Matricing and Wedging.

Fig. 10: Putty index of Wax-up.

Fig. 16: Polymerisation of Oxygen inhibited layer under Glycerine.

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DENTAL TRIBUNE SOUTH ASIA
EDITION

PUBLISHER
Ruumi J. DARUWALLA
CHIEF EDITOR
Dr. Meera VERMA

CLINICAL EDITOR
Dr. Dilip DESHPANDE

RESEARCH EDITOR
Dr. Shobha DESHPANDE
Fig. 11: Shade selection.

Fig. 17: Gross finishing done.

ASSOCIATE EDITOR
Dr. GN ANANDAKRISHNA
EXECUTIVE EDITOR
Dr. Rajeev CHITGUPPI

ASSISTANT EXECUTIVE EDITOR
Dr. Riddhi D. TELISARA
DESIGNER
Anil LAHANE

PRINTER
Mehernosh MISTRY
Burzin MISTRY
Ampersand, Mumbai, India

Fig. 12: Shade selection.

Fig. 18: Incisal edge build-up.

[5] =>

NEWS

Dental Tribune South Asia Edition | 05/2024

About the author

Fig. 19: Final Post-op.

Fig. 22: Pre op.

Dr Priya Titus Singh

Dr Priya Titus Singh graduated from Terna Dental College
(MUHS), Navi Mumbai. She has
been a recipient of the prestigious Tata scholarships during
her BDS. She runs a successful
private practice at Kharghar,
Navi Mumbai.

Fig. 20: Final Post-op.

Fig. 23: Pre op.

Fig. 21: Final Post-op.

1. Habit-breaking appliance
2. Orthodontics
3. Composite build-ups on
teeth 12, 11, 21 and 22 (a decision regarding 13 and 23 to
be made after orthodontics is
completed)
4. Clear retainers
Phase 1
A habit-breaking appliance
was provided for 8 months. By
the end of this period, the patient no longer exhibited tongue
thrusting during swallowing.
Phase 2
Orthodontic brackets were
applied to correct the proclination and close the spaces. The
wire sequence used was 0.016
NiTi wire, 0.016x 0.022 NiTi wire,
0.016x 0.022 SS wire and E-chain
for space closure. This phase
took 13 months. The spaces in
the mandibular anterior teeth
were completely closed with orthodontics. In the maxillary
teeth, proclination was corrected
and the spaces were reduced
and equalised between the four
incisors to be restored with composite resin in the next treatment phase.
Phase 3
After the orthodontic treatment was completed, the restorative phase commenced. The or-

thodontist removed the brackets
from the maxillary incisors and
impressions were taken and sent
to the laboratory for a wax-up. A
putty index of the palatal surface
of the wax-up for the maxillary
incisors was created to assist in
achieving perfect symmetry.
During the first appointment of
this phase, the primary objective
was to establish proximal contacts. Shade selection was performed using Vita Classic shade
tabs and the composite button
technique. Given the small
spaces, a simple layering approach was chosen: an A2 medium translucency shade for the
cervical area and an A1 medium
translucency shade for the incisal area were selected. The
teeth were isolated with a split
dam, roughened using a coarse
disc to remove aprismatic
enamel, etched with 37% phosphoric acid for 20 seconds and
bonded using a fifth-generation
bonding agent.
Palatal shells were made
using the putty index. Metal sectional matrices were positioned
vertically with a wedge to establish the contact area. The final
layer of composite resin was applied and cured under glycerine
to eliminate the oxygen-inhibited layer. Gross finishing and an
occlusion check were performed
and the patient was then referred back to the orthodontist
for debonding of the lower anterior brackets. Once the lower

Fig. 24: Final smile.

brackets were removed, there
was room to increase the length
of the upper incisors to achieve
the ideal golden proportions
(where the widths of the central
incisors should be approximately
80% of their lengths). An incisal
edge build-up was completed,
and line angles were marked on
the composite to create perfectly shaped central incisors.
Finishing was carried out with a
focus on interference-free anterior guidance. Finally, the restorations were polished, and the
patient was once again referred
to the orthodontist for debonding of the remaining brackets
and the next phase of treatment.
Phase 4
The patient is continuing to
use clear retainers following the
completion of the composite
restorations. Given the patient’s
previous tongue-thrusting habit,
the retention phase is expected
to be extended. Currently, the
restorations and occlusion remain stable. The patient has also
been advised to undergo a
frenectomy to address the slight
black triangle in the midline, although this does not concern
him. He is very pleased with the
outcome after nearly four years
of treatment. The patient has
been instructed to avoid shearing with the incisor teeth and to
visit the dental practice every six
months for polishing of the composites.

Conclusion:
Golden proportions are key
determinants of an aesthetic smile.
This case report presents an interdisciplinary approach to addressing aesthetic concerns such as diastemata caused by a combination
of tongue thrusting and discrepancies between arch size and
tooth shape. A combination of orthodontic and restorative treatment, underpinned by careful diagnosis and planning, was essential for achieving improved functional and aesthetic outcomes.
Some of the photographs have
been tilt-corrected and cropped.
No other digital editing has been
applied to any of the photographs.

Acknowledgement:
I would like to thank Dr Indranil Majumdar and Dr Komal
Majumdar for entrusting me
with this case. I would also like to
thank Dr Aniket Gandhi for the
provision of the habit-breaking
appliance and orthodontic treatment.

Her areas of interest include
Aesthetic Dentistry, Implant
Dentistry, Restorative Dentistry
and Dental Photography. She is
an Accredited member of IAACD
(Indian Academy of Aesthetic
and Cosmetic Dentistry). She has
multiple articles on Anterior Direct and Indirect restorations
published in Indian and international publications. She is also a
life member of ISOI (Indian society of Oral Implantology)
She regularly attends dental
conferences in India and overseas so as to be updated with ever-changing concepts and technology in Dentistry. She also lectures on Anterior and Posterior
direct and indirect restorations,
Rubber Dam Isolation and Dental Photography.
Though she is a thorough Clinician, she is just as passionate
about Indian classical dance. She
is a classically trained dancer
with a Distinction in her Final BA
(Bachelor of Fine Arts - Bharata
Natyam) from the Akhil Bharatiya Gandharva Mahavidyalaya.

[6] =>

NEWS

Dental Tribune South Asia Edition | 05/2024

Bringing Dr Jordi Manauta‘s LAYERS to
India

“The Complete LAYERS Composite Course” by Dr Jordi Manauta was a resounding success. (Image: Buzzdent)

By Dr Sheetal Tripathi
Mumbai, India: Organized by
BuzzDent, “The Complete LAYERS Composite Course” by
Dr Jordi Manauta took place in
Mumbai from August 2 to 4,
2024, in Hotel Sea Princess Juhu.
BuzzDent, a leading platform
for dental education and e-commerce, held its inaugural conference, titled “The Complete LAYERS Composite Course,” at Hotel
Sea Princess, Juhu, Mumbai. The
three-day event commenced on
2 August 2024 with an engaging
lecture and a 90-minute demonstration designed to deepen understanding of key restorative
concepts. The subsequent two
days were dedicated to intensive
hands-on exercises under the
guidance of Dr Jordi Manauta,
ensuring that each participant
acquired ample practical experience.
Dr Anand Mohatta and
Dr Abhishek Mahajan, the founding partners of BuzzDent, are
also charter members of the
World Dental Association (WDA),
a robust community of over
100,000 active dentists globally.
Though BuzzDent and WDA are
distinct entities, both share a
common mission: advancing
dental education and making
cutting-edge equipment easily

accessible to practitioners in
India.

According to Dr Mohatta’s
vision, BuzzDent was always intended to be more than an

e-commerce site. It serves as a
platform for delivering the latest
advancements in dentistry—

covering concepts, technology,
equipment, and materials—in
the simplest way possible.

Dr Anand Mohatta addressing the crowd. (All images: BuzzDent)

Lecture on the latest composite restorative techniques by Dr Jordi Manauta.

Dr Abhishek Mahajan addressing the crowd.

Dr Prashant Hatkar, Dr Suhas Lele, Mr Farhat Hasan
(Managing Director, Coltene, India).

[7] =>

NEWS

Dental Tribune South Asia Edition | 05/2024

Through BuzzDent, Dr Mohatta
and Dr Mahajan aim to introduce
global dental practices to India,
focusing on techniques that
make procedures more comfortable for patients and yield
long-lasting results for clinicians.
The course showcased the
expertise of Dr Jordi Manauta, a
globally recognised leader in restorative dentistry and a prominent member of Styleitaliano.
Known for his work on composite restorations and as the author of Layers and Layers 2,
Dr Manauta presented his techniques in a feasible, teachable,
and repeatable manner, aligned
with the principles of Styleitaliano.
The event adhered strictly to
schedule, starting at 9 a.m. each
day, with ample time allocated
for each topic, followed by indepth Q&A sessions. The course
opened on 2 August with a captivating lecture that attracted
participants from across the
country, including several distinguished dentists such as
Dr Suhas Lele, Dr Prashant
Hatkar, Dr Vishal Gupta, and
Dr Irfan Kachwala—well-known
figures in Indian dentistry. Following the lecture, a 90-minute
live demonstration ensured that
participants understood the theoretical framework and its clinical application.
The hands-on sessions over
the next two days provided participants with fully equipped
workstations and access to
high-quality restorative tools.
Admetec loupes were provided
to simulate real clinical environments, enabling participants to
work with precision. Other resources supporting these highend restorative exercises were
provided by Polydentia India,
India Vikings, and the principal
supporting partner, Coltene
India. Dr Manauta offered personalised guidance, moving
from table to table and assisting
each participant individually on
their restorations. His mentorship helped attendees refine
their techniques, overcome challenges and build confidence in
implementing these refined yet
straightforward procedures in
their practices.
The course concluded with
participants receiving certificates
from Dr Manauta himself, along
with expressions of gratitude for
the event’s supporting partners.
BuzzDent extended heartfelt
thanks to Coltene, their primary
supporting
partner,
whose
contributions were essential to
the high quality of the hands-on
sessions.
BuzzDent
also
acknowledged their academic
partners, the Academy of
Cosmetic
Dentistry
India
(ACDI)—a sister organisation of
the
prestigious
American
Academy of Cosmetic Dentistry

The 3-day hands-on sessions.

Personal feedbacks on restorative techniques by Dr Jordi Manauta to the attendees.

The 3-day hands-on sessions.

Dr Harpreet Singh (Dean DAV Dental College, HOD Endodontics)
receiving participation certification.

The 3-day extensive hands-on workshop.

Expression of gratitude to Coltene.

Detailed Q&A sessions.

Dr Vinutha Manjunath, Dr Riddhi Mukati, Dr Abhishek Mahajan, Dr Anand Mohatta,
Dr Jordi Manauta, Dr Adit Mehta, Dr Jenish Parmar, Dr Ashray Nimje,
Dr Akshata Gohil, Dr Archana Borse, Dr Sheetal Tripathi, Dr Payal Batavia.
(Left to Right).

(AACD)—and
Dr
Mohan
Bhuvaneswaran,
for
their
unwavering support, which
played a crucial role in amplifying
the event’s reach and impact.
Special mention was also made
of the team: Dr Anand Mohatta,
Dr
Abhishek
Mahajan,

Dr Adit Mehta, Dr Archana Borse,
Dr Jenish Parmar, Dr Riddhi
Mukati, and Dr Sheetal Tripathi,
whose
relentless
efforts,
meticulous
planning,
and
commitment transformed this
event into a resounding success.

“The Complete LAYERS Composite Course” not only marks a
milestone in restorative dentistry education in India but also
reaffirms BuzzDent’s commitment to bringing world-class expertise to the Indian dental community. With the current leader-

ship at the helm, BuzzDent will
continue to organise transformative events that bridge the
gap between global innovations
and Indian dentistry.

[8] =>

INTERVIEW

Dental Tribune South Asia Edition | 05/2024

“The term ‘regeneration’ is very misleading”
uals after lectures is rewarding, as
I can gather feedback and answer
questions. I learn a great deal
through these discussions, particularly about the local context of
dental practices. Understanding
an audience’s background and experience level is essential, as it varies widely. Although I cover similar
material for all levels, I tailor the
presentation depth and adjust for
local treatment approaches, materials, and instruments.

By Dr Shikha Sharma
In this candid interview, Prof.
Paul Abbott, a specialist Endodontist, currently the Winthrop Professor of Clinical Dentistry at The
University of Western Australia,
shares his wisdom gathered from
his decades of experience in dental traumatology and endodontics.
Prof. Abbott, with your extensive experience in both private
practice and academia, what inspired you to pursue a career in
dentistry, particularly in the specialised field of Endodontics?
My interest in dentistry was
sparked in high school. For many
years, I had aspired to be a medical
doctor, but then I discovered dentistry—partly through discussions
with my own dentist at the time
and partly through conversations
with dental students I knew. I liked
the idea of performing practical,
hands-on clinical procedures, and
dentistry certainly offered that,
whereas medicine seemed more
focused on consulting and prescribing unless one became a surgeon. In those days, dentistry was
a relatively small profession in
terms of the number of dentists,
yet it enjoyed a high profile of
honesty and professionalism
within the community. Hence, I
changed my mind and applied for
dental school—and the rest is history! During dental school, I particularly enjoyed the theory of
Endodontics and the clinical challenges it presented. There were
very few Endodontists in Australia
at that time, so after four years of
general practice, I was fortunate to
be accepted into the Endodontic
training programme at the University of Adelaide under the guidance of Prof. Geoffrey Heithersay.
This was a turning point in my life.
Prof. Heithersay was an incredible
role model, mentor, and inspiration. I was also privileged to have
Prof. Rory Hume as my research
supervisor. Together, they inspired
the research aspects of my subsequent career.
Your tenure as Editor-in-Chief
of Dental Traumatology spanned
nearly a decade. Could you share
some insights into the evolving
landscape of dental traumatology during this period and any
significant advancements that
have shaped the field?
Dental traumatology is a
unique area within dentistry, as it
involves all the specialist fields. As
Editor-in-Chief, I was exposed to
research across all these specialties and had opportunities to work
with experts in each field. Dental
trauma remains an area many dentists find challenging, a fact highlighted by research in the past decade. These studies underscore
the considerable need for ongoing
education of dentists and the general public about how to respond
to traumatic dental injuries (TDIs).
Research also continues in areas

Prof. Paul Abbott talks shares his life journey as well as his expertise in this interview
with Dr Shikha Sharma. (Image:https://alumni.uwa.edu.au)

such as tooth resorption, splinting,
and emergency management of
TDIs. Conservation of dental pulp,
while not a new focus, has gained
renewed interest, with more practitioners attempting partial pulpotomies when feasible to preserve
pulp health.
With over 232 articles in refereed journals, 25 textbook chapters, and 47 newsletter articles,
your contributions to dental literature are vast. How do you balance your academic pursuits with
clinical practice, and what advice
would you offer to aspiring researchers in the field?
I believe it’s essential to maintain a balance between clinical
practice, research, teaching and
service to the profession to be an
effective academic. Clinical practice is crucial for honing skills and
ensuring that research and teaching remain relevant to real-world
dentistry. In the earlier part of my
career, I primarily practised privately with part-time university
work, then later transitioned to a
full-time academic role. In Australia, full-time academic dentists can
undertake the equivalent of one
day per week of clinical practice.
Additionally, surrounding oneself
with students and colleagues and
collaborating with experts globally helps sustain innovation, relevance, and quality in academic
pursuits. This approach ultimately
aims to improve patient care and
outcomes.
Your research interests encompass a range of areas within
dentistry, including tooth resorption, pain control, and root canal
disinfection. Could you highlight
some recent developments in
these areas that hold promise for
improving patient outcomes?
Many of these areas have seen
gradual, steady progress rather
than “breakthroughs,” as is typical
of dental research. In tooth resorption, there remains uncertainty around managing different
resorption types. We have shown
that corticosteroid/antibiotic intracanal medicaments can effec-

tively prevent or arrest external inflammatory resorption if initiated
early after injuries that damage
the periodontal ligament (PDL).
Unfortunately, preventing external replacement resorption remains a challenge. Pain management has advanced through studies exploring pre-operative anti-inflammatory agents, local
anaesthetic solutions and injection techniques, resulting in more
effective strategies for intra-operative pain. Disinfection of the root
canal system continues to rely on
sodium hypochlorite and EDTA,
followed by medicaments like calcium hydroxide.
As former Dean and Head of
the School of Dentistry at the
University of Western Australia,
and Director of the Oral Health
Centre of Western Australia, what
strategies did you implement to
foster excellence in education
and research within the dental
community?
I was fortunate to become
Dean just as we had moved into
the new Oral Health Centre of
Western Australia—a state-ofthe-art facility with modern equipment and a new model of care,
supported by government funding to subsidise treatment for
low-income patients. We had the
opportunity to establish policies,
protocols, and workflows and to
develop a new undergraduate curriculum tailored to the new facility,
refining it over my seven years as
Dean. We also expanded our postgraduate programmes, which
boosted our research output and
attracted more Masters and PhD
students. I am proud of what we
achieved, thanks to the dedication
of our staff and students.
Having delivered over 1,000
lectures and courses in 50 countries, what do you find most rewarding about sharing your
knowledge on a global scale, and
how do you adapt your teaching
approach to diverse audiences?
I love teaching and meeting
people, especially students and
colleagues. Engaging with individ-

Given the rapid advancements in dental technology and
techniques, how do you stay
abreast of the latest developments, and how do you incorporate innovation into your clinical
practice and research?
While dentistry has seen numerous advancements in recent
decades, it’s crucial to remember
that the fundamentals remain the
same. The aim of root canal treatment is still to disinfect the root
canal system. Outcomes of endodontic treatment haven’t significantly changed since the 1970s
and 1980s, indicating the efficacy
of past methods. Newer techniques tend to make treatment
easier and quicker rather than improving results. To stay current, I
attend conferences, read journals,
and discuss developments with
colleagues and manufacturers. I
approach new tools cautiously
and critically, using only those that
offer genuine benefits to patients
and are safe and evidence-based.
In your experience, what are
some of the most challenging aspects of diagnosing and managing pulp and peri-radicular conditions, and how do you approach these challenges to ensure optimal patient care?
Pain diagnosis can be challenging, although pulpitis and apical periodontitis are relatively
straightforward if all necessary information is gathered. Unfortunately, many dentists don’t use
pulp sensibility tests or take adequate radiographs. Persistent apical periodontitis after root canal
treatment presents another challenge, as deciding whether to retreat can be complex. Endodontic
retreatment is a major focus of my
clinical work and research, and although it generally yields good results, success depends on understanding why the initial treatment
failed and addressing those issues
effectively.
As an Officer of the Order of
Australia, you’ve been recognised
for your distinguished service to
clinical dentistry, higher education, and professional organisations. What motivates you to
continue advancing dentistry
after such a prestigious honour?
Receiving the Officer of the
Order of Australia award was a career highlight and an unexpected
honour, especially as it came from
the community. It motivated me to
continue contributing to the pro-

fession. The award was also recognition of those who supported me,
especially my family, students, and
colleagues. They inspired me before and after the award, and it’s
been fulfilling to give back.
Based on current evidence
and advancements in endodontic
practice, are there any traditional
methods of root canal treatment
that you believe should be discontinued?
No, I believe that traditional
methods should not be discontinued. Modern techniques have not
shown significantly improved outcomes; traditional methods still
yield excellent results. Furthermore, it’s essential for students to
learn traditional techniques, as
they build hand skills, and are essential for cases where modern instruments aren’t applicable.
Looking ahead, what do you
envision as the future of endodontics, and what areas will
likely be the focus of research
and clinical innovation?
While it’s difficult to predict, I
foresee ongoing development of
instruments driven by manufacturers. I hope that research on disinfection agents, dental trauma,
and tooth resorption continues.
The terms “pulp regeneration” and
“revascularisation” remain misleading, as true pulp regeneration
has not been shown to occur in
human or animal teeth despite decades of research. Current regenerative techniques are better
termed “repair,” and much more
research is needed to ensure predictable outcomes.
What are your top three book
recommendations in endodontics?
My top recommendation is
Andreasen, Andreasen, and Andersson’s Textbook and Color
Atlas of Traumatic Injuries to the
Teeth—the “trauma bible” every
dentist should have. For Endodontics, I recommend Ingle’s Endodontics and Pathways of the Pulp,
along with Endodontic Advances
and Evidence-Based Clinical Guidelines by Ahmed and Dummer.
Lastly, if you could sum up
your philosophy on life, what
would it be?
I believe in doing what you
enjoy and enjoying what you do.
Family comes first, then friends,
then work. I also think what you
get out of life depends on what
you put in. Whether through charitable work, pro bono treatment,
or community support, we can always find ways to give back. We
are privileged in our profession,
and we have the ability to make a
positive difference. Once you find
a way you enjoy, go for it!

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[cover] => DT South Asia No. 5, 2024

[toc] => Array ( [0] => Array ( [title] => “Our book on AI in dentistry is regarded as a premier global resource“— Dr Rohan Jagtap [page] => 1 ) [1] => Array ( [title] => Ortho-Resto Continuum—An Interdisciplinary Approach: Case Report [page] => 3 ) [2] => Array ( [title] => Bringing Dr Jordi Manauta‘s LAYERS to India [page] => 6 ) [3] => Array ( [title] => Interview: “The term ‘regeneration’ is very misleading” [page] => 8 ) ) [toc_html] =>

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