The 10th edition of the International Dental Exhibition and Meeting (IDEM) opened today. Asia Pacific's cornerstone event in dentistry takes place from 13-15 April 2018 at Suntec Singapore Convention and Exhibition Centre
This year's theme of Striving for Clinical Excellence in Dentistry. The conference began with Dr Angelo Mariotti, who spoke about how implants can play an important role in a patient's life
This was followed by a session by Dr Christopher Ho, who shared concepts of additive dentistry and went into detail on how to select the techniques and materials of choice for various clinical scenarios, as well as how to use provisional restorations to assess aesthetics and occlusion.
The networking sessions at the IDEM Cafe as well as the exhibition floors were equally packed with delegates who were eager to catch-up with their peers, learn about new innovations as well make new connection
The use of digital technologies is a growing trend in most industries, and dentistry is no exception. More than 90 percent of dental clinics are now working with digital X-ray systems, and it is only a matter of time before all impressions are taken digitally using scanners, believes Dr Andreas Kurbad, who has lectured and taught courses on computer-assisted design (CAD) and computer-aided manufacturing (CAM) in dentistry for more than 20 years.
“It’s faster, simpler and more accurate. With the use of modern design software and effective milling units, digital impressions can be directly processed, and the final restorations produced in one treatment session, saving time and money for patients,” said Dr Kurbad, who has also authored a German textbook on the subject, CAD/CAM und Vollkeramik – Ästhetische Restaurationen in der Praxis (CAD/CAM and All-Ceramics – Aesthetic Restorations in Practice).
He noted that all currently available intraoral 3D cameras are optical-based. “This means that you can only scan what you can see, so if there is blood on the preparation margin, it will not be visible. This is obviously a disadvantage now, but, in the future, the use of ultrasonic scanners should be able to solve this problem,” he said.
He predicted that the dentistry’s digitisation will also take another leap forward when data from various devices are pooled for the patients’ benefit. “Already, in the SICAT Function system, the digital recording of jaw movements can be connected with data from 3D X-rays to find and restore the optimal jaw relationship, and the data can also be used in a digital CAD/CAM system for the production of restorations. This is especially interesting for the creation of a new occlusal vertical dimension,” he explained.
He concluded: “More and more materials will be optimised for in-office, one-session treatments. Many of them are already strong enough and have very short processing times and perfect aesthetics. Modern cementation techniques will complete the digital system. There are so many benefits that no one will want to return to the old methods.”
Dr. Kurbad will be speaking in depth about the developments of digital technology at the IDEM 2018 Conference in Singapore in April.
Root canal treatments are one of the most common procedures in dentistry, but some dentists, especially general practitioners and those who are new to the profession, are still unfamiliar with the process or may miss crucial steps that could save patients’ time and money.
To help guide these dentists, Professor Simone Grandini, Chair of Endodontics and Restorative Dentistry, Head of the Department of Endodontics and Restorative Dentistry and Dean of the School of Dental Hygienists at the University of Siena in Italy, and his colleagues have developed a workflow reference for the treatment.
The workflow, which consists of 10 steps and includes two options depending on the tooth’s condition, begins with diagnosis and treatment planning. “This is a very important step because you need to assess whether the tooth is restorable. If it is not, there is no point in doing the root canal treatment. It is also essential that dentists decide what to do, and what’s going to happen to the tooth, before starting treatment,” said Prof Grandini.
The next five steps are, in order: access and interim restoration; shaping; irrigation; dressing and temporary restoration; and obturation. The final four steps depend on whether there is enough tooth structure left. If so, dentists should perform matrix placement, bonding, bulk filling and, finally, capping, finishing and polishing. If not, they should first build up the core of the tooth and place a post in it, then take an impression or scan, and finally conduct temporisation and cementation.
Since developing the workflow in 2017, Prof Grandini and his colleagues have presented it to dentists at conferences in Europe, Australia, Africa and Asia, including in Singapore, Malaysia, Thailand, Indonesia and Hong Kong. They will also launch it in the United States soon. He said: “Almost everyone whom we’ve spoken to have been enthusiastic and excited about it, and we’ve also received emails from dentists who have used the workflow with great success. We think it could be very useful for the profession and look forward to presenting it at IDEM in April.”
Prof Simone Grandini will be presenting at IDEM Singapore from 13 – 15 April 2018. For more information on IDEM Singapore, click here
Additive dentistry can be used to solve patients’ complex dental problems while preserving their existing tooth structure, and more dentists should use it, says Dr Christopher Ho, a lecturer at the University of Sydney, Australia, visiting lecturer at King’s College London in Britain and faculty member of the Global Institute for Dental Education and Academy of Dental Excellence.
“In the past, we had to grind teeth down to provide room for crowns made of porcelain fused to metal. Now, we can just bond very thin layers of materials such as ceramic or nano-hybrid composite resin to the remaining tooth structure instead. This is healthier and a superior treatment option because when you remove tooth structure, you are removing the integrity of the tooth and weakening the tooth, and you might also cause inadvertent damage to the pulp in the tooth,” he explained.
Furthermore, such additive techniques help to preserve teeth’s remaining enamel. “When you bond materials to enamel, you get a very predictable bond over the long term, which is good for patients,” Dr Ho said. Recent advances in additive materials, such as the nano-hybrids and new versions of lithium disilicates, also have increased strength, excellent longevity and better aesthetics with lustre and fluorescence similar to natural teeth.
Dr Ho said that additive dentistry is especially recommended for people whose teeth has been worn down due to the grinding of teeth or acid erosion caused by poor diet or diseases such as anorexia and bulimia. Dentists should also be familiar with both direct and indirect additive restoration techniques, and use them either singly or in combination depending on the patients’ needs.
He concluded: “All dentists should have these additive concepts in their back pocket and know when and how to use them.”
Dr. Ho will be speaking on the ‘Additive Approach to Complex Rehabilitation: Digital Workflow Meets the Art and Science of Dentistry’ at the IDEM 2018 Conference in Singapore in April.
Peri-implantitis is one of the most frequent pathological conditions that dentists and dental hygienists face. A systematic review of epidemiology published in the Journal of Clinical Periodontology in 2015, for example, found that 22 percent of patients were affected by it. To date, however, there is no gold standard of treatment, nor randomised clinical trials in the literature comparing surgical and non-surgical treatment.
To combat the condition, Dr Magda Mensi, Assistant Professor of Periodontology, Oral Surgery and Implantology at the University of Brescia’s Dental and Hygiene School in Italy, embarked on a pilot study in 2013 to determine whether a combination of low-abrasive powder, topical antibiotic and curettage could be more effective against severe peri-implantitis than conventional manual or mechanical debridement.
After one year, Dr Mensi and her colleagues observed 4 millimetres of pocket probing depth reduction, more than 3.7 millimetres of attachment level gain, and only 6.5 percent of bleeding on probing at level site in their study’s 15 patients’ 27 implants. These results were better than those of the conventional treatments. Furthermore, in the four years since the study began, only one patient has had a reoccurrence of peri-implantitis, and that was likely due to the patient missing several control and maintenance appointments and taking immunosuppressive drugs, as well as a worsening of her general health.
Dr Mensi’s Multiple Anti-Infective Non-Surgical Therapy (MAINST) protocol consists of using topical 14 percent doxycycline delivered by a biodegradable controlled released vehicle to solve the peri-implantitis acute phase, a session of full mouth air-polishing therapy with erythritol powder delivered sub-gingival with a special nozzle, curettage of the internal pocket line with a piezoceramic device with PEEK-coated tips and, finally, a second application of the doxycycline gel.
The patients also underwent quarterly maintenance sessions and were instructed to use personalised home care instruments, such as sonic toothbrushes, interdental brushes and floss. “This is very important. The patients have to be educated in plaque and calculus removal, motivated to carry out this maintenance at home, and show up for their dental sessions. If they come back only when there is a problem, it will be too late,” said Dr Mensi.
She added that the results from her study so far indicate that her MAINST protocol could be a gold standard of treatment for peri-implantitis. She said: “The only surgery that really works for peri-implantitis is regenerative, reconstructive surgery, but our protocol can be a better, non-surgical alternative. We are going to conduct a randomised control study to validate this hypothesis.”
Dr. Mensi will speak in depth about the non-surgical approaches to peri-implantits at IDEM 2018 in April in Singapore. For more information on IDEM Singapore, visit http://www.idem-singapore.com/.