Dental Asia January/February 2019

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Under the Spotlight An Exciting Age in Orthodontics Interviewed by Dr. Chala R. Platon With the advent of innovative techniques and appliances aided by progressive technologies, the field of orthodontics in particular is an interesting one to watch. Sydney-based orthodontist specialist, Dr. Vandana Katyal will agree heartily, having spent many years researching on oral appliances alongside delivering the latest, most efficient and most comfortable invisible dental orthodontic treatments. Besides being a specialist orthodontist, Dr. Katyal is also entrepreneur (or a ‘dentaprenuer’ as she calls herself) who founded Best Orthodontic Seminars & Sessions (BOSS), which aims to help dental practitioners develop the best evidencebased orthodontic treatment goals and more. As head lecturer at BOSS coupled with many research achievements in the field, Dr. Katyal’s knowledge and experience in orthodontics is unparalleled. Dental Asia sat down with her to find out more about her journey into orthodontics and her thoughts on upcoming digital trends and popular innovations such as clear aligners. Kindly walk us through your beginnings as a dental professional. I graduated from Sydney University with my Bachelor of Dental Surgery in 2001. Since then, I’ve been in dental practice, finally choosing to specialise as an orthodontist in 2013. I also hold a Master of Science in Clinical Epidemiology – which is all about the study and clinical research on the incidence and prevalence of a disease – and I am currently about to finish my Master’s degree in Business Administration in February 2019 from one of Australia’s most innovative business schools. I also lecture for Best Orthodontic Seminars & Sessions (BOSS), a company which I founded, teaching dentists and orthodontists the future of orthodontics while maintaining my clinical orthodontic practice in Sydney, Australia. What influenced you to specialise in the field of orthodontics? I enjoy creating smiles and have always been fascinated by the influence of science and art in dentistry which can change lives! For me, there is no speciality other than orthodontics wherein the artistic elements are combined with science and evidence-based research. Orthodontics was just a natural decision and path to take as I am very passionate about straightening teeth, improving function and giving people beautiful smiles. For me, orthodontics is a more natural way of giving patients the most natural smile without having to use crowns or veneers. Presently, there are numerous innovations and advancements in orthodontics such as clear aligners. What are your views on this? I think we are in a very exciting age in orthodontics – never before has there been the ability to create an individualised appliance for each patient. For the very first time, we have a customisable appliance that is not only comfortable for patients but also suits the various lifestyles of teen and adult patients. The clear aligner is a revolutionary innovation that has dramatically changed the face of the industry. As expected, there are advantages and disadvantages to consider when choosing between fixed traditional appliances and clear aligners. However, in the hands of an experienced orthodontist, both appliances are equally as effective and efficient in achieving the best results in straightening teeth. 18 DENTAL ASIA JANUARY / FEBRUARY 2019
Under the Spotlight What are the advantages and indications of using clear aligners? Currently, there are a lot of evidencebased studies and research that can help us better understand how clear aligners work. Let us look at the benefits of clear aligners for patients. Firstly, the pain level is reduced. There is no doubt that all studies show proof that clear aligners are more comfortable, less painful and have a positive effect on the patient’s quality of life. Secondly, the gingival health or periodontal health are improved especially for patients who are predisposed or often have periodontal disease/problems. Thirdly, there is less enamel damage on the teeth as there are no brackets or molar bands attached to tooth structure, resulting in reduced enamel decalcification. Aside from all these benefits, the invisibility of clear aligners is a plus for most patients who are very conscious about how they look. Nowadays, with the advent of social media applications such as Snapchat, Instagram and Facebook, there is no denying that many care about their physical appearances. Finally, there are some studies showing clear aligners can work a little bit faster than traditional fixed braces/appliances – shortening orthodontic treatment down by about five months for some simple to moderate Class I cases. Clear aligners are primarily indicated for simple to moderate malocclusion cases, which is majority of the cases that we see in our practice. Clear aligners are now becoming common and popular for teens. But for cases that require uprighting molars or more complex movements such as extrusion of impacted canines, traditional braces would still be used. Also in cases where surgery is needed, oral surgeons still prefer traditional braces over clear aligners. In your practice, do you prefer using clear aligners over traditional braces? Why? Clear aligners are very powerful and can move teeth comfortably. At the moment, 80% of our cases are clear aligners and only 20% are fixed appliances. We find that with clear aligners, we don’t have to make unnecessary appointments. There are also studies that show patients are more motivated while wearing clear aligners over traditional appliances and we have noticed this as well. Overall, we are a happy practice and we have happy patients who love the fact that they can have comfortable treatments with reduced emergencies and oral health impacts. It has been said that digitalisation is already the way of the future in dentistry. Presently, Dental Monitoring (DM) is being used in orthodontics. Kindly tell us more about it and how it works. Dental Monitoring is a simple application for monitoring patients, which gives dentists a lot of control in their patients’ treatment such as when to change aligners, how often and what stage the patient needs to be checked. I consider myself as a pioneer in the orthodontic industry, being one of the very first orthodontists in Australia to use DM mainly on clear aligners. Now we use DM for every treatment, including maxillary expanders and retainers. For example, in our practice, we ask our patients to take a weekly video of their face and teeth with and without an appliance using their smartphone and upload them into the application. The DM application uses artificial intelligence (AI) to recognise photographs, videos and backgrounds and from there, monitor gum health, teeth movement, and rate of teeth movement and predictability of movement of each patient week after week. For me, as an orthodontist, this is the definition of providing ultimate care for my patients. Not only now we are giving them customised treatment but also personalised to their biological response and compliance. Before DM, we would traditionally see patients every six to eight weeks for adjustments and have no idea what the condition of the patient is like in between dental visits. Now, we can monitor patients outside the clinic and catch problems early and troubleshoot early. This is a clear advantage of DM. With the weekly monitoring, patients have the peace of mind and are reassured as they know their dentists are keeping a close eye on them. However, there is a misconception that DM is fully-automated and completely driven by AI. DM is only semi-automated JANUARY / FEBRUARY 2019 DENTAL ASIA 19
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Dental Asia January/February 2019

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