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Dental Asia January/February 2024

For more than two decades, Dental Asia is the premium journal in linking dental innovators and manufacturers to its rightful audience. We devote ourselves in showcasing the latest dental technology and share evidence-based clinical philosophies to serve as an educational platform to dental professionals. Our combined portfolio of print and digital media also allows us to reach a wider market and secure our position as the leading dental media in the Asia Pacific region while facilitating global interactions among our readers.

For more than two decades, Dental Asia is the premium journal in linking dental innovators and manufacturers to its rightful audience. We devote ourselves in showcasing the latest dental technology and share evidence-based clinical philosophies to serve as an educational platform to dental professionals. Our combined portfolio of print and digital media also allows us to reach a wider market and secure our position as the leading dental media in the Asia Pacific region while facilitating global interactions among our readers.

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www.dentalasia.net<br />

JANUARY / FEBRUARY <strong>2024</strong><br />

Under The Spotlight:<br />

The calling of an association<br />

<strong>Dental</strong> Profile:<br />

Into the Dentaverse<br />

Clinical Feature:<br />

Same-day dentistry with<br />

3D-printed crowns: Case report


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19<br />

25<br />

CONTENTS<br />

DENTAL PROFILE<br />

25 Turning customer feedback into product improvement<br />

27 How to future-proof a dental school<br />

30 Into the Dentaverse<br />

TRENDS<br />

14 Why is the adoption of new technology so slow?<br />

CLINICAL FEATURE<br />

UNDER THE SPOTLIGHT<br />

16 The calling of an association<br />

19 Four countries and counting: Another step in Oracare Group’s ‘pan<br />

South East <strong>Asia</strong>n’ dental network<br />

22 A common foundation for preventive and integrative healthcare<br />

33 The necessary reassessment of mask use in dentistry<br />

37 Efficient layering for high-quality dental implant aesthetics:<br />

Case study<br />

39 Same-day dentistry with 3D-printed crowns: Case report<br />

42 Best-practice in instrument reprocessing: The hygiene<br />

workflow in the practice of Dr Kayla Teh<br />

2 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


37<br />

39<br />

52<br />

USER REPORT<br />

45 All about the All-on-4<br />

SHOW REVIEW<br />

61 Joint 37th IADR-SEA annual scientific meeting and 2nd<br />

International Oral Health Symposium hosted in Singapore<br />

BEHIND THE SCENES<br />

47 Advocates of digital dentistry from the lab<br />

IN DEPTH WITH<br />

50 Why customise the dental scaffold for alveolar height<br />

augmentation?<br />

52 New capabilities and fully digital workflows with IBT Flex<br />

Resin<br />

54 exocad introduces <strong>Dental</strong>CAD 3.2 Elefsina software with over<br />

60 new features<br />

REGULARS<br />

4 Editor’s Note<br />

6 <strong>Dental</strong> Updates<br />

56 Product Highlights<br />

63 Events Calendar<br />

64 Advertisers’ Index<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong><br />

3


www.dentalasia.net<br />

Under The Spotlight:<br />

JANUARY / FEBRUARY <strong>2024</strong><br />

The calling of an association<br />

3D-printed crowns: Case report<br />

What’s new for <strong>2024</strong>?<br />

EDITOR’S NOTE<br />

James Yau Assistant Editor<br />

Belated happy new year and season’s greetings to all readers of <strong>Dental</strong><br />

<strong>Asia</strong>!<br />

facilities that can stand the test of time for multiple generations of<br />

students (p. 27).<br />

As this period into <strong>2024</strong> presents various opportunities, milestones,<br />

and challenges, you have probably heard or seen the phrase ‘new year,<br />

new me’ in conversations or readings about the new year. Despite the<br />

expression’s usage as a festive quip about resolutions for the new year, it<br />

calls to mind about the opportunities for changes that one encounters in<br />

the spirit of edification rather than for novelty’s sake.<br />

To ring in the new year in this first issue for <strong>2024</strong>, we sought out the latest<br />

developments and advancements in dental education, for each dental<br />

professional to reflect upon their growth and learnings.<br />

For freshman at the Faculty of Dentistry in the National University of<br />

Singapore, a new interdisciplinary Common Curriculum that spans across<br />

healthcare disciplines including Medicine, Nursing, and Pharmacy has<br />

been introduced to develop future dental and healthcare professionals<br />

with the necessary skills for a new shift in healthcare towards integrative<br />

and preventive approaches (p. 22). Behind the fitting and shaping of<br />

such educational centres, we spoke with Jussi Ylisaari from Planmeca to<br />

learn about the considerations and challenges faced when educational<br />

institutions and manufacturers collaborate in designing and building<br />

We also explore novel ways in which dental education is being pushed<br />

to advance oral care standards. Dr Samintharaj Kumar of Nuffield <strong>Dental</strong><br />

believes that by providing continuing education courses on specialised<br />

treatment plans such as the ‘All-on-4s’ implant method, all patients can<br />

benefit as these skills are rippled through the wider dental fraternity<br />

(p. 45). On the “virtual” end of the education spectrum, mixed reality<br />

company Dentaverse has confidence in evolving technologies of virtual<br />

reality, blockchain, and Web3.0, which has led them to build a mixed reality<br />

platform that aims to make dental education, networking, and events,<br />

more accessible and immersive than ever before (p. 30).<br />

Thank you for your continued support in 2023 and through the past 24<br />

years. We hope you enjoyed reading and found our coverage of all-thingsdentistry<br />

valuable in your respective roles and regions across <strong>Asia</strong> and the<br />

world.<br />

James Yau<br />

Cover credit:<br />

Planmeca<br />

<strong>Dental</strong> Profile:<br />

Into the Dentaverse<br />

Clinical Feature:<br />

Same-day dentistry with<br />

Scan for digital copy<br />

of <strong>Dental</strong> <strong>Asia</strong><br />

LET’S CONNECT<br />

@dentalasia<br />

4 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


PABLO SINGAPORE<br />

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owner. Whilst every care is taken to ensure accuracy of the information in this publication, the Publisher accepts no liability for damages caused by misinterpretation of information, expressed or implied, within the pages of the magazine. All<br />

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control. Please refer to subscription form provided in the publication for more details. Printed by Times Printers Pte Ltd<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong><br />

5


DENTAL UPDATES<br />

Pearl appoints new COO and VP in<br />

expansion of leadership team<br />

Provider of dental AI solutions Pearl<br />

recently announced the appointment of<br />

Ben Plomion to chief operating officer<br />

(COO) and Dr Mike Barniv, DDS, to vicepresident<br />

of clinical affairs. In their roles,<br />

Plomion and Dr Barniv will help drive<br />

the company’s next phase of growth and<br />

innovation while further strengthening<br />

Pearl’s leadership team.<br />

As new COO, Plomion will oversee<br />

cross-departmental operations with<br />

a comprehensive focus on scaling the<br />

company’s growth. Prior to joining Pearl,<br />

Plomion served as the chief tokenisation<br />

officer at Dibbs, a tokenisation-asservice<br />

platform, and chief growth and<br />

marketing officer at GumGum, an AI<br />

advertising company. With over two<br />

decades of experience driving successful<br />

commercialisation efforts in the field<br />

of AI, Plomion will play a key role in the<br />

advancement of Pearl’s development and<br />

commercial operations.<br />

Dr Barniv joins Pearl as the company’s<br />

vice-president of clinical affairs after<br />

spending 20 years as a full-time, private<br />

practice dentist. Most recently, he<br />

served as vice-president at Delta <strong>Dental</strong><br />

of Idaho, overseeing claims, customer<br />

service, utilisation management and AI<br />

implementation. As a former assistant<br />

professor at the University of the Pacific<br />

School of Dentistry in San Francisco,<br />

California, and the director of their AEGD<br />

residency clinic for over four years, Barniv<br />

will apply his extensive multidisciplinary<br />

dental experience towards advancing<br />

the company’s commercial, clinical, and<br />

institutional impact, according to Pearl.<br />

“Ben and Mike each bring uniquely relevant<br />

and valuable experience to Pearl’s growing<br />

leadership team, and we are privileged to<br />

welcome their support as we expand our<br />

capabilities and reach across the global<br />

dental market,” said founder and CEO<br />

of Pearl, Ophir Tanz. “Ben’s world-class<br />

Pearl’s CEO and founder Ophir Tanz speaking at<br />

the Global Symposium on Artificial Intelligence in<br />

Dentistry (Image: Pearl)<br />

growth and organisational leadership<br />

and Mike’s extraordinary clinical and<br />

commercial versatility prime Pearl to<br />

further expand its efforts to redefine the<br />

AI-powered future of dentistry.”<br />

Since receiving its second patent from<br />

the United States Patent and Trademark<br />

Office in June 2023 for its chairside AI<br />

disease dection software, Second Opinion,<br />

the company has been quick to expand<br />

its reach. It received clearance from the<br />

Turkish Medicines and Medical Devices<br />

Agency (TMMDA) as a Class IIa medical<br />

device, and partnered with Gamma Tech,<br />

a provider of radiographic services for<br />

the Australia and New Zealand dental<br />

community, to distribute Pearl’s AI<br />

software in the region. DA<br />

Kevin Boyle appointed<br />

chief technology officer<br />

for Dentsply Sirona<br />

Dentsply Sirona announced that Kevin<br />

Boyle has been appointed as senior<br />

vice-president, chief technology (CTO)<br />

officer and member of the management<br />

committee, effective 4 Dec 2023. In this<br />

new role, Boyle reports to the CEO, Simon<br />

Campion.<br />

“Kevin brings a results-oriented, innovative,<br />

and strategic leadership approach and<br />

has deep expertise collaborating crossfunctionally<br />

to maximise business success.<br />

His strong commitment to the continued<br />

advancement of healthcare by solving<br />

unmet clinical and process needs through<br />

deep customer intimacy, coupled with<br />

his focus on developing diverse teams,<br />

provides an excellent fit with our values,”<br />

said president and CEO of Dentsply<br />

Sirona, Simon Campion. “Innovation is and<br />

will continue to be a cornerstone of our<br />

strategy and Kevin’s appointment ensures<br />

our advances in that area are meaningful.”<br />

Boyle has over 20 years of leadership<br />

experience in research and development<br />

at MedTech companies. He joins Dentsply<br />

Sirona from Becton Dickinson and<br />

Company (BD), where he most recently<br />

served as senior vice-president of research<br />

and development, Interventional Segment.<br />

He was previously vice-president of<br />

(Image:<br />

Dentsply<br />

Sirona)<br />

research and development, Peripheral<br />

Intervention, at BD and worked at<br />

Medtronic in various R&D roles.<br />

Boyle also holds a Master’s Degree in<br />

engineering in biomedical engineering from<br />

Texas A&M as well as a Master’s Degree in<br />

management information systems from the<br />

Michael Smurfit Business School, UCD, in<br />

Ireland.<br />

“I am very proud to join Dentsply Sirona<br />

with its long history of groundbreaking<br />

innovation in all areas of dentistry and<br />

continence care,” said Boyle, senior<br />

vice-president, CTO of Dentsply Sirona.<br />

“My goal is to drive major advancements<br />

to our innovation strategy, increasing<br />

Dentsply Sirona’s competitive advantage<br />

and bringing value to our customers and<br />

their patients. I am excited to support the<br />

company’s mission to transform dentistry<br />

and continence care through innovation and<br />

improve people’s lives.” DA<br />

6 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


DENTAL UPDATES<br />

New Government <strong>Dental</strong> College and<br />

Hospital opens in Chennai, India<br />

Chief minister of Tamil Nadu M K Stalin<br />

inaugurated the new Government <strong>Dental</strong><br />

College and Hospital in the Pudukkottai<br />

district of the city of Chennai over a video<br />

conference on 15 Nov 2023.<br />

Construction of the site began on 21 Oct<br />

2021 and was expected to be completed<br />

by 15 Jul 2023, prior to the inauguration.<br />

According to the Times of India, the<br />

facility cost Rs67.83m (US$8.15m) and the<br />

government provided equipment worth<br />

Rs51m (US$0.61m).<br />

The campus of the Government<br />

<strong>Dental</strong> College and Hospital includes<br />

administrative buildings, outpatient<br />

quarters for students and staff, buildings<br />

for academic activities and dining blocks.<br />

In addition, the new facility will have<br />

a faculty of six professors, 11 associate<br />

professors, 30 assistant professors and 102<br />

non-teaching staff according to DT Next.<br />

The college admitted 50 BDS students in<br />

August 2023 after it was accredited by the<br />

<strong>Dental</strong> Council of India earlier in May.<br />

The facility is said to be the third state-run dental<br />

college hospital in the state of Tamil Nadu (Image:<br />

The Hindu)<br />

Chief minister Stalin will further<br />

inaugurate 17 primary health centres and<br />

subcentres while the state government<br />

will also inaugurate 152 wellness centres<br />

by December 2023, 40 of which will be in<br />

Chennai. The current estimated population<br />

of Chennai city is 6,407,000 with its<br />

metropolitan population estimated at<br />

11,933,000. DA<br />

Align Technology opens <strong>2024</strong> Annual Research Award<br />

Programme with US$300,000 in awards<br />

Align Technology recently announced<br />

the opening of its <strong>2024</strong> Annual Research<br />

Award Programme which aims to support<br />

clinical and scientific dental research in<br />

universities across the globe.<br />

Up to US$300,000 will be awarded to<br />

university staff members for scientific<br />

and technological research initiatives<br />

to advance patient care in the fields<br />

of orthodontics and dentistry. Align<br />

Technology’s Research Award Programme<br />

has funded approximately $3m in research<br />

since the its inception in 2010.<br />

“This programme is an exciting opportunity<br />

for university researchers globally to<br />

expand scientific and clinical learnings to<br />

elevate patient care. We look forward to<br />

the topics and research studies that may<br />

ultimately improve treatment outcomes<br />

and the quality of life for more patients<br />

worldwide,” said Align senior vice-president<br />

of global clinical, Dr Mitra Derakhshan.<br />

Awards available for dental research at<br />

universities are available in the three<br />

regions: the Americas (US, Canada, Mexico,<br />

Central and South America) with four<br />

one-year awards of up to $25,000 each, the<br />

EMEA region with four one-year awards of<br />

up to $25,000 each, and the APAC region<br />

with four one-year awards of up to $25,000<br />

each.<br />

“Once again, we anticipate receiving<br />

a large number of applications to this<br />

research programme. The topics submitted<br />

throughout the past years have been<br />

diverse and often on the forefront of<br />

(Image: Ani Kolleshi/ Unsplash)<br />

the dental field. Align Technology is<br />

proud to fund this research program<br />

with the purpose of improving dental<br />

care throughout the world,” said Align<br />

vice-president, product innovation and<br />

technical fellow, John Morton.<br />

Eligible applicants for dental research<br />

awards include full-time and part-time<br />

faculty involved in dental or scientific<br />

research at universities where Invisalign<br />

treatment or the iTero scanner is available.<br />

Research proposals and completed<br />

applications must be received by 5pm<br />

Pacific Time on 8 Mar <strong>2024</strong>, and award<br />

recipients will be notified by 3 Jun <strong>2024</strong>.<br />

All applications are reviewed by an<br />

independent academic committee that<br />

forwards its recommendations to Align for<br />

final selection. Consideration will be given<br />

to first-time applications from a university<br />

programme.<br />

Award recipients for the 2023 programme<br />

includes the University of Washington for<br />

the Americas, UniCamillus, International<br />

Medical University for EMEA, and Sichuan<br />

University for APAC. DA<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong><br />

7


DENTAL UPDATES<br />

SmileDirectClub shuts down months<br />

after filing for bankruptcy, leaving<br />

many in the lurch<br />

Less than three months after filing for<br />

bankruptcy in September 2023, remote<br />

invisible aligners treatment company<br />

SmileDirectClub has confirmed that it<br />

would shut down its global operations<br />

in a FAQ page published on its website<br />

on 8 Dec 2023.<br />

A statement published read:<br />

“SmileDirectClub has made the incredibly<br />

difficult decision to wind down its global<br />

operations, effective immediately. For new<br />

customers interested in SmileDirectClub<br />

services, thank you for your interest, but<br />

aligner treatment is no longer available<br />

through our telehealth platform. For<br />

existing customers, we apologise for the<br />

inconvenience, but customer care support<br />

is no longer available. Thank you for your<br />

support and letting us improve over two<br />

million smiles and lives.”<br />

Accompanying the statement were a series<br />

of FAQ for customers concerning payments<br />

and order fulfilment. All orders placed for<br />

SmileDirectClub aligners but have not yet<br />

been received have been cancelled without<br />

further details. SmilePay customers were<br />

expected to continue making monthly<br />

payments where service provider HPD's<br />

contact information was referred. More<br />

information is expected to be released once<br />

the bankruptcy process determines next<br />

steps and additional measures customers<br />

can take.<br />

The American Association of Orthodontists<br />

(AAO) offered guidance to patients impacted<br />

by the recent closure of SmileDirectClub<br />

through a statement issued on 14 Dec 2023.<br />

"The best thing SmileDirectClub patients<br />

can do at this point is to book an inperson<br />

exam with a licensed orthodontist<br />

in their area,” said Myron Guymon,<br />

DDS, MS, president of the AAO. "Most<br />

SmileDirectClub patients have not had an<br />

x-ray or in-person exam, which are critical<br />

to ensuring an accurate diagnosis and safe<br />

and effective treatment plan."<br />

The AAO issued a series of steps for<br />

affected parties. For patients with<br />

complaints, including those who may<br />

be unable to contact the dentist that<br />

was supervising their SmileDirectClub<br />

treatment, AAO recommends reaching out<br />

to state dental boards that have individual<br />

complaint processes for dental treatments.<br />

If finances are a concern, the AAO urged<br />

to ask about complimentary consultations<br />

offered by many AAO orthodontists when<br />

booking an appointment with a local<br />

licensed orthodontist.<br />

The AAO also advised caution of other<br />

mail-order orthodontic companies<br />

feeding on SmileDirectClub's failure, and<br />

emphasised the importance of an in-person<br />

examination and x-rays before starting<br />

any orthodontics with a provider to avoid<br />

irreparable harm.<br />

"We are committed to helping<br />

SmileDirectClub patients navigate through<br />

this challenging situation. Our members<br />

are available to provide the care and<br />

support patients need to achieve a healthy<br />

and confident smile,” added Dr Guymon.<br />

As reported by local media outlet<br />

NewsChannel 5, former employees like<br />

Melissa Malingowski who worked at<br />

SmileDirectClub for nearly six years were<br />

left in a lurch with the sudden closure.<br />

"About 12:30pm, they pulled us all to the<br />

floor and were like: 'Hey, we are closing<br />

operations like, immediately. Everybody go<br />

home. I was balling. I lost it. We also found<br />

out later that they had originally wanted<br />

us to continue working through the end of<br />

the day. People just lost their livelihoods,<br />

and you want us to continue making a<br />

product that is not going to go anywhere?"<br />

Malingowski said.<br />

(Image: SmileDirectClub)<br />

"Honestly, they made it sound like we were<br />

going to be fine. We were restructuring<br />

everything. We would be good. We were<br />

literally told business as usual. And with the<br />

sudden closure, some of us have 401(k)s,<br />

and we do not have access to them. For me,<br />

they said effective immediately — this is<br />

your last paid day, and we were supposed<br />

to get paid at the end of December, and<br />

I cannot pay my rent in two weeks,”<br />

Malingowski added.<br />

SmileDirectClub was co-founded in 2014<br />

by Jordan Katzman and Alex Fenkell, based<br />

in Nashville, Tennessee, US. It reportedly<br />

served over two million people since its<br />

by selling clear dental aligners directly to<br />

consumers as a faster and more affordable<br />

alternative to braces.<br />

The company was valued at about US$8.9bn<br />

after its stock began trading publicly in<br />

2019 but its value fell over time as the<br />

company proved to be unprofitable, losing<br />

$86.4m in 2022.<br />

SmileDirectClub was also involved in<br />

lawsuit over unfair practices after a 2020<br />

report from The New York Times revealed<br />

that the company tied confidentially<br />

agreements to refunds. The District of<br />

Columbia attorney general’s office sued the<br />

company in 2022 where they were required<br />

to release more than 17,000 customers<br />

from the agreements and pay $500,000 to<br />

the district.<br />

SmileDirectClub filed for Chapter 11<br />

bankruptcy protection at the end of<br />

September with the company reporting<br />

nearly $900m in debt at the time. DA<br />

8 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


DENTAL UPDATES<br />

Roland DGA and Straumann USA<br />

partner to offer restorative solutions<br />

Roland DGA’s DGSHAPE Americas <strong>Dental</strong><br />

Business Group and Straumann USA have<br />

announced a partnership to combine<br />

their collective talents and expertise to<br />

accelerate the awareness and acceptance<br />

of high-quality restorative solutions in the<br />

dental market.<br />

This new collaboration is said to create<br />

an opportunity to provide world-class,<br />

full-service restorative solutions featuring<br />

Straumann’s implant solutions and<br />

DGSHAPE’s DWX <strong>Dental</strong> Milling Solutions.<br />

The partnership also enables Straumann<br />

USA to distribute Roland DGA’s DGSHAPE<br />

DWX mills throughout the US and Canada.<br />

Based on shared values, goals, and desired<br />

outcomes, the new working relationship<br />

between these two companies is expected<br />

to benefit both Roland DGA and Straumann<br />

USA, boosting revenue and fueling<br />

innovation for the respective businesses.<br />

“The Roland DGA and Straumann alliance<br />

will enhance the workflow and quality<br />

of restorative and implant solutions<br />

for dental professionals. We will work<br />

together to satisfy the growing demand for<br />

technological innovation and improve the<br />

overall clinician/patient experience,” said<br />

Roland DGA’s dental marketing manager,<br />

Lisa Aquirre.<br />

Both businesses are also focused on<br />

(Image: Roland<br />

and Straumann)<br />

providing products that effectively address<br />

the needs and wants of labs and clinicians to<br />

better the oral health of patients worldwide.<br />

The two companies are entering this<br />

partnership as new digital advancements<br />

continue to transform the dental industry.<br />

According to a recent ResearchAndMarkets<br />

report, restorative dentistry is undergoing<br />

a revolution due to CAD/CAM technologies.<br />

Digital impressions, design, and the<br />

manufacturing of restorations such as<br />

crowns, bridges, and dentures are accurate<br />

and time-and-cost-effective because of<br />

intraoral scanners, 3D imaging, and CAD/<br />

CAM technologies. With greater accuracy,<br />

quicker turnaround times, and superior<br />

patient experience, this trend is predicted<br />

to continue expanding.<br />

“Our partnership combines the branding<br />

leverage and the reputations of both<br />

companies to expand market awareness,<br />

reach, and adoption for the advancement<br />

of the dental community. This initiative<br />

will consist of a product-based and<br />

communications-based effort to grow<br />

digital dental workflows and processes,”<br />

added Aguirre. DA<br />

Qatar Investment Authority invests<br />

US$50m in India’s Clove <strong>Dental</strong><br />

Sovereign wealth fund Qatar Investment<br />

Authority (QIA) has made an equity<br />

investment of US$50m (Rs416crore)<br />

in Global <strong>Dental</strong> Services, the parent<br />

company of Clove <strong>Dental</strong>, India’s largest<br />

tech-enabled-dental-platform. The group<br />

operates more than 400 company-owned<br />

and company-operated dental clinics under<br />

the ‘Clove <strong>Dental</strong>’ banner.<br />

The equity injection from QIA is said to<br />

unlock significant growth opportunities for<br />

the group as it seeks to expand across India,<br />

ensuring that more Indians have access to<br />

reliable, high-quality, and affordable dental<br />

care.<br />

“This investment from QIA will enable our<br />

group to pursue its ambitious growth plans<br />

in both existing and new tier I & II cities<br />

across India, ensuring that more Indians<br />

have access to reliable, high-quality, and<br />

affordable dental care,” said founder and<br />

CEO of Global <strong>Dental</strong>, Amarinder Singh.<br />

Prior to QIA, Clove <strong>Dental</strong> raised around<br />

$66m (Rs549crore) in December 2022 in<br />

a round led by Investcorp, which brings<br />

the total investment raised by the group<br />

to $116m (Rs963crore). The funds will<br />

reportedly be used to rapidly grow the<br />

Clove <strong>Dental</strong> clinical network and develop<br />

a therapeutic oral care products range,<br />

reported the Times of India.<br />

This investment in Clove <strong>Dental</strong> comes as<br />

QIA looks to further diversify its portfolio<br />

in India’s fast-growing economy and comes<br />

on the back of recent investments in India<br />

within the retail and real estate sectors, and<br />

in green energy investments.<br />

“QIA is committed to supporting innovative<br />

companies with high-growth potential and<br />

(Image: Clove <strong>Dental</strong>)<br />

sees great potential in India’s fast-growing<br />

healthcare and retail markets. We have<br />

been impressed by Clove’s rapid expansion<br />

across India, commitment to quality, and<br />

innovative approach to dental care and look<br />

forward to welcoming them to our diverse<br />

global healthcare portfolio,” said Sheikh<br />

Faisal Thani Al-Thani, chief investment<br />

officer, Africa & APAC at QIA.<br />

“From inception, we have been, and are,<br />

very selective in whom we bring on as<br />

partners and shareholders. QIA is an<br />

outstanding example of a shareholder<br />

who is aligned with the long-term vision<br />

of the group. At Global <strong>Dental</strong> we have<br />

made significant investments in people,<br />

technology, equipment, and infrastructure,”<br />

said chairman of Global <strong>Dental</strong>, Louis<br />

Shakinovsky. DA<br />

10 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


DENTAL UPDATES<br />

Diego Gabathuler named new CEO of Geistlich<br />

Geistlich Pharma AG has announced the<br />

appointment of Diego Gabathuler as its<br />

new CEO, effective 1 Dec 2023. He succeeds<br />

Ralf Halbach, who departed the company in<br />

August 2023.<br />

(Image: Geistlich<br />

Pharma AG)<br />

Gabathuler is a 49-year-old Swiss National<br />

who brings a broad range of experience<br />

from various management positions as<br />

well as extensive knowledge in business<br />

development and strategic marketing.<br />

Most recently, Gabathuler was CEO of the<br />

dental company Ivoclar. He has expertise in<br />

the MedTech sector, excellent leadership<br />

qualities, and a proven strategic acumen.<br />

Sharing his excitement online, Gabathuler<br />

wrote on his Linkedin post of his belief<br />

in the culture and people comprising a<br />

company.<br />

“I look forward to meeting our teams<br />

around the world, our highly valued<br />

customers and business partners, as well<br />

as the people at the three foundations<br />

and within our strong global scientific<br />

network,” he wrote. “I am deeply convinced,<br />

that the people and the company culture<br />

is the most important success factor.<br />

People create innovation, people overcome<br />

hurdles and people build relationships and<br />

businesses.”<br />

Geistlich specialises in the regeneration of<br />

bone, cartilage and tissue. The company<br />

has more than 800 employees worldwide<br />

in the field of regenerative medicine, 13<br />

affiliates and 60 distribution partners,<br />

where its medical devices and medicinal<br />

products reaches around 90 markets<br />

worldwide. Under its dental portfolio, it<br />

offers solutions covering dental implants,<br />

periodontitis, and biomaterials.<br />

“The Geistlich strategic plan includes<br />

further investment in new products,<br />

solutions, and technologies in order to<br />

apply regenerative medicine in helping<br />

even more people around the world. We<br />

are convinced that Gabathuler’s expertise<br />

will support us significantly in this mission,”<br />

said chairman of the board of directors,<br />

Andreas Geistlich. DA<br />

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DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong><br />

11


DENTAL UPDATES<br />

Senator Bong Go advocates for advancement of the<br />

dental profession at the Manila <strong>Dental</strong> Chapter 4th<br />

Scientific Seminar<br />

The Manila <strong>Dental</strong> Chapter 4th Scientific<br />

Seminar was held at the Hotel Benilde in<br />

Manila City, the Philippines, on 12 Nov 2023<br />

under the theme ‘Synergizing Biofunctional<br />

Dentistry and Effective Communication’.<br />

Led by Dr Michelle Lamug, the event<br />

brought together dental professionals,<br />

practitioners, and enthusiasts, who listened<br />

to featured speakers and experts speak on<br />

the latest advancements in biofunctional<br />

dentistry and the important role of<br />

effective communication in promoting<br />

dental health. In attendance was senator<br />

Christopher “Bong” Go, chairperson of<br />

the Senate Committee on Health and<br />

Demography, where he advocated for the<br />

advancement of the dental profession.<br />

“I am committed to working with you and<br />

the entire dental community to ensure<br />

that our healthcare policies are responsive<br />

to your needs and that we provide the<br />

necessary support to help you excel in your<br />

field. I believe that through collaboration<br />

and open dialogue, we can achieve the best<br />

outcomes for the health of our people.<br />

We need initiatives that will shape our<br />

healthcare landscapes for the betterment<br />

of all Filipinos,” said Go.<br />

Go emphasised the need for a holistic<br />

approach to healthcare that includes<br />

oral health as an integral component.<br />

He highlighted the role of biofunctional<br />

dentistry not only in treating dental issues<br />

but also in promoting overall wellbeing.<br />

Go also stressed the importance of<br />

raising awareness about maintaining good<br />

health as he encouraged the public to<br />

take advantage of the medical assistance<br />

programmes offered in Malasakit Centers.<br />

Chairperson of the Senate Committee on Health<br />

and Demography, senator Christopher “Bong” Go<br />

(Image: Senate of the Philippines)<br />

Furthermore, Go continued to push for<br />

the construction of more Super Health<br />

Centers nationwide. Such centres will offer<br />

database management, dental, outpatient,<br />

birthing, isolation, diagnostic, pharmacy,<br />

and an ambulatory surgical unit. Other<br />

services that will be available include<br />

eye, ear, nose, and throat care, oncology<br />

centres, physical therapy and rehabilitation<br />

centres, and telemedicine. DA<br />

Young Innovations acquires Salvin <strong>Dental</strong> Specialties<br />

(Image: Young Innovations and Salvin)<br />

Global supplier of dental products Young<br />

Innovations announced the acquisition of<br />

Salvin <strong>Dental</strong> Specialties (Salvin). Based<br />

in Charlotte, North Carolina, US, Salvin is<br />

a supplier of regenerative biomaterials,<br />

surgical instrumentation, supplies and<br />

equipment specifically for implant<br />

dentistry.<br />

“Salvin takes great pride in delivering an<br />

exceptional customer experience and<br />

clinical support to implant practices, with a<br />

robust product line specifically designed by<br />

the Salvin team to meet the unique needs<br />

of this specialty segment,” said Dave Sproat,<br />

CEO of Young Innovations. “We are excited<br />

to support the ongoing growth of Salvin’s<br />

business, employees, customers, vendors<br />

and brand as a part of our broader global<br />

portfolio.”<br />

Bob Salvin, founder and CEO of Salvin, will<br />

serve as an adviser to Young Innovations<br />

and continue to provide counsel and<br />

support for the Salvin team and its<br />

customers. William Simmons, CEO, and<br />

Greg Slayton, president, will continue to<br />

provide daily leadership and management<br />

for the business from Charlotte. There<br />

are no changes to ordering and service<br />

procedures for customers or vendors.<br />

“I am exceptionally proud of the company<br />

we have built for over 40 years with<br />

our valued employees, customers, and<br />

partners,” said Bob Salvin. “We have<br />

achieved our goal of creating a business<br />

focused on providing everything for the<br />

implant practice but the implants. Thanks<br />

to our strong team, culture, and focus, we<br />

are well positioned for continued success.<br />

We are excited to be partnered with Young<br />

in this new chapter of growth for Salvin.”<br />

“Our acquisition of Salvin reflects our<br />

continued commitment to invest in the<br />

oral surgery market. The combination<br />

of Salvin and Young now makes us the<br />

largest dental implant-agnostic supplier<br />

in the industry,” added Steve Clareen,<br />

vice-president/general manager at Young<br />

Innovations. “The leadership team at Salvin<br />

is exceptional. They have built a fantastic<br />

business with a respected portfolio. We<br />

look forward to working together to drive<br />

additional value to Salvin’s customers and<br />

the patients they serve.” DA<br />

12 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


DENTAL UPDATES<br />

Myanmar <strong>Dental</strong> Health<br />

Science Conference 2023<br />

in Nay Pyi Taw<br />

The Myanmar <strong>Dental</strong> Health Science Conference 2023 organised<br />

by the Ministry of Health took place from 3-4 Nov 2023 at the<br />

Myanmar International Convention Centre-II (MICC-II) in the<br />

country’s capital city of Nay Pyi Taw, under the theme ‘Quality<br />

<strong>Dental</strong> Care for Community’.<br />

<strong>Dental</strong> experts from Thailand, Japan, the Republic of Korea and<br />

Malaysia participated in the two-day conference where local<br />

specialists delivered quality treatment systems and reading<br />

sessions of 32 posters and 30 papers were held. In attendance<br />

were member of the State Administration Council (SAC) Dr Ba<br />

Shwe, union minister for health Prof Dr Thet Khaing Win, and<br />

chairman of the Nay Pyi Taw Council.<br />

Dr Thet Khaing Win then attended the signing ceremony for<br />

the Memorandum of Understanding (MoU) on the exchange of<br />

medical knowledge on surgical treatment of congenital cleft lip<br />

and palate patients between the Department of Medical Services<br />

and the Korea University Medicine.<br />

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On day two of the Myanmar <strong>Dental</strong> Health Science Conference,<br />

deputy minister for health Prof Dr Aye Tun attended the signing<br />

ceremony to extend an MoU between Myanmar and the Faculty<br />

of Dentistry, Khon Kaen University, Thailand to exchange<br />

medical knowledge, and academic methods and to strengthen<br />

collaboration for research on dental health.<br />

In addition, professors from the Korean University of Medicine<br />

and the Japan Heart Foundation shared knowledge on dental<br />

implant treatments and cleft lip and palate surgeries respectively.<br />

This was followed by a discussion of face, jaw and oral surgeries<br />

contributed by a surgeon of the International Medical University,<br />

Malaysia. DA<br />

Over 650 experts were involved in the discussions on dental health<br />

from 3-4 Nov (Image: The Global New Light of Myanmar)<br />

→ www.mectron.com<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong><br />

13


TRENDS<br />

Why is the adoption of new<br />

technology so slow?<br />

By Dr Alan Kwong Hing, DDS, MSc, chairman, PBM Group and A&H Academy<br />

As we enter the new year, some questions dental professionals tend to ask are: What are the<br />

latest technologies? Which of these should we incorporate into our medical/dental practices?<br />

Should we adopt new innovations? How will this impact the delivery of patient care and overall<br />

performances of our offices?<br />

Although there has been rapid advancement of technology, there is hesitancy, and adoption is<br />

relatively slow in medicine and dentistry compared to other sectors. It is frequently stated that<br />

it takes an average of 17 years of research to provide evidence of the efficacy of a new device<br />

or medications to reach mainstream clinical practice usage. 1-5 In reality, how "new" is the new<br />

technology we are considering using?


TRENDS<br />

practice is between 17-23 years. 5 While the<br />

development of new medicines and medical/<br />

dental innovations holds immense potential,<br />

their integration into mainstream practice<br />

is a complex and time-consuming process.<br />

Rigorous research and testing, regulatory<br />

hurdles, economic considerations, education,<br />

and peer acceptance collectively contribute to<br />

the delay.<br />

RIGOROUS RESEARCH AND TESTING<br />

Before a new medicine or medical/dental<br />

device can enter the market, it must undergo<br />

extensive preclinical research, clinical trials,<br />

and regulatory approval processes. These are<br />

to verify safety and efficacy, ensuring the new<br />

treatment meets stringent standards. Rigorous<br />

testing is essential to protect patient welfare,<br />

which can result in a substantial amount of<br />

time required to complete these steps.<br />

REGULATORY HURDLES<br />

Regulatory bodies play a crucial role in<br />

assessing the safety and efficacy of new<br />

medicines or medical/dental devices.<br />

Obtaining regulatory approval involves<br />

navigating complex procedures and<br />

regulations and paperwork, which can<br />

consume a significant amount of time and<br />

resources. Stringent evaluations, certifications,<br />

and compliance with various standards all<br />

contribute to the lengthy process of gaining<br />

regulatory clearance.<br />

ECONOMIC CONSIDERATIONS<br />

Cost/benefit is a significant factor in the<br />

adoption of new medicines or medical/<br />

dental devices especially in a small office.<br />

Healthcare systems and providers need to<br />

evaluate the economic impact of integrating<br />

new treatments, considering factors<br />

such as affordability, reimbursement and<br />

cost-effectiveness compared to existing<br />

alternatives.<br />

time-consuming process before the clinician<br />

has the necessary expertise and confidence<br />

to incorporate these innovations safely and<br />

effectively into patient care.<br />

Who or what institution will provide the training<br />

without being seen as self-serving and credible<br />

must be determined by the developer of the<br />

technology or innovation. This vetting process<br />

can add considerable time to the overall<br />

process.<br />

PEER ACCEPTANCE AND ADOPTION<br />

Professionals rely highly on scientific literature,<br />

guidelines, and recommendations from<br />

professional associations before embracing<br />

new treatments or medical/dental devices.<br />

Peer acceptance and consensus play a vital<br />

role in driving the adoption of novel therapies.<br />

It takes time for research findings to be<br />

critically reviewed, then disseminated and<br />

widely accepted within the medical/dental<br />

community.<br />

Building evidence and generating consensus<br />

are essential for increasing the likelihood<br />

of adoption by healthcare practitioners.<br />

Identifying and working with key opinion<br />

leaders who can legitimise use of the<br />

innovation is a difficult process and takes time.<br />

CONCLUSION<br />

The estimated time lag from the development<br />

of an innovation to its everyday use in<br />

By understanding these factors, stakeholders<br />

can work together to streamline the adoption<br />

process, ensuring that safe and effective<br />

innovations reach patients in a timely manner.<br />

The key components in this process are<br />

identifying which time-lags are beneficial and<br />

which are unnecessary and implementing<br />

changes to remove timelines for adoption.<br />

A quicker translation from scientific<br />

discoveries to benefitting patients should be a<br />

priority to improve patient care and decrease<br />

unnecessary pain and suffering. By making<br />

more practitioners aware of the time lag, I hope<br />

they can advocate for the changes necessary<br />

for a faster adoption and decreasing the 17-23-<br />

year adoption timeline. DA<br />

REFERENCES<br />

1. Westfall JM, Mold J, Fagnan L. Practice-Based<br />

Research—“Blue Highways” on the NIH Roadmap.<br />

JAMA. 2007;297(4):403–406.<br />

2. Trochim WMK. Translation won't happen<br />

without dissemination and implementation: Some<br />

measurement and evaluation issues. Proceedings<br />

of the 3rd Annual NIH Conference on the Science<br />

of Dissemination and Implementation, Bethesda,<br />

MD, Accessed March 16, 2010.<br />

3. Green LW, Ottoson JM, García C, Hiatt RA.<br />

Diffusion theory and knowledge dissemination,<br />

utilization, and integration in public health. Annu<br />

Rev Public Health. 2009;30:151-74.<br />

4. Balas EA, Boren SA. Managing Clinical<br />

Knowledge for Health Care Improvement. Yearb<br />

Med Inform. 2000;(1):65-70.<br />

5. Morris ZS, Wooding S, Grant J. The answer is 17<br />

years, what is the question: understanding time<br />

lags in translational research. J R Soc Med. 2011<br />

Dec;104(12):510-20.<br />

EDUCATION AND TRAINING<br />

The successful integration of new treatments<br />

or techniques often requires healthcare<br />

professionals to be trained and educated in<br />

their proper usage. Informing and training<br />

medical/dental personnel on specific<br />

protocols, administration techniques, and<br />

potential side effects associated with<br />

new medicines or the devices can be a<br />

ABOUT THE AUTHOR<br />

Dr Alan Kwong Hing DDS, MSc graduated with his Doctor of <strong>Dental</strong> Surgery<br />

degree (with distinction) from the University of Western Ontario. He<br />

received the University Gold Medal and completed a concurrent Master’s<br />

Degree in Pathology with a focus on Bone Biology. He has earned multiple<br />

degrees and received numerous awards including the IADR predoctoral Hatton award.<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong><br />

15


The calling of<br />

an association<br />

Empowering community responsibility,<br />

being seen by the public, and informing<br />

oral health strategies: These ideas only<br />

scratch the surface of how Dr Mas Suryalis<br />

hopes to raise the profile of her association<br />

and improve oral health outcomes for<br />

all Malaysians. <strong>Dental</strong> <strong>Asia</strong> speaks with<br />

the president of the Malaysian <strong>Dental</strong><br />

Association (MDA) on the changes she is<br />

driving both in and outside the MDA.<br />

By James Yau<br />

Reflecting on the milestones and<br />

influential moments in her career, Dr<br />

Suryalis described herself as “driven”.<br />

“I like to challenge myself and take on<br />

responsibilities that other people may<br />

be afraid of. Whenever I am given a<br />

task, I will challenge myself to do it in<br />

the best way that I can,” she said.<br />

However, she was quick to point out<br />

that it is not always smooth sailing.<br />

“I like to try many things and that is<br />

why I do a lot of things. But it does not<br />

mean that I excel in everything I do. I<br />

learn from my mistakes and failures,<br />

and I believe these experiences shape<br />

me into the person that I am today,”<br />

she added.<br />

This tenacious mindset proves to<br />

be a familiar theme in her career.<br />

After graduating with a BDS from the<br />

University of Malaya, Malaysia, in 2006,<br />

Dr Suryalis worked under the Ministry<br />

of Health before joining academia<br />

and subsequently undertaking her<br />

specialist training in special care<br />

dentistry in Australia. She underwent<br />

training in various hospitals and<br />

healthcare institutions and graduated<br />

with Doctor of Clinical Dentistry and<br />

Doctor of Philosophy degrees from the<br />

University of Melbourne in 2016.<br />

In her latest appointment as MDA<br />

president since June 2023, Dr Suryalis<br />

was once again banking on the lessons<br />

and character developed and gleaned<br />

throughout her career to help better<br />

oral health outcomes in Malaysia and<br />

raise the profile of the MDA.<br />

The new initiatives she drove to<br />

implement included goals such<br />

as increasing membership rates,<br />

encouraging community programmes,<br />

promoting oral health equity, and<br />

informing policies with government<br />

stakeholders.<br />

“It is not an easy process because you<br />

are exposed to different challenges.<br />

You have to work with so many<br />

different people and are in situations<br />

where you have to work fast and<br />

troubleshoot. All these are learning<br />

experiences and has helped me to<br />

become a good person and leader,”<br />

she said.<br />

MDA FRATERNITY<br />

A major facet of Dr Suryalis’s<br />

vision for the MDA centres around<br />

increasing its public visibility.<br />

“People are not aware of our roles<br />

because we shy away from the<br />

media. We have done a lot for the<br />

dental fraternity, but our publicity<br />

and promotion are still not as strong,”<br />

she said.<br />

Recognising the importance of public<br />

relations, a social media and public<br />

health committee were set up to<br />

develop a relationship with the public<br />

and leverage on MDA’s experts to<br />

weigh in on current affairs.<br />

“If there are any controversial issues<br />

or new policies, we would like to be<br />

16 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


UNDER THE SPOTLIGHT<br />

at the forefront to provide our opinion<br />

and voice our concerns. We are still<br />

establishing that because we need to<br />

look for suitable people to be in that<br />

committee,” she added.<br />

The increased media presence is also<br />

targeted at other dental professionals<br />

in Malaysia to raise awareness of<br />

the function of MDA itself. With over<br />

4,000 registered members of the<br />

13,000 dentist population, the MDA<br />

is the largest dental association in<br />

Malaysia. Still, Dr Suryalis hopes<br />

to see more dentists register with<br />

MDA. Working with various specialist<br />

associations to partner with MDA as<br />

affiliates, Dr Suryalis sees the benefits<br />

of collaboration to amplify the voice of<br />

the dentist in the society.<br />

“We would like to be the umbrella body<br />

to all the other dental associations,<br />

including the specialist. If there are any<br />

causes or issues to raise, we have a<br />

stronger voice,” said Dr Suryalis.<br />

Furthermore, the MDA’s increased<br />

media presence is not envisioned as<br />

a one-way dialogue as Dr Suryalis<br />

encourages members of the public<br />

to voice their opinions and concerns<br />

through the provided channels such<br />

as the MDA’s direct email for general<br />

inquiries, or the MDA patient complaint<br />

bureau to seek assistance or advice<br />

pertaining to patient care.<br />

"With technology and social media,<br />

people can say anything on the<br />

internet. We would like to urge<br />

members of the dental fraternity to<br />

use the right channels so their voices<br />

are heard and problems solved,”<br />

Dr Suryalis added.<br />

One pressing issue Dr Suryalis has<br />

witnessed among dental professionals<br />

and proffered support is on mental<br />

health. She explained that with<br />

the competition in the market and<br />

effects of the COVID-19 pandemic,<br />

the profession can be very stressful<br />

causing a high prevalence of mental<br />

health issues.<br />

“We want our members to know that<br />

if they have any problems with mental<br />

health, we are here to help. If there<br />

is anything that the association can<br />

help, for example in doing activities or<br />

programmes, come and reach out to<br />

us. Some of members have a social<br />

media channel to offer support for<br />

those struggling with mental health<br />

issues,” she said.<br />

MDA IN MALAYSIA<br />

Looking outwards to the MDA’s<br />

involvement in the wider society,<br />

Dr Suryalis hopes to develop closer<br />

partnerships with its government<br />

partners as well as the FDI World<br />

<strong>Dental</strong> Federation (FDI).<br />

Dr Suryalis shared that MDA has been<br />

very active in providing its reviews,<br />

ideas and suggestions at international<br />

conferences and exhibitions. During<br />

the FDI convention in Sydney during<br />

September 2023, the MDA was involved<br />

with the reviewing of policy statements.<br />

"This year we discussed about many<br />

issues including sugar consumption,<br />

alcohol intake, antenatal programmes,<br />

and smoking cessation. We gave our<br />

opinions which were considered in the<br />

improvement of the policy statements,”<br />

she said. The hope of being an active<br />

member in such international oral<br />

health organisations is to disseminate<br />

these policy statements among MDA<br />

members for dental practitioners in<br />

Malaysia to adopt.<br />

This involvement of policy making<br />

on the international stage no doubt<br />

provided useful experience in the<br />

MDA's role to inform oral health policies<br />

within the country.<br />

Under the National Oral Health<br />

Strategic Plan 2022-2030 which<br />

outlined the country’s oral healthcare<br />

Representatives of the MDA meeting with the principal director of Oral Health<br />

in Malaysia to discuss collaborative opportunities<br />

The MDA delegates at FDI Sydney made a concerted effort to be<br />

involved in reviewing policy statements<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong><br />

17


UNDER THE SPOTLIGHT<br />

delivery strategies and activities, MDA<br />

acts as an agency tasked with various<br />

actions contained within nine strategic<br />

thrusts of blueprint. Working in tandem<br />

with other agencies such as the<br />

Ministry of Health, Ministry of Defence,<br />

and the Ministry of Higher Education,<br />

this ranges from initiatives concerning<br />

oral cancer screening, smoking<br />

cessation counselling, developing<br />

periodontal care protocols, and<br />

monitoring the use of dental amalgam.<br />

The MDA is currently gathering data<br />

on involvement among its members of<br />

participation in the initiatives outlined<br />

in the strategic plan.<br />

“We get feedback from our members<br />

so we can measure whether or not<br />

whatever initiatives that the policy<br />

makers and stakeholders are doing<br />

is actually impactful, and how we<br />

can strategise and collaborate for an<br />

improved outcome,” Dr Suryalis said.<br />

Another public initiative which Dr<br />

Suryalis is eager to promote is an<br />

increased role of community service<br />

among MDA members. Of the 20 CPD<br />

points required by dentists to renew<br />

their annual practicing certificates, up<br />

to five points can be earned through<br />

participation in outreach programmes<br />

or community service activities,<br />

depending on the level of involvement.<br />

The scope of community service<br />

activities varies from providing oral<br />

health checkups to giving educational<br />

talks and is not limited to dental care<br />

alone. It encompasses a wider set of<br />

community service activities depending<br />

on the organisation or association<br />

conducting the programme. By<br />

promoting and organising such<br />

progammes, Dr Suryalis hoped<br />

for dentists to see the benefits of<br />

community service activities for their<br />

professional development.<br />

“We would like to have more people<br />

empowered and engaged in these<br />

community service activities. We have<br />

collaborated with a few universities<br />

locally who have done community<br />

service projects across the country. We<br />

do not just keep it within just MDA, but<br />

we want to empower as many people<br />

as we can within the dental fraternity,<br />

including those in the private sectors<br />

and in the higher institutions,” she said.<br />

Dr Suryalis added that since promoting<br />

these community programmes,<br />

organisations have been becoming<br />

more active within their local<br />

communities. Moreover, the Ministry of<br />

Health was supportive of this mindset<br />

as it aligned the overall objective of<br />

improving oral health in the nation.<br />

The MDA also recently introduced the<br />

MDA Community Service Grant worth<br />

for all Malaysian <strong>Dental</strong> Schools<br />

and affiliated dental associations<br />

to conduct community service<br />

activities in conjunction with the<br />

World Oral Health Day.<br />

checkups and treatments are provided<br />

in rural areas for the indigenous<br />

community.<br />

“There are a lot of initiatives and<br />

programmes by the Ministry of Health,<br />

and they would like MDA to also be on<br />

board to help achieve the various goals<br />

and ultimately achieve the mission<br />

and vision of various policies and<br />

programmes,” she said.<br />

Dr Suryalis highlighted that oral<br />

health prevention and management<br />

strategies for different demographics<br />

of the population within Malaysia<br />

required different approaches given the<br />

differences in cultural practices and<br />

traditions.<br />

For example, studies have reported high<br />

daily sugar intake among the Malays,<br />

notably from Kelantan state, which<br />

may increase the risk of caries. Other<br />

studies reported betel/tobacco quid<br />

chewing habit in the Indian community,<br />

especially those living in the estates,<br />

which may predispose them to higher<br />

risk of oral cancer.<br />

For the wider Malaysian public, Dr<br />

Suryalis observed a growing demand<br />

and awareness of aesthetics and digital<br />

dentistry as beauty standards and<br />

knowledge of dentistry rises. While the<br />

knowledge and cost barriers to these<br />

trends remain, working with industry<br />

partners and training programmes<br />

would only spur demand further.<br />

With an acute grasp of the needs of the<br />

community and a course charted for<br />

the MDA, Dr Suryalis called on all dental<br />

professionals to cater for Malaysians<br />

from all walks of life.<br />

A community service activity programme<br />

with a local university designed to foster a<br />

sense of community responsibility within<br />

the dental fraternity<br />

Under the second strategic thrust<br />

which sought to increase accessibility,<br />

affordability, and equitability of oral<br />

healthcare services especially in<br />

under-served and rural areas plan, the<br />

MDA Eastern Zone presiding in the<br />

Borneo regions of Sabah and Sarawak<br />

has been actively participating in<br />

community service activities where<br />

“Whether you are in private or public<br />

practice, you have the responsibility<br />

to provide equitable access to quality<br />

healthcare service for everyone.<br />

<strong>Dental</strong> practitioners must be ready<br />

with essential knowledge and skills to<br />

provide services, whether it is for the<br />

higher socioeconomic patients or those<br />

who are at disadvantage.” DA<br />

18 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


Four countries and<br />

counting: Another<br />

step in Oracare<br />

Group's 'pan South<br />

East <strong>Asia</strong>n' dental<br />

network<br />

Oracare Group's latest partership with Uy <strong>Dental</strong><br />

Clinic Group (UDC) represents not only a tried-andtested<br />

business strategy, but also a step forward in<br />

realising regional co-operation and entrepreneurship<br />

to advance dental care in South East <strong>Asia</strong>. <strong>Dental</strong> <strong>Asia</strong><br />

speaks with co-founders of Oracare Group, Leon Luai<br />

and Andy Cropp, on this collective vision. By James Yau<br />

First Singapore, then Indonesia, Thailand, and<br />

most recently — the Philippines.<br />

Under its ambit, the Oracare Group (Oracare)<br />

manages dental clinics across four countries<br />

in South East <strong>Asia</strong> with Family <strong>Dental</strong> Centre<br />

and Expat <strong>Dental</strong> in Singapore, Tawa <strong>Dental</strong><br />

in Indonesia, MOS <strong>Dental</strong> in Thailand, and<br />

UDC in the Philippines, collectively boasting<br />

a network of 62 dental clinics, 652 staff<br />

members, and over 316,000 annual patients<br />

visits. Oracare's business model is centred on<br />

providing professional management expertise<br />

to complement the dental entrepreneur's<br />

passion, which coupled with investment<br />

capital, unlocks further potential enabling<br />

the entrepreneur to achieve their growth<br />

ambitions.<br />

From left: Cropp, Dr Charlston, and Luai at a celebration event in Manila, the Philippines to<br />

welcome UDC into Oracare Group<br />

UNDER THE SPOTLIGHT<br />

Following Oracare’s venture in Thailand in 2019,<br />

where it scaled the MOS <strong>Dental</strong> brand from<br />

14 to 30 clinics within the span of four years<br />

despite headwinds from the pandemic, the<br />

group has similar ambitions for its newest clinic<br />

partner since its partnership on 27 Oct 2023.<br />

“Our goals for UDC in the Philippines over the<br />

next five years are ambitious yet strategic,<br />

drawing inspiration from the successful<br />

growth of the MOS dental partnership in<br />

Thailand,” said Andy Cropp, CFO of Oracare.<br />

Demographics such as a dentist to population<br />

ratio of 1:4,000 and a large economy drew<br />

Oracare’s attention to the Philippines as an<br />

under-served market with significant growth<br />

opportunities.<br />

“We want to position UDC as the market<br />

leader in the Philippines, particularly focusing<br />

on expanding access to high-quality dental<br />

care in both urban and provincial areas,<br />

surpassing industry standards. This would<br />

increase UDC's presence beyond the capital<br />

Manila, by strategically establishing clinics<br />

in key provinces, ensuring a wider reach and<br />

impact on dental healthcare accessibility,”<br />

Cropp added.<br />

Leon Luai, CEO of Oracare, echoed his cofounder’s<br />

enthusiasm: “Collectively, we are<br />

confident in achieving the same trajectory<br />

of growth in the major cities and provinces.<br />

Oracare is about backing dental entrepreneurs<br />

in South East <strong>Asia</strong>n countries in their growth<br />

journey.”<br />

To achieve this market leadership, the<br />

co-founders, together with Dr Charlston Uy,<br />

founder of UDC, have set out three primary<br />

goals. First, they intend to develop UDC into<br />

a recognised centre of excellence for dental<br />

care; this would involve elevating its clinical<br />

standards, offering cutting-edge treatments,<br />

and ensuring exceptional patient care. Second,<br />

the group aims to leverage the expertise within<br />

UDC to establish it as a hub for dental training<br />

and education to contribute to the growth<br />

and development of dental professionals<br />

in the Philippines. Third, they will foster<br />

partnerships with local healthcare institutions,<br />

industry influencers, and government bodies<br />

to strengthen UDC's position within the dental<br />

healthcare landscape.<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong><br />

19


UNDER THE SPOTLIGHT<br />

“By replicating our successful model applied<br />

to MOS dental partnership, we plan to adopt<br />

strategies that have proven effective in driving<br />

growth and excellence in dental healthcare<br />

services,” said Cropp.<br />

For Oracare however, potential partnerships<br />

require more than just attractive business<br />

opportunities, as it follows a strategic<br />

approach when identifying its partners. By<br />

focusing on fostering entrepreneurship, the<br />

emphasis of its partnerships lies in ensuring<br />

a strong cultural fit and building robust<br />

relationships from the outset to achieve a<br />

long-term collaboration.<br />

“Our Thailand approach started by assessing<br />

dental businesses in terms of their market<br />

segment, scale, and reputation. These<br />

candidates were eventually narrowed down to<br />

MOS <strong>Dental</strong> who had 14 clinics at the time,”<br />

said Luai.<br />

Another key criterion to partner selection<br />

is alignment with Oracare's core values of<br />

professionalism, respect, integrity, dedication,<br />

and entrepreneurship.<br />

“Dr Charlston, founder and CEO of UDC,<br />

shared with us his vision as well as his pain<br />

points, which were very similar to those that<br />

Dr Adisorn, founder and CEO of MOS <strong>Dental</strong>,<br />

faced during his growth journey. We are<br />

confident that we can value-add to each other<br />

and this culminated in the establishment<br />

of the partnership,” said Luai. “For UDC, our<br />

discussion started in 2019 after they read in<br />

<strong>Dental</strong> <strong>Asia</strong> about our joining forces with MOS<br />

<strong>Dental</strong>.”<br />

ORACARE’S ROADMAP FOR ITS<br />

GROWING NETWORK<br />

Beyond its plans with UDC in the Philippines,<br />

the co-founders shared that Oracare’s<br />

trajectory in South East <strong>Asia</strong> involves a<br />

multifaceted approach, including targeted<br />

partnerships, market-specific collaborations,<br />

and establishing specialised clinics to meet<br />

the diverse dental care needs of locals,<br />

tourists and expatriate populations.<br />

The group is currently exploring a strategic<br />

partnership in Thailand, specifically with a<br />

well-established and reputable brand serving<br />

the premium segment. This initiative aims<br />

to capitalise on the strengths and market<br />

positioning of a premium segment partner to<br />

expand Oracare’s influence in the Thai dental<br />

market.<br />

For its operation in Indonesia, the group is<br />

eyeing a dual approach which seeks to tap into<br />

diverse market segments to cater for a broad<br />

spectrum of dental care needs in Indonesia.<br />

First it is focused on growing its premium Tawa<br />

<strong>Dental</strong> brand; second it is looking to establish<br />

a presence with a mass-market brand by<br />

leveraging existing relationships.<br />

Oracare has also outlined a growth plan for<br />

Expat <strong>Dental</strong> with a vision to serve globallymobile<br />

individuals and their families through<br />

a network of clinics in major <strong>Asia</strong>n cities<br />

and expatriate hotspots. Using its flagship<br />

clinic in Singapore as a springboard, its first<br />

international step will be its upcoming clinic in<br />

Bali, Indonesia, slated to open in Q1 <strong>2024</strong>. This<br />

strategy placement will enable it to fulfil its<br />

goal of being the go-to provider for expatriate<br />

communities in the region.<br />

Beyond existing markets, Oracare is also<br />

exploring collaborative opportunities for<br />

expansions into new and emerging markets<br />

by cultivating relationships with founders of<br />

dental groups in Vietnam, Cambodia, and<br />

Malaysia. “In the next five years, Oracare<br />

envisions an expansion strategy that solidifies<br />

its position as the premier dental group in<br />

South East <strong>Asia</strong>,” said Cropp.<br />

In addition to these regional strategies, the<br />

group ensures that its clinics maintain a<br />

strong focus on providing patient-centric<br />

services. Teledentistry services have<br />

been employed to provide patients<br />

preliminary video discussions with<br />

dental professionals before deciding<br />

if a physical visit is warranted. Clinic<br />

management software and online<br />

messaging platforms such as WhatsApp<br />

and Line have been utilised to improve<br />

communications between patients and<br />

clinics. A partnership with software-as-aservice<br />

(SaaS) platform Momos enabled<br />

better engagement with customers and<br />

drove the customer lifecycle.<br />

The group is also incorporating new<br />

technologies like AI within its 'Smilogy'<br />

invisible aligners business with plans to further<br />

integrate augmented reality and imaging<br />

technologies. VR goggles are also being trialled<br />

to enhance patient experience by providing<br />

immersive and interactive elements.<br />

Other than market-proven technologies,<br />

Oracare has also been invited to participate in<br />

the development of new technologies such as<br />

implementing robotics in dentistry. While still<br />

in its early stages, Luai shared that robotics is<br />

showing potential in performing certain dental<br />

procedures with precision, and robotic systems<br />

can assist dentists in tasks such as implant<br />

placement.<br />

DIFFERENT CULTURES, COMMON<br />

DESIRES<br />

With their focus on building a network of clinics<br />

across South East <strong>Asia</strong>, Luai and Cropp kept<br />

abreast of factors driving the overall growth of<br />

the dental care market in the region.<br />

According to the pair, there is a growing<br />

emphasis on dental aesthetics as the rise<br />

in beauty standards has contributed to an<br />

upswing in the demand for cosmetic dentistry<br />

services. Platforms like Instagram and TikTok<br />

have catalysed a trend towards achieving the<br />

perfect ‘Instagrammable Smile’ as individuals<br />

keep pace with evolving beauty standards.<br />

The co-founders also highlighted that the<br />

adoption of advanced dental technologies<br />

among dental providers has attracted<br />

individuals seeking state-of-the-art dental<br />

solutions. As awareness and education of oral<br />

health increase, people are becoming more<br />

In the near<br />

future, Oracare<br />

hopes to include<br />

four more South<br />

East <strong>Asia</strong>n<br />

countries into<br />

its group<br />

20 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


Leaders of the dental brands in the Oracare family at the Oracare-UDC celebration event in Manila, the Philippines<br />

proactive in seeking regular dental check-ups<br />

and adopting preventive measures.<br />

Other notable developments include<br />

economic and demographic changes. The<br />

region's economic growth has resulted in<br />

higher disposable incomes for a significant<br />

portion of the population, translating into<br />

increased spending on dental treatments.<br />

Ageing populations in some South East <strong>Asia</strong>n<br />

countries contribute to a higher prevalence<br />

of dental issues, and a surge in demand for<br />

restorative and preventive dental treatments.<br />

More importantly, driving its past and future<br />

endeavours is an identity and role that<br />

Oracare sees itself playing in the region. Luai<br />

and Cropp explained the designation of a ‘pan<br />

South East <strong>Asia</strong>n’ dental group, which Oracare<br />

has assumed, is grounded in its commitment<br />

to advancing oral care across a region marked<br />

by diverse cultural and healthcare landscapes.<br />

With a 662 million population and a combined<br />

GDP of US$3.2tn, ASEAN serves as the<br />

backdrop of Oracare’s collective vision<br />

that leverages the talent of the best dental<br />

entrepreneurs in South East <strong>Asia</strong>. By fostering<br />

a sense of unity and shared purpose among<br />

these diverse talents, Oracare aims to create a<br />

collaborative network which contributes to the<br />

advancement of oral care standards across<br />

borders.<br />

“Our alignment with ASEAN's economic cooperation<br />

promotes not only regional growth<br />

but also the exchange of knowledge and best<br />

practices in oral care. In essence, Oracare<br />

Group's ‘pan South East <strong>Asia</strong>n’ identity is<br />

more than just a designation; it is a strategic<br />

framework that harmonises diverse talents,<br />

acknowledges regional distinctions, and<br />

positions us as a key player in advancing oral<br />

care standards throughout South East <strong>Asia</strong>,”<br />

the pair said.<br />

However, with this vision lies challenges<br />

given the differences in language, politics,<br />

culture, business methods, and levels of<br />

care in each country. “South East <strong>Asia</strong> is<br />

not a homogenous market. Unlike the US or<br />

China, the entry barrier to create a pan South<br />

East <strong>Asia</strong>n group is high. Building trusted<br />

relationships in each market is critical, and<br />

this takes time," said Cropp.<br />

“Each country and their clinics may have<br />

unique approaches to patient interaction,<br />

treatment methodologies, and business<br />

operations as well as varying regulatory<br />

environments. While navigating through<br />

the different regulatory frameworks and<br />

compliance requirements in each country,<br />

being adaptive to adhere to the diverse<br />

regulations is crucial for seamless operations,”<br />

said Luai.<br />

A nuanced understanding of cultural<br />

preferences and local trends facilitates the<br />

tailoring of marketing strategies to resonate<br />

with diverse customer bases. “Adapting<br />

promotional campaigns to suit each market<br />

is essential. For instance, restorative and<br />

aesthetic are increasingly in demand in<br />

Singapore but may not in high demand in the<br />

Philippines yet,” Luai added.<br />

Despite the varying cultures and practices,<br />

the co-founders believe that there are more<br />

similarities than differences across countries<br />

and consumers. “What is universal across all<br />

countries is the common desire of patients<br />

to have access to quality dentistry in a<br />

modern, well-equipped clinic with high<br />

hygiene standards, dentists with excellent<br />

clinical skills, and clinic staff with a focus on<br />

customer service,” said Luai.<br />

Moreover, the common challenges faced<br />

by dental providers will continue to be a<br />

driver for like-minded practitioners to join<br />

forces with larger groups like Oracare in<br />

order to leverage potential synergies for<br />

mutual benefit. “In the current environment<br />

of hyper competition for talent, many clinic<br />

owners experience high staff turnover.<br />

Rising consumable, supply costs as well as<br />

utilities are eating into operating margins.<br />

Clinic owners also find it difficult to set aside<br />

dedicated resources to market their services<br />

to consumers and corporations and compete<br />

in the over-saturated online marketing<br />

channels,” said Luai.<br />

He added: “This is where the growth<br />

platform that we have developed comes<br />

into play. For example, we were able to offer<br />

structured career paths, with onboarding<br />

and training programme, hence attracting<br />

new talent with no prior experience in dental<br />

assisting, as well as retaining the best and<br />

the brightest. With scale, we are also better<br />

able to deploy staff to cross cover clinics<br />

that experience staff absenteeism.”<br />

The confluence of economic, technological,<br />

and social factors provides a timely tailwind<br />

boost for the ambitions and strategies<br />

charted by Oracare. With its proven business<br />

model and collective experience gained from<br />

past ventures, Luai and Cropp are confident<br />

of replicating the success of Oracare in the<br />

Philippines and beyond. DA<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong><br />

21


UNDER THE SPOTLIGHT<br />

Undergraduate students studying Dentistry, Medicine, Nursing and Pharmacy from<br />

the National University of Singapore (NUS) will be able to gain deeper and broader<br />

knowledge and understanding of healthcare issues and challenges through a new<br />

interdisciplinary Common Curriculum. <strong>Dental</strong> <strong>Asia</strong> speaks with Professor Chris<br />

Peck, Dean of NUS Faculty of Dentistry, and Associate Professor Wong Mun Loke,<br />

Vice Dean (Education) of NUS Faculty of Dentistry, on how the changes in the<br />

curriculum and the wider healthcare landscape will influence dental education.<br />

By James Yau<br />

A common foundation for<br />

preventive and integrative<br />

healthcare<br />

Since August 2023, Dentistry undergraduates<br />

from NUS joined peers from Medicine,<br />

Nursing and Pharmacy as the first cohort of<br />

students enrolled in a new curriculum aimed at<br />

enhancing undergraduate healthcare education<br />

to future-proof Singapore’s healthcare system.<br />

The new interdisciplinary Common Curriculum<br />

was introduced for undergraduates in Dentistry,<br />

Medicine, Nursing and Pharmacy where about<br />

870 first-year students enrolled in five specially<br />

designed pillars together, collaborating across<br />

the four healthcare disciplines as part of their<br />

learning journey.<br />

Interdisciplinary and collaborative skills are at the centre of a new transformative Common Curriculum<br />

offered by NUS to train future healthcare professionals<br />

Against the background of the nation’s<br />

healthcare initiative — Healthier SG — which<br />

focuses on integrated and preventive care,<br />

doctors, nurses, dentists and pharmacists<br />

will need to work together to support and<br />

holistically care for the community in all<br />

aspects of their healthcare needs.<br />

The cross-disciplinary curriculum seeks to<br />

cultivate in students the awareness of social<br />

issues and their impact on health, teamwork,<br />

communication skills, professionalism, digital<br />

literacy, and interprofessional education.<br />

“Given the well-established relationships<br />

between oral health and general health, for<br />

example between periodontal disease and<br />

diabetes, there is value in the interprofessional<br />

management of patients to ensure their oral<br />

and general health needs are appropriately<br />

addressed. This underscores the need to begin<br />

equipping healthcare profession students<br />

with the knowledge of such oral-systemic<br />

interactions through platforms such as the<br />

Common Curriculum,” said Assoc Prof Wong.<br />

COMMON GROUND<br />

The newly curated Common Curriculum<br />

draws on academic content from Dentistry,<br />

Medicine, Nursing and Pharmacy, and has<br />

to be completed in the first two years of<br />

candidature. It complements the existing<br />

curriculum of the four disciplines and<br />

comprises five pillars — Social and Behavioural<br />

Determinants of Health, The Foundations<br />

of Health Professionalism, Basic Skills in<br />

Health Professionalism, and two pillars that<br />

address different aspects of data literacy<br />

for healthcare — with each course to be<br />

completed within 13 weeks.<br />

For Dentistry students, its scope and contents<br />

reinforce the pre-clinical curriculum delivered<br />

in the first two years of the Bachelor of <strong>Dental</strong><br />

Surgery (BDS) programme. “What used to be<br />

taught uni-professionally, is now taught interprofessionally<br />

among Dentistry, Medicine,<br />

Nursing and Pharmacy students. For instance,<br />

our dental students now learn about the<br />

'Social and Behavioural Determinants of<br />

Health' as well as 'Patient Communication'<br />

together with their peers from the other<br />

22 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


UNDER THE SPOTLIGHT<br />

healthcare programmes through the Common<br />

Curriculum instead of learning it among<br />

themselves," explained Assoc Prof Wong.<br />

The interdisciplinary collaborative learning,<br />

facilitated by the Common Curriculum, not<br />

only allows students from different healthcare<br />

disciplines to better understand the broad<br />

range of health issues faced by patients; it<br />

also allows them to better understand the<br />

roles and responsibilities of the various<br />

healthcare professionals.<br />

“With an increasingly ageing population,<br />

many older adults may present with medical<br />

conditions alongside their oral health issues.<br />

The co-management of these patients by the<br />

larger healthcare team comprising doctors,<br />

nurses, pharmacists and dentists will ensure<br />

that older adult patients receive holistic,<br />

comprehensive and quality care,” Assoc Prof<br />

Wong added.<br />

In real-world practice, the need to refer<br />

patients for different aspects of care will be<br />

required. Armed with an understanding of<br />

common health issues and the professional<br />

roles played by various members of the<br />

healthcare team, students can better plan<br />

appropriate referrals for their patients when<br />

they graduate and enter the healthcare<br />

workforce in the future. Furthermore,<br />

with students from different healthcare<br />

programmes learning together, they can<br />

also pick up skills on interprofessional<br />

communication.<br />

In addition to increased collaboration across<br />

healthcare disciplines, the new Common<br />

Curriculum seeks to inculcate preventive<br />

health paradigms. As part of the ‘Healthier SG’<br />

vision, the significance of prevention across<br />

one’s lifespan is emphasised. Coupled with<br />

rising developments in preventive health tools<br />

through AI software and data collection, oral<br />

healthcare professionals play an important<br />

role in providing good preventive strategies for<br />

population health.<br />

“Preventive dentistry has always been<br />

a fundamental and pivotal part of oral<br />

healthcare to help individuals maintain good<br />

oral health and avoid the need for complex<br />

treatment. Beyond dental health education,<br />

oral healthcare professionals are also well<br />

positioned to offer opportunistic health<br />

education to promote healthy lifestyles,<br />

including healthy diets and tobacco cessation<br />

advice, among their patients. The Common<br />

Curriculum is therefore well-poised to equip<br />

our students with the knowledge and skills to<br />

help their patients engage in more preventive<br />

health practices," said Assoc Prof Wong.<br />

The shift in healthcare is not only visible<br />

top-down from institutional planners, but<br />

also within a wider public attitude towards<br />

the future of healthcare. Gabriel Tan Yih-<br />

Shyan, a first-year BDS student at the NUS<br />

Faculty of Dentistry, finds the new Common<br />

Curriculum an apt reflection of the healthcare<br />

transformation which has expanded his<br />

perception of dentistry and redefined the very<br />

essence of the roles of dental professionals.<br />

"Prevention is an important part of healthcare.<br />

Guiding patients on the preventive steps they<br />

should take to maintain good oral hygiene and<br />

minimise the need for invasive treatment is an<br />

equally important aspect of being a dentist,”<br />

said Tan. “To do so, dental professionals<br />

must be able to decipher the intricate socioecological<br />

factors influencing their patient’s<br />

oral health."<br />

Tan highlighted how the course on 'Social<br />

and Behavioural Determinants of Health'<br />

shaped his perspective as a future healthcare<br />

professional. “This course underscores the<br />

clinical imperative of transcending mere<br />

diagnoses, encouraging me to view patients<br />

as intricate whole individuals. By assigning<br />

equal significance to the socio-ecological<br />

factors influencing their health, I am better<br />

equipped not just to treat their existing<br />

conditions but to empower them on a<br />

transformative path to holistic wellbeing,”<br />

Tan said.<br />

DATA, APPROACHES, AND<br />

EDUCATION<br />

On the evergreen challenge to “futureproof”<br />

dental students and professionals<br />

in an evolving future, Prof Peck takes the<br />

consideration of how the communities served<br />

are changing and then adapting to these<br />

changes as the first step.<br />

“Across <strong>Asia</strong>, our populations are ageing,<br />

and there is much diversity culturally,<br />

educationally, and socioeconomically. These<br />

and other social determinants of health<br />

play a large role in shaping one’s oral health<br />

and access to care. Consequently, dental<br />

practitioners need to individualise care so<br />

that it is person-centred, considering the<br />

individual's biological, psychological and social<br />

factors,” said Prof Peck.<br />

Prof Peck explained that this “biopsychosocial”<br />

approach is especially important for the<br />

dental practitioner as the oral and craniofacial<br />

region is important for an individual's physical<br />

and emotional identity, for verbal and nonverbal<br />

communication, mastication, and is<br />

associated with the very important special<br />

senses of taste, smell, vision and hearing.<br />

Specific skills required of a dental practitioner<br />

include cultural competence, an understanding<br />

of the needs of elderly patients and other<br />

groups who are at risk of poorer oral health,<br />

a focus on interprofessional collaborative<br />

practice to integrate oral health in the broader<br />

healthcare context, and communication skills<br />

to deal with the diverse range of health literacy<br />

in our communities.<br />

“Healthcare contributes substantially to<br />

environmental degradation and we all need<br />

to take steps to minimise or reverse this<br />

impact through a focus on sustainable oral<br />

healthcare. A greater focus on preventive care<br />

reduces the need for operative and surgical<br />

treatments and when these are needed, they<br />

should be planned and implemented carefully<br />

ensuring high quality, predictable outcomes.<br />

Advances in the digital workflow and AI can<br />

help here with efficient use of resources and<br />

optimising individualised care," said Prof Peck.<br />

Data literacy skills will empower healthcare<br />

and dental professionals in navigating<br />

transformations in their respective fields (Image:<br />

Unsplash/ Carlos Muza)<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong> 23


Prof Peck addressing the cohort of first-year students and their family members in September 2023<br />

<strong>Dental</strong> education has embraced technologies<br />

and advanced simulation learning<br />

environments to help students develop<br />

competency through individualised training of<br />

such surgical skills.<br />

Some of the initiatives at the NUS Faculty of<br />

Dentistry to integrate technology in student<br />

learning include a collaboration with the<br />

NUS College of Design and Engineering to<br />

develop a 3D-printed dental extraction kit to<br />

simulate teeth extraction for a broad range<br />

of scenarios. A 3D-printed silicon device was<br />

also developed to train students to administer<br />

local anaesthesia in an augmented-reality<br />

setting before performing on actual patients.<br />

Digital workflows are utilised to improve<br />

outcomes in oral and maxillofacial surgery<br />

through customised 3D-printed maxillofacial<br />

prostheses to reconstruct and promote bone<br />

growth in bony defects.<br />

“Of course, we need to consider the impact of<br />

technology on an individual’s data privacy and<br />

the responsible use of technology in decisionmaking.<br />

These are not issues unique to<br />

dentistry and we have developed the Common<br />

Curriculum across health professions to<br />

address such issues," said Prof Peck.<br />

Alongside the increasing use of technology in<br />

dentistry, there is a growing awareness of the<br />

need to harness data in informing the practice<br />

of evidence-based oral healthcare. In an<br />

age of big data, the role of such information<br />

and an understanding of how it is collected,<br />

managed, and analysed will help students<br />

to make use of it, and guide their decisionmaking<br />

processes in the diagnosis and<br />

subsequent design of patient treatment plans.<br />

With this context in mind, a keen awareness<br />

and appreciation of how data can be critiqued<br />

will help students embrace evidence-informed<br />

approaches to healthcare. To achieve this,<br />

two pillars of the Common Curriculum seek to<br />

imbue skills and knowledge in data literacy.<br />

The first-year course on data literacy features<br />

components of evidence-based practice<br />

and covers the principles of data analysis as<br />

well as decision-making under uncertainty<br />

which are relevant to clinical practice. This<br />

foundation is expanded further in a secondyear<br />

course which explores skills such as<br />

computational thinking, data science, AI, and<br />

machine learning in the healthcare context,<br />

and more.<br />

"Healthcare needs to be underpinned by<br />

evidence and while there have been enormous<br />

advances in biomedical research over the past<br />

century, we are considering a more integrated<br />

approach of research, education and clinical<br />

care so that research is targeted, and research<br />

findings are implemented effectively and<br />

efficiently," said Prof Peck.<br />

Such an approach can be used in various<br />

stages of the student lifecycle, from<br />

undergraduate through to postgraduate<br />

education and continuing professional<br />

development, to help develop and maintain<br />

competencies.<br />

Furthermore, Prof Peck believes that a personcentred,<br />

rather than patient-centred<br />

approach, is needed to manage oral health at<br />

both individual and population levels to place<br />

greater emphasis on prevention. This is<br />

illustrated where dental professionals typically<br />

believe chronic pain patients are primarily keen<br />

on reducing pain intensity. However, these<br />

patients often prioritise a desire to restore their<br />

regular family, social and work activities.<br />

Another interprofessional approach involves<br />

working with language experts to enhance<br />

communication and health literacy to improve<br />

applied research and community health<br />

outcomes.<br />

“Importantly, all of us in dental education and<br />

research need to consider what the dental<br />

professional of 2030 and beyond looks like,<br />

as we are now training graduates for then.<br />

The dental professional needs to be firmly<br />

embedded as part of the healthcare team and<br />

focus on a person-centred approach,” Prof<br />

Peck concluded.<br />

With the confluence of economic conditions,<br />

society values, technology enablers, and<br />

demographic factors shaping health and<br />

healthcare across the globe, the new Common<br />

Curriculum will better prepare students across<br />

various health professions to take on the<br />

healthcare needs of the population. DA<br />

24 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


DENTAL PROFILE<br />

Turning customer feedback<br />

into product improvement<br />

Amid the constant flurry of launches and upgrades<br />

for the latest dental product, how do some<br />

product features make the cut while others miss<br />

out? Alexis Miche shares on his role as a product<br />

manager at Ackuretta and how feedback gets<br />

transformed into new features for users.<br />

By James Yau<br />

As a product manager, Miche is responsible<br />

for all aspects of Ackuretta’s products<br />

and leads the strategic development of<br />

new products. He supervises the product<br />

development lifecycle of a given product to<br />

ensure it progresses on time and on budget<br />

prior to the go-to market phase.<br />

A big part of his role is product improvement.<br />

This entails the collection of feedback,<br />

recommending product improvements<br />

to engineering teams, implementing new<br />

features, and communicating the changes<br />

across the organisation.<br />

“While feedback is important in creating<br />

a user-friendly product, it is important for<br />

us to gauge the risks<br />

and benefits of any new<br />

product feature to ensure it<br />

is the most optimal use of<br />

our available capacity and<br />

resources,” said Miche.<br />

“The key variables important to consider for<br />

any new product launch or product update are<br />

the value a feature provides to the user and the<br />

difficulty of its implementation.”<br />

AN EAR TO THE GROUND<br />

As a product manager, Miche believes it is<br />

important to stay attuned to the demands<br />

and needs of customers at different stages<br />

of a given product. He employs a variety<br />

of mechanisms through which feedback<br />

is collected to help him stay in touch with<br />

customers.<br />

This includes training sessions, interactions<br />

with Ackuretta’s customer support team,<br />

communication with its partner dentists, social<br />

media channels, and surveys sent to users.<br />

“Our Ackuretta User Group on Facebook is an<br />

invaluable tool for us to engage directly with<br />

our users to hear their issues and suggestions<br />

in real time as well as get their feedback as to<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong> 25


DENTAL PROFILE<br />

the direction we should go with updates,”<br />

said Miche.<br />

One product from Ackuretta where such<br />

feedback mechanisms are at play is its new<br />

AI-assisted 3D slicing software, ALPHA AI.<br />

At its launch on 10 Jan 2023, the company<br />

promised to release constant updates every<br />

three months to add new features and<br />

functions to the dental 3D printing software.<br />

The latest update to the software on 9 Nov<br />

2023 included three new compatible<br />

applications for denture base, denture teeth,<br />

and removable die.<br />

“We hold regular training sessions with<br />

users which serve as a very effective forum<br />

to collect feedback and understand how<br />

Ackuretta products can be improved. Tools<br />

such as surveys and feedback forms are also<br />

used to engage with ALPHA AI users to get<br />

their thoughts on the software and how it<br />

could be improved,” said Miche.<br />

Moreover, internal customer support and<br />

product support teams play important roles<br />

in collecting feedback as they liaise directly<br />

with end users, including its partner dentists<br />

who often have early access to new ALPHA AI<br />

updates.<br />

Before launch, products are sent to partners<br />

such as resin manufacturers and dental<br />

professionals to gather feedback for product<br />

development and improvement processes.<br />

Furthermore, pre-launch internal processes<br />

collect feedback and review based on the<br />

requirements of different teams internally.<br />

Miche meets both before and after product<br />

launch with Ackuretta’s R&D and customer<br />

success teams to go over proposed features<br />

and create a priority list for the engineering<br />

team.<br />

“This process ensures that we adhere to our<br />

organisational standards and are able to<br />

release an update to our existing products<br />

every three months at minimum,” said Miche.<br />

The feedback mechanisms also follow<br />

the same principles and processes for the<br />

company’s hardware products. However, due<br />

to the limited interactions with the end users<br />

as compared to its software counterparts,<br />

distributors are relied on as a channel for<br />

feedback.<br />

“In most of our markets we work with<br />

hardware distributors who interface directly<br />

with our end consumers. Working with<br />

distributors gives us a comprehensive sense<br />

of common questions and feedback from<br />

users worldwide,” said Miche.<br />

“Naturally we are aware of what our<br />

competitors are doing and strive to continue<br />

positioning our products in a premium place<br />

in the market,” he added.<br />

Miche does this by following conversations<br />

online about what end users are looking for.<br />

Media coverage on dentistry, 3D printing, and<br />

technology are channels where he keeps up<br />

to date on emerging developments for his<br />

consideration.<br />

A BALANCING ACT<br />

Another skill required of the product manager<br />

is to balance requirements and expectations<br />

of internal teams, where different teams have<br />

differing views of a product.<br />

“For example, the R&D team may consider<br />

a product based on its difficulty and cost to<br />

implement while marketing evaluates it based<br />

on its performance quality and support is<br />

concerned about its user friendliness and<br />

ease of repair,” explained Miche.<br />

Miche strikes the balance by being clear on<br />

the most important aspects of the products<br />

and judging the right way forward based<br />

on a cumulative view of the key variables.<br />

Customer data can clarify between the<br />

subjective and bottom-line benefits which<br />

makes it easier for decision making.<br />

“We often have meetings between heads of<br />

departments before big launches or updates<br />

to go over the most important factors and<br />

judge the importance for users. Sometimes it<br />

is easy to decide and sometimes it is not. The<br />

most important thing is to have buy-in and<br />

understanding across our organisation,”<br />

said Miche.<br />

With the service for customers as its main<br />

priority, Miche added that the benefit and<br />

value provided to the user always comes<br />

first. “Getting to the final decision internally is<br />

about putting our team in the best position to<br />

enable the user to get the best results for their<br />

practice and patients,” Miche added.<br />

ON THE OUTLOOK<br />

For Miche, to stay at the forefront of the<br />

evolution of dentistry requires a keen<br />

awareness of not only the latest trends and<br />

technologies within the industry, but also<br />

across various sectors as he shared what he<br />

has been keeping his eye on.<br />

“AI continues to have expanding applications<br />

in dentistry. ALPHA AI’s functionalities<br />

continue to expand, particularly with the<br />

addition of new dental applications which<br />

benefit from AI-generated supports and autoorientation.<br />

We are currently exploring how AI<br />

can be integrated effectively in other aspects<br />

of the dental 3D-printing workflow and expect<br />

to see breakthroughs in the coming years.”<br />

Another trend that Miche noticed broadly is<br />

towards multi-use hardware that is designed<br />

for results across different industries and<br />

printed applications. He also highlighted that<br />

it is essential for products to have the highest<br />

results for the full range of dental applications<br />

while considering the needs of practitioners<br />

ranging from high volume labs to smaller<br />

clinics with a low capacity.<br />

“While our focus is on the dentistry market,<br />

we continue to strive to create adaptable<br />

products which can produce the highest<br />

quality applications for different needs and<br />

customers.” DA<br />

26 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


How to future-proof a<br />

dental school<br />

<strong>Dental</strong> schools globally are faced with a constant need to assess the technology<br />

and equipment used to equip students with relevant skills in an ever-evolving<br />

industry. Providing fully digital and customisable solutions for the varying needs<br />

of over 300 dental schools, manufacturers like Planmeca play a crucial part in<br />

supporting the design and build of these education spaces.<br />

When it comes to designing spaces where<br />

the next generation of dentists is trained, it<br />

is not as simple as plugging and fitting the<br />

most modern technology but ensuring the<br />

investments made equip students with the<br />

skills to navigate the foreseeable future.<br />

Universities with dental faculties like the<br />

University of Hong Kong (HKU) has witnessed<br />

the struggle with keeping up with the fast<br />

technological change in dentistry. Likewise,<br />

for the University of British Columbia (UBC), it<br />

is important to find a solution that is not only<br />

durable but also looks great year after year,<br />

since resources for continuously upgrading<br />

the facilities are often limited.<br />

At the crux of this struggle is director of aftersales<br />

and university projects for Planmeca,<br />

Jussi Ylisaari where he helps dental schools<br />

navigate the constant battle for needs and the<br />

advancements that industry has to offer.<br />

“It all starts with a dialogue with the dental<br />

school. We want to learn the school’s specific<br />

needs and visions. How do they teach? What<br />

exact factors are relevant to them? Once we<br />

understand these aspects, we can tell them<br />

how Planmeca’s dental school solutions can<br />

improve their unique environment,” Jussi<br />

Ylisaari told <strong>Dental</strong> <strong>Asia</strong>. “It is an ongoing<br />

dialogue, but our focus is always on adapting<br />

to the school’s needs. They are the educational<br />

experts. Our job is to make sure that our<br />

technologies and implementations optimally<br />

support the school and the valuable work done<br />

there,” Ylisaari commented.<br />

DURABILITY IN FUNCTION AND STYLE<br />

In 2022, the UBC Faculty of Dentistry upgraded<br />

the 144 dental care units in their Nobel Biocare<br />

Oral Health Centre (OHC) dental clinic and<br />

opened a new simulation laboratory. The main<br />

goals for these projects were to enhance<br />

the learning environment, facilitate patient<br />

care and ensure the students will continue<br />

to receive the best possible educational<br />

experience over the next decade.<br />

“We like to train competent general dentists<br />

that are also critical thinkers. This way, as<br />

new technologies and methodologies are<br />

applied to dentistry, our students will be able<br />

to assess those and incorporate them in their<br />

private practices,” said Dr Mary MacDougall,<br />

professor and dean of the Faculty of Dentistry<br />

at the UBC at the time of the investment.<br />

The Faculty of Dentistry at UBC hosts around<br />

500 students across their degree and postgraduate<br />

programmes, receiving 550-650<br />

applications for the DMD programme, among<br />

which 65 applicants are accepted. <strong>Dental</strong><br />

education revolves around the student as a<br />

learner and according to Dr MacDougall, this<br />

is accomplished by offering the students the<br />

necessary means for the training.<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong> 27


DENTAL PROFILE<br />

“The durability of the products and the service<br />

by Planmeca, which we had witnessed firsthand,<br />

was essential for us and helped us<br />

make the decision. Given the prior reliability<br />

and generally low maintenance needs of<br />

Planmeca dental units, Planmeca was also<br />

very competitive from the standpoint of<br />

pricing and the product’s capabilities. With<br />

regards to usability, they are quite intuitive,”<br />

said Dr MacDougall.<br />

In addition to upgrading the OHC with<br />

Planmeca Compact i Classic dental units, UBC<br />

opened the 123Dentist Simulation Laboratory<br />

with Planmeca Compact iSim simulation<br />

units in September 2022. The laboratory<br />

layout was planned together with Planmeca<br />

to fit the simulation laboratory in the existing<br />

premises and to ensure efficiency and smooth<br />

simulation workflows in the facility.<br />

“We had limited space available for the<br />

simulation laboratory. Therefore, the<br />

layout design was very critical to facilitate<br />

student learning and allow instructor<br />

access throughout the learning process,”<br />

Dr MacDougall said. “Since Planmeca<br />

had vast experience in designing other<br />

simulation facilities, they were able to help<br />

us with their knowledge. They made very<br />

valuable suggestions on the floor plan as<br />

well as format. Similar to dental units, the<br />

simulation equipment is aesthetically modern<br />

and pleasing, so the 123Dentist Simulation<br />

Laboratory is truly a showcase for us here at<br />

the university.”<br />

On an annual basis, over 40,000 patients<br />

are taken care of in the OHC, which means<br />

the equipment is in high use throughout<br />

the year. At this end, Ylisaari highlighted<br />

how Planmeca products can be updated<br />

and retrofitted with new features instead of<br />

replacing them, which also makes Planmeca<br />

units a sustainable choice for dental schools.<br />

“What sets Planmeca apart from others is<br />

that instead of individual products we offer<br />

an entire platform. We fully understand that<br />

these are sizable, 15-20-year investments for<br />

dental schools, so we create equipment with<br />

long lifespans.”<br />

Ylisaari added: “They are manufactured from<br />

durable materials and can be upgraded with<br />

new technologies as time passes. We have<br />

The 123Dentist Simulation Laboratory at UBC<br />

Dentistry has 73 Planmeca Compact iSim<br />

simulation units<br />

kept our product development process entirely<br />

in-house so that we are able to remain agile<br />

and to quickly react to new trends as they<br />

emerge. For decades, we have closely listened<br />

to dental schools to create consistently better<br />

and meaningful products and solutions.”<br />

DIGITALISATION IN APAC<br />

Across the Pacific for Dr Gary S P Cheung,<br />

the biggest challenge for dental education<br />

today is indeed the disparity between the<br />

necessary investments in new technologies<br />

and the available resources to fund these<br />

investments.<br />

Over the past decade, the clinical professor<br />

who has since assumed a new position<br />

in the Shenzhen Hospital of the HKU has<br />

overseen the undergraduate dental studies<br />

at the university’s Faculty of Dentistry. His<br />

experience in upgrading the faculty’s facilities<br />

emphasised early exposure to clinical training.<br />

“Thirty years ago, when you wanted to explore<br />

the most modern equipment, you could visit<br />

any dental school in town rather than a dental<br />

practice. Today it is the other way around.<br />

Worldwide, it is usually dental practices that<br />

are using the latest digital tools rather than<br />

universities,” said Dr Cheung.<br />

“Our students get exposed to the clinical<br />

environment very early, as they start training<br />

in the simulation laboratory from the second<br />

year onwards. Although they start their work<br />

with very simple things, they already get<br />

to experience the clinical environment and<br />

handle real instruments first-hand.”<br />

In 2017, the simulation laboratory at the HKU<br />

Faculty of Dentistry was equipped with 82<br />

Planmeca simulation units, two of which<br />

are designated for teaching purposes. The<br />

laboratory was expanded further in 2023<br />

with 20 Planmeca Compact iSim units. The<br />

simulation laboratory allows HKU students to<br />

utilise digital dental equipment from the very<br />

start of their preclinical studies.<br />

The facilities also encompass eight lead-lined<br />

Planmeca ProX intraoral x-ray simulation<br />

cabinets, allowing students to practise<br />

intraoral imaging techniques safely, as well<br />

as one Planmeca ProScanner imaging plate<br />

scanner.<br />

“We wanted a simulation environment that is<br />

future-proof and able to integrate our teaching<br />

technology. The Planmeca simulation<br />

laboratory has proven to do just that. The<br />

beauty of Planmeca is that the simulation<br />

unit with a phantom head is exactly the same<br />

as the clinical units we use in the university<br />

hospital, which makes the transition from<br />

simulation to actual clinical work easier,” Dr<br />

Cheung said.<br />

Students also learn to view and process the<br />

intraoral x-ray images they have captured with<br />

the intraoral imaging simulation cabinets.<br />

These images are immediately available in<br />

Planmeca Romexis software on the student’s<br />

workstation.<br />

“I can see that our students like the Planmeca<br />

equipment and especially the AV connection<br />

of the simulation units. The clinic’s layout,<br />

which we planned together with Planmeca,<br />

also allows us to teach our students all at the<br />

same time or separately, and the students<br />

really appreciate that they always have the<br />

same working setup either way,” Dr Cheung<br />

added.<br />

Planmeca assembles a dedicated team for<br />

each university project, which supports the<br />

dental school in every stage of the project<br />

from vision to equipment deliveries and<br />

28 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


DENTAL PROFILE<br />

The layout plan of the simulation laboratory<br />

extension at HKU Faculty of Dentistry with 20<br />

Planmeca Compact iSim units<br />

maintenance. The team offers advice on<br />

matters such as optimising floor space,<br />

efficient organisation of supplies, necessary<br />

clinic utilities, infection control routines,<br />

material and patient flows, and adapting the<br />

space to different educational needs.<br />

“Another thing that really impressed us about<br />

Planmeca was the communication. We<br />

could ask all kinds of questions about the<br />

configuration and placement of the devices,<br />

and we were involved throughout the project<br />

and in the clinical layout planning,” said<br />

Dr Cheung.<br />

Every year, the HKU Faculty of Dentistry<br />

receives thousands of applications for the<br />

BDS programme, where 90 applicants are<br />

accepted into the BDS programme. The key to<br />

its learning places a strong emphasis on highcalibre<br />

dental research and a problem-based<br />

learning (PBL) curriculum.<br />

In PBL, students are presented with reallife<br />

clinical problems where they learn to<br />

solve in interactive groups. The students are<br />

encouraged to face clinical challenges and<br />

apply new technologies with an open mind —<br />

which is necessary in the ever-evolving world<br />

of dentistry. The PBL approach is reinforced<br />

by practical training, both in preclinical and<br />

clinical setting. Moreover, the students gather<br />

interprofessional experience for example<br />

by training alongside dental hygienists and<br />

dental surgery assistants.<br />

Planmeca’s platform-based solutions<br />

provided an ideal solution for this challenge<br />

with their upgradability: All products can<br />

be easily upgraded with new features and<br />

functionalities as they become available, for<br />

example with software updates and retrofits.<br />

New features are regularly introduced to<br />

Romexis software, ensuring users have<br />

access to the latest innovations in dentistry<br />

for years to come. The university will also<br />

benefit from the new AI-based features of<br />

Romexis once they become available.<br />

Ylisaari believes that technology is becoming<br />

less of a trend and more of a requirement in<br />

dentistry.<br />

“It is no longer something that is nice to have,<br />

but rather an indispensable part of learning.<br />

Today’s students are the first truly digital<br />

generation, Gen Z. They are fast to adapt to<br />

new technological environments and expect<br />

to use the latest innovations in their education<br />

and work. This is really a global phenomenon,<br />

but one that is also very clearly visible in the<br />

APAC region," he said.<br />

CAUSE AND EFFECT<br />

In both universities, a knock-on effect of<br />

its future-proofing efforts is a rise in global<br />

rankings and applications volume for its<br />

programmes.<br />

For research at the HKU Faculty of Dentistry,<br />

the university rankings have sparked a positive<br />

cycle. The university rankings have had little<br />

effect on the number of BDS applicants.<br />

Instead, the increased international attention<br />

generated by the rankings has made the postgraduate<br />

training and specialist training more<br />

appealing to international applicants.<br />

On the one hand, the prominent position in<br />

the rankings is partly due to the university’s<br />

investments in clinical and non-clinical<br />

Future-proofing efforts at both universities has<br />

had a larger impact of raising their profile across<br />

its body of academic programmes and research<br />

research. On the other hand, the heightened<br />

attention caused by the rankings has<br />

contributed to an environment that fosters<br />

research.<br />

“Our faculty staff has quite a high publication<br />

rate per capita and we have dedicated<br />

professors to ensure our involvement in<br />

high-calibre research, too. Our researchers<br />

also train PhD students and collaborate a lot,<br />

which enhances the visibility of our research<br />

and helps get more citations, which in turn<br />

contributes to our rankings,” Dr Cheung<br />

explained.<br />

As for UBC, the new facilities with Planmeca<br />

products have also contributed to students<br />

choosing the university, according to Dr<br />

MacDougall. As students are interviewed<br />

for admission to UBC Dentistry, they are<br />

presented with videos and photographs<br />

highlighting the facilities, and the new<br />

simulation laboratory is one of those facilities<br />

being highlighted.<br />

“The new facility is quite impressive. We have<br />

heard from our students that having such<br />

high-tech equipment to support their learning<br />

is one of the features why they have chosen<br />

UBC,” Dr MacDougall said. “We appreciate the<br />

due diligence by the entire Planmeca team in<br />

the initial planning and design phase because<br />

I think that has led to the success we have<br />

had in recent years.”<br />

Keeping an eye on future developments,<br />

Ylisaari alluded to digitalisation and AI as<br />

considerable ongoing drivers. He further<br />

noted that self-learning and self-assessment<br />

are also increasingly relevant trends, where<br />

students are becoming more independent in<br />

some aspects, leading to a shift away from<br />

traditional lecture-based learning. Digital tools<br />

open up numerous possibilities for supporting<br />

this shift.<br />

“Our responsibility is to help integrate these<br />

new tools into the educational environment,<br />

to have them support learning,” he said.<br />

“Transitioning to digital dentistry teaching<br />

does not happen overnight and might be<br />

challenging due to various reasons. Our<br />

adaptive, platform-based solutions are<br />

designed to support the schools during every<br />

phase of this journey.” DA<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong> 29


DENTAL PROFILE<br />

Into the Dentaverse<br />

Imagine a virtual realm where dental practitioners<br />

could attend live dental exhibitions, education<br />

programmes, and networking meetups from anywhere<br />

in the world. With advancements in virtual reality (VR)<br />

technology, virtual events could soon be a staple of the<br />

dental industry. <strong>Dental</strong> <strong>Asia</strong> speaks with dental Web3<br />

and mixed reality platform Dentaverse on the potential<br />

and future of the virtual world. By James Yau<br />

At its core, the Dentaverse seeks to solve the<br />

problem of information isolation within global<br />

dentistry.<br />

“Although information distribution worldwide<br />

is pretty good, there is a small percentage<br />

of the industry that has access to such<br />

innovative and technological information.<br />

Through virtual events and hybrid models, you<br />

can open the market to more people and have<br />

the information readily available for a bigger<br />

audience,” said COO for Dentaverse, Floris<br />

Keyzer.<br />

Founded in 2022, Dentaverse started as an<br />

NFT community who saw an opportunity<br />

in the potential of VR. Where traditional<br />

avenues for dental learning experiences, event<br />

hosting, and networking opportunities would<br />

be limited by geographical and economic<br />

factors, Dentaverse aims to provide a platform<br />

where the same content, opportunities and<br />

experiences can be accessed virtually.<br />

light design provide a leap in visual fidelity in<br />

these dynamic spaces with a touch of artistic<br />

direction and realism.<br />

Among the benefits of a virtual world are more<br />

access to high-quality dental education by<br />

eliminating the need for physical infrastructure<br />

and travel, and the removal of geographical<br />

barriers enabling dental professionals and<br />

students to connect effortlessly and globally.<br />

To encourage user adoption for those<br />

unfamiliar with the technology, a driving focus<br />

for Dentaverse is about promoting exploration<br />

and discovery within the platform.<br />

“By providing resources, tutorials, and support,<br />

we aim to demystify the technology and<br />

showcase its practical benefits in the dental<br />

field. This education-first approach helps<br />

in gradually building user confidence and<br />

comfort with the platform, thereby fostering<br />

a more tech-savvy dental community,” said<br />

Keyzer.<br />

He shared that Dentaverse has welcomed<br />

over 10,000 visitors to its virtual events<br />

which signalled an increasing acceptance of<br />

mixed reality as a medium for professional<br />

engagement and education in the dental<br />

sector. “The creation of the first global<br />

dental community has been a major draw<br />

for users, fostering a sense of belonging and<br />

shared purpose among dental professionals<br />

worldwide.”<br />

In her efforts to educate users on the benefits<br />

of the medium, Leyla Ibrahimli, head of<br />

community for Dentaverse, noted that the<br />

response of users is different based on<br />

geographic area.<br />

“Our focus pivots on creating an immersive<br />

VR experience that transcends traditional<br />

boundaries of learning and networking in<br />

dentistry,” Keyzer added.<br />

WEB3<br />

Powered by real-time 3D content capabilities<br />

in Unreal Engine 5, a popular creation engine<br />

commonly used by game developers, the<br />

Dentaverse creates live-rendered VR spaces<br />

in the form of classrooms, conferences, and<br />

connectivity hubs. The details in geometry and<br />

Education plays a key role in convincing potential<br />

users of the benefits of the technology<br />

For instance, markets in the Middle East<br />

were open and enthusiastic to trying new<br />

technologies while consumers from Eastern<br />

Europe were more pragmatic in seeing<br />

immediate returns for the technology’s<br />

functionality. Regulations in the EU also<br />

caused consumers to be more concerned<br />

about data privacy and regulation.<br />

The incorporation of Web3 elements like<br />

NFTs, decentralisation, and blockchain in<br />

the core functions of Dentaverse embodies<br />

30 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


DENTAL PROFILE<br />

“We aim to not only increase our user base<br />

but also deepen engagement, providing more<br />

tailored and interactive experiences that<br />

cater to the diverse needs of our users,”<br />

Keyzer added.<br />

For dental professionals, its VR spaces take<br />

the form of virtual patients where existing 3D<br />

tools like intraoral scans can be integrated into<br />

treatments for virtual clinics.<br />

Virtual patients can explore treatment options in virtual clinics through the<br />

integration of 3D tools like intraoral scans<br />

the company’s philosophy of building an<br />

empowered community of users and user<br />

experience. Compared to a Web2 era of the<br />

internet where content is user-generated and<br />

ownership of virtual spaces are private, the<br />

new iteration of Web3 focuses on shared<br />

ownership and transparency of virtual spaces<br />

through underlying technologies such as the<br />

blockchain.<br />

“The integration of Web3 elements in<br />

Dentaverse aims to enhance security,<br />

transparency, and user experience. Our future<br />

vision includes leveraging these technologies<br />

to further empower our users and foster a<br />

dynamic and thriving dental community,”<br />

Keyzer said.<br />

We are not here trying to create everything<br />

on our own, but we are there to help those<br />

who create things to come together and build<br />

together,” she said.<br />

Viewing itself as a collaborator rather than a<br />

competitor, Dentaverse is focusing on dental<br />

professionals, brands or distributors, and<br />

educational institutions as its target audiences,<br />

where VR technology would provide the next<br />

evolution in patient experiences in an industry<br />

that was moving towards 3D tools. Medical<br />

equipment suppliers like Medistock and<br />

Dumont instruments were among the first<br />

settlers of Dentaverse integrating their services<br />

and operations into the collaborative space.<br />

Furthermore, integrating such tools also<br />

proves useful for educational providers<br />

where the use of 3D models and immersive<br />

and videos of dental procedures provides<br />

a level of detail and realism that cannot be<br />

achieved with traditional teaching methods.<br />

The development of haptic technologies<br />

further provides opportunities for interactive<br />

simulations scenarios.<br />

“Haptic technology is heavily in production<br />

and development now. I tried it myself during<br />

IDS [2023]. It is crazy how you can feel the<br />

difference between a bone, gum, or a metal<br />

implant,” Ibrahimli said.<br />

For dental brands and distributors, Dentaverse<br />

holds the potential of an omnichannel sales<br />

and marketing tool where virtual showrooms<br />

display products in a more interactive manner.<br />

Another tangent for dental brands is the<br />

opportunity for technical and equipment<br />

training which could be hosted and simulated<br />

on the platform.<br />

Blockchain technology provides a secure<br />

framework for transactions and data<br />

management, user information and<br />

activities against unauthorised access and<br />

manipulation. The transparent nature of<br />

blockchain allows for clear and traceable<br />

records of transactions and interactions<br />

within the platform.<br />

Virtual spaces for<br />

conferences and<br />

lectures provide a<br />

more immersive and<br />

accessible outlet to<br />

information<br />

Decentralisation for instance sought to<br />

give users a stake in building the virtual<br />

community according to its unique needs.<br />

Ibrahimli highlighted an example of how<br />

a group of senior dental students from a<br />

university in Romania wanted to use the<br />

platform to engage junior students. “We<br />

aim to be the ecosystem and hub for open<br />

creation and integrations with other projects.<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong><br />

31


Three-dimensional product showrooms provide a more immersive outlet for dental brands<br />

“If you look at the evolution of marketing or<br />

sales, starting with a physical shop you may<br />

extend to a web shop where you can include<br />

social media for example. Dentaverse adds<br />

a new Web3 layer to your brand awareness<br />

and presence to a 24/7 immersive platform,”<br />

Ibrahimli explained.<br />

To ease the transition to virtual platforms,<br />

Dentaverse is promoting a hybrid event model.<br />

This combines elements of both physical and<br />

virtual events, allowing users to experience<br />

the benefits of virtual environments while<br />

still retaining some aspects of traditional<br />

conference formats. The approach showcases<br />

how the technology can complement and<br />

enhance traditional methods.<br />

A DIFFERENT REALITY<br />

In the ever-evolving landscape of technology<br />

and dentistry, Keyzer and Ibrahimli recognise<br />

the importance of agility and responsiveness<br />

to market conditions.<br />

“How do you ride the wave of an unestablished<br />

piece of innovation that is followed up very<br />

rapidly? For example, the difference between<br />

the first oculus and the latest oculus is<br />

immense. That kind of made us pivot from<br />

talking about VR and AR into talking about<br />

mixed reality,” Keyzer said.<br />

Ibrahimli believes that the technology<br />

currently lies in between disruption and<br />

deception stages, based on growth and<br />

development models for new technologies:<br />

“It is in a phase where within a few years or<br />

months, new developments or innovations<br />

will totally disrupt the environment and it<br />

will grow exponentially. Things will become<br />

lighter, cheaper, and more open for mass<br />

production.”<br />

Despite the alluring prospect of disrupting<br />

the modality of interactions and shaping<br />

a brand-new virtual world for the dental<br />

industry, Keyzer and Ibrahimli stand grounded<br />

in advancing the dental profession over<br />

technology. Their approach is anchored in<br />

a dual focus on innovation and user-centric<br />

development.<br />

“How do you build an industry in virtual<br />

reality? There are not many companies having<br />

this approach specifically aimed at the dental<br />

industry,” said Keyzer.<br />

The company envisioned a growing role<br />

for Web3 elements within the platform. A<br />

planned initial coin offering (ICO), where a<br />

virtual currency is launched to public buyers<br />

in a similar fashion to an initial public offering<br />

(IPO) to raise capital, aims to provide a<br />

tangible value proposition, incentivising<br />

participation and engagement within the<br />

Dentaverse community. The virtual token<br />

usable on the platform would be distributed<br />

and can be earned by users.<br />

The company is also monitoring the<br />

evolution of mixed reality hardware and<br />

software where improvements in the fidelity,<br />

interactivity, and accessibility of these<br />

technologies would enable Dentaverse to<br />

offer even more immersive and realistic<br />

experiences in virtual dentistry.<br />

“We know for sure that the technology will<br />

only develop, and it will get smaller, cheaper,<br />

and more accessible. I think the lesson<br />

that we learned in 2023 is that actually<br />

sometimes the value is not in diversification,<br />

but in keeping it simple and stupid to a<br />

certain extent, and going from there,” said<br />

Ibrahimli.<br />

Keyzer agreed: “We are going to take<br />

every element, from the dentists, clinics,<br />

assistants, students, universities,<br />

manufacturers and distributor all into this<br />

platform. That does not mean we want<br />

people to spend their days in the platform;<br />

in the end, what makes good technology is<br />

simplicity and usability.” DA<br />

32 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


CLINICAL FEATURE<br />

The necessary reassessment<br />

of mask use in dentistry<br />

By Dr John Hardie BDS, MSc, PhD, FRCDC, and Dr George Freedman BSc, DDS, DiplABAD, FIADFE, FAACD<br />

INTRODUCTION<br />

For at least three decades, masks<br />

have been compulsory requirements<br />

of the uniform worn by dentists and<br />

their clinical staff. The impetus for<br />

this behaviour might well have been<br />

the belief that masks would prevent<br />

contamination of blood and saliva<br />

from HIV infected patients. Although<br />

such a source of infection has never<br />

been documented, masked dentists<br />

have become the rule rather than the<br />

exception.<br />

Simultaneously with this development,<br />

numerous clinical and laboratory<br />

studies have led to a better<br />

understanding of how respiratory<br />

pathogens, and particularly viruses<br />

are transmitted. These studies raised<br />

serious doubts concerning the ability<br />

of traditional masks to stop the<br />

transmission of respiratory infections<br />

such as influenza. These concerns<br />

were ignored during the COVID-19<br />

pandemic when mask wearing became<br />

obligatory within all levels of society.<br />

Fortunately, earlier studies on mask<br />

efficacy have continued culminating<br />

in the release of a recent major<br />

study which proves with as much<br />

certainty as is possible — that masks<br />

do not stop the spread of respiratory<br />

diseases such as COVID-19.<br />

Based on this understanding, mask<br />

use in dentistry should be a personal<br />

decision irrespective of the opinions<br />

of peers and regulatory authorities.<br />

This article will provide the evidence to<br />

substantiate such a reassessment.<br />

AIRBORNE TRANSMISSION<br />

A purported reason for a mask is to<br />

prevent the airborne transmission<br />

of respiratory pathogens expelled<br />

as a moisture-laden suspension of<br />

droplet, and considerably smaller<br />

aerosol particles, during coughing,<br />

sneezing, and talking. The suspension<br />

experiences rapid dehydration which<br />

results in desiccation of the particles.<br />

This induces conformational changes<br />

in the lipid envelopes surrounding<br />

influenza, respiratory syncytial and<br />

coronaviruses such that they lose<br />

their ability to attach to and infect new<br />

host cells, effectively becoming noninfectious<br />

(Fig. 1). 1,2<br />

Fig. 1: Viruses with envelopes are less surface-stable, and more susceptible to disinfectants<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong> 33


CLINICAL FEATURE<br />

Fig. 2: Masks stop viruses much like this strainer collects sand<br />

While this phenomenon might be<br />

one reason why the role of airborne<br />

transmissions in hospital infections<br />

and from dental and orthopedic<br />

aerosols remains debatable, it serves<br />

to question the necessity of masks. 3,4<br />

SIZE MATTERS<br />

A nanometer is one billionth of a<br />

metre. A strand of human hair is<br />

approximately between 80,000-<br />

100,000nm wide. The influenza and<br />

coronaviruses range from 80-120nm,<br />

or approximately 0.1µm in diameter.<br />

This means that approximately 1,000<br />

of these viruses would fit across the<br />

width of a human hair. 5,6 The best<br />

fitting mask will not prevent a single<br />

human hair from passing between it<br />

and the face.<br />

N95 mask fabrics are designed to<br />

filter out 95% of airborne particles<br />

provided they are larger than 0.3µm<br />

in diameter and most surgical mask<br />

materials filter out particles 2.5µm or<br />

larger. 7 Therefore, its effectiveness<br />

in filtering out viruses of 0.1µm in<br />

diameter is highly questionable. Even<br />

if such devices did impede the flow of<br />

influenza and coronaviruses, millions<br />

of stray viruses would continue to pass<br />

through the gaps present around the<br />

periphery of masks.<br />

In practical terms this means that a<br />

mask is no more effective at stopping<br />

viruses than a strainer is at collecting<br />

sand (Fig. 2).<br />

HISTORICAL PERSPECTIVE<br />

Beginning with studies from 1946,<br />

a meta-analysis of masks efficacy<br />

published in <strong>February</strong> 2020 concluded<br />

that surgical-type face masks were<br />

not effective in reducing influenza<br />

transmissions. 8<br />

In 2013, nurses from Ontario, Canada,<br />

filed a grievance against the use<br />

of masks in lieu of receiving a flu<br />

vaccination. Independent arbitrators<br />

in 2015 and 2018 reviewed hundreds<br />

of relevant documents and found<br />

that hospitals could not force mask<br />

mandates because supporting<br />

evidence was insufficient, inadequate,<br />

and completely unpersuasive. 9,10<br />

In 2017 the Centers for Disease<br />

Control and Prevention (CDC) compiled<br />

a report based on a 16-year study of<br />

almost 200 articles concerning nonpharmaceutical<br />

methods of mitigating<br />

the effects of influenza pandemics.<br />

Masks were not mentioned — attesting<br />

to the CDC’s recognition of its<br />

ineffectiveness. 11<br />

The World Health Organization (WHO)<br />

in 2019, while commenting on the use<br />

of non-pharmaceutical measures to<br />

avoid respiratory transmissions, noted<br />

that: “There is also a lack of evidence<br />

for the effectiveness of improved<br />

respiratory etiquette and the use of<br />

face masks in community settings<br />

during influenza epidemics and<br />

pandemics.” 12<br />

In a March 2020 interview on the ’60<br />

minutes’ news programme, Dr Anthony<br />

Fauci stated categorically that “there<br />

is no reason to be walking around<br />

wearing a mask”. 13<br />

The large randomised DANMASK-19<br />

study released in 2021 concluded that<br />

surgical masks did not reduce SARS-<br />

CoV-2 infection rates among wearers in<br />

a community setting. 14<br />

This is but a small sample of the<br />

decades of studies refuting mask<br />

efficacy. For more extensive reviews,<br />

readers are referred to: ‘The Mask<br />

Studies You Should Know’ 15 and ‘More<br />

than 170 Comparative Studies and<br />

Articles on Mask Ineffectiveness and<br />

Harms’. 16<br />

REAL WORLD DATA<br />

In his 2022 book, UNMASKED: The<br />

Global Failure of COVID Mask Mandates,<br />

Ian Millar provides numerous graphs<br />

from around the world comparing<br />

unmasked and masked populations (Fig.<br />

3). These real-world experiences show<br />

no appreciable differences in COVID<br />

infection rates among the two groups. 17<br />

HARMS<br />

A fundamental tenet of health care is:<br />

“First, do no harm”. This applies not only<br />

to the delivery of healthcare but also<br />

to measures taken to mitigate disease<br />

transmission, including the use of<br />

masks.<br />

Fig. 3: Mask wearing results in no appreciable difference in the<br />

number of COVID-19 cases<br />

34 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


CLINICAL FEATURE<br />

The harmful effects of masks include<br />

increased irritability and headaches, 18<br />

face mask dermatitis, 19 increased rates<br />

of caries and gingivitis, 20 and bacterial<br />

and fungal contamination. 21 Alterations in<br />

oxygen and carbon dioxide blood levels<br />

and changes in respiratory physiology<br />

and function among other harmful effects<br />

of masks including their ineffectiveness<br />

are comprehensively discussed by Dr J<br />

Meehan in, ‘An Evidence Based Scientific<br />

Analysis of Why masks are Ineffective,<br />

Unnecessary, and Harmful’. 22<br />

It has been reported that each surgical<br />

and N95 face mask releases more than a<br />

billion nanoplastics and microplastics. 23<br />

Although their pathological effects are<br />

unknown, these miniscule particles have<br />

been detected in the nasal mucosa and<br />

blood of mask wearers. 23,24 The possibility<br />

exists of titanium dioxide, a potential<br />

carcinogen, being inhaled from the<br />

synthetic fibres of face masks. 25<br />

By 2021, surgical and N95 masks were<br />

major components of eight million<br />

tonnes of COVID-related plastic waste. 26<br />

In landfills these plastics leach toxic<br />

chemicals and their disposal in the<br />

oceans leads to ingestion by seabirds<br />

and marine animals. The environmental<br />

and ecological degradation from this<br />

humongous mass of mask induced<br />

pollution is unfathomable.<br />

If masks were a drug or new surgical<br />

treatment, they would not be approved<br />

as their identified harms outweigh any<br />

tangible benefits.<br />

COCHRANE REVIEW<br />

The Cochrane Collaboration, based in<br />

London, England, is an independent<br />

not-for-profit international network of<br />

researchers. By adopting meta-analytical<br />

methods which limit biases, random<br />

errors and increases the statistical power<br />

of its conclusions, the Collaboration has<br />

earned a global reputation for providing<br />

the highest standard in evidence-based<br />

healthcare. 27<br />

Randomised trials, the gold standard<br />

for medical research, are a major focus<br />

of the Collaboration. Such a trial for<br />

masks would consist of the subjects<br />

being divided at random into two<br />

groups: one with masks, one without<br />

masks, balanced by age, sex, and<br />

other pertinent characteristics. The<br />

Collaboration has been conducting<br />

meta-analysis reviews on physical<br />

interventions, including masks, to<br />

reduce respiratory viral transmissions<br />

since 2006.<br />

The latest review of 11 new and 67<br />

previous randomised trials involving<br />

a total of 610,872 participants was<br />

released in <strong>January</strong> 2023. 28 It is a<br />

comprehensive, detailed 324-page<br />

report including results pertinent to the<br />

H1N1 pandemic, SARS, and COVID-19.<br />

Significant findings are as follows:<br />

First, moderate degree of certainty<br />

that wearing masks compared to not<br />

wearing masks in the community<br />

makes little to no difference to the<br />

outcome of influenza-like and COVID-<br />

19-like illness.<br />

Second, moderate degree of certainty<br />

that wearing masks compared to not<br />

wearing masks in the community<br />

makes little or no difference to the<br />

outcome of laboratory-confirmed<br />

influenza/SARS-CoV-2.<br />

Third, moderate degree of certainty<br />

that the use of N95/P2 respirators<br />

compared to surgical masks probably<br />

makes little to no difference for the<br />

objective and more precise outcome<br />

of laboratory-confirmed influenza<br />

infection.<br />

Fourth, there were no clear differences<br />

between the use of medical/surgical<br />

masks compared with N95/P2<br />

respirators in healthcare workers<br />

when used in routine care to reduce<br />

respiratory tract infection.<br />

Fifth, there is a moderate level of<br />

confidence in the accuracy of the<br />

above findings; and lastly, potential<br />

harms of wearing masks were rarely<br />

reported and poorly measured.<br />

Accepting that the Cochrane Reviews<br />

are based on sophisticated statistical<br />

analyses of human behaviour, the latest<br />

review supports the results of previous<br />

ones that — with as much certainty<br />

as it is possible to have — masks and<br />

respirators provide neither meaningful<br />

nor observable benefits regarding the<br />

prevention of respiratory infections.<br />

IN SUPPORT OF THE COCHRANE<br />

REVIEW<br />

On 7 Apr 2023, St George’s Hospital<br />

London, released the results of a<br />

study which showed that surgical<br />

mask use made no appreciable<br />

difference in reducing hospital acquired<br />

COVID-19 infections. The results of<br />

this investigation was presented at the<br />

April 2023 meeting of the European<br />

Congress of Clinical Microbiological<br />

and Infectious Diseases. 29<br />

CONCLUSION<br />

The enthusiastic intuitive adoption of<br />

mask mandates because “they must do<br />

some good” ignored the effects of viral<br />

desiccation and size, dismissed the<br />

absence of any historical and scientific<br />

support, and disregarded their obvious<br />

harms.<br />

Mandating mask use must be<br />

supported by the highest level of<br />

evidence. This requires clinically<br />

derived substantiation that masks<br />

and respirators categorically prevent<br />

the transmission of respiratory viral<br />

infections. The recent Cochrane review<br />

demonstrates that such validation does<br />

not exist.<br />

Regulatory authorities must admit<br />

that any advantages that might accrue<br />

from masks and respirators are<br />

outweighed by many countervailing<br />

factors, the most important of which<br />

are their harmful effects and the lack<br />

of evidence that they are effective.<br />

They would not survive a risk/benefit<br />

analysis. Failure to appreciate these<br />

facts is indicative of the arrogance of<br />

those advocating mask mandates and<br />

their total ignorance of the scientific<br />

database.<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong> 35


CLINICAL FEATURE<br />

This understanding justifies a<br />

necessary reassessment of mask use<br />

in dentistry. Such a change simply<br />

demands that wearing a mask or a<br />

respirator must be a personal informed<br />

decision of the clinician. Once made,<br />

it must be respected by peers and<br />

professional organisations. DA<br />

REFERENCES<br />

1. Laidler JR. Reversible inactivation and<br />

desiccation tolerance of silicified viruses.<br />

J Virol 2013; 7(24): 13927-13929.<br />

2. Viral Envelope. Wikipedia. Available<br />

at: https://en.wikipedia.org/wiki/Viral_<br />

envelope<br />

3. Fernstrom A. Aerobiology and its role in<br />

the transmission of infectious diseases. J<br />

of Pathogens 2013; Article ID 493960.<br />

4. Tellier R. Recognition of aerosol<br />

transmission of infectious agents: a<br />

commentary. BMC Infectious Diseases<br />

2019; 19: 101.<br />

5. National Nanotechnology Initiative.<br />

Size of the Nanoscale. Available at:<br />

https://www.nano.gov/nanotech-101/<br />

what/nano-size<br />

6. The Royal College of Pathologists. Ever<br />

changing flu. Available at: file:///C:/Users/<br />

John/Downloads/Virology-Flu-Virus%20<br />

(6).pdf<br />

7. Mask ratings and particle sizes. What<br />

does it all mean? 2021. Available at:<br />

https://filti.com/mask-ratings-particlesizes/<br />

8. Jingyi X. Non pharmaceutical<br />

measures for pandemic influenza<br />

in nonhealthcare settings-personal<br />

protective and environmental measures.<br />

Emerg Infect Dis 2020; 26(5):967-975.<br />

9. Ontario Nurses Association. ONA Wins<br />

2015. Available at: https://www.ona.<br />

org/wp-content/uploads/ona_rightsarb_arbitratorsideswithonainlandmarkinfluenzavomgrievance_20160921.<br />

pdf?x72008#:~:text=ONA%20has%20<br />

won%20a%20precedent-setting%20a<br />

10. Canadian Lawyer. ONA wins second<br />

arbitration against hospital on ‘vaccine<br />

or mandate’ policy. Available at: https://<br />

www.canadianlawyermag.com/practiceareas/privacy-and-data/ona-winssecond-arbitration-against-hospitalson-vaccinate-or-mask-policy/275455<br />

11. Centers for Disease Prevention and<br />

Control. How flu spreads. CDC Website.<br />

2019. Available at: https://www.cdc.gov/<br />

flu/about/disease/spreads.htm.<br />

12. World Health Organization. Nonpharmaceutical<br />

public health measures<br />

for mitigating the risk and impact of<br />

epidemic and pandemic influenza. 2019.<br />

Available at: https://www.who.int/<br />

publications/i/item/non-pharmaceuticalpublic-health-measuresfor-mitigatingthe-risk-and-impact-of-epidemic-andpandemic-influenza<br />

13. Reuters Fact check: Outdated video<br />

of Fauci saying ‘there’s no reason to be<br />

walking around wearing a mask.’ Available<br />

at: https://www.reuters.com/article/ukfactcheck-fauci-outdated-video-masksidUSKBN26T2TR<br />

14. Henning B. Effectiveness of adding<br />

a mask recommendation to other public<br />

health measures to pre-vent SARS-CoV-2<br />

infection in Danish mask wearers. Ann Int<br />

Med 2021; 174(3): 335-343.<br />

15. Stevenson J. The mask studies you<br />

should know. Brownstone Institute 2022.<br />

Available at: https://brownstone.org/<br />

articles/the-mask-studies-you-shouldknow/<br />

16. Alexander PE. More than 170<br />

comparative studies and articles on mask<br />

ineffectiveness and harms. Brownstone<br />

Institute 2021. Available at: https://<br />

brownstone.org/articles/the-maskstudies-you-should-know/<br />

17. Miller I. UNMASKED The global failure<br />

of COVID mask mandates. 2022. Post Hill<br />

Press. New York.<br />

18. Ong JY. Headaches associated<br />

with personal protective equipment - a<br />

cross sectional study among frontline<br />

healthcare workers during COVID-19. J<br />

Head and Face Pain 2020; 60(5):819-<br />

1039.<br />

19. Niesert AC. “Face mask dermatitis” due<br />

to compulsory facial masks during the<br />

SARS-CoV-2 pandem-ic: data from 550<br />

health care and non-health care workers<br />

in Germany. Eur J Dermatology 2021;<br />

31(2):199-204.<br />

20. Licea M. ‘Mask mouth’ is a seriously<br />

stinky side effect of wearing masks. New<br />

York Post, 2020 Au-gust 5th.<br />

21. Sachdev R. Is safeguard<br />

compromised? Surgical moth mask<br />

harboring hazardous microorganisms in<br />

dental practice. J Famil Med Prim Care<br />

2020; 9(2):759-763.<br />

22. Meehan J. An evidence based<br />

scientific analysis of why face masks are<br />

ineffective, unnecessary and harmful.<br />

Available at: https://www.meehanmd.<br />

com/blog/2020-10-10-an-evidencebased-scientific-analysis-of-why-masksare-ineffective-unnecessary-andharmful/<br />

23. Me J. Face masks as a source<br />

of nanoparticles and microplastics<br />

in the environment: quantification,<br />

characterization, and potential for<br />

bioaccumulation. Environ Pollut 2021;<br />

288:117748 Available at: https://pubmed.<br />

ncbi.nlm.nih.gov/34265560/<br />

24. Leslie HA. Discovery and<br />

quantification of plastic particle pollution<br />

in human blood. Environment Intl 2022;<br />

163: 107199 Available at: https://www.<br />

sciencedirect.com/science/article/pii/<br />

S0160412022001258<br />

25. Verleysen E. Titanium dioxide particles<br />

frequently present in face masks intended<br />

for general use require regulatory control.<br />

Scientific Reports 2022; 12: article number<br />

2529 Available at: https://www.nature.<br />

com/articles/s41598-022-06605-w<br />

26. Vandiver WA. Yes, disposable masks<br />

are made of plastic. And that’s a problem.<br />

Fix Feb 2022. Availa-ble at: https://grist.<br />

org/fix/opinion/disposable-plasticmasks-ocean-pollution/<br />

27. Cipriani A. What is a Cochrane review?<br />

Epidemiol Psychiatr Sci 2011; 20(3):231-<br />

233.<br />

28. Jefferson T. Physical intervention<br />

to interrupt or reduce the spread of<br />

respiratory viruses (Review). Cochrane<br />

Database of Systemic Reviews 2023<br />

Issue 3. Art. No. CD0066207. Available at:<br />

https://www.cochranelibrary.com/cdsr/<br />

doi/10.1002/14651858.CD006207.pub6/<br />

full?s=08<br />

29. Masks made no difference to hospital<br />

COVID Infection Rates; Study finds. Daily<br />

Sceptic 7th April, 2023. Available at:<br />

https://dailysceptic.org/2023/04/07/<br />

masks-made-no-difference-to-hospitalcovid-infection-rates-study-finds/<br />

ABOUT THE<br />

AUTHORS<br />

Dr George<br />

Freedman<br />

is a founder<br />

and past<br />

president, American Academy of<br />

Cosmetic Dentistry; co-founder,<br />

Canadian Academy for Esthetic<br />

Dentistry; Regent and Fellow,<br />

International Academy for<br />

<strong>Dental</strong> Facial Esthetics (IADFE);<br />

Diplomate and Chair, American<br />

Board of Aesthetic Dentistry;<br />

and Adjunct Professor, <strong>Dental</strong><br />

Medicine at Western University,<br />

Pomona, California. Dr Freedman<br />

is the author of 14 textbooks and<br />

more than 900 articles, and an<br />

internationally renowned lecturer.<br />

As an oral<br />

pathologist, Dr John<br />

Hardie’s career<br />

focused on hospitalbased<br />

dentistry in<br />

Ottawa, Vancouver,<br />

Saudi Arabia and<br />

Northern Ireland. This fostered<br />

an interest in infection prevention<br />

and control as it related to<br />

dentistry. He has published<br />

numerous articles on that topic<br />

and presented lectures on it<br />

and related subjects throughout<br />

North America, the UK, Europe<br />

and the Middle and Far East.<br />

36 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


CLINICAL FEATURE<br />

Efficient layering for<br />

high-quality dental<br />

implant aesthetics:<br />

Case study<br />

A natural looking and aesthetically pleasing<br />

restoration can be achieved using simple technique<br />

and complementary materials. Master <strong>Dental</strong><br />

Technician Marcio Breda describes how beauty can<br />

be created with ease on six implants using the highly<br />

translucent zirconia VITA YZ HT White and the<br />

universal veneering ceramic VITA LUMEX AC.<br />

CASE STUDY<br />

A 35-year-old patient was dissatisfied with the<br />

functionality and aesthetics of the full dentures<br />

in his upper jaw. The patient complained of<br />

the insufficient suction effect, which generally<br />

made him feel insecure in public and was<br />

accompanied by rocking when biting and<br />

chewing. As a result, he avoided hard foods.<br />

The denture teeth and the base of the full<br />

denture also appeared lifeless and artificial.<br />

The patient wanted a fixed restoration on<br />

implants that would give him security and<br />

age-appropriate aesthetics. After detailed<br />

diagnostics and a consultation, he decided<br />

on six implants and a superstructure made of<br />

zirconia and veneer ceramics that could be<br />

fitted individually and match the natural teeth<br />

in his lower jaw. The base tooth shade A3 was<br />

determined for the incisors in the lower jaw<br />

using the VITA classical A1-D4 shade guide.<br />

CLINICAL STEPS AND CAD/CAM<br />

After the insertion and healing of the implants,<br />

an impression with model analogues and an<br />

opposing jaw impression provided the basis<br />

for the production of a master model and<br />

its articulation in the registered jaw relation.<br />

The model situation was then digitised in the<br />

laboratory scanner Ceramill Map 400+.<br />

The construction was anatomically reduced,<br />

incorporating six GM Mini Conical Abutments<br />

with the exocad software. The zirconia<br />

substructure was finally milled from the zirconia<br />

VITA YZ HT White using the Ceramill Motion 2<br />

(Fig. 1). The highly translucent framework<br />

structure was intended to ensure natural<br />

translucency in the area of the teeth right from<br />

the start.<br />

INFILTRATION AND LAYERING<br />

After finishing, the dental parts of the framework<br />

were infiltrated with VITA YZ HT SHADE LIQUID<br />

A3 to match the base tooth shade of the lower<br />

jaw teeth. A corresponding infiltration with VITA<br />

YZ EFFECT LIQUID Pink was carried out in the<br />

gingival area for the basic reproduction of the<br />

gingiva. After drying, the framework was sintered.<br />

The washbake was done in the dental area<br />

with VITA LUMEX AC FLUO INTENSE sand to<br />

implement a natural fluorescence in the depths.<br />

Strong GINGIVA rosewood was used in the<br />

mucosal area for an initial reproduction (Fig. 2).<br />

The dentine cores were layered with more<br />

chromatic DENTINE A3 on the canines and with<br />

DENTINE A2 on the other teeth (Fig. 3). Next,<br />

anatomical cut-backs were performed (Fig. 4).<br />

On the incisors, the mamelon structure was<br />

reconstructed with MAMELON saffron (Fig. 5).<br />

The first enamel layering was done in the upper<br />

two-thirds with translucent ENAMEL clear to<br />

allow the mamelon anatomy to appear 3D from<br />

the depths (Fig. 6).<br />

Fig. 1: The stained zirconia substructure made of<br />

VITA YZ HT after sintering<br />

Fig. 2: The washbake with FLUO INTENSE sand<br />

and GINGIVA rosewood<br />

Fig. 3: The dentine core with DENTINE A3 on the<br />

canines and DENTINE A2 on the other teeth<br />

Fig. 4: Anatomical cut-backs were made after the<br />

layering of the dentine core<br />

Fig. 5: The mamelon structure of the incisors was<br />

reconstructed with MAMELON saffron<br />

Fig. 6: The first enamel layering was done in the<br />

upper two-thirds with ENAMEL clear<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong> 37


CLINICAL FEATURE<br />

After the first firing, the approximal areas were<br />

separated to eliminate tension (Fig. 7). This<br />

was followed by alternate layering of ENAMEL<br />

clear, ENAMEL fog and OPAL TRANSLUCENT<br />

opal-neutral (Fig. 8).<br />

After the second firing, the cutting edge was<br />

completed with alternating layers of ENAMEL<br />

fog and TRANSLUCENT smoky-white. The<br />

gingiva was then reproduced with a balanced<br />

mixture of GINGIVA grapefruit and ENAMEL<br />

clear (Fig. 9).<br />

After the third firing, only morphological<br />

corrections were made in the dental area<br />

Fig. 7: The approximal region was separated to<br />

prevent tension<br />

with PEARL shell, which achieved a ‘mother-ofpearl’<br />

effect. A mixture of ENAMEL clear and<br />

GINGIVA light-rose completed the mucosal area<br />

(Fig. 10). After the last firing, the finishing was<br />

carried out with differently shaped, fine diamond<br />

instruments and rubber polishers (Fig. 11). A<br />

glaze firing with VITA AKZENT PLUS GLAZE LT<br />

provided the finalisation.<br />

HIGH-QUALITY AESTHETICS WITH EASE<br />

As the furnace slowly opened, details of the<br />

nearly finished work became visible. Teeth and<br />

gingiva appeared as a natural unit (Figs. 12-14).<br />

An anatomically preformed framework and the<br />

targeted colouring of the dental and gingival<br />

Fig. 8: Alternating layering of the cutting edge<br />

with ENAMEL clear, fog, and OPAL TRANSLUCENT<br />

opal-neutral<br />

areas were the basis for the successful<br />

reproduction.<br />

After only a few layers, it was possible to<br />

achieve a highly aesthetic result. This proved<br />

to be an efficient advantage, particularly in the<br />

long span restoration. The layered ceramic<br />

simplicity had created a no-frills and believable<br />

aesthetic quickly.<br />

CONCLUSION<br />

A ceramic veneering system should<br />

complement the simple process so that the<br />

dental technician’s skills can be optimised<br />

when it comes to natural beauty. Many in<br />

dental technology have had this experience:<br />

A small embellishment or too much creativity<br />

can take away the natural look of a restoration.<br />

The restoration can look less like a natureinspired<br />

work of art that blends with the<br />

neighbouring hard tooth substance to form a<br />

unit, but more of something that is artificial and<br />

superimposed.<br />

Thanks to new framework materials for the<br />

digital workflow, edentulous jaws can now be<br />

restored with all-ceramic implant prosthetics.<br />

Zirconia provides a stable and aesthetic base<br />

for veneering ceramics, which makes it easier<br />

to reproduce the beauty of nature. DA<br />

Fig. 9: ENAMEL fog, TRANSLUCENT smoky-white<br />

in the region of the teeth and GINGIVA grapefruit<br />

with ENAMEL clear in the gingival region<br />

Fig. 10: The correction firing was done dentally<br />

with PEARL shell and gingivally with GINGIVA<br />

light-rose<br />

ABOUT THE AUTHOR<br />

Fig. 11: The restoration after finishing with<br />

diamonds and rubber polishing<br />

Fig. 12: The finished, glazed implant prosthetic<br />

work looked natural<br />

Master <strong>Dental</strong><br />

Technician Marcio<br />

Breda is a specialist<br />

in dental ceramics and challenging<br />

aesthetics. Since 1989, he has been<br />

managing his own dental lab in<br />

Vitória, Brazil, and has authored and<br />

co-authored various international<br />

publications on the topics of aesthetics<br />

and implantology.<br />

Fig. 13: With efficient layering, a highly aesthetic<br />

result was achieved<br />

Fig. 14: The gingiva and teeth had merged into an<br />

identical unit<br />

Currently, he is a consultant for VITA<br />

Zahnfabrik in Latin America and director<br />

of the educational institution, Centro de<br />

Estudios y formacion.<br />

38 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


CLINICAL FEATURE<br />

Same-day dentistry with<br />

3D-printed crowns: Case report<br />

By Dr Michael Weiß<br />

INTRODUCTION<br />

Treating patients with permanent restorations<br />

in same-day treatments is now state-of-theart<br />

in many dental clinics. Modern 3D printing<br />

materials and quicker production times in<br />

additive manufacturing allow dentists to offer<br />

patients with highly aesthetic and definitive<br />

restorations in just one visit. Patients<br />

appreciate the time savings and simplicity<br />

in same-day treatment compared to a<br />

conservative approach, which involves several<br />

treatment appointments.<br />

Currently, subtractive procedures are<br />

predominantly used for the fabrication of<br />

dental restorations for same-day treatments,<br />

in which the required restoration is usually<br />

made of high-strength zirconium dioxide<br />

or lithium disilicate. However, additive<br />

manufacturing offers several advantages with<br />

highly developed 3D printing materials and<br />

decreasing production times.<br />

The cost-saving production of complex<br />

geometries with high precision in a short<br />

period of time in the additive process should<br />

be emphasised; with modern 3D printing<br />

materials, it is possible to produce definitive<br />

restorations.<br />

One material in this field is the ceramic-filled<br />

hybrid material VarseoSmile Crown plus.<br />

Its high mechanical stability and durability<br />

have been proven in numerous scientific<br />

studies. 1 Due to its strength, the material is<br />

more antagonist-friendly and offers better<br />

cushioning compared to high-strength<br />

restorative materials. VarseoSmile Crown plus<br />

is also characterised by high biological safety<br />

and good aesthetic properties.<br />

These new technologies enable dentists,<br />

in cooperation with the dental labs that<br />

supply them, to offer patients therapeutically<br />

effective, fast, and cost-effective tooth<br />

replacement treatments. The following<br />

case description illustrates the concept of a<br />

same-day restoration with 3D-printed crowns<br />

made of the ceramic-filled hybrid material<br />

VarseoSmile Crown plus.<br />

CASE DESCRIPTION<br />

A 52-year-old patient presented for a regular<br />

check-up appointment. The patient’s general<br />

oral hygiene was good but due to an existing<br />

root filling in region 46 and 47, there was a<br />

risk of fracture in the molars located in the<br />

masticatory centre (Fig. 1). In addition, there<br />

was no sufficient chewing function due to<br />

the lack of occlusal surface design (Fig. 2).<br />

Crowning of the teeth was therefore indicated.<br />

The patient wished to receive the final<br />

restoration as quickly as possible and without<br />

an additional appointment. It was decided<br />

to print the crowns from the ceramic-filled<br />

hybrid material VarseoSmile Crown plus for<br />

final restorations in the neighbouring dental<br />

lab immediately after the preparation of the<br />

affected teeth, and to place them on the same<br />

day.<br />

PREPARATION AND DIGITAL IMPRESSION<br />

The region to be treated was first<br />

anaesthetised. An intraoral scan of the initial<br />

situation was performed while the anaesthetic<br />

was in place. Teeth 46 and 47 were then<br />

prepared. A chamfer or stepped preparation is<br />

recommended for the selected crown material;<br />

the preparation was made in the form of a<br />

chamfer for this patient case.<br />

Fig. 1 Fig. 2<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong> 39


CLINICAL FEATURE<br />

As root canal-treated teeth are more<br />

susceptible to fractures, tooth 47 was restored<br />

with a root post and an adhesive build-up during<br />

preparation. To create a biologically wide zone<br />

between the gingiva and the crown margin<br />

and to prevent possible chronic gingivitis, the<br />

gingiva was remodelled using an electrotome<br />

(Fig. 3). Retraction cords were placed around<br />

the prepared teeth to displace and retain the<br />

gingiva from the tooth neck (Fig. 4).<br />

During the subsequent intraoral scan of<br />

the prepared situation, the upper jaw was<br />

scanned first. Before scanning the lower jaw,<br />

the previously placed retraction sutures were<br />

removed. An astringent retraction paste was<br />

applied for temporary additional retraction<br />

and hemostasis of the marginal gingiva and<br />

to drain the sulcus. After the scan of the<br />

prepared mandible, the final step of the digital<br />

impression was to take the bite. Up to this<br />

point, the treatment lasted approximately<br />

90mins.<br />

The data set of the intraoral scan was<br />

transferred to the dental lab without further<br />

processing so that the fabrication of the<br />

restoration could begin. The patient was<br />

allowed to leave the treatment room for the<br />

duration of the crown preparation. She was<br />

asked not to eat anything during the waiting<br />

time so as not to cause any irritation to the<br />

prepared teeth.<br />

WORK STEPS IN THE LAB<br />

The crowns were digitally designed with<br />

exocad software. The occlusal space<br />

available posed a particular challenge. For<br />

an anatomically and functionally correct fit<br />

of the restoration, it was necessary to fall<br />

below the minimum wall thickness of 1mm<br />

recommended by the manufacturer.<br />

The design of the two crowns and the creation<br />

of the corresponding digital images took<br />

approximately 20mins. After this, nesting took<br />

place where the objects were virtually placed<br />

on the build platform of the printer. A Varseo<br />

XS DLP printer was used. Once the required<br />

support structures had been correctly placed<br />

and planned, the print job could be started.<br />

Printing the two crowns took around 40mins.<br />

The printed objects were cleaned of residual<br />

resin in ethanol and polymerised in the<br />

BEGO Otoflash post-curing unit. When using<br />

VarseoSmile Crown plus, the printed objects<br />

should be blasted at a pressure of 1.5bar<br />

between the cleaning and post-curing steps to<br />

remove the ceramic deposits on the surface<br />

of the objects caused by cleaning in ethanol.<br />

This process was also considered in the<br />

fabrication of the two crowns. The blasting<br />

agent used was Perlablast Micro.<br />

Finally, the printed and polymerised crowns<br />

were individualised with VITA Akzent LC<br />

composite stains (Figs. 5 and 6). The finished<br />

crowns were delivered to the dental practice<br />

just 90mins after preparation.<br />

INSERTION<br />

Back in the treatment room, the crowns were<br />

first tried in. While an exact fit had already<br />

been achieved at the preparation margin, a<br />

check of the bite revealed the need for manual<br />

correction of the occlusal points. After<br />

correction, the occlusion was checked with<br />

Shimstock foil and found to be satisfactory.<br />

Fig. 3<br />

Fig. 4<br />

Fig. 5: VITA Akzent LC was chosen as the composite stains<br />

Fig. 6: A view of the completed crowns that took 90mins to produce<br />

40 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


CLINICAL FEATURE<br />

Before insertion, the bonding surfaces of the crowns were conditioned<br />

with 3M Scotchbond and the crowns were then seated adhesively with<br />

3M RelyX Unicem. The dentist and patient were satisfied with the fit<br />

and aesthetic appearance of the restoration (Fig. 7). The patient could<br />

not spontaneously feel any difference between the printed crowns and<br />

her natural teeth.<br />

CONDITION AFTER SIX MONTHS<br />

Approximately six months after insertion of the restoration, the patient<br />

presented for another check-up. The crowns in region 46 and 47 were<br />

completely intact. They showed no noticeable wear, discolouration, or<br />

chipping, and the gums had healed well (Figs. 8 and 9). The check-up<br />

of the same-day restoration described above was therefore without any<br />

findings.<br />

DISCUSSION<br />

The use of additive manufacturing technology in combination with<br />

the VarseoSmile Crown plus hybrid material for the 3D printing of final<br />

restorations enabled the patient to complete an aesthetic restoration<br />

in just one day. The aesthetics of the finished restorations were<br />

impressive and comparable to a ceramic restoration. In this case, the<br />

aesthetics of the crowns were due to the combination of the optimal<br />

properties of the 3D printing material and the proficiency of the dental<br />

technician during the individualisation process.<br />

With the further development of 3D printing devices and the associated<br />

materials, a shortening of the production workflow can be expected.<br />

In the foreseeable future, it will no longer be necessary for the patient<br />

to leave the treatment room or the dental practice between the digital<br />

recording of the prepared situation and the insertion of the finished<br />

work.<br />

In the case described there was also a delay in the treatment<br />

procedure. The anatomical characteristics meant that the minimum<br />

wall thickness of the material recommended by the manufacturer<br />

was not achieved and subsequent manual correction of the occlusal<br />

surface was needed. Even with many restorative materials fabricated<br />

subtractively, the minimum wall thickness specified is rarely lower so<br />

that a corresponding complication would have been expected.<br />

Ceramic-filled hybrid materials for 3D printing of definitive dental<br />

restorations represent a new class of materials, the durability of which<br />

cannot be assessed in terms of strength alone. Numerous publications<br />

of in-vitro studies suggest excellent clinical performance of these<br />

materials.<br />

Fig. 7: A view of the inserted 3D-printed crowns<br />

However, due to the novelty of the material class, only a few<br />

publications on long-term clinical observations are available to date.<br />

The material used in this case report is currently the only known<br />

material for which one-year-data from clinical studies is available, that<br />

confirm the promising data from the in-vitro studies.<br />

This case report shows that same-day restorations using additive<br />

manufacturing and ceramic-filled hybrid materials are not only possible<br />

but can also lead to highly aesthetic results. Although available data<br />

from clinical research confirms the long-term stability of the restorative<br />

material, the new material class of ceramic-filled 3D printing materials<br />

remains the subject of further clinical investigations. DA<br />

REFERENCE<br />

1. Scientific studies on VarseoSmile Crownplus [Registration: Scientific studies<br />

on VarseoSmile Crown plus - BEGO 3D printing]<br />

Fig. 8<br />

ABOUT THE AUTHOR<br />

Fig. 9<br />

Dr Michael Weiß successfully completed his dental<br />

technician apprenticeship in 1980. He completed<br />

his training as master craftsman in dental<br />

technologies in University of Münster in Germany<br />

before studying dentistry at the University of Witten/Herdecke in<br />

1986 and qualifying in 1993. After his residency in 1995, Dr Weiß<br />

founded his own dental practice ‘Zahnarztpraxis Dr. Michael Weiß’<br />

in the technology park of the University of Bremen. He received his<br />

doctorate from the University of Münster in 1996.<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong><br />

41


CLINICAL FEATURE<br />

Best-practice in instrument<br />

reprocessing: The hygiene<br />

workflow in the practice of<br />

Dr Kayla Teh<br />

With a team of 16 staff and four treatment<br />

rooms, Dr Kayla Teh’s practice focuses on<br />

various aspects of dental conservation,<br />

prevention and aesthetics. To ensure a<br />

high quality of care and meet patient<br />

expectations, the practice places<br />

importance on a seamless hygiene<br />

chain for instrument reprocessing. This<br />

article outlines Dr Teh’s best-practice<br />

procedures, emphasising the importance<br />

of reliable instrument decontamination and<br />

patient safety.<br />

SYSTEM SOLUTION FOR INSTRUMENT<br />

REPROCESSING<br />

Instrument reprocessing is a critical<br />

procedure involving physical or chemical<br />

methods to decontaminate reusable medical<br />

devices, ensuring their safety for subsequent<br />

use on patients and handling by staff. The<br />

primary objective of instrument reprocessing<br />

is to safeguard the wellbeing of both<br />

patients and practice staff by effectively<br />

eliminating harmful microorganisms present<br />

on the instruments.<br />

To achieve comprehensive instrument<br />

decontamination, a series of essential steps<br />

must be followed. These steps include<br />

cleaning and disinfection, inspection,<br />

packaging, sterilisation, as well as<br />

documentation and approval. Adherence<br />

to international guidelines is paramount,<br />

as they emphasise the necessity for<br />

trained personnel to execute the entire<br />

instrument reprocessing process using<br />

closely monitored procedures to ensure<br />

reproducibility. These stringent requirements<br />

serve to enhance the health and safety of<br />

patients, users, and all individuals involved.<br />

Dr Kayla Teh’s practice has adopted a<br />

comprehensive system solution from<br />

German solution provider, MELAG. This<br />

solution integrates components such as<br />

autoclaves, washer-disinfectors, sealing<br />

devices, and software solutions into a<br />

single workflow. By utilising this solution,<br />

the practice ensures a streamlined and<br />

synchronised process for instrument<br />

reprocessing.<br />

At the heart of the system solution approach<br />

is a personalised experience for the practice’s<br />

patients. With the provision of a central<br />

contact, the practice gains the advantage of<br />

having a single point of contact to address all<br />

infection control questions, providing prompt<br />

and comprehensive support. Whether there<br />

are inquiries regarding device operation,<br />

maintenance, or troubleshooting, the central<br />

contact from MELAG ensures that the<br />

practice receives immediate assistance,<br />

thus delivering an efficient instrument<br />

reprocessing processes.<br />

Efficiency is a paramount consideration for<br />

any dental practice, and a system solution in<br />

the decontamination room can optimise costs<br />

and synchronise services. By harmonising the<br />

service of all devices in the decontamination<br />

42 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


CLINICAL FEATURE<br />

room, Dr Teh’s practice achieves a costeffective<br />

approach to maintenance and<br />

support. Instead of managing multiple<br />

service contracts and coordinating various<br />

providers, the practice can rely on a single<br />

source for all their service needs. This<br />

not only streamlines the administrative<br />

aspects but also ensures that all devices<br />

receive timely and synchronised service,<br />

minimising downtime and maximising<br />

operational efficiency.<br />

Moreover, a key advantage of system<br />

solution lies in its process-optimised<br />

operating concept. The components of the<br />

system are designed to work seamlessly<br />

together, eliminating potential malfunctions<br />

and enhancing everyday practice. The<br />

coordinated approach of the autoclaves,<br />

washer-disinfectors, sealing devices,<br />

and software solution creates a smooth<br />

workflow that minimises errors, ensures<br />

consistent adherence to best practices,<br />

and maximises the reliability of instrument<br />

reprocessing procedures.<br />

Furthermore, the system solution from<br />

MELAG offers additional benefits: The<br />

integration of various components from a<br />

single source ensures compatibility and a<br />

unified user experience. The practice can<br />

rely on a standardised approach throughout<br />

the entire instrument reprocessing<br />

workflow, simplifying training, and<br />

enhancing staff proficiency. Additionally,<br />

the availability of comprehensive<br />

documentation and traceability features<br />

allows for easy compliance with legal<br />

requirements, enhances quality control, and<br />

strengthens patient safety measures.<br />

By closely following a standardised workflow<br />

with MELAG´s system solution, Dr Teh’s<br />

practice delivers optimal patient care and<br />

mitigates any potential risks associated with<br />

cross-contamination or infections.<br />

Step one: Preparing the instruments<br />

The first critical step in instrument<br />

reprocessing is proper instrument preparation.<br />

This includes collecting the used instruments,<br />

pre-cleaning them if necessary, and<br />

transporting them quickly from the treatment<br />

room to the designated decontamination<br />

area. Pre-cleaning of instruments from coarse<br />

soil and water-insoluble residues should be<br />

performed immediately after the instrument is<br />

used in the treatment room.<br />

To optimise the reprocessing outcome, it<br />

is essential that the instruments must be<br />

transported to the decontamination area<br />

as quickly as possible. Health and safety<br />

regulations require that instruments be<br />

transported in closed containers or trays to<br />

protect both the patients and practice team.<br />

In the decontamination room, plastic brushes<br />

are used to protect instrument surfaces<br />

during pre-cleaning, and ultrasonic devices<br />

may be used to assist in the removal of<br />

stubborn contaminants.<br />

Step two: Cleaning, disinfection, and drying<br />

The preparation step is followed by cleaning<br />

and disinfection. Automated cleaning and<br />

disinfection using a washer-disinfector is<br />

preferable to manual, chemical cleaning<br />

and disinfection in tubs. Manual<br />

disinfection is prone to error due to a<br />

number of factors, whereas a washerdisinfector<br />

ensures a reproducible<br />

and validated result through constant<br />

monitoring of parameters.<br />

The use of a washer-disinfector provides<br />

numerous benefits to Dr Teh’s practice<br />

team. One benefit is the increased<br />

efficiency it brings to the practice. By<br />

automating cleaning and disinfection<br />

procedures, the washer-disinfector frees<br />

up time for team members to focus on<br />

other important responsibilities and tasks<br />

within the practice, optimising productivity<br />

and workflow.<br />

In addition, the washer-disinfector reduces<br />

exposure to contaminated instruments,<br />

improving the overall safety of the<br />

practice team. By eliminating the need for<br />

manual handling of instruments during<br />

the cleaning and disinfection process, the<br />

risk of accidental exposure to potentially<br />

hazardous substances or pathogens is<br />

reduced. This promotes a safer working<br />

environment, safeguarding the wellbeing<br />

of dental professionals and ensuring their<br />

peace of mind while performing their<br />

duties.<br />

Once the automated cleaning and<br />

disinfection is complete, the washerdisinfector<br />

should perform an automated<br />

active drying process. This step is<br />

essential to prevent recontamination<br />

and corrosion caused by residual<br />

moisture. Ideally, instruments should be<br />

reprocessed in the washer-disinfector<br />

within six hours of use to prevent protein<br />

coagulation. Hollow instruments, such<br />

as ultrasonic scaler tips, handpieces,<br />

turbines can be effectively cleaned and<br />

disinfected using adapters on the injector<br />

rail of the base basket.<br />

Step three: Inspection and care<br />

The electronic system of the washerdisinfector<br />

ensures compliance with<br />

all required parameters for automatic<br />

decontamination. However, trained<br />

personnel must conduct a visual and<br />

functional inspection of the instruments<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong> 43


CLINICAL FEATURE<br />

after successful cleaning, disinfection, and<br />

drying. A magnifying glass with light can be<br />

used to facilitate the inspection process.<br />

Damaged instruments or those with altered<br />

surfaces should be identified and removed.<br />

Some instruments require the use of specific<br />

care products, and it is crucial to adhere<br />

to the manufacturer’s recommendations.<br />

For hinged instruments and other moving<br />

parts, sterilisable and steam-permeable oil<br />

should be applied in accordance with the<br />

manufacturer’s specifications.<br />

Step four: Packaging<br />

Before sterilisation in an autoclave,<br />

instruments must be appropriately wrapped.<br />

This can be done by sealing them in<br />

sterilisation pouches using a sealing device<br />

or grouping them together in sterilisation<br />

containers. This step should be performed<br />

in a clean area of the decontamination room<br />

using approved products. When wrapping<br />

individual instruments in sterilising pouches,<br />

the following points should be considered:<br />

• Protective caps should be used on sharp<br />

instruments to prevent damage to the<br />

sterilisation packaging;<br />

• Hinged instruments need to be slightly<br />

opened to ensure proper sterilisation;<br />

• Sterilisation pouches should not be filled<br />

beyond 75% capacity and should not<br />

exceed a maximum weight of 3kg per<br />

package.<br />

Step five: Steam sterilisation<br />

The sterilisation process is systematically<br />

carried out only after meticulous cleaning<br />

and disinfection of instruments. Steam<br />

sterilisation at 134°C is the preferred<br />

standard procedure due to its low<br />

dependence on influencing factors. It is<br />

crucial to ensure that steam has access<br />

to all the outer and inner surfaces of the<br />

instruments. Instruments with complex<br />

hollow bodies, such as dental handpieces,<br />

should be sterilised in a class B autoclave.<br />

Class B autoclaves enable the sterilisation of<br />

both wrapped and unwrapped instruments,<br />

no matter their type and complexity. The<br />

fractionated vacuum reduces the air in the<br />

sterilisation chamber through repeated<br />

evacuation and steam injection. This process<br />

permits the sterilisation not only of solid and<br />

porous instruments, but also of complex<br />

hollow body instruments with narrow lumen<br />

such as surgical hand pieces.<br />

During the sterilisation process, sealed<br />

pouches should be placed on the tray with<br />

the paper side facing downwards, multiple<br />

pouches should not be stacked on top of<br />

each other to ensure effective sterilisation<br />

and a helix test body can be used for<br />

controlling the sterilisation result of hollow<br />

body instruments.<br />

Step six: Documentation, approval, and<br />

labelling<br />

The instrument decontamination process is<br />

completed by obtaining batch approval, which<br />

must be performed and documented by<br />

authorised personnel. This approval is based<br />

on the process parameters determined during<br />

decontamination, as well as the validation<br />

and installation reports. The approval of the<br />

steam steriliser involves documenting batchrelated<br />

tests and checking the integrity and<br />

dryness of the instruments and packaging.<br />

To ensure legal certainty and reliable<br />

traceability, it is essential to maintain a<br />

complete documentation of instrument<br />

decontamination logs and reports for a<br />

minimum of five years. It is recommended<br />

to store records for 30 years to mitigate<br />

liability risks. Digital data carriers can be<br />

utilised to facilitate long-term storage.<br />

Additionally, the label or batch number<br />

must be transferred to the patient record<br />

after instrument use to ensure complete<br />

traceability.<br />

Step seven: Storage of instruments<br />

Sterile instruments must be protected<br />

from recontamination during transport<br />

and storage. Therefore, the sterilised<br />

instruments should be safely wrapped to<br />

prevent recontamination. They should be<br />

stored at room temperature in a clean and<br />

dry location, shielded from dust. Careful<br />

handling is necessary to avoid damage<br />

and loss of sterility. It is recommended not<br />

to store individually wrapped instruments<br />

for more than six months. Seals around<br />

instrument storage cupboards’ doors<br />

offer additional protection against dust<br />

and external influences, preserving the<br />

sterilised instruments’ integrity.<br />

CONCLUSION<br />

Implementing a comprehensive hygiene<br />

workflow for instrument reprocessing<br />

is of utmost importance in maintaining<br />

patient safety and preventing the spread<br />

of infections in dental practices. Dr Teh’s<br />

practice executes stringent procedures,<br />

including: proper instrument preparation,<br />

cleaning, disinfection, drying, inspection,<br />

packaging, sterilisation, documentation,<br />

and storage.<br />

MELAG’s system solution, encompassing<br />

autoclaves, washer-disinfectors, sealing<br />

devices, and software solutions, supports<br />

Dr Teh’s practice with a comprehensive<br />

and coordinated approach to instrument<br />

reprocessing. The advantages of a central<br />

contact for instrument reprocessing<br />

inquiries, cost optimisation through<br />

synchronised device service, and a<br />

process-optimised operating concept<br />

underscore the effectiveness and value of<br />

MELAG’s system solution. In employing<br />

this solution, Dr Teh’s practice has<br />

enhanced their instrument reprocessing<br />

practices, ensuring better patient care,<br />

optimal efficiency, and adherence to high<br />

standards of hygiene and safety. DA<br />

44 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


USER REPORT<br />

All about the All-on-4<br />

The All-on-4 (AO4) treatment concept enables 4-6 implant fixtures to be<br />

placed into each jaw at one go, providing patients with a full set of teeth in<br />

a day. <strong>Dental</strong> <strong>Asia</strong> speaks with Dr Samintharaj Kumar, CEO and founder of<br />

Nuffield <strong>Dental</strong> where he teaches dentists on the procedure.<br />

From 16-17 Dec 2023, Nuffield<br />

Academy conducted a clinical live<br />

residency for students to gain the<br />

knowledge and competencies about<br />

the AO4 treatment procedure. The<br />

educational branch of Nuffield <strong>Dental</strong>,<br />

the academy brought its students<br />

through from the concept’s origins<br />

to surgical techniques and hands-on<br />

exercises to gain competencies in the<br />

method.<br />

First developed 26 years ago by Dr Paulo<br />

Malo, the AO4 treatment aimed to transcend<br />

conventional dentistry by offering full-arch<br />

restoration for patients grappling with the<br />

challenges of extensive tooth loss.<br />

The implant technique uses four implants per<br />

arch, where traditional implants use anywhere<br />

from 6-8 implants in each arch. In the long run,<br />

fewer implants would be more cost-efficient<br />

as compared to single dental implants.<br />

Moreover, its immediate restoration enables<br />

the treatment to be performed in one single<br />

surgery, providing an efficient and effective<br />

way to replace a full arch of teeth overnight.<br />

Dr Kumar was granted deep insights into<br />

the methodology, having trained at the Malo<br />

Clinic Lisbon in 2009 under Dr Malo himself.<br />

“Learning from Dr Malo was not just about<br />

acquiring technical skills; it was an immersive<br />

experience into his visionary approach. This<br />

training has been instrumental in shaping<br />

my expertise and philosophy in dental<br />

implantology,” said Dr Kumar.<br />

Dr Kumar at Nuffield Academy teaching students<br />

about the AO4 treatment concept<br />

jawbone. The fusing of the implant into the<br />

jawbone also results in a more convenient<br />

and longer-lasting impact for patients. Instead<br />

of having to remove dentures, AO4 implants<br />

function like a natural set of teeth that requires<br />

no sticky dental adhesive. In addition, AO4<br />

requires no bone grafting for many patients,<br />

which is common in traditional implant<br />

procedures.<br />

On the first day of Nuffield Academy’s training,<br />

students underwent lectures in basic surgical<br />

and prosthetic principles. They witnessed<br />

a live surgery for unimaxillary full-arch<br />

rehabilitation with immediate loading which<br />

covered the AO4 surgical in accordance with<br />

protocols from Malo <strong>Dental</strong>.<br />

As an affiliated clinic, the partnership<br />

between Nuffield <strong>Dental</strong> and Malo <strong>Dental</strong><br />

has benefitted patient care by bringing<br />

world-class methodologies to the forefront<br />

of its treatments, where it has become a<br />

cornerstone of Dr Kumar’s practice at Nuffield<br />

<strong>Dental</strong>.<br />

adept in both the science and art of<br />

this procedure,” said Dr Kumar. “For<br />

our students, this association is not<br />

merely academic; it is an immersive<br />

foundation into the highest standards<br />

of dental excellence, providing them<br />

with a travelator that will accelerate<br />

their pace of developing their own<br />

practices.”<br />

Dr Kumar also believes that AO4<br />

treatment is profound where the<br />

emotional and psychological uplift patients<br />

experience is as significant as the clinical<br />

outcome, a sentiment echoed in patient<br />

satisfaction studies.<br />

“This full-arch restoration technique is not<br />

merely a dental intervention; it is a catalyst<br />

for renewed self-esteem and an enhanced<br />

quality of life, as documented by Brånemark et<br />

al. in their foundational work on the subject,”<br />

he said. Shortly after his training, Dr Kumar<br />

completed his first AO4 surgery on a family<br />

member who to date has no clinical issues<br />

and is enjoying eating what she was unable<br />

to before.<br />

The implants of the AO4 procedure are placed<br />

at an angle providing for increased contact<br />

by using the natural support of the patient’s<br />

“By incorporating the AO4 into our educational<br />

offerings at Nuffield Academy, we are<br />

nurturing a cadre of dental professionals<br />

Dr Kumar conducting a lecture<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong> 45


USER REPORT<br />

“Imagine seeing the joy on a patient’s<br />

face when they get a full set of teeth<br />

in just one day — that is what AO4 is<br />

all about. It is not just about smiles;<br />

it is about giving people back their<br />

confidence, comfort, and a big part of<br />

their lives,” Dr Kumar added.<br />

On the second day of the training,<br />

students reviewed surgical cases<br />

and principles before learning about<br />

maintenance regime principles. They<br />

were also introduced to T-scans<br />

before a review case in Malo <strong>Dental</strong>’s<br />

protocol on maintenance appointment.<br />

The course concluded with a lecture<br />

and hands-on session for denture<br />

conversion.<br />

“The impact of such education is<br />

twofold: It not only elevates patient<br />

care to new heights by ensuring more<br />

practitioners can deliver this lifealtering<br />

treatment but also propels<br />

the dental field forward, setting<br />

new benchmarks of excellence in<br />

implantology.”<br />

Looking forward, Dr Kumar believes<br />

that the AO4 concept is poised for<br />

further advancements.<br />

“Over the next decade, we anticipate<br />

material innovations leading to more<br />

effective osseointegration. Digital<br />

dentistry will likely take centre stage,<br />

with precision planning and execution<br />

becoming more mainstream through<br />

technologies like 3D printing and<br />

digital scanning,” he said.<br />

The application of minimally invasive<br />

techniques is also set to redefine<br />

patient experiences, offering quicker,<br />

more comfortable recovery periods.<br />

Regenerative medicine promises<br />

new avenues for bone regeneration,<br />

potentially obviating the need for<br />

extensive pre-surgical preparation.<br />

The role of AI and machine learning<br />

in diagnostics and treatment<br />

planning is expected to enhance the<br />

personalisation and success rates of<br />

AO4 procedures.<br />

In practice and training, Dr Kumar<br />

preference for materials and<br />

equipment aligns with high standards<br />

of clinical excellence. For implants,<br />

he advocates for both high-quality<br />

titanium and zirconia due to their<br />

proven track record in osseointegration<br />

and biocompatibility, recommending<br />

brands like Nobel Biocare, Noris<br />

Medical and Zeramex. For prosthetics,<br />

he highlighted advanced ceramics<br />

and high-grade acrylic materials,<br />

particularly zirconia, as the offering<br />

for a perfect balance of durability,<br />

aesthetics, and patient comfort.<br />

“In my practice, these preferences<br />

stem from a commitment to providing<br />

our patients with the best possible<br />

outcomes. Using top-tier materials<br />

and the latest equipment, we ensure<br />

that each AO4 treatment is not<br />

just effective, but also provides the<br />

most comfortable and satisfying<br />

experience for our patients.”<br />

For equipment, Dr Kumar noted the<br />

use of advanced CBCT scanners<br />

and software for treatment planning<br />

further ensures precision and<br />

efficiency. Customised surgical<br />

guides, created with 3D printing<br />

technology provide accurate implant<br />

placement, minimising surgical time<br />

and enhancing patient comfort.<br />

Additionally, when addressing<br />

bone deficiencies, top-grade bone<br />

graft materials and membranes<br />

are essential for encouraging bone<br />

growth and implant stability.<br />

A critical component of the patient<br />

journey Dr Kumar highlighted is the<br />

attention to a patient’s bite. “I am<br />

unable to get the results I get without<br />

daily use of TekScan — this is a force<br />

sensor which objectively measures<br />

bite strength, symmetry and also<br />

adjusts for premature contacts,”<br />

he said.<br />

“During training sessions, I always<br />

emphasise the importance of these<br />

materials and tools. It is not just about<br />

teaching the technical steps of AO4; it<br />

is about imparting an understanding<br />

of how the right materials and<br />

equipment play a crucial role in the<br />

success of the procedure.” DA<br />

Dr Kumar performing a live surgery<br />

Dr Kumar believes that through such training courses, the dental field<br />

progresses forward as more patients have access to the treatment<br />

46 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


BEHIND THE SCENES<br />

Advocates of digital dentistry<br />

from the lab<br />

Driven by the region’s dynamic healthcare<br />

landscape and the growing demand for advanced<br />

dental solutions, Modern <strong>Dental</strong> Group saw an<br />

opportunity to contribute its expertise to an<br />

evolving dental landscape and expanded its<br />

dental laboratory operations into South East<br />

<strong>Asia</strong> in 2018. <strong>Dental</strong> <strong>Asia</strong> speaks with Richie<br />

Leung, business director for<br />

Modern <strong>Dental</strong> South East <strong>Asia</strong><br />

on its journey and outlook for<br />

the region into <strong>2024</strong>.<br />

By James Yau<br />

Founded in 1986 in Hong Kong as a<br />

manufacturer and distributor of dental<br />

prosthetic devices, Modern <strong>Dental</strong> Group<br />

has since grown into a global portfolio of<br />

brands, including Labocast, Permadental and<br />

Elysee <strong>Dental</strong> in Western Europe, Yangzhijing<br />

in China, Modern <strong>Dental</strong> USA in the US, and<br />

Southern Cross <strong>Dental</strong> in Australia.<br />

The group entered the South East <strong>Asia</strong>n<br />

market in 2018 with the establishment of<br />

subsidiaries in Singapore, Malaysia and<br />

Thailand. Currently, the group has its dental<br />

labs in Taiwan, Singapore, Malaysia and<br />

newly established sites in Vietnam with the<br />

support of over 4,000 dental technicians<br />

from its centralised production sites in China<br />

and Vietnam to fulfil local needs and reduce<br />

production lead time to any urgent cases.<br />

Over the past five years, Modern <strong>Dental</strong><br />

Group’s journey in South East <strong>Asia</strong> has<br />

been marked by strategic collaborations,<br />

technological innovation and a commitment<br />

to elevating dental care standards.<br />

“We have forged strong partnerships with<br />

dental professionals, clinics and institutions,<br />

aiming to provide them with state-of-the-art<br />

laboratory products and advanced dental<br />

solutions. The journey has been characterised<br />

by continuous learning and a dedication to<br />

excellence,” said Leung.<br />

A GLOBAL HUB FOR DENTAL<br />

TECHNICIANS<br />

Serving over 25 countries and 30,000<br />

downstream customers globally, quality<br />

control is key in production to ensure its dental<br />

prostheses meet the mark for a wide market.<br />

The coupling of in-house technicians and<br />

larger production facilities enables regional<br />

and local manufacturing teams to work<br />

together effectively.<br />

The direct presence of skilled technicians<br />

creates a dynamic environment where<br />

expertise is actively applied and shared; their<br />

immediate access allows for real-time problemsolving,<br />

contributing to a responsive and<br />

adaptive knowledge base. The collaborative<br />

environment created also encourages<br />

customisation, innovation, and experimentation<br />

with new techniques. Quality assurance is<br />

achieved while being able to support mass<br />

demand from all corners of the world.<br />

“This cohesive in-house team promotes<br />

efficient workflows and a positive workplace<br />

culture. We can rely on our main production<br />

site in Dongguan, China to provide<br />

worldclass products without capacity<br />

issues. Overall, managing in-house dental<br />

technicians transforms our lab into a vibrant<br />

knowledge centre, enhancing craftsmanship<br />

and generating positive ripple effects across<br />

our operations,” said Leung.<br />

In addition, the group employs various<br />

mechanics to ensure quality control in its<br />

production process. The establishment of<br />

feedback loops from end-users and dental<br />

professionals to continuously improve<br />

processes and product quality. This further<br />

helps the manufacturing in regularly<br />

reviewing and updating quality control<br />

processes to incorporate improvements and<br />

innovations. The use advanced technologies<br />

also ensure precision and consistency during<br />

the production process.<br />

“By incorporating these measures, we can<br />

confidently assure the quality of our dental<br />

prostheses, meeting the demands of a<br />

diverse market with reliability and excellence.<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong> 47


BEHIND THE SCENES<br />

We pride ourselves on our ability to efficiently<br />

meet the needs of a global customer base,<br />

ensuring seamless operations and exceptional<br />

service on a large scale,” Leung added.<br />

In the labs at Modern <strong>Dental</strong> Group, the<br />

digital dentistry revolution is embraced.<br />

Advanced CAD/CAM systems and 3D imaging<br />

and printing solutions are sought after as<br />

“practical technologies” to elevate precision<br />

and efficiency in its production processes.<br />

Collaborations with reputable brands is<br />

a cornerstone of Modern <strong>Dental</strong> Group’s<br />

approach from whose solutions become<br />

integral components of its technology arsenal.<br />

The group’s collaborations with intraoral<br />

scanner brands as well as its own Eletra<br />

brand are viewed as more than just tools,<br />

but as “eyes” which provide accuracy and<br />

customisation of its dental prostheses.<br />

“We can happily say goodbye to messy<br />

traditional moulds and hello to a streamlined,<br />

patient-friendly experience by utilising intraoral<br />

scanners. It is not just about capturing images;<br />

it is about providing dental professionals<br />

with the tools they need for precise treatment<br />

planning and execution,” said Leung.<br />

A collaboration with 3D printer brands plays<br />

a crucial role in Modern <strong>Dental</strong> Group’s<br />

manufacturing process. From design to<br />

printing to clinical work, the end-to-end<br />

process can transform the design into a<br />

finished product quickly, providing a simple<br />

and economical method to improve the<br />

efficiency and treatment time. The Form Auto<br />

hardware extension automatically removes<br />

finished parts and starts the next print<br />

without the need for operator interaction,<br />

enabling 24/7 3D printing with no printer<br />

downtime.<br />

“This scales capacity with demand and make<br />

production quicker and more affordable.<br />

It definitely shows how adopting digital<br />

technologies helps in costs, efficiency and<br />

production capacity of a dental lab,”<br />

Leung added.<br />

Looking ahead, the group is excited to<br />

offer its own technology by integrating its<br />

own clear aligner, TrioClear with 3D facial<br />

scanner. The integration offers recording from<br />

multiple angles simultaneously in reportedly<br />

“under half a second”. Facial scanners can<br />

reconstruct smiles into realistic 3D data and<br />

provide a suitable solution for digital smile<br />

line design instantly and accurately. It can<br />

also realise clinical ideas.<br />

The results of stereoscopic scans are used for<br />

aesthetic and complex oral repair treatments<br />

such as dental correction, dental implantation<br />

and oral reconstruction. For Leung, the<br />

integration is a “game-changer” which<br />

combines clear aligners with facial scanning<br />

seamlessly to simplify clinic workflows and<br />

ensures a smooth and effective patient<br />

treatment experience.<br />

“The integration of facial scanners, intraoral<br />

scanners and 3D printers into our workflow<br />

is not just about staying on trend, it is<br />

about tangible advantages. Efficiency is<br />

the immediate gain — quicker turnarounds<br />

mean happier patients and more streamlined<br />

processes for dental professionals.”<br />

DIGITAL ADVOCATES<br />

In South East <strong>Asia</strong>, Leung observes some key<br />

trends and developments that are shaping the<br />

landscape.<br />

One significant influence is the increasing<br />

adoption of digital dentistry practices. More<br />

dental professionals are embracing digital<br />

technologies, such as intraoral scanners,<br />

3D facial scanners and 3D printing. This<br />

shift towards digital solutions streamlines<br />

processes to improve efficiency and enhance<br />

precision allowing for more personalised and<br />

accurate treatments.<br />

Likewise for manufacturers, the ongoing<br />

advancements in digital dentistry solutions<br />

will influence the supply chain of dental<br />

prostheses products. Leung highlighted a<br />

notable shift towards increased efficiency<br />

and speed to provide quicker delivery times.<br />

The precision and customisation capabilities<br />

offered by advanced digital tools are set to<br />

meet the surging demand for personalised<br />

dental prostheses.<br />

“What stands out to me is the potential for<br />

decentralised manufacturing, facilitated by the<br />

seamless electronic transmission of digital<br />

files, allowing for localised production to cater<br />

to specific regional needs,” Leung said.<br />

An extensive pool of dental technicians and production facilities provides a knowledge base which is<br />

shared across Modern <strong>Dental</strong> Group’s regional and international manufacturing network<br />

Furthermore, Leung points out that the<br />

impact of digital dentistry is not just about<br />

hardware but also on a strong emphasis on<br />

collaboration and interoperability to create<br />

a connected supply chain. The increasing<br />

adoption of additive manufacturing, 3D<br />

printing and laser sintering, will revolutionise<br />

traditional production methods, introducing a<br />

more agile and resource-efficient approach.<br />

48 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


BEHIND THE SCENES<br />

Recognising such developments, Leung is<br />

assured to stay ahead of the curve by taking<br />

the lead as opposed to simply following<br />

trends: “Digital dentistry is not just a fancy<br />

direction for us; it is what we are all about.<br />

We are convinced that blending digital tools<br />

makes everything more accurate and efficient,<br />

leading to better results for patients.”<br />

Navigating these changes, it introduces<br />

a need for technicians to manage these<br />

technologies effectively. To back this belief,<br />

the group organises educational clubs<br />

and courses focused on digital dentistry<br />

where dental professionals receive handson<br />

exposure to the latest technologies and<br />

techniques.<br />

“Education and training programmes are<br />

paramount to equip dental professionals<br />

with the requisite skills, ensuring they<br />

remain at the forefront of technological<br />

advancements. However, it is important to<br />

acknowledge that the proliferation of digital<br />

tools might affect manual labour employment<br />

in the industry, necessitating thoughtful<br />

strategies for workforce transitions and<br />

reskilling initiatives,” said Leung.<br />

One trend Leung is excited by is the<br />

integration of different digital tools like<br />

intraoral scanners and 3D printers for a<br />

smoother workflow. “It is like a tech duet,<br />

making everything more connected and<br />

efficient in the dental world.”<br />

Another example is the advancement in<br />

facial scanning, that can cope with growing<br />

demands from patients requesting a better<br />

visualisation of their treatment results, from<br />

clear aligner treatment, to smile design and<br />

full-mouth aesthetic makeovers. “As digital<br />

dentistry advocates, we are stoked to be right<br />

in the middle of this change. Our study clubs<br />

and courses shout out our commitment to<br />

helping South East <strong>Asia</strong>’s dental professional<br />

rock the digital era.”<br />

In the next five years, the group is focused<br />

on strengthening its brand and making<br />

Modern <strong>Dental</strong> Group more recognisable in<br />

the South East <strong>Asia</strong> market, offering dental<br />

professionals in the region the best digital<br />

dentistry solutions with broader geographic<br />

coverage. With advancements in technology<br />

associated in the<br />

manufacturing<br />

process, Leung sees<br />

more opportunities<br />

across regions<br />

to reach a larger<br />

audience. Leung is<br />

on the outlook for<br />

potential partnerships<br />

and acquisitions<br />

with local dental<br />

professionals or<br />

acquiring existing<br />

dental labs to<br />

establish Modern<br />

<strong>Dental</strong> Group in new<br />

markets.<br />

“We think that this<br />

approach lets us<br />

benefit from the local<br />

expertise and patient base of established<br />

practices. Overall, our goal is to provide better<br />

and more comprehensive services to all<br />

customers in the region,” Leung said.<br />

Set on expanding its business in South East<br />

<strong>Asia</strong>, Leung recognises several challenges<br />

along the way. Regulatory compliance poses<br />

a complex task, considering the unique dental<br />

regulations and licensing requirements in<br />

each country.<br />

“Navigating through these legal frameworks<br />

and ensuring adherence to local laws is a<br />

time-consuming yet crucial aspect of our<br />

strategy. Additionally, access to skilled<br />

staff, especially in areas with a shortage of<br />

qualified practitioners, is another challenge<br />

we anticipate,” Leung added.<br />

To overcome these challenges, Leung is<br />

aiming to invest in training programmes and<br />

explore partnerships with local dental schools<br />

in the region. Moreover, Leung emphasised<br />

on a fundamental understanding and meeting<br />

the diverse dental needs and expectations<br />

across the region.<br />

“Our approach involves adapting<br />

our services to cater to local market<br />

demands, offering specialised<br />

treatments, accommodating cultural<br />

preferences and providing affordable<br />

options to different socioeconomic<br />

Behind the scenes at<br />

Modern <strong>Dental</strong> Group,<br />

an embrace and belief in<br />

digital dentistry is taking<br />

the group in new directions<br />

segments. Through a pragmatic approach, we<br />

aim to navigate these challenges successfully<br />

and contribute meaningfully to the South East<br />

<strong>Asia</strong> dental landscape,” said Leung.<br />

“I would say the digital transformation<br />

in dentistry holds immense promise,<br />

but a nuanced approach is essential. As<br />

technology evolves, so must the skills of<br />

dental technicians and the industry should<br />

proactively address the potential impact<br />

on employment, striving for a harmonious<br />

integration of digital advancements with the<br />

expertise and craftsmanship of<br />

skilled professionals.” DA


IN DEPTH WITH<br />

Why customise the dental<br />

scaffold for alveolar height<br />

augmentation?<br />

Traditionally, customising a titanium mesh for alveolar<br />

height augmentation involves a lengthy process of 3D<br />

metal printing. This requires extended communication<br />

between the surgeon and the designer, and a delivery time<br />

of 6-9 weeks. Osteopore’s Digital Surgical Dentistry (DSD)<br />

system aims to provide clinicians with the flexibility to<br />

customise dental scaffolds chair-side during surgery, all<br />

within the same day as the patient’s visit.<br />

Singaporean dental 3D printing company Star3D<br />

Materials Development Company, collaborates<br />

with Osteopore International as both homegrown<br />

companies seek to advance digital dentistry<br />

solutions. Together, Osteopore and Star3D aim to<br />

reduce the wait time to treat jawbone resorption<br />

with factory customised titanium mesh from<br />

6-9 weeks to a same-day treatment. Leveraging<br />

Osteopore’s expertise in regenerative biomimetic<br />

scaffolds, the collaboration introduces the DSD<br />

System, enhancing surgical procedures and<br />

optimising patient outcomes.<br />

The DSD system encompasses the 3D3 Mini<br />

2 printer, Osteomesh, and a water bath. This<br />

system solution is designed to follow a five-step<br />

process starting from printing of the patient’s<br />

model, to sterilising, shaping and trimming the<br />

Osteomesh, before trying it in and inserting the<br />

material into the patient.<br />

Such outcomes are achieved in three key areas.<br />

First, surgical procedures are streamlined as<br />

pre-moulding of the Osteomesh allows for sameday<br />

treatments and reduces the operation time.<br />

Next, the precision in customisation minimises<br />

soft tissue disruption by avoiding several trials<br />

of inserting the mesh. Last, patient comfort is<br />

elevated as the DSD System reduces the duration<br />

of mouth opening.<br />

50 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


IN DEPTH WITH<br />

3D3 Mini 2 printer<br />

The 3D3 Mini 2 model SLA 3D printer<br />

is designed to develop precise<br />

patient models. Its specifications<br />

include a 4k resolution to achieve<br />

anatomical accuracy with clarity and<br />

a capability to print fine layers at<br />

50μm per layer to capture intricate<br />

features precisely. Furthermore, the<br />

printer features a built-in light cure<br />

box for streamlined post-print curing,<br />

and a double guide rail system for<br />

steady performances.<br />

Efficient speed settings provide<br />

a balance between speed and<br />

accuracy, and the printer can<br />

accommodate complex anatomies<br />

with a 90mm print height. It comes<br />

with a one-year warranty period,<br />

supports .STL files, and connects via<br />

LAN, wifi.<br />

Moreover, the DSD System<br />

includes a post-curing station that<br />

complements the 3D3 Mini 2 printer.<br />

The station tailors curing times<br />

with intervals of 1min, ranging from<br />

5-60mins. It also provides water and<br />

air curing methods to suit specific<br />

needs, with a wavelength of 405nm.<br />

Preparation of Osteomesh<br />

At the heart of the system lies<br />

the Osteomesh — a semi-flexible,<br />

bioresorbable mesh engineered<br />

to provide dimensional retention<br />

and graft material support. This<br />

innovation offers predictable shape<br />

and volume of regenerated bone<br />

tissue in guided bone regeneration.<br />

Its preparation follows three steps.<br />

Sizing of defect: Select the suitable<br />

size of Osteomesh, remove from<br />

single wrap sterile packaging and<br />

place in dry sterile bowl.<br />

Trimming: Using a pair of<br />

sterile surgical scissors, trim<br />

Osteomesh to the desired shape.<br />

It is recommended to completely<br />

remove the borders of the mesh.<br />

Moulding: Warm up sterile saline to<br />

the appropriate temperature in the<br />

water bath for moulding.<br />

Immerse Osteomesh for<br />

approximately 10secs to make<br />

it more malleable. Using the<br />

sterile model as a guide, contour<br />

and form the Osteomesh in the<br />

desired vertical and horizontal<br />

measurements for approximately<br />

5secs. Remove Osteomesh from<br />

the warm saline while holding it in<br />

its new shape for another 10secs.<br />

Repeat step until desired shape is<br />

formed. Refer to the table for the<br />

appropriate temperature.<br />

Mesh thickness Temperature (°C)<br />

(mm)<br />

1.25 50<br />

The water bath ensures the<br />

Osteomesh achieves the ideal<br />

consistency. It is recommended to<br />

place a sterile beaker or a sterile<br />

polyethylene bag or sheet in the<br />

water bath machine before pouring<br />

the sterile saline solution.<br />

FINAL STEPS<br />

Having sterilised the model and<br />

prepared the Osteomesh, it can<br />

be tried-in onto the patient’s<br />

model crafted by the 3D3 Mini 2<br />

printer. This allows for precise<br />

customisation before the surgery.<br />

Three print platform sizes:<br />

i) 140mm*80mm<br />

ii) 80mm*80mm<br />

iii) 50mm*50mm<br />

Dimensions:<br />

261mm(W) x 322mm(D) x 420mm(H)<br />

Weight: 13kg<br />

Curing size: 180 x 100mm<br />

Dimensions:<br />

220mm(W) x 220mm(L) x 325mm(H)<br />

Weight: 5.5kg<br />

Next, the Osteomesh can be<br />

inserted into the patient to complete<br />

the procedure.<br />

Following the five-step process,<br />

the three components within the<br />

DSD system aim to revolutionise<br />

alveolar height augmentation.<br />

This is achieved through<br />

Osteopore’s approach towards<br />

bone regeneration which can be<br />

completed within a single day with<br />

precision and customisation for<br />

enhanced patient outcomes and<br />

streamlined surgical procedures. DA<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong><br />

51


IN DEPTH WITH<br />

New capabilities and fully digital<br />

workflows with IBT Flex Resin<br />

Formlabs <strong>Dental</strong> materials portfolio sees a new addition with the IBT Flex<br />

Resin for 3D printed indirect bonding trays and direct composite restoration<br />

guides. Together with the Form 3B+ stereolithography (SLA) 3D printer, IBT<br />

Flex Resin can enable dentists, orthodontists, and dental lab technicians to<br />

improve clinical outcomes and deliver better results in less time.<br />

In what is said to be a first-of-its-kind capability for digital dentistry,<br />

dental professionals can use IBT Flex Resin to 3D print direct<br />

composite restoration guides to assist in the build-up of single units<br />

to full smile designs. Compared with traditional approaches, using a<br />

3D printed guide improves consistency and reduces procedure time<br />

and cost.<br />

IBT Flex Resin is biocompatible, FDA registered, and CE marked<br />

according to the EU MDR, and manufactured in the US at Formlabs’ ISO<br />

13485 certified facility for dental and medical materials development<br />

and manufacturing. IBT Flex Resin can be used in Formlabs Form 3B/+<br />

and Form 3BL resin 3D printers.<br />

The new resin aims to provide an upgrade on traditional approaches to<br />

deliver cost-savings and more efficient workflows<br />

Furthermore, with IBT Flex Resin, dental professionals can 3D print<br />

flexible, translucent indirect bonding trays for bracket placement that<br />

save time and deliver consistent and predictable outcomes.<br />

while minimising the risk of error. Indirect bonding trays can be printed<br />

in IBT Flex Resin at the 100µm layer height quickly and accurately.<br />

For both indications, the strength, flexibility, tear resistance, and clarity<br />

of the new resin enable dental professionals to operate with efficiency<br />

and confidence. Its elongation reduces worry on intraoral breakage<br />

or tearing. Teams can also integrate IBT Flex Resin into their in-house<br />

digital workflow, with its quick print and post-process times.<br />

Chair time for full mouth, individual bracket<br />

cementation<br />

Chair time for full mouth, indirect bonding tray<br />

cementation<br />

40-60mins<br />

10-20mins<br />

Property IBT Flex Resin Other 3D-printed indirect<br />

bonding resins<br />

Shore hardness 77-80A 89-95A<br />

Elongation (%) 135


IN DEPTH WITH<br />

of indirect bonding. As an accurate material with optimal clarity, IBT<br />

Flex Resin enables orthodontists to avoid bond failures and minimises<br />

rework.<br />

“IBT Flex Resin is an enhanced material that provides a higher quality<br />

of flexibility and translucency in comparison with other indirect bonding<br />

materials we have used. IBT Flex Resin provides superb accuracy and<br />

fit of the brackets. Providers can be confident it will deliver an excellent<br />

indirect bonding experience for their team members and patients. The<br />

workflow from beginning to end is effortless and will leave an overall<br />

lasting impression,” said Patricia Mitchell, digital specialist at Alvetro<br />

Orthodontics, on the resin’s impact. Based Sidney, Ohio, the clinic relies<br />

on the Form 3B+ and Form Auto for producing models and various<br />

appliances to treat over 120 patients a day.<br />

NEW CAPABILITIES IN DIRECT COMPOSITE RESTORATION<br />

GUIDES<br />

Printed at a 50µm layer height, the new capability of IBT Flex<br />

Resin in 3D printing direct composite restoration guides displays a<br />

good surface finish and reduces the time needed for polishing. A<br />

streamlined and fully digitised workflow produces a guide with optimal<br />

transparency, flexibility, and fit, allowing dentists to focus on the<br />

aesthetics and performance.<br />

According to Formlabs, the digital production of 3D printed direct<br />

composite restoration guides provides several advantages compared<br />

to the traditional production where clear polyvinyl siloxane (PVS) is<br />

used:<br />

The traditional workflow requires printing a model with the ideal design<br />

or wax-up which is later used to fabricate the silicone index upon. The<br />

ability to 3D print the guide directly eliminates the model production as<br />

a whole.<br />

As fewer steps are required, it reduces the possibilities of losing details<br />

or adding errors throughout the way. The directly printed appliance<br />

can accurately transfer the wax-up to the patient’s mouth based on the<br />

digital design already planned in the CAD software.<br />

Traditional clear PVS materials can range from US$80-130 for two<br />

cartridges of material which cost $10-20 per tray depending on the<br />

design. The cost for a full arch direct composite restoration tray 3D<br />

printed with IBT Flex Resin is reduced to $2-5.<br />

Fewer steps are needed with the capability of the resin in printing direct<br />

composite restoration guides<br />

Three-dimensionally printing the guides enables dental professionals to<br />

accurately design the extension of the guide and control its adaptation<br />

at the gingiva margin which is critical for the technique. Waste is also<br />

reduced as there is no need to cut the guides with a blade to adjust to<br />

the gingiva margin. Moreover, the thickness of the appliance can be<br />

controlled when designed digitally to ensure it is consistent throughout<br />

the appliance which is not achievable via the analogue workflow.<br />

Traditional silicone guides require the application of a separating<br />

agent to prevent the composite from adhering to it during clinical use.<br />

For trays used for guided restorative techniques, some composites<br />

do not adhere to the tray, providing a nice advantage compared to<br />

conventional workflows.<br />

“There is great fidelity between the reference and the printed guide,<br />

which results in the good reproduction of details and helps to<br />

avoid surface or occlusion corrections. Another advantage is the<br />

translucency of the material, which makes it possible to control the<br />

distribution of the temporary resin in the guide and avoid the presence<br />

of bubbles,” said Dr Edouard Lanoiselée, DDS.<br />

A Formlabs <strong>Dental</strong> key opinion leader and restorative dentistry expert,<br />

Dr Lanoiselée has been testing and using IBT Flex Resin for chairside<br />

permanent and temporary crowns and bridges, mock-ups or try-ins<br />

during aesthetic treatments, and moulds for restorations.<br />

“The printed guide is flexible, so it is easy to insert and remove.<br />

Furthermore, the composite does not stick to the printed guide so<br />

we can use it for different techniques with chemo-polymerisable<br />

resins such as temporary resins or photo-polymerisable restoration<br />

composites.”<br />

The indirect bonding<br />

tray workflow with<br />

IBT Flex Resin can<br />

reduce over 30mins<br />

in patient chair time<br />

Dentists might perform direct composite restorations freehand or<br />

use a variety of digital or analogue tools. With IBT Flex Resin, dental<br />

professionals can go directly from digital design to the 3D printed index,<br />

reducing costly steps that create rooms for mistakes. The 3D printed<br />

guide directly replicates a digital design with accuracy, whether a design<br />

is a single unit, a full smile, or anywhere in between. DA<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong> 53


IN DEPTH WITH<br />

exocad introduces <strong>Dental</strong>CAD<br />

3.2 Elefsina software with over<br />

60 new features<br />

exocad’s new <strong>Dental</strong>CAD 3.2 Elefsina<br />

software aims to provide more<br />

intuitive workflows with over 60<br />

features designed to meet customer<br />

requirements and enhance workflows —<br />

from treatment planning to design and<br />

manufacturing.<br />

“<strong>Dental</strong>CAD 3.2 Elefsina delivers the<br />

exciting functionalities dental experts<br />

have been waiting for. The new release<br />

offers more automation, speed, and<br />

intuitive workflows from CAD to CAM,”<br />

said Tillmann Steinbrecher, CEO of<br />

exocad.<br />

Named after the current EU ‘European<br />

Capitals of Culture’, exocad has chosen<br />

the Greek city of Elefsina to bear the<br />

name of its the latest version of its<br />

CAD software. <strong>Dental</strong>CAD 3.2 Elefsina<br />

incorporates numerous time-saving<br />

features. The new preparation margin<br />

repair tool allows users to make the<br />

most out of imperfect intraoral scans,<br />

enabling them to fix margins and<br />

achieve acceptable results despite<br />

artifacts or holes in the scan.<br />

The addition of a new autoarticulator<br />

offers fully automatic consideration<br />

of dynamic occlusion. Also, a new<br />

integration of compact milling machines<br />

enables users to select their preferred<br />

block, initiate production seamlessly<br />

within their CAD software, and switch<br />

tooth libraries while retaining their<br />

previous setup.<br />

The ‘Bite Splint Module’ in <strong>Dental</strong>CAD<br />

3.2 Elefsina introduces increased<br />

automation in bite splint design. The<br />

‘Full Denture Module’ now includes<br />

a feature to rapidly copy an existing<br />

denture in a highly automated<br />

workflow, offering a faster and more<br />

cost-effective alternative to relining,<br />

leveraging recent advances in 3D<br />

printing. Additionally, dentures on<br />

ball attachments are now supported<br />

and an add-on module for the Ivoclar<br />

Ivotion Denture System along with a<br />

dedicated Ivoclar tooth library.<br />

New tools in the ‘Smile Creator’ module<br />

provide users with more predictability<br />

and better planning options. Users can<br />

design virtual gingiva for more realistic<br />

outcomes and create smiles based<br />

on patients’ natural teeth. The ability<br />

to adjust 3D rendering to the camera’s<br />

focal length enables a more precise<br />

photo-driven smile design.<br />

To enhance collaboration between labs<br />

and doctors, clinicians can now share<br />

external case-related files such as<br />

images, videos, and x-rays with exocad<br />

<strong>Dental</strong>CAD users through the MyiTero<br />

portal. The new bi-directional case<br />

communication allows <strong>Dental</strong>CAD<br />

users to share their 3D designs with<br />

the doctor for an efficient previewand-approval<br />

process. Within the CAD<br />

software, lab users can also validate<br />

margins with iTero intraoral camera<br />

images and visualise internal tooth<br />

structure with iTero near infrared<br />

imaging (NIRI) technology.<br />

Other highlights of the <strong>Dental</strong>CAD 3.2<br />

Elefsina include the ability to design<br />

post and core restorations so that<br />

a crown matching the core can be<br />

designed in the same step, a new<br />

‘Virtual Articulator’ support for Gamma<br />

<strong>Dental</strong> Reference SL, Kavo PROTARevo<br />

5B, with an anatomical ‘in-skull’<br />

articulator visualisation, and an easier<br />

and more efficient process for titanium<br />

bases supporting variable screw<br />

channel angulation.<br />

exocad will offer hands-on<br />

demonstrations of the new <strong>Dental</strong>CAD<br />

3.2 Elefsina release at various<br />

upcoming dental exhibitions and at<br />

Insights <strong>2024</strong> taking place from 9-10<br />

May <strong>2024</strong>, in Palma de Mallorca, Spain.<br />

The company’s global event will include<br />

opportunities for attendees to discover<br />

more about the latest Elefsina features<br />

from dental industry leaders and<br />

application specialists. DA<br />

54 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


PRODUCT HIGHLIGHTS<br />

Amann Girrbach releases Ceramill<br />

Map FX, new 3D desktop scanner<br />

Amann Girrbach has launched the Ceramill<br />

Map FX, a new lab scanner which aims to<br />

offer high precision with short scanning<br />

times and maximum versatility.<br />

The Ceramill Map FX scanner is said to<br />

operate with precision and repeatability<br />

while keeping scanning times short. To<br />

ensure safe and efficient processes, the<br />

Ceramill Map FX is fully integrated into<br />

the digital workflow and its compact<br />

dimensions allows the scanner to be<br />

integrated into lab environment where<br />

space is limited.<br />

Two comprehensive upgrade options allow<br />

the scanner to be expanded to meet the<br />

specific needs of the user. The basic version<br />

of the Ceramill Map FX provides the user<br />

with entry-level digitisation at an attractive<br />

price/performance ratio. With its<br />

modular design, the system is reportedly<br />

future-proof and can be expanded and<br />

upgraded at any time.<br />

In addition to basic prosthetic and<br />

orthodontic indications, advanced<br />

scanning options are also included in the<br />

enhancements. All variants offer high<br />

precision with short scanning times. For<br />

example, the optional HD scan achieves<br />

an accuracy of up to 4µm, and scanning<br />

options such as impression scanning or<br />

‘multidie’ offer maximum convenience.<br />

All common CAD/CAM systems can be<br />

connected via an open interface such as<br />

.STL and .PLY file types.<br />

“With the Ceramill Map FX, we have<br />

achieved an unbeatable combination<br />

of precision, economy and versatility:<br />

Without a doubt, the scanner will convince<br />

laboratories and practice laboratories that<br />

appreciate efficiency and future-proofing,”<br />

said product manager for Lab CAD/CAM<br />

Equipment at Amann Girrbach, Larissa<br />

Duarte. “The OneShot Scan can also be<br />

ideally combined with the popular Artex<br />

articulator system — for example, removing<br />

the rotation axis enables vestibular<br />

scanning of the articulator. Overall,<br />

handling is simple and intuitive. Owing<br />

to the integration of the Ceramill Map FX<br />

into the digital workflow, high process<br />

reliability as well as reproducible results<br />

are also ensured.” DA<br />

BUSCH launches COOL-DIAMANT<br />

and XTi-cut line of cutting instruments<br />

BUSCH has released the COOL-DIAMANT<br />

Instrument with optimised coolant flow,<br />

its product in the diamond segment<br />

which aims to provides more expedient<br />

preparation. The grinding performance<br />

reduces the treatment time needed, thus<br />

benefiting the practitioner as well as the<br />

patient.<br />

The many diagonal cooling grooves<br />

interrupt the grinding process up to<br />

seven times per rotation which provides<br />

additional support for the coolant spray<br />

and the removal chip.<br />

The continuous diamond coating even in<br />

the deeper grooves ensures great and easy<br />

grinding performance, facilitates removal<br />

thanks to the edge effect around the groove<br />

transitions and optimises the service life.<br />

COOL-DIAMANT Instruments are coated<br />

with pure gold. This fully covers the<br />

nickel bonding layer and enhances tissue<br />

compatibility. The COOL-DIAMANT range<br />

comprises 124 application-oriented variants<br />

in coarse, medium and fine diamond grit.<br />

Titanium is a difficult material to work with<br />

using conventional cutters. The penetration<br />

resistance can<br />

only be overcome<br />

inadequately,<br />

with an<br />

undesirable<br />

build-up of heat<br />

leading to oxidation on the surface of the<br />

material. BUSCH offers carbide cutters<br />

with XTi-cut for such applications.<br />

The instruments with cross-cut have a<br />

slight right-hand twist in the guide cutters<br />

and are characterised by deep chip spaces.<br />

In this way, the penetration resistance<br />

can be overcome with considerably less<br />

generated heat. Users can choose from 10<br />

instruments in different shapes and sizes<br />

specific to the respective applications. DA<br />

56 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


PRODUCT HIGHLIGHTS<br />

Vivos Therapeutics receives<br />

first FDA 510(k) clearance for<br />

oral device treatment of severe<br />

obstructive sleep apnea<br />

Vivos Therapeutics, a medical device and<br />

technology company specialising in the<br />

development and of treatments for sleep<br />

related breathing disorders, announced<br />

that it has been granted 510(k) clearance<br />

from the US Food and Drug Administration<br />

(FDA) for treating severe obstructive<br />

sleep apnea (OSA) in adults using the<br />

Vivos’ removable CARE (Complete Airway<br />

Repositioning and/or Expansion) oral<br />

appliances. Vivos’ CARE appliances include<br />

the DNA oral appliance, the mRNA oral<br />

appliance and the mmRNA oral appliance.<br />

With the clearance, Vivos is reportedly<br />

the first company to have approved and<br />

bring to market an alternative treatment to<br />

continuous positive airway pressure (CPAP)<br />

or surgical neurostimulation implants for<br />

patients with severe OSA.<br />

This latest clearance comes 11 months after<br />

the FDA granted Vivos 510(k) clearance for<br />

the DNA oral appliance to treat mild-tomoderate<br />

OSA, and represents the first<br />

time the FDA has granted an oral appliance<br />

a clearance to treat moderate and severe<br />

OSA in adults, 18-years of age and older<br />

along with positive airway pressure (PAP)<br />

and/or myofunctional therapy, as needed.<br />

“Before this, severe OSA patients’ only<br />

realistic treatment options were CPAP,<br />

neurostimulation implants or other<br />

The Vivos DNA appliance (left) and mRNA<br />

appliance (right) (Image: Vivos Therapeutics)<br />

invasive surgeries. Today, they have what<br />

we believe is a far more desirable option<br />

that is very affordable and does not require<br />

surgery or a lifetime of nightly use and<br />

intervention,” said chairman and CEO of<br />

Vivos, Kirk Huntsman.<br />

According to the company, the statistically<br />

significant data submitted to the FDA from<br />

73 severe OSA patients showed that 80%<br />

of patients experienced an improvement<br />

of at least one classification or at least a<br />

50% improvement in the Apnea Hypopnea<br />

Index (AHI), and 97% of patients improved<br />

or stayed the same. The average treatment<br />

time was 9.7 months.<br />

Treatment results with severe sleep apnea<br />

patients were better than with mild and<br />

moderate patients. All pre- and posttreatment<br />

testing was conducted with no<br />

device in the mouth. The company further<br />

added that unlike other oral appliances<br />

on the market, Vivos’ proprietary CARE<br />

appliances gradually reposition the hard<br />

and soft tissues that define the airway,<br />

thereby opening it up and optimising its<br />

function and flow. DA<br />

Myerson introduces Trusana 3D Premium Denture<br />

System, exclusively distributed by Zahn <strong>Dental</strong><br />

Manufacturing digital dental materials<br />

company Myerson has announced the<br />

launch of the Trusana Premium Denture<br />

System. The system is comprised of<br />

Trusana Premium 3D Tooth Resin and<br />

the newly released Trusana Premium 3D<br />

Denture Base Resin and Trusana Bond<br />

Denture Adhesive.<br />

The three products work together to create<br />

a denture with optimal physical properties<br />

and aesthetics. Created by a team of<br />

scientists and clinicians from around the<br />

world, Trusana resins won a RadTech/UVA<br />

Emerging Technology award for additive<br />

manufacturing in 2020.<br />

wear-resistance. Trusana also mirrors the<br />

beauty and translucency of a natural smile.<br />

“We are thrilled to introduce the new<br />

Trusana Premium Denture System. We<br />

dedicated years of university-based<br />

research to create resins for 3D printing<br />

denture teeth with exceptional wear<br />

resistance and optimal esthetics and a<br />

denture base with high-impact strength.<br />

Independent clinical and in vitro multisite<br />

studies have shown our patented<br />

3D resins deliver the requisite strength<br />

and toughness with minimal moisture<br />

absorption,” said president and CEO for<br />

Myerson, Jim Swartout.<br />

(Image:<br />

Myserson)<br />

and technology, and the ability to produce<br />

final digital dentures that maintain<br />

strength and the characteristics of a<br />

traditional denture. Together, the Trusana<br />

premium 3D resins result in a high-quality<br />

product for doctors while helping to save<br />

time, money, and materials.<br />

Trusana’s patented chemistry delivers<br />

an aesthetic, unfilled polymer with high<br />

flexural strength, fracture toughness, and<br />

The Trusana premium denture system is<br />

designed to provide dental labs what they<br />

are seeking in terms of innovative science<br />

Zahn <strong>Dental</strong>, the US dental lab business<br />

of Henry Schein, Inc, is the exclusive<br />

distributor of Trusana resins. DA<br />

58 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


PRODUCT HIGHLIGHTS<br />

Carbon introduces<br />

three new resins to<br />

its platform<br />

Carbon has announced the<br />

release of three resins on its<br />

platform — Pac-Dent Rodin<br />

Sculpture, Desktop Health<br />

Flexcera Base, and Keystone<br />

KeyGuard. The launch is<br />

part of Carbon’s initiative<br />

(Image: Carbon, Desktop Health,<br />

Keystone and Pac-Dent)<br />

to facilitate innovation in the dental industry, empowering<br />

labs to diversify their production capabilities and explore new<br />

applications.<br />

→ DISCOVER PERFECTION<br />

IN PROPHYLAXIS -<br />

THE NEW COMBI touch<br />

“With the introduction of these new resins, dental labs can look<br />

forward to improving their workflow efficiency and product<br />

offerings while providing customers with the latest in dental<br />

care advancements,” said co-founder and office of the CEO,<br />

Phillip DeSimone. “Each resin will unlock new opportunities for<br />

dental labs and further highlight Carbon’s unwavering resolve<br />

to drive dental industry innovation via advanced, best-in-class<br />

resins.”<br />

→ ultra-gentle prophylaxis<br />

→ ergonomic handling<br />

→ made in Italy<br />

→ 40 years experience<br />

Pac-Dent Rodin Sculpture Resin: Developed for modern dental<br />

restorations, the Pac-Dent Rodin Sculpture Resin introduces a<br />

new all-on-x solution for long-term provisionals on the Carbon<br />

platform for precision, aesthetics, and strength. This resin is<br />

the first in Carbon’s lineup that is FDA 510k-cleared for all-on-x<br />

temporary dental appliances, offering a nanohybrid ceramic<br />

formulation for lifelike permanent restorations. Additionally,<br />

it is reportedly the first permanent crown material to contain<br />

over 50% ceramic filler, meeting requirements for updated ADA<br />

insurance code reimbursements D2740, D2630, and D2644.<br />

Desktop Health Flexcera Base: Following the successful<br />

validation of Flexcera Smile Ultra+ restorative tooth resin,<br />

Flexcera Base joins Carbon’s portfolio as the latest innovation in<br />

denture base materials. This resin is designed for creating highimpact<br />

denture bases, combining optimal fracture resistance<br />

with good aesthetic quality. Both Flexcera Base and Flexcera<br />

Smile Ultra+ are FDA-cleared, ensuring that dental labs can<br />

confidently offer reliable permanent and temporary solutions<br />

to their customers.<br />

Keystone Industries KeyGuard: Keystone Industries brings to<br />

the Carbon platform the Keystone KeyGuard, a flexible resin for<br />

crafting high-quality, custom-fit mouthguards. This addition<br />

offers dental professionals the opportunity to design sports<br />

mouthguards digitally with custom variable wall thicknesses to<br />

provide comfort and protection to the end user. DA<br />

→ www.mectron.com<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong><br />

59


PRODUCT HIGHLIGHTS<br />

Ackuretta upgrades ALPHA AI to<br />

simplify 3D-printing workflows<br />

Ackuretta has announced a series of<br />

upgrades to its ALPHA AI slicing software<br />

aimed at simplifying dental 3D printing<br />

workflows for users.<br />

With the new ALPHA AI Premium, users<br />

can now take advantage of auto-orientation<br />

and AI generated support building with<br />

upgraded features including three new<br />

compatible applications — denture<br />

base, denture teeth, and removable die.<br />

These upgraded features are in addition<br />

to previously added compatible dental<br />

applications including hollow/solid model,<br />

splint, crown, bridge, and surgical guide.<br />

The upgrade also provides users the ability<br />

to access ALPHA AI on four devices at the<br />

same time.<br />

Furthermore, new users are now able<br />

to sign up for ALPHA AI Premium with<br />

a brand new 2-year subscription option<br />

matching the Ackuretta SOL’s extended<br />

warranty length available via Ackuretta<br />

Concierge. New users will now also get<br />

an extra month free after signing up for a<br />

1-year or 2-year subscription.<br />

By making orientation, stacking, nesting,<br />

supports, and .STL file export for nine<br />

compatible applications easier, ALPHA<br />

AI is said to increase the print success<br />

rate, thereby increasing productivity,<br />

time, and resource savings. Its capabilities<br />

and integration with the Ackuretta 3D<br />

Printing Solution also makes it easy for<br />

practitioners to delegate with no resource<br />

intensive design training needed.<br />

The company further cited ‘incorrect<br />

orientation’ as the cause of 75% of failed<br />

prints. ALPHA AI Premium aims to reduce<br />

this rate with its auto-orientation which<br />

allows users to orient an application, add<br />

AI-generated supports, and save the file<br />

in .STL, .I3DP, or .IBF format for export to<br />

their dental 3D printer. ALPHA AI’s workflow<br />

is designed for users to import their file,<br />

choose the 3D printer and resin used, select<br />

the desired layer thickness, before orienting<br />

and adding supports to the application, and<br />

then slicing it to be ready for printing. DA<br />

Pearlie White and NDCS unveils new mouth<br />

rinse, developed from research study on SARS-<br />

CoV-2 virus<br />

A study from the National <strong>Dental</strong> Centre<br />

Singapore (NDCS) on the efficacy of mouth<br />

rinses in reducing the SARS CoV-2 virus<br />

during the COVID-19 pandemic has led to<br />

the development of an antiseptic mouth<br />

rinse with anti-viral properties. The new<br />

product is named Pearlie White Defenze<br />

Antiseptic Fluoride Mouth Rinse and<br />

was developed by NDCS in partnership<br />

with Singaporean oral care brand Pearlie<br />

White, highlighting the innovation of<br />

public-industry partnerships which brings<br />

together medical research with commercial<br />

expertise.<br />

“Inspiration for this research first<br />

originated from my volunteer work at<br />

the migrant workers’ dormitory during<br />

the height of the pandemic in 2020. I am<br />

elated we were able to rapidly progress<br />

the study to achieve this unique mouth<br />

rinse formulation with the vast industry<br />

experience from Pearlie White,” said<br />

The proprietary formulation of CPC, zinc and<br />

xylitol provides the mouth rinse with its enhanced<br />

antiviral properties (Image: Pearlie White)<br />

Assoc Prof Jaya Seneviratne, principal<br />

investigator, National <strong>Dental</strong> Research<br />

Institute Singapore (NDRIS).<br />

Assoc Prof Jaya first conducted a<br />

randomised clinical trial in 2020 to study<br />

the efficacy of mouth rinses on reducing<br />

the salivary SARS CoV-2, which showed<br />

that Cetylpyridinium Chloride (CPC)<br />

formulated commercial mouth rinses<br />

effectively suppress the salivary SARS-<br />

CoV-2 levels within five minutes of use and<br />

sustain for up to six hours after use.<br />

The alcohol-free antiseptic formulation<br />

contains a combination of anti-viral and<br />

plaque fighting ingredients, including CPC,<br />

fluoride, xylitol and zinc gluconate. It is<br />

also enhanced with natural ingredients<br />

such as echinacea, chamomile, cinnamon,<br />

honeysuckle, licorice, myrrh, sage, and tea<br />

tree oil. It is dermatologically tested and<br />

safe for daily use.<br />

Following the results of the study, NDCS<br />

partnered with Pearlie White to develop a<br />

unique formulation of a topical antiseptic<br />

mouth rinse with anti-viral properties.<br />

The formulation brings together expertise<br />

in oral health research and deep industry<br />

knowledge and experience. Assoc Prof<br />

Jaya and his team will be furthering their<br />

study with a clinical trial based on the new<br />

formulation. DA<br />

60 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


SHOW REVIEW<br />

Joint 37th<br />

IADR-SEA<br />

annual scientific<br />

meeting and 2nd<br />

International Oral<br />

Health Symposium<br />

hosted in<br />

Singapore<br />

From 22-25 Nov 2023, the National <strong>Dental</strong><br />

Research Institute Singapore (NDRIS) hosted<br />

the Joint 37th International Association for<br />

<strong>Dental</strong> Research, South East <strong>Asia</strong> (IADR-SEA)<br />

Division Annual Scientific Meeting and 2nd<br />

International Oral Health Symposium (IOHS) at<br />

the Singapore General Hospital Campus in what<br />

is said to be South East <strong>Asia</strong>’s largest scientific<br />

dental conference. Under the theme ‘Applying<br />

Oral Research Excellence to Advocate Oral<br />

Health for All’, the conference saw an assembly<br />

of about 450 oral health researchers, scientists,<br />

and oral health professionals from member<br />

countries in ASEAN as well as international<br />

researchers from Australia, Sweden, Japan,<br />

Taiwan and Hong Kong to showcase their<br />

research activities, foster collaborations and<br />

expand their collaborative research network.<br />

The IADR was established since 1920 to<br />

promote research in all aspects of craniofacial,<br />

oral, and dental research and to encourage<br />

development of improved methods for the<br />

prevention and treatment of oral and dental<br />

diseases to improve the oral health of the<br />

public.<br />

Divided into five regions, the IADR-SEA is<br />

its South East <strong>Asia</strong>n Division, with member<br />

countries including Cambodia, Hong Kong,<br />

Indonesia, Malaysia, Myanmar, the Philippines,<br />

Singapore, Taiwan, Thailand, and Vietnam.<br />

The IOHS stems from a collaborative platform<br />

between oral health research institutes in<br />

Australia, Hong Kong, Japan, Singapore and<br />

Sweden.<br />

The joint event was the first face-to-face<br />

meeting since the start of the COVID-19<br />

pandemic. It commenced with a series<br />

of workshops and a preview to a special<br />

issue of the Community Dentistry and Oral<br />

Epidemiology Journal.<br />

Panel discussion at IADR-SEA 2023. From left: Prof Hoang Trong Hung, Vietnam; Prof May Wong,<br />

Hong Kong; Prof Marco Peres, Singapore; Prof Callum Durward, Cambodia; Assoc Prof Waranuch<br />

Pitiphat, Thailand; Prof Edward Lo, Hong Kong<br />

At the official opening ceremony for the main<br />

conference on 23 Nov, guest-of-honour Assoc<br />

Prof Chng Chai Kiat, chief dental officer for the<br />

Ministry of Health highlighted the importance<br />

of collaborations in advancing oral care.<br />

“Oral health surveillance studies are crucial<br />

in providing quality data to enable effective<br />

policymaking and health system planning.<br />

Research helps us to further identify critical<br />

gaps in oral disease levels and trends. This<br />

includes knowledge about their aetiology,<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong><br />

61


SHOW REVIEW<br />

impact, treatment needs,<br />

priorities, and management.<br />

Plugging these gaps<br />

through research helps to<br />

improve our health as a<br />

whole, while serving as a<br />

key driver for innovation in<br />

the delivery of quality oral<br />

care,” said Assoc Prof Chng.<br />

After the opening address,<br />

Prof Marco Peres,<br />

deputy CEO research and<br />

education, National <strong>Dental</strong><br />

Centre Singapore (NDCS),<br />

set the tone for the joint<br />

event in his plenary lecture<br />

on ‘Achieving Universal<br />

Oral Health Coverage for<br />

All’. Prof Peres added the<br />

clause “is necessary but<br />

not sufficient” to the title<br />

of his lecture to frame<br />

and complete his view on<br />

universal health coverage<br />

as spoke of his strong<br />

support on the subject and<br />

highlighted areas in need of<br />

improvement.<br />

A panel discussion<br />

moderated by IADR-SEA<br />

Division president Prof<br />

May Wong followed where representatives<br />

from Thailand, Hong Kong, Vietnam, and<br />

Cambodia expounded on the current state and<br />

challenges of oral health in their respective<br />

countries.<br />

After the opening ceremony, the programme<br />

for the remaining days featured a line-up<br />

of over 60 local and international speakers<br />

in a series of workshops, lectures, and<br />

symposiums.<br />

The ‘Temporomandibular Disorders (TMD)<br />

Research in SEA: Strength in Synergy’<br />

workshop gathered clinicians and scientists<br />

interested in TMD research and the key leads<br />

of International Network for Orofacial Pain<br />

and Related Disorders Methodology (INfORM)<br />

in South East <strong>Asia</strong>. Singapore’s Dr Adrian Yap,<br />

Malaysia’s Dr Kathreena Kadir, the Philippines’<br />

Dr Jonathan Fandialan, Indonesia’s Dr Carolina<br />

Marpaung, and Thailand’s Dr Phanomporn<br />

A workshop session on TMD research in South East <strong>Asia</strong><br />

A ‘Lunch and Learn’ session where participants gathered in smaller groups over food<br />

where speakers provided insights on unique topics<br />

Vanichanon all spoke during the session<br />

which introduced the current concepts of<br />

TMD, its signs/symptoms, classification,<br />

aetiology, and identification.<br />

In other programme highlights, Laureate<br />

Prof Eric Reynolds, Centre for Oral Health<br />

Research, Melbourne <strong>Dental</strong> School, and Prof<br />

Paul Pronyk, director of Duke-NUS Center for<br />

Outbreak Preparedness (COP) gave plenary<br />

lectures on ‘Microbiome Modulation and<br />

Fluoride Activation by a Saliva Biomimetic<br />

Promotes Oral Health’ and ‘Evolutions in<br />

Global Health – what does it mean for oral<br />

health?’ respectively.<br />

Some of the key topics that were covered<br />

included universal oral health coverage, oral<br />

systemic health connection, microbiome<br />

modulation and periodontal disease, teledentistry,<br />

AI, orofacial devices, and digital<br />

dentistry technologies.<br />

The IADR also provided<br />

a platform to facilitate<br />

cooperation among<br />

investigators and the<br />

communication of<br />

research findings and their<br />

implications throughout the<br />

world. Two hundred and<br />

nineteen submissions for<br />

abstracts were accepted<br />

and displayed in various<br />

oral and poster sessions at<br />

the event venue.<br />

Tanyaphon Danpipat from<br />

Chulalongkorn University,<br />

Thailand won the first prize<br />

in the Hatton Award, Junior<br />

Category, for her submission<br />

on ‘Amino-acid Starvation<br />

and DNA-proteincrosslink<br />

Repair Affect Candida<br />

Oxidative Stress<br />

Susceptibility’. Winner of<br />

the Hatton Award, Senior<br />

Category, was Shuting Gao<br />

from The University of Hong<br />

Kong, for his submission<br />

on ‘Injectable Polyxylitol<br />

succinate-based Adhesive<br />

Hydrogel for Periodontal<br />

Regeneration’.<br />

Against a backdrop of the growing burden of<br />

oral diseases worldwide with 3.5 billion people<br />

afflicted, 1,2 the socioeconomic burden from<br />

direct costs such as treatment expenditures<br />

and indirect costs from lowered productivity<br />

due to absenteeism from work or school and<br />

reduced quality of life for those afflicted, can<br />

be substantial.<br />

The convergence of international dental<br />

researchers and oral health professionals at<br />

the Joint IADR-SEA/IOHS scientific meeting<br />

strives to play a role in fostering collaboration<br />

and continuous learning for impactful<br />

research to improve oral health outcomes. DA<br />

REFERENCES<br />

1. GBD 2017 Disease and Injury Incidence and<br />

Prevalence Collaborators. Lancet 2018.<br />

2. GBD 2017 DALYs and HALE Collaborators.<br />

Lancet 2018.<br />

62 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


EVENTS CAL NDAR <strong>2024</strong><br />

JANUARY<br />

13 – 14<br />

Global <strong>Dental</strong> Conclave<br />

Mumbai, India<br />

18 – 20<br />

The Saudi International <strong>Dental</strong> Conference<br />

(SIDC) <strong>2024</strong><br />

Riyadh, Saudi Arabia<br />

25 – 27<br />

International Congress of Oral<br />

Implantologists (ICOI) Winter Implant<br />

Symposium <strong>2024</strong><br />

San Diego, US<br />

26 – 28<br />

Malaysian <strong>Dental</strong> Association (MDA)<br />

SCATE <strong>2024</strong><br />

Kuala Lumpur, Malaysia<br />

FEBRUARY<br />

6 – 8<br />

AEEDC Dubai <strong>2024</strong><br />

Dubai, UAE<br />

28 – 29<br />

10th World <strong>Dental</strong> Conference (WDC) <strong>2024</strong><br />

Bangkok, Thailand<br />

MARCH<br />

3 – 6<br />

<strong>Dental</strong> South China <strong>2024</strong><br />

Guangzhou, China<br />

8 – 10<br />

12th Borneo <strong>Dental</strong> Congress<br />

Sarawak, Malaysia<br />

14 – 16<br />

Expodental <strong>2024</strong><br />

Madrid, Spain<br />

14 – 16<br />

<strong>Dental</strong> Expo<br />

Auckland, New Zealand<br />

20 – 23<br />

ADX <strong>2024</strong><br />

Sydney, Australia<br />

22 – 23<br />

BDIA <strong>Dental</strong> Showcase - London 2023<br />

London, UK<br />

APRIL<br />

19 – 21<br />

IDEM <strong>2024</strong><br />

Singapore<br />

21 – 23<br />

<strong>Dental</strong>Forum USA Spring<br />

Texas, US<br />

MAY<br />

2 – 5<br />

47th <strong>Asia</strong> Pacific <strong>Dental</strong> Congress (APDC) <strong>2024</strong><br />

Taipei, Taiwan<br />

3 – 6<br />

AAO Annual Session <strong>2024</strong> - American<br />

Association of Orthodontists<br />

New Orleans, US<br />

8 – 11<br />

IDEX <strong>2024</strong> - International Istanbul <strong>Dental</strong><br />

Equipment and Materials Exhibition<br />

Istanbul, Turkey<br />

9 – 11<br />

International Team for Implantology (ITI)<br />

World Symposium <strong>2024</strong><br />

Singapore<br />

16 – 18<br />

Expodental Meeting <strong>2024</strong><br />

Rimini, Italy<br />

31 May – 2 June<br />

Famdent<br />

Mumbai, India<br />

JUNE<br />

7 – 9<br />

SIDEX <strong>2024</strong><br />

Seoul, South Korea<br />

9 – 12<br />

Sino <strong>Dental</strong> China<br />

Beijing, China<br />

13 – 15<br />

Implant Solutions World Summit<br />

Miami, US<br />

17 – 18<br />

<strong>Dental</strong>Forum UK<br />

Alicante, Spain<br />

AUGUST<br />

1 – 3<br />

Vietnam <strong>Dental</strong> Expo <strong>2024</strong> – Ho Chi Minh<br />

Ho Chi Minh, Vietnam<br />

21 – 23<br />

Vietnam International <strong>Dental</strong> Exhibition &<br />

Congress (VIDEC) <strong>2024</strong><br />

Hanoi, Vietnam<br />

23 – 25<br />

Hong Kong International <strong>Dental</strong> Expo and<br />

Symposium (HKIDEAS) <strong>2024</strong><br />

Hong Kong, Hong Kong (China)<br />

SEPTEMBER<br />

8 – 10<br />

<strong>Dental</strong>Forum USA Fall<br />

Florida, US<br />

12 – 15<br />

FDI World <strong>Dental</strong> Congress (WDC)<br />

Istanbul, Türkiye<br />

19 – 21<br />

International Congress of Oral Implantologists<br />

(ICOI) World Congress <strong>2024</strong><br />

Orlando, US<br />

OCTOBER<br />

10 – 12<br />

<strong>Dental</strong> World <strong>2024</strong><br />

Budapest, Hungary<br />

13 – 15<br />

<strong>Dental</strong>Forum Europe <strong>2024</strong><br />

Sitges, Spain<br />

24 – 26<br />

31th EAO annual congress<br />

Milan, Italy<br />

DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong> 63


ADVERTISERS’<br />

INDEX<br />

COMPANY<br />

PAGE<br />

Bego<br />

IBC<br />

Coltene<br />

IFC<br />

<strong>Dental</strong> <strong>Asia</strong> House Ad 64<br />

<strong>Dental</strong> South China 9<br />

exocad<br />

OBC<br />

Fotona 1<br />

Mectron 13, 59<br />

Ningbo Woson Medical Instrument Co., Ltd 57<br />

Shofu inc 55<br />

VITA Zahnfabrik 11<br />

For information, visit us at<br />

www.dentalasia.net<br />

or contact us at<br />

sales@pabloasia.com<br />

FOLLOW US @dentalasia<br />

64 DENTAL ASIA JANUARY / FEBRUARY <strong>2024</strong>


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