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MDAJuly-Sept 2017
A p u b l i c a t i o n o f M a l a y s i a n D e n t a l A s s o c i a t i o n
NE
WS
Prof Toh Chooi Gaiton her journey to becomethe founding Dean ofDentistry at IMU
LIFE INACADEMIA
CAD/CAM-Future of Dentistry-Are We Ready?
33
Molar-Incisior Hypomineralisation:What Do We Know?
28
Eastern Zone Community Engagement Project
14
July-September 2017
EditorDr Mas Suryalis Ahmad Dr Goh Seong Ling
Contributing writersDr Ng Woan TyngDr Chow Kai FooDr Siow Ang YenDr James Chhoa Jau MinDr Angie WongDr Lim Kiat LinDr Rohaida Abdul HalimDr. Mohd Faiz Nasruddin
Ex-officioDr Chow Kai Foo
TreasurerDr Koh Mei Yen, Eileen
Advertisement LiaisonDr Wong Chin Mee, AngieDr Ng Su Chin, JanicePuan Razana Abdul Karim
MALAYSIAN DENTAL ASSOCIATIONMalaysian Dental AssociationD-5-1, Pusat Komersial Parklane,Jalan SS7/26, Kelana Jaya,47301 Petaling Jaya, Selangor.
Tel: 603-7887 6760 603-7887 6762Fax: 603-7887 6764E-mail: [email protected] [email protected]: www.mda.org.my
Conceptualised & Produced byPaul & Marigold (DeCalais Sdn Bhd)No. 23A-6 Strata Office,KL Eco City, Lot 215,Pantai Baru, Jalan Bangsar,59200 Kuala Lumpur
Tel: 603-2201 6499Email: [email protected]: www.paulandmarigold.com
Note:Views expressed are not necessarily those of The Malaysian Dental Association. The Malaysian Dental Association takes no responsibility for the consequences of any action taken based on any information published in MDA News and neither shall it be held liable for any product or service advertised in the same. No part of this publication may be reproduced without the permission of the publisher.
Messagefrom the Honorary Publication Secretary Dr Mas Suryalis Ahmad
Greetings from MDA!
It is nice to say hello again to everyone, after my recent re-election as the Honorary Publication Secretary of the Malaysian Dental Association.
I wish members of the MDA Council all the best. May this year be an enjoyable one, in spite of the ongoing challenges we face in supporting the profession in every aspect.
This year, MDA plans to organise more continuous professional development activities for its members, as well as a number of community social responsibility programmes to increase public awareness of current issues, including illegal dentistry.
Please join us as MDA perseveres to promote the arts and science of dentistry for the benefit of the public.
We wish to thank all our members for your continuous support. If you have any suggestions on how MDA can further contribute to the betterment of the profession and community at large, do not hesitate to contact us.
Until next time.
Dr Mas Suryalis Ahmad Honorary Publication Secretary Malaysian Dental Association 2017/2018
MDA News welcomes submission of scientific articles to be featured in our upcoming issues. Please forward your articles to: [email protected]
22 Life In Academia
28 Molar-Incisor Hypomineralisation: What Do We Know?
33 CAD/CAM- Future of Dentistry - Are We Ready?
InsideFeatures
Activities
14 Eastern Zone Community Engagement Project
16 MIDEC 2017
20 Southern Zone Back to Basics Module- Perio In Sight
July-September 2017
5MDA Council 2017/2018President: Dr Ng Woan Tyng Immediate Past President: Dr Chow Kai Foo President Elect: Dr Leong Kei Joe Honorary General Secretary: Dr Siow Ang Yen Assistant Honorary General Secretary: Dr Lim Chiew Wooi Honorary Financial Secretary: Dr Eileen Koh Mei Yen Assistant Honorary Financial Secretary: Dr Angie Wong Chin Mee Honorary Publication Secretary: Dr Mas Suryalis Ahmad Elected Council Member: Prof Dr David Ngeow Wei Chong Elected Council Member: Dr Ng Ben Chuan Elected Council Member: Dr Naseem Banu Sadrudeen Appointed Council Member: Prof Mohamed Ibrahim Hassan Appointed Council member: Mej. Jen. Dato’ (Dr) Mohd Ilham Hj Haron Appointed Council Member: Dr Nurul Syakirin Abdul Shukor Appointed Council Member: Dr Rasidah Ayob Appointed Council Member: Dr Neduchelian Vengu MDAEZ Chairman: Dr James Chhoa Jau Min MDAEZ Secretary: Dr Sim Wei Sann MDANZ Chairman: Dr Tan Sock Hooi MDANZ Secretary: Dr Tan Hooi San MDASZ Chairman: Dr Zeo Lee Wei Zin MDASZ Secretary: Dr Lim Kiat Lin
Internal Auditor: Dr Hu Chang Lek Internal Auditor: Dr John Ting Sii Ong
Speaker: Datuk Dr Lakshmanan Nachiappan Deputy Speaker: Datuk Dr Khairiyah Abd Muttalib
Dear esteemed MDA members,
Greetings from the Malaysian Dental Association. It gives me great pleasure to pen my inaugural message to you, in my capacity as MDA President. First, I would like to congratulate and welcome all members of MDA who were appointed following an election
process in the recently concluded 74th AGM, on June 18 in the MDA headquarters.
I am pleased to announce the line-up of my council and standing committee as below:
Message from the President
Dr Ng Woan TyngPresident Malaysian Dental Association
MALAYSIAN DENTAL ASSOCIATION
MDA News
6
Dear members, the MDA has done very well in the past years and I pledge to continue and expand upon the good work of the past councils to advance the interests of our members and the profession as a whole.
I intend to build upon this success with the following aspirations:
1. To maintain the financial stability of MDA unabated.
2. To focus on shaping the leadership capacity at all levels, including the zones, and to ensure membership in council and associated positions are granted on the strict basis of merit and capabilities.
3. Engage strongly and meaningfully with all stakeholders in the profession, especially the affiliate associations.
4. Guard the best interest and rights of the profession in this challenging era of the eminent passing of the new Dental Bill to replace the Dental Act 1971, and the enforcement of new acts that have bearing upon the dental profession. Direct greater attention and deliberation in addressing the pressing issues of policy and regulatory guidelines in an intelligent and effective manner.
5. To improve the benefit to our members in our dental conferences through smart management of CPD programmes. Almost all of us are aware that the CPD point system is well under way. The Dental Bill 2016 is very likely to be tabled at the Parliament. I must again emphasise the importance of attending CPD courses whenever there is an opportunity as eventually it will play an important role in obtaining the Annual Practicing Certificate.
6. Enhance the public image of the MDA.
Standing Committee
Patient Complaint Bureau Committee
Chairman: Dr Darren Yap Yoke Yong Secretary: Dr Shashitaran Sadacharan Elected members: Prof Phrabhakaran Nambiar Dr Shubon Sinha Roy Dr Mohamad Muzafar Hamirudin
Appointed members: Dr Chow Kai Foo Dr Jasprit Kaur Dr Alex Lo Arn Loong Dr Alex Lo Shen En Dr Nicholas Yeo Eng Shen
MDA Property Board of Trustee
Chairman: Dr Neoh Gim Bok Secretary: Dr Teh Tat Beng Treasurer: Dr Mary Soo Wai Kuan
Elected Members: Dato’ Dr Yim Khai Kee Dato’ Dr Sivanesan Sivalingam Dr Neoh Ein Yau
Appointed Members: Dr Darren Yap Yoke Yong Dr Mohamad Muzafat Hamirudin
Election Committee
Chairman: Dr Malliga Vadiveloo Deputy Chairman: Datuk Dr Teo Choo Kum
Elected Members: Dr Rani Panadam Dr Ahmad Termizi Zamzuri Dr Martin Arulanandam Dr Hetal Ashwin Kumar Dr Jaswant Singh
Disciplinary Enquiry Board
Chairman: Dr Paul Lee Chu Kob Deputy Chairman: Dr Haja Badrudeen Sirajudeen
Members: Dr Jaspall Singh Dr Rani Panadam Dr Sarat Chandra Datta Dr Firdaus Hanapiah Dr Lee Chin Sze, Dennis Dr Phun Tzy Chieh, Steven
July-September 2017
7
My esteemed members, even with half a century plus four years behind me, I am still excited to be grabbing the bull by its horns. As I believe in nurturing of talents. And I value teamwork, as well as the significance of being observant, forward-looking, innovative and versatile.
I will certainly adapt and work with different people from the stakeholders. We were once weakened in our finances but we are now strong.
Today, I say to you, the challenges we once faced are real. They are many and serious. They will not be met easily in a short span of time. Let faith and ethics guide us through issues and situations. We shall put aside all differences and focus in serving the objectives of our beloved association.
In affirming the greatness of our association, we have to understand that greatness is never given. It must be earned, and there is no short cuts or settling for less. The MDA council members are risk takers, the doers and the makers.
Guided by these principles, we can certainly meet these new challenges that demand even greater efforts, cooperation and understanding among all stakeholders. With hope and virtue, we shall seek a new way forward, based on mutual respects and interest.
On this note, I am pleased to report I have recently returned from a few very fruitful visits to Hong Kong, Vietnam, Spain and China in my capacity as the MDA President.
• Hong Kong International Dental Exhibition and Annual Scientific Congress from August 4 to 6
• 10th VIDEC in Hanoi, Vietnam from August 22 to 24
• 105th FDI World Dental Congress in Madrid, Spain from August 26 to September 1
• 19th Annual Meeting of the Chinese Stomatological Association in Shanghai, China from September 21 to 24
MDA News
8
Dear members, oral health is the key element in setting priorities in health policies. This is especially appropriate in the light of discussion with the leaders of the National Dental Association whom I met in Hong Kong, Vietnam, China and Spain.
I also had the opportunity to renew contact with the leadership in other national dental associations, recognising the longstanding friendship, strong economic ties and close cultural links.
I believe it is timely to set up joint study groups and enhance the conference support among Asian countries through exchange of speakers and delegations.
On the home front, I am pleased to announce shortly after the installation of council, the MDA council members paid a courtesy visit to the Principal Director of Oral Health, Datuk Dr Aliyah, in her office in Putrajaya, and also successfully held meetings with the presidents of affiliate associations and the council of the Malaysian Dental Dealer Association.
I also witnessed the opening ceremony of the 10th IMU Oral Health Carnival in the School of Dentistry, International Medical University on September 9. Kindly log on to the MDA website for updated reports.
Last but not least, I would like to take this golden opportunity to wish all our Hindu members Happy Deepavali while the celebration begins in October, and to everyone else, I hope the last quarter of 2017 will be a productive and fulfilling one.
July-September 2017
9Message from the Immediate Past President
Dr Chow Kai FooImmediate Past PresidentMalaysian Dental Association
MALAYSIAN DENTAL ASSOCIATION
The prime directive of the Malaysian Dental Association is to promote the art and science of dentistry for the benefit of the public.
It was Plato who said,
“He who has one end in mind makes all things serve.”
Therefore no matter what the MDA do or plan to do, it must be done in such a manner that the prime stated purpose of the MDA is served.
Dentistry or to be more accurate, stomatology, is an important component of medicine. Dentists are physicians who just happen to specialise in the mouth or stoma.
About 10% of all the healthcare money is spent on dentistry, making dentistry a vital cog in medicine and healthcare. As dentists we must remain always on the cutting edge of the knowledge and skills of dentistry.
This is a lifelong commitment because knowledge and skills in the field and almost any field is increasing exponentially every year. Technology, digitalisation and artificial intelligence is threatening to take over many jobs in the years to come.
About 10%of all the
healthcare moneyis spent on
dentistry
MDA News
10
Today added sugar is embedded in almost all manufactured and cooked food and drinks. As the consumption of fats decrease, the consumption of sugar increased and the world is waking up to the implications.
We dentists who begun the war on sugar now has added incentive and reasons to do so because it is the prime cause of obesity and consequently diabetes and gum diseases and other worst diseases of the heart, liver, kidneys etc.
As individual dentists and also as organisations like the MDA and affiliates, we need to take part in this vital campaign against the excessive consumption of sugar not only for the sake of oral health but also general health.
Before I drag this too long and get thrown off the stage, I would like to offer the new president and council of the MDA one advice. The Malaysian Dental Association is like a car and like any car has to be driven carefully to ensure it reaches its destination.
When we drive a car, we cannot always depend on our feelings alone or we will drive like a racing driver all the time. We need to drive with feeling and wisdom and observe the environment and the weather and have a good sense of timing.
Sometimes we will speed, sometimes slow and steady but at all times with a good sense of timing and humour.
Dr Chow Kai Foo Immediate Past President
If we dentists are not careful, we will become more and more like technicians and technicians and laboratories may begin to call the shots rather than dentists. Dentists must therefore strive diligently to remain as clinicians with heart and soul and feelings and not become technicians at the beck and call of technicians.
Artificial intelligence will be taking over many jobs in the future. However those jobs that require personal individual attention, creativity and compassion will remain safe. The jobs identified as such are artists, engineers, biologists, psychologists, administrators and dentists. Dentistry is one of the few professions that are irreplaceable with AI.
Freedom must come with responsibility in tandem. The more freedom we demand, the more responsible we must rise up to. In regards to the freedom of practice of dentistry this is a principle that every member of the dental profession must be taught and reminded from dental school and throughout their career.
The need to reduce and ultimately eliminate the excessive consumption of added sugars to our food and drinks. Dentists from time immemorial have known and warned against sugars in the pathogenesis of dental caries.
However in the last few years the world is discovering to its horror that added sugars is not just decaying the teeth but may be a major cause if not the major cause of all the modern chronic diseases since the beginning of the industrial revolution that made added sugar abundant and cheap.
The consumption was additionally driven and increased in the sixties when it was identified that it is fats and cholesterol that was causing heart disease and other modern diseases. With less fats, food became less tasty and, more and more sugar and salt were were added to our food and drinks.
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MDA News
12Dear esteemed MDA members,
It gives me a great pleasure to pen down my first message as the Honorary General Secretary of the Malaysian Dental Association.
I would like to extend my sincere gratitude to all esteemed members for putting your faith in me and electing me into the Council. I shall strive my best to serve the association while looking for the best interest of the dental fraternity.
The dental fraternity has grown substantially in the past five years and the total number of registration of new dental surgeons in 2016 alone has surpassed 1,000 new registrations for the first time in the history, as reported by the Malaysian Dental Council (MDC).
The MDA membership is also growing steadily and we now have a total of 6563 members. As we are expecting more and more dental graduates to be registered with the MDC in few years down the road, it is important to encourage our new colleagues to join the MDA in order to stay relevant and updated in the latest advancement of the rapidly evolving dental industry.
Message from the Honorary General Secretary
Dr Siow Ang YenHonorary General SecretaryMalaysian Dental Association
MALAYSIAN DENTAL ASSOCIATION
July-September 2017
13
Being an MDA member is not just about getting preferential member rate to attend the MDA Conventions, there are many other benefits as listed below:
• Opportunities to serve on various committees/sections in MDA to uphold the image of the profession,
• Assistance from MDA Public Complaint Bureau Committee when need arises,
• Preferential rates for Dental Indemnity, and
• Discounted price for purchase of dental books with Elsevier.
The MDA does not only cater for the professional needs of the member, but we are also concerned about the lifestyles of our members. Thank you to the Honorary Financial Secretary Dr Eileen Koh and her team, as we have managed to negotiate a few attractive deals not only to our members but also to the spouse of our members. They are as follows:
• Affinity Credit Card Programme with CIMB Bank,
• 4% to 7% Discount on Purchase of selected new BMW Fleets,
• 6% to 8% Discount on Purchase of selected new Mercedes-Benz Fleets, and
• Participation in MDA Toastmaster Club.
If you have any contacts that you think would be helpful for us to get better deals for MDA members, do not hesitate to contact us at [email protected].
I would also like to remind all members who have changed their contact details to provide us with an update with an email to [email protected].
Lastly, I would like to wish all our Hindu colleagues a Happy Deepavali.
The MDA membership
is alsogrowing steadily
and we nowhave a total of
6,563members.
MDA News
14Eastern Zone Community Engagement Project
Report by:Dr James Chhoa Jau MinMDAEZ Chairman 2017-2018
On July 1 members of the Sabah Malaysian Dental Association Eastern Zone exco with a team from Luyang Oral Health Clinic visited the Sri Prichard Old Folks Home in Kinarut, Sabah.
A talk titled
“How to look after your teeth and mouth” was presented by Dr Eileen Yap, a specialist in Special Needs Dentistry from Queen Elizabeth 1 Hospital. About 30 able-bodied residents attended the talk.
A booth was also set up to showcase different types of dentures, while the team from the Luyang Oral Health Clinic gave a demonstration on denture construction. In addition, another booth was set up for distribution of gifts and free samples of oral health products.
GSK sponsored door gifts and samples of toothpaste, denture adhesive and denture cleanser.
July-September 2017
15
The event also saw personal interactions and exchanges between team members and the residents.
During the event, all residents were invited to visit the mobile dental bus, borrowed from the Kota Kinabalu Oral Health Regional Office, for an oral examination. The Health Ministry also sent a dental team to assist with checks.
A special lift on the bus made it possible for those on wheelchairs to be transported into the mobile dental clinic. More than 20 patients were screened.
The warden of the home then took the team around the wards, where they were able to interact with residents who were bedridden. Gift packs and free samples of oral health products were distributed.
Special thanks to Dr Yap, Dr Sharon Pua and Dr Tan Wui Jin (dentists in attendance on the mobile dental bus), Dr Jane Lau Ning Shing (project coordinator), Luyang Oral Health Clinic, Kota Kinabalu Oral Health Regional Office and the generous sponsors.
MDA News
16MIDEC 2017
Report by:Dr Angie WongOrganising Secretary MIDEC 2017
The Malaysia-International Dental Exhibition and Conference (MIDEC 2017) was held on July 27 to 30. The theme for this year is “Tomorrow Dentistry Today”, aptly so as it reflects the aspirations of the organising committee to constantly update members of the profession
on new technology and skills that can further improve our service to the public.
Organising chairman Dr John Ting and his committee members had worked tirelessly in bringing together this year’s conference.
The conference, held at the Kuala Lumpur Convention Centre, boasted 38 international and local speakers, in addition to six panelists from various specialty backgrounds in dentistry.
The lectures and workshops covered many facets of dentistry from photography, communication, clear aligners, full digitally guided implant surgeries, aesthetics dentistry using direct composites, communications, instrumentations of severely curved canals, periodontal health, infection control and pain management.
Twenty CPD points were awarded for the main conference, four points for half-day workshop and six points for full day workshop.
The conference was supported by the Oral Health Division. MIDEC 2017 was also supported by speakers from the World Dental Federation and the Dental Dean’s Council of Malaysia.
There were two parallel sessions as well as masterclass programmes, seven workshops, Joint Specialist Affiliate Association Symposium, MIDEC Forum 2017, Young Dentist Forum, Academia Short Communication, Allied Health Symposium, oral presentation competition, gala dinner and President’s Installation Night.
July-September 2017
17
Opening ceremonyThe opening ceremony on July 29 was graced by the Principal Director of Oral Health Datuk Dr Noor Aliyah Ismail. Heads of different national dental associations were in attendance.
MIDEC Forum 2017MIDEC Forum 2017, themed “Financing Oral Healthcare: Country Experiences”, was attended by heads and representatives from eight different countries. It is hoped that this forum lays a foundation of friendship and camaraderie among the participants.
The Young Dentist Forum titled “Over-empowered for Dentists? What is the next step? ” had panellist from five different sectors – Health Ministry, Defence Ministry, academia, private practice and dental industry.
The forum started with experience-sharing. It was indeed a fruitful session as each of the representative shared their journey of success and challenges in their respective field.
The conference attracted 1,208 delegates from 26 countries around the world, including New Zealand, Australia, Brunei, USA, Canada, China, France, Hong Kong, India, Indonesia, Ireland, Italy, Japan, Mongolia, Myamnar, Nepal, Philippines, Qatar, Moldova, Saudi Arabia, Singapore, Taiwan, Thailand, United Arab Emirates, United Kingdom, Vietnam and Yemen.
The delegation consisted of dental surgeons in both private and government practices including the Health Ministry, Armed Forces and the academia. Other delegates are dental auxiliaries and dental students. There were 1,258 trade visitors and 855 traders exhibiting their latest products.
MDA News
18
Joint Specialist Affiliate Association SymposiumThe Joint Specialist Affiliate Association Symposium was chaired and moderated by Dr Angie Wong and featured five topics from five specialist associations. Aptly themed “ Update in Dentistry”, the forum consists of representatives from the Malaysian Endodontic Soceity, Malaysian Oral Implant Association, Malaysian Association of Prosthodontics, Malaysian Association of Oral & Maxillofacial Surgeon and Malaysian Association of Pediatric Dentistry. It is hoped that this symposium will encourage more participation from affiliate associations, while fostering professional relationship with MDA.
Allied Health Symposium The Allied Health Symposium was well attended by both government and private sectors. Allied health practice is an important component of dentistry, and MDA has made an initiative to gather these practitioners once a year to provide them with opportunities to update their professional knowledge.
July-September 2017
19Oral presentation competitionThis year’s oral presentation competition, headed by Prof. Khoo Suan Phaik, attracted 15 presenters covering a wide range of topics. It was judged by Associate Professor Dr Chai Wen Lin, Dr Pravinkumar Patil and Dr Jothi Ramahlingam. The winners of the oral presentation competition were Dr. Mas Suryalis Ahmad (overall winner) and Dr Lim Sing Ying (first runner-up).
Academia Short Communication Sessions Eleven speakers from eight local private and public universities in Malaysia were involved with the Academia Short Communication Sessions, which was held in collaboration with the Dean’s Council of Malaysia. These sessions were organised and headed by Prof Dr Mohamad Ibrahim, the current President of the Dental Dean’s Council.
WorkshopSix workshops were held at different locations pre- and post-conference. These workshops were conducted in KLCC, Impiana Hotel, MDA secretariat, Universiti Kebangsaan Malaysia, as well as additional ones at trade booths.
Gala dinnerThemed “Smiles to remember: A night of stars”, the gala dinner was graced by guest of honour Health Director-General Dato’ Dr Noor Hisham Abdullah. Installation of the new MDA president and MDA council was held in conjunction with the dinner. Dato’ Emeritus Professor Kepten Dr Hashim Yaacob was conferred Honorary Membership for his meritorious service to the MDA and the promotion of dental and allied sciences to the profession.
MDA News
20Southern Zone Back to Basics Module – Perio In Sight
Report by:Dr Lim Kiat Lin
Dentistry is a continuously evolving field. It is important to constantly be up-to-date with the most recent information in practice. However, it is also important to refresh basic knowledge from time to time.
With that in mind, Malaysian Dental Association Southern Zone (MDASZ), with the support of Johor Oral Health Division, organised the first of a few series of Back to Basics modules with the theme “Perio in Sight”.
This inaugural event on July 9, consisted of a few lectures and hands-on workshop, which was carried out at the Bake & Frost Café and a.b.c. Dental Center, Johor Bahru.
July-September 2017
21
Wise Heritage sponsored the event, which involved 16 young Dentists from the government sector who managed to try their hands at the EMS Piezon Scaler Unit, as well as the EMS AirFlow Technology.
The lectures and hands-on workshop were both headed by Dr Wong Li Beng, who is an experienced periodontist, currently working as FAMS Director, Preventive Dentistry and Consultant at Ng Teng Fong General Hospital & Jurong Medical Centre, Singapore.
In conclusion, it was a successful event where participants had the chance to refresh their basic knowledge, gain new knowledge, and experience the EMS technologies firsthand, whilst having fun at the same time. The success of this first module beckons more to be conducted in the near future.
Malaysian Dental Association Southern
Zone (MDASZ) organised the first of a few series of Back
to Basics modules with the theme
“Perio in Sight”
MDA News
22Life in Academia
Prof Toh Chooi Gait shares her love of learning and the journey that led her to become the founding Dean of Dentistry and Professor of Restorative Dentistry at the International Medical University in Kuala Lumpur. She also serves as the Pro-Vice Chancellor (Development).
Interviewee: Prof Toh Chooi Gait
Interviewed by: Khaw Chia Hui
July-September 2017
23
When you first graduated as a dentist in the 1970s, were you one of the few women to do so?The field of dentistry has often drawn women over the years. Before the first dental school was established in Malaysia (Universiti Malaya in 1972), most of us were trained in Singapore.
Generally in a class, you will find more women than men, about 60-80%. If you look at women leadership in dentistry, you can see them in academia and the government bodies related to oral health, especially in the recent years as the acceptance for women leaders grow.
Right from the start, in my early years, there were a lot of women dentists but you might not find them in leading positions as men were preferred in those said positions.
In your opinion, why do women prefer dentistry compared to other fields of medicine?If you compare dentistry to medicine, both fields are assumed to be on equal footing. Length of study and training is the same. When they graduate, both are doctors. If you look at the career path of a dental surgeon, it is more appealing to women due to its work life balance whereas medical doctors have longer working hours.
Generally in a class, you will find women,
60-80%more than men
MDA News
24
You started your academic career in Universiti Malaya and you’ve held high positions in the public university. How is the experience in the public university?It is a different experience and I’m pleased to have the opportunity to be in both. In a public university, you feel a certain pride contributing to the profession and country in training the students. A deep sense of responsibility for doing so. When I was in Universiti Malaya, it was the country’s first dental school and along with that came a set of challenges.
After a long time in a certain workplace, people tend to create their own comfort zones, evident not just in academia but across all industries. In UM, people live in the sense that it is always respected as a premier school in the country. But there are downsides to that – the fear of taking risk and change.
Change has no certain outcome. It can make you better, make you a leader or expose to failure. The fear of failure prevents you from taking on challenges and being restricted from doing things with more innovation.
In a government institution, change has to be top down otherwise there will be resistance. Telling people to change means confrontation. Many people don’t like having to confront others. When you have a work culture that wants things to go smoothly, rather than upset the status quo, there is a sense of who’s going to shoulder the responsibility if things go wrong. So these factors may cause resistance to change.
What were the changes that you tried to push for in UM?I remember taking up the challenge of having an administrative role as I felt it was difficult to initiate change if you were just a lecturer. When Prof Datuk Dr Hashim Yaacob became the dean, he had a vision to improve the standing of the dentistry faculty – pushing for us to get GDC (General Dental Council) recognition. He asked for assistance among his staff to help achieve this mission. So I volunteered.
I saw it as an opportunity to initiate change, regardless we got the recognition or not. It was a great challenge for me as the deputy dean and I learnt a lot from that project.
How did you address the resistance from people who wanted to stay in their comfort zones?I felt it was about giving them the confidence to succeed. The early part of the journey was a lonely one. I found myself doing a lot of things on my own, despite the dean’s blessing. Part of getting the recognition required not just a change in mindset but in our curriculum and amenities.
I tried to get help from the various heads of department to plan for facility improvement for me to apply for funding under the 5th Malaysia Plan. However, they were reluctant as they had applied and were unsuccessful to receive any funding under the previous 4th Malaysia Plan. Thus they considered that it would be a futile effort to even try.
I was told to just refer to the earlier plan and if I could get that secured, that was good enough for them. I had a look at that plan and found it to be quite inadequate.
July-September 2017
25
How did you get started on pursuing the recognition, seeing that you didn’t get much help?In my own field of study, I knew which gaps to address. As for the other fields, I looked to CICHE (Committee for International Cooperation in Higher Education) for help where I got experts to visit us and gave feedback. The programme also granted me an opportunity to visit a number of universities in the UK to speak to the staff and have a look at what they are doing and how their curriculum was laid out. The UK universities
at that time had just changed their programme from four to five years. And for UM to get GDC recognition, we needed to follow suit. It wasn’t about duplicating their curriculum but we could bring back and adopt their best practices.
After that, I returned to UM and reported my findings and formed a Curriculum Review Committee to look into making the relevant changes to transform our 4-year curriculum to that of 5 years in line with the UK universities. We were also missing vital equipment, for example, in oral radiology.
In those days, there were only a couple of radiographic equipment operated by a single
MDA News
26While working on the GDC recognition, what happened to the submission for Malaysia Plan?As for the submission to the Malaysia Plan, I wrote it up myself, requesting for RM30 million just for the faculty. Of course, people thought I was crazy (laughs). This was because the faculty had requested for RM50,000 before, and they didn’t get anything. Feeling dejected, they thought I was asking for too much.
You don’t just need a solid plan but also putting in groundwork in talking to people. We had a polyclinic in the faculty and many people came through our doors, and some of them were in positions of power to help. I had opportunity to treat a VIP as my patient and took the opportunity to share with him the dire need to upgrade the equipment of the faculty as no changes and upgrading had been made since its establishment more than 12 years ago. Soon word spread to the Ministry of Education and a delegation led by the Chief Minister visited the Faculty on short notice to evaluate the situation.
The new dean was perturbed by this unscheduled visit and tasked me to handle the situation. I was unfazed and led the delegation on a tour of the facilities to show them the poor state of the dental chairs and equipment in the clinics. The appearance of the dental units appeared in a sorry state especially with the Elastoplast strips that were left stuck on the dental units by the students after using them on patients to identify some anatomical landmarks. The Chief Minister thought that the units were in such a poor state of disrepair that Elastoplast strips were used to hold broken parts together. Later we received the good news after their visit that the Faculty was granted RM100,000 to carry out immediate repair of the dental units.
After the 5th Malaysia Plan was unveiled I was successful in being awarded every cent I had asked for the Faculty. The wonderful thing was one realized that things can be done in the public sector with hard work and concerted effort to get the attention of the right personnel.
The revamp took years too as we upgraded clinic by clinic and so on.
radiographer. There was no oral radiologist. I sought help from Rita Mason, who was one of the leading teachers of dental radiography and imaging in the UK. She visited UM a few times and I worked with her to address the shortcomings of oral radiology equipment to support teaching and service. With her assistance we redesigned and furnished the oral radiology unit to be properly equipped with the latest imaging equipment. Later with the return of a trained oral radiologist and recruitment of more radiographers, the unit became an oral radiology and imaging department.
For example, the first desk autoclave we had in UM, I got it via a donation from the Yayasan Tun Onn Jaafar. The purchase of the table top autoclave and ultrasonic cleaner was to introduce sterilisation of dental instruments in the polyclinic. At the time, it had cost RM10,000.
The foundation chairman who was also Tun’s granddaughter came to the clinic as my patient. She saw me wearing gloves and wondered why. Back then we had boilers to sterilise the equipment and wearing gloves were uncommon. I learnt about infection control when I went to the US on my sabbatical. After I explained what I had learnt there, she asked me to put in a request to her foundation for the sterilisation equipment.
I always felt dental education
need to be in the forefront,
teaching cutting edge techniques
or introducing new technology
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Did your success finally shake people out of their comfort zones?It was refreshing. The mindset of all the staff changed. When things don’t change for a long time, people feel like they are in a rut and discouraged, like nothing they do is going to make a difference.
When the dental school first started, there was plenty of excitement but as the years went on, disappointment wore some people down as their requests or proposals got shot down. They retreated to their comfort zones. That was why they thought I was Don Quixote, charging at the windmill – vain effort for nothing.
When the money started coming in, people began believing that things could be done. Besides the renovation and re-equipping the clinical facilities, staff revamped the curriculum to change it to a 5-year curriculum to match the standards of the United Kingdom. All in all, it took UM many years to prepare and finally received the GDC recognition in 1997.
What were some of the hurdles you have in interacting with students?I always felt dental education need to be in the forefront, teaching cutting edge techniques or introducing new technology. The students should not be trained to be doing something that is no longer practised in the real world. One thing about me is that I hated to be out of date especially in my classes. So I try to read as much as I can.
In my younger days, I don’t think I was as effective as I am now. Because now I know better. When
I joined UM as an assistant lecturer, I had just graduated, with no experience in teaching. In those days, there were no instructions or classes to guide you on how to teach.
My first subject to teach for the year was dental materials. I laboured over the preparation of my first lecture and I saw my boss sitting in. I wasn’t intimidated but I just wanted to do my best. After the class ended, he told me, ‘you’re all right’. And he never sat in my classes again. I supposed he thought I could handle the classes by myself.
Nowadays, I enjoyed my interaction with the students tremendously. Now learning is student-centred, a shift from teacher-centred. I learnt to become a better teacher when I joined IMU.
How is it now that you’re running your own show in a private university?When I was approached by IMU to be their founding dean for their dental school, I was nearing retirement age. I admit I was comfortable, knowing how to get things done effectively at UM. And by coming to a private university, first, it was starting from scratch, and secondly, how was the environment like. Will emphasis be placed on quality?
My main concern was there must be quality, and the Provost responded with “IMU is all about quality”. The common perception of private education is that it is all about profit making and no investment in quality or research.
Research enhances the quality of a university. But research is expensive. It contributes scientific evidence to support professional practice and not just based on shared anecdotes or guess work. I went to IMU to check out the research facilities and found they are well equipped. It was quite a challenge to set up a new dental school. I decided to take up the challenge. It was a fantastic opportunity for me to introduce all the things that I wanted to include in dental education but could not quite successfully introduced in my old place of work due to various challenges.
Money don’t come easy for private universities. Every ringgit spent has to be accountable and you’ll be surprised how far a ringgit can stretch. Quality comes at a cost.
Now learning is student-centred, a shift from teacher-centred.
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Developmental dental anomalies are common in both deciduous and permanent dentitions. It is crucial for clinicians to be able to distinguish the normal dental development from that which has pathological changes.
It requires careful evaluation of the patient including full prenatal, neonatal, and postnatal medical histories, clinical and radiographic examination, and histology where appropriate.
Developmental dental anomalies of teeth are defined as deviations from the normal. These includes the colour, shape, size, tissue quality or number originating from systemic as well as local factors that causes disturbances in the development.
One of the most commonly encountered developmental dental anomalies in clinical practice is developmental defects of enamel (DDE).
DDE often results from disturbances to the highly specialised ameloblasts cells at vulnerable stages of amelogenesis. Any disturbances during development can manifest as permanent defects in the erupted tooth (Suckling,1989).
Classically, attention on DDE was centred around the rare genetic disorder amelogenesis imperfecta (AI) and on dental fluorosis. However, this scenario has changed over the past decades.
The acquired DDE termed Molar-Incisor Hypomineralisation (MIH) (Weerheijm, 2003) has been encountered in clinical practice with reported prevalence of between 2.8% (Cho et al., 2008) and 40.2% (Soviero et al., 2009) worldwide and 18.8% in New Zealand (Mahoney and Morrison, 2011).
Molar-Incisor Hypomineralisa-tion: What Do We Know?
Article written by:Dr Rohaida Abdul Halim DClinDent (Otago), BDS (Malaya)Senior Lecturer (Paediatric Dentistry)Faculty of Dentistry, Universiti Teknologi MARA.
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years of life, or nephritic diseases, toxin and antibiotics consumption, malnutrition, intestinal inflammation, diarrhoeas and hypoparathyroidism occurring during amelogenesis.
Based on the random distribution of hypomineralisation on the affected teeth, the disturbances could be more chronic in nature over a longer period.
Characteristics of MIH affected teethMIH is a qualitative defective enamel classified as hypomineralised type that follows incremental lines of enamel formation, from cuspal to cemento-enamel junction (Farah et al, 2010, Fearne et al, 2004).
The borders between well-demarcated defects of enamel and sound enamel are usually distinct. It can have different clinical presentations of enamel defects ranging from chalky white-opaque lesions with loss of translucency, or yellow, or brown, atypical restorations, and/or post-eruptive breakdown.
The cusp tips and cervical of MIH-affected teeth is almost always sound/do not appear to be hypomineralised with no evidence of defective structure (Farah et al, 2010).
MIH refers to a qualitative enamel developmental defect of systemic origin that affects the first permanent molars and occasionally the incisors. Clinically, this manifest as demarcated discolouration that range from white-opaque to yellow-brown defects that are soft and fragile.
It could be characterised by the presence of demarcated opacities evident in the change of translucency/colour of the enamel, post-eruptive enamel breakdown (not hypoplasia), atypical restorations in terms of being different from typical caries-related restorations by occupying unusual surfaces and areas, extracted molars not due to caries, and failure of a molar or incisor (Weerheijm et al,2003).
Until today, the aetiology of MIH remains unclear and is thought to be acquired via multifactorial, systemic disturbances during amelogenesis (Alaluusua, 2010, Crombie et al., 2009, Whatling and Fearne, 2008, Fagrell, 2011, Weerheijm, 2004, Abdul Halim,2012).
Some of the possible causes to be associated with this condition are high fever, oxygen deficiency at birth, prenatal and perinatal sickness, respiratory infections in the first three
Developmental dental anomalies are common in both deciduous and permanent dentitions.
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30The most severely affected teeth are the first permanent molars, incisors are frequently affected too but not as severe as the molars (Lygidakis et al, 2008) and a few have reported that the cusps of permanent second molars and canines, as well as the second deciduous molars being affected (Weerheijm, 2003, Elfrink et al, 2012).
The distribution of the enamel defects in the mouth is usually asymmetrical; meaning not all first permanent molars are necessarily affected to the same degree. The distribution also varies among patients and within patient.
Clinically, MIH defects can be distinguished from carious lesions by their location on teeth, and their colour, shape and hardness. When post-eruptive breakdown occurs, they appear different to hypoplastic defects (Farah et al, 2010, Fearne, 2004).
It may affect one to all four first permanent molars, and the presentation varies from individual to individual. MIH molars exhibit normal morphology and appearance except for differences in colour in the affected areas.
Areas of disintegrated enamel are close to darkly stained enamel, the lucency and smoothness of the affected areas are similar to normal enamel, except in the white-opaque areas, where the enamel appears dull.
Clinical implications of MIH-problems and managementMIH presents a set of problems sometimes requiring a multi-disciplinary approach to the management. It has been associated with a number of problems for treatment for the patients themselves.
Among them are dental sensitivity and pain, post-eruptive breakdown, poor aesthetics in affected incisors, difficulty in achieving proper local anaesthesia, dental fear and anxiety associated with pain, difficulties in restoring the teeth and dental caries (Weerheijm, 2003).
Its management could be a challenge to clinician because MIH only becomes apparent with the eruption of the permanent first molars and permanent incisors, and may requires significant dental treatment at the ages of six to eight years.
In such a young age group, this may lead to dental anxiety (Jälevik and Klingberg, 2002, Weerheijm, 2004). Majority of dentist considered MIH to be a problem to them.
MIH-affected teeth can be very sensitive, which may result in the child avoiding brushing and eventually caries development. The irregular tooth structure following post-eruptive breakdown may also result in greater plaque retention and a higher risk of dental caries.
Clinical images of MIH-affected teethThe diagnosis of MIH is usually made clinically and, to diagnose MIH, at least one of the first permanent molars has to be affected. If there are more affected molars and incisors, the defects could be considered as to be more severe.
MIH defects can be distinguished from carious lesions by their location on teeth, and their colour, shape and hardness.
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The MIH-affected teeth usually require early management as a result of rapid breakdown of the tooth structure, giving rise to acute symptoms and the need for more complicated treatment.
Treatment needs will usually depend on the extent of the defects, the degree of tooth eruption, the symptoms and the ability of the patient to cope with care, and the oral hygiene and diet habits of the patient, because the affected teeth are at a higher caries risk and post-eruptive breakdown due to its porosity.
Management ranges from using topical fluorides to encourage further mineralisation to the use of adhesive materials to seal the enamel and restore defects, or extraction of the severely affected teeth as part of orthodontic treatment.
Children with MIH-affected teeth have been reported to have higher levels of dental fear and anxiety, apart from the restorative difficulties faced by the dental clinicians.
These behaviour-related problems may be related to pain experienced by these children during multiple treatment appointments, because many experience inadequate anaesthesia or even have treatment without local anaesthesia.
These children have been shown to receive more dental treatment than unaffected children (Jälevik and Klingberg, 2002, Kotsanos et al., 2005).
It is therefore very important to diagnose MIH as early as possible in order to reduce the vulnerability of the MIH-affected teeth to
breakdown or other symptoms by focusing on early prevention and management, including diagnosis of hypomineralised primary second molar (HPSM) or previously known as deciduous molar hypomineralisation (DMH) as the predictor of MIH (Negre-Barber et al, 2016, Ghanim et al, 2013, Ha et al, 2017).
This is because the development of second deciduous molars and permanent first molars starts at similar times (but the maturation phase of the permanent first molars is considerably longer).
If any disturbance or risk factor occurs during this overlapping period, hypomineralisation might occur in both deciduous and permanent dentitions.
Early management should also include explanation of the condition and its associated problems to the child and the parents. Reassurance should be given, because the other teeth are not affected by MIH (Weerheijm, 2004).
Treatment planning for these children should also consider the long-term prognosis of the MIH- affected teeth and will, in some cases, involve a multi-disciplinary approach.
The key to successful management of MIH is good treatment planning, encouragement of the child, and parental cooperation with the management that is needed.
ConclusionTreatment of severe MIH cases may be demanding, and referral to specialists in paediatric dentistry is beneficial. Nevertheless, the low availability of paediatric dentists in this country may deter prompt and effective management of such lesions.
Continuing education of general dentists in this field is therefore crucial and required to ensure identification and appropriate management of this condition. It is hoped that active participation of members of the fraternity may help with proper management of MIH, which is important towards fulfilling children’s rights to achieving the highest attainable standard of oral health and general well being.
Children with MIH-affected teeth have been reported to have higher levels of dental fear and anxiety
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References1. ABDUL HALIM, R. 2012. Identification of factors in the natal
and neonatal period influencing enamel development in the permanent first molars and incisors. Doctor of Clinical Dentistry (Paediatric Dentistry), University of Otago.
2. ALALUUSUA, S. 2010. Aetiology of Molar-Incisor Hypomineralisation: A systematic review. European Archives of Paediatric Dentistry, 11, 53-58.
3. CHO, S. Y., KI, Y. & CHU, V. 2008. Molar incisor hypomineralization in Hong Kong Chinese children. International Journal of Paediatric Dentistry, 18, 348-352
4. CROMBIE, F., MANTON, D. & KILPATRICK, N. M. 2009. Aetiology of molar- incisor hypomineralisation: a critical review. International Journal of Paediatric Dentistry, 19, 73-83.
5. ELFRINK, M. E. C., TEN CATE, J. M., JADDOE, V. W. V., HOFMAN, A., MOLL, H. A. & VEERKAMP, S. J. 2012. Deciduous molar hypomineralization and molar incisor hypomineralization. Journal of Dental Research, 91, 551-555.
6. FAGRELL, T. 2011. Molar Incisor Hypomineralization: Morphological and chemical aspects, onset and possible etiological factors. Swedish Dental Journal Supplement, 216, 1-83.
7. FARAH, R. A., DRUMMOND, B. K., SWAIN, M. V. & WILLIAMS, S. 2010. Linking the clinical presentation of molar-incisor hypomineralisation to its mineral density. International Journal of Paediatric Dentistry, 20, 353-360.
8. FEARNE, J., ANDERSON, P. & DAVIS, G. R. 2004. 3D X-ray microscopic study of the extent of variations in enamel density in first permanent molars with idiopathic enamel hypomineralisation. British Dental Journal, 196, 634-638.
9. GHANIM A, MANTON D, MARIÑO R, MORGAN M, BAILEY D. 2013. Prevalence of demarcated hypomineralisation defects in second primary molars in Iraqi children. International Journal of Paediatric Dentistry, 23, 48–55.
10. HA, N, KIM, Y, KIM, H & NAM, S. 2017. A Prognostic Assessment of First Permanent Molars Showing Molar-Incisor Hypomineralization Based on Restorative Materials and Defect Class. Journal of The Korean Academy of Pediatric Dentistry, 44(3), 263-270.
11. JÄLEVIK, B. & KLINGBERG, G. 2002. Dental treatment, dental fear and behaviour management problems in children with severe enamel hypomineralization of their permanent first molars. International Journal of Paediatric Dentistry, 12, 24-32.
12. KOTSANOS, N., KAKLAMANOS, E. G. & ARAPOSTATHIS, K. 2005. Treatment management of first permanent molars in children with Molar-Incisor Hypomineralisation. European Journal of Paediatric Dentistry, 6 179-184.
13. LYGIDAKIS, N. A., DIMOU, G. & MARINOU, D. 2008. Molar-incisor- hypomineralisation (MIH). A retrospective clinical study in Greek children. II. Possible medical aetiological factors. European Archives of Paediatric Dentistry, 9, 207-217.
14. MAHONEY, E. K. & MORRISON, D. G. 2011. Further examination of the prevalence of MIH in the Wellington region. New Zealand Dental Journal, 107, 79-84.
15. NEGRE-BARBER, A, MONTIEL-COMPANY, J. M., BORONAT-CATALÁ, M., CATALÁ-PIZARRO, V. & ALMERICH-SILLA, J. M. 2016. Hypomineralized Second Primary Molars as Predictor of Molar Incisor Hypomineralization. Scientific Reports 6, Article number: 31929
16. SOVIERO, V., HAUBEK, D., TRINDADE, C., DA MATTA, T. & POULSEN, S. 2009. Prevalence and distribution of demarcated opacities and their sequelae in permanent 1st molars and incisors in 7 to 13-year-old Brazilian children. Acta Odontologica Scandinavica, 67, 170-175.
17. SUCKLING, G. W. 1989. Developmental defects of enamel-historical and present day perspectives of their pathogenesis. Advances in Dental Research, 3, 87-94.
18. WEERHEIJM, K. L. 2003. Molar Incisor Hypomineralisation. European Journal of Paediatric Dentistry, 3, 115-120.
19. WEERHEIJM, K. L. 2004. Molar Incisor Hypomineralization (MIH): Clinical Presentation, Aetiology and Management. Dental Update, 31, 9-12.
20. WHATLING, R. & FEARNE, J. M. 2008. Molar incisor hypomineralization: a study of aetiological factors in a group of UK children. International Journal of Paediatric Dentistry, 18, 155-162.
July-September 2017
33CAD/CAM- Future of Dentistry - Are We Ready?
Report by:Dr. Mohd Faiz Nasruddin, PhDFaculty of Dentistry,Universiti Teknologi MARA
Almost 40 years ago, Dr Patrick J Hanratty developed the first commercialised Computer Aided Design/Computer Assisted Manufacturing (CAD/CAM) system. Such developments in dentistry, soon followed by Dr Duret and Dr Mormann, made
a revolution as it allowed dental prosthesis to be completed in a single visit.
Continued progress made a more user-friendly system with incorporation of advanced robotics for dental personnel to utilise. While most dental practitioners realise its usefulness and agree that the way forward in dentistry is digital, some are still skeptical on this technology. Numerous studies showed its effectiveness in terms of its accuracy and reliability.
What is CAD/CAM?To understand better, we need to know how the system works. CAD/CAM is divided into three processes:
CAD is the process of designing, modifying and optimisation of an engineered drawing, all performed by computers. It also conveys information of material choice and dimensional settings.
CAM is the process of fabricating the design through automation in manufacturing processes. It incorporates planned computerized strategies for the machinery to create a work piece.
The most important process is the link between the two components, which is usually done through an electronic data exchange.
The CAD involves scanning of the teeth/model with a digital scanner and registering data points. The data points are then processed in CAD software, before being sent to the CAM machinery through computer files, usually in STL format.
The CAM then takes the material predetermined earlier in CAD and creates. This serves as a step up from the conventional method where an impression is required to fabricate a model followed by hand works of a dental technician.
CAD is the process of designing, modifying and optimisation of an engineered drawing
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Advantages of CAD/CAMThe main advantage of CAD/CAM is quick dental prosthesis fabrication and indirectly faster dental treatment. However, developments in CAD/CAM systems make the outcome very accurate and reliable.
The conventional method of fabricating relies too heavily on dental technician expertise and time, when all this can be controlled via advancements of computers. In most countries, the dental treatment is being marketed as a one-visit dental treatment with acceptable aesthetics.
In addition, the preparation of teeth prior to receiving dental prosthesis has changed, as only minimal tooth structure is to be prepared. Another advantage is the possibility of using the digital scanner as a profilometer.
This has gathered considerable interests in the research world nowadays as a 3D model of anything it scans can be portrayed, thus minimizing the need for storage rooms.
Advantages of dental CAD/CAM are:• Minimally invasive
• Highly adaptive
• Speed
• Digital data/models
CAM is the process of fabricating the design through automation in manufacturing processes.
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Disadvantages of CAD/CAMThe machine is costly. While the machine may possibly decrease in price as the system continues to develop, it remains a big stumbling block for potential buyers. In terms of economics, the treatment may be cheaper or at least the same price as the conventional method due to bulk fabrication of materials and less repeats of incorrect impression-taking during treatment.
Proper training is the main reason why dental personnel tend to shy away from utilising the technology. The learning curve is steep as it is a new method altogether. However, in any modern technology, this is expected to ease once knowledge gets through.
The stigma of not wanting to learn a new method or update oneself in professional developments is the main reason as people tend to be used to the conventional methods.
Lastly, the disadvantage of CAD/CAM is that the ability to produce prosthesis will be limited to what can the machine do. Having said this, the machinery keeps on developing, while its performance is regularly being updated. Dental CAD/CAM disadvantages are:
• High initial investment
• Difficult training process
• Difficult for complex treatment
Indications/ContraindicationsThe indications for CAD/CAM vary and are in abundance. Almost all types of treatment can be performed via CAD/CAM technology including implant placement and orthodontics.
The most important thing to know is the indications of CAD/CAM system and the materials that come with the technology. CAD/CAM systems come in 3, 4, 5 and 6-axis of CAM machinery. Most dental systems are 3-axis, which are usually good enough to perform fabrication for a normal fixed dental prosthesis.
The number of axis is not crucial but it does give an advantage if a more complex design is required (i.e. a deep fissured crown, an overly bulbous cusp). As for materials, the choice depends on what is required. CAD/CAM can construct the softest of materials such as composite resin or wax, to the hardest of materials such as zirconia or dental alloys. The indications lie on the treatment opted and the properties of material required (i.e. aesthetic, strength).
ConclusionFirst world countries are using the dental CAD/CAM technology in abundance. However, the use of such treatment approach in our country is unknown. We still need some reassurance before embracing this technology.
CAD/CAM usage is the future of dentistry, with its use being widely accepted across the world. To keep up with the latest advancements in dental technology, we need to be bold in accepting changes.
References1. Beuer F, Schweiger J, Edelhoff D. Digital dentistry: an overview of recent
developments for CAD/CAM generated restorations. British Dental Journal. 2008;204(9):505-11.
2. van Noort R. The future of dental devices is digital. Dental materials. 2012;28(1):3-12.
3. Abduo J, Lyons K, Swain M. Fit of zirconia fixed partial denture: a systematic review. J Oral Rehabil. 2010;37(11):866-76
