Abstract: Continuously improving oral health is a key factor to addressing general health of our patients. Globally, more patients are maintaining their teeth into older age, which is great, but this creates increased risk, especially around the impact of inflammoaging, the fact that our inflammatory response changes as we age (individually and as a population). We need to understand how this trend will impact on our patient’s health. The “Triple Aim”, articulated by Dr. Donald Berwick, has three trends we must address to improve oral health: improving patient outcomes, reducing costs and improve population health of our society. The delivery of oral health in undergoing a fascinating, complex and rather mesmerizing set of these three transformations. Are you ready?
The first trend is around the patient experience involving an enhanced understanding by the dentist of the patient’s implicitly requested job to be done around a holistic understanding of patient’s expectations, needs and desires framing predictable therapies that are time efficient, stable with esthetic and patient-oriented outcomes. Why? They will be on social media, within minutes, weeks and years later…
A second trend is the often discussed shift to “digital” dentistry. This transformation represents more than a scanner, a mill or printer. It’s not data, information but knowledge. The advent of machine learning will do more than drive the patient to your office, it will monitor daily health, healing, progress in treatments such as orthodontics, report and create dashboards of progress on a care plan. The key is care will be far more efficient in a patient population in first world; needing less of our traditional services but desire a mix of highly esthetic, rejuvenate care in an environment of predictability. Less care per patient but more precise care when needed. Less care per person, freeing more time for more care, more efficient, for others. The key to this transformation is the application of AI technology allowing the delivery of substantial rehabilitation to far more, around the world in our global communities. This is not a threat, it’s a wonderful opportunity! Predictable care, for a global community, at a cost the world can afford with a professional dental community that is at the center of the care team.
The ultimate trend? The third key application of technology and the changing role(s) of oral health and the Profession of Dentistry is to become an integral member of the primary care team. Working with our fellow medical, nursing, pharmacy and other allied health professions, we will as a team improve population health. It is through these three trends: improving patient experiences, reducing cost with strong outcomes that we will, improve global health. Without this North Pole, the Profession of Dentistry may get lost. Technology is a facilitator, it is not an answer, in isolation. Technology, is a tool to a set of solutions we use to help our increasing diverse patients wanting a clear and defined role in their care. Engagement by the team will therefore create the best in outcomes creating the best trend for the future of Dentistry. Dentistry is a wonderful profession that will never become, irrelevant. Why?
A beautiful smile will always open a door, invite a conversation, and create a window, to the soul.
Objectives:
- Understand the triple aim framed around the changes in dental practice
- Understand the role of risk evaluation and management in the contemporary dental practice
- Understand the pathway of skills each of us needs to develop to prepare as occupants in this rapidly changing health care landscape.
Objectives:
- Understand the triple aim framed around the changes in dental practice
- Understand the role of risk evaluation and management in the contemporary dental practice
- Understand the pathway of skills each of us needs to develop to prepare as occupants in this rapidly changing health care landscape.
Forward thinking schools of dentistry must provide students with educational experiences that best prepare them to adapt to and function in evolving health care models. Considering the future role of dentists in the changing landscape of integrated healthcare delivery, we envision that a sizable portion of dental care will be delivered in an integrated healthcare environment with team-based, multi-professional expertise. Based on current trends, oral healthcare delivery approaches will likely emphasize health and wellness, and person-centered care. To prepare our graduates to function in this dynamic environment, we should seek to provide an educational system in which students learn to be thinkers and problem solvers, with effective communication skills, and with the ability to leverage technology to deliver oral healthcare in a range of collaborative care settings.
Learning Objectives:
- Recognize the need to increase student experiences that prepare future oral healthcare providers to function in an integrated healthcare environment
- Identify how dental schools can maximize digital technology to transform educational programs and optimize effectiveness and efficiency of curricular delivery
- Recognize that a vibrant future of our dental profession depends on the constant drive to generate new knowledge
We are at a pivotal moment in American healthcare history. Presently, the U.S. healthcare system as it exists essentially rations healthcare by income class or socioeconomic status, while covering only 70% of the population. Health inequities (e.g. mental, vision, hearing and oral healthcare, etc.) abound! The U.S. pays more for healthcare than any other industrial nation in the world as percent gross domestic product (GDP) at 18.9% for U.S.A. and Switzerland 2nd at 12.3%. Spending for U.S. healthcare in 2019 was $3.5 trillion, and spending is projected to become $5.6 trillion by 2027. How can we increase access for the entire 330 million people of the population, reduce costs to 10%GDP, and improve health outcomes as measured by infant morbidity and mortality, chronic diseases and disorders, oral chronic infection and tooth loss, and life expectancy? In tandem, an unprecedented convergence of biomedical and behavioral scientific knowledge, technology and data science is revolutionizing patient and population healthcare. Public-Private State and National partnerships are spearheading the next generation of personalized healthcare with diverse partners from various industries, government agencies, and disciplines. These efforts are bringing together a unique understanding of human biology and behavior with new ways to assess health data. The emerging vision is to ensure that the screening, risk assessment, diagnosis, treatment, health outcomes, and even prevention of diseases will more quickly and effectively transform the lives of people everywhere – ensuring the right treatment for the right patient at the right time. Imagine innovations that integrate oral healthcare into primary care. “Precision healthcare” may provide the innovations that become the future including oral healthcare.
Learning Objectives:
- Explain the significance of demography to predict the future
- Describe the current trajectory of U.S. healthcare in terms of access, cost, and health outcomes
- What is the value proposition for integrating oral health into primary healthcare in U.S.A.
Artificial intelligence (AI) is a broad term, which in medicine and dentistry mainly refers to the autonomous learning of machines in order to develop skills and competencies, for example in the diagnosis, planning and/or evaluation of therapeutic results. In this case, the “machine” is a software structured like a neural network in order to program and improve itself by picking up stimuli or data – in our case e.g. X-ray images – without any help of software engineers. Due to the presence of more and more patient data in digitized form (Big Data), more and more digital workflows and relatively inexpensive storage and computing capacity, more and more AI-based applications are published in dentistry and will be used very soon in everyday clinical practice. The effects of this megatrend will greatly enrich many areas of dental therapies. Especially younger dentists can achieve a higher level of competence through the use of AI in diagnostics and therapy planning, and experienced clinicians can more objectively evaluate their treatment outcome. Thus, querying the AI for patient-specific questions – as if asking a long-term practicing colleague for a particular patient case for an experience-based advice – will be nearly replacing querying simple documented knowledge that is mostly not direct applicable to the individual patient situation (Google, Youtube, PubMed. etc.).
Learning goals:
At the completion of this lecture, participants will be able to:
- Gain insights in the basic functioning of machine learning, in particular in a self-programming and self-improving software.
- Become familiar with some dental applications of AI (X-ray diagnostics, oro-facial aesthetics, tooth preservation vs. tooth extraction, guided implant placement, tooth color determination, etc.).
- Understand about the future potential, the limits and the risks of AI in dentistry.
However, in order to reduce the invasiveness and improve patient care the next level for hard- and soft tissue regeneration needs to be achieved. On the level of hard tissue regeneration this includes using stabilized bone graft materials, which provide more volume stability. On the level of the soft tissue there is a need to replace the invasive techniques of autogenous grafts and replace them by volume stable soft tissue substitutes.
Objectives:
- To learn the new trend of 3D printing in surgical implant dentistry
- To understand the utilization of the various applications of in-office of 3D printing
- To review the potential new trend of 3D bio-printing for GBR procedures
The regeneration of the soft and bone tissue within the oral cavity in preparation of implant therapy is a complex process. In the last three decades blood concentrates have been used, in order to promote the tissue regeneration within oral cavity.
Up to now, however, there is no systematic approach, how to apply blood concentrates for different applications in dental surgery. In this lecture, the development of PRF.
(Platelet-Rich-Fibrin) as an autologous blood concentrate and the LSCC (low speed centrifugation concepts will be introduced. The results of multiple preclinical studies as well as clinical studies for the use of PRF in different indications in oral medicine will be shown, in order to highlight the potential of PRF for improving conditions during dental surgery. The systematic indication-based use of PRF will allow to enhance the wound healing associated with surgical procedures in oral and maxillofacial surgery.
Japan is an aging society with far greater population shift than other countries. Therefore, current public health issues in Japan are likely to have application in other countries in the future. It has been found that frailty of oral function will contribute to overall frailty. Immediate loading is a treatment modality which has many benefits, particularly in the elderly. This modality shortens treatment time and limits the number of procedures. Photofunctionalization has been used as an adjunctive therapy to improve osseointegration and increase the predictability of implant therapy, in particular during immediate loading. This presentation will provide a protocol to improve the predictability of immediate loading with particular application for geriatric patients.
This lecture will explore the current trends of treatment planning and implant restorative design through the analysis of different full arch scenarios, covering the different prosthetic and surgical potential “pitfalls” and how to avoid them with proper planning. It will analyze and compare current trends in digital dentistry and guided surgery, and provide guidelines that can be easily implemented in practice in order to help interdisciplinary communication between the restorative dentist, the surgeon and the laboratory.
LEARNING OBJECTIVES:
- To understand treatment planning and digital dentistry trends to avoid surgical/prosthetic pitfalls.
- To utilize a trendy classification for edentulous arches that will allow the participant to better comprehend treatment indications and patient risk assessment for the edentulous maxilla.
- To utilize the current trend of guided surgery properly and to optimize communication between the restorative dentist and the laboratory in the digital era.
- Understand strategic tooth recontouring through better lab communication for the placement of ultra-thin veneers
- Learn to tackle challenging alignment, asymmetrical arch forms and other complex cases with veneers
- Practice color modification techniques
- Understand how the business of esthetics brings in qualified patients
Educational Objectives
- Management of soft tissue graft and flap vectors
- Installation of corticocancellous bone grafts — management and stabilization
- 20/20 vision for complications
Why soft tissues are the key point when dealing with esthetics in implant dentistry? What is their biological role? Why pink esthetics, intended as the proper relationship between the implant fixture and the supported crown, is so important for the final outcome of the therapy? The concept of soft-tissue integration is the new challenge in implant dentistry. The current knowledge about the role played by peri-implant mucosal thickness in maintaining marginal bone levels will be discussed. The creation of a proper soft-tissue barrier as key point for long term stability will be either described. During this lecture different surgical and prosthetic approaches will be showed. The use of connective tissue graft as well as the use of alternatives to CTG will be assessed.
Once hard tissue has been successfully augmented, an adequate soft tissue thickness becomes mandatory in order to create healthy and stable peri-implant tissues and to improve function as well as the final esthetic outcome. Different sites, different protocols, one goal: predicability.
- Defining clinical and molecular terms related to acute and chronic inflammation
- Discussing the role of lipid mediators that active biochemical signals important for the resolution of inflammation
- Introducing novel concepts from the immune system that are essential for tissue healing
- Presenting the role of endogenous and exogenous specialized lipid mediators in tissue regeneration
Immediate tooth replacement therapy has become a mainstream treatment modality for single and multiple tooth implants in the esthetic zone. However, esthetic risks and complications exist such as socket perforation, loss of labial plate thickness over time, and loss of the interdental papilla due to proximity issues with tooth-to-implant distance following placement.
Consequently, an inventive macro design concept based upon biologic principles that combines hybrid strategies in implant diameter, shape, and thread pattern has been designed and developed to address these problems. This inverted body-shift design concept will be supported by pre-clinical [animal histology] and clinical [human] studies that scientifically supports, validates, and reinforces the biologic principles in design that ultimately enhances esthetic outcomes in modern day implantology.
Learning Objectives:
- Understand the implant complications and risks in the esthetic zone
- Understand the inverted body-shift concept in macro implant design
- Understand the biology behind circumferential bone volume for long term maintenance to prevent ridge collapse, recession, and papillae loss
- Long term success with no peri-implant inflammation is the goal of implant therapy. How to achieve it will be demonstrated
- Increasing soft tissue thickness around the implant collar without surgery
- Concave abutments can improve long term esthetic and soft tissue stability
- Creating papillae with immediate correct implant placement in the esthetic zone
Educational objectives:
- Risk assessment for prosthetically compromised dentition
- Restorative solutions for prosthetically compromised dentition
- Outcome analysis of prosthetic reconstruction of teeth versus implant-supported restorations
