VOLUME 15 - NUMBER 2 - 2023
Digital orthodontics: 25 years after the advent of Align Technology’s transparent aligners, a revolution that continues.
University of L’Aquila
Digital dentistry is a constantly growing field, combining digital technologies with traditional dental practice. This innovative approach has revolutionized the way dental treatments are carried out, improving efficiency, accuracy and overall preci-sion. Digitalization has had a significant impact in several areas of dentistry, in-cluding diagnostics, treatment planning, design and manufacturing, as well as in patient management from all points of view, which is why the term “virtual patient” is already in use. Digital dentistry, in addition to acting in purely clinical areas, as mentioned above, also acts on the communicative sphere between patient and dentist. This happens, for example, when we use those software that, through the acquisition of patient data and images, are able to simulate a dental treatment before surgery, but as we will see later, also through devices designed for diagnostic use only. In Orthodontics the digital revolution was started by the advent of transparent aligners produced by Align Technology more than 25 years ago. Much has changed in this time, the technique has become increasingly predictable and performing and aligners have gained an important part of the market today. They are no longer used only for aesthetic corrections but also in the in-terceptive orthodontic treatment of the growing patient. The innovation was not only dedicated to the materials used for the production of aligners, but above all to the Clincheck software, a powerful diagnostic tool and to the implementation with the Itero intraoral scanner. The scannner is an integral part of the digital flow, it is able not only to help the special-ist in communicating with the patient with the various simulation software but also to be more performing in monitoring the therapy with the integrated digital monitoring tools. We can say that the constant digital evolution, not only in Or-thodontics, but also in the other branches of Dentistry, will involve not only the specialist but will guide and develop him “digitally” also broadening the views to interdisciplinary treatment and in the treatment of the growing patient. Sometimes the digital revolution may seem slow, but it is certainly tireless and more and more than we can imagine. Artificial intel-ligence will become an important integral part of development software and will increasingly support dentistry. All that remains is to live this evolution and digital revolution, in Orthodontics and dentistry in general, aware that it will change often and will not stop, but will allow us to integrate basic knowledge and clinical practice into a digital system that will al-low patients to be treated in a more predictable way and with more effective communication. My advice? Have fun being an integral part of this digital revolution and keep your mind open to continuous innovations, software and techniques, never being frightened, but absolutely fascinated, because your human intelligentsia will guide you.
VOLUME 14 - NUMBER 1- 2023
Dentistry and the elderly patients: A challenge for the future!
Adda district director
Head of Corporate Dental Services
ASST Melegnano e della Martesana (Mi)
Innovative “prescriptions”, to improve the treatment of the citizen in need of odontostomatological care, are published daily on dental journals. These “prescriptions” are mostly indications from The Experts who have the aim of favouring citizens’ access to dental care in the dental facilities of the Servizio Sanitario Nazionale (SSN), which is constantly grappling with the long-standing and never solved problems of waiting lists and staff shortages. Beyond the goodness of the initiative, the arranged action plans always need the commitment of financial resources, nowadays not widely available. The question then arises as to how a project is feasible without the appropriate financial backing or, better yet, how economic resources can be found. However, the reason why the suggestions are never related to structures, technologies and personnel optimization, is not known. One example among many is the appointment agendas of outpatient visits and services, which punctuate the work activity of every health professional, both public and private. Are we sure that the visits' and services' scheduling is calibrated based on actual staff availability and patient demand? A study conducted a few years ago by the WHO Collaborating Centre for Epidemiology and Community Dentistry showed that the average daily time spent using a dental unit in the Public Service is about 3 hours. The time spent on the dental unit turns out to be about half that of a health professionals’ work shift (7.36 hours) established for medical management by the CCNL’s health area (this is not valid for departmental chiefs). The same concept is true for the assistance staff, of the health care professionals, (7.12 hours) working in the dental team. In addition, once the opening time of the dental service is defined, the agendas must be set based on the time space established for each service, which is characterized by a known execution time. This execution time considers not only the average medical time but also some corrections (ancillary times). However, many times this approach is still not used, indeed, in various situations what is seen is an “agenda personalization”. All of this shows that only with the application of simple scheduling rules, accompanied by the system's monitoring and control, we can ensure the delivery of the required services and expand the number of beneficiaries without the need of further monetary expenses for the structure.
VOLUME 13 - NUMBER 1-4 - 2022
Dentistry and the elderly patients: A challenge for the future!
The average age and life expectancy of the population is constantly increasing, and a great challenge for the healthcare systems around the globe will be to ensure a healthy aging for the future generations.
The dentist must also be prepared and trained to know how to enhance and maintain a “healthy” smile in the different age groups and promote all the actions necessary to im- prove the health of the oral cavity and dental solutions effective from a biological point of view but also financially sustainable.
So far, oral health has been largely neglected on the global health agenda. Yet, most dental disorders are mostly preventable and treatable.
A good prevention campaign will have to play an increasingly indispensable role, thus allowing huge economic sav- ings and improving the quality of life of the population.
A new approach to “senior” dentistry is being born and will need to be developed, with solutions designed specifically for the resolution of functional problems, but increasingly also aesthetic.
It should not be forgotten that among professionals, doctors and dentists, we notice the same effects of the aging of the general population, with an increasingly high average age. Professional updating, new technologies and different models in the interpretation of medicine are outlining the study of the future: an interconnection of numerous profes- sionals who will exchange information on the state of health and well-being of their patients.
The change is also taking place on management models that, in the near future, will have to integrate with modern technologies and new forms of communication and relationship with patients.
Ensuring effective treatment in a safe and controlled environment is equivalent to ensuring “longevity” also to our studies.
VOLUME 12 - NUMBER 1-4 - 2021
Digital dentistry: myth or reality?
In an age in which digital overspreads in every area of the social, personal, and working life, the dental field is certainly not an exception. What, not so long ago, seemed to be “the future”, now constitutes the “present” of our daily work. The digital revolution has undergone a rapid development up to our days, in which we can make use of a real digital workflow, which changes totally what was the used to be plan, from the first steps of data collection to the diagnosis and design of a plan, to the diagnos- tic and communicative simulation, up to the realization of the treatment. In other words, digital dentistry is today a mature and complete workflow that leverages multiple tools and systems to create 3D models of the patient’s dental anatomy and it can produce accurate digital dental restorations leading to a huge paradigm shift in all aspects of dentistry. In contemporary dentistry, digital technologies such as conical beam computed tomography (CBCT), mandibular movement scanning, intraoral 3D scanning, facial scanning, 3D printing, and personalized treatment planning have taken on an important role in both research and clinical practice toward the goal of precise medicine. These technologies are having a major impact on processes and procedures, as well as workflows and time spent in clinical procedures, resulting in more personalized, predictable, and effective treatment by reducing iatrogenic complications. Fingerprints with intraoral scanners (IOS), digitally made prostheses, augmented reality and virtual patients have become a reality today. All this information interconnects with each other, making it much easier to include all the dental specialties involved in multidisciplinary treatments and even to make use of advanced artificial intelligence (AI) and Machine Learning (ML) tools in the planning process of the treatment. The current digital revolution is different from the previous ones, because we find the emergence of artificial intel- ligence as an element that seeks to complement or replace the human factor. Many healthcare professionals have already integrated digital technologies into practical workflows, which reduce reliance on manual skills and visual recognition. Although the principles on which clinical decisions are based remain the same, the incorporation of digital technology is bringing about radical changes in the relationship and communication with the patient and with other members of the working group, in procedures and in clinical materials. Today we can say that every branch of dentistry has been strongly influenced by digital technology and has had a significant impact on dentistry like never before, and this has led to a radical change in the way we work by facilitating care and improving the results of clinical treatment. Also in dental research, we can see the continuous growth of many new articles and the birth of new journals focused on digital dentistry and this is favoring the constant discovery of new therapeutic possibilities. Despite all this, even today among dentists there is a certain confusion and perplexity when it comes to introducing new tools and digital processes in their clinics. As industry professionals we should always make sure that our knowl- edge and skills are up to date to improve our ability to care for our patients. The digitalization of dentistry is having a huge impact on workflows and time spent on clinical procedures. Make no mistake: The digital revolution has now reached dentistry, it is not the future, it is now the present. Enter the world of Digital Dentistry now!
VOLUME 11 - NUMBER 1-4 - 2020
In the recent years I have witnessed the constant growth of some young colleagues who, thanks to a widespread, open, and constant sharing of experience, have actively entered our editorial project and today constitute a key figure and are surely part of the esprit de corps that led us to the publication of the second issue of Annali di Stomatologia. Joining our working group means sharing its values but, not only! “The more people who share knowledge, the more the community benefits from it” and it is in this spirit, that we want to give back to our readers this final product of a high-level research that aims to represent a point of reference in the affirmation of knowledge in our sector. Including many young people in our team of researchers has been a challenge, but it is returning a great satisfaction, indeed. A great number of people, motivated to increase their knowledge without fear of discussion, sometimes even in opposition to the traditional techniques and rules, has given new life to new debates. And it is from there that we have started, walking together the path of a shared plan and a mutual exchange of ideas and knowledge, aiming to the excellence without ever taking anything for granted. Young editors who question them- selves about their knowledge, lead us to a great challenge with ourselves, sometimes breaking down barriers that open us and new possible horizons of research. As part of our goals, we enhance the quality of information, we favor the cultural growth of the Dental community and we open to the principles of modernity and technical evolution, improving a change in action while also maintaining constant attention on possible translations with respect to the current practices. Scenarios in a swift and constant evolution are for us a further stimulus to continue with passion and perseverance and while we are about to start a new chapter of our work, I would like to address a thank you to all the professionals who have worked with incessant commitment and have renewed daily their will to guarantee us a spot on the inter- national level. Happy reading!
VOLUME 10 - NUMBER 1-4 - 2019
Why Negotiation is the most critical business skill for dentists.
Dentistry in Italy have been through many changes during the last 20 year. Dental tourism and dental clinics and social media have totally inverted the patients’ focus on dental care. Moreover, toaday dentistry is not only a matter of clinical approach, but also management, intended as financial, human resources and patient’s of course, which is the dentists’ main asset. However, this is the fact: dentists are not trained on management during the dental school. Nowadays, to achieve coherence between results and busy agenda, dentists need to put clinical training right aside management one, empowering 2 of the master soft skills, able to generate a meaningful difference both for the dentist practice as well as the patient experience. We are referring to Communication and Negotiating. Between them, negotiation represents a crucial skill to be trained and acted throughout the dental office, since it is meant to bring a brand new approach to dental treatment presentation and patient experience. Negotiation allows dentists to differentiate from their competing collegues in the field. Some dentists are successful thanks to their personal talent in treating and giving care to their patient, simply because they have naturally developed such communicating and negotiating skills. For those who do not have such talent, there is a way: the so called negotiation protocol. These are the main features of the negotiation protocol: 1. It is indipendent from any personal talent, since it implies a scientific approach to negotiation, due the specific steps to be held; 2. It allows the dentist have a more specific patient profile; 3. It allows the dentist communicating the treatment to the patient with a deepest clearness and fullfilling comprehension. 4. It allows the dentist access to a detailed financial planning of the cures towards the patient’s commitment; 5. The protocoll make it possible to hire new personnel or change it if necessary, guaranteeing continuity with the process itself, thank to the scientific approach. It is remarkable how negotiation itself is a process, asking to involve the whole human resources working on and for the patient in the office: dentist, lab operators, assistants and of course the dental office secretary. Negotiating protocol enphasizes the role of the dentist and his team, acting to give the patient the best medical result and human experience ever, and yet allowing the dentist as manager to get hold on those precious data, able to develop the dental office performances.
VOLUME 9 - NUMBER 4 - 2018
It is with a great deal of satisfaction and pride that I present, as Editor in Chief, the first new edition of Annals of Stomatology. A scientific magazine, founded in 1959, which after a period of pause, is ready to return pursuing its original mission with passion and renewed enthusiasm; seeking growth, im- provement, and innovation. Our magazine offers itself, in the international scene, as a tool for Research, analysis, and scientific dissemination, thanks to the knowledge and contribute of many scholars and re- searchers in the Sector. With a solid base of teamwork, sharing the same goals and purposes, exchanging dynamic and transversal knowledge, we will work with commitment, determination and constancy to deliver a great magazine to support Research and Innovation. Thanks to our professional background, we will be able to offer the consulting of updated and rigorous works as well as the dwelling on the in-depth treatment of individual clinical cases, received and characterized by elements of greater interest. Through a screening of carefully analyzed data we will evaluate a selection of papers, these will also include a study review from dental schools. On top of that we will present protocols and treatment procedures, also done through the most modern technologies; we aspire to possible new development and innovation projects. Being an editor puts forward numerous possibilities, but above all, it offers a privileged approach to Research. I am grateful for this role and certificate of esteem, that I wish to be able to honor and share with the entire team. My fellow colleagues returned a great deal of enthusiasm, starting from the beginning of the project and along the route of our path. We hope for an ever more widespread participation, openness to discussion and constructive exchange; if we will man- age to turn our work into a tool of support and cultural and scientific enrichment, then we will have achieved our goal! Enjoy this reading!