Healthcare 09 00118
Healthcare 09 00118
Healthcare 09 00118
net/publication/348752700
The Modern and Digital Transformation of Oral Health Care: A Mini Review
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1 Department of Conservative Dentistry and Prosthodontics, Faculty of Dentistry, Universiti Sains Islam
Malaysia, Kuala Lumpur 56100, Malaysia
2 Faculty of Syariah and Law, Universiti Sains Islam Malaysia, Nilai 71800, Malaysia;
ahmadsyukran@usim.edu.my
3 Faculty of Science and Technology, Universiti Sains Islam Malaysia, Nilai 71800, Malaysia;
ifwat.ghazali@usim.edu.my
* Correspondence: syafiq.alauddin@usim.edu.my
Abstract: Dentistry is a part of the field of medicine which is advocated in this digital revolution. The
increasing trend in dentistry digitalization has led to the advancement in computer-derived data pro-
cessing and manufacturing. This progress has been exponentially supported by the Internet of medical
things (IoMT), big data and analytical algorithm, internet and communication technologies (ICT)
including digital social media, augmented and virtual reality (AR and VR), and artificial intelligence
(AI). The interplay between these sophisticated digital aspects has dramatically changed the healthcare
and biomedical sectors, especially for dentistry. This myriad of applications of technologies will not
only be able to streamline oral health care, facilitate workflow, increase oral health at a fraction of the
current conventional cost, relieve dentist and dental auxiliary staff from routine and laborious tasks,
but also ignite participatory in personalized oral health care. This narrative article review highlights
recent dentistry digitalization encompassing technological advancement, limitations, challenges, and
conceptual theoretical modern approaches in oral health prevention and care, particularly in ensuring
Citation: Alauddin, M.S.; Baharuddin,
the quality, efficiency, and strategic dental care in the modern era of dentistry.
A.S.; Mohd Ghazali, M.I. The Modern
and Digital Transformation of Oral
Health Care: A Mini Review.
Keywords: big data; digital dentistry; artificial intelligence; internet of things; augmented reality;
Healthcare 2021, 9, 118. dental implants
https://doi.org/healthcare9020118
Figure 1. Virtual design in prosthodontics depicting tooth designing done digitally to amend slight rotation and tilting of
the front teeth. The left picture shows a misaligned front dentition and the right picture shows the dentition after digital
modifications. The final standard triangle language (STL) file is able to be three-dimensionally printed using specific resin
via a 3D printer and can be used as a communication tool with the dental technician.
Figure 2. Virtual implant planning utilizing specialized software in which the dental surgeon preplans the surgical implant
site using a specialized software to allow precise implant placement prior to the surgery. The figure shows a planned
implant placement using R2 Gate™ (R2 Gate, Megagen, South Korea).
system to complement the existing technique for delivering oral health care. The treatment
objectives have also shifted towards a preventative program rather than the conventional
“drill and fill” sequence [23,24]. Remote clinical consultation is a platform that enables
sharing of a patient’s data between primary and secondary care as a way to allow a fully
integrated comprehensive total patient management system by using a superfast internet
connection utilizing visual and audio aid streaming [25]. This will enable simultaneous
discussion and decision to occur among patient, dentist, and specialist, thus, enabling
a comprehensive oral health care to take place. This system will prevent unnecessary
travelling and allow the review or consultation to be conducted at home, at communal
facilities, or primary care settings. It will effectively prevent and minimize the risk of
infection, especially to the immunocompromised community like the elderly, people with
chronic disease such as asthma, heart disease, renal failure, and children [26–30].
4. Additive Manufacturing
Additive manufacturing is a rapid production process of any three-dimensional (3D)
object using 3D printers. The process allows a complex geometrical design to be produced
with additional benefits such as a reduction of unnecessary raw material wastage, mass
production of the desired items, and fast production and manufacturing of dental prosthe-
ses as compared to subtractive manufacturing [31]. In dentistry, additive manufacturing
has been adopted in multiple dental fields such as prosthodontics, implant dentistry, oral
surgery, and others [32,33]. The production of a chairside dental model through a 3D
printing method allows a quick reference to the dentist after the virtual designing is com-
pleted, thus, facilitating the treatment plan and communication between the dentist and
patient [34]. A surgical guide for implant placement which is produced by the additive
manufacturing method will allow the precise placement of a dental implant. This technique
will help to eliminate a possible complication in which the vital nerve and blood vessels
are traumatized. It will instead permit a “prosthesis-driven implant placement”. Moreover,
a surgical guide is a specifically designed tool which utilizes multiple specialized softwares
to adopt the virtual simulation process prior to the surgical appointment [35,36]. Due
to the limitation of subtractive manufacturing such as the milling process, 3D printing
is considered as the solution from a scientific and technical point of view. The overall
schematic flow of the utilization of an additive manufacturing is simplified in Figure 2 with
the example emphasized in implant surgical guide construction and fabrication protocol.
Owing to the rapid development and thriving evolution of the implant rehabilitation
utilizing additive manufacturing, the author briefly discusses the contemporary update on
the field particularly on the surgical static and dynamic system.
prosthesis fulfills the acceptable aesthetic profile. This specialized software will then link
adherently to the interpretation of the anatomical structures which are derived from the
CBCT, virtual planning of surgical and prosthesis, and accurate surgical and prosthe-
ses intervention. This provides numerous advantages to dental practitioners including
previsualizing and premeasurement of important anatomical landmark and structures,
accurate implant placement to satisfy both functional and aesthetic profile, profiling the
final implant prosthesis at the earliest planning stage, predictable surgical stage with less
clinical stress to the practitioners, reducing significant amount of chairside time, and the
ability to learn a case difficulty and challenges ahead of time [39–41]. That information is
briefly described in Table 2 together with the commercial global brand of manufacturers
accompanying the surgical guide material in Table 3. This development promotes the
implementation of technology in a computer-aided surgery (CAS) implant placement
conceptual system. This conceptual protocol has thus far been used extensively in the field
of medicine, particularly orthopedic surgery and neurosurgery [42]. The concepts can be
further divided into computer-guided (static) and computer-navigated (dynamic) systems.
Manufacturer Software
3 Shape Implant Studio
Nobel Biocare NobelClinician
Straumann CoDiagnostix™
Sirona SICAT
Materialise SimPlant®
Bredent SKYplanX
360Imaging 360dps
BlueSky bio BlueskyPlan
Anatomage Anatomage guide
AstraTech dental Facilitate
BioHorizons VIP 3
CyberMed OnDemand3D™
Swissmeda AG Swissmeda Planning Solution
SICAT GmbH & Co. KG SICAT Implant 2.0
MIS MGUIDE
Megagen Implant R2 Gate
OSSTEM OneGuide
Exocad Implant Module
Amann Girrbach Ceramill M-Plant (abutment module only)
Planmeca Planmeca Romexis® 3D
Healthcare 2021, 9, 118 6 of 15
Table 2. List of advantages and disadvantages of implementing surgical static guided surgery.
Advantages Disadvantages
Avoid risks of injuring important anatomical structures Steep initial learning curve
Involve multidisciplinary approaches High initial cost
Possible avoidance of complex bone regeneration/grafting
Increased preoperative surgical planning
technique
Adequate mouth opening; challenges for microstomia patient or
Reduced surgical chairside time
posterior implant placement.
Allow minimal surgical intervention (flapless surgery) Limited visual on implant crestal depth location
Improve dentist-patient communication due to required
Risk of fracture on the surgical templates
preoperative planning
Table 3. List of three-dimensional (3D) surgical guide materials (resin) from manufacturers.
Manufacturer Material
NextDent NexDent-SG
Stratasys MED610
EnvisionTec E-Guide Tint
Surgical Guide Resin
Formlabs
Dental SG Resin
Zortrax Raydent Surgical Guide Resin
BEGO VarseoWax Surgical Guide
SHERA SHERAprint-sg
DentalMed 3Delta Guide S
Carbon Whip Mix Surgical Guide
Detax FREEPRINT® splint 2.0
3D Systems Visijet M3 Stoneplast
Zenith ZMD-1000B CLEAR-SG
SprintRay SprintRay Surgical Guide 2
Shining 3D® Resin Shining 3D Surgical Guide
Prodways Tech PLASTCure Clear 200
DMG LuxaPrint Ortho
UNIZ zSG (Surgical Guide) Resin
3Dresyns Dental 3Dresyns OD
Makex Surgical Guide
VOCO V-Print SG
Figure 3. Schematic workflow of static guided surgery. Please note the 3D printing in the manufac-
turing stage.
Figure 4. The example of a surgical implant guide (left) virtually designed via a specialized computer software to allow
a precise and accurate implant placement with the desirable inter implant distance as depicted on the right picture. The
surgical guide is produced by utilizing an additive manufacturing method manufactured by a 3D printer.
Healthcare 2021, 9, 118 8 of 15
Manufacturer System
ClaroNav Technology Inc. Navident
X-Nav Technologies X Guide™
Image Navigation Image Guided Implant (IGI) Dentistry System
Neocis YOMI®
Navigate Surgical Inliant®
9. Conclusions
The delivery of modern oral healthcare should be derived based on modern technol-
ogy driven by a patient-centered outcome. Digitalization in dentistry will facilitate oral
healthcare to an optimum level. The pandemic of COVID-19 showed that tele-dentistry
with remote consultation and artificial intelligence has a major role to play. It will in-
definitely reduce the unnecessary contact between the patients and healthcare providers,
shorten the duration of treatment, and be more cost effective in the long run. The field of
dentistry is most likely to benefit especially in the utilization of AR/VR and AI systems
for the delivery of pedagogy and clinical skills teaching. The research on digitalization in
healthcare especially in dentistry should be the main focus in the next few decades with the
aim of improving data acquisition and big datasets, safety and security of the “Big Data”,
updating the neural networks, machined and deep learning of artificial intelligence, and
other relevant fields.
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