Future of 50 BDS (final-year) students in jeopardy

Vol. 22 No. 06 August 2016
Published Monthly
Reg. No. SS-1210
Inside
ISSN 1728-1512 Rs 100
Lifestyle
CPSP faces internal
crisis: Prof Tipu Sultan
19
Compliance of UNEP
Treaty on Mercury ...
06
24
Dental News wishes its readers
a very happy Independence Day
DE-RECOGNITION OF BADC CREATES UNCERTAINTY
Future of 50 BDS (final-year)
students in jeopardy
By Our Special Correspondent
KARACHI - As many as 50 BDS (finalyear) students - 37 girls and 13 boys of Bibi Aseefa Dental College (BADC),
Larkana, have been running from pillar
to post to get their examinations
scheduled which had already been
delayed by more than two months owing
to an uncertain situation reportedly created
by PMDC's recent circular whereby
affiliation of the college has been
suspended.
According to the affected students, the college
administration was not in a position to announce
the date of their final-year exams unless and
until they get a green signal from the PMDC
vis-à-vis recognition of their college.
However, principal of the college has assured
us that he was trying his best to arrange the
Editorial Board
Editor in Chief
Ayaz Mahmood
Business Executives
Ghulam Hussain
Publisher & Managing Editor
Syed Hashim A Hasan
(Lahore: 0300-4601388)
Haroon Rashid
PMDC team's visit to the college as soon as
possible so that he could conduct their exams
in October, they added.
Voicing their concern over inordinate delay in
their exams, the perturbed students said that
not only they but even their parents are also
highly disturbed over the news of de-recognition
of their college by the PMDC.
They were of the opinion that the college
administration should immediately meet
the PMDC's requirement of appointing
associate professors of different subjects
in the college for final-year BDS students.
"At present we have lecturers of certain
subjects but not associate professors,"
they deplored.
Ilyas Sheikh, when contacted by Dental
News said that a team of PMDC which
undertook its third visit to the college on
Dec 15, 2014, through a letter (dated Aug
28, 2015) informed that the college had been
recognized. But the recognition of the college
Continued on Page 46
LOANS FOR HOSPITALS:
Editorial on Page 16
IAMRA urges PMDC to improve
quality of education or face the music
(Islamabad: 0300-9710774)
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M Hassan Mahmood
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DN Monitoring Desk
ISLAMABAD - Thousands of Pakistani doctors
face a threat of a comprehensive ban on practice
and study in the United States and Europe in the
wake of IAMRA's (International Association of
Medical Regulatory Authorities) repeated warnings
to the PMDC that it should help improve the quality
of medical education and close down all illegal
medical colleges in the country.
According to media reports, the IAMRA had, a few
months, back asked the PMDC to improve the
quality of medical education and shut all illegal
medical colleges.
The IAMRA had reportedly warned that in case of
non-compliance, it would ask the governments of
the United States and all the European countries
to impose a ban on the Pakistani doctors' work or
study in their respective countries.
Confirming that that the IAMRA had issued the
warning, PMDC president Prof Shabbir Lehri said
that the Council fought the case before the IAMRA
and got one-year relaxation for improving the quality
of medical education in the country.
Continued on Page 46
National News
NCP workshop highlights
importance of protein sciences
DN Report
KARACHI - A one-day
workshop on
"Human Saliva Banking and Protein
Analysis for Diseases Detection" held
here under the aegis of Karachi
University's National Centre for
Proteomics (NCP) highlighted the
importance of saliva as a possible
diagnostic body fluid with respect to
protein studies.
Delivering her welcome speech, NCP's
director Prof. Dr Shamshad Zarina
highlighted the importance of protein
sciences, saying it was now moving with
high pace throughout the world, making a
difference in medical sciences.
"The National Centre for Proteomics is the only
dedicated centre in the country which is equipped
with state-of-the-art instruments for conducting
protein research. NCP provides services to all
the academia in the country and playing its role
effectively in human resource development," she
said while highlighting the centre's contribution
in the form of international publications, number
of students passing out from the centre and its
other academic activities since its inception.
Others who spoke on the occasion included a
young dental researcher and author of many
dental books, Dr. Zohaib Khurshid; Assistant
professor at Karachi University's National Centre
for Proteomics, Dr. Syed Faraz Moin and Dr
Rabia Sannam Khan, who is currently working
on salivary proteomics, cancer and MSD.
Sharing their views in the concluding session,
participants described the proceedings of the
workshop quite informative.
In her concluding remarks, Dr Zarina said that
the centre was providing all possible opportunity
to young researchers and students from biological
and medical disciplines in excelling in proteomics
field and the workshop was part of such ongoing
activities.
The workshop was attended, among others, by
representatives of several colleges, including
Baqai University, Ziauddin University, Dow
University of Health Sciences (DUHS), Hamdard
University, LCMD, Karachi University as well as
faculty members of Dow, the Aga Khan University
and Baqai University, students of BDS, biomedical
engineering, protein sciences and postgraduate
students.
Facilitators of the workshop included experts
from faculty of Dentistry, King Faisal University,
Saudi Arabia and Baqai Dental College.
The session concluded with a vote of thanks and
distribution of certificates among participants.
World Hepatitis Day
observed countrywide
DN Report
KARACHI - The World Hepatitis Day
was marked in Pakistan as elsewhere
in the world with a pledge to spread
awareness for prevention, control and
treatment of this deadly disease.
On World Hepatitis Day, 28 July 2016,
the World Health Organization (WHO)
sets out this year's theme, "Know
hepatitis - Act now", with an objective
to sensitize policy-makers, health
workers and the public know about
the infection, know their status by
getting tested, and finally seek
treatment to reduce needless deaths
from this preventable and treatable
infection.
Activities such as walks, seminars and
free medical camps were held around
the country to improve public
knowledge relating the risk of hepatitis,
and enhance access to tests of
hepatitis and treatment services so as
to help eradicate the dreadful disease
hepatitis which is fully preventable and
treatable disease.
Viral hepatitis - known as hepatitis A,
B, C, D, and E - affects millions of
people worldwide, causing acute and
chronic liver disease.
Around the world 400 million people
Continued on Page 46
Liver cancer assuming alarming proportion
DN Report
KARACHI - Vice
President of Pakistan
Society for the Study of Liver Diseases
(PSSLD), Dr. Ziagham Abbas said
here that liver cancer is the fifth most
common cancer globally accounting
for 600,000 new cancer cases annually
and major burden of this disease lies
in the developing countries.
This, he said, while addressing an
awareness seminar organized by Pakistan
Society for the Study of Liver Diseases in
connection of the World Hepatitis Day
observed on July 28 every year across
the globe.
Dr Zaigham said about 10,000 new liver cancer
cases reports every year in Pakistan and
incidents of such cases are growing rapidly
in developing countries. He said liver cancer
cases are more common among males across
the world. He said in Pakistan, it can affect
six (06) per 100,000 males and four (04) per
100,000 females.
He said liver cancer tends to occur in livers
damaged most commonly by chronic infections
such as hepatitis B and C. "Contaminated and
improperly stored grains and spices may be
a contributing factor in causing liver cancer,"
he added.
He said many liver cancers could be prevented
by reducing exposures to known risk factors.
He said vaccine to prevent hepatitis B is
available but there is no vaccine for hepatitis
C.
He said these viruses can spread through
sharing contaminated needles and syringes,
reusing unsterilized equipment for surgical
and dental procedures, improperly screened
blood transfusion, and through childbirth.
He suggested people at high risk for hepatitis
B or C should be tested for these infections
so they can be treated, if required.
PSSLD's founding president Prof Dr Wasim
Jafri said there are 400 million people in the
world who live with chronic hepatitis B. He
said hepatitis B transmitted throughout blood,
unnecessary use of needles and from an
infected mother to her newborn baby during
delivery.
He said hepatitis B which reportedly affects
3pc of the population in Pakistan is dangerous
because it is a "silent infection". He said most
people infected with hepatitis B are unaware
of their infection and can unknowingly pass
the virus to others through their blood and
infected bodily fluids.
Quoting a recent survey, speakers said
hepatitis B and C are major public health
problems for
Pakistan with an estimated 20 million people
affected. Both infections can eventually result
in severe liver disease, and in many cases
liver cancer, if they are allowed to continue
04 DENTAL NEWS / August 2016
unchecked. "In the later stages, these
infections are life threatening and become
largely untreatable," they said and added:
"Unfortunately, most patients with end stage
liver disease and liver cancer are in the prime
of their lives and often the main bread earners
for the family."
They further said there have been major
advances in the treatment of hepatitis B and
C virus infections in recent times. In most
patients hepatitis B can be effectively controlled
and hepatitis C can be completely cured with
the currently available treatments.
They said prevention course is the key to
reduce the overall disease burden. Main steps
include the wide use of hepatitis B vaccine,
provision of safe blood and use of sterile
needles, surgical instruments, razors, and
raising public awareness across the country.
Prof Saeed Hamid, Prof Masood Siddiq, Prof
S.M. Munir, Prof Masroor Ahmed, Prof Jameel
Ahmed and others also spoke on this occasion.
Now, most dentist's chairs go up
and down, don't they? The one I
was in went back and forwards. I
thought 'This is unusual'. And the
dentist said to me 'Mr Vine, get out
of the filing cabinet. Tim Vine
Life Style
Sugar: Should we keep it or eliminate
it from our diet?
S
ugar seems to have developed a
reputation as the big bad wolf in
relation to health. Numerous
studies associating sugar intake with
increased aging, cardiovascular disease,
obesity and even cancer had been
reported in past years. Such research
has led to many health experts around
the globe calling for reductions in
recommended sugar intake, with some
saying we should cut out sugar
completely. But is it really that bad for
our health?
to halve their recommended daily free sugar
intake from 10% to 5%.
"The objective of this guideline is to provide
recommendations on the consumption of free
sugars to reduce the risk of non-communicable
diseases in adults and children," WHO
explained, "with a particular focus on the
prevention and control of weight gain and
dental caries."
Biochemist Leah Fitzsimmons, of the University
of Birmingham in the UK, told;
"Cutting all sugar from your diet would be
very difficult to achieve. Fruits, vegetables,
dairy products and dairy replacements,
Let's investigate; put simply, sugar is a eggs, alcohol and nuts all contain sugar,
crystalline carbohydrate that makes foods which would leave you with little other
taste sweet. There are many different types than meat and fats to eat - definitely not
very healthy."
of sugar, including glucose, fructose,
lactose, maltose and sucrose - also known
The study, published in the journal Nature,
as table sugar.
suggests artificial sweeteners - including
Some of these sugars, such as glucose, fructose
and lactose, occur naturally in fruits, vegetables
and other foods. But many of the foods we
consume contain "added" sugars - sugar that
we add to a product ourselves to enhance the
flavor or sugar that has been added to a
product by a manufacturer.
The most common sources of added
sugars include soft drinks, cakes, pies,
chocolate, fruit drinks and desserts. Just
a single can of cola can contain up to
7 tsps of added sugar, while an averagesized chocolate bar can contain up to
6 tsps. It is added sugars that have been
cited as a contributor to many health
problems.
saccharin, sucralose and aspartame - interfere
with gut bacteria, increasing the activity of
pathways associated with obesity and diabetes.
What is more, they found long-term
consumption of artificial sweeteners was
associated with increased weight, abdominal
obesity, higher fasting blood glucose levels
and increased glycosylated hemoglobin levels.
"Together with other major shifts that occurred
in human nutrition, this increase in artificial
sweetener consumption coincides with the
dramatic increase in the obesity and diabetes
epidemics," the authors note. "Our findings
suggest that artificial sweeteners may have
directly contributed to enhancing the exact
epidemic that they themselves were intended
to fight."
Is eliminating sugar from our diet Sugar can be part of a healthy,
balanced diet
healthy?
A 2013 study published in The American
Journal of Clinical Nutrition suggested that
consumption of sugar-sweetened beverages
increases weight gain in both children and
adults, while a review paper from the World
Health Organization (WHO) notes an increase
in the consumption of such beverages
correlates with the increase in obesity.
Instead of steering
away from sugar
completely, many
health experts
believe it can be
consumed as part
of a healthy diet,
with some noting
that sugar also has
benefits.
Sugars can often help to make certain
nutritious foods more palatable, which can
promote variety in a healthy, balanced diet."
The American Heart Association (AHA) - who
recommend women should consume no
more than 100 calories a day (6 tsps) and
men should consume no more than 150
calories a day (9 tsps) from added sugars disagrees, stating that our bodies do not
need sugar to function properly.
"Added sugars contribute additional calories
and zero nutrients to food," they add. But
even the AHA do not recommend cutting
out sugar completely.
Tips to reduce sugar intake
Health experts recommend reducing sugar
intake to within recommended guidelines.
The AHA provide some tips to help do just
that:
. Cut back on the amount of sugar you may
regularly add to foods and drinks, such as
tea, coffee, cereal and pancakes
. Replace sugar-sweetened beverages with
sugar-free or low-calorie drinks
. Compare food labels and select the
products with the lowest amounts of added
sugars
. When baking cakes, reduce the amount of
sugar in the recipe by a third
. Try replacing sugar in recipes with extracts
or spices, such as cinnamon, ginger, almond
or vanilla
. Replace sugar on cereal or oatmeal
with fruit.
"The key thing to remember
is that sugars occur
naturally in a wide range
of foods - including fruit,
vegetables and dairy
products - and can be
consumed within a healthy,
The array of studies reporting the negative
balanced diet and active lifestyle.
implications of added sugar led to WHO making
sources
of
calories,
sugars
can
be
As always, balance and variety in a
a proposal to revise their added sugar
consumed
within
a
healthy,
balanced
diet is the most important thing for
recommendations in 2014. The organization
issued a draft guideline stating they would like diet and active lifestyle"
people to remember."
06 DENTAL NEWS / August 2016
FDI BRIEFS
Women leading change at the FDI annual
congress
IN a timely nod to political and socio-economic reality,
the morning session of the 2016 Women Dentists
Worldwide (WDW) Forum, on Sept 8, will be held under
the theme 'Women's leadership in global health'.
****
Victory for health in Uruguay tobacco ruling
HEALTH has just scored a major victory in its fight against
'big tobacco' following the dismissal by the World Bank's
International Centre for Settlement of Investment Disputes
(ICSID) of a case brought by Philip Morris against the
government of Uruguay.
****
Session on Oral Health
FAITHFUL to its tradition of addressing the most pressing
oral health issues of the day, FDI will be holding a special
session on oral health and an ageing population on 10
September - the final day of the Annual World Dental
Congress 2016 - in Poznan, Poland.
****
Oral Health Literacy
THE Academy of Dentistry International, an FDI affiliate
member, was recently invited to hold a workshop in the
context of the 66th United Nations DPI/NGO Conference
'Education for Global Citizenship, Achieving the Sustainable
Development Goals Together' (Gyeongju, Republic of
Korea, 30 May-1 June).
08 DENTAL NEWS / August 2016
Oral Health Observatory
THE aim of the Oral Health
Observatory is to understand
current needs in dental care
related to patients and dental
professionals at different levels:
local (country-wise), regional
and global. It focuses on three
main areas of interest:
behaviour, clinical and dental
practice. Within this context,
FDI acts as global convener in
oral health and invites all its
members to participate.
The information collected will allow
analysis of current needs in dental
care, according to demand,
guidance, policy and funding. This
will help shape the medium-term
planning of professional resources
and oral health systems.
Behavioural and clinical data in
addition to information from the dental
practices are collected directly from
a network of local dentists. National
Dental Associations are responsible
for the recruitment of participating
dentists. This network of general
dental practitioners is responsible for
interviewing and "observing" adults
and children in their country. Data is
collected in a systematic manner using
the same core indicators guaranteeing
its comparability across different
levels.
A pilot project was carried out by three
National Dental Associations in three
countries: Germany, Mexico and The
Netherlands from April to July 2015.
During the pilot, the project "know
how" was evaluate and fine-tuned for
its future implementation.
Implant dentistry requires Lecture and Hands-On
workshop at ICDE
expertise: DrJaffer
DN Report
KARACHI - The Academy of
Aesthetic, as a part of
continuous dental initiative,
organized a workshop on
implant at its office here
recently.
Delivering his lecture on the
subject, Dr. M. Amin Jaffer, who
did his doctorate in dental
surgery (DDS) from the
sharing his clinical experience
in depth with the participants of
the workshop.
He alsogave detailed
presentation on Atraumatic
Extraction with immediate
placement.
"Today, most of the treatment
procedures in dentistry are as
much about art and experience
KARACHI- Dental Specialists
Institute of Continuing Dental
Education as a part of CME
organized a lecture and hands-on
workshop on post, core and
impression techniques by using fiber
post, bulkfill core and Pentamix
Impregum (3M).
Students and faculty members
belonging to different dental colleges
attended the workshop.
Dr Zahid Iqbal, HOD & Associate
Professor at Isra Dental College,
who was programme facilitator,
delivered a lecture on post, core
and impression techniques. He also
explained diagnosis-treatment
planning for post and core cases,
post system and core materials. He
emphasized on different impression
materials and Pentamix impression
unit (3M) with its application.
Dr Zahid also showed different
cases which were treated and
restored with fiber post, core and
crowns.
All the participants were provided
an opportunity for the fiber post
placement, resin cements (Rely x
U 200 3M) cementation, bulkfill core
restoration and impression by using
Pentamix.
Later, certificates were given to the
participants of the programme.
PDA (K) forms women wing
University of Michigan, said that
the practice of implant dentistry
requires expertise in planning,
surgery and tooth restoration.
Dr Amin, who is doing his
private practice in Ann Arbor,
Michigan and is associated with
Mish Implant Institute since
2012, also presented interesting
clinical implant cases, besides
as it is about science," he
remarked.
The workshop was followed by
a lively question-answer
session in which participants
posed a variety of questions to
the speaker who answered all
such queries in detail.
Participantsof the workshop
Continued on Page 46
10 DENTAL NEWS / August 2016
KARACHI - Pakistan Dental Association's (PDA)
Karachi chapter with a view to promoting the
art and science of dentistry has formed its women
wing.
According to a press release of the association,
the first four members of the women wing are:
Dr Maimoona Mushtaq Khan, Dr Sidra Khan,
Dr Tahira Haider and Dr Shahper Shahryar.
The aim behind the move is to encourage, guide
and help members of the profession in the establishment of their career.
Meanwhile, PDA-Karachi has planned an endodontic symposium in
mid-August, the release added.
Int'l seminar on Dental Research & Periodontology ends
DN Report
LAHORE - University of Health
Sciences Lahore recently
celebrated its first dental week,
titled as "International Seminars in
Dental Research &
Periodontology". Dr Sarah Ghafoor
from the Department of Oral
Biology University of Health
Sciences organised the event in
collaboration with Pak Association
for Dental Research (IADR
Pakistan Section), IADSR and
Dental News.
The week included lecture and
workshop seminar.
The seminar which was attended
by more than 500 participants was
aimed at apprising about the recent
research and clinical updates,
besides giving expert advice on
the subject Periodontology to
researchers, scientists, general
dentists, clinicians, students and
community, at large.
Guest speakers of the seminar
included Prof Dr Khalid Almas, Dr
Maher Almasri and Dr Kashif
Hafeez from the United Kingdom.
The guests' visit was funded by
the President's Programme for
Care of Highly Qualified Overseas
Pakistanis (National Talent Pool)
under the Ministry of Federal
Education and Professional
Training, Islamabad.
The lectures and workshop were
kept free of registration not only in
the UHS, but also in two other
institutes - Fatima Memorial
Hospital College of Medicine &
Dentistry and Interdisciplinary
Research Center for Biomedical
Materials (IRCBM) COMSATS,
Lahore. CME/CDE activities were
12 DENTAL NEWS / August 2016
also arranged during the dental
week.
The opening session of the event
was chaired by vice chancellor
University of Health Sciences,
Major-General (Retd) Prof
Muhammad Aslam.
Later, Dr Maher Almasri and Prof
Khalid Almas delivered lectures on
the topics of "Hard Tissue
Management in Implant Dentistry
- Respecting the Biology of Bone"
and "Think Outside the Mouth-The
Oral Systemic Link: An Update"
FMH College of Dentistry Prof Dr
NaziaYazdani, Prof Khalid Almas
lecture on, "Oral Malodor (a social
stigma): Etiology, Diagnosis and
Management" and research
interactive session on
Periodontology & Implantitis by
FCPS post graduate residents,
faculty of Periodontology,
Maxillofacial Surgery and
Prosthodontics. Third day of the
week included session on, "Guided
Tissue Regeneration in Periodontal
Practice" at IRCBM COMSATS
and interactive session on career
guidance, respectively.
Those who spoke on the second
day of the week included Dean
Dental Sciences and Principal
Lahore which was conducted by
Dr Aqif Anwar Chaudhry who
emphasized on the significance of
Dental Materials research and
clinical integration, which was
continued with dental biomaterials
and Guided Tissue Regeneration
session with Researcher and
Scientists at IRCBM who are
working on indigenous-sourced
dental materials and biomaterials.
Continued on Page 46
National News
PMDC sans permanent registrar
DN Report
ISLAMABAD - Pakistan Medical
and Dental Council (PMDC) is
without a permanent registrar
although around eight months
had already elapsed since the
election of the council's
incumbent executive committee.
There is no full-time registrar in
the PMDC since the incumbent,
Dr. Ahmad Nadeem Akbar, was
forced out in January 2013 on
the alleged charges of corruption
and mismanagement.
After Dr. Ahmad's
unceremonious exit, which ran
the organisation into a longdrawn-out litigation, either junior
registrars or deputationists
landed the job on interim basis.
Among them were Pakistan
Institute Medical Sciences
Islamabad's Children Hospital
joint executive director Dr Raja
Amjad Mehmood, PMDC deputy
registrar Dr Shaista Faisal and
former Rai Medical College
Sargodha chief operating officer
Brig (retd.) Hafizuddin Ahmad
Siddiqui.
Currently, PMDC assistant
registrar Syed Azhar Ali Shah
stands in for the permanent
registrar.
Though no one from within the
organisation is understood to be
currently eligible to run for the
prestigious position, Dr Ahmad
insists even now, he 'lawfully'
holds the registrar's office.
He even tried to occupy the
registrar's office in line with the
health services and regulation
ministry's 'favourable notification'
issued shortly after the interim
management was created.
However, the then acting
registrar, Dr Shaista Faisal, got
in the way and foiled the bid by
calling in the police.
Dr Shaista Faisal also lays a
claim to the office but insiders
disagree saying she is shorter in
length of tenure and also in the
bad books of the incumbent
health ministry's bosses for being
part of the previous Dr Asim
Hussain-led 'corrupt' setup at the
PMDC.
Though there is a high likelihood
of an outsider clinching the
position, Dr Ahmad and Dr
Shaista are pulling out all the
stops for becoming the registrar,
especially by drumming up
support for their candidacy from
within the organisation, the health
services and regulation ministry
overseeing it.
Insiders are not optimistic of the
PMDC getting a permanent
14 DENTAL NEWS / August 2016
registrar in the near future in the
wake of a controversy over the
council's rightful management
following lapse of presidential
ordinance, last year. The
incumbent executive committee
of the PMDC was elected
following promulgation of the
ordinance in April, 2015.
PMDC President Professor
Shabir Lehri insists the
incumbent executive committee
is the organisation's rightful and
lawful management, so it will stay
put.
However, his predecessor, Prof
Masood Hameed, claims that
with the lapse of the August 2015
presidential ordinance, previous
management of the PMDC had
automatically comes into
existence.
Meanwhile, National Assembly
Secretariat's Legislative Branch
has reportedly decided to table
the bill in a joint session of
parliament for approval of the
PMDC (Amendment) Bill 2015
that had been pending before
the Senate for approval for the
last three months or so.
It may be recalled here that the
bill had been approved by the
National Assembly in March this
year.
Don’t seek admission to
unregistered medical &
dental colleges: PMDC
DN Report
ISLAMABAD - The Pakistan
Medical and Dental Council
(PMDC) has advised
students to get admission in
only recognised and
registered medical and
dental colleges.
According to an official of the
PMDC, all such students could
check the list of registered and
authorised medical and dental
colleges from the PMDC
website. He said that no
medical or dental institution
was allowed to train students
which was not registered with
the PMDC.
He said that all the institutions
which were advertising
admissions of medical and dental
colleges must follow the seat
allocation prescribed by the
council in order to avoid any
inconvenience in future.
He added that passed out medical
dental graduates without having
students registration with the
PMDC would not be registered
as medical and dental
practitioners.
National News
E d itor ia l
Loans for hospitals
T
HE State Bank of Pakistan's recent decision of
launching soft loans scheme for private hospitals
empanelled under Prime Ministers National Health
Programme (PMNHP) to upgrade their facilities is,
of course, a commendable move as the ultimate
beneficiaries of the scheme would be the have-nots.
The SBP's soft loan scheme will, on the one hand, help
improve the facilities existing at the healthcare institutions
empanelled under PMNHP and, on the other, provide
better treatment facilities and health insurance to the
poorest segments of the society at affordable rates.
However, it was only possible when the SBP makes it
mandatory for the borrowers to pass on the benefit of
the subsidy to patients.
The PMNHP is not the incumbent government's first
initiative to provide health facilities to the poorest segments
of the population as it had earlier launched a similar
scheme, called Prime Minister's National Insurance
Programme (PMNIP). The former scheme was aimed at
providing inpatient hospitalisation insurance coverage to
3,100 million enrolled beneficiaries and as per its
parameters, the coverage limit was Rs50,000 for
secondary care service and Rs250,000 for tertiary care
for specified diseases.
Highlighting the salient features of the scheme, the SBP
announced that mark-up will be charged at KIBOR+500
basis points (bps), however, borrower will actually pay
six (06) per cent and the difference of the cost of
KIBOR+500 bps will be paid by the federal government.
Under risk mitigation, the government will bear up to five
(05) per cent losses on the portfolio of banks under the
scheme. NBP and FWBL will be the executing agency
while other banks will also be encouraged to participate
in the scheme. The facility for soft loans will be initially
launched in 23 selected districts but would subsequently
be expanded to cover the entire country.
The loans under PMNHP will be offered to private
empanelled hospitals for upgrading their facilities which
include purchase of equipment, operation theatre's upgradation and improvement in emergency services. All
hospitals, clinics, healthcare units empanelled/shortlisted
under PMNHP will be eligible for loans. Besides, qualified
MBBS/BDS doctors from an institution recognised by
PMDC, clinics/hospitals/labs registered with PMDC and
PMA, sole proprietors, partnership firms, private and
public limited companies, other bodies/trusts running
hospitals and empanelled under PMNHP will also be
provided soft loans. Debt-equity ratio will be 80:20 and
the borrowers' contribution of equity could be in the form
of existing assets and property offered as collateral subject
to valuation by banks. Soft loans under PMNHP will be
term loans up to Rs10 million and with maximum tenor
of eight years. Loans will be disbursed in single tranche
but the mode of repayment will be in equal monthly
instalments.
However, the government and the SBP will have to take
certain measures aimed at ensuring that the beneficiaries
of the soft loan must spend the amount for the purpose
it is being offered, borrowers might not face any hassle
in obtaining the loan and, on top of that, the element of
transparency must be ensured.
No doubt, the need of the hour is to help upgrade the
facilities available at private healthcare facilities, most of
which, despite being owned by doctors, have
compromised the quality in their institutions, but at the
same time, one hopes that all the four provincial
governments will also make sincere efforts in improving
facilities at public sector hospitals so that poor and lowincome group people, who cannot afford expansive
treatment charges of private hospitals, may not be
deprived of getting quality treatment and that too in a
congenial atmosphere.
16 DENTAL NEWS / August 2016
RCPS appoints Prof Ghani as
Dental Adviser
DN Report
PESHAWAR - The Royal College of
Physicians & Surgeons, Glasgow (UK)
has appointed Prof. Dr. Fazal Ghani as
its Dental Adviser from Pakistan for a
three-year term in recognition of his
services in dental education, dental
research and dental health. As such
Prof. Ghani has become Dental
representative from Pakistan as a
member of the International Advisers
Network of the prestigious Royal
Surgical College in the United Kingdom.
A short biography of Prof. Ghani has
been posted on the Website of the
Royal Surgical College Glasgow. As an
international adviser to the Royal
College, Prof Ghani will frequently hold
online meetings, besides undertaking
visits to the Royal Surgical College,
Glasgow.
Prof Ghani did his BSc and BDS from
Peshawar, M. Sc, PhD (from London)
and FDS & RCPS (from Glasgow). He
is currently working as Professor and
Head of Department of Prosthodontics,
Dean Postgraduate Dental Studies and
as Coordinator International Relations
at Peshawar Dental College, Peshawar.
Earlier, he has worked as Professor
and Head of the Department of
Prosthodontics, Khyber College of
Dentistry Peshawar.
Hailing from village Shewa, District
Swabi, Prof Ghani did
his BDS from the
Department of
Dentistry, Khyber
Medical College,
Peshawar in 1981,
received postgraduate dental training
and education and work experience
from the world-famous dental
institutions, including Eastman Dental
Institute London, University College &
Middlesex School of Dentistry London,
The Dental Institute, London Hospital
Medical College London, Royal College
of Physicians & Surgeons of Glasgow
(UK), University of Tohoku, Sendai,
Japan and Wonk Wong University,
South Korea.
Prof. Ghani is the pioneer training
supervisor and examiner for the
fellowship in prosthodontics of the
College of Physicians & Surgeons,
Pakistan. He has supervised and
examined many candidates and
scholars sitting for Fellowship, Master
of Science, M. Phil and PhD in the basic
and clinical dental disciplines. He has
delivered lectures and presented
research papers at both national and
international conferences and meetings.
He has also published over 100 articles
and reviewed over 200 articles for
publications in various national and
Continued on Page 46
Honour for Pakistani doctor
LAHORE - Head and Assistant Professor at CMH Medical College, Lahore,
Dr Salman Aziz, recently ranked among top six best research presenters of
Unilever
Competition and
Awards ceremony2016 at the 94th
General Session
HYDERABAD - Dr Zahid Iqbal, who
and Exhibition of
is currently
International
associated with
Association for
the Operative
Dental Research
Dentistry
(IADR) held in
department of Isra
Seoul, South Korea.
Dental
press release, there were 59 candidates
College/Isra
in the competition.
University
The topic of his research was
Hyderabad, has recently been
"Discrimination between normal,
promoted as Associate Professor.
dysplastic and cancerous oral mucosa
Dr Zahid, who did his graduation
using Raman Spectroscopy: A Tissue
from Karachi Medical & Dental
Engineering Approach", an emerging
College (KMDC) and FCPS
field in biomedical research and holds
residency, had earlier served
a promising future for tissue/organ
Ziauddin Dental College as senior
transplants. - PR
lecturer, assistant professor and
consultant Restorative Dentist and
the College of Dentistry,Qassim
University, Saudi Arabia, as assistant
professor.
Dr.Zahid joined Isra Dental College
in 2014 as chairperson/assistant
professor & postgraduate supervisors
(FCPS, MDS, and MSc
PROMOTION
International
ADVICE FOR DENTISTS
Compliance of UNEP Treaty on Mercury
may become effect by 2017
THE recently adopted United
Nations Environmental
Programme Treaty on
Mercury, known as the
Minamata Convention, is
aimed at protecting human
health and the environment
from the adverse effects of
mercury.
The Treaty was designed to
allow significant flexibility to
account for local circumstances.
This means that each country
can comply with the Treaty in
a unique way and compliance
is likely to come into effect by
2017. Dentists should
communicate with their local
health ministry for the exact
details of their country's
compliance agreements.
This is the first international treaty
to name and include dentistry,
prevention and dental research.
The Minamata Treaty contains the
following provisions to support a
phase-down in the use of
amalgam: (i) Set objectives to
prevent caries thus minimizing the
need for restorations; (ii) Setting
objectives aiming at minimizing
use of amalgam; (iii) Promoting
the use of alternatives; (iv)
Promoting research into alternative
restorative materials; (v) Promoting
training in the use of mercury-free
alternatives; (vi) Discouraging
insurance policies that favour the
use of amalgam; (vii) Encouraging
insurance policies to favour the
use of alternatives to amalgam;
(viii) Restricting the use of dental
amalgam to its encapsulated form;
(ix) Promoting the best
environmental practices to reduce
the release of mercury.
Compliance programmes will need
to be taken up by National Dental
Associations, and we encourage
all practicing dentists to become
involved with their dental
associations to assist in advocacy
for oral health for all. In many cases
countries may already comply with
a number of these provisions but
the Treaty provides an opportunity
to develop and refine the relevant
activities. The improvement and
extension of initiatives to prevent
caries is a clear example of how
the provisions provide a framework
for improvement rather than a
single clear defined end point.
This toolkit is aimed at the clinical
dentist and emphasizes the
implementation of programmes in
health promotion and disease
prevention, how dental amalgam
compares to other direct restorative
materials and best management
practices for amalgam waste. The
toolkit focuses on the best available
practices but recognizes that not
all resources are available in all
regions of the world. Where
appropriate the toolkit indicates
possible alternative approaches.
The FDI World Dental Federation,
collaborating with the World Health
Organization (WHO) and the
International Association for Dental
Research (IADR), played a crucial
role during the negotiations to
balance the need to protect the
environment with the provision of
optimal oral healthcare. The Treaty
goes beyond a simple
recommendation to phase down
the use of dental amalgam and
includes a range of forwardthinking provisions for oral health.
These provisions include improved
oral health promotion and disease
prevention, supporting dental
materials research, and offering
guidelines for best management
practices for amalgam waste.
The FDI, in leading the world to
optimal oral health, presents this
practical informational toolkit to
support clinical dentists worldwide
so they can understand and
comply with the provisions of the
Minamata Convention. The toolkit
includes a range of ways that
individual dentists can adopt
immediately that will allow the best
care of patients and at the same
time to recognize that dentists have
a responsibility to the environment
for a healthy future for all humans
around the globe.
The Minamata Convention was
agreed upon by 147 nations in
January, 2013, opened for
signatures in October 10, 2013
and has 102 nation signatures as
24 DENTAL NEWS / August 2016
of September 2014.
Dental caries, despite being largely
preventable, is the most common
global chronic disease, and is still
the most common chronic disease
of childhood (Peterson, 2009).
Dental amalgam has long been a
safe, effective, durable, and
affordable material to restore
carious teeth. The presence of
mercury in dental amalgam led to
dentistry and the FDI becoming
directly involved with the United
Nations Environmental Programme
negotiations on mercury. The FDI
negotiating team, collaborating with
WHO and IADR, worked hard to
ensure that health and oral health
care would be supported in the
treaty whilst still recognizing the
need to protect the environment.
Specifically, the Minamata
Convention "upholds the use of
dental amalgam as a durable, safe,
effective cavity filling material" and
calls for phasing down amalgam
by supporting prevention and
health promotion (thereby requiring
fewer restorations), encouraging
best management practices for
amalgam waste disposal and
supporting research into alternative
materials.
Mercury levels in the environment
have increased over the last
century largely due to human
activity. Mercury can be
concentrated in the food chain,
particularly in fish and marine
mammals. The town of Minamata,
Japan, after which the Treaty is
named, experienced severe
mercury poisoning disease from
industrial release of methyl
mercury in 1950s. Products,
processes and industries where
mercury is used, released or
emitted are addressed in the
Treaty, and dental amalgam
represents a relatively small but
quantifiable part of the overall
mercury burden. Natural emissions
of mercury into the environment,
such as volcanoes, have always
been present, but human activity
has exceeded natural emissions
over the last 200 years (Bayne, et
al., 2013). Once released, mercury
persists in the environment, and
can be repeatedly mobilized,
deposited and remobilized
between air, water, and soil.
Although the total use and release
of mercury has declined
significantly in many countries in
recent years, the fact that mercury
can be transported by wind and
ocean currents means that it can
only be controlled effectively at a
global level. Environmental
mercury exists in several forms,
and those forms have differing
impacts on humans and the
environment. Methyl-mercury,
which affected the residents of
Minamata, is the most toxic form
of mercury. Dental amalgam
contains mercury that is metallically
bound to silver and other trace
metals. The extremely minimal
release of mercury in various
oxidation states from amalgam
fillings is considered to be far below
the limits set by WHO or other
competent authorities (Bayne, et
al., 2013).
Additionally, dental amalgam waste
is a very small contribution to the
mercury in the environment, while
significant environmental
emissions of mercury occur
primarily from burning coal chloralkali production, artisanal gold
mining and fluorescent light bulbs.
By properly handling amalgam and
amalgam waste, the dental
profession can protect the health
of the environment and still provide
optimal patient care.
Perhaps most importantly, efforts
and success in disease prevention
will diminish the need for
restoration and, therefore, diminish
the waste products of any
restorative material, while
increasing human health through
improved oral health.
Indeed, our leading role in
compliance by the dental
community with the Minamata
Convention will help lead to
positive changes to global oral
health. The commitment to a
phase-down in the use of dental
amalgam in the Minamata
convention is supported by nine
provisions. To be compliant with
the Treaty, governments must
adopt at least two of these
provisions.
A clinical demonstration of Duo: porcelain
composite hybrid
By Dr Muhammad Ali
BDS, MCPS, MDS
front of teeth to create a smile
makeover. They create a beautiful
result. Porcelain mimics tooth
structure is better than any other
restorative material and it is a very
durable and extraordinarily strong
material that has similar texture,
REESTABLISHING a
patient's lost natural dental
aesthetics is among the
important topics of today's
dentistry, in addition to
function. Color, shape and
structural and position
abnormalities of anterior
teeth might lead to important
Before
aesthetic problems for
translucence and colour to the
patients.
In order to solve such problems,
the technique preferred
frequently is to cover the teeth
with dental crowns. However,
excessive preparation of teeth
and damages to the
surrounding tissues such as
gingiva, are some of
disadvantages of crowns.
enamel of your natural teeth.
Dental artists can manipulate the
colour and translucency to recreate the look of any tooth. And
it resists stain better than tooth
enamel. Very rarely will it discolour,
Therefore, in recent years,
laminate veneer restorations as a
more aesthetic and more
conservative treatment option,
have been used in dentistry.
Veneers are thin, semi-translucent
facings usually made out of
porcelain that are bonded onto the
28 DENTAL NEWS / August 2016
unless the surface has been
damaged. These thin shells of
porcelain are bonded to your
frontal surface of teeth to conceal
any discoloration, damage or
altered alignment.
Not every patient can afford
After
veneers, especially in today's
economy. Until now, there hasn't
been a more affordable solution
that you can stand behind clinically
but Duo: PCH changes that.
Duo: PCH is a Porcelain
Composite Hybrid is an entirely
new aesthetics category,
combining the convenience of a
composite build-up with the
finishing beauty of cerinate
porcelain. They are much more
simple and affordable as
compared with the conventional
porcelain veneers.
Porcelain veneers in Duo: PCH
comes with different shape and
size that allows the dentist to mix
and match veneer to patient's
tooth. And finally, the
veneers are bonded
to the teeth using
strong resin composite material.
CASE REPORT
A 26 -year-old female patient with
chief complain of discoloration of
anterior maxillary teeth was
referred to the Dental OPD. After
number of options this young lady
decided to have all her anterior
upper front teeth to be veneered
to get rid of discoloration.
CLINICAL EXAMINATION:
Discoloration observed on all teeth
due to fluorosis
MATERIAL: Duo: PCH (prep less
pre-fabricated veneers)
METHOD: The procedure
included; size, recontour, adjust,
seat, cure and finish.
CONCLUSION: Patient was
extremely happy with the result as
it was less costly than labfabricated veneers. Smile
makeover was done in two visits.
There was minimal removal of
tooth structure for malalignment
of central incisors. Patient
achieved beautiful, long-lasting
aesthetics that won't stain or wear
over time.
The researcher is resident (Operative
Dentistry) at FJDCH
Internship programme
KARACHI - Sindh Institute of Oral Health Sciences
recently organized a six-day-long internship
programme.
The aim of this programme was to guide students
and help them in career building with a hope of
success.
Internship programme included career awareness
session, pre-dental hand skills activities, study skill
programme and also preparation session for admission
in the college.-PR
Seminar on oral health held at SIOHS
KARACHI - The community department of Sindh Institute of Oral Health
Sciences, Jinnah Sindh Medical University recently organized a
seminar on "Oral hygiene and Dental health".
The motive behind organizing the seminar was to apprise participants about
basic dental care as well as to highlight the importance of professional
intervention.
Seminar was arranged for the parents of Deaf students who were evaluated
earlier by dentists. This seminar helped parents to understand how to take
care of dental health.
Expertise plans to provide dental service to 200 students free of cost.-PR
Free Dental Camp
KARACHI - Dr
Iqbal Khalidi of Dr Iqbal Khalidi
& Associates recently organized a free dental
camp at Hamdard University Hospital.
The aim behind organizing the dental camp was
to raise awareness in the community about dental
health and to highlight the significance of maintaining
oral hygiene.
Around 300 patients who visited the camp were
examined free of charge and provided 25 per cent
discount in overall dental treatment.
The doctors who manned camp included Dr Uzma,
Dr Humera, Dr Assra, Dr Arsalan and Dr Sidra.
The dental camp concluded with distribution of dental
kits among patients.-PR
30 DENTAL NEWS / August 2016
Dental camp held at
Sindh Rangers Hospital
SUKKUR - Dr Sikandar Ali Mahar who's working as senior dental surgeon at
Taluka hospital, Rohri, recently organized free dental checkup at Sindh Rangers'
Hospital, Sukkur.
The purpose of organising the dental camp was to create awareness among
people about significance of maintaining oral hygiene.
All those who visited the dental camp were thoroughly examined.
The event concluded with distribution of gifts and goody bags among patients of
Sindh Rangers hospital. - PR
Eid Milan at HUDH
KARACHI - Hamdard University Dental Hospital's
(HUDH) faculty members participated in different games
at an Eid Milan party held at the lawns of the hospital.
The event which began with the recitation from the Holy
Quran was followed by speeches.
Speaking on the occasion, HCM&D's vice principal and
head of Dental Section, Prof Dr Nadeem Hafeez Khokhar,
lauded the efforts of organisers of the Eid Milan party.
Welcome address was presented by Dr Ayesha Basit.
The event was followed by a prize distribution ceremony
where awards were given to the `Lady of the day' and
HUDH lecturer bags award
KARACHI - Hamdard University Dental Hospital's
(HUDH) senior lecturer, Dr Wardah
Ahmed, won the award for
presenting "Best paper for
publication" during her participation
in the 3rd Public Health Conference
held recently in Kuching, Malaysia.
The title of her paper was
"Assessment of Health Literacy in
adult population of Karachi: a
preliminary investigation for conceptbased evidence".
In her presentation, she highlighted the health care
system in cross-cultural perspective, low health literacy
level. Stressing the need for resolving such problems at
grassroots level through Health Education, she also
proposed some policy recommendations.
HU faculty members have felicitated her on winning the
award at the moot. - PR
32 DENTAL NEWS / August 2016
Gum disease bacteria linked to esophageal cancer
I
n a new study, researchers proposed
for the first time that Porphyromonas
gingivalis - the bacterium behind
gum disease - could be a risk factor for
esophageal cancer.
Based on studies it was suggested that P.
gingivalis are present in cancerous tissue.
Findings of different studies provided the first
direct evidence that infection could be a novel
risk factor for ESCC, and may also serve as a
prognostic biomarker for this type of cancer.
Researchers found out that levels of both the
enzyme and the bacterial DNA were
significantly higher in the cancerous tissue of
ESCC patients than in surrounding tissue or
tissue of normal controls.
According to the Centers for Disease Control
and Prevention (CDC), every year, around
15,000 people are diagnosed with
esophageal cancer - a cancer that starts in
the esophagus or gullet, the muscular tube
that moves food from the throat into the
stomach.
The researchers found levels of P. gingivalis
were significantly higher in the cancerous
tissue of ESCC patients than in surrounding
tissue or tissue of normal controls
The lining of the esophagus is made of two
kinds of cell, which is why there are two
main types of esophageal cancer:
esophageal adenocarcinoma and
esophageal squamous cell carcinoma
(ESCC). ESCC is more common in
developing countries.
Speculating on possible explanations; ESCC
cells are a "preferred niche" for the bacterium
to thrive in, or infection with the bacterium
somehow spurs the development of the cancer.
If the reason is that the cancer cells offer the
bacterium a niche, then simple antibiotics could
be a way forward for treatment. Another
approach could be to use genetic technology
to target the bacterium and ultimately eliminate
the cancer cells.
The cancer is hard to diagnose
in the early stages. At times
cancer develops rapidly after
diagnosis and prognosis is not
good. The known risk factors for
esophageal cancer include
chemical exposure, diet, heredity
and age - all factors already
common to many other cancers.
36 DENTAL NEWS / August 2016
"It would suggest that improving oral hygiene
may reduce ESCC risk; screening for P.
gingivalis in dental plaque may identify
susceptible subjects; and using antibiotics or
other antibacterial strategies may prevent
ESCC progression."
International
Neutrophil and cancer cell ‘crosstalk’
underlies oral cancer metastasis
A
immunotherapies for patients with
n abnormal immune
oral cancer that could effectively
response or
shut down the abnormal immune
“feedback loop” could
response, the team is currently
very well be the underlying
expanding upon their study of
cause of metastases in oral
inflammation and oral cancer.
Approximately 3,600 cases of oral
cancers, according to
cancer are diagnosed in Canada
Dr. Marco Magalhaes,
every year, yet the survival rates
assistant professor at the
— 50 to 60 percent over five years
University of Toronto’s Faculty
— have remained stagnant for
of Dentistry and lead
decades while other cancer survival
rates
have dramatically improved.
researcher in a study
Oral squamous cell is shown invading the extracellular matrix of a healthy cell.
About
the Faculty of Dentistry,
published in the journal
University of Toronto
neutrophils secrete a group of molecules,
Cancer Immunology Research.
Combining the rigours of biological and clinical
including TNFa, that regulates how the body
Magalhaes has unearthed a significant responds to inflammation.
research with a comprehensive educational
connection between the inflammatory The study noted that oral cancer cells secreted experience across a full range of undergraduate
and graduate programs — with and without
IL8, another inflammatory mediator, which
response of a very specific form of
advanced specialty training — the Faculty of
activates
neutrophils,
effectively
establishing
immune cells, neutrophils, and the
Dentistry at the University of Toronto has earned
a massive immune-response buildup or
spread of this deadly disease.
international respect for its dental research and
“feedback loop.”
“There’s a unique inflammatory response
with oral cancers,” explains Magalhaes,
citing the growing body of evidence
between cellular inflammation and cancer,
“because the oral cavity is quite unique in
the body. A great many things are
happening at the same time.”
Magalhaes focused attention on neutrophils,
immune cells commonly found in saliva and
the oral cavity but not widely researched in
relation to oral cancer. Like other immune cells,
Ultimately, the researchers found, the immuneresponse loop resulted in increased invasive
structures known as “invadapodia,” used by
the cancer cells to invade and metastasize.
“If we understand how the immune system
interacts with the cancer, we can modulate the
immune response to acquire an anti-cancer
response instead of a pro-tumor response,”
Magalhaes argues.
While the study points to the possibility of one
day creating targeted, personalized
38 DENTAL NEWS / August 2016
training.
Whether focused on biomaterials and
microbiology, next-generation nanoparticles,
stem-cell therapies or ground-breaking
population and access-to-care studies, the
mission is to shape the future of dentistry and
promote optimal health by striving for integrity
and excellence in all aspects of research,
education and clinical practice. You can learn
more at www.dentistry.utoronto.ca. -Courtesy
DTI, Canada
Clinical Cosmetic Dentistry
Central details: Smile renewed Esthetic replacement of anterior
with esthetic Obsidian crown class IV restorations
By Anamaria Muresan, DMD,
ME, CDT
In the anterior region where
esthetics are paramount, certain
complications can preclude the
use of all-ceramic material. The
task then becomes finding a
material worthy of the anterior
with the durability to meet precise
standards. Obsidian Lithium
Silicate Ceramic Pressed to
Metal (Prismatik Dentalcraft Inc.;
Irvine, Calif.) puts an innovative
spin on PFMs, with traditional
porcelain passed over for lithium
silicate ceramic.
The result is five times the
strength and more than two times
the chip resistance of traditional
PFMs.
A 27-year-old male patient
presented with an old PFM crown
on tooth #9, which had
undergone endodontic treatment
about 10 years prior to address
decay. A darkened margin, visible
due to gum recession on the
facial, posed a distinct problem
for this anterior case. In addition,
the esthetics of the PFM crown
were noticeably inadequate.
To achieve an optimal outcome
in the face of these difficulties,
the first task in the treatment plan
was to match the gingival height
Before
Fig. 1: A 27-year-old male patient presents with
an old PFM crown on tooth #9, which had
undergone endodontic treatment about 10 years
prior to address decay.
Esthetics Clinical Case
Clinical dentistry and photography by: Dr. Paulo Monteiro, Caparica,
Portugal.
Initial Situation
Female patient 30 years old.
Patient was not satisfied with current anterior restorations (maxillary
central incisors). Patient also expressed dissatisfaction with shade and
surface texture.
Challenge
Creating smooth and natural-looking restorations for patients who
demand the highest level of esthetics can be challenging. Using materials
that mimic shade and opacity of dentin and enamel is critical. -Courtesy
DTI, Portugal
After
Fig. 2: Obsidian Pressed to Metal crown masks
the darkened stump shade at the gingival third
while also blending in with the overall smile.
of tooth #9 to #8. Choosing
Obsidian for the new crown was
important in providing esthetics,
as all-ceramic materials were
eliminated from consideration
due to the dark gingiva of the
tooth in question.
In relation to the rest of the
patient’s smile, the PFM crown
on tooth #9 does not offer
harmonious shade and contours
and fails to mirror the natural
translucency and character of
tooth #8. I used a gingivectomy
Continued on Page 46
42 DENTAL NEWS / August 2016
Fig. 1: Initial situation: patient was not
satisfied with current restorations.
Fig. 2: Teeth were etched after preparation
using Single Bond Universal Etchant.
Fig. 3: Single Bond Universal Adhesive is scrubbed
into the surface, air dried and light cured with
Elipar™ DeepCure-S LED Curing Light.
Fig. 4: A silicone matrix was used to create the
palatal wall with Filtek™ Z350XT Universal
Restorative, shade CT.
Fig. 5: The interproximal enamel layer was built
with Filtek™ 350XT Universal Restorative, shade
A3E and light cured with Elipar™ DeepCure-S LED
Curing Light. For the incisal halo, Filtek™ Z350XT
Flowable Restorative
Fig. 6: Application of the dentin layer using Filtek™
Z350XT Universal Restorative, shade A1D. For
volume control the Misura instrument (LM Arte by
Style Italiano) was used to leave a 0.5mm space
for the facial enamel.
Fig. 7: Creation of mamelons and application of a
small portion of Filtek™ Z350XT Universal Restorative,
shade CT between the dentin layer and incisal halo to
enhance translucency at the incisal edge.
Fig. 8: The final enamel layer of Filtek™ Z350XT
Universal Restorative, shade A3E was applied and
light cured.
Fig. 9: Sof-Lex™ Discs are used to define the outline
of the restoration and create secondary anatomy.
Fig. 10: Pre-polishing of restoration with Sof-Lex™
Pre-Polishing Spiral.
Fig. 11: Polishing with Sof-Lex™ Diamond Polishing
Spiral to create a final smooth and high-gloss polish.
Fig. 12: Final restoration is very natural-looking.
International
Dental plaque bacteria hitch a ride in blood
to fortify colon cancer
Mouth microbes travel through
the circulatory system to give
tumours at the other end of the
gastrointestinal tract a helping
hand. Belinda Smith reports.
Bacteria that cause dental disease
hijack thebloodstream to travel to
the colon where they latch on to
tumours and help them grow, new
research shows.
Biologists from the US and Israel
discovered that the common
Fusobacterium nucleatum bacteria
uses a protein called Fap2 to stick
to colorectal cancer cells and
shields the tumour from the body's
immune system.
The work, published in Cell Host
& Microbe, may not only give
oncologists a means to block
colorectal tumour growth, but also
a means to deliver cancer-killing
drugs.
Only in the past few years has the
influence of microbes that dwell
in and on our body on the growth
and progression of colorectal
cancer been unveiled.
One particular strain, F. nucleatum,
emerged as an interesting
example. Colon tumours tend to
have lots of the rod-shaped
bacteria stuck to them while the
surrounding tissue is pretty much
bare.
But the bacteria's preferred habitat
isn't the gut - it's the mouth, where
it binds to other microbes to form
blobs called biofilms. These
masses of bacteria are the plaque
that accrues on tooth enamel and
along the gum line and can cause
diseases.
So how does F. nucleatum make
the journey from mouth to colon?
The obvious answer is it's
swallowed and travels through the
gastrointestinal tract, but studies
searching for it in the stomach and
small intestine have largely drawn
a blank.
Jawad Abed and Johanna Emgard
from the Hebrew University in
Israel and colleagues thought the
bacterium may hitch a ride in the
bloodstream. To test this, they
injected fusobacteria into the vein
of mice with colorectal tumours.
They found it didn't matter if the
tumours were precancerous or
malignant - fusobacteria in the
blood sought them out and stuck
on tight, but largely ignored the
surrounding healthy tissue.
The colon of mice without tumours
had no fusobacteria, suggesting
that a tumour is required for the
bacteria to make the jump from
the bloodstream.
Using human and mouse cells,
the team uncovered the sticking
mechanism favoured by
fusobacteria.
A protein hanging off the outside
of the bacterial cell, Fap2,
recognised and grabbed onto a
sugar found on colorectal tumour
cells called D-galactose-?(1-3)-Nacetyl-D-galactosamine (thankfully
shortened to Gal-GalNac).
Previous studies showed that Fap2
is instrumental in helping colorectal
tumour cells fly under the immune
system's radar, too - so allowing
the tumour to grow and the
bacteria flourish.
Poo transplants transfer much
more than bacteria
Gilad Bachrach, also from the
Hebrew University and a senior
author of the study, acknowledges
that the work does have limitations.
For instance, in some mouse
models, colorectal tumours grow
quickly - often within a few months.
In humans, though, tumours tend
to grow over years.
And will brushing teeth more often
help keep the risk of colorectal
cancer risk down?
Bachrach's not sure yet: "Based
on our findings, it's too early to say
whether we can prevent mouth
bacteria from travelling through
blood to the colon and promoting
tumour formation or if some people
are more at risk than others."
- Courtesy Cosmosmagazine.
New study: North American dental lasers
market 2016: global industry research report
By Carl Jackson
Laser therapy in dentistry ensures
less bleeding, less trauma, reduces
contamination through instruments,
and increase in comfort of the
patient. The procedural time is
reduced as most of the tedious
processes are eliminated.
Latest industry research report on: Dental
lasers are used for diagnosing dental disorders
using laser therapy. It eliminates the need of
surgical instruments such as dental drills, hand
pieces, and dental anesthetics.
The reduction in risks associated
with dental surgical instruments and
time for therapy creates new
pathways for the use of dental
lasers.
The global increase in the awareness level of
oral hygiene, increasing aging population,
increasing demand for cosmetic dentistry,
prevalence of gingivitis, caries & periodontics,
and rising disposable income in the developed
nations such as the U.S. and Canada are
factors responsible for the growth of the North
American dental lasers market.
However, high cost of surgery is a factor
restraining the growth of the market.
The North American dental lasers market is
segmented on the basis of product, end users,
and countries. The product segment is
classified based on soft-tissue lasers and alltissue (hard/soft) lasers.
The market is further classified based on end
user into dental clinics, hospitals, and other
end users. Geographically, the market is
divided into U.S.A., Canada, and Mexico.
The prominent market players operating in
the world are AMD Lasers, CAO Group Inc.,
Biolase Inc., Fotona D.D., Danaher
Corporation- Kavo Dental GMBH, Convergent
Dental, Ivoclar Vivadent AG, Sirona Dental
Systems Inc., Syneron Dental Lasers -Syneron
Medical Ltd., and Zolar Technology & Mfg Co.
Inc. Various strategies, such as mergers &
acquisitions, expansions, joint ventures, and
others have been implemented by key
manufacturers to gain stronghold of the market.
. The report offers an in-depth analysis of key
48 DENTAL NEWS / August 2016
driving and hindering factors of the North
American dental lasers market.
. The report provides an extensive analysis
of current and future market status of the North
American dental lasers market.
. This report offers an in-depth quantitative
analysis of the current market and estimations
through 2015 and 2020, which assists in
identifying the prevailing Market Opportunities.
. Geographically, the North American dental
lasers market is segmented into U.S., Canada,
and Mexico.
. An extensive analysis of dominant market
shares for each segment helps in
understanding the current market status.
. The report provides an exhaustive
information about new product launches,
research and recent developments of the North
American dental lasers market.
. This study evaluating competitive landscape
has been taken into account to help in
understanding the competitive environment
across geographies.
Key Market Player are: AMD Lasers, CAO
Group Inc., Biolase Inc., Fotona D.D. Danaher
Corporation- Kavo Dental GMBH Ivoclar
Vivadent AG Convergent Dental, Sirona Dental
Systems Inc., Syneron Dental Lasers - Syneron
Medical Ltd. And Zolar Technology & Mfg Co.
Inc.