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When practice meets research - a future full of possibilities

Our 2013 clinical research symposium attracted many distinguished presenters and participants. Here is a list of our speakers outlining their expertise and research interests.

Dr Suzanne McEwan Hanlin MDS FRACDS MRACDS (Pros) FPFA FADI FICD (Prosthodontist)

Suzanne completed her Masters degree in Restorative Dentistry at the University of Otago in 1989 and obtained registration as a Prosthodontist in Victoria Australia. She has worked in Prosthodontic practice in central Melbourne from 1990 until 2011 when she moved back to New Zealand to take up a teaching position as a senior lecturer with the University of Otago in the Department of Oral Rehabilitation.

She is a Past President of the Australian Dental Association Victorian Branch (ADAVB) and past Hon. Treasurer of the Royal Australasian College of Dental Surgeons and College nominee to the Australian Dental Council. She has been associated with teaching at the University of Melbourne Dental School since 1991 as a visiting clinical tutor to post graduate and undergraduate students and lecturer to Overseas Dentists in their registration training programme. Suzanne has lectured as a keynote speaker in Australia, New Zealand and Hong Kong.

Digital dentistry in prosthodontics. From CADCAM to webcam and everything in between

Over the last 10 years digital technologies have been progressively revolutionising dentistry. Prosthodontics as a lead specialty in oral rehabilitation has been at the forefront of this change. Integrating “digital dentistry” into our working life requires us to think in areas outside the current paradigms for patient care, and to reflect on both the advantages and pitfalls that are implied by these changes. This presentation will briefly explore digital dentistry as it can apply to Prosthodontics including the diversity of concepts that are implied by dental informatics: digital photography, electronic patient management systems, clinician support systems, shade matching, CADCAM, stereolithography and digital impressions, guided surgery, changed work flow, e-Health, m-Health, computer aided learning, haptics, and finally a consideration of data security/ ethics and research opportunity.

Dr Basil Al-Amleh BDS, DClinDent, MRACDS(Pros)

Basil completed his BDS in 2001 and a Clinical Doctorate in Prosthodontics in 2011, both gained from the University of Otago. Subsequently he was appointed Senior Lecturer and Prosthodontist in the Department of Oral Rehabilitation at Otago, and is actively involved in undergraduate and postgraduate teaching and research supervision with a focus on Biomaterials Science. His research interest is focused on dental ceramics, in particular the issue of veneer chipping affecting zirconia-based restorations.

Ceramic fractures and their origins

All-ceramic restorations have gained popularity over the last few decades due to their superior aesthetic potential, and the continuous development of new and improved ceramic systems by manufacturers. Recent clinical studies report survival rates comparable to metal-ceramic restorations, however this may be site and/or material specific. Chipping of veneering porcelain and complete fracture of all-ceramic restorations still plagues this treatment modality due to ceramic’s inherent brittle nature, and its susceptibility to fatigue and slow crack growth in moist conditions. Furthermore, nearly every fabrication technique and processing step may introduce a variety of fabrication defects that act as sites of weakness and potential origins of failure.

Dr Andrew Tawse-Smith

Dr Tawse-Smith obtained his DDS at the Colombian School of Dentistry (COC) in 1986 after which he completed his specialist degree in periodontology in 1992 at Gothenburg University. He has worked in both private specialist practice and universities for more than 20 years during which he was a former dean at COC. He is the scientific director of the Journal Odontologico Colegial , a referee for the Cochrane Oral health Review Group and the Scientific Journal SOBRAPE (Sociedad Brasilera de Periodoncia). He is also a member of the Editorial Committee Scientific Journal “Clinica e Pesquisa em Odontologia (CLIPE)-UNITAU (Universidad de Taubate) Brazil”.
Dr Tawse-Smith has multiple publications in the theme of oral implantology focusing on the biological complications and maintenance issues. He is a member of the Oral Implantology Research Group at the Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, New Zealand.

Challenges of oral implant maintenance

The paradigm shift to using oral implants to restore missing teeth has been supported by evidence-based literature. In order to ensure a long-term success outcome, the health of the peri-implant tissue must be maintained. However, it appears that clinicians and patients are still struggling to base their treatment options on clear evidence-based guidelines to achieve long-term peri-implant health. This presentation will review the diagnosis of peri-implant tissue disease and focus on evidence-based therapeutic strategies for dealing with biological implant complications.

Mike Morgan and Denise Bailey

eviDent - a Dental Practice Based Research Network in action. Experiences from across the ditch.

Mike Morgan will present two lectures relating to Dental Practice Based Research Networks (DPBRN) drawing on experiences from eviDent, a recently formed (and still evolving) DPBRN operating in Victoria, Australia.

The first presentation will identify the key precepts supporting the eviDent DPBRN. It will include a description of DPBRNs, how they work (including practitioner involvement), their potential benefits, and research activities which are commonly embarked on under their banner. A brief history of evident, together with challenges and opportunities, will also be presented.

The second presentation will highlight those projects which have formed the basis of eviDent. This will include the lead up to the projects, the involvement of the researchers and practitioners together with research outcomes from the projects.

Mike Morgan was fortunate to graduate from The Faculty of Dentistry at the University of Otago in 1979. He currently holds the Colgate Chair of Population Oral Health, at the Melbourne Dental School at The University of Melbourne. He is a Director on the Australian Dental Council, a Board member of VicHealth and is Principal Oral Health Advisor to the CEO of Dental Health Services Victoria. Mike’s principal teaching and research interests are in population oral health, focusing on oral disease causation in relation to common risk factors and disease prevention at a population level - with an emphasis on community water fluoridation. He has a strong interest in the causes and prevention of oral disease, oral health informatics and clinical trials of dental caries preventive agents. Mike is co-Chair of the eviDent DPBRN Committee which is a joint endeavour between the Australian Dental Association (Vic Branch) and the Oral Health Co-operative Research Centre (OH-CRC) based at the Melbourne Dental School.

Denise Bailey is Chair of the eviDent Foundation Board, a member of eviDent’s dental practice-based research network committee and an eviDent Chief Investigator on multiple projects. As Clinical Manager – Clinical Trials, Denise is well placed to understand the unique difficulties encountered when conducting a research project in a primary care setting and to help facilitate solutions to these problems at the project design stage. She successfully co-project managed the clinical trial of a sugar-free chewing gum which was the largest dental clinical intervention study conducted in Australia and undertook the first clinical trial of Tooth Mousse in Victorian dental practices. A suite of clinical trial related standard operating procedures, training manuals and standardisation and calibration tools have been developed as a result of these studies. Denise has a strong interest in ethics, and lectures to students regarding ethics and research design.

Professor Jan Clarkson, BSc, BDS, PhD, FDS, RCS(Ed), FDS(Paed), RCS(Ed)

Practice based research networks: The UK experience (by podcast)

Jan Clarkson graduated in dentistry from the University of Newcastle upon Tyne in 1987 and after 10 years at the University of Manchester, she joined DHSRU (Dental Health Services Research Unit) at the University of Dundee. Since 1998 she has been the Effective Dental Practice Programme Director, conducting high quality research and promoting implementation of research evidence in dental primary care. She is a founding member of the Cochrane Oral Health Group and her role as Joint Co-Ordinating Editor has influenced her research activity. She is on the specialist list for Paediatric Dentistry. Jan is Director of the Scottish Dental Practice Based Research Network which has undertaken unique trials in healthcare, both in clinical practice and education. As Director of the Scottish Dental Clinical Effectiveness Programme, she is responsible for the development, production and dissemination of guidance in priority areas for dentistry in Scotland. The long-term collaboration with researchers affiliated to DHSRU in particular the Health Services Research Unit, University of Aberdeen, has created an international research collaboration which is currently taking forward knowledge transfer to inform both service and educational policy in dentistry. Jan is Joint Principal Investigator in 3 NIHR HTA funded UK Multi Centre Trials and is an experienced trialist having successfully initiated, developed and conducted more than 20 clinical research trials in primary dental care.

Jonathan Broadbent

Jonathan is a Senior Lecturer in the Department of Oral Rehabilitation at the Faculty of Dentistry and current president of the NZDA Otago Branch. Jonathan has been involved in research with the Dunedin Multidisciplinary Study for a number of years, and his research focuses on the epidemiology of dental caries, tooth loss, and periodontal disease (with emphasis upon longitudinal research).

The animated dental chart

Traditionally, routine dental examination data are recorded on dental charts that provide a ‘snapshot’ of the state of a person’s mouth at one point in time; while this is important, it is difficult to demonstrate to a patient the changes that occur between examinations. This presentation demonstrates the utility of time-animated dental charts. Simple animation of dental charts can help to demonstrate changes that occur in dental health over time, especially to lay people in the context of health promotion or in student education.

Bernadette Drummond

Bernadette Drummond graduated at Otago and completed graduate training in the USA and England. She worked in hospital practice and general practice during her early career. She is Professor at the University of Otago where she heads the paediatric dentistry programmes including a practice-based graduate diploma programme and a clinical doctorate. She provides specialist paediatric dental services for the Southern District Health Board involving dental care for children and young adults. She is involved in research related to children’s oral health-related quality of life, outcomes of dental care and and prevention of dental diseases. Bernadette is a past President of the RACDS and ANZSPD. She has served on the board of the NZDA and chaired the Education Committee. She is actively involved in providing continuing education for dentists in New Zealand and has lectured throughout Australasia and internationally. She is on the editorial boards of two international paediatric dental journals.

Management for molar incisor hypomineralisation with and without enamel breakdown

Molar Incisor hypomineralisation (MIH) is now a well recognized entity which affects at least 15% of New Zealand children. The hypomineralisation ranges in severity from lesions with a well mineralized surface to soft brown lesions which fracture under normal occlusal load leaving teeth highly sensitive and difficult to restore. This presentation will examine the different types of lesions found in MIH and discuss options for sealing, restoration, protection and extraction to optimize the health of the teeth in the long term development of the dentition.

Lara Friedlander

Lara qualified with a Bachelor of Dental Surgery degree from Otago University in 1992. Thereafter she worked in hospitals and general practice whilst completing her Fellowship with the RACDS by examination in 1996. Since 2010 has been an active member of the NZ RACDS committee. In 1999, Lara completed her specialist training in Endodontics at Otago University and from 2008 has been a full time Senior Lecturer in Endodontics. She co-ordinates undergraduate and postgraduate clinical teaching in Endodontics and has been responsible for introducing and delivering advanced endodontic modules in rotary endodontics into the undergraduate BDS programme. She was recently invited to Switzerland to present the outcomes of this published work with other international Universities. Lara has publications and research interests in endodontic education and improving clinical teaching and is an active member of the Oral immunopathology research group within the Sir John Walsh Research Institute as an advisor and supervisor of PhD and Clinical Doctorate students. She is currently completing a PhD in Pulp angiogenesis and regenerative healing in immature permanent teeth.

The use of contemporary endodontic techniques to improve patient outcomes

Abstract: The focus of contemporary root canal treatment is more conservative than it has ever been but the way we manage cases to offer patients the most predictable long-term outcome needs planning and thought. There is a move away from drilling big holes in root canals with a greater appreciation of anatomy and the complexity of the root canal system. Instrumentation and the removal of infected dentine is only part of this process and new file systems allow us more time for disinfection. The pulp is not the “doomed organ” it was once thought, rather it has an amazing capacity for healing. Apexification procedures may be a last resort as angiogenesis and regenerative healing can be facilitated by immature cells already present in the area. Following injury to an immature permanent tooth apexogenesis with continued root development and maturation is an achievable goal with positive biological, functional and social outcomes.