ISBN – “978-81-959741-1-5”

RECENT TRENDS AND INNOVATIONS IN DENTISTRY

Col. (Retd.) Dr. Ravindra V. Manerikar1, Dr. Pooja Shah2,

Dr. Apoorva Tonde3, Dr. G. Chandra Sekhar4, Dr. T. P. Chaturvedi5,
Dr. Veera Bhosale6
1Professor and Principal, Department of Orthodontics, Rural Dental

College, PIMS, Loni

2Lecturer in Department of Orthodontics, PIMS, Rural Dental College,

Loni
3MDS 1st Year Student in Department of Orthodontics, Rural dental

College, Loni
4Professor and Head in Department of Orthodontics, Panineeya Dental

College, Hyderabad
5Professor and Head, Faculty of Dental Sciences, BHU, Varanasi

6Professor and Head in Bharati Vidyapeeth dental college, Katraj, Pune

Abstract - The digital transformation in dental medicine, based on

electronic health data information, is acknowledged as one of the major
game-changers of the 21st century to tackle present and forthcoming
challenges in dental and oral healthcare. This chapter focuses on the
estimated trends and innovations of this new digital era, with the
potential to influence the direction of dental research.
Digital dentistry needs to manage expectations pragmatically and
assuring transparency for all stakeholders: patients, healthcare
providers, university and research institutions, the MedTech industry,
insurance, public media, and state policy. It should not be claimed or
indicated that digital smart data technologies will replace humans
providing dental expertise and the capacity for patient empathy. The
dental team that controls digital applications remains the key and will
continue to play the central role in treating patients. In this context, the
latest trend word is created: augmented intelligence, e.g., the meaningful
combination of digital applications paired with human qualities and
abilities in order to achieve improved dental and oral healthcare,
ensuring the quality of life.

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ISBN – “978-81-959741-1-5”
1 INTRODUCTION
Digital transformation is the universal catchword in a variety of business
sectors, and (dental) medicine is no exception. Continuous progress in
information technology (IT) has made it possible to overcome the
limitations and hurdles that existed in clinical and technological
workflows just a few years ago.
In dental medicine, several digital workflows for production
processing have already been integrated into treatment protocols,
particularly in the rapidly rising branch of computer-aided design/
computer-aided manufacturing (CAD/CAM) and rapid prototyping (RP).
New opportunities have opened up for automated processing in
radiological imaging using artificial intelligence (AI) and machine
learning (ML). Moreover, augmented and virtual reality (AR/VR) is the
technological basis for the superimposition of various imaging files
creating virtual dental patients and non-invasive simulations comparing
different results before any clinical intervention. Increased IT power has
promoted these profitable and promising technologies, whose possible
uses can only be assessed in the future.
To sum up, unseen possibilities will arise due to digital
transformation in oral healthcare and dental research. Therefore, this
chapter highlights the estimated top healthcare trends and innovations
of the dawning digital era that might influence the direction of dental
research and its stakeholders in the near future.

2 TOP HEALTHCARE TRENDS AND INNOVATIONS

1. RAPID PROTOTYPING (RP)
RP is a method to quickly and automatically construct three-dimensional
(3D) models of a final product or a part of a whole using 3D-printers. The
additive manufacturing process permits the inexpensive production of
complex 3Dgeometries from various materials and minimal material
wastage. However, while the future looks very optimistic from a
technical and scientific point of view, it is not clear how RP and its
products will be handled.
In dentistry, one of the main problems today is the choice of
materials. Commercially available materials commonly used for RP are

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ISBN – “978-81-959741-1-5”
currently allowed for short to medium-term intraoral retention only and
are, therefore, restricted to temporary restorations and not yet aimed for
definitive dental reconstructions.
RP offers great potential in dental technology for mass production
of dental models, but also for the fabrication of implant surgical guides.
For those indications, prolonged intraoral retention is not required.
From an economic point of view, a great benefit is the production in large
quantities at the same time in a reproducible and standardized way.
Another crucial area of application is the use of 3D-printed models
in dental education based on CBCT or μCT. An initial analysis, however,
has revealed that 3D-printed dental models can show changes in
dimensional accuracy over periods of 4 weeks and longer.
In the near future, those material-related barriers and limitations
will likely be broken down. Many research groups are concentrating on
the evolution of printable materials for dental reconstructions, such as
zirconium dioxide (ZrO2). This different mode of fabrication of ZrO2
structures could allow us to realize entirely innovative geometries with
hollow bodies that might be used, for example, for time-dependent low-
dose release of anti-inflammatory agents in implant dentistry. A
completely revolutionary aspect would be the synthesis of biomaterials
to artificially build lost tooth structures using RP technology. Instead of
using a preformed dental tooth databank, a patient-specific digital dental
dataset could be acquired at the time of growth completion and used for
future dental reconstructions. Likewise, the whole tooth can be
duplicated to serve as an individualized implant. RP will most likely offer
low-cost production and highly customized solutions in various fields of
dental medicine that can be tailored to suit the specific needs of each
patient. [1]

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Fig.1 [2]

2. AUGMENTED AND VIRTUAL REALITY (AR/VR)

AR is an interactive technology improving a real-world environment by
computer-animated perceptual information. In other words, AR expands
the real world with virtual content. In most cases, it is the
superimposition of additional digital information on live images or
videos. VR, in contrast, uses only artificial computerized scenarios
without relation to reality. Relying on the method, every conceivable way
of sensation can be used, mainly visual, auditory, and haptic,
independently or in any combination. Today, there is a rapidly improving
number of applications for AR/VR technologies in dental medicine as a
whole, as well as many fascinating developments for both patients and
healthcare providers.
AR/VR software allows users to superimpose virtually created
visualizations onto recordings of the patient in natural motion. Any 3D-
model, for instance, a prosthetic design of a possible reconstruction, can
be augmented into the individual patient situation to simulate diverse,
prospective effects in advance without invasive work steps. These digital
models can then be viewed in realtime and facilitate communication not
only with the patient to demystify the complex treatment steps but also
between dental professionals to make the treatment more predictable

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ISBN – “978-81-959741-1-5”
and efficient. In the future, the possibilities will continue to grow and
help promote the dental routine. An interesting manifestation is the
augmentation of CBCT-based virtual implant planning directly into the
oral cavity or while using intraoral scanners (IOS), projection, and
display of the optically detected area with AR glasses.
Another promising area of interest is the sector of dental education,
assigning theoretical knowledge and practical exercises to offer
interactive teaching with 24/7-access and objective evaluation. AR/VR-
based motor skill training for tooth preparation especially facilitates
efficient and independent learning for dental students. Initial studies
have shown that AR/VR technologies stimulate more senses to learn
meritoriously. Moreover, in postgraduate education, challenging and
complex clinical protocols can be trained in a complete virtual
environment without risk or harm for real patients; additionally,
specialists can continuously maintain their skills while training with
AR/VR-simulations. Within a few years, AR/VR will have the potential to
revolutionize dental education radically.

Fig. 2

3. ARTIFICIAL INTELLIGENCE (AI) AND MACHINE LEARNING (ML)

AI (including ML) has already invaded and established itself in our daily
lives, although in more subtle means, such as virtual assistants named
“Siri” or “Alexa”. The basis for AI is the increasing power of computers to
think like and complete tasks currently performed by humans with
greater speed, accuracy, and lower resource utilization. Therefore, AI
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ISBN – “978-81-959741-1-5”
technology is perfect for work that requires the analysis and evaluation
of large amounts of data. Repetitive activities are boring and exhausting
for humans in the long-run with high risk of error, while AI-based
applications do not show signs of fatigue. In contrast to humans, the
artificial learning process results in constant better performance with
increasing workload. Additionally, computers are not biased compared
to humans, who come with innate biases and may judge things
prematurely and differently from each other.
The most valuable indication for the use of AI and ML in dentistry is
the entire field of diagnostic imaging in dento-maxillofacial radiology.
Currently, applications and research in AI purposes in dental radiology
focus on automated localization of cephalometric landmarks, diagnosis of
osteoporosis, classification/segmentation of maxillofacial cysts and/or
tumours, and identification of periodontitis/periapical disease. Computer
software analysing radiographs has to be trained on huge datasets (“big
data”) to recognize meaningful patterns. The diagnostic performance of
AI models varies among different algorithms used, is also dependent on
the observers labelling the datasets, and it is still necessary to verify the
generalizability and reliability of these models by using adequate,
representative images. AI software must be able to understand new
information presented by images as well as written text or spoken
language with proper context. Finally, the software must be able to make
intelligent decisions regarding this new information, and then, learn from
mistakes to improve the decision-making for future processing.
A beneficial AI system should realize all of this in about the same
time that a human being can perform the given task. Up to now,
applications of AI on a broad scale were not technically feasible or cost-
effective, so the reality of AI has not yet matched the possibilities in
routine dental applications, although the technical progress is
exponential, and very soon, a large number of AI models will be
developed for automated diagnostics of 3D-imaging identifying
pathologies, prediction of disease risk, to propose potential therapeutic
options, and to evaluate prognosis.

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ISBN – “978-81-959741-1-5”

Fig.3

Fig.4 [3]

4.PERSONALIZED (DENTAL) MEDICINE

Electronic health records (EHR) with standardized diagnostics and
generally accepted data formats are the mandatory door opener to
personalized medicine and predictive models investigating a broader
population. The structured assessment and systematic collection of
patient information is an effective instrument in health economics.
Health data can be obtained from routine dental healthcare and clinical
trials, as well as from diverse new sources, as IoT in general, and
specifically, data on the social determinants of health.
The linkage of individual patient data gathered from various
sources enables the diagnosis of rare diseases and completely novel
strategies for research. Examining large population-based patient
cohorts could detect unidentified correlations of diseases and create
prognostic models for new treatment concepts. The linkage of patient-
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ISBN – “978-81-959741-1-5”
level information to population-based citizen cohorts and biobanks
provides the required reference of diagnostic and screening cut-offs that
could identify new biomarkers through personalized health research.
EHR has great power for a change of research both ways. On the
other side, the digitized transparent patient could be stigmatized and
categorized by insurance companies, provoking adverse effects that have
not yet been determined socially. Therefore, linked biomedical data
supporting register-based research pose several risks and
methodological challenges for clinical research: appropriate security
settings and the development of algorithms for statistical calculations,
including interpretation of collected health data. A generally accepted
code of conduct has to be defined and established for the ethical and
meaningful use of register-based patient data.
Overall, personalized medicine holds the key to unlocking a new
frontier in dental research. Genomic sequencing, combined with the
developments in medical imaging and regenerative technology, has
redefined personalized medicine using novel molecular tools to perform
patient-specific precision healthcare. It has the potential to revolutionize
healthcare using genomics information for individual biomarker
identification. The vision is an interdisciplinary approach to dental
patient sample analysis, in which dentists, physicians, and nurses can
collaborate to understand the inter-connectivity of disease in a cost-
effective way.

Fig.5 [4]
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5. TELE-HEALTHCARE
Tele-healthcare enables a convenient way for patients to increase self-
care while potentially reducing office visits and travel time. Considering
the growing number of the elderly population with reduced mobility
and/or nursing homestay, special-care patients, as well as people living
in rural areas, these patient groups would benefit significantly from tele-
dentistry. Measures to be taken in case of dental trauma can be
effectively communicated by telephone counsellors and can be
frequently used during out-of-office hours. In general, it facilitates easier
access to care and also represents a cost-reduced option for patients, as
instead of expensive treatments, tele-dentistry shifts towards prevention
practices and allows patients to consult with otherwise unavailable
dental professionals, for example, using a live consult via video-
streaming. Nevertheless, it must be emphasized that tele-dentistry can
never replace a real dentist; rather, it must be understood as an
additional tool.
Today, tele-dentistry is only in an early start-up phase. Early
studies have mainly focused on specific and rare diseases that might
require surgery, but there are findings that suggest that a teleradiology
system in general dental practice could be helpful for the differential
diagnosis of common lesions and may result in a reduction of
unnecessary costs. There is a fundamental need to regulate the
expanding field of tele-healthcare, with guidelines to secure clinical
quality standards. The legislation must be clearly defined and clarified
for routine implementation of a national-wide tele-dentistry platform.
The technical requirements must be met and security standards for
sensitive patient information guaranteed, with well-defined regulatory
affairs.

Fig. 6
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6. LASER DENTISTRY
Like 3D printing, laser dentistry is also one of the biggest trends in
dentistry. Before laser dentistry, procedures like filling cavities and
repairing damaged gums required invasive and often painful treatments.
In some cases, laser technology can even replace dental drills to remove
or reshape tissue, remove cavities, repair fillings, and more.
Laser dentistry allows for minimally invasive oral surgery, reducing
the need for sutures. It also allows for less bleeding, little to no pain,
faster healing, and a reduced risk of infection.
Laser technology is the most in-demand and fastest-growing field
in dentistry. The reason for this is the variety of applications and benefits
lasers offer. From teeth whitening to fighting tooth decay, removing
lesions, reshaping the gums, killing oral bacteria, and much more, lasers
can do it all. Besides the versatility of lasers, the main benefits are the
accuracy and speed at which treatment may be given. This means a
tangible increase in patients' comfort levels, both in terms of far less pain
and discomfort and reduced treatment times. Another benefit is the
reduced recovery and healing time.

Fig. 7
7. CAD/CAM
CAD/CAM technologies have started a new age in dentistry. The quality
of dental prostheses has improved significantly by means of standardised
production processes. This makes very efficient quality management
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ISBN – “978-81-959741-1-5”
possible. On the one hand it increased the productivity tremendously and
changed dental laboratories from manufacturers to modern
computerised production centres. On the other hand, this increase in
productivity leads to a competitive capability to produce dental
prostheses independent of the manufacturing site, which might be a
major factor for the high wage countries to keep business volume in the
country. Last but not least CAD/CAM technology has made it possible to
machine interesting new materials like the high-performance ceramics
and titanium with high accuracy.
However, some drawbacks of this fabrication technology have to be
mentioned. The high investment for machines might overextend the
budget of smaller laboratories. Some applications are limited due to
software and production procedures.
CAD/CAM technology has already changed dentistry and will
replace more and more of the traditional techniques in fabricating dental
restorations. [5]

Fig.8

3 SOME RECENT INNOVATIONS IN DENTISTRY:

3.1 Smart toothbrush:
Our home will be filled with connected, smart devices in the future, so
why would our bathroom be an exception. At first, it might feel a bit
strange to let a sensor into one of your most intimate activities, tooth
brushing, but it makes a lot easier to maintain oral hygiene and prevent
plaque or cavities.
The Kolibree smart electric toothbrush makes sure you are
brushing your teeth the right way through its app and offers kids fun

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games to keep up the good habit of regularly cleaning their teeth. Philips’
Sonicare smart toothbrush comes packed with sensors in its handle.
These provide real-time feedback via a companion app warning you if
you are applying too much pressure, where you are brushing and even
coach the user as to how to brush properly. And there are several such
devices on the market from companies like Colgate and Oral-B.

Fig.9

While having a personal coach to optimise your daily oral hygiene might
sound enticing, not everyone is enthusiastic about the technology. Firstly,
dental experts emphasise the need for proper brushing techniques which
these devices won’t improve upon. Rather, it’s a dental professional who
can demonstrate the proper techniques at your next appointment.
Additionally, by buying smart toothbrushes from companies like
Procter & Gamble and Philips Oral Healthcare you agree to their privacy
policies that enable them to share your data with third parties. Now that
health data is the new oil, companies will want to profit off of these in as
many ways as possible.
So, you might want to adopt a smart toothbrush from a company
that gives you more control over your data or one that doesn’t share it
with third parties at all.

3.2 Intra-oral camera:

One of the greatest inconveniences while being seated in the dentists’
chair is that sometimes, no matter how wide you open your mouth, the
dentist still cannot see what they would like to see, even by using the
trusty dental mirror. Such situations are not only uncomfortable for both
the patient and the doctor, but also painful. However, the advent of intra-
oral cameras can remedy this exact problem.
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Fig.10

Mouth Watch and Carestream Dental are some of the many companies to
have launched intra-oral cameras on the market. The latter promises
revolutionary cameras, which are real “patient conversation starters.”
The camera’s unique liquid lens technology works like the human eye to
ensure effortless image capture to deliver clear, detailed images patients
can really understand. [6]

4 CRISPR
CRISPR is a ground-breaking genome editing method offered by Mother
Nature herself, but researchers have discovered its immense potential
only recently. As explored in our dedicated articles, it might become the
ultimate weapon against cancer or, more controversially, help design
babies in the future. And the field of dentistry will also benefit from the
technology as well.
Chinese researchers are conducting studies with the technology to
isolate and switch off oral cancer-associated genes. Other researchers are
using CRISPR to alter the functioning of bacteria responsible for plaque
formation. Their endeavour could even lead to the reduction or outright
prevention of dental caries and periodontal disease. But please don’t give
up on brushing your teeth just yet!

Fig.11
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ISBN – “978-81-959741-1-5”
5 CONCLUSION
The future direction of dental research should foster the linkage of oral
and general health in order to focus on personalized medicine
considering patient entered outcomes. In this context, dental research
must have an impact as a deliverable to society, not just research to
churn out scientific publications but to truly change protocols applied in
the clinic. Moreover, here, digitization with AI/ML and AR/VR represents
the most promising tools for innovative research today. Furthermore,
research in a digital era will also be more and more assessed in terms of
“impact” as a deliverable good.
For digital dentistry, this requires managing expectations
pragmatically and ensuring transparency for all stakeholders: patients,
healthcare providers, university and other research institutions, the
MedTech industry, insurance, public media, and state policy. It should
not be claimed or implied that digital smart data technologies will
replace humans who possess dental expertise and the capacity for
patient empathy. Therefore, the dental team controlling the power of the
digital toolbox is the key and will continue to play a central role in the
patient’s journey to receive the best possible individual treatment, and to
provide emotional support. The collection, storage, and analysis of
digitized biomedical patient data pose several challenges. In addition to
technical aspects for the handling of huge amounts of data, considering
internationally defined standards, an ethical and meaningful policy must
ensure the protection of patient data for safety optimal impact.
Nowadays, the mixed term “augmented intelligence” is perhaps
somewhat prematurely introduced in social media. However, the benefits
of digital applications will complement human qualities and abilities in
order to achieve improved and cost-efficient healthcare for patients.
Augmented intelligence based on big data will help to reduce the
incidence of misdiagnosis and offers more useful insights—quickly,
accurately, and easily.

REFERENCES
1. Joda, T.; Bornstein, M.M.; Jung, R.E.; Ferrari, M.; Waltimo, T.; Zitzmann, N.U.
Recent Trends and Future Direction of Dental Research in The Digital Era. Int. J.

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ISBN – “978-81-959741-1-5”
Environ. Res. Public Health 2020, 17, 1987.
https://doi.org/10.3390/ijerph17061987
2. Danial Khorsandi, Amir Fahimipour, Payam Abasian, Sepehr Sadeghpour Saber,
Mahla Seyedi, Sonya Ghanavati, Amir Ahmad, Andrea Amoretti De Stephanis,
Fatemeh Taghavinezhaddilami, Anna Leonova, Reza Mohammadinejad, Majid
Shabani, Barbara Mazzolai, Virgilio Mattoli, Franklin R. Tay, Pooyan
Makvandi,3d and 4d Printing In Dentistry And Maxillofacial Surgery: Printing
Techniques, Materials, and Applications, Acta Biomaterialia, Volume 122, 2021,
Pages 26-49, Issn 1742-7061, https://doi.org/10.1016/j.actbio.2020.12.044.
(https://www.sciencedirect.com/science/article/pii/s17427061 20307674
3. Agrawal P, Nikhade P (July 28, 2022) Artificial Intelligence in Dentistry: Past,
Present, and Future. Cureus 14(7): E27405. Doi:10.7759/cureus.27405. doi:
10.7759/cureus.27405.published: july 28, 2022
4. Dascalu, Cristina & Oniciuc, Cosmin & Zegan, Georgeta. (2012). An Algorithm to
Identify the Kennedy Classes in Partial Reduced Edentulism. Advances in
Applied Information Science. 219-224.
5. Beuer, F., Schweiger, J. & Edelhoff, D. Digital Dentistry: An Overview of Recent
Developments for Cad/Cam Generated Restorations. Br Dent J 204, 505–511
(2008).
https://doi.org/10.1038/sj.bdj.2008.350
6. Dr.Mesko Bertalan, the Medical Futurist. (12th April 2022). Technologies That
Will Shape the Future of Dentistry. https://medicalfuturist.com/the-amazing-
futureof- dentistry-and-oral-health/

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