Gap Magazine Implant Dentistry Today No 17

Implant Dentistry Today 32 Prediction: Personalised health providers disrupt professional services via full diagnostic workflow processes Orthodontic removable sequential aligners were first designed in 1997 by Align Technologies, the company behind the Invisalign system. It took several years for the service to become profitable. In 2016, the company reported sales of $1B and their four millionth Invisalign case. 40 of their patents expired in 2017, and subsequently 23 annually. This expiration rate continues until 2028 1 . Through 2017- 18, sales increased by almost another million and four other large dental industry companies entered the clear aligner market 2 . In 2021, there are many more companies offering this service, and the author estimates the number of Invisalign cases to be 7-8 million. Smile Direct Club launched in 2014 1,2 as a direct to public service for aligners, via retail stores and otherwise materials sent to customers by post. By 2016-17, Align Technologies had a 19% stake and became a supplier of some of SDC’s aligners. During this period, Align also set up 12 stores across USA, as a direct to public service. SDC alleged Align had breached a non-compete clause of their supply agreement, and this was subsequently upheld via legal arbitration in 2019. The non-compete clause was extended to August 2022 3, 4,5 . Align were ordered to tender their membership interest in SDC and the amount, subjected to a protracted appeal, was finalised earlier this year. In 2020, SDC announced it was selling aligners to dental professionals. These observations have led the author to form the following opinions: n Some aligner companies may enter the direct to public market, as providers of personalised health orthodontic appliances. n SDC’s engagement of dental professionals will evolve into a new service for patients to include the general and specialist profession contributing to diagnosis, design and interventions. n Other new personalised health providers will arise to compete with SDC and existing aligner companies that have ventured direct to public. n Diagnostic services in retail stores will evolve to include other aesthetic dentistry disciplines, with increased access to disruptive clinical technologies such as social and continuum robots (replacing human staff), optical coherence tomography (which replace RGB and much ionising radiation scanning), generative adversarial network-based decision support systems (GANs; for diagnosis and planning) and future technical subspecialists to communicate this data and access to clinicians across their networks. Prediction: Dentists’ training in AIML with undergraduate, postgraduate & professional development education A study in 2013, repeated in 2017 8 with similar results, found the susceptibility of dental professionals’ (including general dentists, orthodontists, oral and maxillofacial surgeons, prosthodontists and health educators) jobs to com­ puterisation was very low. Dental auxillaries and assistants were considered at medium risk and, not surprisingly, dental technicians’ jobs were considered high risk of susceptibility to computerisation. These studies were commissioned by the US Federal Government, examining 702 listed occupations across 12 labour markets, and the authors were from Oxford University 8 . In 2020, an MIT group published a larger report 9 which stated, “As technological advances displace human labour from some tasks, they spur three other forces that generate new work”: 1. Automation makes workers more productive in the tasks that are not automated. 2. Automation drives productivity increases that raise total income in the economy. 3. As automation eliminates human Prosthodontics and Dentistry 2041 This three-article series provides a brief insight into some predictions which the author believes are relevant for prosthodontics and dentistry over the next twenty years. Part two. Personalised health, AI/ML skills and education technologies By Dr Ken Hooi labour from certain tasks, tech­ nological change leads to new kinds of work. New goods and services, new industries and occupations demand new skills and offer new earnings opportunities. In 2019, a report published by the Royal Bank of Canada 10 provided an industry-specific analysis of agriculture and its labour market considerations of future automation technologies, identifying five different contributors to a farming business. It is the author’s opinion that our profession of dentistry would benefit from an analysis similar to that produced by the RBC. Defining vocational roles will assist in managing the work force during the personalised health disruption. Personalised education technologies founded in neuroscience, and incorporating artificial intelligence, were reported by an industry leader in 2016 11 . Learning systems were defined in accordance with Rote Learning (algorithmic type designs), Generative AI (neural network and GAN designs) and integrative (generative with other applications such as augmented reality) types. Integrative AI in undergraduate clinical simulation 12 and augmented reality in implant surgery 13 have already been published. It is the author’s opinion that dental education technologies are relevant at a global scale, and that these will be imminently available in professional development, undergraduate and post­ graduate environments. n Previous article September-October 2021: Clinical technologies Next article IDT – March-April 2022: Part Three. Prosthodontics and dentistry 2041 Infographic by WOW Studios Content of these articles is derived from an invited presentation of the 2021 Scientific Meeting of The International College of Prosthodontists, “Prosthodontics 2041 – Dr Ken Hooi”. For a full list of references contact gapmagazines@gmail.com