Embracing state of the art technology

Dr Thanatip: Our network, Thonburi Healthcare Group, has many hospitals. We operate a large hospital in Bangkok and medium-sized ones in upcountry provinces. We also have branches in foreign countries -- in China and Myanmar. However, for medical centre tourism we see this as the flagship hospital to accommodate foreign patients. We have also opened disease specialist centres such as Digital Dental Center, Wellness Clinic, Diabetes wound treatment centre -- which attract many foreigners -- to treat diseases needing specialist attention. They are located in the Bamrungmuang area where many Thai-Chinese people living. Bamrungmuang, Sampeng, Yaowarat and Worachak are in a two-kilometre radius from Bangkok’s famous China Town. It is the main patient base for the Thonburi group as people cross the Memorial Bridge or Somdet Phra Pinklao Bridge can visit our hospital.

Vehicles can also easily access the hospital, right?

Dr Thanatip: The new location is huge with plenty of parking lots. The design is modern.

Talk about the number of patients -- both Thais and foreigners?
Dr Thanatip: Our patients are mostly foreigners. They are from the Middle East, Western countries and some from China. Out Western patients come for dental treatments while Middle Eastern people come to treat diabetic wounds.

So, where are you going to take us to?
Dr Thanatip: I will take you the Digital Dental Center lab. We can see how digital technology helps in dental treatments, especially in cases considered very difficult, such as implant placement. For foreigners, it used to be painful -- the expense and the long time it took time, about two weeks. However, with 3D printing getting better and more widely accepted, we bought this high technology equipment from Germany.

MC: Which means implant placement can be done in one day?
Dr Thanatip: Exactly.

Then let’s see what it looks like.
One-day dental care

by Dr Vorawee Laovoravit: 

We are at the dental centre lab of Thonburi Bamrungmuang Hospital. What kind of treatments do you provide here?
Dr Vorawee: We provide all treatments -- from cleaning, polishing, teeth fillings, tooth extraction to implant placement and root canal treatment. We offer the entire range of dental treatments.

What is the highlight of the services you provide here?
Dr Vorawee: Well, we have brought the latest technology to treat our customers better. We also have our own lab to create material for dentistry use. We cover everything from dental clinic to laboratory.

However, the most talked about feature is the one-day dental care. Could you please explain?
Dr Vorawee: In the past, when we needed to make a crown first, it took a really long time.

Many days.
Dr Vorawee: Yes. You had to meet the doctor many times to continue the treatment. However, with the newest technology, we have shortened the crown-making process to one day.

We can complete the process in one day? If you come in the morning, you will go home in the afternoon? Can you tell us about the process?
Dr Vorawee: We have high technology equipment such as a 3D cavity scanner. When we drill the teeth and prepare to install a crown, we will use this equipment to scan our patient’s cavity. Usually, when scanning is finished, we used to send the data to other dentistry labs but since we have our own lab, we can send it out to the lab instantly. The lab uses a computer for analysis and shapes in the dental piece, increasing accuracy.

Less procedure but more accuracy. This is the crown-making process. What about the implant placement process? I heard many patients come here for treatments, especially seniors. Could you give us more information?
Dr Vorawee: We have a one-day implant placement service but it is only available for simple cases or for patients who have lost the front teeth. When they have to participate in an important event, we can create new front teeth for them in a day.

This also can be done in a day if you come early in the morning. How about the root-canal treatment process? Is it complicated?
Dr Vorawee: We have to prepare for dental implant surgery. First, we have to check if the tooth has been completely extracted and then arrange the implant placement. The placement that replaces the natural tooth root is made of titanium. After the implant is placed in the jawbone, we can place an abutment and a permanent crown.

Can everyone go for implant placement or is it on a case by case basis?
Dr Vorawee: It is case by case. We have to check first if you have enough bone mass volume for implantation. In the case of insufficient bone volume, patients have to increase bone volume first.

As Dr Vorawee said before, this dental centre has brought many new technologies. Could you provide us an example?
Dr Vorawee: We have a 3D oral cavity scanner and 3D X-ray technology. The previous technology used to give us a 2D result, which did not help an examination in detail. The 2D result comes on paper with tooth images from each view while results in 3D can be rotated to see it from every angle.

Then we can see it at 360 degrees.
Dr Vorawee: Correct, 360 degrees. We also take each layer out to see what happens inside the tooth providing a more accurate examination.

There is another instrument called microscope.
Dr Vorawee: It is an instrument that used to observe small objects. We usually used it for root canal treatment. Patients with decayed tooth usually receive root canal treatment, which is for tooth that has decayed but cannot be filled, but at the same time does not need to be removed. Root canal treatment starts with the tooth opening to flushed out pulp and bacteria. Then it will be filled and sealed.

Microscope is like a magnifying glass, right?
Dr Vorawee: Yes. People usually think that tooth treatment is done in narrow areas with difficulty. Normally, we do them with our bare hands and eyes. With a microscope, the doctor can see the tooth area in more detail and make a better judgement.

What about the examination room?
Dr Vorawee: We have installed a system and located a server room. Every information and scanning result of our patients will be shared with every examination room. Patients can X-ray or have 3D scanned result in every room, and all the data will be uploaded to the server. The patient can 3D-scan in A room and see other doctors in every room.

If a patient returns for another treatment, the patient’s history and information is prepared in the server and is ready for use, right?
Dr Vorawee: Yes.

Today, Dr Vorawee will guide us to the highlighted area, the digital lab. What is its speciality?
Dr Vorawee: It offers high support to the dentist and dental technicians.

Interesting. let’s look inside then.
 
A 3D approach

Now we are inside the digital dental lab where some people are at work. What is this machine for?
Dr Vorawee: This is the 3D oral cavity scanner.

How does it work?
Dr Vorawee: It works like a camera and takes photos inside the cavity. It will take a small set of pictures then process them into a 3D model of the patient’s tooth.

What can we see?
Dr Vorawee: Everything. We can rotate the 3D model of the patient’s tooth. When we make a crown, we can retrieve information and scan the result from the server instead.

Can you provide overall information in this lab?
Dr Vorawee: Well, we have working space. After scanning the patient’s oral cavity, we will use the information to design the crown or plan the placement implantation by computer.

Another thing you mentioned is shaping the crown.
Dr Vorawee: Yes. The shaping station is in another room.

Can you explain the shaping process?
Dr Vorawee: We use cubed premixed material then put it into the machine that works like a grinder and lathe. It will slowly and accurately grind it into the tooth shape.

What are the placement and crown made of?
Dr Vorawee: The placement is made of titanium while the crown uses ceramic, which provides the yellowish-white colour like a natural tooth. We rarely use metal as a material.

You also mentioned the 3D printer in this lab.
Dr Vorawee: The 3D printer works like a normal printer but the outcome is 3D not 2D on the paper. After 3D scanning, the doctor who really needs to print out the result will bring the model of the teeth out.

Since the hospital owns the dental lab, it is much easier to work. How about the patient?
Dr Vorawee: They will receive faster service from examination to the dental price process since everything happens here. Secondly, the quality of the work is controlled by dentists as it was an internal work. Third, since the work is done by a computer, there is no scope for human error.

We have received much information from the dental centre at Thonburi Bamrungmuang Hospital. All technologies have been installed to give patients the best treatment. Our thanks to Dr Vorawee.