Review links pay to patient numbers / DH guidance ‘logistical nightmare’ / News & Opinions / Creating perception: building reality / Endo Tribune 2/2009 (part1) / Endo Tribune 2/2009 (part2) / Endo Tribune 2/2009 (part3) / Performing dentistry / Trust the system / Welcoming new patients / Industry News / Make Hawaii happen
Review links pay to patient numbers
01 - 02 viewDH guidance ‘logistical nightmare’
03 - 03 viewNews & Opinions
04 - 08 viewCreating perception: building reality
09 - 10 viewEndo Tribune 2/2009 (part1)
11 - 14 viewEndo Tribune 2/2009 (part2)
15 - 18 viewEndo Tribune 2/2009 (part3)
20 - 21 viewPerforming dentistry
22 - 22 viewTrust the system
23 - 23 viewWelcoming new patients
25 - 25 viewIndustry News
26 - 29 viewMake Hawaii happen
30 - 30 viewArray
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DTUK1809_01_Title
DENTAL TRIBUNE
The World’s Dental Newspaper · United Kingdom Edition
PUBLISHED IN LONDON
News in brief
JULY 13–19, 2009
News
VOL. 3 NO. 18
Endo Tribune
Education
DCPs
Sadly missed
Interesting findings
Canal anatomy
Performing dentistry
First impressions
A ‘shameful’ lack of IT investment
and patient confusion over what
the NHS actually offers in terms of
dentistry are revealed in Jimmy
Steele’s review.
In this case report, Siju Jacob suggests that if you don’t recognise
and treat aberrant canal anatomy,
it can affect the prognosis of endodontic treatment.
In 2006, when the old NHS system
came to an end, the dental associate
made way for the dental performer.
But what is the difference and has
the change been for the better?
Although it takes the whole team
makes a new patient feel at home,
it’s the receptionist who will at first
influence a new patient’s opinion
of a practice.
page2
page11
page22
page25
LDC chair
Mick Armstrong, a representative on the British Dental Association’s General Dental Practice Committee, has been
elected as chair of the Local
Dental Committees for 2010/
2011. He said: ‘I would like to
give the annual conference a
bit of life and get dentists united
as much as possible under this
awkward new contract.’
Review links pay to patient numbers
Professor Jimmy Steele, author
of the report wants to see dentists
‘more explicitly accountable’ for
providing high-quality and longlasting treatments (eg, fillings and
root canals). He also wants to see
more of a focus on prevention with
dentists taking the time to advise
patients on preventive care.
Free treatment
A singing dentist in Richmond,
West London is awaiting the
release of his debut album after securing a £1 million
record deal with SonyBMG.
Andrew Bain, began singing in
choirs at a young age, went on
tour with Cameron Mackintosh’s production of Les Misérables in 1999 and Bill Kenwright’s Whistle Down the
Wind in 2002 and signed his
million pound contract last
July. He currently works two
days a week at the Park Dental
Clinic in Upper Richmond
Road West.
To see him in action, visit myspace.com/andrewbainsings.
www.dental-tribune.co.uk
T
he long-awaited independent review into NHS dentistry wants dentists’ pay
linked to how many patients are on
their books.
The Independent Review of
NHS Dental Services, looks set to reverse the reforms of the 2006 contract, with dentists being paid for the
number of treatments they provide.
Critics claimed that this has led
to patients tending to have their
teeth extracted rather than have
fillings or crowns, as it is more profitable for dentists to take a tooth out,
than to try to save it with complex
treatments such as crowns or
bridges.
Before the contract, dentists
were paid per procedure, but after
it came in they were paid to provide
a specific rate of procedures in the
coming year.
People in many parts of the UK
have had problems accessing an
NHS dentist since the new contract
came in.
It is hoped that by linking dentists’ pay to patient registration, this
will encourage dentists to take on
more NHS patients.
Under the recommendations,
dentists would have a ‘significant
chunk’ of their annual income –
possibly as much as 50 per cent –
linked to the number of patients on
their books.
We have recommended some
significant changes to the system by
which dentists are paid in order to
support their work with patients to
improve oral health, prevent oral
disease and provide treatment of
the highest quality.’
The BDA has urged the Government to heed the report’s recommendation to pilot properly any reforms it introduces as a result of this
report.
The report’s recommendations appear to be far-reaching.
They describe a new approach to
dental care that dentists hope will
mean a move away from the target-driven arrangements that are
currently in place. Clearly, the detail of how that approach will be
delivered will be vital.’
John Milne, chair of the BDA’s
General Dental Practice Committee, said: ‘The BDA is pleased that
this report has been published.
Professor Steele and his team
DENTSPLY Procedures
W
DT page 2
Indirect Restorations
fi
Record deal
Professor Jimmy Steele
Professor Steele said: ‘This review is a vision of a better deal for
both patients and dentists. It’s about
making sure that patients can see
an NHS dentist who will take longterm responsibility for their care.
have clearly listened carefully to
patients, dentists and primary
care trusts. We have an opportunity to learn from the difficulties
of 2006, and it is vital that opportunity is taken.
S
Y
D
PL
TS CE N uk
N TI OU .co.
DE AC P tsply
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E R
N P N .de
O E LIO ww
N
O IL a t w
M ore
E
N ut m
O nd o
A dentist in Edinburgh is giving free dental treatment
worth thousands of pounds to
children affected by the Chernobyl nuclear disaster.
Biju Krishnan, who runs the
Scottish Dental Implant Centre in Edinburgh, has been
treating the teeth of 25 Belarussian children from the
town of Mogilev in Belarus.
The Friends of Chernobyl’s
Children organisation have
brought the children over for a
month’s treatment with Dr Krishnan providing free dental
examinations and treatments.
He said: ‘The children can
have terrible teeth because of
the conditions back home –
their poor diets and the poor
agriculture thanks to the radiation effects – and we have to
try and counter that here.’
The average lifespan of those
affected by the disaster is 30
years old.
The review has been welcomed
by The British Dental Association
(BDA), which has called on the
Government to work constructively with patients and the profession on its findings.
Cross Infection Control
Rotary Endodontics
Anterior Restorations
Posterior Restorations
Periodontal Treatment
The report also wants dentists
to give a clearer definition of the patients’ rights upon registering with
an NHS dentist and for there to be a
simpler registration process with
dentists, with information on local
services made available through
NHS Direct or the NHS Choices
website.
Patients will still pay NHS
charges, which cover about 80 per
cent of the cost of treatment, but
these may be divided into up to 10
payment bands, compared with the
existing three, to tie them more
closely to the amount of work done.
Gain
verifiable
DENTSPLY Rotary Endodontic Team
Embrace Endodontic Success
Health Secretary Andy Burnham welcomed the review and said
access to NHS dentistry is already
improving and new NHS dental
surgeries are opening up all over
the country.
He accepted the recommendations in ‘principle’ and said: ‘From
the autumn, many will be asked to
pilot the changes that the review
has recommended. I recognise that
more needs to be done to bring NHS
dentistry up to the standards that
the patient should expect.’
CPD
with our sales
specialists
Mrs ProTaper Universal lies at the centre of most successful
Endodontic procedures in the UK*.
Due to her unique shape, she cuts quickly ensuring efficiency, whilst
maintaining flexibility whether you are heading straight or into a curve.
She doesn’t mind how experienced you are, whether you are a GDP who
hasn’t used her before or an endodontist, she’s high quality and easy to
work with, ensuring excellent and consistent results every time.
She’s a true exception – let her be at the centre of your
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UKP00203
A dentist from Worcester has
been killed in a motorbike accident. Father-of-two, John
Bue from the NHS Dines Green
dental surgery on Gresham
Road, died in Worcestershire
Royal Hospital, following an
accident on the A4440.
Councillor Margaret Layland,
who helped Dr Bue set up his
surgery in 2002, said her ‘great
friend’ who believed in free
healthcare for everyone would
be ‘sadly missed’.
enquiry.uk@dentsply.com
w
y co.uk www
ww.dentsply.co
y m
www.dentsply.
[2] =>
DTUK1809_01_Title
2
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
News
Review links pay to patient numbers
help look after Britain’s oral
health.
DT page 1
He added: ‘What is important
now is that the Government pilots
properly the changes it makes and
engages fully with the profession
and patient groups as we move
forward. The BDA looks forward
to playing a full part in that
process.’
Prior to the report’s publication,
Dr Milne speaking at the annual
conference of Local Dental Committees said that he hoped the report would enable dentists and the
public to move on ‘from the current
climate of mistrust’.
Patients are confused about NHS charges and treatments.
Lack of IT funding
‘quite shameful’
P
rofessor Jimmy Steele, who
led the independent review
into NHS dentistry, has
called the lack of IT investment
into dentistry ‘quite shameful’.
Professor Steele, who has
been carrying out research into
the state of NHS dentistry over the
last six months, spoke about his
findings at the annual conference of Local Dental Committees
in London, just prior to the publication of the report.
He revealed that a big reason
he took on the task given to him
by the Government was that he
was ‘very concerned’ about the
state of NHS dentistry.
He revealed that researching
‘The Independent Review of NHS
Dental Services’ has been difficult and he has had to deal ‘over
the last six months with some
very conflicting viewpoints’.
‘I have had to deal with a profession that is hostile to the reforms and you cannot have a
good dental service if you don’t
have happy dentists.
I was also dealing with an
NHS that was telling me that
more money had been put into it
but there are fewer patients being treated.
I felt like a man on a tightrope
trying to keep my balance and
trying to keep my balance for you.
Of course I recognise that there
are priorities for the NHS as there
is a fixed pot of money and we
have spent a lot of time thinking
about these priorities,’ he said.
Professor Steele did have
praise for NHS dental care and
said: ‘There are many patients
who are receiving outstanding
care from the NHS and it is excellent value for money. I would
rather have the NHS dental care
in this country than quite a lot of
the care that is being provided in
the developed world.’
However, on the negative
side, he found that ‘some patients
are not able to access care and
added: ‘I am really concerned
that some of the best dentists are
unable to provide the best care
they want to provide.’
He also expressed concern
about the ‘highly variable commissioning’ that takes place now
it is all done at a local level’ and
said: ‘There needs to be more robust performance management
from the PCTs and better coordination of information and better
data and improved use of data.’
One of the core reforms of the
2006 contract was the move to local commissioning.
So one of the real issues, since
it came in, has been the competence of the PCTs.
‘Where it is done well, you
have the local dental committee, commissioners and chief
executives fully engaged in the
process,’ he said.
He also dealt with the problem of UDAs (units of dental activity) and said: ‘There is unrealistic remuneration for certain
procedures and to have the UDA
as a sole measure of payment is
wrong’.
Another problem with the
current contract is that the NHS
offer is unclear so ‘patients are
confused about charges and
what treatments are available
on the NHS’.
He also feels there is a problem with the image of dentists
and called them ‘fairly unpopular’, second on people’s dislike
list only to lawyers and politicians.
To reverse this trend, there
needs to be ‘high level support
for dentistry’ and from all political parties and said: ‘That commitment is really important’. DT
The British Dental Health
Foundation (BDHF), praised Professor Steele and his team for their
work following an open and widereaching consultation process,
and welcomed the emphasis on
prevention and evidence-based
treatment to support better oral
healthcare.
Foundation chief executive Dr
Nigel Carter said: ‘This thorough
report and its proposals represent
a sorely-needed opportunity to
reform the existing system and
The Foundation is particularly
happy to note the emphasis on prevention and reward for prevention
within the system, which will help
more of us attain a sound level of
dental hygiene to help look after
our health.
The review marks a welcome
return to continuity of treatment
through patient registration and
the report’s emphasis on thorough
oral health assessments to determine necessary treatment and a
strong evidence base for any decisions are pleasing.
The proposed ‘pyramid of need’
approach, addressing advanced
care, routine care and emergency
treatment, is a sensible plan to ensure effective treatment when required.
We also welcome a commitment to testing any proposals before they are implemented as many
of the existing problems with NHS
dentistry arose from a lack of thorough groundwork before contracts
were introduced.’
Tony Reed, executive director
of the British Dental Trade Association also welcomed the focus on
preventative care.
He said: ‘I am particularly
pleased with the emphasis on quality and the recognition of the role
that oral health should play in the
public-health arena.
I have no doubt that some dentists will be disappointed that
there is no quick fix for the UDA
but the commitment to trialling
better payment systems, based on
outcomes rather than treatments,
is an encouraging step in the right
direction. We look forward to
working with the Government
and other interested parties to
help implement the report’s recommendations.’
The Department of Health will
now work with the NHS to develop
national quality measures for NHS
dentistry and discuss with the dentistry profession how to take forward recommendations that dentists should provide a longer guarantee for some work, and pay for a
replacement if the treatment fails
prematurely. DT
Dentists call for consistency
D
entists at the Local Dental
Committees’ conference
debated the 2006 dental
contract and called for more consistency from primary care trusts.
They also held a vigorous debate on
whether the Government should
fund the General Dental Council
(GDC).
Alasdair
McKendrick
of
Northamptonshire LDC, claimed
dentists will no longer be regulating themselves from this October,
as there will be more lay members
on the GDC than dentists.
The Council currently has 29
council members – 10 are members of the public appointed by
the NHS Appointments Commission, and 19 are dental professionals (15 dentists and four dental hygienists and therapists)
elected by dental professionals.
Under the restructure in October, there will be 12 lay members,
eight dentists and four dental
care professionals (dental hygienists, dental therapists, dental
nurses, dental technicians, or-
thodontic therapists, clinical
dental technicians). A chair will
be elected from within the membership of Council (dental professional or lay).
tivity) said: ‘You all know they are
corrosive and we need to be rid of
them or if not, see them lose some
of their power’.
He also referred to the relationship between dentists and primary
care trusts (PCTs) and said: ‘A good
relationship between the Local
Dental Committees and the PCTs
needs to exist.’
John Milne, chair of the BDA’s General Dental Practice Committee
However, Jason Stokes for Norfolk LDC argued that although he
didn’t like the structure of the GDC,
its role is to protect the patient and
therefore it needs lay members on
the panel.
‘I don’t want to be regulated by
the Government. At the moment it
is still our regulatory body,’ he said.
John Milne, chair of the BDA’s
General Dental Practice Committee, speaking on the contentious
subject of UDAs (units of dental ac-
Ian Gordon, an LDC representative from Tees put many of
the problems of the new contract
at the door of the PCTs. He said: ‘It
didn’t help that the PCTs were in
an embryonic stage when the
new contract was brought in. But
I also find that you go to all that effort building up a good relationship with the PCT then the person
you have been dealing with
moves on and you have to start all
over again.’
There was also a call for all PCTs
to be consistent within a Strategic
Health Authority region in their
policies towards UDA (units of dental activity) achievement. DT
International Imprint
Executive Vice President
Marketing & Sales
Peter Witteczek
p.witteczek@dental-tribune.com
DENTAL TRIBUNE
The World’s Dental Newspaper · United Kingdom Edition
Published by Dental Tribune UK Ltd
© 2009, Dental Tribune UK Ltd. All rights reserved.
Dental Tribune UK Ltd makes every effort to report clinical
information and manufacturer’s product news accurately, but
cannot assume responsibility for the validity of product claims,
or for typographical errors. The publishers also do not assume
responsibility for product names or claims, or statements made
by advertisers. Opinions expressed by authors are their own and
may not reflect those of Dental Tribune International.
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Torsten Oemus
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[3] =>
DTUK1809_01_Title
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
News
3
DH guidance ‘logistical nightmare’
N
HS dentists in England are
calling for extra funding
to help them implement
the decontamination guidance
issued by the Department of
Health.
Dentists at the Local Dental
Committees’ (LDC) annual conference voiced their concerns
over the extra time, extra staff
and extra equipment needed to
implement HTM 01-05.
The Department of Health
produced this guidance in response to emerging evidence
around the effectiveness of decontamination in primary care
dental practices and the possibility of prion transmission through
protein contamination of dental
instruments.
equipment, he or she will have to
show how it will be cleaned.
All practices will have to have
a rota in place detailing how all
the areas in the dental practices
are cleaned. The guidance also
stipulates that single use instruments are used wherever possible.
When cleaning instruments and equipment, manual
cleaning is still acceptable according to the guidelines but
automated and validated
processes need to be used
where possible.
Ms Derry said: ‘These are national guidelines but PCTs will be
able to adapt them as they see
suitable.’
John Milne, chair of the BDA’s
General Dental Practice Committee, also spoke and said he
had been in discussion with the
Health Minister Ann Keen expressing his concern about the
guidance and detailing the prob-
lems that dental professionals
will have implementing the decontamination guidance.
The full guidance can be accessed online at http://www.dh.
gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/D
H_089245 DT
Introducing Pro-Argin™ Technology –
a breakthrough in dentine hypersensitivity relief
The guidance for dentists in
England was published online in
April.
All NHS dentists have 12
months to implement HTM 0105, from when they receive the
hard copy of the guidance, which
should be with all dentists over
the next couple of months.
Dentists in Wales will also
adopt 01-05 with a few modifications of the terminology. But
Scotland has decided not to follow the guidance.
Lesley Derry, head of education and standards at the British
Dentists Association (BDA),
who spoke at the LDC conference said: ‘At the moment, Scotland has just cleaning protocols
in place and this may be less arduous but I don’t think Scotland
is getting much of an easier
time.’
Under Scottish guidance, all
dentists in Scotland have to have
a Local Decontamination Unit in
place by the end of the year. They
are being given grants of around
£20,000 to help them do this.
Pro-Argin™ Technology plugs dentine tubules to help block pain stimuli
Colgate offers a safe and effective new in surgery treatment for dentine
hypersensitivity patients with innovative Pro-Argin™ T h l
However, a Scottish dentist at
the conference revealed that
there are currently 55 dental
practices in Glasgow facing closure as they are unable to comply
with this, as they do not have the
space.
Based on a natural process of tubule oc
the key components arginine and calciu
Jason Stokes from Norfolk
LDC called for the Government
to offer dentists in England similar financial help.
Dentine hypersensitivity treatment and
polishing in one step
‘The Department of Health
needs to offer funding to primary
care trusts (PCTs) to help dentists
implement 01-05. If it wants to
see more patient safety, we want
to see extra funding,’ he said.
While Vijay Sudra of Birmingham LDC claimed that the guidance will create ‘chaos’ and leave
dentists with a ‘logistical nightmare’.
Under the guidance, all dentists will have to have an overarching infection control policy. So
if a dentist gets a new piece of
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* Graphical representation based on SEM photography; for illustration only
[4] =>
DTUK1809_01_Title
DTUK1809_02-08_News
4
01.07.2009
16:59 Uhr
Seite 3
News & Opinions
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
Scottish dentist struck off
A
dentist described as the
‘worst in Scotland’ has
been struck off from the
profession. Andrew Boyd, who
practised at the Barassie Street
Dental Practice in Troon, Ayrshire, left one man looking ‘like
the Elephant Man’.
While another patient was
forced to spend £17,000 on pri-
vate treatment to repair the damage caused by Mr Boyd.
Health campaigners have
called him the ‘the worst dentist
in Scotland’.
Mr Boyd was accused of not
examining patients properly,
failing to take x-rays and not
recording treatment.
The General Dental Council
(GDC) chairwoman, Marilyn
Green, said: ‘He omitted to take
proper care of his patients on a
large number of occasions, and
failed to provide the basic diagnosis and treatment of common oral
disease which would be expected
of a competent dental practitioner. This amounted to the supervised neglect of his patients.’
She added: ‘The committee
has to protect the public and
maintain its confidence in the
profession.
shocking that it took so long for
his behaviour to be exposed
when he was very clearly endangering patients’ lives.
Therefore the committee has
decided that erasure from the
Dentists’ Register is the only appropriate and proportionate sanction in this case.’
Bad oral hygiene can cause all
sorts of health problems especially if the patient has an underlying health condition such as a
heart problem.’
Margaret Watt, chairwoman
of Scotland Patients Association,
said: ‘This dentist is the worst I’ve
ever heard about in Scotland. It’s
The hearing heard that
around a hundred of Mr Boyd’s patients needed ‘immediate treatment’ after going to see him.
Dozens of them suffered from
problems with gum tissue and
tooth pulp.
Dental experts discovered
other patients’ fillings had not
stopped their teeth rotting because Boyd had failed to remove
decay.
Boyd was removed from the
NHS practitioners’ list after a
misconduct hearing in 2006.
In 2007, he admitted a series
of misconduct charges involving sub-standard dental care
and was suspended for five
months.
He failed to attend a review
hearing in June 2008 and was
banned from working for another 12 months.
Mr Boyd did not attend his
hearing at the GDC. DT
Rochdale
sees NHS
boost
R
ochdale is to get five new
NHS dentists as part of a
£1.3 million plan to improve dental services in the area.
NHS Heywood, Middleton
and Rochdale want to open a surgery in Brimrod with four NHS
dentists.
A fifth dentist will be based at
an existing practice in Littleborough.
It is hoped that the extra dentists will be in place by the end of
the year.
All of the dentists will provide
NHS treatment and are expected
to treat an extra 17,000 patients.
Carole Williams, the Trust’s
primary care dental lead, said:
‘We have been working really
hard to bring more dental services to the borough and it’s fantastic that we are able to do this
before the end of the year.
Access to NHS dentistry has
slowly improved over the past
two years but these new services will accommodate in the region of 17,000 new patients
when at full capacity, significantly boosting our local NHS
dental services.’ DT
[5] =>
DTUK1809_01_Title
News & Opinions
Patient left to suffer ‘extreme pain’
A
dentist has been accused
of leaving a woman to suffer months of ‘extreme
pain’, according to a misconduct
hearing at the General Dental
Council.
Dental expert Anthony Lynn
told the hearing that some pain
was to be expected because in-
The GDC heard that Mr
Rudland sold his practice in
2006 and moved to Spain
where he is thought to be living in Marbella with his wife.
He has not been present at
the hearing.
The woman told the hearing
at the General Dental Council
(GDC) that the pain was so bad
she was unable to sleep at night.
stalling bridges was a ‘severe
process for the teeth’.
However, he said Mr Rudland
was under a duty to investigate
UDA system ‘bad’
O
ver 90 per cent of dentists
disagree with using units
of dental activity as a way
of measuring the work they do,
according to a recent survey.
The survey carried out by Challenge, a pressure group for dentists,
found that 91 per cent of respondents believe that the introduction
of units of dental activity (UDAs) to
measure activity, has had a damaging influence on diagnosis and
treatment planning for patients.
While 89 per cent felt that the
new contract did not make it easier for them to give preventive advice and treatment for their patients than previous General Dental Service (GDS) arrangements.
A spokesman for Challenge
said that the findings showed
that ‘dentists working within the
GDS feel that UDAs are a bad
system, damage treatment planning and do nothing to encourage prevention’.
If found guilty, he could be
struck off.
S
The two-hour programme,
‘Prevention in Practice: Using
Delivering Better Oral Health’
was developed by Smile-on at the
request of NHS Education South
Central (NESC).
He added: ‘They also feel that
the contract makes providing appropriate care more difficult,
produces more financial risk, alters the management of disease
and that patients are less happy.
Newly qualified dentists don’t
find the contract easy to manage,
don’t feel their education and
skills are fully used or that UDAs
measure work effectively.
While dentists outside the GDS
withdrew from the GDS because of
the introduction of the contract,
they found more untreated disease
on new patients than before.’ DT
It has had input from members of the team that produced
the Delivering Better Oral Health
toolkit, which was sent to all NHS
practices in England in 2007, by
the Department of Health.
that it asks questions about attitudes at the start of each topic and
then checks on knowledge
gained at the end.
Dr Gill Davies, specialist in
dental public health for Manchester Primary Care Trust,
who wrote some of the educational material on the DVD
said: ‘It deals with issues such
as the best ways of communicating with patients and overcoming opposition within the
practice and the perceived
barriers to integrating preventive activity for every patient.’
It can be watched from start to
finish or the user can dip in and
out of topics as they choose – the
screen is very user friendly and
constantly shows the stage the
viewer has reached.’
She added: ‘A variety of teaching methods are used, including
short film sequences, illustrations of key points and indications of the sources of the evidence on which the prevention
toolkit is based. It is interactive in
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The hearing continues. DT
Smile-on helps deliver better oral health
mile-on, the learning resources provider, has come
up with an innovative elearning solution to help dental
practices implement Government guidance on improving patients’ oral health.
Precision Hand
Instruments
He said that he thought
Mr Rudland did not carry out
enough investigations into
the cause of pain as there
were no radiographs.
Simon Rudland, of Falgrave
Road surgery in Scarborough, installed bridges to the patient's
upper and lower mouth between
2005 and 2006.
She had a number of further
appointments with Mr Rudland
but he failed to correct the problem.
the problem, particularly as the
patient returned for further consultations.
The e-learning package can
either be downloaded online or
bought as a CD-ROM.
The programme is for all dental professionals from dentists to
orthodontists to hygienists.
Each DVD provides two hours
of CPD.
Silicone Handle
Precision composite instruments have special tips
which have been coated with titanium nitride. This
coating gives the instruments non-stick properties to
enable easy placement and sculpting of composite
restorations in the mouth. The round solid handles
have been perfectly weighted to reduce risk of
developing carpal tunnel syndrome and enable
easier sculpting of the material in the mouth. The
silicone handles provide a soft comfortable grip and
are designed to reduce risk of developing carpal
tunnel syndrome. The tips come in a variety of
different shapes.
Premium Rotary Instruments
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Available in kits or as individual burs
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expansion burs to be used with
various implant systems.
For more information on the
programme, call 020 7400 8989
or email info@smile-on.com. DT
Army dentist treats Kenyan villagers
A
dentist with the Royal
Army Dentist Corps is currently visiting remote villages in Kenya, providing ‘once
in a lifetime’ dental care for the
villagers.
Captain James Scott, a dentist
with the Royal Army Dentist
Corps, is one of 151 British Army
medics, on exercise in Kenya,
giving dental treatment, primary
health care and inoculations to
people in remote
across Kenya.
locations
be seen in the clinics which open at
8am and close when it gets dark.
Captain Scott has spent four
weeks out there setting up temporary mobile dental clinics
which provide villagers with often their only chance of dental
care in their lifetime.
Captain Scott said: ‘Most teeth
we have been looking at have
tooth decay, so if there is imminent pain, we suggest taking it
out because the patients are unlikely to see dental care soon.
There is such a demand for the
treatment that some villagers have
walked more than 50 kilometres to
In some cases, we are providing the first and last dental care
some of our patients will see.’ DT
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[6] =>
DTUK1809_01_Title
6
News & Opinions
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
Filling baby teeth may have ‘no benefit’
A
n NHS study is looking at
treatment options, after
research found that filling
baby teeth may have ‘no significant benefit’. Around 40 per cent
of five-year-olds in the UK have
tooth decay and at least one in 10
of these is treated with fillings.
Researchers from Manchester looked at case notes of 50 den-
tists, which suggests that filling
baby teeth may achieve nothing
but expose children to the discomfort of an injection and the
sound of the drill.
Children receive a wide variation of care on the NHS with
some dentists choosing to give a
filling with another opting to extract it.
Professor Martin Tickle, of
the University of Manchester,
found no difference in the numbers of extractions for pain or infection whether baby teeth had
been filled or not.
He also carried out a survey of
the parents of all five-year-olds
living in Ellesmere Port and
Chester in 2003, and found only
six per cent would want their
child to have a filling if they had
symptomless decay in a baby
tooth.
While a third would want the
dentist to monitor the tooth but
provide no treatment.
Kamini Shah, honorary secretary of the British Association
for the Study of Community Dentistry, said: ‘There are two
schools of thought, one being
that baby teeth can cause pain
and sleepless nights and so dentists should fill.
The other is that actually the
evidence around filling baby
teeth is questionable.’
Advisers to the NHS are now
beginning a study on treatment
options to provide dentists with
clear evidence-based guidelines.
Freedom to stand out
from the crowd
Experts working for the
Health Technology Assessment
Programme want to recruit over
1,000 children from across the
UK to take part in a study that will
compare the outcomes of three
treatment options.
They are drilling and filling,
no fillings or a painless paint-on
tooth treatment that merely seals
and contains the decay.
The trial will run for four
years from 2011 across England,
Scotland and Wales. DT
Charity
appeals for
donations
T
he Dentists’ Health Support Programme made an
appeal for more donations at the Local Dental Committee’s annual conference in
London.
The charity gives support to
dentists suffering from alcohol
and drug addiction. It is estimated that one in 10 dentists suffer from an alcohol or drug-related problem.
Brian Westbury, chairman of
the Dentists’ Health Support
Trust which runs the programme, said: ‘We save the professional and personal lives of
these people and every year we
take on about 70 new cases.
We inevitably have a growing
caseload. Many of these colleagues are helped to a stable
condition. None however are
truly cured and they may need
access to our help and support at
any time they feel vulnerable.’
Take control of your future.
Building your brand has never been more important. In these challenging times you need to differentiate to ensure
success. Whether you are planning for a future in private practice or already practise privately, we understand you
need strong advice, strong support and, most importantly, a strong brand to survive.
This is why our custom-branded dental plans are tailored to run alongside your practice ethos, image and goals.
Our team of regional support managers, marketers, expert consultants and business partners will be with you step
by step, helping you to build your own unique brand, develop your business and take control of your future.
We’ll provide the level of support that’s right for you. When it’s right for you.
To find out more call 01691 684135 or visit www.practiceplan.co.uk
The Trust enables the programme to run a 24-hour service
with access to its co-ordinators
and UK wide network of voluntary special referees. The Trust
pays for the co-ordinators and
their expenses but not for the
dentists’ treatment, which must
be funded privately or through
the NHS.
Any donations should be sent
to the Trust’s treasurer Michael
Stern, 48 Pollard Road, Whetstone, London N20 OUD. DT
[7] =>
DTUK1809_01_Title
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
News & Opinions
Scotland gets advanced treatment
T
wo dentists in Scotland
have opened one of the
country’s most advanced
treatment centres combining
dental treatment and alternative
therapies.
Biju Krishnan and Lubino do
Rego have opened Lubiju in Edinburgh, which offers some of the
most hi-tech treatment techniques and equipment available
in cosmetic dentistry.
The pair already run the Scottish Dental Implant Centre open
to NHS patients, a specialist facility in Edinburgh, dedicated to
providing patients with solutions
to missing teeth or loose dentures.
Dr Krishnan said: “We’re really excited about the possibilities at the new practice. Scotland
has a patchy dental record and
we are now at the leading edge of
bringing the best new techniques
and technology into the country.
We are looking at everything
from the most advanced implants and surgical methods, to
breakthroughs in needle-free
and painless treatments and also
the most up-to-date cosmetic
dentistry.’
Recession
hits BDA
Fund
He added: ‘On top of that we
have also recognised the growing respect, understanding and
awareness of complementary
therapies and are incorporating
holistic and natural treatments
along with the latest that medical
science has to offer.’
The practice has two consulting rooms, an x-ray area which
was created using a ton of lead
and a Local Decontamination
Unit.
It is also fitted out with three
treatment suites, each with a
designer flat-screen TV on the
ceiling, so patients can watch
DVDs during longer treatments such as laser tooth
whitening.
Each suite is equipped with
hi-tech, ceiling-mounted cameras, which can film surgical and
cosmetic procedures to be
beamed to specialist audiences
elsewhere in the practice – or
anywhere in the world – for training and teaching purposes.
Lubiju also has its own dedicated massage and comple-
mentary therapy treatment
room, with staff who provide alternative health advice, relaxation and beauty treatments,
non-surgical facelifts and other
rejuvenation and detox treatments.
Dr Krishnan said: ‘There is
nowhere else in Scotland – and
very few centres in the UK –
which offer this unique blend of
advanced medical treatments
and the very best in alternative
therapies.’ DT
PracticeWorks
Practice Management Software
and Digital Imaging Systems
Our team at PracticeWorks are recognised for their expertise in dental technology, from
installation through to support and maintenance, whether it’s the most advanced practice
management software or the most innovative digital imaging systems.
We have over 70,000 software installations worldwide to prove it. We also developed the first
intraoral sensor, “RVG”, which started the digital radiography revolution.
And when you buy a PracticeWorks product you also buy great support. Our trainers,
engineers and help desk staff are always on hand to ensure you get the most from our
products and services
So not only do you get the very best service at all times, you also get peace of mind from
knowing that your satisfaction is our top priority.
T
he British Dental Association Benevolent Fund is
struggling financially in
the current economic climate
with more and more people appealing for help.
Ian McIntyre from the Fund
said: ‘One of the problems is that
beneficiaries are getting younger
so they will be dependent on the
Fund for considerably longer.
The youngest applicant we have
had was 24. We are currently
helping the twins of a 35-year-old
female dentist who recently died.
Her husband is a tenant farmer
and he has financial problems so
we are helping them to get back
on their feet.’
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5100
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Applications to the Fund are
up 50 per cent on the year before
and nearly a quarter of these applicants were below the age of 40.
The Fund operates by giving
loans of up to £250,000 to dentists
and their families.
The very best products, expertise, support and service
brought to you on a plate
However, the recession has
hit the amount of money the Fund
has tied up in bank dividends and
it is ‘facing a reduced income
stream combined with an increased demand for help’.
For more information or to place an order please call 0800 169 9692
or visit www.practiceworks.co.uk
Any donations are much appreciated. For more information, go to www.bdabenevolentfund.org.uk. DT
PracticeWorks
7
© PracticeWorks Limited 2009
[8] =>
DTUK1809_01_Title
News & Opinions
DCPs storm GDC website
by SMS or by letter. The changes
help make the process as hasslefree as possible while maintaining the level of security.’
Anne Gerulat, processing
manager at the GDC, said: ‘We’re
hoping DCPs in particular take
advantage of eGDC this summer.
T
here has been a surge in
the number of dental care
professionals using the
General Dental Council’s website, since its relaunch.
Over 2,600 dental care professionals (DCPs) have created accounts on the General Dental
Council’s (GDC) website, eGDC,
since its re-launch in April this
year, according to figures from the
GDC.
This brings the total number
of dental professionals who are
using the site, first launched last
November, to over 5,200.
The eGDC site is designed to
make things as easy as possible
for registrants to keep on top of
registration requirements at the
click of a mouse.
It allows users to update their
contact details, pay their annual
retention fee and, in the future,
submit continuing professional
development returns.
A spokeswoman for the GDC
said: ‘We have made changes to the
log-in procedure on eGDC after listening to feedback from site users.
Registering on the site can
now be done instantly, meaning
there’s no wait for a password letter, providing you have an ID verification code.
If you don’t have your code
you can request one on the site,
BOS Education Day
T
he British Orthodontic Society is organising the UK’s
first National Orthodontic
Commissioning Education Day.
The event will be held this
September and the day is aimed
at individuals or organisations
who are directly or indirectly involved in commissioning NHS
orthodontic services.
A spokeswoman for the
British Orthodontic Society
(BOS) said: ‘Whilst the new contractual arrangements of 2006 in
England and Wales brought
about a number of positive
changes, there are still many issues that would benefit from further clarification and guidance.
With this in mind, there is no
doubt that shared knowledge between strategic health authorities, primary care trusts (PCTs),
orthodontic managed clinical
networks and providers is of
huge benefit.
After discussion with both
commissioners and the Department of Health, the British Orthodontic Society is keen to help facilitate this process and so is organising the day-long event as a parallel
session at its annual conference
which takes place on Tuesday 15
September in Edinburgh.’
The BOS has already run a
number of education days at a local level in the last year and these
will form the blueprint for the
first national event.
During the day, delegates will
learn at first hand about several
examples of commissioners and
providers successfully working
together as part of local clinical
networks and there will be good
practice to share with those involved with commissioning.
The BOS wants this day to
be as inclusive as possible and,
with that in mind, has announced that representatives
They’re fast approaching the
31 July deadline to pay their annual retention fee and eGDC has
plenty of extra information about
how they can do that.
Some DCPs will also be asked
to complete their continuing professional development returns
this August and will be able to
submit this on eGDC.’
The deadline for all DCPs to
pay their £96 annual retention
fee to remain on the register is 31
July and will be 31 July each year
from now on.
The deadline for dentists to
pay their fee will still be 31 December each year.
For more information, contact
the GDC customer advice and information team on 0845 222 4141
or email CAIT@gdc-uk.org. DT
from PCTs, the BSA, the Department of Health, as well as
the British Orthodontic Society will give presentations.
The topics to be covered
during the day include justification and scope of orthodontics, background and principles of the PDS contract and orthodontic monitoring and BSA
reports.
There will also be information on handling practice sales
and retirements, referral management, the benefits of local
managed clinical networks and
dealing with orthodontic tenders and re-commissioning.
Registration for the meeting
is free, but places must be booked
in advance.
Lunch and refreshments will
also be provided free by the
British Orthodontic Society.
More information and a booking form is available from
www. bos.org.uk. DT
Bridge2Aid has a ball
T
ickets are now on sale for
this year’s Bridge2Aid
charity ball – a UK charity
offering dental and community
development programmes in
North West Tanzania.
The Bridge2Aid charity ball
will be held on 13 November at
the Hilton Metropole Hotel in
Birmingham at the 2009 British
Dental Trade Association (BDTA)
Showcase and is being sponsored
by Dentsply.
The Bridge2Aid charity runs a
not-for-profit dental clinic, an innovative dental training programme
for local health workers, and a community development programme
helping the poor and disabled in
North West Tanzania in Africa.
A spokeswoman for Dentsply
said: ‘Dentsply has provided continuing support to Bridge2Aid
over the years, and is delighted to
assist with the organisation of
such a highly anticipated event.’
Tickets to the ball cost £42 each.
For further information on
Bridge2Aid, please visit www.
bridge2aid.org. DT
[9] =>
DTUK1809_01_Title
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
Practice Management
9
Creating perception: building reality
When it comes to considering how to brand your practice, it’s essential you make sure
people don’t draw the wrong conclusion about your business. Andy McDougall explains
‘All that is gold does not glitter; not all those that wander are
lost.’ J.R.R. Tolkien. In other
words, making assumptions
can lead to incorrect conclusions and that has never been
more applicable than when
considering your practice
branding. As the practice principal you may be absolutely
clear about the brand values of
your practice, but if I were to ask
a select number of your patients
and each member of your team
independently, would those
same values be reiterated? In
the majority of cases, I would
suggest they would not. This article seeks to give you some food
for thought and aims to help you
derive tangible benefits from
any investment you make in
your brand.
‘Brand values
help you to
establish your
brand and how
your vision of it is
delivered to the
customer’
What is brand?
While there are many variations of definition, in essence a
brand is a collection of perceptions in the mind of the consumer. The purpose of a brand
is to differentiate competing
products or services and to
highlight what is unique about
each. Brand values help you to
establish your brand. They provide physical and emotional
triggers that create a relationship between consumers and
your products/services. In
essence, they represent the core
values and qualities that sum up
your brand and provide the
benchmark to measure the behaviour and performance of
your products/services. Essentially, your brand values determine how the vision and your
promises are delivered to the
consumer.
The confusing bit
Branding, marketing, logo:
because the terms are often incorrectly interchanged, confusion arises. The Chartered Institute of Marketing, which is
the world's largest marketing
body, defines marketing as ‘The
management process responsible for identifying, anticipating
and satisfying customer requirements profitably.’ That
means it is all the activities you
undertake to attract and retain
customers and encourage them
to purchase your goods and
services. In contrast, a logo is
merely a graphic element designed for immediate recognition that forms one aspect of
your overall brand.
What it all means is that while
you may have invested a substantial proportion of your marketing
budget (and I do hope you have a
marketing budget) in establish-
ing a logo and producing practice
literature, you may not have determined your position relative to
your competition or determined
how to achieve consistency be-
tween what you say (your brand
values) and what you do (the customer’s experience). In my expe DT page 10
Time to talk about dry mouth?
Approximately 20% of people suffer symptoms
of dry mouth1, primarily related to disease and
medication use. More than 400 medicines
including tricyclic antidepressants and
antihistamines can cause dry mouth2 and the
prevalence is directly related to the total
number of drugs taken.3
The Biotène patented salivary LP3 enzyme system
The Biotène formulation supplements natural saliva, providing some of
the missing salivary enzymes and proteins in patients with xerostomia
and hyposalivation to replenish dry mouths.
The Biotène system allows patients to choose appropriate products
to fit in with their lifestyles:
Ask your patients
Products specially formulated for dry mouth:
Some patients develop advanced coping strategies for
dealing with dry mouth, unaware that there are products
available that can help to provide protection against dry
mouth, like the Biotène system.
UÊ ÌmiÊ"À>Ê >>ViÊ->Û>Ê,i«>ViiÌÊi
UÊ ÌmiÊ"À>Ê >>ViÊ µÕ`°
Diagnosis may also be complicated by the fact physical
symptoms of dry mouth may not occur until salivary flow
has been reduced by 50%.4,5,6
Diagnosing dry mouth
Four key questions have been validated to help determine
the subjective evaluation of a patient’s dry mouth:7
1
2
3
4
Do you have any difficulty swallowing?
Does your mouth feel dry when eating a meal?
Do you sip liquids to aid in swallowing dry food?
Does the amount of saliva in your mouth seem to be
too little, too much or you do not notice?
Hygiene Products:
UÊ ÌmiÊ ÀÞÊ ÕÌ Ê/Ì «>ÃÌiÊÊÊ UÊ ÌmiÊ ÀÞÊ ÕÌ Ê ÕÌ Ü>Ã °
The range is appropriately formulated for the sensitive mucosa
of the dry mouth patient:
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UÊ `Êv>ÛÕÀÊ
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The Biotène formulation:
UÊ i«ÃÊ>Ì>ÊÌ iÊÀ>ÊiÛÀiÌÊ>`Ê«ÀÛ`iÊ«ÀÌiVÌ
against dry mouth
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GSK welcomes
Biotène to its oral
care family
Clinical evaluations can also help to pick up on the
condition, in particular:
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the buccal mucosa and tongue. If it adheres to the
tissues, then salivary secretion may be reduced
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looking for unusual sites, e.g. incisal, cuspal and
cervical caries.
Consequences of unmanaged dry mouth include
caries, halitosis and oral infections.
Samples available from
www.gsk-dentalprofessionals.co.uk
for dry mouth
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[10] =>
DTUK1809_01_Title
10 Practice Management
DT page 9
rience, many businesses falter
when it comes to providing consistency, usually due to poor communication from the visionary
and a lack of understanding of
what delivering a consistent
brand means in practice.
A consistent brand
To illustrate what I mean I
have taken the three words ethi-
cal, effective and caring that, after
a good deal of thought, a practice
recently decided represented
their brand values. Once they
had determined what they stood
for, their logo was created to visually symbolise those values and
they began to establish how they
would carry them through to
every touch point (every opportunity to interact with a customer
whether on the phone, via letter,
email and the web, in person,
through advertising and literature, etc.).
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
They took one of the words,
caring, and asked every member of the team how he or she
could express that value in
what they did. The receptionist
would ensure that she listened
and attended to patients’ concerns and would provide
prompt solutions.
knowledged. The hygienists
wanted to provide some free
inter-dental products to encourage patients to take more
care of their oral hygiene between visits. The practice introduced free dental check ups
for the children of patients on a
plan. And on it went.
The team decided they
should introduce a process that
regularly asked patients for
their feedback, which would
be sincerely and swiftly ac-
The point is that once this
practice had established its
brand values, it began to work
hard on consistently applying
them in everything it did.
Probably the best innovation in dental
health since the toothbrush
Definition is vital
In my experience, few businesses can articulate their
brand values. Even when the
leader’s vision is evident, staff
will generally be vague and falter when questioned. The point
is that if you can’t articulate
your brand values, how do you
expect customers and prospective customers to do so? In the
absence of your clear communication, your intended audience is likely to draw its own
conclusions, which may not be
to your advantage.
Perception exists, whether
you create it or not. The point of
building a brand is to shape
perception according to the
values you want to instil. A
strong brand is not a great logo:
it is clarity of communication
and experience that leaves
everyone absolutely clear
about what you stand for, and
what they can expect when
they engage with your business. The quality of communication is the response that you
get.
Perception is reality
The customers’ perception
is your reality, so why leave it to
chance? Especially when you
have probably spent thousands
of pounds on creating marketing communications vehicles
such as your web, logo, literature, and so on. Even if you
have all these things in place, it
is never too late to bring the
team together to clarify exactly
what it is you stand for and exactly how they can behave to
deliver a consistent message
and experience to patients. As
part of your strategic planning
process, and in conjunction
with creating your business
plan, this is one of the most vital and beneficial activities you
could undertake. DT
About the author
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or call 07710 382559.
[11] =>
DTUK1809_01_Title
ENDO TRIBUNE
Canals
Treatment
Evaluation
Products
Clinical skills
Canal anatomy
Different perspectives
Learning curve
Useful website
Following up
Siju Jacob says that if you don’t
recognise and treat aberrant canal anatomy, it can affect the
prognosis of endodontic therapy.
Whether root canal treatment
can be successful after just one
or multiple sessions is a common topic of discussion.
Clearing the teeth is a valuable
process that allows us to evaluate
endodontic failures. Dr Barrington and Dr Willis explain why.
Professor Liviu Steier looks at a
new website which aims to
simplify the process of choosing products and materials.
Dr Barrington suggests that
although treatment failure is
unfavourable, it’s a chance to
improve our skills.
pages 11–12
pages 13
pages 14–15
pages 18
pages 20–21
Case report: Middle mesial canal
Siju Jacob shows why it pays to be aware of the
possibility of a third mesial canal when treating
mandibular molars
Fig. 1
Abstract
Failure to recognise and
treat aberrant canal anatomy
can affect the prognosis of endodontic therapy. This case report shows a variation in conventional anatomy in mandibular first molars. A third mesial
canal may be present between
the Mesio-lingual and Mesiobuccal canal in Mandibular molars. A clinician should be
aware of the possibility of this
extra anatomy when treating
mandibular molars.
variations is essential to ensure
consistency in endodontic therapy. Variations from conventional anatomy are encountered
occasionally in all teeth. Inability to recognise, detect and treat
this additional anatomy can
lead to failure of endodontic
therapy1.
In mandibular first molars,
the normal anatomical pattern
consists of two mesial canals
and one or two distal canals2.
However, a third mesial canal
may be occasionally present between the mesio-buccal and the
Introduction
A comprehensive knowledge of canal anatomy and its
ET page 12
Fig. 2
Authors
Year
No. of teeth
Method
Three Canals (%)
Skidmore and Bjorndol
1971
45
Vitro
0
Pineda and Kuttler
1972
300
Vitro
0
Vertucci
1974
100
Vitro
1
Pomeranz
1981
100
Vivo
12
Martinez-Berna and Badanelli
1983
1418
Vivo
1.5
Fabra-Campos
1985
145
Vivo
2.1
Fabra-Campos
1989
760
Vivo
2.6
Goel
1991
60
Vivo
15
Table 1: Prevalence of a third canal in the mesial root of Mandibular Molars according to different authors. (Courtesy
Navarro et al3)
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
[12] =>
DTUK1809_01_Title
DENTAL TRIBUNE United Kingdom Edition · July 6–12, 2009
12 Endo Tribune
Fig. 9a
ET page 11
mesio-lingual canal. This is referred to as the middle mesial
canal. The middle mesial canal
maybe confluent or may have a
separate portal of exit. The incidence of middle mesial canals
varies from 1 to 15 per cent 3.
(See Table. 1).
This article will illustrate
the clinical management of the
middle mesial canal.
Fig. 9b
Fig. 10
lar (see Fig. 2). A diagnosis of
chronic apical periodontitis
was made. Treatment options
were discussed with the patient and Endodontic therapy
was the treatment of choice.
After local anesthesia and
rubber dam application, an
access cavity was prepared.
Initial access revealed two
mesial canals and one distal
canal (see Fig, 3). On closer
examination with a surgical
microscope (Zeiss Germany)
cal canal. Canals were irrigated with 5.2 per cent sodium
hypochlorite, 17 per cent EDTA
and two per cent Chlorhexidine. Canals were dried using
paper points and a calcium hydroxide paste (Apexcal, Ivoclar
Vivadent, Switzerland) was
placed in the canals (see Figs. 9
a and 9b). The access cavity
was sealed with a layer of Cavit
(3M ESPE, Germany) followed
by glass ionomer cement (Fuji
VII, GC, Japan).
The patient was recalled
two weeks later. The calcium
hydroxide was removed (see
Fig. 10). The canals were obturated using gutta percha and
AH plus sealer (Dentsply DeTrey, Germany) in warm vertical condensation. The access
cavity was sealed and the core
buildup done using a dual
cured resin (Luxacore, DMG,
Germany) (see Figs. 11 to 15).
Discussion
Fig. 12
Case report
A 27-year-old male patient
reported to the clinic with chief
complaint of food impaction in
the right mandibular posterior
tooth for the past four months.
There was no history of pain.
His past medical history was
non-contributory.
Clinical examination revealed a large carious lesion in
the right mandibular first molar tooth (see Fig. 1). The tooth
was not tender to percussion
and probing depths were
within normal limits. Radiographic examination revealed a large radiolucent lesion in relation to the first mo-
a ledge of dentin was found between the mesio- buccal and
mesio-lingual canals (see Fig.
4). The ledge was removed
using ultrasonics (Proultra,
Maillefer, Switzerland) (see
Fig. 5). Removal of the dentinal shelf revealed an isthmus
(see Fig. 6). Troughing of this
isthmus with ultrasonics under magnification revealed
a middle mesial canal (see
Fig. 7).
All canals were cleaned and
shaped (see Fig. 8) using Protaper (Dentsply Maillefer,
Switzerland) and hand files.
The Middle mesial canal was
confluent with the Mesio buc-
The biologic objectives of
endodontic therapy include removal of all potential irritants
from the root canal space and
the control of infection and periapical inflammation. Complex root canal anatomy can
prevent achievement of endodontic goals. It is important
to debride, disinfect and obturate as much anatomy as possible. A missed canal can lead to
failure of Endodontic therapy
1. Therefore every effort must
be made to locate additional
canals if any.
An extra mesial canal
known as the middle-mesial
canal has been documented by
numerous researchers3-9. The
percentage varies from one to
15 per cent. The majority of
middle mesial canals will
merge with either the mesiobuccal
or
mesio-lingual
canals. Rarely, they may have a
separate apical portal of exit.
Numerous techniques enable the clinician to look for the
middle mesial canal. It is im-
Squareshaped
Tulip
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Fig. 11
Fig. 13
Fig. 14
Fig. 15
portant to have an adequately
flared access cavity to visualise
the anatomy of the chamber.
Constricted access can lead to
missed anatomy10.
The use of the surgical operating microscope has vastly
enhanced the quality of Endodontic therapy11,12. Magnification coupled with coaxial
lighting greatly enhances visualisation and the potential to
discover additional anatomy.
enhance the prognosis of endodontic therapy.
References available on request. ET
About the author
The use of ultrasonic tips
for precise cutting has gained
favour among clinicians in the
last decade. Ultrasonics in
conjunction with the surgical
microscope
(Microsonics)
greatly enhances the clinician’s ability to locate extra
canals13.
Dr Siju Jacob BDS MDS
Conclusion
Variations in conventional
root canal anatomy can occur
in any teeth. The middle
mesial canal in Mandibular
molars is one such variation.
Knowledge of anatomical variations and the techniques to
discover and manage these
variations will significantly
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[13] =>
DTUK1809_01_Title
Endo Tribune
One versus multiple session
endodontic treatment
One Source – One Solution
It is one of the most discussed topics in modern
endodontics. Prof. Dr. Liviu Steier explains the
key factors for success
For a better understanding of
successful single visit endodontic therapy the following factors
are key:
1. Adequate working length control (using electric measurement devices and if necessary
x-ray)
2. Mechanical root canal preparation (best results will combine the use of hand and rotary
files)
3. Chemical root canal disinfection (using irrigants – advanced devices and technologies)
4. An optial root canal obturation
to avoid apical leakage.
5. Coronal sealing to prevent
coronal leakage.
Each one of this key factors
are determined by other factors.
Determinant factors for an adequate working length control:
1. Straight-line access
2. Establishing glide path
3. Use of adequate file to correctly bind.
Determinant factors for adequate mechanical root canal
preparation:
1. Straight line access
2. Establishing glide path
3. Hand-file preshaping to size 25
or 30
4. Determination of the “first file
to bind” – “Master apically file”
5. Shaping of the so called “apical
capture zone”
6. Adequate use of sequential
files protocol either hand or rotary
7. Adequate irrigation and smear
layer removal protocol while
mechanical shaping.
Determinant factors for adequate chemical root canal disinfection:
1. Coronal isolation (rubber dam)
2. Adequate coronal access
3. Adequate shaping protocol
4. Use of irrigation solutions in
optimised sequence
5. Optimized irrigant delivery
6. Adequate energising of the irrigants
7. Satisfactory irrigant evacuation.
Determinat factors for inadequate root canal obturation (either under filling or incomplete
filling):
1. Canals not dry prior to obturation
2. Inadequate straight-line access
3. Inadequate irrigation protocol
4. Excessive enlargement of a
curved canal
5. Packing of debris in the apical
portion of the canal
6. Skipping of sequential file
sizes
7. Inadequate tug back
8. Inadequate master cone selection
9. Inadequate condensation procedures
10. Coronal seal.
Monomer-free
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4. Oliet S., Single-visit endodontics: a
clinical study. Journal of Endodontics, 1983; 9:147–52.
5. Roane J.B., Dryden J.A., Grimes E.W.,
Incidence of postoperative pain after
single- and multiple-visit endodontic procedures. Oral Surg Oral Med
Oral Pathol, 1983; 55:68–72.
6. Southard DW, Rooney TP. Effective
one-visit therapy for the acute periapical abscess. Journal of Endodontics, 1984; 10:580–3.
7. Ashkenaz PJ. One-visit endodontics.
Dent Clin N Am, 1984;28:853–63.
8. Sjogren U, Figdor D, Persson S,
Sundqist G., Influence of infection at
the time of root filling on the outcome
of endodontic treatment of teeth with
apical periodontitis. International
Endodontics Journal, 1997;30:
297–306.
9. Eleazer P.D., Eleazer K.R., Flare-up
rate in pulpally necrotic molars in
one-visit versus two-visit endodontic
treatment. Journal of Endodontics,
1998; 24:614–6.
10. Katebzadeh N, Hupp J, Trope M., Histological periapical repair after obturation of infected root canals in dogs.
Journal of Endodontics, 1999;
25:364–8.
11. Trope M, Delano O, Orstavik D., Endodontic treatment of teeth with apical periodontitis: single vs. multivisit treatment. Journal of Endodontics, 1999; 25:345–50.
12. Katebzadeh N, Sigurdsson A, Trope
M., Radiographic evaluation of periapical healing after obturation of infected root canals: an in vivo study.
International Endodontics Journal,
2000; 33:60–6.
13. Weiger R, Rosendahl R, Lost C., Influence of calcium hydroxide intracanal dressings on the prognosis of
teeth with endodontically induced
periapical lesions. International Endodontics Journal, 2000; 33:219–26.
14. Sathorn C, Parashos P, Messer HH.,
Effectiveness of single- versus multiple-visit endodontic treatment of
teeth with apical periodontitis: a systematic review and meta-analysis.
International Endodontics Journal,
2005; 38:347–55.
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Conclusion
A trained and experienced
operator who follows a strict
treatment protocol can manage
to perform root canal treatments
in one visit alone having in mind
the management of postoperative complications. The author
needs to acknowledge that not all
root canal treatments can be executed as single session. ET
About the author
and get a Demo Model
worth £129 FREE!
Useful reading
1. Soltanoff W., A comparative study of
the single-visit and the multiple-visit
endodontic procedure. Journal of
Endodontics, 1978; 4:278–81.
2. Calhoun R.L, Landers R.R., One-appointment endodontic therapy: A nationwide survey of endodontists.
Journal of Endodontics, 1982;
8:35–40.
3. Mulhern J.M., Patterson S.S., Newton
C.W., Ringel A.M., Incidence of postoperative pain after one-appointment endodontic treatment of
asymptomatic pulpal necrosis in single-rooted teeth. Journal of Endodontics 1982; 8:370–5.
Dr. med. dent. Liviu Steier
is a visiting professor at the School
of Dental Medicine in Florence;
visiting professor at Tufts School of
Dental Medicine on its endodontic
postgraduate programme; and an
honorary clinical associate professor at Warwick Medical School. He
is a registered specialist in endodontics (GDC) and Spezialist
fuer Prothetik (www.dgzpw.de).
He can be reached at
l.steier@msdentistry.co.uk
Terms & Conditions Apply
SUN-BUK01/5
E
vidence shows that the
number of sessions used
to perform a successful
root canal treatment does not
differ between one or multiple
sessions. The only possible postoperative complications with
single session root canal treatments are:
1. Post-operative pain.
2. Flare up.
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[14] =>
DTUK1809_01_Title
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
14 Endo Tribune
Case report: Failure
evaluation in endodotics
Initial view of the lower second
molar in the x-ray. Shrinkage of
the root occurs during the clearing process and this can give the
appearance that the crown fits the
tooth poorly. The crown on this
tooth actually fit quite nicely.
Dr Hank Willis and Dr Craig Barrington
discuss how we can use failed treatments
to help us learn from our mistakes
Root Master
T
he patient was a 44-yearold female with non-contributory medical history.
No known drug allergies and no
current medications. She reported a dental phobia and was
tearful during the exam. She
hadn't seen a dentist in three to
four years and reported that her
last dental visits have made her
lose hope for her teeth.
Direct view of the mesial root. Noted
the anatomic “webbing” between the
roots. Note the striations in the dentin
The Routemaster was once just as familiar a sight on
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emergency management of patients with irreversible
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canal treatment can be performed. Ledermix Dental
Paste contains one third more steroid than Ledermix
Dental Cement. Consequently the paste is usually
preferred in pulp exposure cases.
In endodontic therapy Ledermix Dental Paste can
be used when periapical periodontitis is present.
After pulp extirpation and during endodontic therapy,
the canals may be filled with Ledermix Dental Paste
(or a mix of Ledermix and calcium hydroxide).
The cavity is closed with a cotton wool pledget
and a temporary filling.
Side view of both roots. Note the
“black” material on the root on the
upper left corner of the picture. That
is left over periodontal ligament.
Note and compare the endodontic
fill in the x-ray vs what actually
occurred in reality with the fill.
Ledermix Dental Cement
Ledermix Dental Cement may be used as a
temporary sublining for deep cavities where no
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120 Wigmore Street, London W1U 3LS
Ledermix*
Demeclocycline/Triamcinolone/Eugenol
Lower first molar in the x-ray. Note
the screw post in the canal. Note the
incomplete treatment of the apical
anatomy. Note the white striations in
the dentin from the post. Compare
and contrast the root canal therapy
fill to the x-ray and what actually occurred and was revealed by the root
clearing process
Information about adverse event reporting can be found at www.yellowcard.gov.uk
Adverse events should also be reported to Blackwell Supplies, Medcare House, Centurion Close, Gillingham Business Park,
Gillingham, Kent ME8 0SB or by telephone: 01634 877525
Please refer to the Summary of Product Characteristics before using Ledermix for Dental Use.
PRESENTATION: Ledermix dental combination kit consists of a package containing 4 units. 1.
Ledermix dental paste. Each gram contains Demeclocycline calcium equivalent to Demeclocycline
hydrochloride 30mg. Triamcinolone acetonide10mg. 2. Ledermix dental cement. Each gram contains
Demeclocycline hydrochloride 20mg. Triamcinolone acetonide 6.7mg 3. Hardener F (fast setting
time) 85% w/w Eugenol. 4. Hardener S (slow setting time). 85% w/w Eugenol
INDICATIONS: Pulpitis, Periapical Periodontitis. Hypersensitive Dentine.
DOSAGE AND ADMINISTRATION ADULTS AND CHILDREN: Pulpitis in all instances of
exposed pulp and acute pulpitis (except total purulent pulpitis) Ledermix Dental Paste is applied with
a small cotton pledget to the dentine. The cavity is then closed with a temporary filling. Approx 3-6
days later the vitality of the tooth is determined, the cavity re-opened and the cotton pledget
removed. The dentine close to the pulp of the wound in the pulp is covered with Ledermix Dental
Cement. Periapical periodontitis: In primary acute periodontitis and acute exacerbations of chronic
periodontitis, the canal may be prepared to the apex at the first sitting. After irrigation the canal may
be filled completely with Ledermix Dental Paste sealed and repeated if necessary on the follow up
visit, or the canal may be irrigated and further treatment carried out. Where an alveolar abscess is
present, drainage should be effective before starting treatment with Ledermix. Hypersensitive
Dentine: Ledermix Dental Cement plus Hardener maybe used as a lining for deep cavities. The
setting of Ledermix Dental Cement is greatly affected by temperature and humidity conditions and by
individual technique. CONTRAINDICATIONS: Total purulent pulpitis or hypersensitivity to any of
the active ingredients. PRECAUTIONS: Prolonged use may result in reduced healing capacity of the
pulp or superinfection or development of resistant micro-organisms. If a severe or idiosyncratic
reaction occurs the filling should be removed and appropriate measures taken.
SIDE EFFECTS: The possibility of systemic side-effects is extremely rare. A few cases of allergic
reaction including anaphylaxis, urticaria, rash and pruritis have been reported. Pulpal necrosis may
occur. Monitor pulp vitality regularly. LEGAL CATEGORY: POM COST: Combination kit £45.79
PRODUCT LICENCE/AUTHORISATION NUMBERS: PL 27880/0002 PA1321/2/1
LICENCE HOLDER: Henry Schein UK Holdings Ltd DISTRIBUTED BY: Blackwell Supplies a
division of Henry Schein UK Holdings Ltd, Medcare House, Gillingham Business Park, Gillingham,
Kent ME8 0SB Tel 020 7224 1457 Fax 020 7224 1694 DATE OF PREPARATION: December 2008.
*Registered Trade Mark
BLA/LED 14
Another view of all four canals of the
lower first molar in the xray. Note the
incomplete treatment of the canal systems. Compare and contrast this between the radiographic view and
what the root clearing reveals about
the treatment.
[15] =>
DTUK1809_01_Title
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
Direct view of the distal root of the
lower first molar in the x-ray. Note
again the incomplete treatment of the
canal system.
Side view of the distial root with the mesial root(s) in the
back ground.
Endo Tribune 15
Here is the distal root of the lower second molar in the x-ray again. The striations in the dentin are
interesting and was something I had never witnessed before in the hundreds of cleared teeth I have
worked with and analysed.
2 and 32 were sectioned and the
roots were delivered. Finally, 30 chromic gut sutures were
placed.
Transporting the teeth
Here is another direct view of the distal root. The picture was mostly taken
to try to capture the “white lines”
coming off the post. The source of the
white lines are unknown but are
demonstrated as they were seen as
this tooth was held at specific angles
to allow the light to reflect off of them.
It was a feature never witnessed before by this photographer of clear
teeth that seemed interesting.
On examination, teeth 2, 30,
and 30 were painful to palpation
and percussion. Panoramic and
full mouth radiographs revealed large periradicular radiolucencies associated with the
lower right first and second molars. These teeth were deemed
unrestorable and the patient
elected to have them extracted.
Additionally, tooth 2 had gross
distal caries and needed extraction. Fixed partial dentures utilising the third molars were discussed as a potential, though far
from ideal, treatment option.
The patient elected to extract
the third molars as well and
move toward dental implants to
replace tooth 30 (and possibly 2
and 31).
The teeth were transported
in a 10 per cent buffered formalin solution. Upon arrival, they
were immediately transferred
to a hydrochloric acid solution
and soaked for 24 hours. From
there they were moved to a 95
per cent alcohol solution. They
were again soaked for 24 hours,
and after that they were placed
in methyl salicylate for one
hour.
For the photography, the
teeth were placed in a glass dappen dish and totally submerged
in methy salicylate. They were
then back lit with a xenon fibreoptic light source and photographed with a Canon A 650 IS
camera mounted on a high
power dental operating microscope.
Panoramic radiograph.
Upper right molars showing gross caries on second molar, conical root on third molar which presents poor
bridge abutment, and silver point endodontic treatment
on first molar which is asymptomatic, but would need
retreatment prior to utilisation as a bridge abutment.
Lower right periapical radiograph showing failing
endodontic treatment on the first molar.
Another view of the failing first molar.
Bitewing radiograph showing failing first and second
molars.
A valuable process
Clearing teeth is a valuable
process to allow us to evaluate
endodontic failures as teeth are
left in virtually their true
anatomic form yet we can see
through them to see what was accomplished or not accomplished
in a treatment protocols. ET
For anxiolysis, 0.25mg Triazolam was prescribed (to be
taken PO 60 minutes prior to the
extraction appointment) and
the patient returned later that
afternoon. Then 72mg two per
cent lido with epinepherine
1:100,000 was administered via
IANB, PSA, long buccal, and
greater palatine. Teeth 1, 30 and
31 were removed simply. Teeth
About the author
About the author
Dr Craig M Barrington,
Dr Hank Willis
DDS is a 1996 graduate of the University of Texas Health Science
Center San Antonio. He practices general dentistry in Waxahachie, Texas with his wife, and has particular interests in endodontics and microscope dentistry. Dr Barrington is also a
part-time clinical associate professor in the Department of Advance Education in General Dentistry at Texas A&M Baylor College of Dentistry in Dallas. He has lectured to a variety of dental
societies and study clubs and has written and co-written a number of articles for various dental journals. Dr Barrington is a
member of the American Dental Association, the Texas Dental
Association, Omicron Kappa Upsilon, and he is an associate
member of the American Academy of Endodontists. To contact
him, call 001 972 973 0374.
is a 2003 graduate of the University
of Washington School of Dentistry
in Seattle. He practices general
dentistry at his own practice in
Bonners Ferry in Idaho and has a
particular interest in microscopeenhanced dentistry. He is also a
member of the Academy of General Dentistry and the American
Dental Association and you can
contact him by calling 001 208 267
6454 or emailing hankwillisdds@gmail.com.
What are you doing now?
I’m saving time and money with www.InventoryCircle.com
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[16] =>
DTUK1809_01_Title
16 Endo Tribune
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
Case report: In search of MB2
Dr Garretson discusses a difficult endodontic procedure
T
he patient presented for
endodontic treatment of a
maxillary molar. The
tooth had developed mild to moderate unprovoked pain, and the
referring dentist had prescribed
penVK five days prior to the treatment visit. The pre-operative di-
agnosis was necrotic pulp with
periradicular periodontitis of endodontic origin.
A lesion was visible radiographically at the apical area
of the mesiobuccal root. (See
Figure 1).
Upon entry, the chamber presented as a curved groove from the
mesio-buccal to the palatal. Figure 2 shows debris accumulated in
the mesiobuccal orifice (bottom of
image), the distobuccal orifice
(middle of image), and the palatal
orifice is not shown (top of image).
Mesiobuccal roots of maxillary molars are characterized by
an isthmus extending palatally
from the mesiobuccal orifice.
These isthmus areas present
with a cariety of configurations,
and can harbor significant
amounts of bacteria and debris. It
Fig. 1
is imperative to debride these areas as thoroughly as possible, because the isthmus may be incommunication with the attachment
apparatus, and may be a source
of persisting disease after treatment.
Vital cases with inadequately
treated mesiobuccal root canal
systems may present with vague
symptoms of discomfort, and
non-vital cases may show lesions
which do not resolve, or worsen,
following therapy.
The dentin ledge covering the
mesiobuccal isthmus is removed
with a Munce Discovery bur
(www.cjmengineering.com).
Ultrasonic tips in a variety of
shapes and sizes are also ideal for
this work. This case demonstrates the use of the bur, and
shows the dark furcal dentin surrounded by the dentin shavings
(left intact for demonstration
purposes).
Fig. 2
Fig. 3
Fig. 2: All images are presented with
the same orientation, showing buccal
on the bottom of the page, palatal on
the top, mesial to the left, distal to the
right. The left side of the image shows
the brighter coloration of the dentin
ledge covering the MB isthmus.
Fig. 3: Instrument in MB canal,
troughing begun for MB2 shows removal of some of the overlying
dentin, DB orifice is a small dark dot
in the center of the picture.
Within the dark area created
by the bur, a small white dot is
formed which can be visualised
with extreme magnification and
lighting. The “dot” is formed by
troughing debris collecting in the
orifice, or isthmus, area. The
next image shows the “dot” becoming more of a “line” as the access is improved. It may be possible to gain entry with a small kfile (06 stainless steel, 08, or 10) at
any point along this line.
Figures 7 and 8 show the result of careful development of
the”mb2” orifice. In this case, the
resulting canal was confluent
apically with the primary
mesiobuccal canal. This is frequently not the case, and furthermore, this author has retreated
cases with persisting disease on
the MB root with untreated MB2
canals, despite the canals being
confluent after instrumentation.An excellent source for information about the morphology
of maxillary molars can be found
in an article by Dr John Stropko,
Journal of Endodontics, June
1999, “Canal morphology of
maxillary molars: Clinical observations of canal configurations”.
[17] =>
DTUK1809_01_Title
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Endo Tribune 17
Fig. 9
Fig. 10
Fig. 11
Fig. 4: The dark circle is created by the bur, revealing the darker coloration of the furcal dentin. Within this area, a small dot is forming. – Fig. 5: Further troughing shows the dot becoming more of a
line. – Fig. 6: 06 k-file pointing to MB2, for demonstration only, not yet ready for negotiation. – Fig. 7: MB1 and MB2. –Fig. 8: MB1 and MB2. – Fig. 9: MB1 and MB2 obturated – Fig. 10: A completed
case. – Fig. 11: A completed case.
In a study of more than 1,700
teeth (1,096 first molars), the operator discovered the MB2 in 93
per cent of maxillary first molars,
with 54.9 per cent of those being
separate canals. This emphasises the importance of uncovering and negotiating this
mesiobuccal root isthmus to
maximise debridement.
Fig. 12: First molar with separate MB1 and MB2. Second
molar with MB2 existing only
as a fin off of the MB1.
Fig. 13: A similar case pre-op.
Fig. 14: A completed case.
Fig. 15: The completed case,
angled view.
Obturation of the canals to
orifice level is accomplished
prior to placement of an orifice
barrier (not shown). Final radiographs, as well as radiographs
from other cases, demonstrating
a variety of presentations of
mesiobuccal root anatomy. ET
About the author
Dr D Kendel Garretson
is a general dentist practicing nonsurgical endodontic treatment
only. He resides in the San Antonio,
Texas area, and can be reached at
onlyendo1@gmail.com.
[18] =>
DTUK1809_01_Title
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
18 Endo Tribune
Choosing wisely
Deciding which materials and products to use in your
practice can be a difficult task, but one that has been made
easier by Dr Michael Miller, founder of RealityEsthetics.
Prof. Dr. Liviu Steier explains
Y
ou’ve just come across a
new material (maybe a
new technology) that you
really like. You’re unsure of what
to do next - should you buy in?
There are lots of questions:
• Could it help/compliment my
daily work?
• Who is the manufacturer?
• What are the strengths and
weakness?
• Where could I get some additional
user information and/or tips?
• How does this perform with my
colleagues? Rating?
come true: Dr Michael Miller. He
founded RealityEsthetics (www.
realityesthetics.com) and not so
long ago RealityEndo.
How does it work?
A colleague told you some
time ago about product evaluators… are they worth looking at?
What was the name again…? Yes,
indeed that is exactly what could
help now… Does this scenario
sound familiar? It is 20 years
since someone made this dream
Dr Miller gathered a group of
about 20 renowned clinicians. He
then spoke to product manufacturers and offered them the chance to
have their products tested by the
clinicians.
Hmm, you may think now:
“This sounds awkward! Why would
the manufacturers want to have clinicians test, evaluate and rank their
products?”
The answer is simple: The feedback received is extremely useful
in that it can be implemented in further developments; for example,
the evaluation received can be useful for advertising.
The Clearstep System
What you might be thinking
now is that the people carrying out
the product evaluations are working for the dental manufacturers.
Well, they’re not and this is what
makes this group so special.
To be accepted as an evaluator,
Dr Miller set up a very strict list of
criteria. To maintain objectivity, the
RealityEsthetics group does not accept any advertisements nor support by third parties or manufactures. The publication is created by
professionals like yourself to benefit professionals like yourself.
Now it is time to have a closer
look into the way the evaluations
are done.
Comprehensive invisible orthodontics made easy
The Clearstep System is a fully comprehensive, invisible
orthodontic system, able to treat patients as young as 7.
It is based around 5 key elements, including
expansion,space closure/creation, alignment, final
detailing and extra treatment options such as functional
jaw correction.
GDP friendly, with our with our Diagnostic Faculty
providing full specialist diagnostic input and treatment
planning, no orthodontic experience is necessary. As
your complete orthodontic toolbox, Clearstep empowers
the General Practitioner to step into the world of
orthodontics and benefit not only their patients, but
their practice too.
Accreditation Seminar
This accreditation seminar is aimed at General
Practitioners, providing you with all the knowledge and
skills required to begin using The Clearstep System
right away.
Accreditation Seminar dates 2009
14th July
London
8th October
London
Personal Accreditation
Receive a visit from a Clearstep Account Manager,
providing a personal accreditation in your practice at a
time convenient to you.
Further Courses
Once accredited, further your orthodontic expertise with
our Hands On Course, where you will learn sectional
fixed skills and other methods to reduce your costs and
treatment times.
Clearstep Advanced Techniques
Hands On Course dates for 2009
1st - 3rd December
London
To find out what Clearstep can do for you contact
us today.
01342 337910
info@clearstep.co.uk
www.clearstep.co.uk
Carrying out evaluations
Each product evaluation starts
with a ranking out of five. Details
are then given of the manufacturer and its website. Next, a product’s benefits and disadvantages
are mentioned –perhaps it’s of
Gold standard, a new design or a
new piece of software. Or maybe
it’s cumbersome or complex to
maintain.
Most of us don’t take much care
or notice of the information we are
given when we purchase a new
product, so it’s good to know there
is a place we can find this. On this
website, you can find out what to do
if your product, for example, needs
a repair.
A detailed product description
follows, and because it is created by
professional colleagues, all their
good and bad experiences, their
helpful suggestions and advice are
implemented in the specially created section called: Use. It is highly
accessible and easy to read, interesting, extremely relevant for the
daily use not. It isn’t called the ‘bible
of Esthetic Dentistry’ by many colleagues for no reason!
Because one day you may need
to know about maintenance, RealityEsthetics stores this information
for you. Almost everyone prefers
first to learn about the essence of a
product before reading the details –
well here you go!
If you’re curious? Just have a
look by logging on to www.RealityEsthetics.com. ET
[19] =>
DTUK1809_01_Title
LONDON
& SOUTH EAST
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CASTELLINI Ltd.
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Free phone 08000933975
[20] =>
DTUK1809_01_Title
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
20 Endo Tribune
Case report: Clear root evaluation
of endodontic failure
Dr Craig Barrington discusses the importance of follow up in
order to see where treatment may have succeeded or failed
Abstract
Endodontic treatment is classified as therapy by definition.
Regimented follow up should be
Fig. 1
an important part of our clinical
actions to evaluate our research
perceptions, ability and performance. Sectioning treated roots
can destroy anatomy and alter
our ability to properly evaluate
failures and successes. Clearing
teeth is an important technique
because it leaves anatomy and
obturations as they were in situ.
Introduction
We perform our clinical
processes and it is rare that we are
able to truly encounter and see
what we have accomplished. Endodontic treatment requires follow
up to evaluate success or failure. Although unfavorable, endodontic
failures allow us the chance to
learn. It is important to know the
cause for failure such that we might
enable ourselves to prevent the occurrence in future treatments.
This case illustrates a
restorative endodontic failure
but further evaluation is required to evaluate the cleaning,
shaping and obturation.
Case report
Hydrim and Statim your perfect partners
in the sterilisation process
A 37-year-old female patient
presented initially in 2001 with
multiple decayed and problematic
teeth. (See Fig. 1). She has a controlled substance problem and has
a history of being an unreliable patient. She wears a complete upper
denture. Her CC was: “I want to
save the rest of my teeth”.
If it isn’t clean, it can’t be sterilised
Hydrim C51wd:
Fig. 2
s The benchtop Hydrim C51wd instrument washer disinfector eliminates the risk of
puncture injuries and perfectly prepares instruments for sterilisation
s The innovative HIP cleaning solution, in combination with dual high pressure
sprays, removes virtually all proteins and organic debris
Fig. 2 is of post extraction of 19
and 20 and was taken in 2002 as
an initial radiographic for
NSRCT of tooth #18. The diagnosis was necrotic pulp with acute
periradicular periodontitis
s Hydrim is independently tested for 99.9-100% efficacy and complies with EN15883
s Hydrim uses patented instrument protection and active drying systems
Statim:
Fig. 3 demonstrates a working length x-ray. Four canals
were located.
s The Statim 2000S, one of the world’s most popular autoclaves, automatically
sterilises solid, hollow, wrapped and unwrapped loads including handpieces
s Statim is 5 times faster than typical B cycle autoclaves
Fig. 4 shows an initial post-op
x-ray prior to rubber dam removal. The canal system was obturated with System B/Obtura
and Kerr’s EWT sealer.
s Statim’s performance is validated by biological and mechanical means
s Statim complies with EN13060 and the 2006 RKI Hygiene guidelines
Fig. 5 shows the post op x-ray
with build up. Build up material
was bonded flowable resin in the
canals and composite resin.
For further information about SciCan products please call
Ken Green on 01594 837327 or visit www.scican.com
Fig. 6 shows an angled post op
x-ray.
Statim® and Hydrim® are registered trademarks of SciCan Limited
Fig. 7 shows a follow up x-ray
two years later. The patient presented with a fractured cusp, so
we placed a stainless steel crown
due to financial constraints.
Healing of the apical radiolucencies was noted.
[21] =>
DTUK1809_01_Title
Endo Tribune
Accolade SRO
Now you see it!
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Simple to use
Great performance
Highly visible
Having trouble seeing your flowable? Then the answer
really is black and white. Accolade SRO, from leading
US company Danville, is the most radiopaque flowable
on the market with a radiopacity 320% of aluminium.
Fig. 7
Used as a lining under composites, Accolade SRO
removes any doubt and allows you to clearly see on
x-rays any decay beneath the filling, guaranteeing
excellent visibility of that all important margin.
This technique, used over bonding agents such as
Prelude, is gaining in popularity and is fast becoming
the technique of choice.
Fig. 8
Fig. 8 shows the seven-year
follow up. Yet again, the patient
disappeared but this time for five
years. Note the drifting of the roots
from the IA canal. No apical radiolucencies are noted but coronal
leakage is certainly present.
Fig. 9 shows the extracted
and cleared mesial root. Note
the space between the canal
wall and the gutta percha fill at
the red arrow. This could be under prepared canal, under
filled, gutta percha shrinkage
on cooling or all of the above.
Note the other lateral anatomy
between the canals. The black
stain is hard to indentify. It is either the silver particles in
Kerr’s EWT or bacteria growth
or both.
Figs. 10 to 12 show other
views of the cleared mesial root
anatomy complex.
Figs. 13 and 14 show the distal
root cleared. The overfill seems
to be beneficial to the system.
Discussion
The biologic objectives of endodontic therapy include removal
of all potential irritants from the
root canal space to control infection and periapical inflammation.
Many complexities in root canal
anatomy can prevent achievement of endodontic goals. It is important to debride, disinfect and
obturate the prepared system and
to protect the treated tooth from
coronal leakage. It is only in fail-
ure and thorough post extraction
evaluation that we are truly able
to see if we accomplished any of
the required tasks.
In spite of our best efforts, failures in our treatment protocol can
occur for multiple reasons and for
reasons beyond our control. Although unwelcomed, these moments can be made in to opportunities for learning and increasing
our endodontic knowledge. This
can eventually lead to improvements in our endodontic treatment approach and protocol.
With its ultra-fine micron filler, this highly thixotropic
flowable composite adapts easily without slumping.
Seeing where you’re placing a cavity liner is just as vital,
Accolade SRO is available in three shades; Extra Light,
A2 and A5, giving you the perfect contrast between
liner and tooth.
Accolade SRO brings together all the benefits of a
flowable composite in a super radiopaque material that
will redefine cavity lining procedures in your practice.
You’ll see everything and a little bit more
with Accolade SRO.
Conclusion
Coronal leakage is a complex
and multifactoral entity that is
still not fully understood. ET
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Fig. 9
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Fig. 11
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Fig. 12a
Fig. 12b
Fig. 13
Fig. 14
[22] =>
DTUK1809_01_Title
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
22 Education
Performing dentistry
The year of 2006 not only ended a long cosy affair with the old NHS system, it also
marked the death of the dental associate. In the wake of the chaos that ensued arose
the dental performer. Neel Kothari discusses the differences and whether the
change has been for the better
U
nlike the dental associate, the dental performer
now has to work within a
very different set of rules that
have never been trialled. Like all
dentists working with UDAs, the
dental performer has to work
their financial plans for the future, as well as allowing flexibility in working patterns. This
current system seems to offer
front-line dentists less flexibility, with penalties incurred for
not meeting Government set
2004, there is no test period and
as such, no accurate way of predicting their working habits, so it
is little wonder many younger
dentists are finding manoeuvring in the new NHS rather
tricky.
Younger performers are struggling to ‘win’ auction-style contracts and set up NHS practices
within defined yearly targets,
but unlike associates, if performers are unhappy with the way
they are working they can no
longer set up a practice just anywhere and expect entitlement to
a slice of taxpayers’ money. Now,
it is down to the PCT to buy dental services to meet the needs of
the local population.
Lack of control
Dental performers no longer
have as much control in this new
system compared with the old
NHS and as a result, finding a
new job can an absolute nightmare. The old system of paying
dentists based on what work
they have done not only sounds
like common sense, it had the
added advantage of enabling
practitioners to budget and set
targets, regardless of the quality
of the work provided.
Many readers will remember back in the early Nineties
the phrase ‘second-gear valuation’ where the Government
sent estate agents to assign
council tax bands for properties
and in many cases the estate
agents assigned the valuation of
a property with just a simple
glance (while still in second
gear). In dentistry, the current
Government has used another
crude assignment called the
‘test period’ where UDA valuations are based on work done
within an arbitrary period of
time.
For performers joining
growing practices, the chances
are they are more likely to be
seeing patients new to the practice who are likely to need far
more work than regular attenders. Even with a quick glance it
is clear to see that the foundations of the test period have been
built on pillars of sand which
may satisfy the masses temporarily, but in the long term
may stifle the growth of younger
practitioners who will inevitably follow working patterns
set by practice owners and PCTs,
rather than at a rate which
works for them as individuals.
Lack of transparency
While for many this transition may pass with little turbulence, for those qualified post-
Since the dental reforms have
taken place, there has been a
shocking lack of transparency
between principals and performers. With principals in most cases
holding on to practice contracts,
the UDA values passed on to performers have not always reflected the UDA values given by
the PCTs. The importance here
for performers lies in
the fact that UDA values
should to a certain degree reflect the amount
of work expected to be
done per course of
treatment; for example
if a dentist was given a
high UDA value perhaps that reflects the
high needs of the local
area compared with another dentist who has
been given a low UDA
value in a lower risk
area since they would
not need to do so much
treatment per course.
The test period not only
does not apply to newly
qualified dentists but is
clearly not future proof.
Many young practitioners looking to relocate
now face a difficult time
of predicting how reasonable their UDA target is, and rather than
having the flexibility of
being a professional
now face the confines of
being a performer.
In the past, this offered a
valuable service to the Government, with dentists fronting the
set up costs in full, unlike general medical practices where
the Government typically paid
up-to 70 per cent of the set up
costs. The DPA argued that the
2006 contract had resulted in a
transfer of financial risk from
the NHS to individual practices.
Under the new arrangements,
the traditional autonomy of
dentists had been replaced by a
system where PCTs ‘dictate to
dentists where they will work,
which patients they will see and
to whom they must sell their
practice in case of ill-health or
retirement’. This all amounts to
a high level of risk placed on individual dentists, which for
some has effectively murdered
the leap from associate to principle. DT
About the author
Proving efficiency
Looking at the past Government investment into NHS dentistry, it is also unclear how efficient this new NHS system really is. With the Department of
Health (DH) boasting an 8.5 per
cent increase in NHS spending
this year, we still have little insight into how much of that is
actually reaching the front lines
rather then filling in the gaps of
PCT spending.
The recent HSC report into
NHS dentistry raised concerns
about a lack of retention of
younger practitioners. While
the recent economic downturn
may have doused the exodus
into private care, we are still left
with the problem of many dentists wanting more work within
the NHS but not being able to get
The Dental Defence Union – The only dental defence organisation
†
in the UK to offer dental professionals access to both discretionary assistance and the
reassurance of insured* indemnity for claims for clinical negligence.
Helplines: Membership enquiries: 0800 085 0614 / 24-hour dento-legal advice: 0800 374 626
it. Younger performers are also
struggling to ‘win’ auction style
contracts and set up NHS practices.
Website: www.the-ddu.com
*Policy arranged through MDU Services Limited (MDUSL) and underwritten by SCOR UK Company Limited and by International Insurance Company of Hannover Limited.
† The Dental Defence Union (the DDU) is the specialist dental division of The Medical Defence Union Limited (the MDU) and references to the DDU and DDU membership mean the MDU and membership of the MDU. MDU Services Limited (MDUSL) is authorised and regulated by
the Financial Services Authority in respect of insurance mediation activities only. MDUSL is an agent for the MDU. The MDU is not an insurance company. The benefits of membership of the MDU are all discretionary and are subject to the Memorandum and Articles of Association.
MDU Services Limited is registered in England 3957086. Registered Office: 230 Blackfriars Road, London, SE1 8PJ. VDP/044v/0309
Neel Kothari
qualified as a dentist from Bristol
University Dental School in 2005,
and currently works in Cambridge
as an associate within the NHS. He
has completed a year-long postgraduate certificate in implantology at UCL’s Eastman Dental Institute, and regularly attends postgraduate courses to keep up-to-date
with current best practice. Immediately post graduation, he was able to
work in the older NHS system and
see the changes brought about
through the introduction of the new
NHS system. Like many other dentists, he has concerns for what the
future holds within the NHS and as
an NHS dentist, appreciates some of
the difficulties in providing dental
healthcare within this widely criticised system.
[23] =>
DTUK1809_01_Title
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
Education 23
Trust the system
device (FORD), you can offer the
highest standard of service to
your entire patient base.
Andrew McCance insists that there is a straightforward
answer to achieving excellent orthodontic results
Complete support
With the right system, you can
augment your treatment list and
begin treating an array of malocclusions, while highly skilled and
experienced orthodontic specialists ensure that you have all
the laboratory support you need.
Also, by bringing to bear extremely accurate diagnostic
tools, the leading system lets you
give your patients the sort of excellent results that will truly set
your practice apart.
Carry out research
If you’re interested in orthodontic treatment, ask the following questions of each system:
• Will I get support as and when I
need it?
• Will you supply pre-activation,
pre-adjustment and indirect
bonding?
• Will you help me treat every single malocclusion that comes
my way?
If you don’t get a resounding
YES in response to all three, you
need to keep looking. The best
system gives you everything you
need to develop your skills, feel
empowered and meet the needs
of patients.
ploys a range of techniques and
approaches to help dentists meet
the needs of any patient. With appliances like the CODA expansion device and the Final Occlusal Refinement and Detailing
With the latest developments,
GDPs can tackle any malocclusion, from mild to severe. The
leading system is organised into
five key elements, for ease of diagnosis and treatment, and em-
To motivate behavioural change, it helps if patients understand the benefits
of brushing for at least 2 minutes twice a day with fluoride toothpaste,
compared to an average brushing time of around 46 seconds.1
New research results from Aquafresh show that increasing brushing time:
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?dl_leXhki^_d] Yb_d_YWbijkZo (
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26% more plaque removal
was observed with brushing
for 120 seconds compared
with 45 seconds*2
&#%
%#.
%#-
Recommend a great
tasting fluoride dentifrice
to encourage your
patients to brush for
longer, for increased
fluoride protection and
plaque removal
%#,
%#+
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%
(%
+%
.%
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7gjh]^c\i^bZ hZXdcYh
About the author
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?di_jk[dWc[b h[c_d[hWb_iWj_ed Yb_d_YWbijkZo
)
Since qualifying in dentistry from
Glasgow University, Dr Andrew
McCance has gained a wealth of
experience in multi-disciplinary
practices. He has held several distinguished positions including
senior house dental surgeon at St
George’s Hospital, Tooting and
senior lecturer at Great Ormond
Street, developing his expertise
through a PhD at University College London. In the mid 1990s, Dr
McCance began to develop the
Clearstep brace, based on the demands of the 4,000 patients treated
annually in his specialist practices.
He is currently taking his Clearstep
vision to a worldwide audience. For
more information on the Clearstep
solution, call 01342 337910 or
email info@clearstep.co.uk.
:cVbZaHB=gZXdkZgn
(+
Dr Andrew McCance
The best benefits of any treatment system are those that delight both patient and dentist
alike. With the fully comprehensive and invisible orthodontic
systems available to today’s GDP,
you can expand your treatment
list and give your patients smiles
they can be proud of. DT
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D;>C8G:6H>C<7GJH=>C<I>B:
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O
rthodontics is a highly
specialised field, and one
that requires superior expertise. By focusing not just on
the dentition, but on the entire
skull, orthodontics is simply the
most effective and thorough way
of achieving a great smile for the
patient naturally, and does not
adversely affect the patient’s
wellbeing.
Of course, some procedures
are more demanding than others,
and you might expect issues such
as increased chair time and intricate, demanding work. Fortunately, the leading system provides
complete support from diagnosis
to completion, with orthodontic
experts carrying out vital tasks to
facilitate expedient treatment. For
instance, the patented CODA expansion device is pre-activated
and pre-adjusted in the laboratory then sent to you for fitting.
(*
Surface microhardness
(SMH) increased in a linear
fashion over the period
30–180 seconds*3
()
((
('
(&
(%
'.
%
*%
&%%
&*%
'%%
7gjh]^c\i^bZ hZXdcYh
* p<0.05
H[\[h[dY[i
1. Beals D, Ngo T, Feng Y, et al. Development and laboratory evaluation of a new toothbrush with a novel brush head design. Am J Dent 2000; 13: SpIss 5A–13A.
2. Gallagher A, Sowinski J et al. The effect of brushing time and dentifrice on dental plaque removal in vivo. [Accepted for publication in J Dent Hyg]
3. Zero DT, Creeth JE et al. The effect of brushing time and dentifrice dose on fluoride delivery in vivo and enamel surface microhardness in situ. [Manuscript submitted]
AQUAFRESH is a registered trade mark of the GlaxoSmithKline group of companies.
[24] =>
DTUK1809_01_Title
[25] =>
DTUK1809_01_Title
DCPs
Welcoming new patients
It’s essential that your receptionist is highly
skilled at nurturing new patients. It will make
their experience worthwhile and they’ll want to
return to your practice, says Sharon Holmes
Specialist Dental Seating
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• High or standard heights, with or without
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I
t takes the whole team to
make a new patient feel at
home, but most of the time, it’s
the receptionist who will at first
influence a new patient’s opinion
of a practice. I always refer to the
reception as the nerve centre of
the practice. Should this centre
be weak, its effects can overflow
onto the financial aspect of the
business and affect the practice
in a very negative way.
Choosing your receptionist
Your choice of who to place in
your reception area needs be
based on key skills such as; people skills, approachability, maturity and a financial understanding of what makes a business do
well. This is a large package to
fill, but so important. By overlooking the obvious simply because the person you have on
your desk is reliable, does not
mean they are the correct person
to be there. Making changes for
the right reasons can be uncomfortable for the principal dentist,
but right for the patients.
I have experienced this kind
of situation so many times which
has lead to serious issues with regards to patient complaints due
to poor customer care. Very
rarely do the patients complain
about clinical work, but more
about poor communication from
both reception and dentists.
From the moment a new patient phones the practice to book
an appointment to the end of the
phone call, they can tell what
kind of relationship they are going to have with the practice.
Even if the first call was poorly
handled, the patient may come in
anyway, due to location and time
availability. From my experi-
ence, this patient is a complaint
waiting to happen and expects
their whole experience to be a
difficult one.
A happy new patient
When the call comes in, what
the patient should hear on the
other end is a clear, concise
friendly voice which is warm and
welcoming. The call should also
be answered within three rings.
The receptionist should know
the dentist’s availability for appointments, the treatments that
are carried out and the costs.
When this is achieved, I can assure you, you are going to have a
happy new patient who has already started to build a relationship with the practice through reception.
When the new patient arrives
at the practice, the receptionist
should know the new patient is
due and note his or her name so
that on entering reception the patient is greeted on a personal
level by surname the receptionist
should offer the patient a health
questionnaire and enquire as to
whether the patient needs assistance or not, this will put across to
the patient that the practice has a
caring attitude towards all its patients. Once the form has been
filled in, it is then the dentist’s responsibility to get the patient into
their surgery on time especially
on a first visit.
A friendly voice
The next important step is the
one carried out by the nurse who
is going to meet the patient in reception. The nurse must make
sure she calls the patient’s name
out just as clearly and in a friendly
inviting voice. The nurse should
introduce herself by name and invite the patient to follow them
through to the surgery where the
she then introduces the patient to
the dentist. Once the dentist carries out a thorough examination
and uses all the tools possible
such as intra-oral cameras, xrays, educational charts and finally a treatment plan that explains all costs, the patient will
walk away feeling that they have
been well cared for and fully informed. Working in private practice, this is always achievable.
Working in NHS is far more stressful and time pressured, but each
member of any dental practice
should make the effort to make all
patients feels welcome and cared
for. Patients do value the staff that
take care of them. DT
• Unique swing around backrest can also be
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• With or without adjustable foot ring
• Twin wheeled rubber surrounded castors for
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• Naugahyde latex free upholstery vinyl used as
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• Extensive colour range
• Every stool in our wide range carries a five
year guarantee
About the author
POS-DC
SDL-12
SADV-GT
Please contact your local distributor
for more information
Sharon Holmes
Originally from South Africa,
Sharon Holmes moved to the UK
in 2002. She thoroughly enjoys
her position as business development manager at the Dental Arts
Studio and her role in the dental
industry, which has moulded her
into a winner in her field. She believes that her position is based on
common sense.
LATEX
FREE
Medical Device
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Unit B • Charlton Mill Way • Charlton
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Telephone: +44 (0)1243 811881
Fax: +44 (0)1243 811855
E-mail: Sales@murrayequipment.co.uk
www.murrayequipment.co.uk
[26] =>
DTUK1809_01_Title
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
26 Aesthetics
is second to none and even in
the current economic climate
this market is expect to grow 2030% in 2009.
NEW CEREC®
AC from Ceramic
Systems
(CEREC®) makes
impression free
dental practice a
reality
The NEW CEREC® AC from
Ceramic Systems (CEREC ®)
enables Clinicians to capture
whole jaw arches – quickly and
conveniently - without the
need for impressions. It combines the NEW Bluecam camera with updated CEREC® 3D
software, making it even easier
to operate.
Bluecam features high-performance LEDs which deliver
optical impressions of unprecedented precision: this ensures
the final restoration’s excellent
accuracy of fit, speeds up the
bonding process and reduces
any excess luting cement to be
removed. Each exposure triggers a series of measurements
which are combined to generate the final image, which is virtually distortion-free even in
peripheral areas. It can acquire
optical impressions anywhere
in the mouth, even those inaccessible to other cameras.
Bluecam delivers razorsharp images, its built-in shake
detection system enhancing
overall precision. Its automatic
exposure function and extensive depth of field means the entire impression-taking process
can now be delegated.
For further information, contact
Ceramic Systems Limited on
01932 582930, e-mail j.colville@
ceramicsystems.co.uk or visit
www.ceramicsystems.co.uk
Extra Revenue
Stream
Ever thought how you might
expand the range of services
you offer in the practice? What
about considering facial aesthetics? After all, your knowledge of head and neck anatomy
Getting started is easy. All
you need to do is undertake specialist training by a recognised
provider in order to gain the appropriate insurance. Med-fx
Training is one such supplier
who offers courses in one of five
locations – London, Manchester, Newcastle, Birmingham and
Glasgow. Their courses are conducted by experienced trainers
all of whom routinely practice
facial aesthetics alongside either dentistry or medicine. After
your training you are fully supported by Med-fx Training. You
will be given a free post-course
support e-mail address where
you can make contact with your
trainer should you have any
questions or queries.
plete and reliable solution for
your endodontic work.
With an easy to use, intuitive
display the Optima MX INT converts your air-driven system to
an upgraded electric operation;
allowing, for example NiTi endodontics to be covered with a
standard 1:1 contra-angled
handpiece. Most other procedures are covered with just two
contra-angles (1:1 and 1:5),
thus replacing several conventional instruments saving time
and expense.
Miris 2 is a development and
improvement based on existing
Miris outstanding technology. A
radio-opaque, highly filled
nano-hybrid composite providing excellent restorations that
meet the highest expectations
with harmony of light, material
and colour; a new way to look
at aesthetic dentistry from
Coltene Whaledent.
This simple system enables
you to change the torque, speed
and ratio in just a few clicks.
With 20 pre-set programmes,
10 designed specifically for
endo work and 10 for operative
programmes, the Optima MX
INT allows you to set a further
20 programmes to your personal requirements. This good
looking unit will suit all surgery décor and the unique
mounting system allows optimum visibility.
For further information please
contact Bien-Air on 01306 711
303 or visit www.bienair.com
The Miris 2 natural layering
concept, which differentiates
between younger, adult and
older patients, is combined with
a new adjusted unique shade
guide which shows a combination of enamel and dentin layer
that allows an accurate preview
of the finished restoration and
perfect natural mimicry, brightness and vitality. With optimised handling properties and
reduced shrinkage Miris 2 has
been kept as simple as possible
to use whilst still providing distinctive characteristic colours
and opalescence
Call Coltene Whaledent on
Freephone 0500 295454 exts
223/224 for your information
pack or to organise a demonstration. www.coltenewhaledent.
com
Accurately
Controlling
Your Handpiece Speed
The Optima MX INT system
from Bien-Air provides a com-
Accolade PV, Starflow and Accolade SRO are available exclusively from Evident. For more
information please contact Evident on FreeCall 0500 321111
or visit www.evident.co.uk
Two NEW
Gradia Direct
Shades
You are not unusual if you
find that you sometimes compromise your composite aesthetic results by using a single
shade of composite for the majority of patients. Help is now at
hand with GC Gradia Direct.
If you wish to register for a
course, or to find out more about
the treatments, please visit
www.medfxtraining.co.uk.
Miris 2
lade SRO. StarFlow had the
highest compressive strength
in CRA testing and was found to
be stronger than some “packable” composites.
Leading the way
with flowable
innovations
Accolade PV Veneer Placement System is a fantastic innovation from leading US company Danville and is now available in the UK from leading supplier Evident. Accolade PV
includes a unique try-in paste,
which is placed directly on the
silane, allowing the veneer to be
simultaneously tried-in for fit
and colour. Accolade PV’s try-in
paste and bonding composite
are the same material, however
the try-in paste has no light sensitive initiators, allowing accurate colour evaluation with
nearly unlimited try-in time.
Using a composite rather than a
glycerine based try-in material
not only speeds-up the procedure but also eliminates the
possibility of contamination by
the try-in material.
Two of the best selling flowable composites in the US are
Danville’s StarFlow and Acco-
Due to the remarkable
shade adaptation of Gradia Direct to the surrounding tooth
structure, you will be astounded
by the brilliant aesthetics of
your restoration, even when
you use only one shade. This
material will provide you with
fantastic aesthetic results due to
the unique particle structure
and light reflectiveness of Gradia Direct.
GC have developed a clever
new shade guide that takes in to
account the chroma, hue and
value of each composite shade
whether you have opted for a
single-shade or if you are extensively restoring a tooth and require multiple shades. This
shade guide incorporates 2 special shades, which are placed
underneath or on top of a standard shade to further enhance
your restoration.
which is the first of its kind to
combine 3 types of nano-particles, won Best Composite 2009.
Additionally the Blue Phase Led
Curing Light also won top honours.
Top Anterior Ceramic 2009 was
awarded to the IPS Empress system, the leading all-ceramic
material for meal-free restorations.
The final accolade for Top Resin
Cement was given to the Ivoclar
Vivadent Multilink Automix.
The high, immediate bond offers many benefits, as it bonds
fast and is easy to apply creating
a strong link to all types of
restorative materials.
Darryl Muff, General Manager,
Ivoclar Vivadent UK comments,
“It is so rewarding for the entire
team to receive such prestigious recognition and these
awards reflect the quality incorporated into the design and innovation across our product
portfolio.”
Herculite, a
brand you can
trust – Improved
Were you a loyal Herculite
user but technology and patient
demand forced you to use the latest nano composites? Now nano
technology is available in the
brand new Herculite XRV Ultra.
For
further
information
please contact GC UK on
(0044) 1908 218999 or visit
www.gceurope.com
‘Top Products’
Recognition
For Ivoclar
Vivadent
Leading ceramic specialists
Ivoclar Vivadent has gained
prestigious recognition regarding a number of products in the
range.
For over 20 years, Herculite
XRV has been the standard of
the industry for composites.
Dentists have filled over 250
million teeth using Herculite
XRV. Following a legacy of innovative, quality products, Kerr is
making history again, launching another breakthrough composite connected to a powerful
brand: Herculite XRV Ultra
nanohybrid composite — another high-quality product clinicians can trust from Kerr.
Renowned industry magazine
The Dental Advisor has selected
six Ivoclar Vivadent products as
Top Product 2009 in various categories.
Herculite XRV Ultra is an extension in Kerr’s composite line
that offers a highly aesthetic
composite restorative for anterior and posterior use. The ever
popular original Herculite XRV
Tetric EvoCeram, the state-ofthe-art universal composite
DT page 27
[27] =>
DTUK1809_01_Title
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
DT page 26
be held later in the year on a variety of topics.
still sets a standard as the tried
and tested micro hybrid composite with proven performance, it will not be discontinued.
A substantial number of delegates who attended the first
seminars hosted by the company felt the courses proved invaluable in relation to important aesthetic dentistry topics.
Developed to help further
strengthen the skills of dental
teams by enabling dental practitioners to achieve greater
client care and long-term success individually, the courses
will continue to run throughout
the year at various locations.
The extended Herculite
family covers all demands in the
modern day dental practice.
For
further
information
please contact Kerr UK on
01733 892292
Building on
CEREC success.
The chairside CEREC 3D
CAD/CAM system couldn’t be
simpler. After taking an optical
impression of the preparation
and the antagonist, you are in
complete control of the finished
prosthesis. You specify the positions of the margins and the
proximal contacts. From there
on the CEREC system fabricates
the crown, inlay, onlay or veneer accurately, quickly and to
the very highest quality. The
finished prosthesis is highly
aesthetic and exhibits excellent
strengths. CEREC automatically accurately computes the
occlusal contacts referring to
the antagonist to do so.
Using the CEREC system
you will produce perfect chairside ceramic restorations. The
system allows you to place the
new prosthesis in the same visit
saving you and your patient
time, laboratory fees and ultimately making your business
more profitable.
To find out how the Sirona
team can directly support
your practice and for a no obligation demonstration of the
CEREC 3D system telephone
0845 071 5040 or email:
info@sironadental.co.uk,
www.sironadental.co.uk
Seminar Success For Ivoclar
Vivadent
An extremely favourable response has been received from
those who attended the Ivoclar
Vivadent seminars recently
held in Lichtenstein and the UK.
Many have stated the positive
benefits and relevance in attending the workshops, with
some expressing an interest to
attend future seminars that will
Endo
Highline
Bespoke
Endodontic
Storage
Solutions
Darryl Muff concludes, “It is
always invaluable to listen to
the opinions of industry professionals who have a wealth of experience from which everyone
can draw initiatives.”
For more information on
other seminars being run by
Ivoclar Vivadent please call
0116 284 7880
The Full Complement from
Dental Sky
Being the exclusive supplier
of R&S products in the UK, Dental Sky has brought together the
perfect combination to enable
you to place the perfect restoration.
The first step is to use
Supraetch. This 37% phosphoric acid provides effective
etching every time.
Step 2 is to use Suprabond
single step bonding agent. Due
to the high level of adhesion,
micro-leakage around the margins is virtually eliminated, allowing for a more durable
restoration without the risk of
secondary caries forming.
Step 3: Suprafil micro hybrid
composite is perfect for both anterior and posterior regions,
Class I to Class V; due to the
combination of a superior abrasion resistance and the high
translucency of the enamel
shades. Suprafil will not stick to
instruments; it stays exactly
where you place it.
The lightweight, fully autoclaveable handle is ergonomically designed for your ultimate
comfort. It incorporates wide,
flat buttons that are clearly set
out, for ease of use.
For further information or to
place your order please call
Dental Sky on 0800 294
4700.
Aesthetics/Endo 27
doesn’t mind how experienced
you are, whether you are a GDP
who hasn’t used her before or
an Endodontist, she’s high quality and easy to work with, ensuring excellent and consistent results every time. She’s a true exception – let her be at the centre
of your endodontic success.
DENTSPLY’S Rotary Endodontic Procedural Team understands that excellence in endodontics is a must. So from access to restoration we will help
you achieve consistent reproducible results. Each of the high
quality products work perfectly
together achieving excellent
clinical outcomes, offering a
simple, cost effective and predictable way to excel in endodontics. “Embrace endodontic success” with DENTSPLY’s
Rotary Endodontic Team!
Access with Mr Start-X™ Ultrasonic Tips “Access all areas”
Highline bespoke healthcare storage solutions, from
Support Chairs, incorporate a
variety of features designed to
make Root Canal Therapy even
easier and more efficient. Available in a choice of nine formats
they are extremely versatile
and cost effective.
Composed of modules, containing sets of 4 different
drawer sizes, they can be combined in one of nine models to
create units of the required
height, width and mixture of
drawer sizes. Some models feature an open space for storing
equipment etc or a glass fronted
lockable cupboard with a height
adjustable shelf. All are fitted
with high quality wheels, offering high ground clearance for
easy movement and hygiene,
and handles as standard.
Stylish and efficient, Highline Endodontic Trolleys are
constructed from aluminium,
steel and high quality plastics,
which are resistant to most
stains including blood. Drawer
fronts are available in either
simulated aluminium or navy
metallic finish.
Highline offers a very economical alternative to traditional fixed cabinetry.
For further information contact Support Chairs on 01296
581764, fax 01296 586583, email
sales@supportstool.co.uk or
visit www.supportstool.co.uk
Shaping with Mrs ProTaper®
Universal NiTi Rotary File
“She’s a true exception”
Mrs ProTaper Universal lies
at the centre of most successful
Endodontic procedures in the
UK*. Due to her unique shape,
she cuts quickly ensuring efficiency, whilst maintaining flexibility, whether you are heading
straight or into a curve. She
Version 5.2 of Sirona Dental
Systems’ SIROEndo software is the passport to more effective and convenient root
canal treatment. As soon as the
dentist reaches the apex he can
reverse the rotation of the file –
either on the SIROEndo unit or
via the foot control. Just one
brief touch is enough to change
from clockwise to counterclockwise rotation and vice
versa.
Introduced six months ago,
the new apex indicator keeps
the user informed at all times.
The exponential progress bar
now consists of eighteen
blocks as opposed to six. It indicates the distance between
the file tip and the apex. When
the file tip reaches the apex an
“A” is displayed. The message
“-1” is shown as soon as the tip
extends beyond the apex. This
is accompanied by differentiated acoustic signals.
For
further
information
please contact: Sirona Dental
Systems 0845 071 5040
Info@sironadental.co.uk
Irrigation with Mr Glyde™
EDTA-based Lubricant “A
smooth operator”
Obturation with Miss AH
Plus™ Sealer “No compromise”
& Mr Thermafil® heated Gutta
Percha “Easy as 1, 2, 3-D”
Temporary Restoration with
Mr Chemfil Molar ® Glassionomer “He’s slick and non
stick”
* ProTaper Universal is the market leader with 56.6% market
share (Q1,09 SDM data)
For more information or to
book an appointment, please
contact your local DENTSPLY
Product Specialist on: +44
(0)800 072 3313 or visit our website: www.dentsply.co.uk
Rotary Endodontic Procedures
Embrace
Endodontic
Success!
As soon as the file reaches
the apex of the root canal thedentist can reverse the direction of rotation via the foot
switch.
New software
update supports
the hands-free
operation of the
SIROEndo endodontic treatment system
Accurately
Controlling
Your Handpiece Speed
The Optima MX INT system
from Bien-Air provides a complete and reliable solution for
your endodontic work.
With an easy to use, intuitive display the Optima MX
INT converts your air-driven
system to an upgraded electric
operation; allowing, for example NiTi endodontics to be covered with a standard 1:1 contra-angled handpiece. Most
other procedures are covered
with just two contra-angles
(1:1 and 1:5), thus replacing
several conventional instruments saving time and expense.
This simple system enables
you to change the torque,
speed and ratio in just a few
clicks. With 20 pre-set programmes, 10 designed specifically for endo work and 10 for
operative programmes, the
Optima MX INT allows you to
set a further 20 programmes to
your personal requirements.
DT page 28
[28] =>
DTUK1809_01_Title
28 Industry News
DT page 27
GC Helping
You to Help
Your Patients
GC’s Gradia Direct drew in
the crowds at the recent BDA
Conference 2009. Due to the remarkable shade adaptation of
Gradia Direct to the surrounding tooth structure, delegates
were astounded by the brilliant
aesthetics of your restoration,
even when only one shade is
used.
This good looking unit will suit
all surgery décor and the
unique mounting system allows optimum visibility.
For further information please
contact Bien-Air on 01306 711
303 or visit www.bienair.com
Industry News
PracticeSafeExcellent bulk
buy offer on
non-drip disinfectant wipes.
PracticeSafe ready to use,
tear-resistant, moist wipes are
designed for the fast cleaning
and disinfection of non-sensitive surfaces and objects. Buy 3
boxes of PracticeSafe disinfectant wipes plus 9 refill packs for
£22.75. Each pack contains 100
wipes.
PracticeSafe is the disinfectant wipe from the new Kemdent range of cross infection
control products. These wipes
do not have the overpowering
odour that many dental professionals might have to tolerate,
in order to disinfect their practice. PracticeSafe wipes are low
odour, non-drip and durable.
They are gentle on the hands
but above all, very effective
against harmful bacteria.
Dry Mouth Gel from GC UK
is a unique, sugar-free product
that has been specifically developed to help relieve dry mouths.
With a unique neutral pH (unlike more acidic competitor
products) it provides ultimate
patient comfort combined with
an immediate soothing effect.
To make your denture patients more comfortable, allowing time for the soft tissue to adjust particularly after implant
surgery, GC has introduced Tissue Conditioner. This all-inone soft reline and conditioning
material is classed as the next
generation of acrylic soft reline
materials, patented by GC. Another new product within GC’s
portfolio is GC Initial IQ; the
new One Body, Press-overMetal and Press-over-Zircon
systems.
For
further
information
please contact GC UK on
01908 218 999.
Velopex Zephyr
150 Surgery Air
Supply
The Velopex Zephyr 150
Surgery Air Supply is available
(until end of July 09) with the
Velopex Aquacut Quattro and
trolley for £2,995.00 + VAT, a
saving of over £1,240 (+VAT)
from list price. Speak to your
normal Dental Equipment supplier, or call Velopex for more
information.
Mark Chapman
Director Sales & Marketing
Mobile: 07734 044877
E-mail: mark@velopex.com
First National
Orthodontic
Commissioning
Education Day
announced
The British Orthodontic Society has announced today that
it is organising the first National
Orthodontic Commissioning
Education Day in September
2009. The day is aimed at individuals or organisations who
are directly or indirectly involved in commissioning NHS
orthodontic services. Whilst
the new contractual arrangements of 2006 in England and
Wales brought about a number
of positive changes, there are
still many issues that would
benefit from further clarification and guidance.
Registration for the meeting is
free but places must be booked
in advance. Lunch and refreshments will also be provided free by the British Orthodontic Society. More information and a booking is available
from www.bos.org.uk.
We are delighted to introduce the Velopex Zephyr 150
Surgery Air Supply. This is the
first Compressor designed
specifically to be sited within
the Dental Surgery – rather than
outside in a shed! The neat
clean lines and white powder
coat finish make this powerful
compressor an easy addition to
a Dental Surgery, either
mounted on a Velopex trolley or
sited within cabinetry. The low
noise signature of this oil free
twin-head design, make it suitable for all occasions.
caries management and the experience gained should improve my assessment skills.’’
The small capacity holding
tank means low maintenance.
Whilst the fast cycle twin head
pump provides over 150 litres of
dry compressed air per minute.
This makes one Velopex Zephyr
150 the ideal base for a complete
surgery air supply.
A number of education days
have already been run at a local
level in the last year and these
have proved very helpful and
popular for all concerned, so
form the blueprint for the first
national event.
Kemdent know their customers demand high quality,
value for money products. PracticeSafe wipes provide all dental professionals and their patients with the highest possible
level of protection.
To place an order for PracticeSafe wipes and other Kemdent
Cross infection control products please ring 01793 770256.
For further information on
special offers or to place orders call Jackie or Helen on
01793 770090 or visit our website www.kemdent.co.uk.
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
Post BDA
New Sensodyne and Corsodyl toothpaste launches wow
delegates at the British Dental
Association Conference and Exhibition (BDA).
GlaxoSmithKline Consumer
Healthcare chose the BDA conference to officially launch 2
new toothpastes to the dental
profession. Visitors were given
the chance to experience new
’’I am delighted to be using
Cariescan PRO™. For the first
time we have a tool that can detect caries in a pit or fissure and
have a validated reason for
leaving it or removing it. The results can be recorded for monitoring decay, without being operator sensitive.’’
Sensodyne Multi Action with
iso-active® technology - a new
daily toothpaste for patients
with sensitive teeth. The unique
formula transforms into a micro
fine foam during brushing to
penetrate hard to reach areas of
the mouth.
In addition delegates could
sample and discuss the new
Corsodyl Daily Gum & Tooth
Paste. This clinically proven
toothpaste helps to maintain
tight and firm gums and over
67% of the ingredients are for
the care of gingiva and teeth, up
to twice the amount of many
other toothpastes.
For more information on the
outstanding benefits CarieScan PRO™ can offer you,
call the dedicated team on
0845 475 9873 or visit www.
cariescan.com
Bridge 2 Aid
Review
On the 4th of April 2009 a
team of 10 Henry Schein Minerva employees and 1 dentist
flew off to Tanzania to renovate
a dormitory in the village of
Bukumbi. The team spent two
weeks working alongside charity Bridge 2 Aid, to help in their
bid to build a sustainable future
for the residents of the Bukumbi
Care Centre.
Jeremy Meader, Sales Director Pharmacy and Dental Channels, comments, “Being a platinum sponsor at the BDA conference provided the ideal platform to engage with dental
healthcare professionals about
these
two
new
product
launches.”
’’I am delighted
to be using
Cariescan
PRO™”
A revolution in caries management, Cariescan PRO™
utilises AC Impedance Spectroscopy Technology (ACIST)
for the earliest caries detection.
Dr Martin Delahaye of 82 Harley
Street, London chose to use
Cariescan PRO™ for improved
patient treatments and early
caries detection and was delighted with the results.
‘’For many years I have carried out a watch and wait policy
on those lesions where caries
could not be quantified. Sometimes I regretted not going in
sooner. The hand-held diagnostic tool will aid me in future
Bridge 2 Aid are a charity
that strive to provide essential
resources for the inhabitants of
North West Tanzania all year
round, providing the means by
which they can not only access
basic dental care, but are also
able to help people within the
community, giving them the
chance to live a better, healthier
lifestyle.
As part of an on-going commitment to raising money for
Bridge 2 Aid, Henry Schein Minerva, Dentsply and Dentistry
Magazine are sponsoring the
Bridge 2 Aid Ball which will coincide with BDTA Showcase on
the evening of Friday 13th November. Tickets are just £42
each and are available from
FMC, so book your tickets for
what is set to be a night to remember!!
For details email elisa.allen@
fmc.co.uk.
Aquacut Quattro Installed
Denmark Hill in London, is
now firmly on the map as far as
DT page 29
[29] =>
DTUK1809_01_Title
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
DT page 28
Fluid Abrasion is concerned!
The latest Velopex Aquacut
Quattro has been installed in Dr
Martin Kellaher‘s busy Department in the Dental Institute.
This light and airy building provides a superb backdrop for this
busy department - which now
offers all patients the availability of fluid abrasion: Cleaning
and Treating, in a calm soothing
environment. Dr Kellehaer
commented: “I’ve got one in my
private practice as well and I’m
happy to call myself a user”.
pecially for highly flowable
mate-rials. The new NDT® syringe permits the products to be
applied in exactly the desired
amount without material waste.
This means procedure that is
not only safe and hygienic, but
also economical.
New restorative in Gingiva
shades
With Amaris Gingiva VOCO
releases the only restorative
that permits chair side gingival
shade matching for highest
standards in aesthetic dentistry.
This new material permits the
reconstruction of the “redwhite” transition with a predictable result. Amaris Gingiva
provides long-lasting, aesthetic
restorations with its low abrasion values as well as its high
compressive and transverse
strength.
Manufacturer: VOCO GmbH,
PO Box 767, 27457 Cuxhaven,
Germany, www.voco.com
Sales Manager UK: Tim McCarthy, Mobile: 07500-769613, t.mccarthy@voco.com
The Velopex Aquacut Quattro contains two chambers,
which can accommodate any
combination of the 3 Cleaning
and Treating media available.
The 53µ Treating powder allows the clinician to ablate hard
tissue (Composite, enamel and
dentine) creating a relatively
rough surface – which is ideal
for the latest bonding and
restorative materials. The 29µ
Treating powder gives the clinician a much smoother cut for
finer work.
For more information or to
ask any questions, please contact: Mark Chapman
Medivance Instruments Ltd
Barretts Green Road
LONDON
NW10 7AP
Tel 07734 044877
VOCO
shows its latest
innovations on
the BDA
conference in
Glasgow
High-quality products “Made
in Germany” for different indications
Several brand new products
for different indications have
been presented by VOCO on the
British Dental Conference and
Exhibition. Such as the nonrunning, non-dripping syringe
ba-sed on the innovative nondripping technology (NDT®) es-
GlaxoSmithKline’s Talking
Points in Dentistry lecture
series just
keeps getting
better!
GlaxoSmithKline (GSK) is
delighted to announce that it
has achieved record-breaking
attendance figures for its 2009
Talking Points in Dentistry lecture programme. With almost
5000 delegates over the seminar series, the attendance at the
Motor Cycle museum in Solihull
was up by 100% totalling 900
delegates alone.
For three weeks, the event
aimed at the whole dental practice, visited 9 venues across the
UK offering topical evening lectures to the whole practice
team. Speakers this year included Philip Ower, Graham
Smart and Ashley Latter.
Jeremy Meader, Sales Director Pharmacy and Dental Channels, comments, “The premise
of Talking Points has always
been to provide further education in an engaging and entertaining manner. Using the positive feedback that we have received from delegates over the
years, has meant that Talking
Points has grown into the
largest dental seminar programme in the UK.”
Industry News 29
GlaxoSmithKline (GSK) is delighted to announce that it has
achieved record-breaking attendance figures for its 2009
Talking Points in Dentistry lecture programme. With almost
5000 delegates over the seminar series, the attendance at the
Motor Cycle museum in Solihull
was up by 100% totalling 900
delegates alone.
For three weeks, the event
aimed at the whole dental practice, visited 9 venues across the
UK offering topical evening lectures to the whole practice
team. Speakers this year included Philip Ower, Graham
Smart and Ashley Latter.
Jeremy Meader, Sales Director
Pharmacy and Dental Channels, comments, “The premise
of Talking Points has always
been to provide further education in an engaging and entertaining manner. Using the positive feedback that we have received from delegates over the
years, has meant that Talking
Points has grown into the
largest dental seminar programme in the UK.”
New Patient
Guide to Periodontal Disease
advanced software to create designs and provides advice on all
fixtures and equipment before
overseeing the construction
phase, to ensure that all runs
smoothly.
Waterpik®
Dental Water
Jets Now Available Across All
Boots Stores!
The benefits of Waterpik®
Dental Water Jet have been documented in numerous clinical
studies. Water Pik is delighted
to announce that this groundbreaking equipment is now
available in over 800 Boots
stores across the UK.
Scientifically proven to offer
great advantages in a daily
healthcare regime, the Waterpik® Dental Water Jet can dramatically improve overall oral
health. More and more UK dental Professionals are recommending their patients try the
Waterpik® dental water jet to
see the results for themselves.
Dental professionals can
also order Waterpik® dental water jets through their dental
wholesaler and make the most
of their professional courtesy
discount.
It is vital that dental patients
are made aware that gum
health is paramount in keeping
teeth healthy and that effective
oral care can maintain gum
condition, avoiding the deterioration that eventually leads to
the onset of periodontitis.
The leaflet is packed with
concise, clear information to
help patients identify if their
gums are healthy, the causes of
gum disease and what to do if
they are experiencing any of the
symptoms described. The
leaflet outlines exactly how
dentists will assess gum health
and what the treatment options
are for controlling gum disease.
There is also extremely useful
information on preventing the
deterioration of gums.
Blackwell Supplies provides
a highly effective yet affordable
range of oral health care products to dental professionals, including Dentomycin for use as
an adjunctive treatment in scaling and root-planing when
treating chronic adult periodontal disease.
For more information please
call John Jesshop of Blackwell
Supplies on 020 7224 1457, fax
020 7224 1694 or email john.
jesshop@blackwellsupplies.
co.uk
Lightweight and cordless,
the Waterpik® dental water jet
offers many advantages. It is
convenient when travelling and
its slender shape enables easy
storage. The many health benefits of Waterpik® dental water
jets include a hygienic mouth,
strong and healthy teeth and
gingivae, fresh breath confidence and excellent protection
against plaque, bacteria, bleeding and a range of periodontal
diseases.
Alison
Telfer
of
the
Glasshouse Clinic in Clapham,
London felt that Genus truly
understood and followed the
brief to deliver a stunning practice design. “Nothing was too
big or too small, nothing was a
problem. They were amazing.”
She praised the way they
worked as a team and added,
“The design is so exceptional
that we’ve had lots of people
popping in to have a look and
asking about the design. Genus
really delivered an outstanding
package.”
Genus prides itself on creating top quality surgeries in line
with the dentist’s vision, fully
equipped to meet the needs of
the whole dental team.
For more information please
call Genus on 01582 840484 or
email info@genusgroup.co.uk,
www.genusinteriors.co.uk
A Tale of
Refurbishment
It was time for a ‘makeover’
of my associate’s surgery, which
would mean stripping the walls
back to the brick, rewiring, replumbing and then replastering
the whole room.
My bête noir is exposed
pipework, and with careful
planning and astute cabinetry
placement, I was determined
that the plumbing and wiring
should be hidden within the
walls and plastered over.
The choice of cabinetry
had to complement the décor
of the rest of the practice,
where we have bold reds and
blacks backed by light ceramic
tiles throughout the treatment
rooms.
For more information visit
www.waterpik.co.uk
Exceptional
Design,
Outstanding
Delivery
Genus provides a cost effective, high quality Design and
Build service to the dental market, working closely with dentists to enable them to develop
their own unique vision of a
practice. The Genus team uses
I was impressed with the elegant Tavom cabinetry range,
offered by my local equipment
dealer, RPA Dental based in
Wigan. Whilst all the Tavom series is designed in Italy, my cabinets were assembled for me locally at RPA Dental.
Working with Tavom was a
real pleasure, and our major refurbishment was successfully
completed within two weeks.
For
further
information
please call Tavom UK on 0870
752 1121. Mr David Rhodes
BDS can be contacted on 0161
8813599.
[30] =>
DTUK1809_01_Title
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
30 Events
Why you should attend
Make Hawaii happen
Inspire creativity and celebrate the ADA’s 150th anniversary at its
2009 Annual Session at the Hawaii Convention Centre, Honolulu
The ADA Annual Session
provides practical advice and
information by bringing together leaders in dental practice, research, academics and
industry.
• Unlock the secrets of running a
highly successful practice.
A
DA invites you to attend
the 2009 Annual Session
and World Marketplace
Exhibition from September 30
to October 4. This isn’t any An-
nual Session. It will make the
culmination of a year-long celebration of the ADA’s 150th anniversary. The refreshing and
energising environment will
inspire excitement and creativity as we celebrate the past and
look to the future of our profession. And of course, it’s never
been more important to sharpen
your practice management skills
and be up to date with today’s latest technologies. The ADA Annual Session will help you stay at
the top of your game.
• With more than 180 continuing
education courses spanning
four days, you’ll find plenty of
ideas you can take home and
use immediately. More than 60
per cent of continuing education course seats are free with
your registration.
• Learn from the finest minds in
the dental community.
• The ADA Annual Session offers
an unparalleled opportunity to
select from leading speakers,
all in one location, and to learn
in the most advanced settings in
the dental community.
• Test-drive the latest products.
• Shop at the ADA World Marketplace Exhibition. Discover cutting-edge technology and new
products from the hundreds of
exhibiting companies.
• Build staff camaraderie.
• With the ADA’s inspiring Opening General Session and the fun
of Hawaii at night, the ADA Annual Session offers almost endless opportunities for teambuilding.
• The place for networking.
• More than 200 alumni and professional associations will
come together during the ADA
Annual Session – the best opportunity to network with
peers, make new professional
acquaintances, and catch up
with old friends.
How to register
Online registration is available at www.ada.org/goto/session. DT
About the American
Dental Association
Celebrating its 150th anniversary,
the not-for-profit ADA is the nation's largest dental association,
representing more than 157,000
dentist members. The premier
source of oral health information,
the ADA has advocated for the public’s health and promoted the art
and science of dentistry since
1859. The ADA’s state-of-the-art
research facilities develop and test
dental products and materials that
have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of
Acceptance long has been a valuable and respected guide to consumer dental care products. The
monthly Journal of the American
Dental Association (JADA) is the
best-read scientific journal in dentistry. For more information about
the ADA, visit the Association’s
website at www.ada.org.
[31] =>
DTUK1809_01_Title
DENTAL TRIBUNE United Kingdom Edition · July 13–19, 2009
Classified 31
Dentist Essential CPD Ad.ai
4/6/09
10:28:13
5 CPD credits each day
7BMVBUJPOT
PURCHASE SALE BUYING IN RETIREMENT
1VSDIBTFT
PRACTICES AVAILABLE COUNTRYWIDE
4BMFT
Essential CPD for
the dental team
TOTALLY CONFIDENTIAL SERVICE FOR VENDORS
Day 1: Saturday 3 Oct 2009
Dental radiography and
radiation protection
Day 2: Saturday 17 Oct 2009
Medical emergencies and
infection control
0RACTICE LOANS ARRANGED FOR ANY PURPOSE FROM ABOVE BASE RATE
2EXMSR[MHI UFBN!GUBTTPDJBUFTDPN
TFSWJDF
XXXGUBTTPDJBUFTDPN
5
'
"RADMORE "UILDING "RADMORE 'REEN "ROOKMANS 0ARK 0OTTERS "AR (ERTS !, 12
Delegates may attend one or both days
This course will be of interest to dentists, dental hygenists,
dental nurses, dental technicians, dental therapists
Earlybird rate available - book before 15 September 2009
For more information contact Cristina Dietmann:
Email: cristina.dietmann@rsm.ac.uk or Tel: +44 (0)20 7290 3919
www.rsm.ac.uk/diary
SPECIALIST DENTAL ACCOUNTANTS
- Assistance with Buying & Setting Up Practices
- New PDS/GDS Contract Advice
- Tax Saving Advice for Associates and Principals
- National Coverage
- Incorporation Advice
- Particular Help for New Associates
- Help for Dentists from Overseas
- We act for more than 550 Dentists
Please contact:
Nick Ledingham BSc, FCA
Tel: 01244 328301
Email: mail@moco.co.uk
Website: www.moco.co.uk/dentists
Dental Education Ltd
PRESENTS
ESSENTIAL KNOWLEDGE
Dr. Howard Stean
Clinician, author and tutor
Course in Aesthetic Restorative Dentistry
September 2009– 2010
5 months one Wednesday per month
AYUB
ENDODONTICS
www.ayub-endo.com
WIMBLEDON
s Suitable for newly qualified and experienced dentists
s Fully updated syllabus with state of the art illustrations
s Practical exercises and assisted study
The Course venue in Kew, West London is
conveniently located and timed to be accessible
from most parts of the UK
The Course is eligible for 30 hours Verifiable CPD
& a Certificate will be issued
Fee of £2250 (plus vat) that includes Course material and buffet
CALL 0208 876 4542 or Email: howardstean@ukteeth.com
103 MORTLAKE ROAD, KEW LONDON TW9 4AA
[32] =>
DTUK1809_01_Title
Sensodyne Pronamel rehardens enamel
\N ]`RLN J MJb N_N[b MJb
NEW
Now introducing new Sensodyne Pronamel
Gentle Whitening toothpaste
* ]XX]QYJ\]N ]QJ] Y[X_RMN\ ]QN JLRM N[X\RXW KNWNOR]\ XO
)
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-
Review links pay to patient numbers
01 - 02
view
-
DH guidance ‘logistical nightmare’
03 - 03
view
-
News & Opinions
04 - 08
view
-
Creating perception: building reality
09 - 10
view
-
Endo Tribune 2/2009 (part1)
11 - 14
view
-
Endo Tribune 2/2009 (part2)
15 - 18
view
-
Endo Tribune 2/2009 (part3)
20 - 21
view
-
Performing dentistry
22 - 22
view
-
Trust the system
23 - 23
view
-
Welcoming new patients
25 - 25
view
-
Industry News
26 - 29
view
-
Make Hawaii happen
30 - 30
view
[toc_titles] => Review links pay to patient numbers
/ DH guidance ‘logistical nightmare’
/ News & Opinions
/ Creating perception: building reality
/ Endo Tribune 2/2009 (part1)
/ Endo Tribune 2/2009 (part2)
/ Endo Tribune 2/2009 (part3)
/ Performing dentistry
/ Trust the system
/ Welcoming new patients
/ Industry News
/ Make Hawaii happen
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