DT UK No. 4, 2014

News / The role of physiotherapy in the management of TMD / Leading the way to Great Dental Care / Annual Planning / Cosmetic Tribune: Just fill! Constic - The self-etching and self-adhesive filling material / Cosmetic Tribune: Conservative smile enhancement / Cosmetic Tribune: Bioactive materials support proactive dental care / SIROLaser Factbook: Comprehensive information on diode lasers / Industry News

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April 2014

PUBLISHED IN LONDON
News in Brief

pages 9-10

page 4

SIROlaser Factbook

Constic

A case presentation of the
filling material

Information on diode lasers

pages 11-12

pages 20-21

Wales may ban e-cigarette
use in public places
Wales could be the first part of the UK to ban the use of ecigarettes in enclosed public places, due to a concern that the
devices normalise smoking and undermine the smoking ban

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“Why should we be treated like smokers? Why should
we be put out at risk of passive smoking ourselves in a
smoking area when we do not
smoke?” DT

R E

ic status and peer pressure
often mean teenagers will be
more reluctant to listen to any
health information they are
given. E-cigarettes are being
marketed as an attractive, appealing alternative, and I urge

He told the BBC: “There are
studies done by Air for Change
in America that say it doesn’t
warrant withdrawing them
from public places, and they
are the same people that said
take cigarettes away from public places.

1

‘Why should we
be treated like
smokers?’

However Richard Filbrandt,
e-cigarette user and co-owner of the Vibrant Vapour café
in Camarthen, said they had
studies showing there was no
risk to passive smokers.

G

The study, carried out by
researchers at the Center for

Chief Executive of the British Dental Health Foundation,
Dr Nigel Carter, said: “When
the Foundation questioned
more than 2,000 people about
safe alternatives to smoking,
more than half (57 per cent)
thought e-cigarettes fell into
this category. This research
shows they appear to be acting

“The results of the study
certainly suggest there is
plenty of room for improvement when it comes to getting
young adults to kick the habit.
Factors such as social econom-

the Government to intervene
and ensure this is stopped immediately.”

Q

This comes as new research
has found that e-cigarette use
among adolescents is associated with cigarette smoking.

These results call into question e-cigarette advertisers’
claims that they are effective
smoking cessation devices.

as a gateway for teenagers to
take up smoking.

M A

“I am also concerned that
their use in enclosed public
places could normalise smoking behaviour. E-cigarettes
contain nicotine, which is
highly addictive, and I want
to minimise the risk of a new
generation becoming addicted
to this drug.”

Tobacco Control Research and
Education, found that e-cigarette use among adolescents
in the US doubled from 3.3 per
cent in 2011 to 6.8 per cent
in 2012. They also found that
those who used e-cigarettes
were more likely to progress to
traditional cigarettes and become regular smokers.

E

H

ealth Minister Mark
Drakeford said: “I have
concerns about the impact of e-cigarettes on the enforcement of Wales’ smoking
ban. That’s why we are proposing restricting their use in
enclosed public places.

%

www.dental-tribune.co.uk

Carina Shaw on strategic
marketing plans

10

Women prosecuted for
illegal tooth whitening
Two women have been prosecuted by the General Dental
Council (GDC) for unlawfully
practising dentistry, namely
tooth whitening. On 23 April
2014 Maggie Peachey pleaded guilty to one offence of unlawfully practising dentistry –
namely tooth whitening – and
Jodie Evans pleaded guilty to
both the unlawful practice of
dentistry and holding herself
as being prepared to practise
dentistry, also in relation to
tooth whitening. All of the offences took place on 31 January 2014 at 10 Harley Street,
London. Ms Peachey was
sentenced to a fine of £750,
victim surcharge of £100 and
GDC costs of £1,000; while
Ms Evans was sentenced to a
sixth month conditional discharge, was ordered to pay
a £15 victim surcharge and
costs to the GDC of £200.

Annual Planning

England to standardise
packaging

O T

Energy drink consumers
‘think they are safe’
A new study by the Centers for Disease Control and
Prevention has revealed
that 20 per cent of young
people who consume energy drinks think they are
safe, and that another 13 per
cent think they are a type of
sports drink. Ruth Litchfield,
associate chair of food science and human nutrition at
Iowa State University, said:
“These drinks have this connotation that they are a performance enhancer because
they’re an energy drink.
Whether that performance is
academic or physical, that’s
the perception. “You’re talking about the equivalent of
five cups of coffee in one energy drink. And it’s not just
the youth who are unaware,
it’s adults. I’ve seen adults
in the grocery store buying
these energy drinks for their
children.” Energy drinks
contain as much as 500 mg
of caffeine, as well as stimulants ma huang (also known
as ephedra) and guarana.

Cigarettes

Advertorial
Clinical

Cosmetic Tribune

Feature

U

Elvis Presley’s dental
crown to tour UK
Dentists across the UK will
be hosting an ‘Elvis Day’ in
May to promote awareness
of mouth cancer. According
to NME, each practice will
host a model of Presley’s
teeth and a dental crown
made for him. The events
will also involve costumes,
music and free mouth cancer screenings. Elvis’s crown
was bought in auction by Canadian dentist Michael Zuk,
for $11,000 (£6,500). This is
the same dentist who bought
John Lennon’s tooth at auction for £19,000.

News

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2 News

United Kingdom Edition

Sugar costs NHS
£1.25bn each year S

April 2014

IDH acquires The
Dental Directory

he National Health Service is spending £1.25
billion each year on
sugar-damaged mouths, according to the Health and Social Care Information Centre
(HSCIC).
According to a blog on
the Teethwise website (www.
teethwise.co.uk),
this
accounts for 33 per cent of its
annual budget, and does not
include the cost of obesity, diabetes and other health complications caused by the consumption of excess amounts
of sugar.
Periodontist Dr Rana AlFalaki said: “Sugar leads to
tooth decay – fixing which requires fissure sealants, simple
fillings, root canal treatments,
and in some cases extractions.
With this in mind, we estimate

that sugar costs the government at least over £1.25bn in
outpatient (dental) fees annually alone, and that’s only if
you’re considering the direct
effect of sugar on the dental
care budget and ignoring the
NHS costs on diabetes and
heart disease.
“Sugar also leads to plaque

build-up, which is the main
factor in the aetiology of periodontal disease. Periodontal
disease is the major cause
of tooth loss, and has strong
links to diabetes, heart disease, and arthritis. Of course
diabetes and sugar have their
own direct connections, but
oral health is a known contributor too.” DT

upply business The Dental Directory has been
bought by Integrated Dental Holdings (IDH), one of Britain’s corporate dental services
providers.
Terry Scicluna, Chief Executive of IDH said: “Dental Directory is a well-established business delivering clear benefits to
its customers and suppliers. The
existing management team,
which will continue to lead the
business, has done a great job of
delivering strong business performance and customer service.
“As part of the Dental Buying Group (‘dbg’), we will have
a comprehensive integrated
consumables and service support structure in the UK for
dental practices. We look forward to building on this in the
future and further improving
the quality of service provided
to both Dental Directory and

dbg businesses’ customers and
members.”
The Dental Directory’s Managing Director Martin Mills said:
“We are delighted to be partnering with IDH. They strongly
support our strategy to continue
to grow and diversify Dental Directory’s services and support to
our customers. The prospect of
greater co-operation with IDH,
which operates one of the largest dental healthcare practice
networks in the UK with over
600 practices, and with dbg, will
significantly add to our ability to
provide a superior, cost effective service to customers.” DT

Low vit D during
CDT fined for unlawful pregnancy linked
practise by GDC
to caries in toddlers

man from Liverpool has
been prosecuted for unlawfully practising den-

tistry.

Treating damage casued by sugar accounts for one third of the NHS budget

Frank
Mulholland,
a
75-year-old who owned and
operated Frank Mulholland
Dental Laboratory on Prescot
Street, Liverpool, has never

been registered with the General Dental Council (GDC).
He had been working illegally for many years as an
un-registered Clinical Dental Technician from his dental
laboratory, which was located
opposite the Royal Liverpool
Dental Hospital, providing dentures and denture repairs to the
local community.
On 17 April 2014 Mr Mulholland pleaded guilty to unlawfully practising dentistry at Liverpool Magistrates’ Court. He
was fined £2,500 and ordered
to pay £1,290.70 GDC costs and
£200 victim surcharge. DT

ow vitamin D levels in
women during pregnancy
lead to a higher risk of
cavities in their toddlers, new
research has found.
According to Reuters, researchers from University of
Manitoba’s dental school in Winnipeg measured vitamin D levels
in the second or early third trimester in 207 pregnant women
and then examined the teeth of
135 of their children when they
were an average of 16 months
old.

els were significantly lower in
women whose toddlers later had
cavities than in women whose
toddlers did not have cavities.
The researchers said: “Prevention efforts should begin during pregnancy by bolstering maternal nutrition, either through
improved dietary intake or supplementation with vitamin D.” DT

In the study, published in
Pediatrics, the researchers found
that prenatal vitamin D lev-

Dentistry ‘under attack’ - BDA
Published by Dental Tribune UK Ltd
© 2014, 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 UK.

Editor
Lisa Townshend
Tel: 020 7400 8979
Lisa@healthcare-learning.
com

Sales Executive
Joe Ackah
Tel: 020 7400 8964
Joe.ackah@
healthcare-learning.com

Advertising Director
Joe Aspis
Tel: 020 7400 8969
Joe@healthcare-learning.
com

Editorial Assistant
Angharad Jones
Angharad.jones@healthcarelearning.com

Design & Production
Ellen Sawle
Tel: 020 7400 8970
ellen@healthcare-learning.
com

Dental Tribune UK Ltd
4th Floor, Treasure House, 19–21 Hatton Garden, London, EC1N 8BA

entistry is under attack from governments, regulators and
the fearfulness of politicians,
Chair of the British Dental
Association’s
(BDA)
Principal Executive Committee
(PEC) Dr Mick Armstrong
(pictured)said at the British
Dental Conference and Exhibition on 10 April 2014.
In his inaugural address,
Dr Armstrong argued that the
dental profession is facing a
burgeoning challenge, with a
double standard between the

professionalism expected of
it, and the lack of professionalism with which it is treated,
emerging.
Dr Armstrong also stated
that the profession could be
proud of the way it continually rises to the challenge and
reasserts its professionalism
when may around it appear to
falter. DT

[3] =>

United Kingdom Edition

News 3

April 2014

Incorporated dental practices challenged by HMRC

growing number of
dentists who have incorporated their dental
practices are being challenged
by HM Revenue and Customs
to defend both the valuation
and the process by which the
practice assets were transferred to the new limited company, recent figures by NASDAL reveal.
If HMRC is successful in its
challenge, any reduction in
the valuation could be taxed
by up to 59 per cent.
Accountant
Alan
Suggett, a member of NASDAL’s
technical committee, said:
“The goodwill transferred to
the limited company can be
treated as taxable remuneration. This creates a liability
for income tax at 45 per cent
and National Insurance at 13.8
per cent.
“In the case of an NHS in-

BDA launches
petition over
DFT salary cuts

he British Dental Association (BDA) has
launched a petition to
oppose a proposal to reduce
the salary paid to Dental Foundation Trainees in England.
C

NHS England is proposing
a cut of nearly eight per cent
to the salary which would see
those beginning DFT in September 2014 would be paid
£28,076, more than £2,000 less
than those currently completing their DFT year.
CM

CMY

The BDA believes that this
is an ‘attack on the youngest
and most vulnerable members
of the profession’, and argues
that dental students are graduating with increasing levels
of debt so are already facing
challenges to manage their
finances and launch their careers.
At the time of going to
press, the e-petition had 4,168
signatures. It can be viewed at
epetitions.direct.gov.uk/petitions/64208. DT

corporation, where the contract remains in the name of
the dentist, this could apply to
the whole goodwill value. How
many practice owners could
afford to write out a cheque to
HMRC for 59 per cent of their
goodwill?”

incorporated without the benefit of specialist advice. In
many instances NHS practices
have been ‘incorporated’ leaving the contract in the name
of the dentist, which throws
up significant problems when
the practice owner wants to
sell the company, NASDAL
says.

This issue is of particular
concern to NASDAL lawyers
DentalTribune_CO_A4_June13.pdf 1 17/06/2013 20:03:40
In addition
who sell practices which were

tax

and

NIC, other problems that result from flawed incorporations can include breaching
the NHS contract and exclusion from the NHS pension
scheme. DT

Do you have an opinion or something to say on any Dental Tribune
UK article? Or would you like to
write your own opinion for our
guest comment page?
If so don’t hesitate to write to:
The Editor,
Dental Tribune UK Ltd,
4th Floor, Treasure House,
19-21 Hatton Garden,
London, EC1 8BA
Or email:
lisa@healthcare-learning.com

[4] =>

4 News

United Kingdom Edition

April 2014

Alasdair Miller named next BDA President

r Alasdair Miller will
take on the role of
President of the British Dental Association (BDA)
from 10 April 2014. He will be
the BDA’s 128th President, succeeding Dr Barry McGonigle.
For more than 20 years
Dr Miller was a partner in a
mainly NHS dental practice in
Taunton. From 1997 to 2013
he was the Regional Postgraduate Dental Dean at the University of Bristol where he was
also Programme Director for
the University’s Open Learning for Dentists Diploma programme. In 2009 he was the

first dentist to become Fellow
of the Academy of Medical Educators.
From 2007 to 2010 he was
consultant to the Peninsula
dental School. He currently
sits on the Council of the MDU
and is the interim Chair of
the Bristol, North Somerset,
Somerset and South Gloucestershire Dental Local Professional Network.
Dr Miller served on the
BDA’s Representative Body
from 1986 to 2012. He also
been an active member of the
BDA’s Education Committee

for ten years and served on
a variety of tasks groups and
advisory boards within the
dental education and training
arena.
Dr Miller said: “It is an
honour to be taking up the
Presidency of the Association
and I look forward to acting as
an ambassador for the profession in what are challenging
times for it. During my year
as President I will champion
the profession and its commitment to maintaining the
highest standards of patient
care and professional excellence.” DT

Binge drinking prolongs wound recovery time

eople who are injured
while binge drinking
are much slower to heal
from wounds, researchers
from Loyola University have
found.
In the United States, alcohol dependence and/or abuse
affects 20 per cent to 40 per
cent of hospitalised patients.
Patients with surgical site infections are hospitalised for
twice as long, have a higher

rate of re-admission and are
twice as likely to die as patients who did not binge drink.
The study, published in the
journal Alcoholism: Clinical
and Experimental Research,
showed that binge drinking
reduces the amount of white
blood cells called macrophages that chew up bacteria and
debris. This makes the wound
more likely to be infected by
bacteria.

Binge drinking also reduced levels of CRAMP – a type
of protein that kills bacteria,
and recruits macrophages and
other immune system cells to
the wound site.

“Together these effects
likely contribute to delayed
wound closure and enhanced
infection severity observed in
intoxicated patients,” the researchers concluded. DT

Call for tougher exams for
international doctors
medical graduates, and that
tougher tests will close this
gap. However, the British International Doctors Association
argues that there should be a
standardised test for all.

igher exam pass marks
are needed for international
medical
graduates to work in the UK,
researchers from Durham University and University College
London suggest.
The researchers found that
there is a ‘performance gap’
between international and UK

In the UK, 37 per cent of
doctors registered with the
General Medical Council in
2012 qualified in other countries, with 27 per cent obtaining
their medical degree from outside the European Economic
Area (EEA).
Dr Paul Tiffin from Durham
University said: “Further research is needed to understand
the potential reasons for these

differences in performance,
and in particular, the possible
role that language and culture
may play. A more detailed analysis based on country, not just
region, of qualification would
also be important to conduct in
the future.
“There may be better ways
of supporting overseas doctors
to adjust to UK culture, and
that of the health service more
quickly.”
Tougher language checks
for European doctors coming to
work in Britain are expected to
begin in June. DT

Dentist who changed
patient records struck off

Birmingham dentist has
been struck off by the General Dental Council (GDC)
for changing patients’ records.
Omar Narayan, who practised
at the Hamstead Dental Practice
in Birmingham, was charged with
adding entries onto a patient’s
original green-coloured private
treatment record, and re-writing
the patient’s brown-coloured NHS
treatment record card. He also
created the document entitled Assessment of Capacity for Proposed
Dental Treatment/Decision.
Mr Narayan said he amended
the records and created the assessment form at the request of
Joyce Trail, the Practice owner
and his employer at the time. As
previously reported in Dental

England to have standardised cigarette packaging

that the Australian legislation
(Australia introduced the ban
in 2012) has had a positive impact.

According to the BBC, Ms
Ellison told MPs the latest independent report has found

“We want our nation’s
children to grow up happy and
healthy and fee from the heavy
burden of disease that tobacco
brings,” she said.

he government is moving ahead with plans to
ban branding on cigarette packaging in England,
Public Health Minister Jane Ellison has said.

However, Labour has accused the government of delaying the decision for too long, with
shadow health secretary Luciana
Berger saying that it is “caving in
to vested interests”; while some
Conservative backbenchers say
that the plan is an example of the
‘nanny state’ and that there were
enough warnings about the dan-

gers of smoking already.
Ellison promised that changes will be implemented before
the next election in May 2015,
although MPs would be given a
vote on the proposals before they
came into force.
Conservative MP Sir Paul

Tribune, Ms Trail was convicted
of conspiracy to defraud the NHS.
She submitted 7,141 fraudulent claims to the NHS, which
amounted to almost £1.4million
being paid to Ms Trail by the NHS.
The
GDC’s
Professional
Conduct Committee said: “The
Committee is satisfied that Mr
Narayan’s dishonest conduct is
so serious that it is fundamentally
incompatible with him remaining on the Dentists Register. For
these reasons, the Committee has
determined that the only appropriate and proportionate sanction
to protect patients and maintain
public confidence in the dental
profession, is to erase the name of
Omar Narayan from the Dentists
Register. DT

Beresford, a dentist, told those
protesting the ban: “If I could arrange for them to come into an
operating theatre to see the damage that oral cancer does to people they might actually change
their mind.” DT

CMY

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6 Feature

United Kingdom Edition

The role of physiotherapy in the
management of TMD
Anne Budenberg discusses using physiotherapy for patients with TMD

he Association of Chartered
Physiotherapists in Temporomandibular Disorders
(ACPTMD) is a clinical interest
group, established in November
2009, dedicated to the advance-

ment of physiotherapy for patients
with Temporomandibular disorders (TMDs). Physiotherapy clinicians in the North West of England
and the TMD Clinic, Manchester
Dental Hospital, started the group

as a response to the lack of specialist physiotherapy practice for
this patient group. Now the ACPTMD has over 140 physiotherapists
listed on their website, and a committee made up of clinicians and

academics across the UK.
A primary objective of the association is to promote the highest standards of clinical physiotherapy practice in the treatment

April 2014

of TMDs. Traditionally, there has
been a paucity of clinical attention
from physiotherapists towards patients with jaw and facial pain. It
is unclear why this is, especially as
there is good evidence to support
the use of physiotherapy in the
management of TMDs. Other
manual therapy groups, such as
Osteopathy and Chiropractic regularly manage patients with maxillofacial pain and jaw movement
problems, but physiotherapy has so
far failed to meaningfully engage
with this patient group. It appears
that there are only small regional
groups of clinicians who happen
to have a specific interest in TMDs
who offer physiotherapy services.
This has resulted in gross national
inequality for this patient group,
and confusion for referring parties.
The ACPTMD aims to provide a
balanced, evidence-based standard of care throughout the UK.
The group hopes to provide
a forum for promoting the exchange of ideas and new developments in treatment of these conditions. Although evidence supports
physiotherapy as an intervention
at a fundamental level, there is
still a lack of clarity as to precisely
which physiotherapy interventions are most effective. Not being
a priority area for many clinicians,
creative and innovative thought
and practice seems to be limited.
The group provides a forum for
exchange of ideas regarding good
practice, challenging existing
practice, and providing peer support for the development of new
practice methods.
ACPTMD is working with the
Chartered Society of Physiotherapy to establish an identity as a
recognised Professional Network.
This relates to the groups aim of
maintaining and strengthening
relationships between itself and
other organisations. The group
hopes to develop future working relationships with relevant
medical and dental organisations.
The group has dental representation at committee level and
hopes to develop existing links
with regional and national medical groups. The group thoroughly
embraces the multi-disciplinary
nature of TMDs management.
Ultimately, it is the purpose of
the ACPTMD to promote professional and public awareness of
the benefits of physiotherapy in
the treatment of TMDs. ACPTMD
intend to work hard over the next
few years to raise the profile of
TMDs management and provide
the right information to the public and media about the value of
physiotherapy management in
the care of patients with TMDs. DT

Info
www.acptmd.co.uk
Anyone wishing to contact the ACPTMD for further information, or to become involved with the group, contact
the group’s Secretary: team@acptmd.co.uk. Information for dentists
please contact the Dental Liason Officer, Anne Budenberg Annebud62@
me.com

[7] =>

United Kingdom Edition

Practice Management 7

April 2014

Leading the way to Great Dental Care
Good leadership and management by Glenys Bridges

A

t every level of dental
care provision the skills
required for good leadership and management are
becoming increasingly important. Dental teams with good
leadership and management
consistently meet compliance
requirements defined in the
regulations of the Health and
Social Care Act and the Dentists Act. These requirements
challenge dental professionals to develop a new range of
non-clinical skills not only to
meet standards, but also to
ensure that doing so realises
tangible benefits for patients,
the team and the business.
The Chartered Management Institute recognises a
six step model of leadership
and management. This model
begins with the development
and communication of goals(the vision) leading to the creation of small achievable steps
to achieve the vision, set out
in a business plan. This requires leadership skills to define what the team is aiming to
achieve and create excitement
about the vision, through the
progression of these steps:
Step 1 - set the vision
Good leadership starts with
‘the end in mind’. These leaders have a clear vision of goals
the practice is working to-

ment. These leaders understand that if you do what
you have always done, you get
what you already have. For
new levels of achievement,
teams need to step put of their

comfort zones. This can be
scary but with the right preparation and support it can be
very rewarding.
Steps one and two are the

leadership phase; from step
three onwards management
skills are required to turn the
aspirations into reality. Now
it’s time for managers to decide ‘How’ to realise the vision

à DT page 8

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Futurabond u
®

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Step 2-Encourage creativity
and drive change
The most effective leaders
are charismatic individuals.
To drive continuous improvement, they need to inform,
involve and inspire their people- so that they can take them
out of their comfort zones and
on to new levels of achieve-

Ta
k
cu e a
rre dv
nt an
of tag
fe e
rs
!*

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‘These requirements
challenge dental
professionals to
develop a new
range of nonclinical skills’

ward. These goals should be
defined in the long term over
the next five to ten years, the
middle term over the next one
to five years and short term
over the next year. Once goals
are defined work can begin
on planning how they will be
achieved and targets can be
set for each aspect of the plan.

by planning, training the team
and
deploying
resources.
Steps three to five are governance steps.

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VOCO_DentalTribune-UK_Mar14_Futurabond U_210x297.indd 1

06.02.2014 14:20:03

[8] =>

8 Feature
ß DT page 7

Step 3-Planning, organising
and allocating work
With the strategic goals in
place the management role
begins with the development
of SMART objectives. These
objectives are specific, measurable, achievable, relevant,
and time bound. These are
operational goals based on
measurable end results and
consideration of how to make

United Kingdom Edition

best use of the skills and resources available. They consider how each individual
aspect fits into the strategic
plan and sets a time frame for
monitoring and completion.

consistent results. Working
instructions should be written
by those carrying out the procedures they cover and should
be continuously developed as
the task evolves.

Step 4 -Instructing the team
Information, communication
and knowledge are the life
blood of successful business
operations. Policies and working procedures supported by
working instructions drive

Step 5 -Co-ordinate the
resources
Good management requires
an operational plan and appropriate resources. By the time
step five has been reached the
operational plan is in place to

direct the deployment of resources such as people, budgets and time. Clever management allows the best use of
resources, without driving
people so hard that they are
unable to produce their best
work.
Step 6 - Measuring and correcting performance
To ensure continuous improvement take time out to
compare the results achieved

April 2014

to the SMART objectives set
at step three. This is an audit,
or gap analysis process that

‘Clear leadership is
the starting point
for the success of
any team’

can be used to recognise and
reward success as well as for
making the corrections needed to keep the strategic plan
on track.
Even in small dental teams
these skills are needed at
three management levels, individuals will invariably work
at more than one level

“As a GDP, Six Month Smiles has added a new dimension to the
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1. Senior management - setting strategic goals and inspiring others
2. Middle management - setting operational goals to deliver the strategic goals
3. Junior management - managing tasks

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Clear leadership is the
starting point for the success
of any team. When leaders
know and understand their
role they are able to inspire
their teams. Good leaders understand how by defining the
practice’s vision and setting
it out as strategic goals and
plans can lead the team to
achieve them. Formal training in leadership and management can enable dental
professionals to excel in these
roles. To find BTEC level
three and four qualifications
geared for dental teams visit
www.dentac.co.uk DT

Become a Six Month Smiles Provider by
registering for an upcoming hands-on course.
Dr. Andy Denny

Dr. Anoop Maini

Weston-super-Mare, UK

London, UK

About the author

Straight Teeth. Less Time. Clear Braces.
001 585 594 0606
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Six Month Smiles®
S h o r t Te r m O r t h o S y s t e m

Glenys is an experienced management trainer and
assessor with 20
years’ experience
of working with
General
Dental
Practitioners and
their teams. In addition, she has expertise and qualifications in Counselling and Life Coaching. Her first book
Dental Practice Management and
Reception was published in 2006 her
second book: Dental Management in
Practice was published during 2012.

[9] =>

United Kingdom Edition

April 2014

Business & Finance 9

Annual Planning
Carina Shaw discesses developing a strategic marketing plan

D

eveloping a strategic marketing plan for the new financial year can not only
help you keep on top of your regular practice marketing, but help
you target the right people at the
right times to achieve the practice
growth you’re aiming for.

regular practice meetings too, as
your team may have some brilliant ideas which are more closely
tailored to your practice.
By establishing your audience

and deciding on the most appropriate way to reach them, you are
far less likely to waste money on
unsuccessful marketing as you
will be far more targeted, as opposed to a more scattergun ap-

proach. However, it’s also a good
idea to monitor your marketing
so that you can see what the most
successful marketing campaign of
the year was. That way you can do
more of that type of campaign in

the future or spend more money
promoting it in your strategic plan
for the following year, thus making your marketing more and
more successful year on year.
à DT page 10

Marketing plans are most effective when set out clearly, reviewed regularly and stuck to.
This way you can allocate a budget for your marketing and tailor
it for the various seasons, school
holidays, anniversaries and national events, such as Mouth Cancer Action Month.
A marketing plan must also be
part of a broader business plan,
however, and be thought about
in a structured, strategic way. For
example, it might not be the right
time to do any marketing if your
practice is at the early stages of a
refurbishment. Here is some advice on how to put together a strategic marketing plan and some
tips on how to populate your regular marketing with timely and interesting content.
Establish your audience
This is where a patient profiling
report, available through some
payment plan providers, can come
in really handy as it will show you
the best audiences to target in your
area. It uses postcode information
to profile the types of people who
live within a reasonable drive of
your practice, categorising them
so that you know who and where
your target audience are and the
best way of reaching them.
For example, that national average for the ‘Affluent Achievers’
category is 22 per cent. If your report says that there are more than
usual in your area, you will know
to pitch your tone of voice and
marketing activity for this group.
Likewise, if you have a high percentage of the ‘Mature Money’
group in your area, social media
marketing might be less effective
so you need to look at alternative
ways to reach this audience.
You may also find that there is
a high percentage of a group you
have never targeted before, which
can be a great opportunity for a
targeted flyer drop or regional
magazine focus, but remember to
always put in a strong call to action so that people have a reason
to contact you.
Get your team involved
Below are just a few ideas from us
on how you can capture your patients’ interest with your marketing efforts each month for the full
financial year. However, it’s worth
including an ideas session in your

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506970-Healthcare Drugs Kit Advert-Full Page 07.indd 1

10/02/2014 17:12

[10] =>

10 Feature
ß DT page 9

United Kingdom Edition

to promote these too.

Monthly tips for regular marketing content
April - Easter – if your area has a
high percentage of families, why
not target parents and children
with some marketing on children’s oral health and tips on how
to enjoy Easter treats without ruining teeth? If you have any payment plans for children at your
practice, then this is a great time

May – From mid May till mid June
it’s National Smile Month. Why
not try hosting an open day or
free check up event to help people in the area make the most of
their smiles? You could even hold
a competition to win some treatment to help someone’s smile be
the best it can be!
June - Summer hydration – create some leaflets, slides for your

practice waiting room screens or
a section in your regular email
newsletter on tips to reduce fizzy/
sugary/acidic drinks in the hot
summer months. Include some
facts and tips and some alternatives to keep people hydrated.
July – It’s National Kissing Day on
6th July, so get involved and perhaps include some facts in your
marketing about targeting bad
breath and some practical tips
for getting your patient’s mouths

healthy for kissing!
August - Back to School –target by
offering tips for pre-school term
check-ups, morning brushing and
lunch boxes. You could also offer
free check-ups for children to get
them school ready and hopefully
encourage their parents to become regular patients.
September – September is Colgate Oral Health Month, so why
not promote an event such as a

The best mince pies
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Which Report

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April 2014

toothbrush amnesty where people
bring in their old toothbrush and
you will give them a new one for
the month? This is a great way
of driving potential patients into
your practice and potentially helping your business to grow.
October - Halloween is becoming more popular in the UK every
year, so get involved by getting
your practice team to dress up in
scary Halloween costumes for an
open day promoting family oral
health. You could also produce flyers or a section on your website
on tooth friendly trick or treating,
recipes and snack ideas!
November – November is Mouth
Cancer Action Month and practices across the country are offering
free screenings to highlight the
importance of the ‘If in Doubt, Get
Checked Out’ message. Mouth
cancer is on the rise and the more
people know about this highly
treatable disease the better the
survival rates will become.
December – It’s Christmas of
course! So a personalised greetings card to your patients is always a nice gesture. But why not
include some tips on how to enjoy
Christmas treats without spoiling their oral health; or run a free
check-up offer leading up to December 24th. It’s a great way of
getting people into the practice
and signing them up to Denplan
can be a way of them fulfilling a
new year’s resolution.
January - New Year’s resolutions –
This can cover anything from quitting smoking, regular attendance,
keeping an eye on alcohol intake,
better diet (from dental perspective) and better oral hygiene.
February - Budgeting – February is the month when a lot of
Christmas credit card bills are due
and is one of the toughest financial months of the year. Target
new patients with information
about payment plan options and
spreading the cost of treatment.
March - Preparation for wedding season – look at what brides
are doing to prepare for the most
important day of their lives – tooth
whitening, straightening, facial rejuvenation etc. Attend some bridal
fairs and talk about your minimally invasive aesthetic services. DT

About the author

See demonstrations at www.pearldentalsoftware.com
Call us on 0800 027 2406 and get a TRIAL COPY
Prices Exclude VAT

BHA-A4-ad-Mince pie (Dentistry).indd 1

14/02/2014 16:52

Carina Shaw is
Senior
Practice
Marketing
Consultant at Denplan.
As a former Business Development
Manager at a large
specialist centre,
as well as a senior Dental Nurse,
Carina understands how dental practices work and provides them with
bespoke advice on how to grow their
patient numbers, using her extensive
knowledge of recruitment and retention strategies.

[11] =>

Cosmetic Tribune
Cosmetic Tribune

Cosmetic Tribune

Cosmetic Tribune

Constic

Bioactive materials

Smile enhancement

A case presentation of the filling material

Dr John Comisi

Direct composite resin restoration

pages 11-12

pages 15-18

pages 13-14

Just fill! Constic - The self-etching
and self-adhesive filling material
A case presentation by Matthias Hodecker and Julia Gerke

B

ecause of today’s wide
selection of bonding
systems with complicated work processes the desire to simplify working steps
during restorative treatment
is becoming greater than ever
before. Particularly in the case
of small Class I restorations, as
well as fissure sealing and lining, which can be performed
relatively quickly, preparatory steps such as etching and
bonding protract the working time unnecessarily. At the
same time, they increase the
number of possible sources of
error since, if certain working

steps are neglected, the durability of the restoration can be
drastically reduced.
Many dentists would like
to have fewer work steps
required, in order to be able
to work more reliably and
focus primarily on the restoration. This can be achieved
through the use of self-etching and self-adhesive synthetic materials.
Constic is the new selfetching
and
self-adhesive
flowable
composite
from
DMG, which combines etch-

ing, bonding and filling in one
step and features superior adhesion to enamel and dentine
along with good aesthetics.
Case study
In the following case, a small
and inadequate Class I restoration on tooth 17 can be seen
(Fig 1).
Procedure
After preparing the cavity, it
is initially recommended to
clean the tooth, remove any
debris using water-spray and
blow it dry (Fig 2). Then an approximately 0.5mm thick layer

of Constic flowable composite
is applied to the cavity using
the Luer-Lock-Tip and massaged in for 25 seconds using
a brush (Figs 3&4). Thereafter
any excess should be removed
(Fig 5). Then the layer is lightcured using a polymerisation
light for 20 seconds (Fig 6).
The actual restoration is
then performed. For the restoration, the material is applied
in layers that are a maximum
of 2mm thick (Fig 7). The lowviscosity and uniform consistency of Constic ensures that
the restoration has no trapped

air or marginal gaps. This is
facilitated by the fact that no
additional bonding materials
are used. Each layer is lightcured for 20 seconds (Fig 8).
Using a dental probe, a
high-quality aesthetic fissure
surface can be achieved prior
to final curing (Fig 9). Apart
from
the
Luer-Lock-Tips
and the brush, which are included in the set, few additional modeling instruments
are required. Thus sterilisation costs and instrument
wear are kept to a minimum.
à DT page 12

Fig. 1 Baseline situation: Occlusal amalgam restoration in tooth 17

Fig. 2 The Class I cavity

Fig. 3 Application of Constic using the Luer-Lock-Tip

Fig. 4 Massaging in Constic with a small brush

Fig. 5 Removing the excess using a foam pellet

Fig. 6 Light polymerisation of the first layer

Fig. 7 Application of another layer of Constic

Fig. 8 Light polymerisation of the second layer

Fig. 9 Result after contouring the restoration using a probe

[12] =>

12 Cosmetic Tribune

Fig. 10 Polishing the restoration using a Super-Greenie

ß DT page 11

The cured restoration is then
checked for overhangs, which

United Kingdom Edition

Fig. 11 Constic restoration after finishing and polishing

are removed using a scaler ,
and then polished (Figs 1012).

Conclusion
Constic, as a self-etching and
self-adhesive flowable com-

April 2014

Fig. 12 Checking the occlusion

posite, stands out due to its
uncomplicated
application
with simultaneously high-

quality aesthetic results.
Since Constic is available
in many different shades, a
restoration that is individually
characterised can be prepared
for each tooth. The range includes shades A1, A2, A3, A3.5,
B1, as well as opaque-white.
Since the working steps of
etching, bonding and filling
are combined into one step,
the dentist is able to have a
shortened working time on
the one hand and also stressfree work on the other hand.
In addition, considerably
fewer instruments are required, which improves both
the work flow and also the
dentist’s concentration on his/
her own work and thus has a
positive effect on the final results.

Constic:
Do more with less.

Steps such as etching,
which represent a certain degree of patient risk, are combined with filling into one
work step and this increases
reliability for the dentist. In
addition, this ensures that no
intermediate step is forgotten.
Due to its versatile applicability - Constic is suitable for
lining and also for small Class
I restorations, as well as fissure sealing - the size of the
inventory improves, while
purchasing costs for other
systems are minimised at the
same time.

NEW !

The radiopacity of the material also ensures easy identification of the restoration by
dentists in the future.
Finally, it can be said that
Constic enables work to be
performed in a more relaxed
fashion, while decreasing
the amount of work and
achieving an aesthetically
challenging and functionally
high-quality result. DT

The new 3-in-1 flowable: etching, bonding, filling in one step.
Faster, easier, safer: experience Constic – the new
self-etching, self-adhesive flowable composite from DMG.
Constic combines etching gel, bonding agent and flowable
in one single product. You thus save treatment steps – and

thereby benefit from increased safety during
application. Whether for small Class I restorations,
linings or fissure sealing: start relying on Constic
- the 3-in-1 flowable now! www.dmg-dental.com

About the authors

Julia Gerke is doing doctoral studies
at the Pathological Institute of RWTH
Aachen.
Matthias Hodecker is currently doing
advanced training for a qualification
in Orthodontics in Aachen.
AZM_Constic_GB_E_2013_8.indd 1

16.08.13 12:50

[13] =>

United Kingdom Edition

April 2014

Cosmetic Tribune 13

Conservative smile enhancement
Dr Monika Marciniak presents a case showing direct composite resin restoration
of conoid lateral incisors

M

inimally
invasive
treatments
restore
form, function and
aesthetics with minimal removal of sound tooth structure. Understandably, the restorations age with the patient.
Eventually, teeth that have
been restored will break down
and patients will need to have
those restorations replaced.

Following enamel preserving preparation using a
tapered,
round-ended
fine
diamond
bur
and
sandblasting, a celluloid strip

was placed subgingivally and
fixed using flowable composite. This helped to create the
desired
emergence
profile
and contact points. Next, a
retraction cord was insert-

phoric acid for 30 seconds, then
thoroughly rinsed and dried. A
fifth-generation bonding agent
was then applied and light

ed into the labial part of the
gingival sulcus (Fig 5).
After isolation of the operative field, the preparation was
etched with 37 per cent phos-

à DT page 14

Only

Fortunately, restorative materials and procedures evolve
constantly. If an initial restoration was created using minimally invasive procedures,
there should be more tooth
structure to work with when a
second restoration is needed.
The following case report demonstrates such a conservative
approach.

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Fig 4
Case report
After orthodontic treatment,
a 19-year-old female patient
was dissatisfied with the unpleasant, disproportional appearance of her conoid maxillary lateral incisors. A direct
composite technique was selected for smile enhancement
at the initial appointment (Figs
1-4).

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14 Cosmetic Tribune

Fig 10

Fig 11

Fig 12

Fig 13

Fig 14

Fig 15

Fig 16

Fig 17

Fig 18

Fig 19

The step-by-step images illustrate how dentists can solve
this cosmetic issue without using aggressive techniques and
with the advantage of being in
full control of shade matching

Fig 20

Fig 21

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O F F

Dr Monika Marciniak
from
andgraduated
characterithe Medical
Universation. DT
sity of Białystok in
Poland in 1992, and
runs a private practice with her husband. She has been
publishing articles
on direct composite restorations since 2007. She is a
member of the European Society of
Cosmetic Dentistry. Contact her at
dentystamarciniak@dentonet.pl

PA I R

About the author

R E

The same procedures were
followed during reconstruction
of the left lateral incisor (Figs
12&13). Figures 14 to 16 show
the situation 30 days post-operatively. The lateral incisors
show favourable integration of

Fig 9

After completion of composite applications and polymerisation, fine flame-tipped
finishing diamond burs and
Sof-Lex discs (3M ESPE) were
used for gross contouring and
creating texture. The final polish was achieved using rubber finishers, a brush, a felt
wheel and a paste kit (Fig 11).

Conclusion
Conoid lateral incisors are
not uncommon. They may be
found unilaterally or bilaterally. Their poor appearance
can spoil an otherwise attractive smile. The case presented
describes a minimally invasive
way of addressing this problem
using direct composite bonding.

Fig 8

Dentine in a darker shade was
placed onto the cervical third.
Prior to light curing, the white
strip was painted horizontally
along the incisal edge of the
enamel shelf using a white
tint and smooth brush (Fig
9). Finally, an enamel resin
layer was placed, contoured,
smoothed with a brush and
light cured (Fig 10).

In presented cases, the recontouring procedure was
carried out using a Soft Tissue Trimmer bur (Edenta).
Modifications were limited
by
the
patient’s
biologic
width. As observed at fourweek follow-up visits, there
was a very good gingival response to the polished restorations (Figs 19&21).

Fig 7

‘The case presented describes a
minimally
invasive way of
addressing this
problem using
direct composite
bonding’

Fig 6

The appropriate dentineshade resin was then applied
in order to create distal and
mesial lobes. These were light
cured for ten seconds (Fig 8).

Some cases present with
conoid lateral incisors displaying a lack of gingival
harmony, as were the cases with those patients (Figs
17&20). This usually manifests
as the translocation of the gingival contour coronal to the
zenith of the canine and the
central incisor. Such a clinical
situation requires gingival recontouring before direct restoration.

Fig 5

M A

The next step entailed creating palatal and two lateral
enamel walls that were completed using increments of
enamel-shade resin. Creating
a lingual shelf in this manner
left room for the subsequent
dentine layering (Fig 7).

cured (Fig 6).

form and colour as achieved
through the direct composite
resin restoration procedure.
Adequate contours and proportions create a smile with harmonious symmetry and a natural appearance.

April 2014

O T

ß DT page 13

United Kingdom Edition

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[15] =>

United Kingdom Edition

Cosmetic Tribune 15

April 2014

Bioactive materials support
proactive dental care
Dr John C Comisi discusses bioactive materials

esin bonding of the human dentition has become a ‘standard’ in
the United States and Canada.
There are more than 80 different bonding systems on the
market today. We have seen
them evolve through multiple generations in an attempt
to ‘simplify’ the bonding process. Yet, as these agents have
simplified, many in our profession have seen many challenges arise.

acids and cause hydrolytic and
enzymatic breakdown of the
dentin and resin bonding agent

interface.5 These enzymes are
called matrix metalloproteinases (MMPs).

Currently, there are only
three methods of reducing these
MMPs: two per cent chlorhex-

£3,300

idine solutions that are used
prior to application of bondà DT page 16

inc.

A significant number of reports in the literature have been
showing that the “immediate
bonding effectiveness of contemporary adhesives are quite
favourable, regardless of the
approach used (however) in
the long term, the bonding effectiveness of some adhesives
drops dramatically.”1 The hydrophillicity that both etch and
rinse and self-etch bonding
agents offer initially in the dentin bonding process becomes
a significant disadvantage in
terms of long-term durability.2
It is this hydrophillicity of
simplified adhesive systems
combined with other operatorinduced challenges that contribute to these failures. Tay,
Carvalho, Pashley, et al. have
reported repeatedly in the literature of this problem.3,4 They
continue to report that these
bonding agents do not coagulate the plasma proteins in the
dentinal fluid enough to reduce
this permeability. The fluid
droplets contribute to the incompatibility of these simplified adhesives and dual-/autocured composites in direct restorations and the use of resin
cements for luting of in direct
restorations.

The previously mentioned
plasma proteins are released
by the dentin when subjected to

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The term “water-tree” formation has been coined to
describe this process, which
originated from the treelike
deterioration
patterns
that were found within polyethylene insulation of underground electrical cables. It is
now being applied to the water
blisters formed by the transfer
of dentinal fluid across the dentin bonding interface. These
“water blisters... act as stress
raisers and form initial flaws
that cause subsequent catastrophic failure along the adhesive composite interfaces.”

All-in-one Laser

[16] =>

16 Cosmetic Tribune

United Kingdom Edition

April 2014

ß DT page 15

Fig 1

ing agents; etchants containing
benzalkonium chloride, otherwise known as BAC (ie Bisco’s
Uni-etch products); and polyvinylphosphonicacid-producing
products (glass ionomer and
resin modified glass ionomers).
Due to the short efficacy of
these chlorhexidine solutions
being used before bonding, this
methodology has come into
question as of late.6 Etchants
with BAC have been shown to
be valuable in the reduction of
MMPs and should be considered
in all bonding processes.7 However, the most intriguing methodology of reducing MMPs and
remineralising tooth structure
is with the use of glass ionomer
cements (GIC) and resin-modified glass ionomers (RMGIC).
Glass ionomers and resinmodified glass ionomers
Glass ionomer cements have
long been used as a direct restorative material. Their early
formulations made the material difficult to handle, and
the breakdown of the material
made it an undesirable solution
in dental restoration. However,
these materials, especially in
today’s formulations and preencapsulated
presentations,
have many properties that make
them very important in the restorative process.
The work at companies such
as SDI North America (Riva
product line), GC America (Fuji
product line) and VOCO (Iono
product line) have continued to
make great strides in improving
these products for easier and
longer-lasting use of GIC and
RMGIC products.
First, these materials are
bioactive, and up until recently,

Fig 5

Fig 2

Fig 3

Fig 4

they were the only materials
with this property; that is they
have the capacity to interact
with living tissue or systems.
Glass ionomers release and recharge with ions from the oral
cavity.

better internal adaption and resistance to microleakage over
extended periods of time, have
no free monomers, can be bulk
filled and offer excellent biocompatibility.11

bacterial invasion of the restored
tooth. RMGIC biomaterials are
multifunctional molecules that
can adhere to both tooth structure and composite resin, thus
providing an improved sealing
ability by chemical or micromechanical adhesion to enamel,
dentin, cementum and composite resin.

This transfer of calcium
phosphate, fluoride, strontium
and other minerals into the
tooth structure helps the dentition deal with the constant
assault of the acidic nature of
day-to-day ingestion of food
and beverages and encourages
remineralisation; and the incorporation of phosphorous into
the acid in today’s GICs creates
polyvinylphosphonic acid.8
This property of GICs makes
them a major agent in the reduction of MMP formation, and
thereby minimising if not eliminating the collagen breakdown
commonly found in many resindentin bonding procedures.9
Second, they bond and
ultimately form a union with
the dentition by chemically fusing to the tooth. The combination of the polyacrylic acid and
the calcium fluoro-alumino
silicate glass typically found in
GICs reacts with the tooth surface, which releases calcium
and phosphate ions that then
combine into the surface layer
of the GIC and forms an intermediate layer called the “interdiffusion zone.”10
No resin bonding agents are
required due to this chemical
fusing to the tooth structure.
This ion release helps inhibit
plaque formation and provides
an acid buffering capability
that helps to create neutralisation effect intraorally. In addition, these GICs have very good
marginal integrity with better
cavity-sealing properties, have

Fig 6

Another important consideration is that GICs are moistureloving materials, which makes
them very sensible for use in
the intraoral cavity. The transfer
of dentinal fluid from the tooth
to the GIC essentially creates a
“self-toughening mechanism of
glass ionomer based materials…
serves to deflect or blunt any
cracks that attempt to propagate
through the matrix [and]…plays
an adjunctive role by obliterating porosities [which] delay the
growth of inherent cracks in the
GIC under loading.”4
The intermediate layer of
the GIC provides flexibility
during functional loading and
acts as a stress absorber at the
interface of the restoration and
the tooth.12
Resin-modified glass ionomers (RMGIC), which are a hybrid of traditional glass ionomer
cements with a small addition
of light-curing resin, exhibit
properties intermediate of the
two materials.13 This material
has been shown to have properties similar to GIC, but with
better aesthetics and immediate
light cure. RMGICs have been
shown to undergo slight internal fracturing from polymerisation shrinkage, yet have an inherent ability to renew broken
bonds and reshape to enforce
new forms.12
Application of RMGIC to all
cut dentin in Class II composite
restorations has been shown to
“significantly reduce micro-leakage along (the) axial wall” of the
restoration,14 and helps prevent

They, like GICs, can be bulk
filled to reduce the amount of
composite necessary to restore
the cavity preparation and act
as dentin substitutes in the
restoration.15
The use of GIC and RMGIC
in the restoration of posterior
Class V restorations and conservative Class I restorations
provides many benefits. They
are easy to place and reasonably forgiving, even in a slightly
moist environment. They should
be placed in a moist but not wet
environment, so familiarity with
technique is imperative as it is
with all dental restorations. I
will often use Riva SC (SDI) or
Fuji 9 GP Extra (GC America) in
posterior Class I and V restorations (Figs 1-7).
Polishing and shaping of the
materials must be done with
water spray and fine/ultra-fine
composite finishing burs and
polishers so as not to destroy
the surface of the material (Fig
8). The use of RMGIC products,
such as Riva LC or Fuji II LC, is
great in bicuspid and anterior
Class V restorations, especially
in high caries prone patients
(Figs 9-12).
Class II restorations, however, have always presented a
challenge to the clinician. If the
operator wanted to use GIC or
RMGIC, there was no easy way
to do this that appeared to provide satisfactory results. It is

Fig 7

with this in mind that the ‘sandwich technique’ was developed.
It was thought that using
the properties of GIC to bond
to the tooth and then applying resin bonding agents and
composite to the set GIC could
help reduce sensitivity and bond
failures typically seen in many
resin-bonded composite (RBC)
techniques.
Typically, the GIC is placed
in the preparation, allowed to
set, cut back to ideal form and
then bonded to with an RBC
technique. However, the inability of RBCs to adhere to the set
GIC often creates many failures.
The materials by themselves
are incompatible over the long
term.
The
modified
sandwich
technique evolved as a means
to overcome this problem. Placing RMGIC over set GIC - and
then adding a RBC to that provided a better solution, but
was as laborious and time
consuming to do, as is the sandwich technique.
The ‘Co-Cure Technique’
In 2006, an article was published16 that, in my opinion, has
revolutionised the way I approach direct posterior restorations and direct restorations as
a whole. The article presented
a radical approach to direct posterior restorations, called the
Co-Cure Technique. This technique is defined as the simultaneous photo-polymerisation
of two different light activated
materials that involves “the
sequential layering of GIC,
RMGIC and composite resin prior to photo-polymerisation and
before the initial set of the GIC
[which] enables an efficient single-visit placement of a [direct]
restoration…”16

[17] =>

United Kingdom Edition

unfilled resin material (ie Riva
Coat by SDI or G-Coat by GC),
wipe away the excess GIC and
composite restoration material
to create your margins and prevent ditching and white lines.

Fig 8

In the Co-Cure Technique,
the composite restoration does
not require a bonding agent because the bonding agent is essentially the RMGIC. The RMGIC
acts as the interface between the
GIC and the composite material.
It combines the GIC, RMGIC and
composite in a way to form what
can best be described as a ‘monolithic biomimetic restoration.’

The occlusal table of the restoration can then be compressed gently with a plastic
occlusal matrix by either having the patient bite or by the
operator pressing gently with
his thumb or forefinger to
improve the coalescence of

Cosmetic Tribune 17

April 2014

the three materials. This can
help reduce the time involved
in creating the final occlusion
of the restoration by creating a
functional occlusal table.
The restoration is then
cured for 30 to 40 seconds with
an LED curing light that generates at least 1,500mW/cm2.
Appropriate light output is
critical for all direct cured restorations, and assurance that
appropriate output is provided
by the curing light is needed

Fig 10

à DT page 18

This restoration is an ‘open
sandwich’ type of sandwich
technique. That is, the GIC
component is exposed to the
oral environment (Fig 13) at
the gingival portion of the restoration. It is quickly and efficiently accomplished and has
significantly reduced postoperative sensitivity compared with
typical direct RBC techniques.
I have been placing these types
of direct posterior restorations
since 2008. They have become
the cornerstone of my practice.
Technique procedure (Fig 14)
After placement of an appropriate dental matrix, the technique
incorporates the use of 37 per
cent phosphoric acid to prepare the tooth for restoration.
The acid is essentially ‘flooded’
into the preparation in a similar
manner to doing a ‘total-etch’
RBC. It is, however, washed off
after five seconds of placement.
The tooth is then dried but not
desiccated. The area remains
slightly moist because the GIC
that will be placed next is hydrophilic.
Fill the preparation with
the triturated GIC material
up to the level of the DEJ, then
immediately place the triturated RMGIC in a very thin layer
to cover the GIC and walls of
the preparation. Finally, place
the composite over the previous materials to slightly overfill
the preparation. With a large
round burnisher dipped in an

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Fig 9

[18] =>

18 Cosmetic Tribune

United Kingdom Edition

April 2014

Fig 13

Fig 11

ß DT page 17

for complete cure of any direct
restoration.
The restoration is evaluated for complete cure and
then a layer of an unfilled resin
is placed on the exposed GIC/
RMGIC/composite complex and
cured for an additional 10 seconds. The matrix band is removed and the restoration is
trimmed and polished as any typical RBC restoration would be.
I have found that an entire
three-surface posterior restoration can be accomplished in
less than three minutes once the
matrix has been placed. Typically, finishing the restoration
can also be done in less than
three minutes. This makes the
direct posterior restoration quite
efficient and beneficial to the clinician and the patient because
we are providing a restoration
that will help enhance healing
of the dentition and reduce recurrent decay and restorative
failure.
Nanotechnology in dental
materials
Nanotechnology involves the
production of functional materials and structures in the range of
0.1 to 100 nanometers by various
physical or chemical methods.
Today, the development of nanotechnology has become one
of the most highly energised disciplines in science and technology because it can stimulate the
creation of many new materials
with previously unimagined applications and properties.
Several studies17,18have shown
that the inclusion of these types
of nano-fillers and nano-fibres
into the dental materials (dental
composites and bonding agents)
can improve the physical properties by increasing the strength,
polishability, wear resistance,
aesthetics and bond strengths in
many dental applications.

Fig 12

It is also envisioned that the
incorporation and utilisation
of these nanoparticles in the
form of nano-rods, nano-fibres,
nano-spheres, nano-tubes and
ormocers (organically modified
ceramics) into dental restorative and bonding agents can create more biomimetic (life-like)
restorations. This will not only
enable these materials to mimic
the physical characteristics of
the tooth structure, but will also
be able to facilitate the remineralisation of that structure.
As Saunders states in his conclusion, “such nano-restorative
biomaterials could very credibly be the next transfor-mative
clinical leap” in restorative dentistry.
Giomers
In that vein, an exciting advancement in bioactive materials is the development of giomer products (SHOFU Dental,
Beautifil II, and Beautifil Flow
Plus). These giomers are resinbased composites that contain
pre-reacted glass ionomer particles (S-PRG). These particles
are made of fluorosilicate glass
reacted with polyacrylic acid
(just like a GIC), just before being incorporated into the resin.
This creates a new type of bioactive material.
These giomer products display properties in a manner similar to GICs19: they release ions
and recharge with ions from the
oral cavity, inhibit plaque formation and neutralise and buffer
the acids of the mouth.20
No other composite material
has this property to date. I use
these giomers instead of traditional nano-hybrid composites
in my restorations because of
these properties. They complete
the entire biomimetic and bioactive nature of all the co-cure
procedures that I create.

The Beautifil Flow Plus product line has also expanded the
way that I create restorations
due to their unique viscosities.
These materials can be stacked
(Fig 15) and used in a restorative
process I call the ‘modified resin
cone technique’ (Fig 16).

desiccate
3) Triturate and apply the
RMGIC bonding agent with a
micro-brush and cure for 20
seconds
4) Place composite to fill the
preparation and cure as appropriate

They can also be applied to
create direct composite veneers
that can be easily placed, sculpted and highly polished (Fig 17).
Easy placement, the ability to
stack and maintain position
and shape, plus their bioactive
nature, make these materials a
‘game changer.’

When I use this material in
the Co-Cure Technique, I just
substitute it for the traditional
RMGIC material that I would
have used otherwise.

Resin-modified, light-cured
bonding agents
Another advancement that I
have been working with is a
product that is a resin-modified,
light-cured bonding agent (SDI,
North America: Riva Bond LC).
This product is a specially formulated liquid RMGIC that can
be used to bond composite restorations in the traditional sense,
used in traditional sandwich and
modified sandwich techniques
and, of course, used in the CoCure Technique.
This concept is especially
appealing in light of research
that indicates RMGICs provide
quite good marginal seal when
used as a bonding agent on cut
dentin surfaces.14 I especially
like to use it with the Co-Cure
Technique and when doing anterior restorations.
Using this technique I am
able to get a completely biomimetic, bioactive restoration in
both situations because of the
bioactive nature of the materials
used.
The technique for use of
this RMGIC bonding agent with
composite is as follows:
1) Etch with 37 per cent phosphoric acid for five seconds
2) Wash and dry but do not

Resin-modified calcium
silicates
Another
recent
interesting
product release is from Bisco
and is called TheraCal LC. This
light cured bioactive material
is used to seal and protect the
dentin-pulp complex. It is the
first of a new class of internal
pulpal
protectant
materials
known as resin modified calcium silicates (RMCS).
It acts as a pulp capping and
liner material. Calcium hydroxide (CH) has been the “gold”
standard for pulp capping for
many years. However, it has always had difficulties in use as a
liner under RBC adhesives. In
fact, despite their frequent use,
the success of CH based therapies is only 30 to 50 per cent.21
It has also been shown that
traditional resin-based lightcured liners have been cytotoxic to cultured odontoblast-like
cells, while light-cured resinbased MTA cements presented
the lowest cytopathic effects.22
Based on this, the creation of
light-cured RMCS is a logical
step in developing a solution for
direct pulpal protection. Calcium has been shown to be crucial
to the formation of apatite, dentin bridge formation and re-apatite potential of affected dentin.
Additionally, alkalinity also
seems to be contributory toward
this goal. This combination in
the RMCS material appears to

Fig 14
Fig 15

Fig 16

Fig 17

form good, hard and thick dentin bridges and stimulates dentin pulp cells to turn into odotoblastic dentin cells.23
This type of material represents a promising new direction
in direct pulp-capping clinical
procedures with its ability to
form apatite and further contribute to the formation of new
dentin.
Conclusion
It is my belief that using bioactive materials in the provision of care for my patients
has been paramount to the
success of the care I have
been providing. In this way,
I have provided ways to heal
the dentition, enhance the restoration and improve the health of
my patients.
I believe we are on the
threshold of further bioactive
material advancements and that
learning
and
incorporating
these restorative materials into
the day-to-day provision of care
will continue to help our patients, our practices and our profession. DT
Editorial note: A complete list
of references is available from
the publisher.

About the author
Dr John C Comisi,
DDS, MAGD, has
been in private practice in Ithaca, NY,
since 1983. He is a
graduate of Northwestern University
Dental School and
received his Bachelor of Science in biology at Fordham
University. He is a member of the
American Dental Association and its
tripartite organisations, the Academy
of General Dentistry, the American
Equilibration Society, the International and American Association of Dental
Research, a research associate at New
York University Dental School and
an editorial board member of Dental
Products Shopper Magazine. Comisi
is a Master of the Academy of General
Dentistry, and holds fellowships in the
Academy of Dentistry International,
the American College of Dentistry,
the Pierre Fauchard Academy and the
International College of Dentistry. He
may be contacted at jcomisi@jcomisi.
com. (Photos provided by Dr John C
Comisi unless noted otherwise)

[19] =>

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BECOME A REPEAT
OFFENDER.

O Excellent ergonomics
O Highest functionality
O Best reliability
O Titanium sleeve

on the many uses and treatment options of diode lasers
with a wavelength of 970nm.
Interesting facts and figures,
study results, documented
case studies with descriptive
pictures, and recommendations for further reading complete the compendium.

‘Anyone with an
interest in laser
dentistry should
read the SIROLaser
Factbook. The book
is especially meant
for beginners, however, experienced
users will also find
it worth reading.’
“Anyone with an interest
in laser dentistry should read
the SIROLaser Factbook,”
says Ingo Höver, product
manager at Sirona. The book
is especially meant for beginners, says the laser specialist.
“However, experienced users
will also find it worth reading.
I am sure that they will be surprised to learn the many possibilities of diode lasers and
the range of applications that
are open to them with models
like the SIROLaser Advance
or SIROLaser Xtend.”
Routine and less common
aspects of dental treatment
The 970-nm diode laser discussed in the SIROLaser
Factbook covers a variety of
dental indications, says copublisher and co-author Professor Doctor Andreas Braun
from the Center for Dental
and Oral Medicine of the

Now you can identify reliably, quickly
and simply where caries does or does
not exist with SIROInspect
Sirona Dental Systems, Lakeside House,
1 Furzeground Way, Stockley Park,
Heathrow, London UB11 1BD
0845 0715040
info@sironadental.co.uk
sirona.com

The

D e n t a l

C o mp a ny
Compact information on lasers:
SIROLaser Factbook

[21] =>

United Kingdom Edition

University of Marburg. These
include incision/excision associated with gingivectomy,
gingivoplasty, implant exposure, and removal of abnormal tissue and reducing bacteria as a supporting measure
in periodontal, peri-implant
or endodontic procedures as
well as adjunctive therapy in
the treatment of aphthous ulcers. “The selected articles
cover both routine and less
common aspects of dental
treatment with a particular
focus on new treatment strategies combined with conventional techniques,” says Prof.
Dr. Braun.

Relaxed
dentists
and
patients
Sirona,
global
innovation
leader for dental equipment,
has two laser models in its
product portfolio that set new
standards: SIROLaser Xtend
with an upgrade option for
beginners and SIROLaser Advance for experts. The lasers

ORTHOPANTOMOGRAPH ® is a registered trademark of Instrumentarium Dental, PaloDEx Group Oy.

‘Academic articles
and real-life user
reports by wellknown experts provide information on
the many uses and
treatment options
of diode lasers with
a wavelength of
970nm. Interesting
facts and figures,
study results, documented case studies with descriptive pictures, and
recommendations
for further reading
complete the
compendium’

recommendations for day-today practice will result from
the treatment procedures described.”

Advertorial 21

April 2014
October
2013

stand for safe, precise procedures, gentle, pain-free treatment, lasting product quality,
and top design. The SIROLaser Advance and SIROLaser
Xtend ensure relaxed dentists
and relaxed patients. More
information for dentists and
the compendium “SIROLaser
Factbook – Clinical articles
about SIROLaser Advance and
Xtend applications” are available for download at www.sirona.de. DT

SIROLaser Advance and Xtend – two models for safe, precise, pain-free treatment

The One
“THE TRUE IMAGING EXPERTS”
GO FOR INSTRUMENTARIUM DENTAL

This is the one that started it all. This is the one,
that set the benchmark for everyone to follow.
This is the one with a long legacy of innovation.
This is the one which became synonymous with
quality – This is Instrumentarium Dental's
ORTHOPANTOMOGRAPH®. The OP1.

“There are few instruments
that symbolise modernity and
innovation in dentistry more
than the laser,” says Prof. Dr.
Roland Frankenberger. Laser
applications in dentistry are
now scientifically established.
The President of the German
Society for Restorative Dentistry (DGZ) writes in his foreword, “I am especially pleased
that a variety of interesting
aspects of routine work are
examined and laser treatment
is conveyed objectively, but
with enthusiasm.” Prof. Dr.
Braun hopes, “Perhaps new

With a legacy of innovation and experience
spanning over 50 years, we’ve mastered
the clinical excellence valued by true dental
professionals. We’re ready for the next 50 years.
As a true professional yourself, are you ready to
join us for this journey?

2D
3D

About the Company
Sirona is the global market and
technology leader in the dental industry and has been a worldwide
partner for specialty traders, dental
practices, clinics, and dental laboratories for more than 130 years.
Sirona develops and produces the
complete spectrum of dental equipment products, including CAD/CAM
systems for computer-assisted ceramic restorations (CEREC), digital
imaging systems for intraoral and
panoramic x-rays, as well as volume tomography (3D), treatment
centres, instruments and hygiene
devices. Sirona’s largest development and production site is in Bensheim, Germany. The company has
more than 3,200 employees around
the world and has been listed on the
NASDAQ since 2006 (symbol: SIRO).
www.sirona.de

1961 | ORTHOPANTOMOGRAPH® OP1

www.instrumentariumdental.com

2011 | ORTHOPANTOMOGRAPH® OP300

2013 | The journey continues

[22] =>

22 Industry News
3M ESPE
Mix and match

United Kingdom Edition

7 Connections
MagicBox

3M ESPE is dedicated to developing practical
and affordable solutions for dentists. The
Pentamix Lite automatic mixing unit is
lightweight, simple to use and can be stored
upright when on standby. It also has an
integrated handgrip, allowing it to be easily moved around the practice as
required.
The Pentamix Lite automatic mixing unit is suitable for all viscosities and works
beautifully with all 3M ESPE impression materials, dispensing a void-free mix
for accurate and precise restorations.

Providing an array of both digital and hard copy
marketing resources, the innovative MagicBox
delivers all the tools you need to market your
practice effectively for the next year.
Posters, personalised referral cards and social media
banners are all featured to name but a few, as well as a 12-month marketing
plan and a return on investment tracker enabling you to monitor your progress
throughout.

The Pentamix Lite automatic mixing unit can be used almost immediately after
delivery – just plug it in, turn it on and start mixing.

And more information is available on the fresh new website, www.7connections.
com, where you can find out more about other business services available, the
team’s backgrounds or upcoming events, while also keeping up-to-date with
the industry by reading the team’s blogs.

For more information, call 0845 602 5094 or visit www.3Mespe.co.uk

Marketing – it’s amazing what you can achieve with a little Magic….

3M ESPE and Pentamix are trademarks of the 3M Company

Book your free marketing review with 7connections today, and quote discount
code MB004 to receive a 25% on your first three months of MagicBox*!
For more information about 7connections and the MagicBox,
please call 01647 478145, email phillippa.goodwin@7connections.com. or
visit the brand new website www.7connections.com
Discount code valid until the end of May 2014

CB12
Effective relief from the
effects of halitosis
Patients who suffer from
chronic bad breath have to
contend with both the physical and psychological effects of their condition.
In a seven-year Swiss study, halitosis has been found to bring about inhibition,
insecurity, withdrawal and reduced social contact to chronic sufferers.
You can greatly help by recommending CB12, which has been proven to
effectively neutralise all three odour-causing Volatile Sulphur Compounds
better than 18 other leading mouthwash brands.
For all-day freshness and confidence, patients can also use CB12 boost. This
new product is a scientifically formulated two-layer, sugar-free gum that
contains zinc, fluoride and xylitol – three ingredients that prevent bad breath,
strengthen teeth and prevent caries, and reduce plaque.
For effective relief from halitosis that can help set your patients’ minds at ease,
you can confidently recommend these two products from CB12.

RelyX Unicem Self-adhesive Resin
Cement
10-year clinical performance

A recently published 10-year clinical study from The Dental Advisor gives RelyX
Unicem self-adhesive resin cement five stars and a 98% clinical rating.
Through scientific evaluation protocol, over one thousand three hundred
anterior and posterior restorations were examined over six-months for postoperative sensitivity, marginal discolouration and retention.
RelyX Unicem self-adhesive resin cement performed well under all criteria,
leading The Dental Advisor to conclude that “RelyX Unicem has proven to be a
reliable self-adhesive resin cement over the 10-year recall period.”1
The UK’s leading permanent dental cement proves itself once again through
outstanding clinical performance.1
For more information, call 0845 602 5094 or visit 3Mespe.co.uk
3M ESPE and RelyX are trademarks of the 3M Company

At EndoCare we don’t just aim to meet
patients’ expectations, we aim to surpass
them. That’s because we believe in
something better. We believe that every
patient is unique and deserves to be
treated with the same level of care that we would expect to receive ourselves.
Our light, airy practices are located across London, and are equipped with
the latest cutting-edge equipment designed to meet the exacting needs of
modern Endodontic practise. Not only will your patients receive the very best
care in a warm and friendly environment, but they will also receive treatment
from recognised experts in their field.
Our team of highly qualified Specialist Endodontists are wholly committed
to diagnosing and treating dental pain, and are widely published in the
professional press.
For the very best Endodontic patient referrals, call the EndoCare team today.
We pride ourselves on forming close working relationships with all our
referring practices, and aim to become an integral part of your practice team.

Let The Dental Directory help
you take a BIG BITE out of your
spending
The Dental Directory’s latest edition
of Big Bite is out now, with offers
on a wide range of oral hygiene
products. Save over 30% on Colgate
MaxWhite One Professional Kit, 25% on SofGrip Scalers, and 30% on Wisdom
Micropower battery toothbrush, plus savings on many other products too.
For many dentists, supplying oral hygiene products to patients has proved to
be a valuable revenue builder for their practice. Big Bite is an ideal source of
inspiration and supplies, ranging from toothbrushes to xylitol chewing gum,
waterflossers to Tooth Fairy envelopes.
Our sales teams are ready to help and with no minimum order value, no
delivery charge and same day dispatch for orders received before 5pm,
we are at your service. Make The Dental Directory your first choice for your
oral hygiene needs. Order by telephone, fax or through our comprehensive
website, where you can view more of the 27,000 products we offer.

For further information please call EndoCare on 020 7224 0999
Or visit www.endocare.co.uk

The Independently Verified Best Priced Dealer!
For more information, contact The Dental Directory on
0800 585 586, or visit www.dental-directory.co.uk.

BPE guidance at your fingertips - new gum
health app available now!
GlaxoSmithKline
Consumer
Healthcare,
manufacturer of Corsodyl mouthwash, has
launched a new mobile app to help support
dental professionals with the use of the Basic
Periodontal Examination (BPE). The app provides
information on:
• Background to the BPE codes
• Description and clinical image of each BPE code
• Summary of recommended treatment

The University of Buckingham and LDTA agreement
The University of Buckingham and the Leicester Dental Teaching Academy
(LDTA) signed a joint venture agreement on April 27th 2012 to establish a
Dental School in Leicester which would initially provide a five year BDS degree
course. This was to complement a new Medical School which the University
was also pursuing at the time.

Developed by the British Society of Periodontology, the BPE allows dental
professionals to consistently & accurately assess their patients’ gum health.1
The assessment of gum health, together with the provision of support
for patients to help prevent periodontal disease, will be of even greater
importance once the Dental Quality & Outcomes Framework comes into force
in the revised dental contract. The Corsodyl brand is committed to supporting
dental professionals when educating patients on the importance of gum
health and the early signs of gum disease. This app forms part of a range of
materials that also includes the Corsodyl Gum Care Guidance Pack which can
be requested for dental practices.
Compatible with iphones and ipads, the app can be downloaded from the app
store by searching “bpe app” and further information can be accessed from
www.gsk-dentalprofessionals.co.uk

Spoilt for choice
Carestream Dental at BDA Conference
and Exhibition
Delegates visiting Carestream Dental at
this year’s BDA Conference and Exhibition
had access to a huge range of cutting-edge
technologies on display.
From the innovative CS Solutions system that enables dentists to scan, design,
mill and place restorations in a single appointment, to the eSignatures module
enhancing patient consent and the time-saving AutoPost service, delegates
were truly spoilt for choice.
The award-winning CS 8100 OPG Unit was particularly popular feature on the
stand, having recently been voted ‘Top Panoramic Imaging System of 2014’
by The Dental Advisor. Delegates were also keen to find out more about the
innovative CS 9300 CBCT impression scanner and CS 3500 intraoral scanner
available. In addition, the team from Carestream Dental introduced the brand
new CS 8100 3D from within the Innovation Zone, demonstrating the many
benefits of easy-to use technology and high quality 3D images in everyday
practice.
For further information on any of the award-winning technologies from
Carestream Dental, contact the experts today.
For more information, contact Carestream Dental on 0800 169 9692 or visit
www.carestreamdental.co.uk

High performance LED technology from
Clark Dental
New from Clark Dental, the Zenium ZYO
is the latest high performance operating
light featuring ‘shadowless’ technology for
perfect clarity of vision.
Designed with the modern practice in mind,
the ZYO is the perfect blend of style and sophistication. The unit consists of
six powerful LED lights that can be adjusted to produce between 5,000 and
32,000 Lux, while innovative new materials improve heat dissipation while
ensuring the unit remains light and compact.
With ergonomics such an important consideration, users will appreciate the
excellent freedom of movement offered by the articulating ZYO arm, which
has been designed to offer maximum fluidity and variety so you can illuminate
your procedures from any angle.
The Zenium ZYO can be purchased as an LED light only as above and also
offers clinicians the additional option of a fully integrated digital HD camera,
complete with zoom function.
For more information call Clark Dental Sales on 01270 766167,
email info@clarkdentalsales.co.uk
or visit www.clarkdentalsurgerydesign.co.uk

For more information about CB12 and how it could benefit your patients,
please visit www.cb12.co.uk

Endocare
Exceeding expectations

April 2014

In October 2012 the University and the LDTA hosted a launch in Leicester to an
invited audience of 200 delegates drawn from Leicester’s dental professionals
and a small number of other interested parties. Both the University and the
LDTA pursued this venture with enthusiasm. However, delays in the anticipated
start date for the Medical School and the large amount of resource required for
this project alone has left the University with no choice but to delay the Dental
School until the Medical School is established. As the University is unable to
commit to a start date this has made it impossible for the LDTA to complete
contracts for the provision and construction of facilities as required in the joint
venture. Both parties therefore reached an amicable agreement to end the
joint venture in January 2014.
The University of Buckingham will support, as far as it is able, the efforts by the
LDTA to attract an alternative venture partner.

Invisalign university programme for post graduate orthodontic training
expands
Align Technology has reached agreement with a further four dental schools
to join its orthodontic training programme, bringing the number at which it
teaches to seven. The Invisalign University Training Programme starts with
an introduction to the Invisalign Doctor Site; treatment options and treatment
selection; record submission; the use of the ClinCheck® software and aligner
delivery, through to monitoring and finishing. Each university is provided
with a University Kit which includes Invisalign materials and access to the
Clincheck software programme - everything the students need to get started.
The participating university is also issued with a username and password for
students to use to access the Invisalign Dr Site which is a website portal for
submitting cases. In addition to this, the site includes an educational sub-site
which is continuously updated with clinical tips, hints, clinical presentations
and publications. Other benefits include additional free Invisalign treatments
and discounts once the first student intake has submitted their first cases.
Every student who participates is also entitled to an Invisalign account which
is activated after their graduation, which allows them to care for patients using
the Invisalign system once they start in practice.
An authorised member of the faculty of universities interested in adding
Invisalign® to its orthodontic training curriculum is requested to email:
eu-universities@aligntech for more information.

Aligned with the British Dental
Health Foundation
Align Technology is supporting the
British Dental Health Foundation’s
2014 National Smile Month campaign.
Orthodontic treatment has the
potential to help some patients
overcome their dental phobia. The
most recent Adult Dental Health
Survey1 showed that 12% of people surveyed in the UK experience extreme
dental anxiety. However orthodontic treatment is viewed as a positive aspect
of dentistry – where people are motivated to actually seek out treatment from
their dental professional to improve their smiles. To back up the campaign,
Align Technology is developing a number of promotions with the BDHF
to educate the public and drive potential patients to enquire about tooth
straightening.
Invisalign providers are also being encouraged to hold open days to capitalise
in the interest being generated during National Smile Month and to support
this initiative; Align is offering them 50% discounts on their lab fees between
19 May and 19 June. The company is also branding the famous National Smile
Month ‘smile on a stick’ providing participating practices with something to
promote Smile Month events.
For more information visit www.nationalsmilemonth.org or
www.invisalign.co.uk

[23] =>

United Kingdom Edition

Carl Zeiss Loupes from Nuview – “The field of
vision is brilliant.”
Many dentists are discovering the numerous
advantages that a set of loupes can bring to their
clinical work. The name Carl Zeiss is recognised
for creating visualisation systems of the very
highest standard and Carl Zeiss’ range of loupes
is no exception.
However, using a set of Carl Zeiss loupes doesn’t
just guarantee enhanced visualisation, it also
ensures comfort. Carl Zeiss loupes allow the user
to sit in an upright position, this improved posture
makes developing back and neck problems a lot
less likely. Dr Uns Moutiz, Dental Associate at All Saints Green Dental Practice
says: “With the loupes I can see minor details, which can otherwise be missed
and helps in diagnostics. I can add finesse to a greater degree, which was not
achievable with naked eye, especially when I am doing cosmetic work and a
higher level of finesse is expected. I don’t have to adjust the light if I want to
see in odd corners of the mouth as the light follows my direction of the head. I
would absolutely recommend these to every dentist.”
Available exclusively in the UK from Nuview, Carl Zeiss loupes offer comfort,
sophisticated technology and unparalleled visualisation.

Industry News 23

April 2014

Enhance Your Patient Service With The
Experts At The London Smile Clinic
Regardless of your dedication to training and education, at some point you will
come across a patient that requires treatment outside of your skill set.
In those cases, offer patients the widest range of treatment options by referring
to the award-winning London Smile Clinic. The practice is open for referrals for
orthodontic treatment, implant work and complex multi-disciplinary cases.
The expert team includes implantologist Dr Zaki Kanaan and Specialist
Orthodontist Dr Preet Bhogal, two highly experienced and qualified
professionals dedicated to ensuring the success of your patient’s treatment.
As the referring dentist, you will be involved in the treatment planning, have
regular progress updates, and be required to approve each stage of the
treatment. Every case is documented with before and after photographs,
while orthodontic referrals receive treatment-planning models to send to their
ceramist. Offer your patients more – contact the London Smile Clinic and see
how they can work with you to provide optimum treatment and patient care.

The Carl Zeiss OMPI Pico microscope – “I
remain as impressed now as I was when I
purchased it
“I’ve been using the OMPI Pico microscope
for about 18 months now and I remain as
impressed now as I was when purchased it,”
says Dr Devin Vaghela of The Morgan Clinic in
Maidenhead. “The unit is very well designed.
Its arms and Mora interface allow it to be
positioned at a wide range of angles over a
two-metre span. Its locking screws hold very
well even when gently tightened, allowing
minor degrees of movement, especially
important when under high magnification. A DSLR or Camcorder specific
adaptor can be mounted on the unit. It’s great for presentations to colleagues
and patients. Assistants like it too!”
The Carl Zeiss OMPI Pico microscope is available exclusively from Nuview
in the UK. “John and his team at Nuview recognise this purchase as a large
investment,” continues Dr Vaghela. “I have dealt with the team for a few years
now and have no hesitation in recommending them. They offer good technical
support, advice and a prompt service.”

For more information, please contact 020 7255 2559
or visit www.londonsmile.co.uk/refer - your patients will be glad you did!

For more information please call Nuview on 01453 872266,
email info@nuview-ltd.com or visit www.nuview.co

BPE guidance at your fingertips - new gum health app available now!
GlaxoSmithKline Consumer Healthcare, manufacturer of Corsodyl mouthwash,
has launched a new mobile app to help support dental professionals with the
use of the Basic Periodontal Examination (BPE). The app provides information on:

Let The Dental Directory help
you take a BIG BITE out of your
spending
The Dental Directory’s latest
edition of Big Bite is out now,
with offers on a wide range of
oral hygiene products. Save over
30% on Colgate MaxWhite One
Professional Kit, 25% on SofGrip
Scalers, and 30% on Wisdom Micropower battery toothbrush, plus savings on
many other products too.

For more information please call Nuview on 01453 872266.

• Background to the BPE codes
• Description and clinical image of each BPE code
• Summary of recommended treatment

The power of information from Christie + Co
Whatever questions you may have about selling of buying a practice, Christie
+ Co can help provide you with the right answers.
From the best strategy to sell your practice to the best specialist dental finance
to suit your needs, Christie + Co can draw upon its years of experience and
expertise to provide you with the right information and the best guidance.
Whether you’re buying or selling a dental practice, Christie + Co knows how
the right information presented in the right way can lead to the most desirable
result – your business or retirement goals, met with ease.

Developed by the British Society of Periodontology, the BPE allows dental
professionals to consistently & accurately assess their patients’ gum health.1 The
assessment of gum health, together with the provision of support for patients to
help prevent periodontal disease, will be of even greater importance once the
Dental Quality & Outcomes Framework comes into force in the revised dental
contract. The Corsodyl brand is committed to supporting dental professionals
when educating patients on the importance of gum health and the early signs
of gum disease. This app forms part of a range of materials that also includes the
Corsodyl Gum Care Guidance Pack which can be requested for dental practices.
Compatible with iphones and ipads, the app can be downloaded from the app
store by searching “bpe app” and further information can be accessed from
www.gsk-dentalprofessionals.co.uk

To discuss how Christie + Co might help you achieve your future plans please
contact Simon Hughes on 0207 227 0749

Give your business the MyRay
Boost
Whether you are looking to enhance
the quality of dental care you
provide, increase your patients’ trust
in you or generate more business
through patient referrals, you need
first-class dental equipment.

Everyday materials and consumables, whitening products and innovative
equipment and imaging systems all feature in this issue. There is even a very special
offer on the Belmont Compass treatment centre that could save you an astonishing
£6,100! Also featured is the Mikrozid disinfection range with savings of up to 27%,
PLUS you can get your hands on FuturaBond U – the latest universal adhesive from
VOCO.

Offering a wide variety of leading digital imaging systems and dental radiography
equipment, MyRay provides a solution. From cutting-edge intraoral cameras to
top-of-the-range Hyperion X7 OPG machines and the advanced Hyperion X9 CBCT
equipment, all products are designed to produce the very best image quality, while
encouraging an efficient and streamlined workflow.
Unique features and styling, free software and more importantly free upgrades as
developments take place have convinced many UK MyRay users, that they made the
right choice when it came to going digital. Two Year warranty on all equipment and
a comprehensive network of Service Technicians, gives the confidence practitioners
require. MyRay have raised the bar in quality whilst striving to reduce costs.

You always get a PLUS from The Dental Directory - the company independently
verified as the Best Priced Dental Dealer in both 2012 and 2013.
The Independently Verified Best Priced Dealer!
For more information, contact The Dental Directory on
0800 585 585, or visit www.dental-directory.co.uk.

Excavating caries: check-ups are
good, SIROInspect is better
In May Sirona, technology leader in the
dental industry, is bringing a detection
system onto the market that enables
dentists to identify reliably, quickly and
simply where caries does or does not
exist: SIROInspect.
SIROInspect is based on Fluorescence-Aided Caries Excavation technology,
known as FACE®, which exploits the fluorescence characteristics of teeth. If
teeth are illuminated with violet light in the spectrum of around 405 nm, it
doesn’t only stimulate degradation products of caries bacteria but also healthy
dentine to fluoresce. Healthy dental tissue lights up green whereas carious
areas are visibly red. The attending dentist can therefore see at first glance –
and very clearly - which areas are carious and which ones are not.
Henry Schein
Belfast: +4 (0) 28 9037 0702 . Cork: +33 (0) 21 434 6392 Dublin . +353 (0) 1 456
5288

Our sales teams are ready to help and with no minimum order value, no delivery
charge and same day dispatch for orders received before 5pm, we are at your
service. Make The Dental Directory your first choice for your oral hygiene needs.
Order by telephone, fax or through our comprehensive website, where you can
view more of the 27,000 products we offer.
The Independently Verified Best Priced Dealer!
For more information, contact The Dental Directory on
0800 585 586, or visit www.dental-directory.co.uk.

There’s Value, and then there’s
VALUE PLUS!
The Dental Directory’s VALUE PLUS
brochure is out now.
This latest issue of Value Plus
features special offers and
impressive savings on a wide range
of products from many of dentistry’s leading brands.

PLUS, don’t forget all this is backed up by The Dental Directory’s commitment to
outstanding customer service, massive stock holdings and free delivery with no
minimum order value and same day dispatch on orders received before 5pm.

For many dentists, supplying oral hygiene products to patients has proved to
be a valuable revenue builder for their practice. Big Bite is an ideal source of
inspiration and supplies, ranging from toothbrushes to xylitol chewing gum,
waterflossers to Tooth Fairy envelopes.

Discover how MyRay could help you improve your practice and boost your patient
service today.

Visualisation solutions for all
situations
Delegates at the BDA Conference and
Exhibition 2014 were given the opportunity to
test for themselves the Carl Zeiss visualisation
systems provided exclusively in the UK by
Nuview. They were particularly impressed by
the incredible image quality and ergonomic
sophistication on display.
With a selection of loupes and dental microscopes ranging from the fantastic TTL
Teleloupe and the GTX, to the top-of-the-range OPMI Pico dental microscope, the
team from Nuview were happy to explain the many advantages of these fantastic
dental tools.
Whether delegates were endodontic specialists looking for the perfect microscope
to see deep down into the root of a problem, or GDPs looking for a set of loupes
to accompany their everyday dentistry, Nuview exhibited an effective solution for
every scenario.
Discover the benefits that employing a Carl Zeiss visualisation system can bring to
your daily practise by contacting the team at Nuview today.
For more information please call Nuview on 01453 872266,
email info@nuview-ltd.com or visit www.nuview.co

Call 0870 752 1121for MyRay in the UK or visit www.my-ray.co.uk

The Best of British
Delegates visiting the award-winning
Sparkle Dental Labs at this year’s BDA
Conference and Exhibition were eager to
find out what the company can offer their
business.
Visitors were keen to find out more about
Sparkle Dental Labs’ courier service to and
from dental practices. The first of its kind when it was introduced by the company, the
service offers free pick up and delivery with fast lab-work turnaround times.
The team were on hand to pass on information about the full certification provided
for each restoration, which complies fully with GDC regulations, and spoke about the
benefits of buying British hand-crafted dental products.
All in all the exhibition was a great success for the company, which looks set to
continue leading the way in product excellence.
For any additional information please call 0800 138 6255 or email
customerservice@sparkledentallabs.com or visit:
www.sparkledentallabs.com

Providing Effective Aftercare
Tandex provide quality Orthodontic Kits to help aid
your patients’ aftercare following treatment.
An effective way to ensure that patients maintain
efficient oral health care after a dental procedure is
complete is to offer a fully prepared kit that contains all
of the necessary tools.
The Tandex Orthodontic Kit has a selection of adjuncts
ranging from an Advance Medium toothbrush to eliminate bacteria from around the
oral cavity, to the SOLO Medium brush for precise interdental cleaning. It also comes
with 4 FLEXI Lime interdental brushes with non-slip flexible grip for pleasant and
versatile maintenance.
The kit includes a detailed user guide that comprehensively instructs patients on
optimum cleaning protocols. Produced in cooperation with dentists and hygienists
the in-depth information allows patients to use the products as they were intended,
for easily achievable and excellent results.
Tandex Orthodontic Kits offer your patients the highest quality tools and direction for
effective aftercare. Contact the team at Tandex today to find out more.

For more information on Tandex’s range of products, visit www.tandex.dk
or email: martin@tandex.dk

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[cover] => DT UK No. 4, 2014

[toc] => Array ( [0] => Array ( [title] => News [page] => 01 ) [1] => Array ( [title] => The role of physiotherapy in the management of TMD [page] => 06 ) [2] => Array ( [title] => Leading the way to Great Dental Care [page] => 07 ) [3] => Array ( [title] => Annual Planning [page] => 09 ) [4] => Array ( [title] => Cosmetic Tribune: Just fill! Constic - The self-etching and self-adhesive filling material [page] => 11 ) [5] => Array ( [title] => Cosmetic Tribune: Conservative smile enhancement [page] => 13 ) [6] => Array ( [title] => Cosmetic Tribune: Bioactive materials support proactive dental care [page] => 15 ) [7] => Array ( [title] => SIROLaser Factbook: Comprehensive information on diode lasers [page] => 20 ) [8] => Array ( [title] => Industry News [page] => 22 ) ) [toc_html] =>

Table of contents

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