CAD/CAM international No. 2, 2015
Cover
/ Editorial
/ Content
/ Virtual reality simulation
/ Smile analysis and photoshop smile design technique
/ Team players: efficiency and aesthetics
/ CAD/CAM custom-milled titanium bar for rehabilitation of an atrophic upper jaw
/ Opening the patient’s eyes
/ A winning combination: CAD/CAM and CBCT in one
/ Exocad DentalCAD - the next generation
/ Enter the world of CAD/CAM technology with Interdent
/ Industry News
/ How a modern implant system is developed
/ Biggest IDS of all time in Cologne
/ International Events
/ Submission guidelines
/ Imprint
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CDE0109_01_Titel
issn 1616-7390
Vol. 6 • Issue 2/2015
CAD/CAM
digital dentistr y
international magazine of
2
2015
| special
Smile analysis and smile design
| technique
Team players: efficiency and aesthetics
| case report
CAD/CAM custom-milled titanium bar
for rehabilitation of an atrophic upper jaw
[2] =>
CDE0109_01_Titel
[3] =>
CDE0109_01_Titel
editorial _ CAD/CAM
I
Digital technology
determines daily routine in modern dental practice
_Digital dental procedures are increasingly becoming an essential part of the daily routine in the modern dental practice. They render patient management and treatment planning
processes more economical and increase time efficiency. At IDS 2015, digital technologies
thus became a core subject, many exhibitors presented their latest product solutions in the
field.
At IDS 2015, the digital technology offerings available for dental practices formed a focal
point for all visitors in the fields of dentistry and dental technology.
The exhibited product ranges contribute to simplifying workflows and, as a result, to reducing treatment times. They create synergies with the digital range for dental laboratories,
yielding positive implications for practice management and therapeutic procedures. That is
why the state of the art in digital technology for dental practices was a major topic at IDS
2015, said Dr Martin Rickert, Chairman of the Association of German Dental Manufacturers.
Presented products included software for efficient patient management and integrated
treatment planning, as well as digital imaging devices, including CBCT and CT, which have
been used alongside conventional radiographic techniques in recent years.
IDS 2015 gave also special attention to digital scanners, which offer a wide range of advantages for patient-specific restorations and implant planning. In particular, intraoral scanners were in the spotlight, as they have contributed significantly to making prosthetic treatment workflows simplifier and more precise.
Overall, both patients and dentists benefit from the use of digital technologies. They help
shorten treatment time and reduce the number of work stages, and enable the dentist to immediately examine and explain preparations on screen. Furthermore, the data gained through
digital procedures can be quickly processed in the dental practice and sent to dental laboratories.
You will find more information about this year’s IDS inside the issue.
DTI
CAD/CAM
2_ 2015
I 03
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I content _ CAD/CAM
I editorial
03
36
Digital technology determines daily routine
in modern dental practice
| exocad
40
44
Virtual reality simulation
Multiple new solutions presented at IDS 2015
bring Straumann closer to being a total solution
provider of choice
| Dr Susan Bridges, Suzanne Perry & Prof. Michael Burrow
| Straumann
I new technology
46
I special
10
The crown that rules them all:
NobelProcera FCZ Implant Crown
| Nobel Biocare
Smile analysis and photoshop smile design technique
| Prof. Edward A. McLaren & Lee Culp
48
How a modern implant system is developed
| DENTSPLY Implants
I technique
20
Enter the world of CAD/CAM technology with Interdent
| Interdent
| DTI
06
exocad DentalCAD, the next generation
Team players: efficiency and aesthetics
50
| Dieter Knappe
MIS implants stand out in comparative
implant surface study
| MIS
I case report
I meetings
26
52
Biggest IDS of all time in Cologne
56
International Events
CAD/CAM custom-milled titanium bar
for rehabilitation of an atrophic upper jaw
| Dr Richard Marcelat
I feature
I about the publisher
32
Opening the patient’s eyes
57
| submission guidelines
| Interview with Dr Luc Vrielinck maxillofacial surgeon,
an expert in computer- and model-based implant planning systems
58
| imprint
I industry news
34
A winning combination: CAD/CAM and CBCT in one
| Planmeca
04 I CAD/CAM
2_ 2015
Cover image courtesy of
Straumann (www.straumann.com).
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© MIS Corporation. All Rights Reserved.
BONE
To experience something truly evolutionarily, you are cordially invited to attend our sponsor
session lecture on June 4 & 5, at 10:30-12:00. Capital Suite 14-16. See our mini-site: v-implant.com
MIS Implants at the EUROPERIO8 in London: Capital Hall, Booth No 7 - so much to see!
By
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[6] =>
CDE0109_01_Titel
I new technology _ VR in dentistry
Virtual reality simulation
Indications and perspectives for the
technology in the field of dental education
Authors_ Dr Susan Bridges, Suzanne Perry & Prof. Michael Burrow, Hong Kong & Australia
_Virtual reality (VR) simulation inevitably conjures up images of futuristic technology, imaginary
worlds or complex robotic devices. What it may not
initially suggest is the use of virtual technology as
a means of training dental students and dentists,
facilitating the development of skills in a safe and
relaxed environment.
Fig. 1
Fig. 1_A sketch of an early phantom
head simulator.
Fig. 2_ The Simodont Dental Trainer
(Moog) haptic VR simulator.
An increase in demand for simulation units over
the last ten to 10 years has indicated growing interest from dental schools, suggesting a certain confidence that simulation systems have potential as a
recognised form of dental skills training in the future.
Using technology inspired primarily from the flight
simulation industry, dental simulators are now able
to create an environment in which users can practise
clinical procedures, such as restorative dentistry,
endodontics, periodontal assessment, implant placement and even dental extractions.
These systems are a far cry from the first phantom head simulator created in the early 1900s that
attempted to represent the oral cavity with a relatively primitive set of upper and lower dental casts
mounted on a metal pole (Fig. 1). Although phantom head systems are now the mainstay for undergraduate training, educationalists are becoming more aware of the additional benefits of VR
simulation, such as the ability to repeat the same
task many times, providing real-time feedback leading to a reduction in supervision, and the benefits
of students being able to practise in their free time
without laboratory supervisors. Other benefits of VR
simulators include the reduction of consumable
costs incurred with plastic teeth and the elimination of water system management issues, reducing
the possibility of water-borne infections such as
Legionella.
Undoubtedly, the initial cost of the VR simulators
is a major deterrent and, with additional concerns
regarding possible lack of realism to the clinical situation, it is natural that many suggest the need for
more evidence-based research prior to committing
to such an investment.
3D Glasses
Viewing screen
Display screen
Dental
handpiece
input device
Foot
pedal
Fig. 2
06 I CAD/CAM
2_ 2015
In the limited literature on VR dental simulation,
studies have been mixed but, in general, are positive
about the use of the technology for dental training.
Research has shown that procedural learning on VR
simulators may be more effective than with the traditional phantom head and may reduce the number
of staff—student interactions without a reduction
in the quality of the practical work.
In contrast, other research has shown that dental performance may be no better using VR simulation and that some students prefer their training to
be on phantom heads. Naturally, further research
will be needed to establish the effectiveness of the
technology.
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More than a lab partner.
True ambition to increase
your efficiency.
At Straumann we are fully committed to taking care of you and the success
of your business. We stand for highest quality, and our passion is to continuously shape our portfolio offering with innovative products & services that
simplify your workflows and increase your efficiency. Find out what’s in it
for you!
www.straumann.com/dentallab
[8] =>
CDE0109_01_Titel
I new technology _ VR in dentistry
_The future of VR simulation in dentistry
Currently, exciting research involving the universities of Hong Kong and Melbourne is looking into
gaining solid evidence concerning the use of haptic
VR simulation in the dental undergraduate curriculum. By utilising neuroimaging techniques, identification of the traits an expert usually displays can occur, which in turn can be built into training pathways
to enhance the effectiveness of procedural learning.
Initial findings have suggested that distinct differences may be apparent in the brains of dental experts
and novices during a simulated clinical task when using a dental haptic VR simulator. Further work in this
area is to be carried out, with additional investigation
into the positioning of haptic VR simulation within
a curriculum and considering its effectiveness compared with traditional phantom head training techniques.
Fig. 3
Fig. 3_An image of a cut tooth from
the Simodont haptic VR simulator.
_What are haptics?
The addition of haptics to VR technology creates a
dimension of sensory feedback for the user. The word
itself originates from the Greek work haptikos, which
means “to touch or grasp”. There are many examples of haptic simulation in modern-day technology,
such as in gaming and the vibration component of a
mobile phone. The aim of haptics in many cases, and
especially simulation, is to improve the realism of the
virtual experience. In dentistry, for example, when
carrying out a cavity preparation on a haptic VR simulator, there is a difference in hardness felt when cutting from enamel to dentine, and if the pulp is damaged an instant loss of resistance occurs, producing
a realistic sensation of drilling through the roof of the
pulp chamber (Figs. 2 & 3).
Naturally, the important question is, does the addition of haptic technology really make a difference
when learning using VR simulation? To answer this,
we have to delve into surgical research for which a
stronger evidence base exists, specifically in the area
of laparoscopy. A review of the use of haptics in surgery suggested that the addition of haptics to simulation can reduce surgical errors and is especially beneficial in the early stages of learning a new skill task.1
Other studies have shown that the addition of haptics
may improve overall performance of surgical skills
and may be beneficial when a trainee is first exposed
to a clinical situation. In dentistry, small-scale studies
of haptic VR simulators suggest that they are at least
as good as phantom heads in training undergraduates.
08 I CAD/CAM
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Already it can be seen that the area of VR in dentistry and especially that of haptic VR simulation is
proving an interesting development, offering encouraging prospects for the future skills-based training of
dentists. The evidence is limited, however, so, prior to
commending this technology as the mainstay of training in dental undergraduate curricula, there is a compelling need to expand the current research base._
_about the authors
CAD/CAM
Dr Susan Bridges
is an associate professor at the
Faculty of Education at the University of Hong Kong in China.
She can be contacted at
sbridges@hku.hk
Suzanne Perry
is a PhD candidate at the
Faculty of Education at the
University of Hong Kong.
She can be contacted at
subygee@yahoo.co.uk
Prof. Michael Burrow
is Professor and Chair of Biomaterials at the Melbourne
Dental School at the University
of Melbourne in Australia.
He can be contacted at
mfburrow@unimelb.edu.au
[9] =>
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Comprehensive solutions for all phases of implant dentistry
Professional and practice
development
www.dentsplyimplants.com
Digital planning
Regenerative solutions
Implants
Restorations
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I special _ smile analysis and smile design
Smile analysis
and photoshop smile
design technique
Authors_ Prof. Edward A. McLaren & Lee Culp, USA
Fig. 1_Three altered views of the
same patient enable analysis of what
can be accomplished to enhance
facial and smile aesthetics.
Fig. 1
_Introduction:
Smile analysis and aesthetic design
Dental facial aesthetics can be defined in three
ways.
Table 1_Components of
smile analysis and aesthetic design.
Traditionally, dental and facial aesthetics have
been defined in terms of macro- and micro-elements. Macro-aesthetics encompasses the interre-
Facial aesthetics
Total facial form and balance
Orofacial aesthetics
Maxillomandibular relationship to the face and the dental midline
relationship to the face pertaining to the teeth, mouth and gingiva
Oral aesthetics
Labial, dental, gingival; the relationships of the lips to the arches,
gingiva, and teeth
Dentogingival aesthetics Relationship of the gingiva to the teeth collectively and individually
Dental aesthetics
Macro- and micro-aesthetics, both inter- and intra-tooth
Table I
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lationships between the face, lips, gingiva, and teeth
and the perception that these relationships are
pleasing. Micro-aesthetics involves the aesthetics
of an individual tooth and the perception that the
colour and form are pleasing.
Historically, accepted smile design concepts and
smile parameters have helped to design aesthetic
treatments. These specific measurements of form,
colour, and tooth/aesthetic elements aid in transferring smile design information between the dentist,
ceramist, and patient. Aesthetics in dentistry can encompass a broad area—known as the aesthetic zone.1
Rufenacht delineated smile analysis into facial
aesthetics, dentofacial aesthetics, and dental aesthetics, encompassing the macro- and micro-elements
described in the first definition above.2 Further classification identifies five levels of aesthetics: facial, orofacial, oral, dentogingival, and dental (Table 1).1, 3
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I
Fig. 2
_Initiating smile analysis: Evaluating
facial and orofacial aesthetics
The smile analysis/design process begins at the
macro level, examining the patient’s face first, progressing to an evaluation of the individual teeth, and
finally moving to material selection considerations.
Multiple photographic views (e.g., facial and sagittal)
facilitate this analysis.
At the macro level, facial elements are evaluated
for form and balance, with an emphasis on how they
may be affected by dental treatment.3,4 During the
macro-analysis, the balance of the facial thirds is
examined (Fig. 1). If something appears unbalanced
in any one of those zones, the face and/or smile will
appear unaesthetic.
Such evaluations help determine the extent and
type of treatment necessary to affect the aesthetic
changes desired. Depending on the complexity and
uniqueness of a given case, orthodontics could be
considered when restorative treatment alone would
not produce the desired results (Fig. 2), such as when
facial height is an issue and the lower third is affected. In other cases—but not all—restorative treatment could alter the vertical dimension of occlusion
to open the bite and enhance aesthetics when a patient presents with relatively even facial thirds (Fig. 3).
_What is the proper tooth display, both statically and
dynamically?
_What is the proper intra- and inter- tooth relationship
(e.g., length and size of teeth, arch form)?
_Can the ideal position be achieved with restorative
dentistry alone, or is orthodontics needed?
Fig. 2_Sagittal views best
demonstrate which specialists
should be involved in treatment,
whether orthodontists or maxillofacial surgeons, to best aesthetically
alter the facial aesthetics.
In order to facilitate smile evaluation based on
these landmarks, the rule of 4.2.2—which refers to the
amount of maxillary central display when the lips are
at rest, the amount of gingival tissue revealed, and the
proximity of the incisal line to the lower lip—is helpful (Fig. 5). At a time when patients perceive fuller and
brighter smiles as most aesthetic, 4mm of maxillary
central incisor display while the lips are at rest may
be ideal.2,5 In an aesthetic smile, seeing no more than
2mm of gingiva when the patient is fully smiling is
ideal.6 Finally, the incisal line should come very close
to and almost touch the lower lip, being no more than
2mm away.2 These guidelines are somewhat subjective and should be used as a starting point for determining proper incisal edge position.
Fig. 3_Drawing a line along the
glabella, subnasale, and pogonion
enables a quick evaluation of
aesthetics without the need for
radiographs to determine alignment
of ideal facial elements.
_Evaluating oral aesthetics
The dentolabial gingival relationship, which is
considered oral aesthetics, has traditionally been the
starting point for treatment planning. This process
begins by determining the ideal maxillary incisal edge
placement (Fig. 4). This is accomplished by understanding the incisal edge position relative to several different landmarks. The following questions can be used
to determine the ideal incisal edge position:
_Where in the face should the maxillary incisal edges
be placed?
Fig. 3
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I special _ smile analysis and smile design
Fig. 4_Evaluating the maxillary
incisal edge position is the starting
point for establishing oral aesthetics.
Fig. 5_According to the 4.2.2 rule,
this patient’s smile is deficient in
aesthetic elements, having only
1mm of tooth display at rest (left),
minus 3mm of gingival display, and
4mm of space between the incisal
edge and the lower lip (right).
Fig. 4
Fig. 5
_Dentogingival aesthetics
Fig. 6_Gingival symmetry in relation
to the central incisors, lateral incisors
and canines is essential to aesthetics. Optimal aesthetics is achieved
when the gingival line is relatively
horizontal and symmetrical on both
sides of the midline in relation to the
central incisors and lateral incisors.
Fig. 7_The aesthetic ideal from the
gingival scallop to the tip of the
papilla is 4–5mm.
Gingival margin placement and the scalloped
shape, in particular, are well discussed in the literature. As gingival heights are measured, heights relative to the central incisor, lateral incisor, and canine in
an up/down/up relationship are considered aesthetic
(Fig. 6). However, this may create a false perception
that the lateral gingival line is incisal to the central incisor. Rather, in most aesthetic tooth relationships,
the gingival line of the four incisors is approximately
the same line (Fig. 6), with the lateral incisor perhaps
being slightly incisal.7 The gingival line should be rel-
atively parallel to the horizon for the central incisors
and the lateral incisors and symmetric on each side of
the midline.2,8 The gingival contours (i.e., gingival
scallop) should follow a radiating arch similar to the
incisal line. The gingival scallop shapes the teeth and
should be between 4mm and 5mm (Fig. 7).9
Related to normal gingival form is midline placement. Although usually the first issue addressed in
smile design, it is not as significant as tooth form, gingival form, tooth shape, or smile line.
Several rules can be applied when considering modifying the midline to create an aesthetic smile design:
_The midline only should be moved to establish an
aesthetic intra- and inter-tooth relationship, with
the two central incisors being most important.
_The midline only should be moved restoratively up to
the root of the adjacent tooth. If the midline is within
4mm of the centre of the face, it will be aesthetically
pleasing.
_The midline should be vertical when the head is in the
postural rest position.
Fig. 6
_Evaluating dental aesthetics
Part of evaluating dental aesthetics for smile design is choosing tooth shapes for patients based on
their facial characteristics (e.g., long and dolichocephalic, or squarish and brachycephalic). When patients present with a longer face, a more rectangular
tooth within the aesthetic range is appropriate. For
someone with a square face, a tooth with an 80 %
width-to-length ratio would be more appropriate.
Fig. 7
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special _ smile analysis and smile design
Fig. 8
The width-to-length ratio most often discussed in
the literature is between 75% and 80%, but aesthetic
smiles could demonstrate ratios between 70% and
75% or between 80% and 85% (Figs. 8–10).1
The length of teeth also affects aesthetics. Maxillary
central incisors average between 10 mm and 11mm
in length. According to Magne, the average length of
an unworn maxillary central to the cementoenamel
junction is slightly over 11mm.10 The aesthetic zone for
central incisor length, according to the authors, is between 10.5mm and 12mm, with 11mm being a good
starting point. Lateral incisors are between 1mm and
a maximum of 2mm shorter than the central incisors,
with the canines slightly shorter than the central incisors by between 0.5mm and 1mm (Fig. 11).
The inter-tooth relationship, or arch form, involves
the golden proportion and position of tooth width.
Although it is a good beginning, it does not reflect
natural tooth proportions. Natural portions demonstrate a lateral incisor between 60% and 70% of the
width of the central incisor, and this is larger than the
golden proportion.11 However, a rule guiding propor-
Fig. 9
tions is that the canine and all teeth distal should be
perceived to occupy less visual space (Fig. 12). Another rule to help maintain proportions throughout
the arch is 1-2-3-4-5; the lateral incisor is two-thirds
of the central incisor and the canine is four-fifths of
the lateral incisor, with some latitude within those
spaces (Fig. 13). Finally, contact areas can be moved
restoratively up to the root of the adjacent tooth.
Beyond that, orthodontics is required (Fig. 14).
_Creating a digital smile designed in
Photoshop
Although there are digital smile design services
available to dentists for a fee, it is possible to use
Photoshop CS5 software (Adobe Systems) to create
and demonstrate for patients the proposed smile
design treatments. It starts by creating tooth grids—
predesigned tooth templates in different width-tolength ratios (e.g., 75% central, 80% central) that can
be incorporated into a custom smile design based on
patient characteristics. You can create as many different tooth grids as you like with different tooth proportions in the aesthetic zone. Once completed, you
I
Fig. 10
Figs. 8–10_Acceptable width-tolength ratios fall between 70 % and
85%, with the ideal range between
80% and 85%.
Fig. 11_An acceptable starting point
for central incisors is 11mm in length,
with lateral incisors 1–2mm shorter
than the central incisors, and canines
0.5–1mm shorter than the central
incisors for an aesthetic smile display.
Fig. 12_The canines and other
teeth distally located are visually
perceived as occupying less space
in an aesthetically pleasing smile.
Fig. 13_A general rule for achieving
proportionate smile design is that
lateral incisors should measure
two-thirds of the central incisors
and canines four-fifths of the lateral
incisors.
Fig. 14_If feasible, the contact areas
can be restoratively moved up to the
root of the adjacent tooth.
Fig. 11
Fig. 12
Fig. 13
Fig. 14
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I special _ smile analysis and smile design
Fig. 15
Fig. 16
Fig. 17
Fig. 18
Fig. 20
Fig. 19
Fig. 22
Fig. 21
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special _ smile analysis and smile design
will not have to do this step again, since you will save
the created tooth grids and use them to create a new
desired outline form for the desired teeth.
Follow these recommended steps:
_To begin creating a tooth grid, use a cheek-retracted
image of an attractive smile as a basis (e.g., one with
a 75% width-to-length ratio). Open the image in
Photoshop and create a new clear transparent layer
on top of the teeth (Fig. 15). This transparent layer
will enable the image to be outlined without the
work being embedded into the image.
_Name the layer appropriately and, when prompted
to identify your choice of fill, choose “no fill,” since
the layer will be transparent, except for the tracing
of the tooth grid.
_To begin tracing the tooth grid, activate a selection
tool, move to the tool palette, and select either the
polygonal lasso tool or the magnetic lasso tool. In
the authors’ opinion, the polygonal works best. Once
activated, zoom in (Fig. 16) and trace the teeth with
the lasso tool.
_To create a pencil outline of the tooth, with the
transparent layer active, click on the edit menu in
the menu bar; in the edit drop-down menu, select
I
Fig. 23
Fig. 24
Fig. 25
Fig. 26
Fig. 15_Photoshop provides an effective and inexpensive way to
design a digital smile with proper patient input. To start creating
custom tooth grids, open an image of an attractive smile in
Photoshop and create a separate transparent layer.
Fig. 16_The polygonal lasso tool is an effective way to select the teeth.
Fig. 17_Click “edit > stroke,” then use a two-pixel stroke line
(with colour set to black) to trace your selection. Make sure the
transparent layer is the active working layer.
Fig. 18_Image of the central incisor with a two-pixel black stroke
(tracing).
Fig. 19_Image of the teeth traced up to the second premolar to
create a tooth grid.
Fig. 20_Size the image in Photoshop.
Fig. 21_Save the grid as a .png or .psd file type and name it
appropriately. Create other dimension grids using the same
technique.
Fig. 22_To determine the digital tooth size, a conversion factor
is created by dividing the proposed length by the existing length of
the tooth.
Fig. 23_Select the ruler tool in Photoshop.
Fig. 24_Measure the digital length of the central incisor using the
ruler tool.
Fig. 25_Measure the new digital length using the conversion factor
created earlier.
Fig. 26_Create a new transparent layer and mark the new proposed
length with the pencil tool.
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I special _ smile analysis and smile design
Fig. 28
Fig. 27
Fig. 29
Fig. 30
Fig. 27_Open the image of the
chosen tooth grid in Photoshop and
drag the grid on to the image of teeth
to be smile designed. This will create
a new layer in the image to be smile
designed.
Fig. 28_Adjust the grid as required
while maintaining proper proportions
by using the free transform tool from
the edit menu.
Fig. 29_Modify the grid shape as
necessary using the liquify tool.
Fig. 30_Select all of the teeth in the
grid by activating the magic wand
selection tool and then clicking
on each tooth with the grid layer
activated (highlighted) in the
layers palette.
16 I CAD/CAM
2_ 2015
“stroke”; choose black for colour, and select a twopixel stroke pencil line (Fig. 17), which will create a
perfect tracing of your selection. Click “OK” to stroke
the selection. Select (trace with the lasso selection
tool) one tooth at a time and then stroke it (Fig. 18).
Select and stroke (trace) the teeth up to the second
premolar (the first molar is acceptable; Fig. 19).
_The image should be sized now for easy future use in
a smile design. In the authors’ experience, it is best to
adjust the size of the image to a height of 720 pixels
(Fig. 20) by opening up the image size menu and
selecting 720 pixels for the height. The width will
adjust proportionately.
_At this time, the tooth grid tracing can be saved, without the image of the teeth, by double-clicking on the
layer of the tooth image. A dialog box reading “new
layer” will appear; click “OK.” This process unlocks the
layer of the teeth so it can be removed. Drag the layer
of the teeth to the trash, leaving only the layer with
the tracing of the teeth (Fig. 21). In the file menu, click
“save as” and choose “.png” or “.psd” (Photoshop) as
the file type. This will preserve the transparency. You
do not want to save it as a JPEG, since this would
create a white background around the tracing. Name
the file appropriately (e.g., 75% W/L central).
_By tracing several patients’ teeth that have tooth
size and proportion in the aesthetic zone and saving
them, you can create a library of tooth grids to custom design new teeth for your patients who require
smile designs.
_The Photoshop smile design technique
The Photoshop Smile Design (PSD) technique
can be done on any image, and images can be combined to show the full face or the lower third with
lips on or lips off. This article demonstrates how to
perform the technique on the cheek-retracted
view.
The first step in the PSD technique is to create a
digital conversion of the actual tooth length and
width, and then digitally determine the proposed
new length and proportion of the teeth.
Determining digital tooth size
To determine digital tooth size, follow these steps:
_Create a conversion factor by dividing the proposed
length (developed from the smile analysis) by the
existing length of the tooth.
_The patient’s tooth can be measured in the mouth or
on the cast (Fig. 22). If the length measures 8.5mm
but needs to be at 11 mm for an aesthetic smile,
divide 11 by 8.5. The conversion factor equals 1.29,
a 29% digital increase lengthwise.
_Open the full-arch cheek-retracted view in Photoshop, and zoom in on the central incisor.
_Select the eyedropper palette. A new menu will
appear. Select the ruler tool (Fig. 23).
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special _ smile analysis and smile design
_Click and drag the ruler tool from the top to
the bottom of the tooth to generate a vertical
number, in this case 170 pixels (Fig. 24). Multiply
the number of pixels by the conversion factor. In
this case, 170 x 1.29 = 219 pixels; 219 pixels is
digitally equivalent to 11 mm (Fig. 25). Determine the digital tooth width using the same formula.
_Create a new layer, leave it transparent, and mark
the measurement with the pencil tool (Fig. 26).
Applying a new proposed tooth form
Next, follow these steps:
I
Fig. 31
Fig. 32
Fig. 33
Fig. 34
the layer activated), press command (or control)
and “t” to bring up the free transform function.
While holding the shift key (holding the shift
key allows you to transform the object proportionally), click and drag a corner left or right to
expand or contract the custom tooth grid.
_Adjust the size of the grid so that the outlines
of the central incisors have the new proposed
length. Move the grid as necessary using the
move tool so that the incisal edge of the tooth
grid lines up with the new proposed length
(Fig. 28).
_Areas of the grid can be individually altered using the liquify tool (Fig. 29).
Fig. 31_Use the selection modify tool
to expand the selection to better fit
the grid shape.
Fig. 32_Activate the layer of the teeth
by clicking on it. Blue-coloured layers
are active.
Fig. 33_With the layer of the teeth
highlighted, choose “liquify”; a new
window will appear with a red
background called a “mask”.
Fig. 34_Shape one tooth at a time
as needed by selecting “wand”.
Fig. 35_Once all of the teeth have
been shaped, use the liquify tool.
_After performing the smile analysis and digital
measurements, choose a custom tooth grid appropriate for the patient. Select a tooth grid based
on the width-to-length ratio of the planned
teeth (e.g., 80/70/90 or 80/65/80). Open the image of the chosen tooth grid in Photoshop and
drag the grid on to the image of teeth to be smile
designed (Fig. 27).
_If the shape or length is deemed inappropriate,
press the command button (control button for
PCs) and “z” to delete and select a suitable
choice.
_Depending on the original image size, the tooth
grid may be proportionally too big or too small.
To enlarge or shrink the tooth grid created (with
Fig. 35
CAD/CAM
2_ 2015
I 17
[18] =>
CDE0109_01_Titel
I special _ smile analysis and smile design
Fig. 36
Fig. 37
Fig. 36_Tooth brightness is adjusted
using commands from the dodge tool
menu or image adjustments menu.
Fig. 37_Image of all the teeth
whitened with the dodge tool.
_authors CAD/CAM
Prof. Edward A. McLaren,
DDS, is the director of the
University of California,
Los Angeles Center for
Esthetic Dentistry in
California, US.
He maintains a private
practice in Los Angeles.
Lee Culp, CDT, is an
adjunct faculty member at
the University of North
Carolina at Chapel Hill
School of Dentistry in the
US and an accredited
member of the American
Academy of Cosmetic
Dentistry. He practices in
Dublin, California, and
Raleigh, North Carolina.
18 I CAD/CAM
2_ 2015
Digitally creating new aesthetic teeth
menu; click “image > adjustments > brightness/
contrast”.
Next, follow these suggested steps:
_With the new tooth grid layer and the magic wand
tool both activated, click on each tooth to select all
of the teeth in the grid (Fig. 30).
_Expand the selection by two pixels in the expand
menu; click “select > modify > expand” (Fig. 31). Note
that the selection better approximates the grid. You
can expand the selection or contract as necessary
using the same menu.
_Activate the layer of the teeth (cheek-retracted
view) by clicking on it (Fig. 32).
_Next, activate the liquify filter (you will see a red
mask around the shapes of the proposed teeth).
The mask creates a digital limit that the teeth
cannot be altered beyond. This is similar to creating a mask with tape for painting a shape
(Fig. 33).
_Use the forward warp tool by clicking on an area of
the existing tooth and dragging to mold/shape the
tooth into the shape of the new proposed outline
form (Fig. 34).
Performing the changes on only one side of the
mouth allows the patient to compare the new smile
design to his/her original teeth before agreeing to
treatment.
Create a copy
To save the information you have created for presentation to the patient, follow these tips:
_Go to “file” and select “save as.”
_When the menu appears, click on the “copy” box.
_Name the file at that step.
_Save it as a JPEG file type.
_Designate where you want it saved.
_Click “save.”
A file of the current state of the image will be created
in the designated area. You can now continue working
on the image and save again at any point you want.
_Conclusion
Repeat this for each tooth. If you make a mistake
or do not like something, click command (or control)
and “z” to go back to the previous edit (Fig. 35).
Adjusting tooth brightness
The following steps are recommended next:
_Select the whitening tool (dodge tool) to brighten
the teeth. In the dodge tool palate, click on “midtones” and set the exposure to approximately 20%.
Click on the areas of the tooth you want brightened
(Figs. 36 & 37).
_Alternatively, with the teeth selected, you can use the
brightness adjustment in the brightness/contrast
Knowledge of smile design, coupled with new and
innovative dental technologies, allows dentists to
diagnose, plan, create, and deliver aesthetically pleasing new smiles. Simultaneously, digital dentistry is
enabling dentists to provide what patients demand:
quick, comfortable, and predictable dental restorations that satisfy their aesthetic needs._
Editorial note: A complete list of references is available
from the publisher.
This article was originally published in the Journal of
Cosmetic Dentistry, spring issue, No 1/2013, Vol. 29, and
the Clinical Masters Magazine No 1/2015.
[19] =>
CDE0109_01_Titel
The new software generation has arrived!
Now with even more possibilities:
Completely reworked user interface
New tools for free forming
Optimized user guidance
Advanced 3D-PDF export
Native multi-touch support
Webcam integration
Optimized 3D-Engine
and much more!
exocad.com/partners
[20] =>
CDE0109_01_Titel
I technique _ monolithic posterior tooth restorations
Team players:
efficiency and aesthetics
Full-contour posterior restorations made with
translucent zirconium oxide
Author_ Dieter Knappe, Germany
Fig. 1
Fig. 2
Figs. 1 & 2_Manual waxing up
of the crowns.
20 I CAD/CAM
2_ 2015
_Introduction
_Preoperative situation
This article is written in celebration of zirconium
oxide, a material which has firmly established itself
in the dental laboratory over the past 15 years or so.
If appropriately used, zirconium oxide restorations
produce very strong and durable results. They also
satisfy demanding aesthetic requirements due to
their translucent properties. The following case
study shows how monolithic zirconium oxide is effectively incorporated into the digital manufacturing chain to produce highly cost-effective dental
restorations without having to compromise on aesthetics. In the case presented, a wax-up was crafted
which served as a basis for fabricating a provisional
restoration (TelioR CAD for Zenotec, Wieland Dental)
and a permanent restoration (Zenostar Zr Translucent, Wieland Dental) with one digital data set and
CAD/CAM milling equipment.
The patient presented to the dental practice with a
fractured ceramic inlay restoration in tooth 26 which
she wished to have replaced. The tooth had been restored many years previously. Since tooth 25 and
tooth 35 were discoloured as a result of root canal
treatment, they were included in the treatment plan.
The existing tooth structure of tooth 26, which had
been prepared to accommodate the inlay in the past,
was preserved to the best possible extent. The patient
had very high aesthetic expectations and wanted the
explicit assurance that the crowns would look completely natural. Nonetheless, we decided to use a very
efficient fabrication method in which monolithic
restorations are produced with translucent zirconium oxide (Zenostar Zr Translucent). Three options
are available for fabricating monolithic restorations
with this approach:
[21] =>
CDE0109_01_Titel
technique _ monolithic posterior tooth restorations
I
Figs. 3 & 4_CAD/CAM images
of the scanned wax-up and the
PMMA-based long-term temporaries
(Telio CAD for Zenotec).
Fig. 3
1. milling, sintering, glazing (efficient, cost-effective);
2. milling, sintering, individualization with ceramic
characterization materials, glazing;
3. milling, individualization with infiltration liquids,
sintering, glazing (highly aesthetic).
We chose to pursue the third method, which would
be very cost-effective as a result of the benefits offered by the digital workflow.
_Advanced zirconium oxide
Zirconium oxide is more than twice as strong
as other dental ceramics, and it exhibits excellent
mechanical properties. Due to its translucent characteristics, the material has been fulfilling highly aesthetic requirements for quite some time now. The material is used to fabricate full-contour (monolithic)
restorations and 20 frameworks that provide a base
for individualized veneers. The zirconium oxide ma-
terial Zenostar Zr Translucent shows excellent light
transmission. In this system, efficiency teams up with
aesthetics to offer impressive results. The wide range
of discs, the matching stains and the brush infiltration
technique allow lifelike effects to be imparted to
restorations in a relatively short time.
_Preparation
The following aspects were paramount in preparing teeth 25, 35 and 26 for the ceramic restorations:
avoidance of sharp edges and observation of a minimum wall thickness. The benefits of using zirconium
oxide include the material’s high strength and as a
consequence, the fact that very little tooth structure
needs to be removed. The cavity in tooth 26 already
showed extensive preparation. However, in order to
properly anchor the new restoration, re-preparation
was shown to be inevitable. The cavity had to be extended towards the buccal aspect. Despite being very
Fig. 4
CAD/CAM
2_ 2015
I 21
[22] =>
CDE0109_01_Titel
I technique _ monolithic posterior tooth restorations
_Fabrication of long-term temporaries
According to the treatment plan, the patient
would have to wear long-term temporaries for
a period of several months. In order to fabricate
these restorations, a wax-up was created (Figs. 1
& 2). In this type of situation we prefer to use the
manual wax-up technique, because we have
found this method to be faster. Alternatively, the
restorations could have been virtually designed.
Irrespective of the method used, a lasting result
can only be achieved if the technician has an indepth knowledge of the principles of functional
occlusion.
The waxed up crowns were transformed into
long-term temporaries with CAD/CAM equipment. First, the physical models and wax-ups
were digitally scanned (Zenotec D500, Wieland
Dental) and the STL file was imported into a corresponding design software (Dental DesignerTM,
3Shape) (Fig. 3). Then, all the parameters were
suitably adjusted and the construction data was
transferred to the milling machine (Zenotec select, Wieland Dental), where the restoration was
cut from a PMMA-based disc (Telio CAD for
Zenotec) (Figs. 4 & 5).
Fig. 5
Fig. 6a
Fig. 6b
Fig. 5_The milled crowns before they
were trimmed from the PMMA disc.
Fig. 6a_The completed long-term
temporaris made of PMMA on the
model and…
Fig. 6b_ … in the mouth.
thin, the buccal cusp walls were in an acceptable condition. The main objective was to maintain the tooth
by restoring it with a crown. Following the preparation phase, impressions were taken of the upper and
lower jaws and the occlusal relationship was established. Then, the clinician fabricated the provisional
restoration chairside with the help of a customized
tray.
Fig. 7_Same digital data set:
preparation for the fabrication
of the zirconium oxide crowns
(Zenostar Zr Translucent)
with CAD/CAM equipment.
Fig. 7
22 I CAD/CAM
2_ 2015
The milled crowns were re-worked only minimally and then placed on the model. In order to
impart the PMMA restorations with a naturallooking appearance, their surface texture was finished in such a way that a natural play of light was
achieved. The crowns were subsequently polished
with a special polishing medium and goat’s hair
brushes (Fig.6a). Next, the clinician removed the
chairside provisional restorations and cemented
the long-term temporaries with a suitable luting
composite (TelioR CS Link) (Fig. 6b).
[23] =>
CDE0109_01_Titel
technique _ monolithic posterior tooth restorations
I
Fig.8_The milled crowns before
they were trimmed from the zirconium
oxide disc.
Fig. 8
_Fabrication of the permanent restorations Zenostar Zr Translucent for the restorations. This maThree months later, it was time to focus on the permanent restorations. In an effort to keep the treatment with monolithic restorations as straightforward
as possible, the existing data set, which had been validated by means of the longterm temporaries, was used
(Fig. 7). We selected the translucent zirconium oxide
terial comes in disc form and in six different shades.
We decided to use the “sun” variant, which would give
the restorations a warm, reddish foundation. Various
possibilities of finishing the restoration were available
after the milling process (Zenotec select) (Fig. 8). In this
case, the unsintered structures were characterized
with the colour infiltration method.
Figs. 9a & b_The unsintered
structure is carefully ground and
smoothed.
Figs. 10a & b_Brush infiltration
before sintering: The colouring liquid
is applied in the cervical areas.
Fig. 9a
Fig. 9b
Fig. 10a
Fig. 10b
CAD/CAM
2_ 2015
I 23
[24] =>
CDE0109_01_Titel
I technique _ monolithic posterior tooth restorations
Fig. 11a
Fig. 11b
Figs. 11a & b_Brush infiltration:
The colouring liquid is applied on
the cusp tips and in the fissures.
Fig. 12_The occlusal surfaces
are polished before the stains
are applied.
_Finishing: brush infiltration
In the brush technique, the milled structures
(crowns) are infiltrated with a colouring liquid
(Zenostar Color Zr, Wieland Dental). In this process,
the restorations acquire a lifelike appearance,
showing a tooth-like progression of shade, already
before the sintering procedure. All the A-D shades
can be reproduced with these colouring solutions.
Five additional characterization stains are available.
In the case at hand, the bar joints were removed
from the milled crowns 26, 25 and 35 by grinding,
and the surfaces were smoothed (Figs. 9a & b). Subsequently, the colouring liquid was selectively
brushed on the cusp tips, around the margins and in
deep fissures (Figs. 10a to 11b).
The charm of this colourless liquid lies in the
fact that it can be made visible. For this purpose a
drop of colour concentrate (Zenostar VisualiZr,
Wieland Dental) is added to the solution. As a result, the individual liquids can be easily distinguished from each other when they are brushed on
the restoration. The colouring material is composed of organic pigments which fire without
leaving any significant residue. Next, the restorations were sintered at 1,450 °C (Zenotec Fire P1,
Wieland Dental). After the sintering process, the
crowns appeared lifelike and showed a warm and
natural glow due to the reddish zirconium oxide
used. Only a few minor adjustments had to be
made on the basis of the inspection on the model.
As a result, this approach not only ensures savings
in terms of time and money, but it also heightens
quality assurance.
At this stage—before the staining materials
were applied—the zirconium oxide crowns were
polished and the surfaces were smoothed (Fig. 12).
This effectively counteracted the common concern of abrasion.
Before the crowns were fired, a glaze (Zenostar
Magic Glaze, Wieland Dental) was sprayed on
their surfaces in order to establish an even base for
the application of the staining materials. Stains in
paste form (Zenostar Art Module Pastes, Wieland
Dental) were used to characterize the restorations.
The pastes had to be mixed to a soft, smooth consistency before they could be applied. The cervical
and incisal areas of the restorations were individualized with the stains (Fig. 13). A film of glaze was
sprayed on the restorations (Fig. 14) before they
were fired. The combination of the stains and the
lightly fluorescent spray glaze produced a threedimensional effect.
Fig. 12
24 I CAD/CAM
2_ 2015
[25] =>
CDE0109_01_Titel
technique _ monolithic posterior tooth restorations
After the final firing, the crowns did not appear
any different from layered restorations. On the
contrary, they looked very lifelike and showed a
natural internal play of colour. In the next step, the
occlusal contacts were checked in the articulator
and the proximal contacts on the model. Then the
crowns were sent to the dental practice for placement.
_Seating of the restorations
Teeth 25, 35 and 26 were suitably prepared for
the permanent restorations. Unfortunately, the attempt to save tooth 26 failed. The buccal crown
wall fractured when the long-term temporary was
removed. Right from the beginning, we were aware
of the fact that the remaining part of this tooth
might not be strong enough to withstand the
treatment.
At this stage, therefore, it became quite clear
that the tooth could not be preserved. Consequently,
the long-term temporaries were re-seated and a
new treatment plan was presented to the patient for
tooth 26 on the basis of a detailed analysis. A few
weeks later, the permanent all-ceramic crowns were
cemented (SpeedCEMR) on tooth 25 and tooth 35.
The plan was to replace tooth 26 with an implantsupported restoration at a later date.
I
Fig. 13
Fig. 14
Fig. 15
Fig. 16
_Conclusion
The monolithic zirconium oxide crowns on tooth
25 and tooth 35 were indiscernible from the other
teeth (Figs. 15 & 16). The patient reported that she
was able to chew comfortably and naturally. The
CAD/CAM fabrication protocol allowed the crowns
to be cost-effectively produced. The translucent
material (Zenostar Zr Translucent) that was used in
this case showed a high level of light transmission.
Therefore, it offered the ideal basis for reproducing
the optical properties of the natural teeth. The described approach will help to satisfy the rising number of cost-conscious and aesthetically discerning
patients, since it offers an attractive alternative to
individually layered ceramic crowns and cast crowns
made of precious or non-precious metal._
_contact
Figs. 13 & 14_The stains were
applied and sprayed with another
coating of glaze.
Fig. 15_The zirconium oxide crown
on tooth 25 immediately after it was
placed. Tooth 26 was provisionally
restored with a PMMA crown.
Fig. 16_A suitable alternative to
a veneered crown and a cast crown –
the full-contour zirconium oxide
crown on tooth 35. It smoothly
blends into the surrounding dentition.
CAD/CAM
Dieter Knappe, CDT
Knappe Zahntechnik GmbH
Weinstraße 14
67889 Schweigen-Rechtenbach
Germany
dieter.knappe@orange.fr
CAD/CAM
2_ 2015
I 25
[26] =>
CDE0109_01_Titel
I case report _ upper jaw rehabilitation
CAD/CAM custom-milled
titanium bar for rehabilitation
of an atrophic upper jaw
Author_ Dr Richard Marcelat, France
_Case presentation
A 75-year-old non-smoking female patient,
whose rheumatoid polyarthritis has been treated
with methotrexate for seven years, presented. This
patient has been fully edentulous in the upper jaw for
30 years. She wore a removable partial denture in the
lower jaw and a removable complete denture in the
upper jaw. Stability of the latter was very precarious
owing to severe crestal bone resorption. The patient’s
motivations were mostly function orientated; she
was eager to regain chewing comfort.
Fig. 1
Fig. 2
Figs. 1 & 2_Scans showing
severe bone resorption and
atrophy of the upper jaw.
_CAD/CAM is playing an increasing role in the
production of implant-retained prostheses. These digital technologies constitute a major advancement in
terms of fit accuracy of the superstructure.1,2 Rehabilitating a fully edentulous upper jaw with an implantretained overdenture may require delicate treatment
because of the biomechanical and anatomical considerations associated with severe bone resorption. This
article describes the contribution of these new digital
technologies to the construction of milled bars for
rehabilitation in such cases.
Fig. 3a
26 I CAD/CAM
2_ 2015
There are centrifugal forces in the lower and centripetal forces in the upper jaw, and bone resorption
reduces the volume of the latter, causing an offset
between the upper and lower jaws. This offset, which
was to be compensated for by the overdenture, must
be taken into account at implant placement.
Pre-implantation surgery
DentaScan (GE Healthcare) allows the evaluation,
as a complement to the initial panoramic radiograph,
of the residual bone volume available for implantretained rehabilitation. In the present case, this examination confirmed that the upper jaw was atrophic
(Figs. 1 & 2). Therefore, bone reconstruction was necessary prior to implant treatment. A bilateral sinus lift
[27] =>
CDE0109_01_Titel
case report _ upper jaw rehabilitation
I
Figs. 3a–c_Implant planning with
SIMPLANT after a bilateral sinus lift.
Fig. 3b
Fig. 3c
with lateral access was performed. The space under
the sinus floor was filled with allogeneic bone (maxgraft, botiss biomaterials) mixed beforehand with the
venous coagulum collected at the beginning of surgery. The following step entailed covering the allogeneic bone with a collagen membrane (Bio-Gide,
Geistlich) and a platelet-rich fibrin membrane. The
complete denture was then hollowed out and relined
periodically with a soft resin.
featuring a reverse conical neck, the conical, doublethreaded implants selected for this rehabilitation
(Fig. 4a) allowed us to obtain excellent primary anchoring, as they, along with the drilling protocol, encourage bone condensation in areas with low bone
density. Moreover, the osteoconductive potential of
their BCP (biphasic calcium phosphate) grit-blasted
surfaces promotes osteoblast differentiation in the
early stages of osseointegration.
Implantation planning
Restorative phase
Four months after implantation, preparation for
The case was planned using the SIMPLANT
(DENTSPLY) treatment planning software. The radi- the final restoration began (Fig. 4b). A percussion test
ographic guide, which is a duplicate of the existing on the implants was carried out, and a control radiograph was taken. Straight multi-unit abutprosthesis, allows the prediction of the poFig. 4a
ments were then placed and definitively
sitioning and orientation of the implants
torqued to 25Ncm. Next, a pop-in imto anticipate the dimensions, locations
pression was taken using a polyether imand axes of the implants and abutments.
pression material (Impregum, 3M ESPE)
It also allows maximal exploitation of the
in a custom tray made by the laboratory
available bone volume (Figs. 3a–c).
technician. For full impressions on multiple implants, we usually prefer to take
Implant surgery
a pick-up impression, with joined imIn order to test the mechanical resistance of the grafted areas on probing, osteogenic stimulation of the sinus filling
material was performed with bone matrix
Osteotensors (Victory), using the technique
described by G. Scortecci and C. Misch.3 The
bone matrix Osteotensors are used in a transparietal technique (flapless procedure). This
endosteal stimulation also activates the cells.
This easy and minimally invasive technique enables the assessment of the quality of the intended
implant sites. These techniques have been successfully used in orthopaedic surgery for a decade. Given
the good response to osteogenic stimulation, the
implantation was planned after 45 days.
Fig. 4a_Axiom PX implant.
Fig. 4b_Occlusal view showing the
multi-unit abutments and protective
caps in place.
Six months postoperatively, seven Axiom PX implants (Anthogyr) were placed in the upper jaw using
the radiographic guide. Self-drilling, self-tapping and
Fig. 4b
CAD/CAM
2_ 2015
I 27
[28] =>
CDE0109_01_Titel
I case report _ upper jaw rehabilitation
Figs. 5a & b_Master cast with
silicone gingiva.
Fig. 6_Plaster index for approval.
Fig. 7_The wax pattern
fabricated by the laboratory
technician.
Fig. 5a
Fig. 5b
Fig. 6
Fig. 7
pression transfers, but this technique could not be
used here because of limited mouth opening.
Girrbach). The aesthetic set-up, maxillomandibular
relationship and occlusion were then checked on
the patient by means of a denture set-up placed on a
thermoformed hard basis. This set-up reflected the
patient’s wishes regarding aesthetics too.
The master cast with abutment analogues and
silicone gingiva was fabricated at the laboratory
(Figs. 5a & b) and then checked in the dental office using an index made of non-expanding stone in order to
ensure absolute precision (Fig. 6). This step is essential
to ensure that the master model is perfectly accurate.4
The maxillomandibular relationship is then transferred to the articulator by relining the existing prosthesis on conical caps of abutments (a bite wax on
a hard basis—a technique considered more accurate
by some—can be used instead). The interpupillary line
was registered by means of an inclinometer (Amann-
The laboratory produced a resin pattern of the
substructure (Fig. 7), namely a milled bar as a true
anchoring beam, screwed on to the abutments. After
approval, the master model and wax-up were sent to
Simeda (Anthogyr). This fabrication centre scans the
master model and virtually designs the component
to be produced (Figs. 8a & b). After approval of this
virtual model at the laboratory by means of a 3-D PDF
document (Figs. 9a & b), the bar was milled from a block
Fig. 8a
Fig. 8b
Fig. 8a_Simeda scan.
Fig. 8b_Scanning.
28 I CAD/CAM
2_ 2015
[29] =>
CDE0109_01_Titel
case report _ upper jaw rehabilitation
I
Figs. 9a & b_3-D CAD model.
Fig. 10_Milling.
Fig. 9a
Fig. 9b
of titanium, using a five-axis CNC milling machine (Fig.
10).5 Titanium—four times lighter than semi-precious
alloys—is the lightest metal used in dentistry. It offers
excellent biocompatibility and very good mechanical
properties.6 The metal is highly reactive to oxygen:
when the metal is exposed to air, a protective film, the
passivation layer, builds up on its surface and makes it
extremely resistant to corrosion and chemical attacks.
Titanium offers additional advantages in oral implantology. The density of the materials used is crucial.
Fig. 10
The weight of a prosthesis for an upper jaw appears
to be a key factor for treatment success.
A few days later, the bar was tried in the patient’s
mouth. It was perfectly adjusted and seated passively
(Figs. 11a–d). Milled bars exhibit a precision fit better
than 10µ. The substructure was sent back to the laboratory technician, who then produced the framework using the silicone indices of the approved functional and aesthetic set-up.
Figs. 11a & b_Simeda milled
titanium bar.
Fig. 11c_The titanium bar in situ.
Fig. 11d_Panoramic radiography
for fit control of the bar.
Fig. 11a
Fig. 11b
Fig. 11c
Fig. 11d
CAD/CAM
2_ 2015
I 29
[30] =>
CDE0109_01_Titel
I case report _ upper jaw rehabilitation
Fig. 12a
Fig. 12b
Figs. 12a–c_The telescopic denture
on a milled bar.
Fig. 13_CEKA attachments as
additional retention devices.
The restoration consisted of two distinct parts:
_the milled bar screwed on to the multi-unit abutments; and
_the removable telescopic part: the prosthesis, friction-retained on the bar (Figs. 12a–c).7,8
As the seven implants were well distributed over
the entire arch, no palatal coverage was needed,
meaning enhanced comfort for the patient. Retention of the prosthesis by the bar was enhanced by
four CEKA attachments (ALPHADENT; Fig. 13).
A milled bar-retained removable prosthesis can
be considered an attractive option for patients presenting with an atrophic upper jaw and/or bruxism
because it efficiently compensates for the tissue loss,
ensuring a good aesthetic outcome, in addition to
excellent stability and retention of the prosthesis.9
For this reason, this option is classified by some as
falling in the category of removable bridges.9–12 The
prosthesis is nevertheless resilient enough to withstand high mechanical stress, reducing the risk of
fracture, especially that of the veneering layer.13,14
Fig. 13
As the subtractive fabrication technique (milling)
associated with this CAD ensures that the material
structure will not be altered, a metal substructure
featuring optimal density and homogeneity is obtained. In addition, the computerized configuration
of this process ensures reproducible results and irreproachable passive insertion of these substructures.
_Conclusion
Today’s laboratory scanners can digitize the
model, wax-up and implant index. CAD/CAM technology offers unmatched work quality, precision and
reproducibility compared with conventional procedures. It is certainly the most appropriate technology
for producing implant-retained superstructures. This
technology also allows improved passive fit of substructures and facilitates the work of the laboratory
technician.
Passive fit as a prerequisite for successful implantretained prostheses ensures long-term reliability of
rehabilitation work.25 Moreover, the fabrication centres can machine biocompatible materials such as
titanium and zirconia.
_Discussion
With conventional casting techniques, producing
a substructure for an implant-retained prosthesis remains technically difficult.15,16 The difficulty of achieving passive fit is proportional to the number of elements and volume of the substructure. Despite the
advances in casting technology, in the case of largespan substructures, primary or secondary brazing is
often needed to compensate for the dimension variations in order to achieve an absolutely passive fit.17,18
Such an accurate, passive fit of the substructure is essential for the bone physiology of implants and longterm reliability of implant-retained rehabilitations.19,20
Owing to its high precision, CAD/CAM is an invaluable
tool for evolving the prosthetic workflow technologically.1,21 The restoration is designed based on a 3-D
CAD image created from the scanned data.22–24
CAD software allows modelling of the prosthesis,
taking into account the material selected (such as zirconia; titanium; cobalt–chromium; IPS e.max, Ivoclar
Vivadent; and PMMA).
30 I CAD/CAM
2_ 2015
These CAD/CAM techniques, which are already
well established in dental laboratories, constitute
a major contribution to our daily practice, and will
soon be essential in all practices._
The author declares no conflict of interest.
Editorial note: A complete list of references is available
from the publisher.
_about the author
CAD/CAM
Dr Richard Marcelat
has a DDS in Oral Implantology from the University of
Liège and in Basal Implantology from the University
of Nice Sophia Antipolis, as well as a Postgraduate
Certificate in Implantology from CURAIO in Lyon
in France.
He can be contacted at richard.marcelat@orange.fr
[31] =>
CDE0109_01_Titel
Maestro 3D DENTAL System
Innovative solutions for dental applications
www.maestro3d.com
OPEN 3D DENTAL SCANNER
Attachment designer
Models Builder module
Label designer
Brackets module
Clear aligner module
IPR
Interproximal reduction
Crown & Bridge
www.maestro3d.com
[32] =>
CDE0109_01_Titel
I feature _ interview
Opening the patient’s eyes
Dr Luc Vrielinck, an oral and
maxillofacial surgeon, an expert in
computer- and model-based implant
planning systems, and a user of
NobelClinician Communicator,
explains how he walks his patients
through the treatment process step
by step. In this interview, he provides
some valuable insight into the use of
the application.
Fig. 1_Dr Luc Vrielinck has learnt
from extensive experience how
powerful visual information can be
when communicating with a patient.
NobelClinician Communicator makes
it possible to consult with the patient
in a relaxed setting. According to
him, it serves as a natural and nonintimidating introduction to treatment
planning, after which the clinician
can easily start discussing success
rates, potential complications and
treatment alternatives.
Fig. 1
_Jim Mack, Managing Editor of Nobel Biocare
News, recently posed a few questions to Dr Vrielinck,
who has extensive experience using the NobelClinician
Communicator iPad app to explain the entire treatment sequence to prospective implant patients.
_For how long have you been using NobelClinician
Software, and why do you use it?
Dr Luc Vrielinck: I have been using NobelClinician
Software since it was released. The 3-D analysis of
underlying bone structures and the computer simulation of implant placement add a new dimension to
the practice of implant dentistry.
32 I CAD/CAM
2_ 2015
It has always worked very well, but today I prefer
to start discussions using an iPad rather than a computer screen. Although using the NobelClinician Communicator app requires a few extra preparation steps
before the NobelClinician planning is ready for viewing on the iPad, it is well worth the effort. Patients
are always impressed with the beautiful images and
rarely hesitate to engage with these images when
asking specific questions.
The NobelClinician Communicator app makes it
possible for me to explain the general treatment plan
to the patient and allows me to demonstrate visually
the need for additional procedures, such as bone
grafting and the use of membranes for augmenting
the thickness of the dentoalveolar ridge. It can also
help me to illustrate the need for a sinus lift, or simply
depict the patient’s own bone anatomy clearly, which
always facilitates a treatment planning conversation.
Having a view in all directions of the bone anatomy
adds to one’s clinical knowledge and augments the
experience of the clinician. While classic radiology
allows us to see the bone, CBCT analysis and 3-D computer planning allow us to define and understand
treatment planning. Knowing and seeing, after all, are
two different things.
_What changed when you began using the NobelClinician Communicator iPad app?
_What has your experience been using NobelClinician as a patient communication tool?
It serves as a natural and non-intimidating introduction to treatment planning, after which the clini-
[33] =>
CDE0109_01_Titel
feature _ interview
cian can easily start discussing success rates, potential complications and treatment alternatives in order
to obtain the informed consent of the patient.
The NobelClinician Communicator app provides
an open invitation to discuss the treatment ahead,
including treatment choices that need to be made,
and makes it possible to consider much more than the
type of implant to be placed.
_Could you explain to us how you use the NobelClinician Communicator app to discuss the treatment
plan with your patients?
Mostly, I start in a cross-sectional view (radiographic cross-sectional image) to explain the bone
structure and bone volume. Next, I show a planned
implant at its intended location. The virtual implant is
depicted in blue and around the implant is a yellow
outline (the safety zone). I describe the importance of
this safety zone and use it to explain that an actual
treatment can never be as precise as depicted on a
screen.
I also explain—if relevant—the relation of the
implant to the inferior alveolar nerve or the maxillary
sinus. If the yellow zones are larger than the thickness
of the bone, this can be viewed easily and provides an
opening for me to explain the necessity of grafting
procedures in such situations to the patient.
_How do your patients perceive the use of such
sophisticated technology in their treatment?
I do not think our patients are surprised to see
the team using an iPad these days. An iPad is used by
the implantologist for explaining the treatment plan
to the patient, by the dental nurse in rehearsing the
treatment plan before the surgery actually starts,
and by the administrative treatment co-ordinator to
establish which implants and components have to be
available and eventually ordered.
If a practice is up to date, well organized and professional, patients should not be surprised to see us
using this technology. Rather, I think they ought to be
surprised if it is not being used!
_Could you explain to us why using the NobelClinician Communicator app helps you gain patient
acceptance of your proposed treatment plan?
The NobelClinician Communicator app is a basic
tool used to present an agglomerate of knowledge to
the patient. The process may have started with a prosthetic set-up and continued with the CBCT scan and
the subsequent treatment planning, but it will always
end up with a final presentation of a solution to the
patient, and that is where this app excels.
When the different individual implant positions
are explained, I often show a 3-D bone model of the
jaw to the patient, but certainly not in every case.
Sometimes the 3-D CBCT images are difficult for patients to interpret, especially in partially edentulous
cases.
The app is not fancy imaging software; it is a tool
used to explain the treatment to the patient. If the
patient feels that one step logically follows the other
to a good solution, he or she will be inclined to accept
the treatment plan proposed via the app in front of
him or her. But it does not stop there. The app can also
be used to explain alternative treatment modalities,
paving the way for informed patient consent._
_NobelClinician can shorten treatment time and
increase safety. Could you imagine working without
it today?
To read more about the user-friendly solution for diagnostics, treatment planning and patient communication, please
visit nobelbiocare.com/nobelclinician.
To me, whether to use NobelClinician for a case is
not in doubt. It is a natural part of the pathway leading to the treatment plan.
Editorial note: iPad is a trademark of Apple Inc.
For my patients, the use of NobelClinician is very
straightforward, and they generally understand it
intuitively. Its purpose is to assess the bone volume
of the patient, to see if implant treatment is possible,
to evaluate whether there is a need for bone augmentation, and to determine the type of implants to
be used.
This assessment results in the formulation of the
treatment plan. In the practice of implant dentistry,
conscientious planning is a necessity for me, like food
and water.
I
_info
CAD/CAM
Dr Luc Vrielinck is in private practice at Ziekenhuis Oost-Limburg (hospital) in Genk in Belgium.
He works extensively with computer- and modelbased implant planning systems. His special field
of interest is atrophic maxillae and treatment with
zygomatic and pterygoid implants, and he teaches
NobelGuide training courses on a regular basis.
CAD/CAM
2_ 2015
I 33
[34] =>
CDE0109_01_Titel
I industry news _ Planmeca
A winning combination:
CAD/CAM and CBCT in one
_The field of digital dentistry is rapidly evolving, with new dental technologies emerging as part
of a more efficient and comprehensive workflow.
By pairing Planmeca CAD/CAM solutions with radiographic units in the Planmeca ProMax 3D family,
dental professionals can bring together a wide
range of detailed information for treatment planning and diagnostic purposes. This seamless
combination of CAD/CAM and CBCT technology presents new possibilities in creating a new standard of care for patients, offering high-quality features for different
specialities, all available through one software interface.
Planmeca Romexis is the only dental software platform in the world to combine all
imaging and the complete CAD/CAM
workflow. This powerful solution is at
the heart of the Planmeca ecosystem, as it provides dental professionals with the ability to acquire datasets that are more detailed than ever before. Planmeca
Romexis includes advanced tools
for all specialities, such as implant planning and other restorative treatments. The software presents dental clinics with a superior way to increase their patient flow and improve the level
of care offered.
_Seeing more than ever before
Bringing together CBCT data and CAD/CAM work
provides a comprehensive level of clarity. Planmeca
ProMax 3D imaging units reveal intricate information
on soft- and hard-tissue structures, including the
mandibular nerve canal, while the Planmeca PlanScan
intra-oral scanner captures precise data above the
gingival margin. This combination of data
ensures a complete understanding of any
case and makes 3-D prosthetic design quick,
accurate and easy. Clinics are able to operate
more flexibly, as restorations can either be
milled in-house with the Planmeca PlanMill
40 milling unit or easily sent to a dental laboratory in an open STL data format.
34 I CAD/CAM
2_ 2015
_The rise of same-day dentistry
A more active role in the manufacture of restorations opens up avenues for dental clinics to significantly increase their patient volume and grow their
business. A streamlined digital workflow ensures the
full utilization of resources, leading to a more efficient
treatment environment. Same-day dentistry is as
beneficial for patients as it is for clinics: instead of two
visits, patients can be treated in 1 hour—with no temporary crowns or physical dental models required.
_Open architecture for maximized
efficiency
Standardized data is the driving force behind many
of the latest developments in digital dentistry, as it
guarantees the interoperability of images and dental
data across different hardware platforms—reducing
costs, increasing predictability and enhancing patient safety. Bringing Planmeca’s CBCT and CAD/CAM
systems together through Planmeca Romexis makes
effective chairside dentistry a reality and presents
dentists with a streamlined opportunity to grow their
practice substantially._
_contact
Planmeca Oy
Asentajankatu 6
00880 Helsinki
Finland
www.planmeca.com
CAD/CAM
[35] =>
CDE0109_01_Titel
CC POWER
2,5kW/holder ffor
or 18 drills/5 axis
CC COSMO
0,97kW/holder for
for 20 drills/5 axis
CC TREND
TRENDY
Y
0,97KW/holder ffor
or 8 drills/5 axis
SUM 3D SW
SW,
W,, JÄGER SPINDLE
WIDEE RANGE OF MA
MATERIALS
ATERIALS
TERIAL
TERIALS
CoCr,, Zircon, Titan,
CoCr
Titan, PMMA, wax, composite, glass ceramic
OPEN
N SY
SYSTEM
S
STEM
STL fformat
ormat
PROFESSIONAL SUPPOR
SUPPORTT
INTERDENT d.o.o. · Opekarniška cesta 26 · 3000 CELJE · SLOVENIA
TTel.:
el.: +386 (0)3 425-62-00 · Fax: +386 (0)3 425-62-02
E-mail: inf
info@interdent.cc
o@interdent.cc · www
www.interdent.cc
.interdent.cc
[36] =>
CDE0109_01_Titel
I industry news _ exocad
exocad DentalCAD,
the next generation
scope. It represents a major leap forward and as
such it presents the next software generation in
one fell swoop. Some of the many new and ongoing developments are presented briefly in this
article.
_How it all began
Fig. 1
Fig. 1_Screenshot of the
software from 2010.
_exocad, a company based in Darmstadt in
Germany, follows the approach of continuous integration to increase product quality. For this
reason, our design software, exocad DentalCAD,
has been developed incrementally since its launch.
This year, there is an update that is unique in its
Fig. 2_Screenshot of
exocam CAM software.
Fig. 2
36 I CAD/CAM
2_ 2015
The Fraunhofer Institute for Computer Graphics Research in Darmstadt is one of the world’s
leading institutions for applied visual computing.
This is where the initial DentalCAD software was
developed. It was characterized by its particular
ease of operation, rapidly achievable results and
open interface for integrating various scanners
and milling machines. The first version was completed in 2008. On 1 March 2010, the then newly
established spin-off company, exocad, was announced as the exclusive licensee. Even then, the
clientele ranged from A for Amann Girrbach of
Koblach in Austria to Z for Zirkonzahn of Gais in
Italy. Figure 1 provides an image of the software
in 2010. A great deal has changed since then and
the new version is being launched not only with
additional features, but also with a completely redesigned user interface.
[37] =>
CDE0109_01_Titel
industry news _ exocad
I
_New user interface
The basic tried-and-trusted workflow when creating jobs and casting remains essentially unchanged
despite the update, so that users of the current version can still find their way around instantly. However, we have implemented closer integration of the
exoscan scanning software and the exocam CAM
software (Fig. 2).
Besides the usual process chains, however, the
update provides far more than a mere facelift in terms
of the user interface; this has been completely redesigned. Until now, only subtle changes have been
made to the design in order to keep the training costs
for existing customers to a minimum. However, according to exocad CEO Tillmann Steinbrecher, the
time had come to give the software a contemporary
look, take account of the current technical findings in
software development and match them to a changed
user experience. With regard to the graphic conceptual design, this involved implementing a contemporary flat look. In this style of interface design of applications and websites, the use of realistic-looking
textures, shadows and ornamentation, as well as 3-D
elements, is deliberately avoided. The move away
from gradients in favour of flatter space and a rather
minimalist design is intended to guide the user’s eye
in a more focused manner towards the essentials
and support more intuitive menu navigation. The new
software’s clear structure is also supported by a
bolder use of colour in the design language, such as
with group lists (Fig. 3). The demand in the past for
realistic icons, based on physical objects as far as possible, is long since obsolete. As (almost) every regular
dental technician now has much greater experience
in this area owing to tablets, smartphones and the
like, increased abstraction is possible. This design also
takes into account that with desktops there has been
an increasing use of touch screens, which could eventually become the standard. Some newcomers may
feel that navigation in a 3-D space with a conventional mouse is certainly a challenge. Operation with
three-finger multi-touch is usually easier.
Fig. 5
Fig. 3
Fig. 4
_New features
The cloud-based tool dentalshare (Fig. 4) will in
future make process co-ordination easier when
working with manufacturing service providers. Their
specific material configurations are stored in the
cloud and are always kept up to date without further
action required by the user. By specifying the recipient when placing a new order, the appropriate design
parameters are automatically used.
One change, which users will notice indirectly,
is the 3-D engine’s switch to a new development platform. This enabled us in the context of TruSmile tech-
Fig. 3_The new version is tidier
and is bolder in its use of colour,
with the indication selector here
as an example.
Fig. 4_Material configurations are
stored in the cloud and automatically
updated for users via dentalshare.
Fig. 5_The new 3-D engine
enables an even more realistic
representation of various tooth
colours and materials.
Fig. 6_Photographs can be
uploaded from webcams and edited
directly in the software.
Fig. 6
CAD/CAM
2_ 2015
I 37
[38] =>
CDE0109_01_Titel
I industry news _ exocad
perspectives and each positioned spatially or certain
areas can be cropped out and overlaid or blanked out
at any time, for example to visualise the lip line.
If required, there is an option to export a 3-D PDF
of the plan, including notes in the 3-D space, in order
to obtain the dentist’s feedback, for example. In designing, the wizard can now be opened and closed at
will without the history being lost. Access to frequently used features has been made easier, so that
displaying penetration by the counter bite is achievable with just one click of the mouse.
Plus, new notifications, for example with contextsensitive prompts, ensure that the user is made aware
whenever the software notices inefficient working
methods. This may be the case, for example, whenever
time-saving hot keys, that is, key combinations for
specific commands, are not used.
Fig. 7
The tools for free forming have been developed
with the claim of being able to do everything that is
possible in wax. Among other things, any geometrics
can be added or subtracted and marked via the new
paint and pull features for dynamic reshaping. For
example, interlocks can now be designed more flexibly (Fig. 7). Furthermore, the ZRS Wiedmann Dental
Library (Manfred Wiedmann Gesicht und Zähne) has
been expanded with additional posterior teeth samples (Fig. 8) and our Model Creator now even supports
the use of implant libraries (Fig. 9).
Fig. 8
_For those who like experimenting
In November 2014, exocad announced its purchase of STI’s SensAble Dental Lab System. According
to exocad’s executive board, this is the most flexible
and high-performance platform for model casting
designs currently available. However, its operation is
said to be rather complicated and only suitable for
power users so far.
The software is now available as a technology preview for exocad users to download free of charge at
exocad.com/technology-preview. An integrated and
optimised version will appear during the year._
Fig. 9
Fig. 7_Improved tools for free
forming provide new options,
such as flexible interlock designs.
Fig. 8_ZRS Wiedmann’s anterior
dental library has been expanded.
Fig. 9_Model Creator supports the
use of implant libraries.
38 I CAD/CAM
2_ 2015
nology, for example, to achieve an even more realistic
representation of different tooth colours and materials (Fig. 5). In combination with 2-D photographs,
this will make it even easier to plan treatment outcomes and an optimized marketing tool is available. It
is true that it has been possible to load photographs
in exocad DentalCAD for quite some time, but owing
to the new webcam integration, it is now especially
easy (Fig. 6). Shots can also be imported from several
_contact
exocad
Julius-Reiber-Str.37
64293 Darmstadt
Germany
www.exocad.com
CAD/CAM
[39] =>
CDE0109_01_Titel
www.DTStudyClub.com
Y education everywhere
and anytime
Y live and interactive webinars
Y more than 500 archived courses
Y a focused discussion forum
Y free membership
Y no travel costs
Y no time away from the practice
Y interaction with colleagues and
experts across the globe
Y a growing database of
scientific articles and case reports
Y ADA CERP-recognized
credit administration
Register for
FREE!
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providersof continuing dental education.
ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.
[40] =>
CDE0109_01_Titel
I industry news _ Interdent
Enter the world of CAD/CAM
technology with Interdent
Author_ Urša Zagožen
Figs. 1a–c_Milling units
CC POWER (a),
CC COSMO (b)
and CC TRENDY (c).
_With over 35 years of experience, a mission to
produce quality products and an environment in
which the user plays the decisive role, Interdent is now
presenting CAD/CAM technology with unlimited possibilities.
The company’s mission has always been to keep
track of new trends in dental care. CAD/CAM technology has been on the market for over 20 years;
however, despite its initial boom, it developed rather slowly. At the beginning, it was based on processing minor non-metal ceramic restorations,
but there were problems concerning precision, speed and the choice of available material at the time. Today, the precision of
gingival fit is already extremely fine, although differences remain between the systems. With adequate materials available, it is
also possible to mill larger restorations;
however, there are many systems on the
market that fail to provide comprehensive
systems for dental laboratories. Systems
are limited to milling only certain materials
and, furthermore, many providers charge licence fees, which means an additional cost
for the user along with the initial investment.
Every new technology takes time to become complete and to find their way on the market. This year,
Interdent paved the way with its new milling units:
CC POWER, CC COSMO and CC TRENDY, which are
available to users of various profiles. The needs of
dental technicians across the world differ greatly,
primarily depending on the existing
capacities and development of
the respective dental laboratory.
The needs of a laboratory employing 200 people are significantly different from the needs
of a laboratory employing ten
people. Since Interdent is focused on the international market, it adopted a broad perspective during development
(Figs. 1a–c).
40 I CAD/CAM
2_ 2015
This was the reason for producing CC POWER,
which with its immense power of 2.5 kW is suitable
for the most demanding of users, as it is able to operate 24/7, maintaining productivity and precision,
while the compact CC COSMO and CC TRENDY are
intended for medium-sized laboratories that will
largely use the device for their own needs. All three
units are extremely compact, with all components
placed on a seamless cast-iron block not bound to
the housing, thus preventing vibrations and providing greater precision. The major difference between
the units lies in power, and all of the units allow fiveaxis simultaneous milling. The axes are driven by alternating current servo-motors made pursuant to
the top industrial standards and ensuring very precise movements, a long service life and the accurate
processing of all materials.
Both units enable wet
and dry milling and include a holder for 18 (CC
POWER), 20 (CC COSMO)
and eight (CC TRENDY) burs.
Hence, the user does not waste
time changing burs for the material to be milled. The unit automatically selects the necessary bur and, if required, replaces it during milling (Fig. 2).
[41] =>
CDE0109_01_Titel
industry news _ Interdent
I
CC POWER, CC COSMO and CC TRENDY are manufactured using only the best, as is evident from
the spindle produced by Jäger, one of the top makers of spindles for CNC machines. Its pneumatic tool
changer and power enable faster milling without
affecting precision.
The materials that can be milled by the units come
in the form of discs measuring 98mm in diameter
and include cobalt–chromium, titanium, zirconium,
PMMA, wax and composite. There is also an adapter
for minor blocks, so that CC POWER, CC COSMO and
CC TRENDY can also be used to process glass-ceramic
and other blocks. These blocks are processed using
diamond burs and water-cooling (Figs. 3 & 4).
The milling calculations and the management
of movements are controlled by electronic systems
that meet the highest industrial standards. The user
operates the unit via a tablet computer installed on
a special stand and running the Windows 8 operating system.
Our development focused on providing users with
an excellent system that will guarantee top quality
and precision, be easy to use and protect users from
additional costs due to licence fees.
For this reason, we use the Sum 3D CAM software
with our CAD/CAM units. It is used to plan for milling
and is considered one of the best programs in dentistry. Upon purchasing the program, the user receives a licence for unlimited
use, so no subsequent payments of monthly or annual
licence fees are required.
Furthermore, our vision
guided us to offer a comprehensive CAD/CAM system that
would, in addition to the CC
POWER, CC COSMO and CC TRENDY
milling units with open Sum 3D software, include a scanner. We searched for the best
and included the Identica Blue Scanner (Medit) and
exocad DentalCAD in our product range (Fig. 5).
Dental CAD software, which is noted for its easy handling and wide selection of modules (crowns, links,
inlays, veneers, onlays, primary crowns, implants,
virtual articulator, shafts, model design, temporary
substitutes, TruSmile, etc.). The thing that most impresses every user is the setting of the preparation
limit, which is done at the click of a button, offering
a major advantage over other available software.
By means of the above, we took a step closer to
most users; however, some still find an investment in
CAD/CAM technology too expensive with regard to
their needs. This mostly applies to small laboratories. Therefore, we came up with the
idea to offer such users milling services.
As a result, the Interdent Milling Centre was established this year,
in which CAD/CAM experts see to
it that orders are received and
restorations are made to order and
delivered in a few working days.
This way, laboratories can offer an
Fig. 2_Bur holder in the
CC POWER unit.
Fig. 3_Milled CC Disk NF CoCr.
Fig. 4_Adapter for milling minor
blocks.
Identica Blue convinced us with its reliability, precision (less than 10 µm), scanning speed (e.g. antagonists can be scanned in only 35 seconds), cuttingedge blue light scanning technology, wide area (allowing the scanning of models in an articulator), and,
naturally, ability to export files in an open STL format,
which provides freedom in CAD/CAM technology.
The logical next step was to upgrade the Identica
Blue scanner with the verified, compatible Exocad
CAD/CAM
2_ 2015
I 41
[42] =>
CDE0109_01_Titel
I industry news _ Interdent
Fig. 5_Identica Blue Scanner.
Fig. 6_The Interdent CAD/CAM team.
extremely diverse range of indications
and materials, as well as use CAD/CAM
technology, with only a minor investment.
will be able to apply your knowledge of dentistry to
advanced computer technology and lay the foundations for optimal results and efficient work.
I have been using a milling unit for a long time
We are pleased to provide a comprehensive solution in CAD/CAM technology that features ease of use, excellent
technology and outstanding material. Since we believe that customer satisfaction depends not only on
the quality of the product, but also on correct handling, Interdent offers professional support throughout the process, from your expressing your desire to
purchase to training and rapid solutions to any problems encountered during use (Fig. 6).
The CC POWER, CC COSMO or CC TRENDY milling
unit has become the centre of your practice. Over
time, new questions or unexpected problems can
arise, requiring efficient, fast and professional support as provided by the Interdent CAD/CAM team.
We are available in person and via various media,
such as by telephone or video.
For more information, please do not hesitate to
contact us._
_Interdent CAD/CAM Training Centre
Are you deciding on a purchase? Have you recently
made a purchase or have you been using a milling unit
for a long time? The Interdent CAD/CAM team is at
your service!
_author
CAD/CAM
I am deciding on a purchase
Interdent will gladly help you in this very important decision and will advise you on a device suitable
for your needs that will optimise your work processes
in the laboratory.
I have just made a purchase
The first important step is behind you, and now
you became a part of the the Interdent CAD/CAM
team. Its experienced dental technicians and CAD/
CAM specialists will train you to use the unit and
materials. With their professional assistance, you
42 I CAD/CAM
2_ 2015
Urša Zagožen
is a marketing manager at
Interdent.
_contact
Interdent
Opekarniška cesta 26
3000 Celje
Slovenia
d.mehmedovic@interdent.cc
www.interdent.cc
[43] =>
CDE0109_01_Titel
1 Year Clinical Masters Program
TM
in Aesthetic and Restorative Dentistry
12 days of intensive live training with the Masters in Athens (GR) and Geneva (CH)
Three sessions with live patient treatment, hands-on practice, plus
online training under the Masters’ supervision.
Learn from the Masters of Aesthetic and Restorative Dentistry:
Registration information:
12 days of live training with the Masters
in Athens (GR), Geneva (CH) + self study
Curriculum fee: €9,900
(Based on your schedule, you can register for this program one session at a time.)
Collaborate
on your cases
University
of the Pacific
and access hours of
premium video training
and live webinars
you will receive
a certificate from the
University of the Pacific
Tribune Group GmbH is the ADA CERP provider. ADA CERP is a service
of the American Dental Association to assist dental professionals in
identifying quality providers of continuing dental education. ADA CERP
does not approve or endorse individual courses or instructors, nor does it
imply acceptance of credit hours by boards of dentistry.
Details on www.TribuneCME.com
contact us at tel.: +49-341-484-74134
email: request@tribunecme.com
100 C.E.
CREDITS
Tribune Group GmbH i is designated as an Approved PACE Program Provider by the
Academy of General Dentistry. The formal continuing dental education programs of this
program provider are accepted by AGD for Fellowship, Mastership, and membership
maintenance credit. Approval does not imply acceptance by a state or provincial board of
dentistry or AGD endorsement.
[44] =>
CDE0109_01_Titel
I industry news _ Straumann
Multiple new solutions presented at
IDS 2015 bring Straumann closer to
being a total solution provider of choice
_At Europe’s leading dental trade fair, the International Dental Show (IDS) in Cologne in Germany, Straumann presented a number of new products and solutions that—together with new partnerships—bring the
group closer to its goal of becoming a complete solution
provider and, thus, the partner of choice in tooth replacement for both dentists and dental laboratories.
_Further advances in implants
Since the 2013 IDS, Straumann has launched its fully
ceramic implant (Straumann PURE) and has successfully upgraded the majority of its surgical customers to
the unique high performance implant material Roxolid,
which has been extended throughout the Straumann
implant range. Owing to its excellent biocompatibility
and strength (greater than pure titanium), Roxolid
makes it possible to use smaller implants, which in turn
can avoid the need for bone augmentation, reducing
treatment invasiveness.
New-generation Bone Level Tapered Implant
Roxolid is a key feature of Straumann’s new Bone
Level Tapered Implant, which offers high surgical flexibility and primary stability. With the controlled market
release having been completed, the new implant is now
available in various endosteal diameters (3.3, 4.1 and
4.8mm) and lengths (8–16mm), and offers a broad range
of prosthetic options. Its design offers high primary stability for immediate or early loading and, with Straumann’s SLActive surface to enhance osseointegration,
implant healing time is significantly reduced—making
this a new-generation bone level tapered implant.
_A complete family of restorative solutions
Straumann is placing significant emphasis on enhanced products, technologies and workflows for dental laboratories—from simple Variobase Abutments and
milling blanks with original Straumann connections to
new high-tech ceramics, state-of-the-art in-laboratory
milling machines, scanners, advanced CAD/CAM functionality and centralized milling services. Together with
the partners in its technology platform, the group is able
to offer total solutions to dental laboratories around
the world. More information on these and other new
44 I CAD/CAM
2_ 2015
launches was shared at a dedicated Lunch and Learn
session for dental laboratory professionals during IDS.
Straumann Pro Arch, a comprehensive combination
The Bone Level Tapered Implant is an important
component in Straumann’s Pro Arch solution, which
was first exhibited at this year’s IDS. Pro Arch is a comprehensive combination of implants, abutments, CAD/
CAM frameworks, auxiliary components and educational support that enable clinicians and dental laboratories to provide accelerated fixed full-arch rehabilitation. This approach reduces the number of treatment
sessions and thus minimizes disruption to patients’
daily lives. Most importantly, it offers fixed full-arch replacements rather than removable dentures, which
many patients view as artificial and inconvenient.
The Pro Arch solution includes a selection of sleek
new abutments and auxiliary components that offer
a wide range of prosthetic options for screw-retained
restorations. The low abutment profile, varied angulations (17 and 30 degrees) and gingival heights give
dentists exceptional flexibility to provide individual
solutions, including tilted posterior implants.
CARES Basic and Advanced Fixed Bars
CARES Visual 9.0, the latest software for Straumann’s
CAD/CAM system, adds the functionality for custommilled bar options and designs to support the final
restoration. This means that clinicians can now provide
custom-milled frameworks—both at implant and abutment levels. In addition to titanium and coron (the company’s cobalt–chromium alloy) options, Straumann will
be introducing zirconium dioxide frameworks this year.
Straumann Variobase becomes a family
At the 2013 IDS, Straumann introduced the CARES
Variobase Abutment, the basis for a cost-effective hybrid solution consisting of a titanium bonding base and
a zirconium dioxide coping. This was to complement its
existing range of customized abutments and to offer
laboratories the combined benefit of a metal–metal implant–abutment interface with an original Straumann
connection and a variety of aesthetic shades. The pop-
[45] =>
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industry news _ Straumann
ularity of this solution has prompted several developments, which made their debut at this year’s IDS.
_New heights
For additional flexibility, for example to support
larger crowns, the Variobase Abutment now comes
with an increased (5.5mm) chimney height, which
can be customized and is available for all Straumann
implant platforms.
_Variobase for bridges and bars
Straumann has also developed a new Variobase
Abutment for screw- and cement-retained bridge and
bar restorations, offering highly flexible and costeffective solutions for multiple-tooth restorations.
Its conical design features special helix threads and
a minimum plateau for long-term stability and passive
fit of the bridge or bar.
_Variobase for CEREC
Dentists using Sirona Dental Systems’ CEREC chairside workflow to produce implant-retained restorations now have the option of a Straumann Variobase
Abutment with an original connection and a concave
collar design for an optimized emergence profile. This
Variobase Abutment is compatible with available material blocks and two-piece scan bodies.
1
CARES X-Stream for bridges and bars
CARES X-Stream was launched at the 2013 IDS and
streamlines the prosthetic workflow so that all the components are manufactured from only one scan and one
design procedure. The digital functionality has been developed further and now includes the processing steps
for bridges and bars on the new Variobase Abutment.
Lava Plus High Translucency Zirconia for CARES
Straumann also announced the availability of
CARES restorations in 3M ESPE’s Lava Plus High
Translucency Zirconia, a material engineered for excellent translucency with uncompromising strength. It is
the only CAD/CAM material system that matches the 16
VITA classical A1–D4 shades and two bleached shades.
Pre-milled abutment blanks
To help dental laboratories build their business and
maintain implant–abutment precision and reliability,
Straumann is now offering titanium blanks with pre-fabricated implant connections. The blanks are compatible
with a wide range of milling machines (e.g. Medentika;
imes-icore; D5, DATRON; GAMMA 202, Wissner; RXD,
Röders; DC5, Dental Concept Systems; COBRA Mill, MB
Maschinen; and vhf camfacture)2 and enable laboratories to fabricate one-piece customized titanium abutments with original Straumann connections in-house.
I
_Technology platform strengthened
Straumann heralded the arrival of the CARES M
Series in-laboratory milling machine developed by
Amann Girrbach to operate with the CARES CAD/CAM
system. The new machine will be offered by Straumann
together with the latest CARES 3Series and 7Series
in-laboratory CAD/CAM scanners, which have been codeveloped with Dental Wings and were also launched
in Cologne. At Straumann’s press conference, Dental
Wings presented the scanners together with its new
intra-oral scanner and revolutionary laser ablation inlaboratory milling machine.
Furthermore, Straumann announced its investment
in Valoc, a developer and manufacturer of innovative
overdenture attachment systems.
N!ce developed by Straumann, manufactured by etkon,
distributed through Instradent
Straumann has developed an exciting new glassceramic material (lithium disilicate-reinforced lithium
aluminosilicate) for high-end restorations, including
crowns, inlays, onlays and veneers. Under the brand
name etkon n!ce, the new material will be manufactured by etkon and supplied in ready-to-mill blocks in
the common C14 format. Its key advantages include
high flexural strength, short milling times and easy
finishing.
It is available in two stages of crystallization. The
partially crystallized version is easy to mill and can be
stained and glazed, making it attractive to laboratories.
The fully crystallized form requires no firing and can be
milled, finished and seated directly, making it the ideal
chairside solution. Straumann plans to release n!ce
through its Instradent platform in May in Europe, with
other regions and distribution channels to follow.
_Value-adding support
Straumann Patient Pro, a new tool for comprehensive
information
Research suggests that every other patient consults the Internet before, after and sometimes even
during the consultation.3 A patient’s choice of treatment and/or dental professional is based on the information found. Straumann Patient Pro is a new
comprehensive platform that provides dental professionals with digital information to educate patients
and to promote their practices. It supports them with
materials and tools for the Internet and social media,
as well as for use in their dental practices.
For more information, please visit the Straumann
website._
Editorial note: A complete list of
references is available from the
publisher.
_contact CAD/CAM
Institut Straumann
Peter Merian-Weg 12
4052 Basel
Switzerland
www.straumann.com
CAD/CAM
2_ 2015
I 45
[46] =>
CDE0109_01_Titel
I industry news _ Nobel Biocare
The crown that rules them all:
NobelProcera FCZ Implant Crown
Patients, clinicians and dental laboratories all want
restorations they can rely on
Author_ Michael Stuart, Nobel Biocare, Switzerland
Fig. 1_Combining strength
with restorative flexibility,
the NobelProcera FCZ Implant
Crown is the ideal solution
for the posterior region.
Fig. 1
_The NobelProcera FCZ (full-contour zirconia)
Implant Crown combines full-contour strength that
is sufficiently robust for the posterior region with superb restorative
flexibility—and all with no cement
in sight.
The NobelProcera FCZ Implant Crown is designed
for use with Nobel Biocare’s extensive range of conical
connection implants. Combining Nobel Biocare components means that all the elements can be trusted to
work together seamlessly for the perfect treatment
outcome.
CAD/CAM manufactured using high-strength
translucent zirconia—in which angulated screw channels can be created—the NobelProcera FCZ Implant
Crown is designed for predictable strength, aesthetics and function.
_Not veneered, but engineered
_No cement, no chipping, no problems
The strength of the FCZ Implant Crown makes it
suitable for all tooth positions, ensuring predictability even under the high occlusal forces of the posterior region, which makes it an ideal restoration for
molars. There is no need to worry about veneer chipping either, as the full-contour characteristics of the
NobelProcera FCZ Implant Crown eliminate the need
for veneering.
Fig. 2_The NobelProcera FCZ
Implant Crown can incorporate an
angulated screw channel. This offers
easy access to the restoration and
can maintain the occlusal function.
_contact CAD/CAM
Nobel Biocare
Balsberg
Balz-Zimmermann-Str. 7
8302 Kloten
Switzerland
www.nobelbiocare.com/
bringinginnovationback
46 I CAD/CAM
2_ 2015
Fig. 2
The biocompatibility of the materials
used represents an additional benefit by supporting biological stability in the areas
where it matters most. Plus, being screw
retained, the FCZ Implant Crown is completely cement free, eliminating the risks
associated with excess cement. Even
the titanium adapter is mechanically
retained.
As it can be placed in the posterior region, the FCZ Implant Crown gives clinicians
the opportunity to increase the number of
screw-retained restorations they place. This
means more patients treated with a restorative solution that is easier to maintain and
retrieve—and all without cement.
With the angulated screw channel option, the
screw access hole can be placed anywhere between
0 degrees and 25 degrees within a 360-degree radius.
This means that it can be angled towards the front
of the mouth for easy access even in tight posterior
spaces; it also means that the access channel does not
need to be placed on the cusp of the tooth, where it
might affect occlusion.
Working on the restoration is further simplified
with the associated Omnigrip Screwdriver. Its effective pick-up function and secure grip on the screw
help the clinician to work safely and efficiently.
Natural-looking tooth colour is another
benefit offered by the FCZ Implant Crown.
Whichever of the eight available shades
is used, the colour will be uniform
throughout the material. This means adjustments can be made without having
to worry about discoloration. Furthermore, cut-backs or staining can be used
to achieve the desired aesthetic effect.
For patients, clinicians and dental laboratories looking for restorations can rely
on, the NobelProcera FCZ Implant Crown
provides extraordinary strength for longterm predictability and delivers restorative flexibility too. As a result, it is well on
its way to becoming the crown that rules
them all!_
[47] =>
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[48] =>
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I industry report _ DENTSPLY Implants
How a modern implant
system is developed
Source_Dentsply Implants
_A dental implant system
consists of hundreds of components. It includes everything from
the highly advanced implant to
simple tweezers. For an optimal function of a system, all parts must interplay.
They must fit together like cogwheels and
create a smooth and well-functioning totality.
If just one cog is misaligned, the entire system will
suffer. And this may cause unnecessary problems
for the dental team and ultimately the patient.
_Mission started
Per Aringskog and
Agneta Broberg Jansson.
Per Aringskog, R&D Director at DENTSPLY Implants, and his team were well aware of this. To
start their development work, they had one of the
most thoroughly documented dental implant systems in the business. Decades of research in areas
as diverse as mechanical loading and osseous integration had created a product that functioned perfectly, with minimal bone loss and healthy soft tissue.
With this as a foundation, the mission now was to cre-
ate an implant system that was
in every detail intuitive for the
users. The set target was that the
new ASTRA TECH Implant System EV
should be the user-friendliest system
on the market. Early on, the team realised
that no matter how much they thought and
tested on their own, there would always be a gap
between what worked well on paper and in the
laboratory compared to what worked in the
everyday clinical reality. In the real world, one
had to add unpredictable situations, users with
different knowledge levels and the various
needs of patients.
_A smart solution
The solution was obvious—let the users take
part in the development work. That way you get a
product that already at launch is tested and
adapted to tackle the unpredictable. A product that
has its origin where it will be used—the clinics.
The solution is not unique, but it is smart and it
works. The method of letting users take part in the development work exists in other businesses. In the
software world they have worked with open source
code for a long time. Some software developers even
publish their software on the Internet. Users and
other interested parties can then suggest improvements and further developments. In earlier development projects at the company, there have been
smaller focus groups involved. This time however, the
team took the idea to a whole new level—a group of
47 clinicians that work with dental implants on an
everyday basis was formed. They became known as
ambassadors.
“The response to our initial contacts was very
positive. Everyone we asked was enthusiastic about
taking part,” says Agneta Broberg Jansson, responsible
at Global Product Management for the ASTRA TECH
Implant System at DENTSPLY Implants.
48 I CAD/CAM
2_ 2015
[49] =>
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industry report _ DENTSPLY Implants
A smaller group whose members had long professional experience with dental implants, was contacted first. The R&D and Product Management team
had by then developed a system. Now, it was time for
their efforts in the laboratory to face reality. The group
was asked to evaluate the core system and contribute
to the further development and refinement of the
system.
“The input given at this stage contributed to
changes in parts of the system. Some designs were improved in ways we could never have imagined if we had
not been open about our work,” says Per Aringskog.
Even if openness and participation turned out to
be the key to success, the contents of the project had
to be kept secret. The company operates in a highly
competitive market where many smaller players are
very interested in using smart solutions, preferably
without having to invest in the development work.
Secrecy was of the utmost importance for this and
similar future projects if they were to bear the expenses. Investing in research and development and
constantly challenging and improving is part of the
company philosophy.
I
confide in three and the whole world knows” was refuted once and for all.
”It is amazing that we managed to keep the contents of the project secret. But, the participants were
so dedicated that they saw this as their own project.
We became one big project team with a great internal
loyalty,” says Per Aringskog.
By now, the work intensified. Six employees visited
the ambassadors in their everyday business and held
concept handling sessions. The ambassadors also
gathered a few times to exchange experiences and
thoughts in the early project phase, and the feedback
kept coming in.
As the project progressed, Per Aringskog and his
colleagues adjusted the system and new tests took
place. After five years of work, only fine-tuning of details remained and eventually everything was ready to
be launched.
“Each individual point of view might seem tiny, but
put together everyone has contributed to the final result,” says Agneta Broberg Jansson, one of those who
worked closest to the ambassadors._
_One big project
Following the initial phase, the more basic parts
started to fall into place. Now it was time to expand
the group of ambassadors and to gather broader and
more detailed feedback. But, allowing the group to
grow was risky seen from a secrecy perspective. From
the initial single-digit group of clinicians, the group
now grew to almost 50 ambassadors on three continents. But, the saying “Confide in one, never in two;
_contact
CAD/CAM
DENTSPLY Implants
Steinzeugstraße 50
68229 Mannheim, Germany
www.dentsplyimplants.com
CAD/CAM
2_ 2015
I 49
[50] =>
CDE0109_01_Titel
I industry news _ MIS
MIS implants stand
out in comparative implant
surface study
roughness, uniformity and purity of our implants on
a daily basis, taking samples from selected batches,
and using our own in-house scanning electron microscope. Because the analysis is done in our own labs,
on-site, there’s no holding up production for repairs.”
“MIS adheres to strict procedures, adding any steps
necessary to ensure the lowest percentage of contaminants, including blasting residue or remnants from
various stages of production,” Reiner added. “Because
the scanning electron microscope analysis is done on
samples only, a trained technician also does a 100 per
cent visual inspection on each and every implant. Any
flawed implants are unconditionally rejected.”
The intermediate report, titled “Surface analysis
of sterile-packaged implants”, was published in the
01/2015 issue of the European Journal for Dental
Implantologists.
Left: Residue-free surface of a MIS
SEVEN implant (500x magnification).
Right: MIS SEVEN implant surface
with micro-/nano-structure
(2,500x magnification).
(Images courtesy of
Dr Dirk Duddeck and
Dr Jörg Neugebauer,
University of Cologne)
_Israeli manufacturer MIS Implants Technologies has announced that its products have achieved
favourable results in an extensive qualitative and
quantitative elemental analysis using scanning electron microscopy. The study was conducted on behalf
of the Quality and Research Committee of the European Association of Dental Implantologists. It included 65 systems of sterile-packaged implants from
37 manufacturers and ten countries.
According to the intermediate study report, the
C1 implant and the SEVEN implant manufactured
by MIS achieved noteworthy results. Although the
SEVEN implant exhibited blasting material on up to
7 per cent of the surface in earlier studies by the committee in 2011 and 2012, the researchers did not find
even isolated spots with residue on the two MIS implant types of Grade 23 titanium in the current study.
MIS Materials Discipline Manager Dr Tal Reiner
explained the surface treatment processes applied
by MIS that led to the results: “We monitor the surface
50 I CAD/CAM
2_ 2015
This is the second time within the past 12 months
that a study has verified MIS’s implant quality
claims. The first study, titled “Identification card and
codification of the chemical and morphological
characteristics of 62 dental implant surfaces. Part 3:
Sand-blasted/acid-etched (SLA type) and related
surfaces (Group 2A, main subtractive process”, was
published in the June 2014 issue of the POSEIDO
journal. According to the study, which included 18
different implants, MIS’s SEVEN implant was among
the three implants that showed no pollution and no
chemical modification of the surface._
_contact
MIS Implants Technologies
P.O. Box 7
Bar Lev Industrial Park
20156 Israel
www.mis-implants.com
CAD/CAM
[51] =>
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[52] =>
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I meetings _ IDS
Biggest IDS of all time
in Cologne
Growth in the number of visitors, exhibitors and exhibition space
Author_Koelnmesse
_After achieving a record result, the 36th International Dental Show (IDS) that was characterised
by an excellent atmosphere closed its doors in
Cologne after five days. Around 138,500 trade visitors from 151 countries attended the world's leading
trade fair of the dental industry, which corresponded
to an increase of almost eleven per cent compared to
the previous event. IDS also achieved new records in
terms of the number of exhibitors and the exhibition
space sold.
2,201 companies (+6.9 per cent) from 56 countries presented a wealth of innovations, product developments and services on exhibition space covering 157,000 square meters (+6.2 per cent). With an
over 70 per cent share of foreign exhibitors (2013:
52 I CAD/CAM
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[53] =>
CDE0109_01_Titel
meetings _ IDS
I
CAD/CAM
I 53
68 per cent) and a 17 per cent increase in the number of trade visitors from abroad the level of internationality of the event was once again significantly
increased. At the same time, the number of trade
visitors from Germany also increased markedly in
comparison to 2013 (+4.3 per cent).
"We succeeded in making the International Dental Show in Cologne even more attractive, on both a
national and international basis. It is thus the most
successful IDS of all time," summed up Dr Martin
Rickert, Chairman of the Association of German
Dental Manufacturers (VDDI). "The quality of the
business contacts between the industry and the trade
as well as between the industry, dentists and dental technicians was extremely high.
The number of orders placed
at IDS rose once again and we
are reckoning with sustainable impulses for the post-fair
follow-up business," added
Katharina C. Hamma, Chief
Operating Officer of Koelnmesse GmbH.
Furthermore she said: "In
addition to the growth in the
number of German trade visitors, the high international
response once again underlines the character of IDS as
the world's leading trade fair of the dental industry.
The International Dental Show particularly recorded
strong growth in the number of visitors from the
Near and Middle East, the United States and Canada,
Brazil as well as from China, Japan and Korea. The
business in the South East European market, especially Italy and Spain, has also increased noticeably."
_Strong interest in innovations
The trade and the users were extremely interested
in innovative products and technologies. "In this
respect, staged every two years, IDS fits in perfectly
with the innovation cycles of the industry regarding
the development and further development of products, materials and services," emphasised Dr Markus
Heibach, Executive Director of VDDI. "This applies for
both breakthrough innovations and further developments of existing products, but also for development progress in smaller phases that are however
significant in terms of quality."
IDS 2015 focused on the intelligent networking
of components for computer-controlled dentistry.
Today, the world of digital systems in diagnostics
and production encompasses the entire workflow
from the practise through to the
laboratory. The computer-controlled process chains are in the
meantime complete and are putting their enormous flexibility to
use.
_Fantastic outcome
of the trade fair and
excellent mood
The hustle and bustle in the
halls made the high attendance at
IDS very apparent. By all accounts, representatives
from all relevant professional groups—from dentists'
surgeries, dental laboratories, from the dental trade,
but also from the higher education sector—from all
over the world had visited the exhibition stands. The
exhibitors were especially pleased about the high
level of internationality of the trade visitors. In terms
of business, IDS was very successful for many companies, because orders were placed—by both national and international customers.
Numerous companies were pleased to announce full order books. Aspects such as grooming
contacts, customer bonding, winning over new customers or penetrating new foreign markets were
at least equally important for the exhibitors. These
goals were also achieved to complete satisfaction at
the 36th International Dental Show. The exhibitors
evaluated the quality of the visitors very positively.
This finding is confirmed by the initial results of an
independent visitor survey: 83 per cent of all of the
visitors are involved in purchasing decisions at their
company.
"The world meets up at IDS in Cologne," summed
up Sebastian Voss, managing partner of Hager &
2_ 2015
[54] =>
CDE0109_01_Titel
I meetings _ IDS
especially well represented, but we also registered
an increase in the number of customers from
Southern Europe." As well as the high frequency of
visitors at his stand, Axel Klarmeyer, Executive Director of BEGO, also reported, "that the customers
were well informed and that they showed great interest in new technologies."
Meisinger GmbH. "More international customer
contacts visited our stand this year than in 2013.
Visitors from Latin America were particularly well
represented, but also from Asia. "We were able to establish countless new contacts at IDS and also met
up with our existing customers." Martin Dürrstein,
Chairman of Dürr Dental AG, was also extremely
satisfied: "The trade fair went very well for us, it was
fantastic. We received a high number of particularly
qualified trade visitors. We are totally satisfied with
the fair, because we were able to welcome many new
customers from Asia, Arabia, Latin America and
South Africa."
Christian Scheu, Executive Director of ScheuDental GmbH also praised the further increased internationality of IDS: "In comparison to 2013, we
were able to further increase the number of visitors
at our stand, in particular visitors from abroad. The
Asiatic region, for instance China and Korea, were
Walter Petersohn, Vice President Sales of Sirona
Dental Systems, was also pleased "about the vast
numbers of international visitors, the buying interest and as always about the large number of attending German dentists and dental technicians."
Michael Tuber, Executive Director of A. Titan also
awarded IDS 2015 top marks. "This is the seventh
time we have exhibited at IDS and we have optimally
achieved the goal we set ourselves, namely further
expanding our international sales network. The
trade fair offers us the perfect platform for meeting
up with our existing customers from all over the
world, but at the same time, we were able to establish many new customer contacts. This is why the
International Dental Show is an absolute must for
every American manufacturer from the dental industry."
IDS 2015 was also a success for Andrew Parker,
CEO of Mydent International: "We met up with our
international customers here in Cologne and were
additionally able to make over 100 interesting new
contacts to dental dealers. No other event in the
world has such international appeal."
_Satisfied visitors all round
The visitor survey revealed that over 75 per cent
of the respondents were (very) satisfied with IDS.
The fair's comprehensive spectrum of products and
new products ensured that 81 per cent of visitors
rated the product range as being (very) good. 74 per
cent of the exhibitors were (very) satisfied in terms
of reaching the goals they had set themselves for the
fair. Overall, 95 per cent of the visitors questioned
would recommend visiting IDS to business partners
and 77 per cent also intend to visit IDS 2017.
The International Dental Show (IDS) takes place
in Cologne every two years and is organised by the
GFDI Gesellschaft zur Förderung der Dental-Industrie mbH, the commercial enterprise of the Association of German Dental Manufacturers (VDDI) and is
staged by Koelnmesse GmbH, Cologne.
The next IDS—the 37th International Dental Show
—is scheduled to take place from 21 to 25 March
2017._
www.ids-cologne.de
54 I CAD/CAM
2_ 2015
[55] =>
CDE0109_01_Titel
The Dental Tribune International
C.E. Magazines
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[56] =>
CDE0109_01_Titel
I meetings _ events
International Events
2015
EuroPerio 8
3–6 June 2015
London, UK
www.efp.org/europerio/
ICOI Summer Implant Symposium
14–16 August 2015
San Francisco, USA
www.icoi.org
20th International Congress of
Dento-Maxillo-Facial Radiology
26–29 August 2015
Santiago, Chile
www.iadmfr2015.org
EAO
24–26 September 2015
Stockholm, Sweden
www.eao-congress.com
SCAD 2015 Annual Conference
24–26 September 2015
Chicago, USA
www.scadent.org
ICOI World Congress
15–17 October 2015
Berlin, Germany
www.icoi.org
AAED Annual Meeting
5–7 August 2015
Telluride, USA
www.estheticacademy.org
AAID Annual Educational Conference
21–24 October 2015
Las Vegas, USA
www.aid.com
DENTECH CHINA
21–24 October 2015
Shanghai, China
www.dentech.com.cn
12th International CAD/CAM Expo & Symposium
20–22 November 2015
Los Angeles, USA
www.dloac.org/symposium
ADF
24–28 November 2015
Paris, France
www.adf.asso.fr
Greater New York Dental Meeting
27 November–2 December 2015
New York, USA
www.gnydm.com
CAD/CAM International Conference 2015
4–5 December 2015
Suntec, Singapore
www.capp-asia.com
56 I CAD/CAM
2_ 2015
[57] =>
CDE0109_01_Titel
about the publisher _ submission guidelines
submission guidelines:
Please note that all the textual components of your submission
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address, e-mail address, etc.).
I
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In addition, please note:
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CAD/CAM
2_ 2015
I 57
[58] =>
CDE0109_01_Titel
I about the publisher _ imprint
CAD/CAM
digital dentistry
international magazine of
Publisher
Torsten R. Oemus
t.oemus@dental-tribune.com
International Media Sales
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58 I CAD/CAM
2_ 2015
[59] =>
CDE0109_01_Titel
Planmeca
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[60] =>
CDE0109_01_Titel
A complete posterior solution
To keep pushing forward, we’re bringing innovation to the back.
Connect with your entire treatment team and achieve shorter
time to teeth with Nobel Biocare’s complete posterior solution.
It offers new ways to overcome the challenges of working in the
posterior region while reducing complexity and risks.
Discover the complete posterior solution:
nobelbiocare.com/bringinginnovationback
GMT 39251 © Nobel Biocare Services AG, 2015. All rights reserved. Nobel Biocare, the Nobel Biocare logotype and all other trademarks are, if nothing else is stated or is evident from the context in a certain case, trademarks of Nobel Biocare. Please refer to nobelbiocare.com/
VTCFGOCTMUHQTOQTGKPHQTOCVKQP2TQFWEVKOCIGUCTGPQVPGEGUUCTKN[VQUECNG&KUENCKOGT 5QOGRTQFWEVUOC[PQVDGTGIWNCVQT[ENGCTGFTGNGCUGFHQTUCNGKPCNNOCTMGVU2NGCUGEQPVCEVVJGNQECN0QDGN$KQECTGUCNGUQHƂEGHQTEWTTGPVRTQFWEVCUUQTVOGPVCPFCXCKNCDKNKV[
Lined up for
efficiency
)
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