DT Nordic No. 1, 2016

Many root fillings of poor quality / Nordic News / Interview: “Prognosis is more important than a single technique” / Business / Intra-oral and peri-oral electronic devices / Utilising smile design software and CAD/CAM for creating a mock-up and final restorations / Posterior restoration with a new nano-hybrid ORMOCER composite / today SCANDEFA Copenhagen 2016

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DTNE0116_01-02_Title 18.04.16 12:46 Seite 1

DENTAL TRIBUNE
The World’s Dental Newspaper · Nordic Edition
Published in Scandinavia

www.dental-tribune.com

Vol. 2, No.1

INTERVIEW

THE POWER OF ELECTRONICS

today SCANDEFA 2016

In 2015, Swedish company TePe
donated 50,000 toothbrushes and
established the Eklund Foundation.
Marketing Director Hanna Sjöström
on giving back to society.
” Page 6

Implementation of electronically
based intra- and peri-oral therapeutic and diagnostic devices
creates new possibilities for all
kinds of novel applications.
” Page 8

Read all about one of Scandinavia’s largest dental events in our
today specialty section included in
this issue.
” Page 17

Many root fillings of poor quality Hormone
controls
By DTI

sweet tooth

GOTHENBURG, Sweden: A new
survey has linked the quality of
root fillings to the level of stress
dentists experience in performing the procedure and the fee
charged. Some dentists reported
that “good enough” was often a
more realistic goal than optimal
quality in light of the complexity
of root fillings and insufficient
time allocated owing to the associated treatment tariff, among
other reasons.
According to the study, which
was conducted as part of a doctoral
thesis at the Sahlgrenska Academy, only half of all root fillings
that are performed in the Swedish
public dental service are of good
quality. Moreover, more than onethird of root fillings show signs
of apical periodontitis, which can
lead to acute symptoms, such as
pain and swelling, and may even
spread and become life-threatening in some cases.
Aiming to investigate the reasons dentists accept technically

By DTI
COPENHAGEN, Denmark: Apparently,
it takes more than a strong will to keep
those with a sweet tooth away from
a sugar overload in their diet, new research from the University of Copenhagen suggests. Aiming to determine
whether sweet taste preference is in
fact genetically biased, the scientists
investigated the mechanism of the
liver hormone fibroblast growth factor 21 (FGF21) in several mouse models.

A survey among Swedish dentists has established the potential for improving the quality of root fillings and thus reducing
persistent inflammation associated with inadequate treatment.

poor root fillings, Lisbeth Dahlström, a senior dental officer
and researcher at the Sahlgrenska
Academy, conducted group interviews with 33 dentists from
the Swedish public dental service.

The results showed that treatment was often associated with
negative feelings, such as stress and
frustration, and it was common for
treatment to be performed with a
sense of a loss of control owing to
the perceived technical difficulty.

Another cause of dentists accepting poorer root fillings was that
allotted time for treatment according to the fee charged was insufficient, participants reported.

” Page 2

“Based on these studies, and more,
we can conclude that FGF21 decreases appetite and intake of sugar,”
said co-author Stephanie von Holstein-Rathlou, a master’s student at
the university. Consequently, FGF21
is the first identified liver-derived
hormone that controls appetite, the
scientists stated. Although these
conclusions are largely still theoretical science, the researchers believe
their discovery could potentially
lead to drug therapy for obesity and
diabetes.
AD

Risks of snoring in children
By DTI
GOTHENBURG, Sweden: A new
study from the Sahlgrenska Academy in Sweden has found that
many parents underestimate the
negative effects that breathing
disturbances can have on their
children’s quality of sleep and
life. Examining the prevalence

of snoring and sleep apnoea in
754 children aged 11 and under,
the researchers found that 4.8 per
cent experienced sleep-disordered
breathing symptoms several times
a week. Despite pronounced snoring, only 31 per cent of these children had been in contact with a
health care provider regarding
their symptoms.

“An obvious result of the study
is that we must consider how parents are given information about
the condition and where they can
seek help,” said Dr Gunnhildur
Gudnadottir from the Department
of Otorhinolaryngology at the
academy.

PRINT
L
DIGITA N
TIO
EDUCA
EVENTS

“Children with persistent snoring often have a reduced quality
of life. In particular, this applies to
children who have sleep apnoea,”
Gudnadottir said. This is mainly
due to the condition affecting
sleep quality, which in turn can
lead to daytime tiredness, concentration and learning diffi culties, bedwetting and delayed
growth.
The results of the study, titled
“Healthcare provider contact for
children with symptoms of sleepdisordered breathing: A population survey”, was published in
the March issue of the Journal of
Laryngology and Otology.

The DTI publishing group is composed of the world’s leading
dental trade publishers that reach more than 650,000 dentists
in more than 90 countries.

[2] =>

DTNE0116_01-02_Title 18.04.16 12:46 Seite 2

WORLD NEWS

Dental Tribune Nordic Edition | 1/2016

First Nordic facial tissue transplant

IMPRINT

By DTI

MANAGING EDITOR DT NORDIC EDITION:
Kristin HÜBNER
k.huebner@dental-tribune.com

HELSINKI, Finland: Finnish dental
manufacturer Planmeca’s ProModel technology has supported
the first facial tissue transplant
procedure in the history of the
Nordic countries. The service,
which designs and creates patientspecific surgical guides and skull
models from CBCT/CT images,
helped surgeons to significantly
reduce operating time for the
demanding procedure, which was
performed at Töölö Hospital in the
Hospital District of Helsinki and
Uusimaa (HUS).

geons and us engineers both see
tremendous potential in this kind
of collaboration,” said Jani Horelli,
CAD/CAM Design Manager at
Planmeca. “The field continues to
advance at a fast rate and it is very
interesting to witness this evolution
first hand. I am proud to be part of
a highly skilled Finnish communi-

ty of specialists. It feels meaningful
to take part in improving the lives
of people, who have encountered
serious illnesses and disabilities.”
Planmeca’s collaboration with
HUS spans nearly a decade. “Planmeca’s role has been essential to
our work for years—we have been

Both HUS and Planmeca began
planning for the operation already
years before the surgery was carried out and this consisted of modelling donor tissue and determining how it matched the recipient,
as well as simulating the operation
together with the surgeons in advance. Following this, the components were designed and manufactured at Planmeca’s headquarters
and transported to the hospital,
where they were taken directly to
the operating room.

In addition to a decrease in surgical time, the ProModel technology
was able to produce significantly
more precise results compared with
conventional methods, the surgical
team stated at a press conference.
Dr Jyrki Törnwall explained: “Based
on literature, we know that it can take
3 to 4 hours to trim bones. In this
particular operation, it took Patrik
[Lassus] and myself under 10 minutes to place the transplant. This led
to a drastic reduction in the duration of the surgery, while also significantly improving the accuracy
of bone placement.”
Using virtual surgery to simulate
procedures is an increasingly important part of surgery today. “Sur-

able to utilise computer simulations to create saw guides, which
allow us to saw at a specific orientation and to an exact depth, as well
as remove facial structures, which
we know match the donor, at a precise angle,” said Törnwall, acknowledging the benefits of the company’s 3-D services.

The facial tissue transplant procedure was planned preoperatively utilising Planmeca’s ProModel technology, which designs and creates patient-specific surgical
guides and skull models from CBCT/CT images.

The extremely rare procedure,
which was only the 35th of its kind
in the world, entailed transplanting
the patient’s upper and lower jaws,
lips and nose, as well as segments
of the skin, midfacial and tongue
muscles, and the nerves of these
muscles. The surgery itself took
21 hours and included a team of
11 surgeons, 20 nurses and other
medical experts. The first face transplant in the world was carried out in
France in 2005.

European Consensus Conference
releases update on dental implants
By DTI
BONN, Germany: The European Association of Dental Implantologists
(BDIZ EDI) has released a new consensus paper that provides an update
on short, angulated and diameterreduced implants. The guidelines
replace the 2011 guidelines, offer recommendations for the assessment
of potential indications, and cover
advantages and limitations of these
types of dental implants.
Based on a working paper of the
University of Cologne, the consensus paper was released after the
11th European Consensus Conference (EuCC), an annual meeting of
an expert panel consisting of prac-

titioners and academics held under
the auspices of the BDIZ EDI, which
aims to develop consensus on topics in implant dentistry and to draft
the respective guidelines.
Regarding the classification of
short, angulated and diameterreduced implants, the EuCC agreed
upon the following: Implants are
usually referred to as short if their
intrabony length measures less
than or equal to 8 mm and their
diameters of 3.75 mm and greater.
Ultra-short implants are considered
to be those with lengths less than
6 mm. Diameter-reduced implants
can be defined as those with intraosseous diameters smaller than
3.5 mm for placement in sites with

reduced alveolar ridge bone width.
Implants with diameters less than
2.7 mm are referred to as mini-implants. In addition, the EuCC stated
that mini-implants have an increased risk of loss and short miniimplants should be avoided.
According to the EuCC recommendations, the use of short, angulated or diameter-reduced implants in sites with reduced bone
volume can be a reliable treatment
option, given the risks associated
with the use of standard-dimension implants in combination with
augmentation procedures. However, the experts highlighted that
the implant surgeon and the
restorative dentist must have the

appropriate training in the use of
short and ultra-short implants.
BDIZ EDI President Christian Berger
said,“It is wrong to assume that short,
angulated or diameter-reduced implants can be used to resolve one’s
own shortcomings in surgical technique. These implants were not developed for operators who have not
(yet) mastered the external sinus lift
and bone augmentation.”
A printed version of the paper
is available on request for €2.50
(including VAT, plus postage). The
guidelines will also be published
in the first 2016 issue of the EDI
Journal, the BDIZ EDI’s official
member journal. It will therefore be
available free of charge to members.

PUBLISHER:
Torsten OEMUS

CLINICAL EDITOR:
Magda WOJTKIEWICZ
ONLINE EDITOR:
Claudia DUSCHEK
EDITOR:
Anne FAULMANN
COPY EDITORS:
Sabrina RAAFF, Hans MOTSCHMANN
PRESIDENT/CEO:
Torsten OEMUS
CFO/COO:
Dan WUNDERLICH
MEDIA SALES MANAGERS:
Matthias DIESSNER
Peter WITTECZEK
Maria KAISER
Melissa BROWN
Weridiana MAGESWKI
Hélène CARPENTIER
Antje KAHNT
INTERNATIONAL PR & PROJECT MANAGER:
Marc CHALUPSKY
MARKETING & SALES SERVICES:
Nicole ANDRAE
ACCOUNTING:
Karen HAMATSCHEK
BUSINESS DEVELOPMENT:
Claudia SALWICZEK-MAJONEK
EXECUTIVE PRODUCER:
Gernot MEYER
AD PRODUCTION:
Marius MEZGER
DESIGNER:
Franziska DACHSEL
INTERNATIONAL EDITORIAL BOARD:
Dr Nasser Barghi, Ceramics, USA
Dr Karl Behr, Endodontics, Germany
Dr George Freedman, Esthetics, Canada
Dr Howard Glazer, Cariology, USA
Prof. Dr I. Krejci, Conservative Dentistry, Switzerland
Dr Edward Lynch, Restorative, Ireland
Dr Ziv Mazor, Implantology, Israel
Prof. Dr Georg Meyer, Restorative, Germany
Prof. Dr Rudolph Slavicek, Function, Austria
Dr Marius Steigmann, Implantology, Germany

Published by DTI
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© 2016, Dental Tribune International GmbH

Page 1

“The dentist then finds they are
facing a dilemma, to ‘go back’ to the
treatment, to optimize quality, or
to offer care within the framework
of the compensation and, thus, risk
accepting an incomplete root filling,” Dahlström explained.
Regarding quality, the dentists
interviewed reported uncertainty

as to what constitutes reasonably
acceptable quality. According to
Dahlström, they often stated that
“good enough” was a more realistic
goal than optimal quality. However, despite the difficulties experienced, the survey also showed that
the dentists wanted to provide
good treatment and that they were
very concerned about their patients, the researcher said.

In order to improve the quality
of root fillings, Dahlström suggested measures such as increased opportunity for continuing education, time for discussion and exchange of experiences
at the workplace, as well as investment in equipment that enhances treatment, shortens the
time needed and improves visibility.

Approximately 250,000 root
fillings are done in Sweden each
year and it has been estimated that
there are at least 2.5 million rootfilled teeth affected by periapical
periodontitis.
Dahlström defended her thesis,
titled “On root-filling quality in
general dental practice”, on 4
March.

All rights reserved. Dental Tribune makes every
effort to report clinical information and manufacturer’s product news accurately, but cannot assume
responsibility for the validity of product claims,
or for typographical errors. The publishers also do
not assume responsibility for product names or
claims, or statements made by advertisers. Opinions
expressed by authors are their
own and may not reflect those
of Dental Tribune International.
Scan this code to subscribe
our weekly Dental Tribune Nordic
e-newsletter.

[3] =>

DTNE0116_03_News 18.04.16 11:06 Seite 1

NORDIC NEWS

Dental Tribune Nordic Edition | 1/2016

03

Drinking between meals may
exacerbate dental erosion

In the study, a team of UiB researchers evaluated the progression
of dental erosion over a period of
four years in a group of 175 adolescents aged 13–14. The prevalence of
dental caries, as well as gingival and
plaque status, was assessed in a clinical examination. Information on
lifestyle factors, such as the method
of drinking, frequency of physical activity, screen-viewing habits, as well
as types and frequency of intake of
certain dietary items, was obtained
via questionnaires. These items included water, all kinds of acidic soft
drinks, milk, yogurt, sour milk, tea,
coffee, sweets, sour sweets, chewing
gum, ice cream, popsicles, biscuits,
snacks, cheese, as well as dried and
fresh fruits.
Over the four-year period, progression of dental erosion occurred
in 35 per cent of the 2,566 tooth surfaces, and 32 per cent of the surfaces
had deteriorated by one severity
grade and 3 per cent by two grades.
Overall, boys showed more severe
erosion than did girls at the followup.

Dental erosion occurs when acid
dissolves the hard tissue of the tooth.
In its early stages, erosion strips away
the surface layers of tooth enamel.
If it progresses to an advanced stage,
it can expose the soft pulp inside the
tooth. In order to minimise the risk
of tooth erosion and decay, experts

of

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Now also
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According to the researchers, dental erosion was common in the study
group, indicating a risk of severe
erosive damage to permanent teeth
even before adolescence. Dental
health workers should therefore be
made aware of this fact and regular
screenings for erosion and recording
of associated lifestyle factors should
be performed, they concluded.

longitudinal study of progression
of dental erosion associated to
lifestyle in 13 to 14 year-old Swedish
adolescents”.
AD

C

Dietary factors associated with
greater progression of dental erosion included higher consumption
of all drinks and sour candy, as well
as drinks between meals, and lower
intake of ordinary and sour milk, all
of which are factors that have been
shown to have a relationship with
dental erosion in previous studies.
Moreover, the habit of retaining
acidic soft drinks in the mouth before swallowing was linked to higher
progression of erosive wear.

The results of the study have
been published online on 8 February in the Journal of Dentistry
in the article “A 4 year prospective

O

I

BERGEN, Norway: Rising consumption of sugary and acidic drinks has
been found to be a key factor in the
development and progression of
dental erosion among children and
adolescents. However, new research
from the University of Bergen (UiB)
indicates that, in addition to the
amount consumed daily, when and
the way in which soft drinks are consumed affects progression of erosive
wear.

recommend checking ingredients
for acid additives, especially citric acid
(ingredient number 330) and phosphoric acid (ingredient number 338).

E

By DTI

C O

M P A T

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[4] =>

DTNE0116_04_News 18.04.16 11:06 Seite 1

NORDIC NEWS

Dental Tribune Nordic Edition | 1/2016

Straumann implants stand out
By DTI
GOTHENBURG, Sweden: New research has found that the effectiveness of implant therapy varied
substantially between implant
systems from different brands.
In this study on the prevalence
AD

of peri-implantitis in a group of
Swedish patients, Straumann implants showed the lowest odds
ratios for the condition among all
of the brands evaluated.

related risk factors, researchers
from the University of Gothenburg examined 588 patients who
had received implant-supported
therapy nine years earlier.

In assessing the prevalence of
peri-implantitis and implant-

The study participants were randomly selected from the national

data register of the Swedish Social
Insurance Agency.
All of the participants underwent clinical and radiographic
examination for typical indicators of peri-implantitis, including
bone loss, bleeding, and increased
pocket depth around their implants. Implants were grouped according to jaw and position, as well
as by length, diameter and placement protocols. Furthermore, the
investigators recorded bone augmentation procedures, including
ridge and sinus augmentation.
ASTRA TECH (DENTSPLY Implants),
Nobel Biocare and Straumann implants constituted 91 per cent of
the 2,277 implants evaluated in
the study. Of these, 96.6 per cent
of the ASTRA TECH implants had
a TiOblast surface, 98.3 per cent
of the Nobel Biocare implants had
a TiUnite surface, and all of the
Straumann implants had an SLA
surface.
Patients treated with Nobel Biocare, ASTRA TECH and other-brand
implants showed significantly
higher odds ratios for moderate/
severe peri-implantitis than did
patients treated with Straumann
implants. However, as implant
brands were unevenly distributed
in the patient cohort, the findings
regarding the prevalence of periimplantitis according to brand of
implant used cannot be generalised, the researchers concluded.
In addition to these findings,
higher odds ratios for moderate/
severe peri-implantitis were associated with patients presenting
with periodontitis, patients with
more than four implants, patients
with implants placed in the mandible and with crown restoration
margins positioned ≤ 1.5 mm
from the crestal bone at baseline,
and with general practitioners
performing the prosthetic therapy.
Overall, 45 per cent of patients in
the study group presented with
peri-implantitis, and 14.5 per cent
had moderate/severe forms of the
condition. The average amount
of bone loss that occurred at implants affected by moderate/
severe peri-implantitis corresponded to about 30 per cent of
the initial bone support of the
implant.
Peri-implantitis lesions are considerably larger and present with
more aggressive features compared with lesions affecting teeth
in periodontitis. Left untreated,
the inflammatory condition can
lead to implant loss.
The study, titled “Effectiveness
of implant therapy analyzed in
a Swedish population: Prevalence
of peri-implantitis”, was published
in the January issue of the Journal
of Dental Research.

[5] =>

DTNE0116_05_News 18.04.16 11:06 Seite 1

OPINION

Dental Tribune Nordic Edition | 1/2016

“Prognosis is more important than
a single technique”
An interview with Dr Giano Ricci, Italy
result in long-term success. However, patients who desire a good
outcome are prepared to invest
time, psychological effort and
money to achieve this goal. It is
natural that they wish to have the
best possible treatment with a
good prognosis in the long term.

Dr Giano Ricci, Italy

In preparation for the 30th Annual
Congress of the European Academy
of Esthetic Dentistry (EAED) from
2 to 4 June in Copenhagen in Denmark, Dental Tribune Nordic Edition
spoke with Dr Giano Ricci, President
of the EAED. He has always been passionate about aesthetic and restorative dentistry and establishing good
periodontal health. As a successful
periodontist with a practice in Florence in Italy since 1972, he has been
keen to keep up to date on the latest
developments in dental aesthetics
—many of which will be discussed
during the meeting.
Dental Tribune Nordic Edition: What
is the aim of the EAED, and what are
the requirements for membership?
Dr Giano Ricci: The academy was
founded in 1986 in Geneva in
Switzerland and received legal
recognition in 1999. Today, we have
110 active members and 167 affiliates from all over the world. Our
members have contributed to more
than 1,000 publications in aesthetic
and restorative dentistry. The promotion and advancement of this
clinical field is our main goal. Membership of the EAED is a distinctive
honour that is bestowed on a person
who has notably contributed to the
improvement of aesthetic dentistry
through education, research or
clinical practice. In order to become
first an affiliate and then an active
member, there is a four-step process
involving attendance of our spring
and autumn meetings and the
successful presentation of a paper
before a members’ committee.
“Prognosis: The key for longevity”
is the theme for this year’s annual
meeting in Copenhagen. Why is discussion about the long-term success
of aesthetic and restorative treatment so important for dentists and
patients?
Every dentist wishes to gain or
maintain a good reputation. It is
therefore essential to achieve longlasting success with a good prognosis. Sometimes the use of a good
technique does not automatically

The range of topics of the presentations include soft- and hard-tissue
therapy, implant longevity, fixed
and composite restorations, and
functional and aesthetic treatment
planning.Why have you chosen such
an interdisciplinary approach to the
meeting’s theme?
It is almost impossible to solve
complex cases without an interdisciplinary approach. Only by combining endodontics, prosthodontics, orthodontics and periodontics
in a clinical collaboration is it possible to achieve good results. This
is what functional and aesthetic
dentistry is all about.
Could you give us a hint about your
presentation? What do you plan to
focus on in your opening remarks?
I will encourage all participants
to interact with the speakers and
to be receptive to engagement and
debate. Communication is fundamental in dentistry. The meeting is
an open forum with many experts
and has been organised as such
for a long time. All of our members,

The 30th Annual Congress of the European Academy of Esthetic Dentistry (EAED) will take place from 2 to 4 June in Copenhagen.

prognosis. Digital dentistry is arguably the most important recent
development in aesthetic dentistry. Clinicians are guided by
technology, which also helps less
experienced dentists to achieve excellent results. I have been working

The next step will be the improvement of results in terms of
soft-tissue treatment. When surgery is needed, we will be able to
minimise tissue contraction as
much as possible. Stem cells and
new molecules will increase soft-

“...aesthetic materials will become
progressively sophisticated and will
mimic nature as closely as possible.”
affiliates and guests have enjoyed
the scientific and social parts of the
EAED meetings. We have done our
best to again organise a very interesting and exiting meeting.
EAED was founded in 1986. Back then,
today’s adhesive technologies, ceramics and digital smile design were
barely thinkable. What advancements in technology and materials
do you personally consider the most
important in aesthetic dentistry?
Indeed, we have many more tools
and materials today. For instance,
adhesive technology allows us to
be less invasive, as well as achieve
good results. We have seen the
same development with modern
ceramics and digital dentistry.
Modern ceramics have great versatility and provide a good long-term

with CAD/CAM and my prosthodontist son, Andrea, has endorsed
digital smile design for his treatments. Digital design has helped
clinicians to better understand the
aesthetic and functional issues and
plan accordingly. It has achieved
higher treatment acceptance by
patients and given patients a better
understanding of the treatment
the clinician wants to provide.
As we have recognised, the demand
for improved aesthetics has led to
the introduction of new ceramic materials and technologies in dentistry.
Consequently, aesthetic and restorative dentistry has made substantial
advancements. In your opinion, what
will be the next steps in aesthetic
dentistry in order to achieve longlasting beautiful results?

tissue response and speed up the
healing process. Also, aesthetic materials will become progressively
sophisticated and will mimic nature as closely as possible. We will
also use more digital technology,
which will become fundamental
for treatment. It will be easier for the
clinician to solve problems owing
to this technique. In the future, its
precision will increase, to the benefit of the patient.
You have announced the first EAED
Innovation Award, sponsored by the
Joerg Strub Foundation. Clinicians,
postgraduate students, dental technicians and researchers can submit
abstracts related to the field of aesthetic and reconstructive dentistry.
Why did you decide to introduce this
award after 30 years of existence?

The mission of the academy is
to expand knowledge in dentistry
with a focus on aesthetic dentistry
specifically. After many years, we
decided to present an award to support motivated colleagues and to
promote research. Prof. Jörg Strub is
a world-known researcher and clinician. His foundation aims to support and promote all fields of aesthetic and restorative dentistry and
its related areas. Both the foundation and the Innovation Award seek
to encourage and challenge young
clinicians to pursue excellent aesthetic and restorative results and to
explore new ways of treatment.
Through the award, we also invite
all professionals to become members and benefit from the expertise
and meetings of the EAED.
Every year, the EAED meeting is
held in a different European city.
Copenhagen is very well known for
its open culture and mild climate in
the summer. What will the social programme for participants involve?
According to a recent United Nations report, Denmark has been declared the world’s happiest country
in 2016. Participants will certainly
have the opportunity to find out if
Copenhagen really is as charming as
everyone says. During and after the
meeting, we will have an exciting
social programme, including a gala
dinner at the National Gallery of
Denmark, a welcome party and a run
through the centre of Copenhagen.
This will help all of us to appreciate
the flavour of this wonderful city.
Thank you very much for the interview.

[6] =>

DTNE0116_06_Business 18.04.16 11:07 Seite 1

BUSINESS

Dental Tribune Nordic Edition | 1/2016

“We aim to facilitate oral hygiene on the go”
An interview with TePe Marketing Director Hanna Sjöström
Ever since its foundation in
1965, Swedish oral care company TePe has highlighted
the importance of a close
professional exchange with
universities, institutes and
dental professionals in developing its oral hygiene
products. This philosophy
culminated in the establishment of the Eklund Foundation for Odontological
Research and Education last
year, marking the company’s 50th anniversary. Dental
Tribune Nordic Edition spoke
to TePe’s Marketing Director,
Hanna Sjöström, about the
company’s general approach
of contributing to society.

searchers will be prioritised
in the selection. The successful candidates will be announced in the autumn.
This year, the foundation
will distribute approximately €160,000 (DKK1.2 million)
to one large project and a
number of smaller projects.

Dental Tribune Nordic Edition:
Could you tell us about
TePe’s commitment to re- Hanna Sjöström, Marketing Director at TePe.
search and education, most
viewers, Dr Anna Nilvéus Olofsson,
recently embodied in the establishManager of Odontology and Scienment of the Eklund Foundation?
tific Affairs at TePe, and Prof. Leif
Hanna Sjöström: Ever since the
Dahlberg, head of the Division of
Eklunds founded TePe in 1965, the
company has had a special relationship with the dental community. After five decades of collaboration with universities, institutes
and dental care professionals
around the world, the Eklund family established the foundation as
a way to show their appreciation
by creating something that would
contribute to knowledge and development within the odontological
field for many years to come.

Last year, TePe donated
50,000 toothbrushes to people displaced by the refugee
crises. As a leading oral health
provider, do you consider these
kinds of actions a responsibility?
Nobody can do everything,
but everyone can do something. As people in flight are
in need of hygiene products,
we felt that the donation
would be one way of putting
our vision of good oral health
for everyone into practice.
Do you think that, generally, the
industry should become more involved in societal commitments?

“Professional exchange
is fundamental...”

Could you explain the application
process for funding that will start on
1 May?
From 1 to 31 May, applications
will be accepted through the online
form at eklundfoundation.org.
During the summer, the applications will be evaluated by our re-

Orthopaedics in the Department
of Clinical Sciences, Lund, at Lund
University. We welcome applications from all fields of dentistry
and will particularly prioritise
projects related to periodontology,
implantology and cariology. Applications from postdoctoral re-

A locally anchored business like
TePe relies on a good relationship
with the business community and
society. The support of our stakeholders is very important to us, and
we earn that trust by contributing
to positive developments wherever
we operate.

TePe’s cleaning device EasyPick has just
been awarded the international Red
Dot Award in Product Design.

Your vision is for people to be able to
keep their teeth for life, thus the
company’s focus on preventive
dental care. Do you think that
the importance of oral health
for overall well-being and
general health is given sufficient attention?
This is a very interesting
discussion, which we are
following very closely. The
suggested connection between oral health and general health emphasises the
significance of good oral
hygiene and entails the insight that we have everything to gain from the prevention of oral disease.
As a company that has
collaborated extensively
with universities and
scientific institutes in
the past, how important is this kind
of professional exchange?
Professional exchange is fundamental for TePe. Our inhouse team of odon-

tological experts, consisting of
both dentists and dental hygienists, work in close dialogue with
universities, institutes and dental
professionals all over the world.
Throughout the development of
our products and educational materials, we incorporate research
findings, as well as clinical requirements of the dental profession.
This approach has earned us credibility and given us extensive
knowledge, which we continue to build on. Our interdental brushes are a good example of our philosophy: once developed as a result of both research
findings and clinical needs, and
thereafter continuously improved,
their efficiency continues to be
supported by scientific studies.
Are there any events or product releases planned for
2016?
We are very pleased that
our new product TePe
EasyPick has been awarded
with the prestigious international Red Dot Award in
Product Design. The innovative interdental cleaning device will be launched
on our international markets this spring. With this
easy-to-use product, we
aim to facilitate oral hygiene on the go. Another
product worth highlighting is our newcomer in
the toothbrush range,
TePe Colour, which is
designed to appeal
to young people and
put “more colour,
more fun” into toothbrushing.
Thank you very much
for the interview.

TRIOS scans most accurate and consistent
Study compares leading intra-oral scanning systems in terms of trueness and precision
BALTIMORE, USA/FREIBURG, Germany:
A new study evaluating the accuracy of six leading intra-oral
scanners in the dental market
has found 3Shape’s TRIOS to be
both the most accurate and consistent performer of the scanners
tested.
The study, which was conducted
jointly by the University of Maryland in Baltimore and the University of Freiburg in Germany, aimed
to compare the ability of intra-oral
scanning systems of different
brands to accurately scan a single
molar abutment tooth in vitro. The
analyses included the following six
scanners: iTero (Align Technology),
3M True Definition (3M ESPE),
PlanScan (Planmeca), CS 3500
(Carestream Dental), TRIOS and

CEREC AC Omnicam (Sirona Dental
Systems).

datasets obtained and then evaluating for 3-D deviations.

1.7 µm), CEREC AC Omnicam (16.2 ±
4.0 µm), and PlanScan (26.4 ± 5.0 µm).

In order to compare the accuracy
of each system, the investigators
used an industrial-grade, highly
accurate reference scanner to create a digital reference dataset for
an acrylic dental model. A single
trained, experienced dentist then
scanned the acrylic model on three
separate occasions using each of
the six intra-oral scanning systems.

Of the 18 datasets analysed, the
smallest deviations for the trueness measurements (± standard
deviation) between the reference dataset and the various
intra-oral scanner datasets
were obtained from TRIOS
(6.9 ± 0.9 µm), followed by
CS 3500 (9.8 ± 0.8 µm), iTero
(9.8 ± 2.5 µm), 3M True Definition
(10.3 ± 0.9 µm), PlanScan (30.9 ±
10.8 µm) and CEREC AC Omnicam
(45.2 ± 17.1 µm).

“The TRIOS scanning technology,
in combination
with

Trueness (accuracy) was defined
by superimposing the three digital
datasets over the reference dataset,
with 3-D comparisons then performed. Precision (consistency)
was defined by superimposing
each dataset over the other two

As for precision values, here too
TRIOS was identified as the most
accurate (4.5 ± 0.9 µm), followed by
3M True Definition (6.1 ± 1.0 µm),
iTero (7.0 ± 1.4 µm), CS 3500 (7.2 ±

tion based on these digital datasets,
the researchers stressed. Moreover,
in an in vivo design, the outcomes
might be different owing to the

3Shape’s intra-oral scanner TRIOS delivered the most accurate results when
compared with other leading scanning systems in a recent study.

the wand design, seems to be beneficial for capturing high quality
datasets with excellent trueness
and precision values,” the investigators said.
However, the results obtained do
not provide any information about
the quality of a fabricated restora-

presence of blood, saliva, and patient movements, they concluded.
The study, titled “Evaluation of
the accuracy of six intraoral scanning devices: An in-vitro investigation”, was published in Volume 10,
Issue 4, of the ADA Professional
Product Review.

[7] =>

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DTNE0116_08-10_Wolff 18.04.16 11:23 Seite 1

TRENDS & APPLICATIONS

Dental Tribune Nordic Edition | 1/2016

Intra-oral and peri-oral electronic devices
An overview of current therapeutic and diagnostic systems
By Dr Andy Wolff, Israel

Fig. 1: The TheraMon microsensor and a removable device to which it will be attached.—Fig. 2: TheraMon” reading station and microsensor, with a removable intraoral device.—Fig. 3: Lirón MAD.

The functions and organ systems of
the human body are, to a significant
extent, controlled by electrical signals
that travel along the nerves. Electronic
medical devices are aimed at controlling biological processes and treat disease by modulating these electrical
impulses. These devices may assist in
the therapy of conditions that are currently untreatable or resistant to
other therapy methods. They may deliver treatment with greater precision
and fewer side-effects than conventional pharmaceutical products do.
In the last few decades, a variety
of wearable electronic medical devices have been introduced to the
market. Examples of such devices
include neuro-stimulators, cardiac
pacemakers, implantable cardiac defibrillators, cochlear implants and
retinal implants. These devices are
used to address a variety of conditions, such as brain disorders
(including epilepsy, Parkinson’s disease, traumatic brain injury, stroke,
psychiatric disorders, etc.), chronic
pain conditions (addressed through
e.g. spinal cord stimulators), incontinence, cardiovascular disorders
(including heart failure, angina and
peripheral vascular disease), deafness and blindness.
A number of vital structures located in the oral cavity region are
controlled by the nervous system,
such as the salivary glands and the
orofacial musculature. Given the
largely proven diagnostic and therapeutic value of electronic devices, it is
surprising that only a few intra- and
peri-oral electronic medical devices
have been released to the market.
Moreover, in contrast to electronic
devices that involve typically inva-

sive procedures, such as pacemakers
and spinal cord stimulators, the
placement and even the wearing of
devices in the intra- and peri-oral
region are not invasive.
Nevertheless, it appears that the
US Food and Drug Administration
(FDA) has considered for many years
that electronic medical devices carry
an increased risk if worn in the head
and neck area, compared with other
body areas, such as the limbs. Thus,
electronic medical devices for the
head and neck area are generally classified by the FDA as Class III devices,
which are the highest risk devices

• On 11 March 2014, the FDA allowed
marketing of an electronic device as
a preventative treatment for migraine headaches (Cefaly, CEFALY
Technology). The portable, batterypowered prescription device resembles a plastic headband worn
across the forehead and atop the
ears.1 The user positions the device
in the centre of the forehead, just
above the eyes, using a self-adhesive electrode. The device applies an
electrical current to the skin and underlying body tissue to stimulate
branches of the trigeminal nerve,
which has been associated with
migraine headaches.

ously, it was a Class III device. This
intra-oral device (more details later
in the article) is restricted to patient
use upon prescription of a dental
practitioner or physician.
• On 22 January 2016, the FDA announced a proposed administrative order to reclassify cranial
electrotherapy stimulator devices
intended to treat insomnia and/or
anxiety, from Class III to Class II
(special controls).
Examples of three electronic intraand peri-oral devices that are available are covered in the paragraphs
that follow.

“...it is surprising that only a few intraand peri-oral electronic medical devices
have been released to the market.”
and are, therefore, subject to the
highest level of regulatory control.
However, recently the FDA has classified a small number of these types
of devices as Class II devices, which
are lower risk devices than Class III
and require less regulatory control
to provide reasonable assurance of
the device’s safety and effectiveness.
Nevertheless, those devices have to
meet special controls, which are requirements intended to address the
unique concerns of specific types
of devices. Some examples are as
follows:

• On 8 July 2014, the FDA issued a final
order classifying a transcranial
magnetic stimulator for headache
into Class II (special controls). The
device delivers rapidly alternating,
or pulsed, magnetic fields of brief
duration that are externally directed at spatially discrete regions
of the brain to induce electrical currents for the treatment of headache.
• On 20 November 2015, the FDA
issued a final order to reclassify
an electrical salivary stimulation
system (SaliPen, Saliwell) as a Class II
(special controls) device. Previ-

Fig. 4: SaliPen device in place, reaching the lingual nerve region bilaterally.—Fig. 5: SaliPen device.—Fig. 6: SaliPen usage.

1. Intra-oral diagnostic device:
Sensor for mandibular
advancement devices
TheraMon (MC Technology) is
a microchip specially designed to
be embedded in removable orthodontic and dental sleep appliances.2
According to the manufacturer,
the sensor reports the temperature
of the device and its surrounding area.
This enables assessment of whether
the sensor (embedded into the oral
appliance) is being worn in the oral
cavity or was outside of the mouth.

The TheraMon system consists of
(a) a micro-sensor that measures
and stores the temperature readings, that is wearing time data of the
removable therapeutic device (Fig. 1).;
(b) a reading station that reads
the memory of the micro-sensor
using radio-frequency identification
technology and transfers the data to
a computer via a USB cable (Fig. 2);
and (c) assessment software that
represents the wearing time in a diagram. TheraMon is a Class I medical
product (lowest level of risk) that
does not claim any medical, therapeutic or diagnostic functionality.
Sensors like TheraMon can be implemented in mandibular advancement devices (MADs), which are
increasingly being prescribed as an
alternative to the use of continuous
positive airway pressure (CPAP) systems in the treatment of obstructive
sleep apnoea. Studies have shown
that MADs are preferred by patients
and, thus, compliance with treatment may be greater than for CPAP.
However, compliance with the treatment can be better measured in the
CPAP system, as the built-in processor allows follow-up of the actual
hours of use of the mask. In contrast,
conventional MADs lack this control
system and, thus, objective verification of compliance is not possible.
Therefore, a microchip for thermal
sensing that is inserted into a MAD
can provide this missing ability to
measure compliance objectively.
In a blind prospective clinical
study of three months’ duration, the
safety and feasibility of objective
measurement of compliance with
MAD wearing was evaluated.3 A Lirón
MAD4 (Fig. 3) equipped with a tem-

[9] =>

DTNE0116_08-10_Wolff 18.04.16 11:23 Seite 2

TRENDS & APPLICATIONS

Dental Tribune Nordic Edition | 1/2016

perature micro-sensor was worn by
43 patients with an established diagnosis of respiratory sleep disorders.
No adverse events related to the micro-sensors were recorded, nor were
problems in reading of the compliance data. In this study, the mean time
of Lirón use was 6.3 ± 1.1 hours per day,
with an 86 per cent compliance rate
after a three-month follow-up. Statistical analysis found no differences
between the data on objective and
subjective use of Lirón. In conclusion,
the results demonstrated the safety
and the efficacy profile of the objective measurement of compliance
with MAD wearing.
2. Intra-oral therapeutic device:
Electrostimulation device
to treat xerostomia
The commonly accepted clinical
definition of xerostomia is the
subjective sensation of dry mouth.
The presence of xerostomia may
indicate that salivary output is decreased or altered, placing patients at
a higher risk of developing a number
of oral diseases and complications.
Increasing secretion of natural saliva
is the most efficient means of relieving xerostomia, as natural saliva
both alleviates dryness and contains
essential dental decay-fighting factors and other components critical
for oral health.5 The prevalence of xerostomia in the adults’ population is
estimated at 10 per cent.
Salivary gland secretion is regulated by the autonomic nervous system, by means of the salivary reflex.
The latter is composed of (a) salivary
nuclei, located in the brain; (b) afferent nerve fibres, carrying stimuli
(such as taste and mastication) from
the peripheral to the salivary nuclei;
and (c) efferent nerve fibres, conveying stimulatory signals from
the salivary nuclei to the salivary
glands. Application of electrical impulses to one or more of the three
components of the salivary reflex
increases salivary secretion.
Saliwell6 has developed a line of
intra-oral electrostimulation devices for which the principle of
action is based on applying stimulatory signals in the vicinity of the lingual nerve, which is the main nerve
controlling salivary function, as it
carries both afferent and efferent fibres. Electrostimulation intensifies
the impulses transmitted through
the afferent and efferent nerve fibres, inducing the salivary glands to
secrete more saliva. To this end, the
device electrodes are placed at the
lingual side, close to the mandibular
third molar, an advantageous location owing to the close proximity to
the lingual nerve, allowing effective
stimulation by the use of lower voltage and current (Fig. 4).
The most recently developed device (SaliPen) has an intra-oral stimulating unit and an extra-oral control unit (Fig. 5).7 The electrodes
protrude at the end of two flexible
silicone arms that are gently inserted underneath the tongue. In a
typical usage profile, due to its long
lasting effect, the device is worn
about 4 times a day and about 4 minutes every time. (Fig. 6).

A double-blind study, carried out
at three medical centres in Europe,
tested the device performance with
short-term use, using a built-in moisture sensor.8 As the primary outcome, measured oral dryness
changes as a result of 10 minutes of
wearing the device were assessed and
compared between the usage
of the device either switched on or
switched off. Twenty-three patients
with xerostomia due to different
causes (primary Sjögren’s syndrome,
medications and idiopathic) were

evaluated. The decrease in oral dryness (as measured by the moisture
sensor) was significantly superior
(p < 0.0001) when induced by the
device in switched-on mode. No significant side-effects were observed.
In a multi-national randomised
clinical trial, long-term (11-month) intra-oral electrostimulation was tested
in a mixed sample of xerostomia patients (Sjögren’s syndrome, radiotherapy, medication-induced, graft-versus-host disease and idiopathic).

In Stage I of the study, switchedon versus switched-off devices
were compared, for a period of one
month in a double-blind design
(96 patients).9
In Stage II, immediately after
Stage I, the xerostomia-relieving
effects of the switched-on device
only, were assessed in an open-label
study (56 patients).10
The results of Stage I show that
the patient-reported degree of oral

moisture improved by 26 per cent
when the device was switched on
(with a statistical significance level of
p < 0.002) versus an 18 per cent improvement when switched off. The
results of Stage II show that the level
of self-perceived oral moisture improved by 34 per cent (p < 0.001) and
the amount of collected saliva increased by 25 per cent (p < 0.001) at
rest and by 18 per cent (p < 0.02) during
mastication. No severe or irreversible
systemic or local adverse effects were
observed at either stage of the trial.
AD

[10] =>

DTNE0116_08-10_Wolff 18.04.16 11:23 Seite 3

TRENDS & APPLICATIONS

Dental Tribune Nordic Edition | 1/2016

Bruxism is prevalent during the
night, but some people with bruxism unconsciously clench their
teeth during the day, often when
they feel anxious or tense. In some
cases, bruxism is mild and may not
even require treatment.

However, it may be frequent
and intense, and can lead to temporomandibular disorder (TMD),
headaches, damaged teeth and
periodontium, and other problems.

Fig. 7: BiteStrip device.—Fig. 8: BiteStrip usage.

Conclusions drawn from the clinical tests are that intra-oral electrostimulation is safe and effective and
performs in a satisfactory manner
to enhance saliva production and
improve dryness symptoms.
3. Peri-oral diagnostic device:
Screening device for bruxism
Bruxism is the most well-known
form of oral parafunction. Parafunctions are movements of the
masticatory system that are considered outside or beyond normal
AD

“The power of electronics and related
technologies is harnessed to provide better
and personal medical services at lower costs.”
function. The prevalence of bruxism in the adult population is estimated at 8 per cent; however, as

many individuals may be unaware
of this condition, the occurrence is
most likely higher.

Unfortunately, people with sleep
bruxism usually are not aware that
they brux, so they are not diagnosed until complications occur.
That is why it is important to diagnose sleep bruxism as early as
possible and to seek appropriate
treatment. Bruxism is usually diagnosed based on clinical examination of the teeth, complaints of jaw
and masticatory pain, and reports
by the bed partner of grinding
noises. Patients suspected of bruxism are not routinely referred to
the sleep laboratory due to its high
cost. Thus, clinical and experimental data are scarce and there is no
widely accepted gold standard for a
definitive, objective diagnosis.
BiteStrip (SLP)11 is a diagnostic
tool that can assist the clinician in
detecting bruxism and assessing
over time the effectiveness of the
therapy delivered to treat the disorder. It is a miniature single-use
electronic device designed as a
screener for bruxism (Fig. 7). It consists of three electromyography
(EMG) electrodes and an amplifier
to acquire masticatory muscle signals, a central processing unit with
real-time software that detects
and analyses EMG Patterns, and a
display that exhibits the measurements in the morning. All elements
are integrated on a single flexible
substrate.
At bedtime, patients are instructed to attach the device over
the mandible to the cheek, to activate it and to perform a series of
maximal strength clenching and
grinding activities in order to establish an individual threshold for
the night-time monitoring (Fig. 8).
The device must be worn for at least
3 hours of sleep. In the morning,
patients deactivate the device and
wait for approximately 20 minutes
for the bruxism index (number of
bruxing events per hour of recording) to be displayed.12
The BiteStrip device was used in
a before-and-after experimental
clinical study with the objective of
evaluating the effect of a MAD on
sleep bruxism and sleep scores.12

After a habituation period of one
week, sleep bruxism scores were
taken at baseline and after use of
the MAD for 30 days. Scores were
compared using BiteStrip, which
registered the number of contractions of the unilateral masseter
muscle after a 5 hours period, giving a severity score of 0 to 3 after
the registrations. In order to assess
sleep, the Sleep Assessment Questionnaire, a screening tool with
scores ranging from 0 to 68, was
administered before and after use
of the MAD.
Twenty-eight subjects (13 women and 15 men; mean age of 42.9
± 12.0) with a clinical history of
sleep bruxism and no spontaneous
TMD pain were selected. The clinical diagnosis of either moderate or
severe sleep bruxism was further
confirmed through use of BiteStrip
(score of 2 or 3) at baseline. A 30-day
follow-up period was used for evaluation. Both methods were validated against polysomnography.
In addition, common signs and
symptoms of TMD based on the
Research Diagnostic Criteria for
Temporomandibular Disorders
were evaluated before and after use
to assess the side-effects of the
MAD. The results showed a statistically significant improvement in
both sleep bruxism and sleep
scores based on BiteStrip and the
Sleep Assessment Questionnaire
(Wilcoxon signed-rank and Student’s
paired t-test, p < 0.05). Concerning
the signs and symptoms of TMD,
there was a significant reduction in
temporomandibular joint sounds,
as well as in masseter and temporalis tenderness to palpation.
In summary, the improvement
measured by BiteStrip was the
same as the improvement assessed
by other methods.

Conclusion
In conclusion, implementation
of electronically based intra- and
peri-oral therapeutic and diagnostic devices creates new possibilities
for all kinds of novel applications
for which the power of electronics
and related technologies (software,
wireless communications) is harnessed to provide better and personal medical services at lower
costs.

Editorial note: A list of references is
available from the publisher.
Conflict of interest declaration: The
author is President of Saliwell.

Dr Andy Wolff
specialised in the
field of oral medicine at Tel Aviv
University and
has been a leading researcher in
the field of salivary glands for
over three decades. In 2003,
he co-founded Saliwell, a company that
offers innovative solutions for people
suffering from chronic dry mouth.

[11] =>

DTNE0116_11-12_Linden 18.04.16 12:37 Seite 1

TRENDS & APPLICATIONS

Dental Tribune Nordic Edition | 1/2016

Utilising smile design software and CAD/CAM
for creating a mock-up and final restorations
By Aki Lindén, Finland

Summary
A 32-year-old woman with hypoplastic pitted amelogenesis imperfecta. Patient photos and smile
design software were used for treatment planning and creating a digital mock-up. A digital impression
was captured with an intraoral
scanner. A digital mock-up design
was used in CAD software for
designing a wax-up. After preparations, a digital impression was
taken again; the final veneers were
designed with CAD software and
created with a milling unit.

Introduction
Treatment planning and smile
designing have been performed
with traditional techniques for
years in aesthetic dentistry. In recent years, various software programmes have emerged to offer
useful new tools for digital designing. When compared to traditional
techniques, the main advantages
of digital designing lie in speed,
flexibility and improved communication between the patient and
the treatment team.

Digital smile
designing

sors was measured with a calliper
for the calibration of the image. The
appropriate shade for the new teeth
was also determined (BL3—Fig. 4,
the third colour from the left). Next,
the patient’s smile photo was imported into a smile design software
programme. The patient’s facial
proportions were analysed—including the smile line, central line
and papillary line (Fig. 5) The different treatment possibilities were explained to the patient visually with
help of the software’s silhouette tool
(Fig. 6). The patient was able to take
part in the treatment planning
process by visually expressing their
expectations of the final result
(Fig. 7). Ultimately, the decision was
made to treat eight anterior maxillary teeth instead of the initially
planned six, as the patient’s wide
smile revealed more teeth than
average. The more comprehensive
1

During the first patient visit, preoperative face photos were taken
with a Canon EOS 6D camera (Fig. 1).
Two photos were taken of the patient—one face photo of a smile
(Fig. 2)and one retractor image (Fig. 3).
The photos were both carefully
taken from the same angle using a
camera stand. The distal distance
between the maxillary central inci-

treatment was also better in line
with the patient’s expectation of the
result (Fig. 8). To finalise the design,
the patient’s retractor image was
superimposed on top of the smile
image, which enabled viewing and
modifying the gingival area (Fig. 9).

Creating wax-up
A digital impression of the patient’s pre-op dentition was taken

using an intraoral scanner (Figs. 10
& 11). Both the upper and lower
arches were scanned and the digital impressions were immediately
available for wax-up designing.
The smile design silhouette was
exported from the smile design
software to the CAD software for
wax-up designing (Fig. 12). The silhouette was adjusted on top of
the digital impression and used as
a guideline for creating veneer de-

signs in the software. The tools in
the CAD software were used to design and finalise the digital wax-up
(Fig. 13).
Next, the digital wax-up was
3-D printed for mock-up creation.
A silicone key was prepared from
the 3-D printed model. Using the
silicon key and the 3M ESPE
Protemp 4 Temporisation Material,
a mock-up was created into the

“The main advantages of digital
designing lie in speed, flexibility and
improved communication between
the patient and the treatment team.”
8

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TRENDS & APPLICATIONS

Dental Tribune Nordic Edition | 1/2016

“Digital smile designing provides several
benefits compared to the traditional way
of smile designing with different wax-ups.”
20

patient’s mouth (Fig. 14), with its fit
and functionality checked. At this
point, the patient had the opportunity to experience the design of
her new teeth and understand the
altered feel and look (Fig. 15).

Preparations and
temporary veneers
After confirming the proper fit,
the patient’s teeth were prepared
(Figs. 16 & 17) and the preparations
were scanned, again using an intraoral scanner. Next, temporary veneers were created with the same
silicon key and 3D ESPE Protemp 4
Temporisation Material. The tem-

porary veneers were tried on the
patient and fixed by spot-etching.

Creating final
restorations
Once the temporary veneers had
been successfully fitted, the final
veneers were created from IPS
e.max CAD blocks using a milling
unit. The restorations were finished
by layering ceramics (e.max Ceram)
to the labial and incisal parts for
maximum aesthetics (Fig. 18). To
conclude a successful treatment
process, the final restorations were
cemented. A photo of the end result
was also taken (Figs. 19 & 20).

Conclusion
Digital smile designing significantly improves the communication between the patient and
the entire treatment team. More
predictable results make patients
more confident, as they can trust
that the outcome will be in accordance with their expectations.
Patients are also pleased to be
actively involved in their own
treatment and that they are able
to take part in the design process
right from the start. As a result,
patient case acceptance is improved. Digital smile designing
provides several benefits compared to the traditional way of

smile designing with different
wax-ups—it is easier, more comfortable for the patient and more
time-efficient.
Acknowledgment: The author would
like to thank Dr Katja Narva, DDS, PhD,
Specialist in Prosthodontics.
Utilised equipment and software: Planmeca Romexis Smile Design software,
Planmeca PlanCAD Premium software,
Planmeca PlanScan intraoral scanner,
Planmeca PlanMill 50 milling unit.
Editorial note: This case report first
appeared in CAD/CAM—international
magazine of digital dentistry, Vol. 7,
Issue 1/2016.

Aki Lindén, CDT
has an extensive
history in aesthetic dentistry
and fixed prosthetics, as he
has worked in
his own dental
laboratory in
Helsinki for over
20 years. Lindén
is a recognised Opinion Leader for
Ivoclar Vivadent in Finland, for which he
regularly serves as an instructor and
lecturer. Mr. Lindén is also a member
of several aesthetic dentistry societies,
such as the Scandinavian Academy of
Esthetic Dentistry (SAED), the American
Academy of Cosmetic Dentistry (AACD),
and the Society for Color and Appearance in Dentistry (SCAD).

[13] =>

DTNE0116_13-15_Manhart 18.04.16 11:10 Seite 1

TRENDS & APPLICATIONS

Dental Tribune Nordic Edition | 1/2016

Posterior restoration with a new
nano-hybrid ORMOCER composite
mer.8 Alternative chemical formulations use silorane resins5, 9–13 and
ORMOCERs.14–22

A case report
By Prof. Jürgen Manhart, Germany
Today, direct composites in posterior
teeth are a very successful part of
the standard therapy spectrum in
restorative dentistry. They are very
popular filling materials with dentists as well as their patients. The
performance of this treatment
method, even in the masticatory
load-bearing posterior region, has
been conclusively proved in many
clinical studies. Aside from composites based on methacrylate chemistry, the choice of filling materials
has now been extended by a pure
nano-hybrid ORMOCER restorative
without any conventional methacrylate monomers in its formulation.

Introduction
For many years, the use of composite resin materials has increased, along with patients’ growing demand for metal-free restorations. This trend has been driven
in large part by patients looking
for an aesthetic alternative for the
repair of carious lesions or traumatised teeth and by patients concerned about potential adverse
systemic reactions to amalgam restorations.1
In recent years, an extensive
range of new materials for di-

rect composite restorations has
emerged on the market.2–5 In addition to regular hybrid and nanohybrid composites for universal
use, a great number of highly aesthetic composite systems have
been introduced owing to rising
aesthetic expectations of patients. These restorative systems
contain composite materials in a
sufficient number of shades and
different opacities or translucencies.6
Some of these composite systems comprise more than 30 different composite materials of
different shades and translucencies. It is therefore essential to
have the requisite experience in
the handling of these materials,
which are processed—especially when used for aesthetically
challenging anterior situations—
according to the polychromatic
stratification technique using
varying opacities and translu cencies.6, 7
Most dental restorative composite materials contain organic
monomer matrices based on traditional methacrylate chemistry,
such as bis-GMA and its derivatives,
UDMA and TEGDMA, the most
commonly used diluent mono-

ORMOCERs (organically modified ceramics) are organically modified, non-metallic inorganic compound materials.23 They are inorganic-organic co-polymeric hybrid
materials that are composed of
an inorganic Si-O-Si glass network
(backbone molecule) and an organic polymer phase.19, 24–26 This
material group was developed
by the Fraunhofer Institute for
Silicate Research in Würzburg in
Germany, in collaboration with
partners from the dental industry,
and introduced as a dental restorative for the first time in 1998.16, 17
Hitherto existing dental ORMOCERs
still contained additional conventional monomers in the matrix for
better handling and manipulation
characteristics (in addition to initiators, stabilisers, pigments and
inorganic filler particles).24, 25, 27
Thus, it is better to refer to these
materials as ORMOCER-based
composites.
Introduced in the year 2015, the
ORMOCER Admira Fusion (VOCO)
features pure ORMOCER matrix
chemistry without any additional
conventional dimethacrylates and
nano-hybrid inorganic filler particles (84 wt%). This diluent-free
restorative material should show
an increased biocompatibility.24
It is available in a wide range of

shades in three different translucency/opacity levels (ten universal VITA shades, four opaque
dentine shades, four special
shades), which allows the use of
this material in a simplified single-shade placement technique in
posterior cavities, as well as using
a more complex polychromatic
layering technique when restoring defects in aesthetically demanding teeth.
A polymerisation shrinkage of
only 1.25 vol% and a low shrinkage stress (3.87 MPa) have been
measured for Admira Fusion. The
ORMOCER can be applied into
tooth cavities in increments of up
to 2 mm. Each increment has to be
polymerised for 20 to 40 seconds
(intensity of the curing light of
> 500 mW/cm²).

Clinical case
presentation
A 51-year-old female patient
presented at our dental office
requesting the replacement of
her in adequate old amalgam
restoration in tooth #16 (Fig. 1).
During the clinical inspection,
the tooth responded sensitively
to the cold test and showed no
negative response to the percussion test. After the patient
had been informed about the
possible treatment options and

the corresponding costs, she
decided in favour of a direct
ORMOCER restoration using
Admira Fusion.
Treatment started by thoroughly removing external deposits
from the affected tooth using a
fluoride-free prophylaxis paste
and a rubber cup. After administration of local anaesthetics, the old
amalgam restoration was carefully
removed while conserving the remaining hard tissue (Fig. 2). Owing
to the spatial expansion of the caries, the cavity had to be extended
to the mesial surface. The tooth was
excavated and subsequently the
cavity was completely prepared
and finished with a fine-grit diamond bur (Fig. 3).
Shade determination was performed on the moist tooth prior
to the application of a rubber dam
(Figs. 4a & b). The tooth was subsequently isolated with a rubber dam
(Fig. 5). The rubber dam separates
the operating site from the oral cavity, facilitates clean and effective
work, and ensures that the working
area remains free of contamination (e.g. blood, sulcular fluid
and saliva). Contamination of the
enamel and dentine would result in
markedly poorer adhesion of the
filling material to the dental hard
tissue and endanger the optimal
marginal integrity of the composite restoration for long-term success. Additionally, the rubber dam

Fig. 1: Preoperative situation: inadequate old amalgam restoration in a maxillary first molar.—Fig. 2: Situation after careful removal of the existing restoration.—Fig. 3:The cavity was prepared and finished after caries
removal.—Figs. 4a & b: Shade selection on the moist tooth.—Fig. 5: Isolation of the operating site with a rubber dam.—Fig. 6: Placement of a metal sectional matrix band, cervically sealed with a plastic wedge.—
Fig. 7: Placement of the sectional matrix system ring to stabilise the metal band and separate the teeth.—Fig. 8: Selective enamel etching with 35 per cent phosphoric acid for 15 seconds.—Fig. 9: After 15 seconds, the
etching agent was extended to the dentine for an additional 15 seconds conditioning period (total etch).—Fig. 10: Situation after thoroughly rinsing off the conditioning agent and gently air-drying the cavity, avoiding
desiccation of the dentine.—Fig. 11: Adhesive pretreatment of the tooth structure with Futurabond U universal adhesive.

[14] =>

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TRENDS & APPLICATIONS

Dental Tribune Nordic Edition | 1/2016

Fig. 12: Careful evaporation of the solvent of the adhesive until a shiny, immobile film formed.—Fig. 13: Light curing of the adhesive for 10 seconds.—Fig. 14: An even shiny cavity surface indicates an appropriately
pretreated tooth structure. This seals the dentinal tubules and prevents postoperative hypersensitivity.—Fig. 15: Admira Fusion was applied into the mesial cavity extension and used to build up the complete proximal
wall to the marginal ridge. The composite material was shaped with a new micro-brush.—Fig. 16: Light curing of Admira Fusion for 20 seconds.—Fig. 17: The Class II cavity was transformed into a functional Class I cavity.—
Fig. 18: Once the proximal composite wall had been sufficiently polymerised, the matrix system was removed completely. With a further increment of Admira Fusion, the cavity floor was levelled out.—Fig. 19: Forming
the mesiobuccal cusp and subsequent polymerisation for 20 seconds.—Fig. 20: Forming the mesiopalatal cusp and subsequent polymerisation for 20 seconds.—Fig. 21: Forming the distobuccal and distopalatal cusps.—
Fig. 22: Light curing of the cusps for 20 seconds each.—Fig. 23: Additional polymerisation at the proximal area from the mesiopalatal aspect for 20 seconds.

protects the patient from irritating
substances, such as the adhesive
product. The rubber dam is thus an
essential aid in ensuring high quality and facilitating work in adhesive dentistry. The minimal effort
required in applying the rubber
dam is compensated for by avoiding the need to change cotton rolls
and the patient’s frequent requests
for rinsing.

A metal sectional matrix system
was used to delimit the threesurface cavity, which was sealed at
the gingival margin using an
anatomically formed plastic wedge
(Fig. 6). The nickel-titanium ring
stabilised the matrix and exerted
an optimal separation force on
the neighbouring teeth to produce a tight contact for the new
restoration (Fig. 7).

F R TO
P
W OM CO
IL TH M
LB E P
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PR D IE
ES US S
EN TR
T Y

24TH INTERNATIONAL DENTAL FAIR

6. - 8. 10. 2016
Prague Exhibition Grounds Holesovice
www.pragodent.eu

EST
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THE L FAIR IN
I
DENTA REPUBLIC
CZECH

In order to optimise the contours, the matrix was carefully
moulded with a hand instrument.
The formation of physiologically
contoured proximal surfaces with
tight contacts to neighbouring
teeth still represents a challenge
when using direct composite
restorations. In contrast to amalgam, composites show a certain
viscoelastic recovery from distortion, which is often seen as undesirable by the user and complicates
the adaptation of matrices to the
neighbouring tooth by packing
pressure.28, 29
The universal adhesive Futurabond U (VOCO) was selected for
bonding. This advanced universal
adhesive is compatible with all
etching techniques: self-etch and
etch techniques based on phosphoric acid (etch-and-rinse approach: selective enamel-etch or
total-etch-and-rinse techniques
involving enamel and dentine).
In this clinical case, the adhesive
was applied using the etch-andrinse technique on both enamel
and dentine. A 35 per cent phosphoric acid (Vococid, VOCO) was
applied along the enamel margins
first for a reaction time of 15 seconds (Fig. 8), followed by conditioning of the dentine for a further
15 seconds (Fig. 9). Subsequently,
the cavity was washed thoroughly
for 20 seconds with an air–water
spray to remove the acid and precipitate residue. The cavity was
then gently air-dried to remove
excess moisture, but avoiding
desiccation of the dentine (Fig. 10).
Ample amounts of Futurabond U
were applied and distributed generously in the area of the cavity
using a micro-brush (Fig. 11). It must
be ensured that all cavity areas

are sufficiently covered by the
adhesive.
After at least 20 seconds of careful scrubbing of the adhesive into
the tooth surface, the solvent was
carefully evaporated from the
bonding agent with oil-free compressed air until a glossy, immobile
adhesive film formed (Fig. 12). The
bonding agent was then subsequently light cured for 10 seconds
(Fig. 13). The result was a shiny cavity surface, evenly covered with adhesive (Fig. 14). This should be carefully checked, as any areas of the
cavity that appear dull are an indication that an insufficient amount
of adhesive has been applied to
those sites. In the worst case, this
could result in both reduced bonding of the restoration in these areas
and in reduced dentinal sealing,
which may lead to postoperative
sensitivity. If such areas are found
in the visual inspection, additional
bonding agent must be selectively
applied to them.
Admira Fusion was applied into
the cavity, starting at the mesial
proximal extension. The entire
proximal wall was built up to the
marginal ridge using a new microbrush as the perfect modelling
instrument to carefully mould
the restorative material (Fig. 15).
The first increment of the composite was polymerised with a highperformance curing light (intensity
of > 500 mW/cm²) for 20 seconds
(Fig. 16). Thus, the Class II cavity
was transformed into a functional
Class I cavity (Fig. 17). Once the
proximal composite wall had been
sufficiently polymerised, the matrix system was no longer necessary and was removed (Fig. 18).
As a result, the operating field
was more accessible to modelling

instruments for the following
working steps and visual control
for sub sequent application of
composite increments was enhanced.
With the second layer of Admira
Fusion, the cavity floor was levelled
to provide an even area with a
maximum increment thickness of
2 mm for the following development of the anatomical structures
of the occlusal surface (Fig. 18). With
the subsequent increments of the
ORMOCER restorative, the occlusal
morphology of the tooth was reconstructed cusp by cusp (Sequential Composite Cusp Technique),
starting with the mesiobuccal cusp
(Fig. 19), followed by the mesiopalatal cusp (Fig. 20), and finished
by the restoration of the distopalatal and distobuccal cusps
(Fig. 21).
This technique allows rebuilding
of the occlusal anatomy in a very
simple, predictable and reproducible way, and results in an excellent approximation of the natural
substrate. After each cusp placement, the restorative material was
light cured for 20 seconds (Fig. 22).
Additional 20 seconds curing cycles from the mesiopalatal (Fig. 23)
and mesiobuccal aspects (Fig. 24)
in the region of the proximal box,
especially at the gingival seat, were
executed after final composite
placement in order to ensure that
all areas previously covered by the
metal matrix band were sufficiently polymerised.
The restoration was checked for
any imperfections before the rubber dam was removed. The fissure
relief and the fossae of the occlusal
anatomy were finished with a pearshaped fine-grit diamond bur. In

[15] =>

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TRENDS & APPLICATIONS

Dental Tribune Nordic Edition | 1/2016

the next step of the standard finishing sequence, a pointed fine-grit
diamond was used to finish the
convexity of the cusps and triangular ridges. After the elimination
of occlusal interferences and adjustment of the static and dynamic
occlusion, the accessible proximal
areas were contoured and pre-polished with abrasive disks.
The use of diamond-impregnated composite polishers (Dimanto,
VOCO) achieved a satin matte, lustrous finish on the smooth surface
of the restoration. Subsequent
high-gloss polishing was completed using the same Dimanto
polishers with reduced pressure
to optimise the lustre of the restorative material. Figure 25 shows
the completed direct ORMOCER
restoration, reconstructing the
original tooth shape with an
anatomical and functional occlusal surface, a physiologically contoured proximal contact area and
an excellent aesthetic appearance.
In order to complete the treatment,
a fluoride varnish (Bifluorid 12,
VOCO) was applied to the affected
tooth using a foam pellet.

rial and sufficient curing of the
composite.
Supplementary to composites based
on traditional methacrylate chemistry, the material options among
light-activated direct placement restoratives have been expanded by a
nano-hybrid ORMOCER that does not
contain any conventional dimethacrylates in its chemical formulation.
24

Editorial note: A list of references is
available from the publisher.

Fig. 24: Additional polymerisation at the proximal area from the mesiobuccal aspect for 20 seconds.—Fig. 25: Final situation: the highgloss polished direct ORMOCER restoration shows successful aesthetic and functional integration with the surrounding dental tissue.
AD

The Dental Tribune International
C.E. Magazines
www.dental-tribune.com

Discussion and
conclusion
The need for composite-based
direct restorative materials is predicted to grow in the future. Therefore, high-quality, scientifically
proven and clinically well-documented composite resin materials
will be in much demand. These
restoratives present a scientifically
validated, high-quality permanent
treatment option for the masticatory load-bearing posterior region
and their reliability has been documented in the literature.30–35 The
results of a comprehensive review
have shown that the annual failure
rate of direct composite restorations in posterior teeth (2.2 per
cent) is not statistically significantly different to that of amalgam
restorations (3.0 per cent).32
Minimally invasive treatment
protocols, in conjunction with the
possibility of detecting carious lesions at a very early stage, are having a positive effect on the longterm survival rate of dental restorations. Nonetheless, a high-quality
direct composite restoration with
excellent marginal adaptation
continues to be dependent on a
number of prerequisites, including
careful placement of the matrix
(if proximal areas are involved),
effective and correct application of
the adhesive system, appropriate
handling of the restorative mate-

Prof. Jürgen
Manhart works
in the Department of Restorative Dentistry
and Periodontology at the
University of
Munich in Germany. He can
be contacted at
manhart@manhart.com.

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[17] =>

DTNE0116_17_todayScandefa 18.04.16 11:11 Seite 1

SCANDEFA · Copenhagen · 28–29 April, 2016

Official news for visitors and exhibitors

Learn and connect at SCANDEFA 2016
Copenhagen welcomes dental professionals to Bella Center
n On 28 and 29 April, thousands of
dental professionals from Denmark
and the wider Scandinavian region
will have the opportunity to discover
a range of innovative companies and
new technologies when SCANDEFA
2016 opens at Bella Center in Copenhagen. Visitors will be able to try out
the latest dental technologies, equipment and accessories at SCANDEFA,
which is one of the largest trade
shows in the region. For the 49th
event, doors will open already from
08:00 to 18:00 on Thursday and to
19:00 on Friday.

Traditionally, the SCANDEFA
Party on Thursday promises great
opportunities to connect and engage
with friends and business partners
in a relaxed atmosphere. The party
starts at 19:00 and will feature live
music from Denmark’s Beverly Hills
Orchestra and guest soloist Morten
Remar.
In addition to the trade exhibition, the Danish Dental Association
is again holding its annual meeting
at Bella Center. The scientific programme, which will cover a range of

subjects, including new material solutions and the latest developments
in CAD/CAM technologies, will be presented by a number of well-known
Danish and international clinicians.
For example, a mini-symposium
on decision-making in restorative
dentistry will feature multiple lectures on such topics as restoration
survival and risk assessment. Furthermore, Dr Thomas E. van Dyke
from the Harvard School of Dental
Medicine will take a closer look at the
future role of the dentist in the health

system, and Prof. Dr Niklaus P. Lang
from the Universities of Zurich and
Berne will address a common complication of implant treatment in his

lecture titled “Peri-implantitis—The
dilemma of the future?”. Registration
for the exhibition is free and can be
done on-site, as well as online. 7

“An event with great professional value”
to speak to Mia Clement
Rosenvinge, Sales and Exhibition Manager at Bella
Center in Copenhagen.

Mia Clement Rosenvinge

n Showcasing an extended live surgery area and welcoming new foreign exhibitors from countries such
as South Africa, China and Israel,
Scandinavia’s leading dental trade
fair certainly has much to offer visitors. Ahead of this year’s event, today
international had the opportunity

today international:
SCANDEFA is one of the
largest dental exhibitions
in the Nordic countries,
providing excellent business opportunities for
both exhibitors and visitors from Scandinavia.
What feedback have you received regarding past editions of the show?
Mia Clement Rosenvinge: We had
positive feedback on the new exhibition layout we used last year. The
goal was to obtain more control of the
flow of visitors during their stay and
participation in the Årskursus (the

educational programme). Prior to last
year, the lunch area for the course
attendees was located in a hall away
from the exhibition area. We managed to incorporate a nice lunch area
in the exhibition hall, which among
other factors, facilitated a better flow
and synergy between the educational programme and exhibition. Furthermore, we have our SCANDEFA
Party on Thursday night, open to
anyone in the dental business. Last
year, we had 300 people partying
and dancing and it was great fun. We
hope to repeat the success this year.
The exhibitors are probably mainly
from Scandinavia, but certainly not
limited to the Nordic countries.
No. This year, we are pleased to
present exhibitors from countries

such as South Africa, Israel and
China too. It is always exciting to
meet our new exhibitors and we
certainly look forward to welcoming
the new foreign representatives to
our Scandinavian trade fair.
The venue, Bella Center, has a very
spacious and light architecture. Do
you think this contributes to the relaxed atmosphere of the trade fair?
Yes, the high ceilings and lots of
daylight in the hall create an airy and
light ambience. We are also very
pleased with our new café in the exhibition hall. Everything adds to the
pleasant environment.
Apart from the exhibition itself, are
there any programme highlights visitors can look forward to?

Our focus this year has been to deliver an event with great professional
value. Therefore, we have teamed up
with Klinikproduktion, the company
that presented live surgeries on-site
for the 2015 show. Based on the positive feedback we received for this
addition to the industry showcase,
we decided to extend this feature to
a larger setting this year. The Klinikproduktion team, along with more
surgeons, will be operating in a 225 m2
presentation area, and visitors will be
able to see five dental live demonstrations every day during the event.
Thank you very much for the interview. 7
Read more about Klinikproduktion and the
surgeries being presented at SCANDEFA on p. 18.

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[18] =>

DTNE0116_18_News 18.04.16 11:18 Seite 1

news

SCANDEFA Copenhagen 2016

Ten live sessions in two days
Once again SCANDEFA is featuring spectacular live demonstrations

Dr Jens Lætgaard and his team performing live surgeries at SCANDEFA 2015 in Copenhagen.

n At SCANDEFA 2015, one of the
highlights certainly was the surgery cage in which Danish dentist
Dr Jens Lætgaard and his team
performed live dental treatments
in the middle of the industry
showcase. After last year’s success,
Lætgaard’s company Klinikproduktion is returning to the trade
show—this time with a designated
event area, a bigger team and an
extended programme of five live
treatments on each day of the show.
AD

Each case takes about 1 hour
and treatment includes the removal of mandibular third molars,
CAD/CAM scanning, planning and
delivery, implant placement and
osteotome sinus lift.
Lætgaard, who founded educational platform Klinikproduktion
and runs a private practice in
Roskilde in Denmark, has been performing live surgeries at seminars
and trade shows for more than ten

years now. “During live treatment,
one can’t hide anything,” he told
today international. This aspect is
essential and one of the reasons
that fellow dental professionals
benefit from public demonstrations, the Dane believes. “If the
bone, instruments or patient do not
act in the manner expected, one has
to continue and show the audience
how to handle the situation,” he
said. “Another advantage of live
surgeries is that often the whole
team attends exhibitions. Dentists,
hygienists and assistants can come
and go as they like. They can watch
and discuss what they have seen—
directly on-site or afterwards—with
no obligations.”
The live sessions at SCANDEFA
will take place in the new 225 m2
event area and its surroundings
in Hall C3. They are open to all
visitors free of charge and without

restrictions. Next to the surgery
cage, there is room for 100 seated
and further standing guests.

Programme for Thursday
and Friday:
•09:00–10:00: CAD/CAM scanning, fabrication and cementation of a crown (Dr Hanne
Lollike)
•11:00–12:00: Endodontic treatment with a microscope (Dr
Kasper Busk)

•13:30–14:30: Implant placement
and osteotome sinus lift (Dr Jens
Lætgaard)
•15:00–16:00: Surgical removal of
third molars (Dr Jens Lætgaard)
•16:30–17:30: Orthodontic treatment with Invisalign, CAD/CAM
scanning, planning and delivery
(Dr Nimmi Holste) 7

More information can be found at
www.klinikproduktion.dk.

Directa launches
novel saliva absorber
n Swedish dental company
Directa has introduced the first
absorbent pad designed for optimal and comfortable collection of
saliva produced by the sublingual
and submandibular glands. First
launched at the UAE International
Dental Conference and Arab Dental Exhibition in Dubai this year,
DryDent Sublingual is now available to Nordic costumers.

over DryDent Sublingual, which
minimises uncomfortable suctions of soft tissue, as well as
pain and noise that patients may
experience during procedures,
such as dental scanning and radiograph capturing. Moreover,
the pads have a soothing effect
owing to reduced stimulation of
the swallowing reflex, Karsk explained.

Many ducts from
the salivary glands
open sublingually,
thus resulting in
a challenging moisture situation in
this area. “DryDent
Sublingual is the
answer to a specific
and important need
in everyday dentistry,” Directa CEO
Henric Karsk said.
“While saliva absorbers for the 5
dry oral environment is a prerequisite for a variety of dental treatparotid glands have Aments.
Aiming for optimal moisture control in the sublingual area,
been available on Swedish company Directa has introduced DryDent Sublingual.
the market for some
“Many dental professionals tell
time, there has been no sublingual
us that this is something they
absorbent pad.”
have been lacking in their daily
According to the company, the work. We tested the product in
pad’s absorbent material keeps the Västra Götaland region, where
the sublingual area dry, even 75 per cent of the dental teams
when it is fully saturated. In ad- interviewed answered ‘yes’ to the
dition to controlling unwanted question of whether a DryDent
moisture, the product is designed Sublingual placed under the salito maximise patient comfort. va ejector simplifies their work,”
Saliva ejectors can be placed Karsk said. 7

[19] =>

[20] =>

DTNE0116_20-21_Exhibitors 18.04.16 11:19 Seite 1

20

service

SCANDEFA Copenhagen 2016

28-29 April 2016

SCANDEFA

C
Center

B
B0

H

C5

A-E-C-B-C5-H

Bella Center

SCANDEFA 2016—Bella Center—Floor plan

[21] =>

DTNE0116_20-21_Exhibitors 18.04.16 11:19 Seite 2

service

SCANDEFA Copenhagen 2016

21

SCANDEFA—28–29 April 2016—Exhibitors List
Company name
3Business—
Enkle løsninger til din klinik!
3D Dental Direct Danmark
3M A/S
A/S Unilever
AB Dental Service A/S
ACTEON
Aros Statsautoriserede
Revisorer I/S
Arum 3d Solutions
Audiovox
Baker Tilly Denmark
BDO Statsautoriseret
revisionsaktieselskab
Blomsterværkstedet
Brother Nordic A/S
Cardia Nordic ApS
Cardinal Klinik &
Jobbeklædning ApS
Cenger Scandinavia A/S
Chengdu Weadon
Dental Manufacture Co.,Ltd.
Chokolade Compagniet
ClasenUNO
CleanCliniC ApS
Climo A/S
CMS Dental A/S
Colgate-Palmolive A/S
Colténe/Whaledent
Cope it
Curaprox / Curaden Scandic ApS
CurePrint A/S
DAB Dental AB

Booth
E-014
C3-004
C2-011
C1-010
C2-002
C2-025A
C1-017A
C3-023
C1-019A
C2-018
C1-007A
E-016
C1-001K
E-010
C1-015
C3-005
C1-013B
E-007
C2-030A
C1-012
C3-006
C2-012
C1-004
C3-017
C2-007A
C2-022
C4-004
C2-031

Company name

Booth

Dagbladet Børsen
C1-001A
Dansk Tandforsikring
C2-017A
Dansk Tandplejerforening
E-005
Dansk Tandprofylakse ApS
C3-021
Danske Dental Laboratorier(DDL)
E-002
Deloitte
C2-025
Dent Support A/S
C2-005
Dental Consult ApS
C1-021
Dental Kompagniet I/S
C1-019
Dental Montering
C3-013
Dental Technology AB
C1-009B
Dental Tribune Int. GmbH
C1-012B
Dentalmind AB
C2-023
Den-Tec ApS
C1-001
Dentsply Sirona
C1-006
DETAX
C3-013B
Donnerberg
C1-005
Dynamo Stol ApS
C1-002
Dürr Dental AG
C3-025
Easy Dent A/S
C2-026
Edenta
C3-001A
Effekt Advokaterne
C1-017
Ekulf NeoDenta Dental ApS
C1-008
Elstrøm Dental A/S
C3-029
EltiDent ApS
C1-001H
Elysee Dental ApS
C2-014
Ergotec ApS
C1-013
Eurofins Miljø
E-011
EURONDA Deutschland GmbH
C3-013
Facad Ortho Tracing by Ilexis AB
C3-024
Focus Dental Service v/Henrik Atzen C3-015
Fyns Dental ApS
C1-007
Garrison Dental Solutions
C3-012C

Company name

Booth

GC Nordic
C3-014
GlaxoSmithKline
Consumer Healthcare AB
C1-016
Gram Dental ApS
C2-028
GreenMatic
C1-015A
GRENKE
C2-021
Grønlandstandplejen
E-001
Health Workers AS
C1-015
Healthcare Channel—Immediad
E-012
HEJCO
C4-001
Heka Dental A/S
C3-007
Heraeus Kulzer Nordic AB
C2-004
HK/Privat-Kommunalt
for tandklinikassistenter
E-004
Hounisen Laboratorieudstyr A/S C1-001E
Implant Direct / Scott Dental Aps C2-015B
Inform a/s
C1-011
ipnordic A/S
C3-012B
Ivoclar Vivadent AB
C2-013
Johnson & Johnson, Filial af
C1-008A
JTA Dental
C3-013
Jyske Bank A/S
C3-020
KaVo Kerr Group
C3-008A
Klinikproduktion ApS
C3-Event
Krebs Ergonomi
C1-002
Lån & Spar Bank A/S
E-009
MA Medicals
C1-014
Manunision ApS
C2-030
Medident Italia
C1-021A
MEDITRENO
INSTRUMENTS (SPAIN)
C1-013A
MELAG
C2-019
Miele A/S Professional
C2-001

Company name

Booth

Nobel Biocare Danmark A/S
C2-006
Nordenta A/S
C3-016
Nordenta AB
C4-003
NSK Danmark ApS
C3-031
Nykredit
C3-018
Orkla Care A/S
C1-018
Orkla Care A/S
C1-022
OurWorld
E-008
Philips AB
C3-013A
Plandent A/S
C2-008
Plandent A/S
C2-008A
Planmeca
C2-009
Pluradent Danmark
C2-006A
Plusdent ApS
C1-016B
Praktiserende
Tandlægers Organisation (PTO)
E-006
Praxis A/S
C4-002
Procter & Gamble / Oral_B
C3-001
PwC
C1-001F
RDS Dental ApS
C3-012A
Rectus ApS
C1-009A
Redent/Rhino Wood & Plastic
Processing Sweden AB
C1-002B
Redmark
C1-011A
RH Dental ApS
C2-015
Roland DG
C2-015A
Rønvig Dental
C1-006A
Scanbiz A/S
C3-009A
Scandinavisk Dentalservice
Denmark A/S
C3-002
Scanleasing Danmark A/S
C1-020
SciVision Nordic
C1-012A
Shenzhen Advanced Dental Lab C1-001M

Company name

Booth

SKT København
E-003
SKT Aarhus
E-003
SnorBan DK ApS
C1-001J
Spar Nord Bank
C1-005C
SpotON Marketing ApS
C2-003
Sri Trang Group
C1-011B
Statens Serum Institut
C2-020
Straumann Danmark ApS
C2-010
Sunstar Sverige
C3-009
SURCAM DENTAL Ltd
C1-015C
Swede Dental AB
C1-002A
Sydbank
C2-017
Tandex A/S
C1-009
Tandlægernesadvokat.dk
C1-016A
Tandsundhed Uden Grænser (TUG) E-006A
Transcom CMS A/S
E-013
Triple O Dental Laboratories Ltd C1-021B
TrollDental
C1-001B
TSpro GmbH
C1-015B
Unident AB
C3-011
Unique Ejendom A/S
C1-014A
VisiQuick Danmark
C3-018A
VOCO GmbH
C3-012
W&H Nordic
C2-007
WeCare4u A/S
C2-027
Wessels Dental ApS
C3-003
Ya Du Oral Health Care Co. Ltd. C1-017B
Zarodent ApS
C3-017A
Zenith Dental ApS
C3-008

Floor plan and exhibitors list are subject
to change. Last update was 7 April, 2016.
AD

[22] =>

DTNE0116_22_Business 18.04.16 11:21 Seite 1

business

SCANDEFA Copenhagen 2016

First solely ceramic-based restorative material
restorative system,
was launched in
1999 already, followed by Grandio,
the first nano-hybrid composite, in
2003. Now, intensive research has
enabled VOCO to
combine the advantages of both restorative
systems.

With Admira Fusion, VOCO
presents the first purely ceramicbased universal restorative material. Its development was made
possible by the innovation of combining proven nano-hybrid tech-

nology with that of ORMOCERs
(organically modified ceramics)
developed in collaboration with the
Fraunhofer Institute for Silicate
Research in Würzburg in Germany.
Admira, the first ORMOCER-based

Silicon dioxide forms
the chemical base for the
new nano-hybrid ORMOCER
restorative material, Admira
Fusion, regarding not only
the fillers but also—and
this represents the innovative research achievement—the resin matrix. This
unique Pure Silicate Technology
offers several remarkable advantages in one: for example, Admira
Fusion, in comparison with all
restorative composites of market

indications, including
Class I to V fillings, lining of Class I and II cavities, reconstruction of
damaged anterior teeth,
locking or splinting of
loose teeth, extended fissure sealing, core buildups and fabrication of
composite inlays.
relevance, shows by far the
lowest level of polymerisation
shrinkage (1.25 per cent by volume), coupled with extremely
low shrinkage stress.
The ORMOCERs used in the
manufacture of Admira Fusion
make it highly biocompatible,
as they contain no conventional
monomers, some components of
which might otherwise be released after polymerisation. The
light-curing, radiopaque nanohybrid material has an 84 per cent
(by weight) content of inorganic
fillers and covers a broad range of

Admira Fusion’s particularly
high colour stability gives it an
additional edge and allows its
universal use—for the highest demands in both the anterior and
posterior regions. This homogeneous material offers outstanding handling and is compatible
with all conventional bonding
materials. Admira Fusion is available in rotating syringes and caps
for direct application.
VOCO GMBH, GERMANY
www.voco.com

Booth C3-012

Simplifying root canal
treatment: S1 System
The S1 System is a single-file
solution that uses reciprocating
motion. The unique design makes
it easy to use and aids steady movements in the canal, for
the best ergonomics.
With S1, endodontic
treatment is simpler
and more cost-effective.

Clinical Masters Program
TM

in Endodontics

11 days of intensive live training with the Masters in Rome (IT), Athens (GR), Florence (IT)

Participants will master techniques that are repeatable, predictable
DQGLQDOOFDVHVKDYHWKHDELOLW\WRFUHDWHGL΍HUHQWEXWDOZD\V
excellent results!
Learn from the Masters of Endodontics:

Registration information:
11 days of live training with the Masters
in Rome (IT) , Athens (GR), Florence (IT) + self study

Curriculum fee: €9,000

(Based on your schedule, you can register for this program one session at a time.)

Collaborate
on your cases
and access hours of
premium video training
and live webinars

Sapienza University
of Rome
this course is created in
collaboration with Sapienza
University of Rome

Tribune Group GmbH is an 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

&HUWLȴFDWHV will be
awarded upon completion

Tribune Group GmbH 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 province board of dentistry or AGD
endorsement. The current term of approval extends from 7/1/2014 to 6/30/2016.
Provider ID# 355051.

Furthermore, the nickel-titanium
alloy’s elasticity and flexibility
minimise the risk of instrument
fracture.

The S1 contra-angle
handpiece has an integrated gearbox and
rotates 180° clockwise
and 30° anti-clockwise
alternately. This smart
solution allows connection of the handpiece
directly to the dental
unit with no need for
an external motor, unlike competing devices,
which require an external motor, cord and foot
pedal.
The system offers
multiple advantages.
Because only one instrument is needed,
treatment is faster. The
instruments come in
a practical sterile treatment pack and are thus
ready to use immediately, saving even more
time, to allow dentists to
treat more patients.
Sendoline’s unique S-profile
with its double cutting edges,
combined with the S1 System’s reciprocating motion, is extremely
effective in the root canal. The
instrument has a non-cutting tip,
making it easy to hold it steady
in the centre of the root canal.

The contra-angle handpiece
can be connected to an apex locator using the accompanying apex
clip. The handpiece is cleaned and
sterilised just as with any other
instrument.
SENDOLINE AB, SWEDEN
www.sendoline.com

Booth C2-007

[23] =>

DTNE0116_23_Business 18.04.16 11:21 Seite 1

business

SCANDEFA Copenhagen 2016

23

Essentia from GC: More creativity, less complexity
n As a family-owned Japanese
company continuously improving its core competences and
technologies, GC strives to develop smart solutions for dentists’ daily challenges, which
sometimes requires going against
traditional concepts. In this respect, GC has taken a daring
new approach to aesthetic dental
restorations: Essentia, developed
together with a group of experts
in aesthetic dentistry, no longer
relies on the classic VITA colours, but on a very simple assortment of seven shades, created to
mimic natural teeth in a patient
of any age and offering dentists
the maximum creative freedom.
At last year’s International Dental Show, GC presented Essentia
to a professional audience for the
first time.
In developing Essentia, GC
pursued a long process of creating a very lean and simple colour
scheme of only seven shades.
This material offers more than
a true alternative to conventional shade systems; it marks
a paradigm shift in restorative
dentistry. Shades are no longer
based on the traditional hues
(A, B, C, D) of commonly used
systems, but instead follow the
chroma (intensity) and value
(lightness) of teeth, in order to
best mimic the natural enamel

and dentine. Therefore, the two
enamel and three dentine shades
are characterised as light, medium or dark.

erties to each shade, each best
suited to its respective use: while
enamel shades offer high polishability and gloss retention,

tency. This makes Essentia a simple and reliable solution for all
aesthetic restorations, as well as
the perfect partner for dentists

while patients profit from a longlasting gloss, as well as a reduced
risk of plaque accumulation
and staining, owing to the optimised composition of the enamel
shades.
In addition, even dentists desiring more detailed characterisation of their restorations gain
from Essentia: four dedicated
modifiers have been developed
to satisfy various demands, such
as the desire for an opalescent
halo on the incisal edge, fissure staining or mimicking white
spots.
By boldly reducing the complexity of conventional shade
systems, Essentia brings restorative dentistry to its essence and
opens up the way to maximal
creativity.

Four main combinations of
enamel and dentine colours suitable for the patient’s age (Young,
Junior, Adult and Senior) make
shade selection easier and are
sufficient to form the basis of any
restoration—at any age.
Four different compositions
were used to give specific prop-

dentine colours display an amazing shade adaptation to the cavity and can easily be modelled.
The Universal shade provides
the best chameleon effect for
mono-shade posterior restorations, and the Masking Liner,
with high opacity, is easy to place
owing to its injectable consis-

looking for a simplified, yet
highly aesthetic system.
Certainly, this straightforward approach offers many advantages: practitioners primarily benefit from a simplified
build-up process, allowing highly aesthetic restorations to be
created in significantly less time,

Once more, GC has conquered
new frontiers to develop an innovative solution for daily challenges that perfectly blends versatility, simplicity and aesthetics
in a smart solution—enabling
dentists to just follow their intuition. 7
GC NORDIC AB,
DENMARK
www.gceurope.com

Booth C3-014
AD

[24] =>

Aesthetics reduced
to its essentials

Essentia
from GC
Essentia represents a paradigm shift
in restorative dentistry with an innovative
shade concept: straightforward and bold.
With just seven syringes and three unique
compositions, optimized for their respective
use, you now have the solution for
all your aesthetic restorations.
Follow your intuition.

GC Nordic
Tlf.: 23 26 03 82
info@denmark.gceurope.com
www.gceurope.com
facebook.com/gcnordic

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[cover] => DT Nordic No. 1, 2016

[toc] => Array ( [0] => Array ( [title] => Many root fillings of poor quality [page] => 01 ) [1] => Array ( [title] => Nordic News [page] => 03 ) [2] => Array ( [title] => Interview: “Prognosis is more important than a single technique” [page] => 05 ) [3] => Array ( [title] => Business [page] => 06 ) [4] => Array ( [title] => Intra-oral and peri-oral electronic devices [page] => 08 ) [5] => Array ( [title] => Utilising smile design software and CAD/CAM for creating a mock-up and final restorations [page] => 11 ) [6] => Array ( [title] => Posterior restoration with a new nano-hybrid ORMOCER composite [page] => 13 ) [7] => Array ( [title] => today SCANDEFA Copenhagen 2016 [page] => 17 ) ) [toc_html] =>

Table of contents

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