Laser International No. 2, 2018

Cover / Editorial / Content / Minimally invasive dentistry with Er,Cr:YSGG / Peripheral giant cell granuloma surgery with diode laser / Erbium laser in ankyloglossia therapy / Successful communication in your daily practice Part VI: Economic crisis / Six Sigma in the management of laser-assisted dental practices / Technology, innovation and passion - Laser devices bring improvement to the daily practice / “The Future of Dentistry is Here” / WFLD’s Pearl Anniversary World Congress 2018 / Manufacturer News / International News / Editorial / News Germany / Imprint

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issn 2193-4665 • Vol. 10 • Issue 2/2018

laser

international magazine of laser dentistry

case report

Peripheral giant cell granuloma surgery

industry

Erbium laser in ankyloglossia therapy

events

WFLD’s Pearl Anniversary World Congress 2018

2/18

[2] =>

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editorial

Prof. Adam Stabholz
Former Dean of the Faculty of Dental Medicine,
Hebrew University Hadassah, Israel

From Maiman’s 1 laser to
the Laser World Congress 2018
st

Dear colleagues and friends,
One hundred years ago Albert Einstein envisioned that
under the right conditions a special kind of light could
be created—a light that nobody has ever seen before.
It would be a single colour, it would not scatter and it
would be intense.
Almost sixty years ago, in 1960, Theodore Maiman
presented the first laser device on earth. Maiman identified five potential uses for the laser, among them concentrating light for industry, chemistry and medicine. The
search for new devices and technologies for dental procedures has always been challenging and in the last four
decades much experience and knowledge have been
gained. Pioneering research in the mid-sixties paved the
way for the use of lasers in dental medicine and the development of pulsed technology with CO2 wavelengths
in the eighties made lasers popular in this medical area.
In 1990, the first laser designed specifically for general
dentistry, the dLase 300 Nd:YAG, was introduced and in
1997, following the FDA approval of the Er:YAG laser for
caries removal, cavity preparations and modification of
dentine and enamel, a new era in laser dentistry began.
With the rapid development of laser technology, new
lasers with a wide range of characteristics are now
available and are being used for soft-tissue procedures,
caries diagnosis and removal, curing composites, tooth
bleaching, paediatric dentistry, endodontics, periodontics, preventive and implant dentistry, control of bleeding
in vascular lesions and Low Level Laser Therapy.
The WFLD congress in Aachen from 1 to 3 October 2018 will mark the 30th anniversary of the WFLD/

ISLD and will provide a perfect stage for friends and colleagues to get together, to exchange knowledge based
on latest research, to learn about the newest developments in laser dentistry and how to implement this
knowledge in the various disciplines mentioned above.
It will be a perfect time as well for building new friendships and planning new collaborations for the future. Do
not miss this unique opportunity to be part of the largest scientific laser in dentistry meeting ever—organised
in the beautiful city of Aachen, Germany, known as the
cathedral city of Europe. It is located on the border to
Belgium and the Netherlands and is a city that lives and
breathes Europe. When not attending one of the lecture
halls, where the world’s most renowned speakers will
be presenting, or participating at one of the workshops
or learning at the posters session, a visit to the Aachen
Cathedral is a must. It is certainly both a local landmark
and a monument of Europe’s illustrious past.
The preparations for the world congress are in full
swing and a tremendous effort is made to ensure its
success. Our thanks and our deepest appreciation
go to the wonderful team headed by Prof. Dr Norbert
Gutknecht, Prof. Dr Lynn Powell, Leon Vanweersch, Dr
Dimitris Strakas, Dr Stefan Grümer, the DGL local organising team and to all members on the international
organising committees.
I look forward to meeting you all in Aachen at this outstanding high-level international scientific event jointly organised by WFLD, DGL and WALED. On 1 October 2018
all roads will lead to Aachen.
All the best and see you soon in Aachen,
Prof. Adam Stabholz

2 2018

[4] =>

| content
editorial
From Maiman’s 1st laser to the Laser World Congress 2018

03

Prof. Adam Stabholz

case report
Minimally invasive dentistry with Er,Cr:YSGG

06

Drs Christina Karanasiou & Dimitris Strakas
page 06

Peripheral giant cell granuloma surgery with diode laser

10

Drs Maziar Mir, Masoud Mojahedi, Jan Tunér & Masoud Shabani

industry
Erbium laser in ankyloglossia therapy

16

Dr Adam J. Wolniewicz

practice management
page 16

Successful communication in your daily practice

20

Dr Anna Maria Yiannikos

Six Sigma in the management of laser-assisted dental practices

22

Dr Imneet Madan

interview
Technology, innovation and passion

26

Timo Krause
page 30

events
“The Future of Dentistry is Here”

28

Dr Diana Constantinescu

WFLD’s Pearl Anniversary World Congress 2018

30

Dr Dimitris Strakas & Leon Vanweersch

news
Cover image courtesy of MEDENCY Srl
www.medency.com
Original Background:
© Thaiview/Shutterstock.com

manufacturer news

32

news international

33

DGL
DGL-Jahreskongress in Aachen am 2. und 3. Oktober 2018

2/18

issn 2193-4665 • Vol. 10 • Issue 2/2018

laser

international magazine of laser dentistry

36

Prof. Dr. Norbert Gutknecht

news germany

38

about the publisher
imprint
case report

Peripheral giant cell granuloma surgery

industry

Erbium laser in ankyloglossia therapy

events

WFLD’s Pearl Anniversary World Congress 2018

04

2 2018

42

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[6] =>

| case report

Minimally invasive dentistry
with Er,Cr:YSGG
Drs Christina Karanasiou & Dimitris Strakas, Greece

Introduction
The concept of minimally invasive dentistry can be defined as the maximal preservation of healthy dental structures, involving the minimal removal of carious lesions
for example. Modern dentistry and its minimally invasive
concepts are supported by the development of innovative materials and cutting-edge techniques.

jority of cases, and the resulting prepared cavity is free of a
smear layer. Moreover, noise and vibration caused by dental burs are contributing factors to the development of dental fear. The use of laser ablation for tooth preparation has
made it possible to avoid these discomforts, thus making
the procedure a life-changing experience for patients. With
lasers, the minimal removal of healthy tooth substance in
operative dentistry can be achieved.

Lasers have been widely used in many fields of dentistry
and several wavelengths have been investigated as substitutes for a high-speed handpiece. Conventional cavity
preparation refers to the removal of infected hard tissue
using rotary instruments. However, dental hard-tissue ablation for cavity preparation by means of irradiation with the
erbium family of lasers has attracted many researchers,
and we can affirmatively state today that the procedure is
safe and can be performed without anaesthesia in the ma-

The erbium family of lasers (located in the mid-infrared region of the electromagnetic spectrum) was introduced in dentistry for cavity preparation owing to the
wavelength’s high absorption in water and hydroxyapatite (hydroxyl radical). Enamel removal occurs by explosive thermomechanical ablation. Light is rapidly absorbed in water molecules leading to a micro-explosion
which consequently results in enamel, dentine and carious tissue removal due to strong subsurface pressure.

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Fig. 5

Fig. 6

Case 1 – Fig. 1: Initial situation: dental caries of the right maxillary lateral incisor. Figs. 2 & 3: Caries removal by Er,Cr:YSGG laser. Fig. 4: Area after laser
treatment. Fig. 5: Restorative procedure performed freehand with composite resin. Fig. 6: Final polishing with medium-fine and superfine oxide discs.

2 2018

[7] =>

case report

Pulp chamber temperature rise during cavity preparation with Er,Cr:YSGG laser irradiation has been reported
by several studies to be lower than with a conventional
method using a bur, suggesting that this system has no
adverse thermal effect.
The Er,Cr:YSGG laser (2,780 nm) has been studied in
dental hard tissue, especially for cavity preparation in clinical situations, and it has proven to be ideal for minimally invasive ablation of carious lesions without any side effects.

Case 1

this purpose (Figs. 2 & 3). For the procedure, the gold
handpiece of the device and a Z-type glass tip of 500 μm
in diameter (MZ5) were used. The laser parameters utilised for this case were as follows: average output power
of 6 W, pulse duration of 140 μs (H-Mode), pulse repetition rate of 20 Hz (300 mJ per pulse, 153 J/cm2 energy
density) and under water spray (air: 60 %, water: 80 %).
All margins received etch modification with the same laser device (Fig. 4). The power settings for bond preparation were as follows: MZ6 tip, average output power of
4.5 W, pulse repetition rate of 50 Hz and H-Mode.

A 25-year-old female patient came to the postgraduate dental clinic of the Department of Operative Dentistry
at the Aristotle University of Thessaloniki, Greece. The
patient’s major complaint was sensitivity and pain at her
right maxillary lateral incisor when exposed to cold water. After taking the medical and dental anamnesis, clinical and radiographic examination were performed. They
revealed dental caries affecting the right maxillary lateral
incisor (Fig. 1).

After drying the tooth with an air blower, the cavity was
treated with an adhesive system in accordance with the
manufacturer’s instructions (Single Bond Universal Adhesive, 3M ESPE). The restorative procedure was performed freehand with composite resin (Fig. 5). In order
to achieve the final two colour shades, A2 for dentine
and A1 for enamel (Clearfil Majesty ES-2 A2D and C
learfil
Majesty ES-2 A1E, Kuraray Noritake Dental) were used.
Final polishing was performed with medium-fine and
superfine oxide discs (Sof-Lex, 3M ESPE; Fig. 6).

Therefore, a fast and minimally invasive method for
caries removal was decided on. An Er,Cr:YSGG laser
(2,780 nm, Waterlase MD Turbo, Biolase) was used for

The laser treatment was performed with no local anaesthesia. The patient reported no sensitivity at any stage
of the procedure.
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case report

Peripheral giant cell granuloma surgery

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[8] =>

| case report

Fig. 7

Fig. 8
Case 2 – Fig. 7: Initial situation: enamel hypomineralisation spots on anterior teeth. Fig. 8: Laser treatment with the gold handpiece and a Z-type glass tip (MZ6).

Case 2
A 27-year-old female patient presented with the main
complaint of white spots on her anterior teeth. The patient
required a minimally invasive solution to improving her
smile. A thorough medical and dental history were taken
prior to the clinical examination (Fig. 7).

According to the patient’s clinical examination, the
white spots were non-carious and were associated with
enamel hypomineralisation. The aetiology of hypomineralised enamel can be genetic, acquired or idiopathic.
General factors include infections during the critical age
of two to three years—especially upper respiratory tract
infections that require treatment with antibiotics in combination with corticosteroids—and nutritional deficiencies
of vitamins A, C and D, calcium and phosphorus. Local
factors include dentoalveolar infections or trauma of primary predecessors, surgical operations, and infections
due to environmental factors, such as dioxins, which may
be present even in breast milk.
When enamel hypomineralisation is observed in the
anterior teeth, aesthetic problems arise, affecting not only
the psychological state but also the social behaviour of
the patient. Minimal intervention is an ideal approach in
managing such white spots. The patient’s expectations
are vital to the decision-making process.
For this case, an Er,Cr:YSGG laser (2,780 nm, Waterlase iPlus, Biolase) was used. For the procedure, the gold
handpiece of the device and a Z-type glass tip of 600 μm
in diameter (MZ6) were used. The laser parameters utilised for this case were as follows: average output power
of 3.25 W, pulse duration of 60 μs (H-Mode), pulse repetition rate of 20 Hz (163 mJ per pulse, 58 J/cm2 energy
density) and under water spray (air: 60 %, water: 70 %;
Fig. 8). All margins received etch modification with the
same laser device. The power settings for bond preparation were as follows: MZ6 tip, average output power of
4.5 W, pulse repetition rate of 50 Hz and H-Mode (Fig. 9).

Fig. 9

Fig. 10
Case 2 – Fig. 9: Bond preparation. Fig. 10: Cavity treated with adhesive system.

2 2018

After drying the tooth with an air blower, the cavity
was treated with an adhesive system in accordance
with the manufacturer’s instructions (Bond Force II,
Tokuyama Dental; Fig. 10). The restorative procedure
was performed freehand with composite resin. In order to

[9] =>

case report

Fig. 11

Fig. 12

Case 2 – Fig. 11: Final polishing with medium-fine and superfine oxide discs. Fig. 12: Final situation after rehydration of the teeth.

achieve the final two colour shades, A2 for dentine and
A2E for enamel (IPS Empress Direct, Ivoclar Vivadent)
were used. Final polishing was performed with medium-
fine and superfine oxide discs (Sof-Lex; Fig. 11).

viable in clinical practice, without damage to the pulp
or periodontal tissue, and with great acceptance by patients owing to decreased vibration and noise, reduction
of pain sensitivity and, in some cases, no need for the
application of local anaesthesia.

The laser treatment was performed with no local anaesthesia. The patient reported no sensitivity at any stage
of the procedure. The final result after rehydration of the
teeth can be seen in Figure 12.

Discussion

contact

As dental technology continues to develop, new, innovative methods will continue to replace those that were
once thought to be the peak. Lasers are now widely used
in minimally invasive treatment in routine clinical procedures. According to the literature, treatments performed
with Er,Cr:YSGG laser can be considered efficient and

Dr Dimitris Strakas
DDS, M.Sc., PhD
Aristotle University of Thessaloniki
Spiridi 28
38221 Volos, Greece
dstrakas@dent.auth.gr

Author details

Kurz & bündig
Moderne Zahnheilkunde und minimalinvasive Konzepte werden besonders durch die Verfügbarkeit innovativer Materialien und hochmoderner Technologien unterstützt. Laser werden heute häufig für minimalinvasive Behandlungen vorrangig bei medizinischen Routine
eingriffen wie bspw. im Fall von Kavitäten verwendet. Studien zufolge, gelten mit dem Er,Cr:YSGG-Laser durchgeführte Behandlungen
als effizient und erfolgreich in der klinischen Praxis ohne die Zahnpulpa oder das parodontale Gewebe zu beschädigen. Aufgrund der
gesenkten Vibration und Lärmbelastung sowie reduzierter Schmerzempfindlichkeit und in manchen Fällen sogar keiner Notwendigkeit
einer Lokalanästhesie, findet diese Behandlungsmethode bei Patienten hohe Akzeptanz.
Die Autoren stellen zwei Fallbeispiele und Behandlungsabläufe ihrer Arbeit für die Abteilung für Zahnchirurgie der Aristoteles Univer
sität in Thessaloniki, Griechenland, unter Verwendung des Er,Cr:YSGG-Lasers vor. Im ersten Fall wurde erfolgreich eine Kavität am rechten
oberen lateralen Schneidezahn behandelt, während im zweiten Fall durch Molaren-Inzisiven-Hypomineralisation verursachte ästhetische
Beeinträchtigungen in Form von weißen Arealen an den Inzisiven entfernt wurden. In beiden Fällen war keine Lokalanästhesie erforderlich,
beide Patienten berichteten über keinerlei Schmerzempfindlichkeit während der Behandlung. Die je Fall verwendete Laserausstattung
sowie die jeweiligen Einstellungsparameter werden detailliert wiedergegeben. Zudem sind auch die folgenden restaurativen Prozesse
dargestellt und bildlich dokumentiert. Dank des Einsatzes der Er,Cr:YSGG-Laser konnten für beide Patienten mit nur minimalinvasiven
Eingriffen die Beschwerden eliminiert und zufriedenstellende Ergebnisse erzielt werden.

2 2018

[10] =>

| case report

Peripheral giant cell granuloma
surgery with diode laser
Dr Maziar Mir, Germany; Dr Masoud Mojahedi, Germany; Dr Jan Tunér, Sweden & Dr Masoud Shabani, Iran

Laser surgery has many benefits, such as
Literature
maintenance of a sterile condition, reduction of
bleeding, good possible estimation of cutting
depth, precision of cutting, often no need for
suturing or bandages, pain reduction, minimally
invasive procedure that reduces patient stress,
promotion of wound healing and less scaring.
Many cases have been reported in the literature regarding the removal of oral exophytic lesions and pain control for aphthous ulcers by laser. In the following, we will
present a case of treatment of a peripheral giant cell
granuloma (PGCG) and multiple aphthous ulcers in one
patient.

many aphthous ulcers is unknown, but possible aetiological factors include stress, lack
of sleep, citrus fruits, trauma, immune system
reactions, and deficiency of vitamin B12, iron
or folic acid. They also occur in relation with
some systemic diseases, such as HIV, Beh
çet’s syndrome, Crohn’s disease and other
autoimmune diseases.16–18

Introduction

A 45-year-old male patient with complaints of a mass
with a duration of ten months and ulcers at the tongue
that had been there for one day was referred for treatment. The mass was not painful, but bled during eating or
sometimes even spontaneously. The ulcers were painful.

A PGCG originates from the periodontal ligament or
the periosteum.1 The lesion is more common in the lower
jaw than in the upper jaw and is also more common in
females than in males.2–4 Any region of the jaw can be
affected by this kind of lesion,4, 5 and mobility and displacement of the adjacent teeth can occur.6 Generally, the
lesion size varies from about 0.1 cm to 3 cm.5, 7
The aetiology is unknown, but local irritating factors,
such as an ill-fitting prosthesis, poor restorations, dental plaque, calculus, chronic infection and lack of nutrients, may have a role in the aetiology. The lesion may
be seen in cases of hyperparathyroidism and after periodontal surgery.8–11 The presence of S-100-positive cells,
which are evidence of Langerhans cells or their precursors, and the presence of fibroblasts, endothelial cells
and myofibroblasts points towards a reactive nature of
the PGCG.12–14
Excision by scalpel, electrocautery or laser, and the
elimination of any local irritating factors must be considered in the treatment of such lesions. The recurrence rate
for lesions ranges from 5 to 11 %.5, 15
A recurrent aphthous ulcer (aphthous stomatitis) is a
common lesion in the mouth and affects ten per cent
of the population. The lesions, based on their morphology, can be classified as minor (3–10 mm in size),
major (> 10 mm) and herpetiform. The exact cause of

10

2 2018

Nowadays, diode lasers are efficiently used for treatment of oral soft-tissue lesions.19, 20

Case presentation

Medical history
The patient’s medical history showed no systemic
medical problems, no allergic reaction, no medications
or recreational drugs and no history of past surgical procedures; thus, the patient did not have to be referred for
medical consultation.
Clinical and radiographic findings
Oral and maxillofacial examination of the patient revealed no temporomandibular joint dysfunction or myofascial disturbances, but poor oral hygiene and an old
denture lacking stability and retention.
An exophytic lesion was diagnosed at the ridge of the
lower jaw. The lesion was partially firm and red to pink and
bled during examination; no pain occurred on probing and
the lesion was completely movable. The radiographic examination showed some retained roots in the lower jaw
and there was no destructive effect such as bone resorption. There were multiple ulcers at the right side of the
tongue. The ulcers were painful and the patient had not
been using any medication for pain relief (Figs. 1 & 2).
The case was provisionally diagnosed as denture
epulis and multiple aphthous ulcers, and we decided to

[11] =>

case report

Fig. 1

Fig. 2

Fig. 3

Fig. 1: Initial radiographic image. Fig. 2: Before treatment: PGCG and aphthous ulcers. Fig. 3: Histological report.

perform a laser-based excisional biopsy of the exophytic
lesion and ulcer photocoagulation by diode laser.
Treatment delivery sequence
After completion of the patient consent form, the surgical area was anaesthetised by infiltration with 2 % lidocaine with 1 : 100,000 adrenaline (1.8 ml) and then a
retraction suture was placed within the lesion. The aphthous ulcer irradiation did not require local anaesthesia
for the photocoagulation process.
The pre-operative procedures were as follows:
–– defining of the controlled area and proper placing of
the laser warning signs to secure the operating room,
–– checking the safety of the patient’s glasses and eye
protection of the patient’s guardian and the assistant,

–– review of the patient’s information (examination sheet,
radiograph, consent form, etc.), and
–– proper calibration of the laser system: fibre cleaving,
beam aiming and initiation of the fibre with articulating paper and test-firing of the laser for the excisional
biopsy, but a non-initiated fibre for the ulcer photo
coagulation.
The excisional biopsy of the lesion was started with
initiated fibre and the incision was performed with the
tissue under tension and with tip-to-tissue contact so
that the lesion was separated in the proper way. At
the beginning of the surgery, we used a 980 nm diode laser, 400 µ fibre, 2 W output power, continuous
wave (CW) and contact mode for an irradiation time of
320 seconds.

2 2018

[12] =>

| case report
After removal of the exophytic lesion in order to perform
the photocoagulation process for the aphthous ulcers,
we changed the laser setting to 400 µ fibre, non-initiated,
0.6 W, CW, non-contact mode and an irradiation time of
30 seconds per ulcer at 18 J and worked in a circular way
from a distance of 6 mm to the ulcer in defocused mode,
advancing towards the lesion (2–3 mm away), covering the
entire surface of the ulcer area.
After the ulcer irradiation, a pain/feeling test was done
by rubbing the lesion with the finger. For one of the lesions,
we needed to increase the output power to 0.7 W (21 J)
for the second irradiation and then to 0.8 W output power
(24 J) for the third irradiation to achieve full pain control.

Fig. 4

During the treatment, high-volume suction was used to
evacuate the vapour plume and objectionable odours at
the site of operation. The laser-tissue interaction was respected in order to prevent any unsuitable reaction and
consequent damage to the surrounding tissue through the
progression of the tissue vaporisation at the base of the
lesion and the patient’s reflexes. A moistened gauze was
used for prevention of unwanted thermal damage to the
adjacent tissue for the removal of the exophytic lesion.
Removal of carbonised tissue was done using a micro-
applicator brush soaked in a 3 % hydrogen peroxide solution. The biopsy was sent in for laboratory examination
(Fig. 3).

Fig. 5

Post-procedural education
The patient was advised on keeping the area clean,
avoiding food and liquids that might cause pain or irritation to the sensitive tissue, and taking over-the-counter
analgesics as needed. The laser setting was registered
in the patient’s file for both stages of gross lesion removal
and aphthous ulcer photocoagulation.
Final result and follow-up
Excellent laser excisional biopsy was observed with no
bleeding, no char and no pain from the aphthous ulcers.
The patient did not experience any discomfort and was
satisfied (Fig. 4).
The first visit after laser excisional biopsy was one day
after the procedure. Healing was as expected, with the
healing progressing well and no swelling or pain from the
surgery or the aphthous lesion areas (Fig. 5). After one
week, the patient revisited and no problem in the healing process was evident (Fig. 6). Finally, after the onemonth follow-up, a successful treatment outcome was
observed (Figs. 7 & 8).

Fig. 6
Fig. 4: Immediately after PGCG surgery and aphthous ulcer photocoag
ulation. Fig. 5: One day after treatment: healing was proceeding well.
Fig. 6: One week after PGCG surgery and aphthous ulcer photocoagulation.

2 2018

Discussion
In comparison with conventional excisional biopsy procedures (scalpel and suturing), laser-assisted excisional

[13] =>

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[14] =>

| case report

Fig. 7

Fig. 8

Fig. 7: Situation one month after PGCG surgery and aphthous ulcer photocoagulation. Fig. 8: Final situation two months after treatment.

biopsy can be performed very quickly, with no bleeding,
less or no pain, less or no oedema, and little or no need
for analgesics.
Because of the size of the lesion in this case, the procedure is traditionally classified as an advanced laser procedure. Full removal of the lesion is very difficult and a recurrent lesion may occur owing to insufficient extension
of the surgical area. In laser surgery, a larger extension
into the surrounding tissue leads to an efficient removal
of the lesion.
Aphthous ulcer photocoagulation was done successfully and pain reduction occurred very rapidly; thus, the
patient did not need to use any medication for aphthous
ulcer pain control.

Conclusion
The 980 nm diode laser is a powerful tool for the
removal of a PGCG as well as for the pain relief for
aphthous ulcers.

contact
Dr Masoud Shabani
Department of Community Dentistry
School of Dentistry
Ardabil University of Medical Sciences
Ardabil, Iran
m.shabani@arums.ac.ir

Author details

Kurz & bündig
Die Nutzung von Lasern zur Entfernung von oralen exophytischen Läsionen und zur Schmerzkontrolle bei aphthöser Stomatitis wurde
bereits in vielen Fällen dokumentiert. Die Laserchirurgie bietet zahlreiche Vorteile, wie die Wahrung steriler Bedingungen, Blutungsreduk
tion, eine sehr gute Einschätzung der Schnitttiefe, präzises Schneiden, meist keine Notwendigkeit von Nähten oder Verbänden, Schmerz
reduzierung, weniger Stress für den Patienten dank minimalinvasiver Prozesse, Förderung der Wundheilung und verringerte Narben
bildung. Heute werden Diodenlaser erfolgreich für die Behandlung von Weichgewebsläsionen eingesetzt.
In dem hier dargestellten Patientenfall behandelten die Autoren ein bereits seit zehn Monaten vorhandenes peripheres Riesenzellgra
nulom (PGCG) sowie multiple aphthöse Ulzerationen, welche etwa einen Tag vor Vorstelligwerden des 45-jährigen Patienten an der Zunge
aufgetreten waren. Während sich das PGCG als nicht schmerzempfindlich erwies, jedoch spontan bei Berührung oder beim Essen blutete,
verursachten die Ulzerationen Schmerzen, welche bisher jedoch nicht medikamentös behandelt wurden. Als Ursache für die Beschwerden
wurden unzureichende Mundhygiene sowie ein schlecht sitzendes Gebiss diagnostiziert.
Für die Behandlung beider Weichgewebserkrankungen erwies sich der 980 nm-Diodenlaser als erfolgreiches Werkzeug. Das PGCG
wurde durch eine großflächige, laserbasierte Exzisionsbiopsie entfernt. Aufgrund der Größe der exophytischen Läsion handelte es sich bei
diesem Eingriff bereits um eine fortgeschrittene Laserbehandlung. Für die aphthösen Ulzerationen konnte mittels Photokoagulation eine
rapide Schmerzlinderung erzielt werden.

2 2018

[15] =>

th
h

1 – 3 OCTOBER 2018
RWTH AACHEN UNIVERSITY
AACHEN, GERMANY

The 16th Congress of the
World Federation for Laser
Dentistry (WFLD)

The 27th Annual Meeting of
the German Society for Laser
Dentistry (DGL)

The 6th Annual Congress
of the World Academy for
Laser Education
in Dentistry (WALED)

This congress will integrate science and practical experience on
different levels of presentation and demonstrations, like:

CONTACT
Headquarters WFLD 2018 Aachen
Mr. Leon Vanweersch
Vice-Organizing Chairman
Phone: +49 151 50610781
headquarters@wfld-aachen2018.com
www.wfld-aachen2018.com

High ranked international keynote speaker lectures
On stage live patient demonstrations
Interactive digital poster presentations
Oral presentations combined with clinical relevant skill training
Short presentations of latest research findings
Clinical case presentations
Rotating company supporting workshops, gaining continuous
education certificates.

[16] =>

| industry

Erbium laser in
ankyloglossia therapy
Dr Adam J. Wolniewicz, Poland

Ankyloglossia is one of the reasons for problems in
breastfeeding, and it causes malocclusion and speech
disorders. Ankyloglossia is a congenital abnormality of
the oral cavity caused by a lingual fraenum that is too
short and thus limits the tongue’s movement. It is not
always recognised by doctors and speech therapists,
causing controversy in both professions. However, if
properly diagnosed in childhood and then subjected to
fraenotomy, the abovementioned problems can be resolved or further treatment enabled. One of the ways of
performing fraenotomy is using an erbium laser.

Literature

Lingual fraena are composed of loose connective tissue
with numerous elastic fibres surrounded by mucosa. In
the fetus, they are responsible for the proper direction of

The lingual fraenum joins the inferior part of the tongue
with the floor of the mouth and is visible when the tongue
is raised towards the palate. If the lingual fraenum is
structured properly and elastic, it does not affect the
tongue’s effectiveness during suckling, moving food,
swallowing, speaking and breathing. If it is short, tight
and wide, tongue mobility may be affected, especially
when the lingual fraenum spreads from the apex of the
tongue to the marginal gingiva of the mandibular incisors lingually.

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Anatomy

Case 1 – Figs. 1–3: Situation before fraenotomy. Fig. 4: Laser parameters.

growth of many structures in the oral
cavity. After birth, their importance
decreases, but if they are improperly
shaped, attached or too short, they
may affect further orthopaedic, maxillary and functional development.

2 2018

[17] =>

industry

Fig. 5

Fig. 6

Fig. 7

Fig. 8

Fig. 9

Fig. 10

Fig. 11

Case 1 – Figs. 5 & 6: Condition on the day of fraenotomy. Figs. 7 & 8: Condition six days after fraenotomy. Figs. 9–11: Condition three weeks after the procedure.

Occurrence rate of ankyloglossia
In the world literature, the frequency of ankyloglossia occurrence is estimated at 3–4 %; yet, English and American
sources report about 10 up to 16 %. However, it is generally said that speech disorders caused by the abnormal
structure of the lingual fraenum occur much more often.

Diagnosis
Despite the fact that this condition seems to be well understood, there are difficulties in diagnosing a short lingual
fraenum because different criteria and methods are used.
Some speech therapists and doctors use a very simple
assessment method via examination of the degree to
which the tongue can be moved forward and into a heart
shape.1 Other specialists, including Ostapiuk, differentiate
the mobility of the tongue according to five movements.2

Some assume that there is the possibility of extending the
lingual fraenum, whereas Pluta-Wojciechowska says that
there is no research proving the effectiveness of extending the lingual fraenum through massage and exercise.3
In her research, Ostapiuk clearly shows that, in the case
of ankyloglossia, effectiveness of speech therapy cannot
be achieved without surgical intervention.2
In a wide study, Fernando proved that untreated ankyloglossia has many consequences for infants, children and adults, ranging from problems with suckling
to interpersonal problems caused by speech disorders.4
A short lingual fraenum limits tongue mobility and prevents its proper peristaltic movements during suckling.
Naturally, it is not the only cause of feeding problems and
proper diagnosis is required. However, in the case of a
lack of proper body weight gain in an infant, fraenotomy
should be taken into consideration.

2 2018

[18] =>

Fig. 12

Fig. 13

Fig. 15

Fig. 16

Fig. 14

Fig. 17

Fig. 18

Case 2 – Figs. 12 & 13: Patient condition before fraenotomy. Fig. 14: Condition on the day of fraenotomy. Figs. 15 & 16: Condition six days after fraenotomy.
Figs. 17 & 18: Condition four weeks after fraenotomy.

Among children, ankyloglossia leads to improper
growth of the maxilla and mandible, which results in
malocclusion. A lingual fraenum that is too short or improperly formed keeps the tongue at the floor of the
mouth, preventing the natural process of maxillary widening. A maxilla that is too narrow, in turn, limits the
efficient development and protrusion of the mandible,
which is the most common cause of Angle Class II malocclusion.
Recognition of the problem before the baby growth
spurts, which is before ten months of age, and performing of fraenotomy together with orthodontic treatment and
speech therapy constitutes the efficient method of preventing the defect affecting the dentition and phonetics.

Fraenotomy
A solution, as well as a method of prevention, can be
fraenotomy, entailing the cutting and releasing of the lingual fraenum, in contrast to fraenectomy, which is the
surgical removal of the fraenum. Fraenotomy can be performed with scissors, a scalpel, cautery or a laser. Depending on the age and condition of the patient, the procedure can be performed under general, local, topical or
no anaesthesia at all.
Among infants, fraenotomy is performed mainly by
paediatric surgeons and is applied owing to lactation
problems, especially in the first days of life, in the hospital. Among older children, however, this procedure is
performed mainly at the request of speech therapists
and orthodontists. Among adults, it is conducted to correct a prosthetic base or to prevent periodontitis.

2 2018

Laser application in soft-tissue surgery
As mentioned, one of the tools used to perform the
cutting of the lingual fraenum is a laser. In soft-tissue surgery, many types of lasers are applied: diode, Nd:YAG,
carbon dioxide, Er,Cr:YSGG and Er:YAG lasers. They
emit various wavelengths and, depending on the work
parameters chosen, they can affect tissue in different
ways. Particularly useful lasers for soft-tissue preparation seem to be the so-called hard lasers, such as carbon dioxide and Er:YAG, because their main feature is a
short penetration depth. This means that the energy they
emit is absorbed only by the surface and does not cause
thermal damage to the deeper-lying tissue.

Case presentation
In my daily practice, I use the LightWalker ATS laser
(Fotona). It combines two radiation sources in one appliance: Er:YAG with a 2,940 nm wavelength and Nd:YAG
with a 1,064 nm wavelength. Owing to this configuration,
this device allows one to perform many advanced procedures and work on both the hard and soft tissue.
In fraenotomy procedures, the following parameters are
used for the Er:YAG laser: VLP 120 mJ, 20 Hz (output power
2.40 W), water: 0, air: 2. The contra-angle handpiece used
most often is the H02. Sometimes, in the case of intensive
bleeding, the Nd:YAG laser is also used in order to stop
bleeding. Then, the parameters are: VLP, 4 W and 20 Hz.
Case 1
A 34-year-old male was referred by the orthodontist for
fraenotomy as a part of the orthodontic treatment plan

[19] =>

Fig. 19

Fig. 20

Fig. 22

Fig. 21

Fig. 23

Case 3 – Figs. 19 & 20: Patient condition before the procedure. Fig. 21: Condition on the day of the procedure. Figs. 22 & 23: Condition 11 days after
fraenotomy.

(Figs. 1–3). Fraenotomy was performed under local infiltration anaesthesia with 4 % Ubistesin forte (3M ESPE)
using the Er:YAG laser (Figs. 4–11).
Case 2
A 10-year-old male patient undergoing speech therapy was referred by the orthodontist for fraenotomy
(Figs. 12 & 13). The procedure was performed under local infiltration anaesthesia with 4 % Ubistesin forte using
the Er:YAG laser. Clot formation was performed with the
Nd:YAG laser (Figs. 14–18).
Case 3
An 11-year-old female patient undergoing speech
therapy was referred by the orthodontist for fraenotomy
(Figs. 19 & 20). Fraenotomy was performed under local
infiltration anaesthesia with 4 % Ubistesin forte using the
Er:YAG laser (Figs. 21–23).

Conclusion
Ankyloglossia certainly has a great impact, ranging
from infancy to adulthood. Fraenotomy performed with
an Er:YAG laser, in particular, is a simple and uncomplicated procedure that allows the avoidance of many
unnecessary consequences resulting from the abnormal
structure of the lingual fraenum.

contact
Dr Adam J. Wolniewicz
Diplomate PSI/ICOI
Member of PTSL, PASE, PSI/ICOI
Orłowska Dental Clinic
Orłowska 61, 81-001 Gdynia, Poland
www.wolniewicz.eu

Author details

Kurz & bündig
Die Auswirkungen einer Ankyloglossie reichen von der Kindheit bis ins Erwachsenenalter. Ankyloglossie gilt als eine der Ursachen für
Probleme beim Stillen und kann Sprachstörungen und Malokklusion bei Säuglingen und Kindern auslösen. Es handelt sich dabei um eine
genetische Fehlbildung der Mundhöhle, welche durch ein verkürztes Zungenbändchen bedingt wird. Das fehlgebildete Frenulum linguale
limitiert aufgrund seiner eingeschränkten Länge die Bewegungsoptionen der Zunge. Die unterschiedlichen angewandten Untersuchungs
kriterien und -methoden resultieren für Sprachtherapeuten und Ärzte häufig in Diagnoseschwierigkeiten. Wird Ankyloglossie jedoch frühzei
tig in der Kindheit erkannt und mit einer Frenotomie behandelt, können die oben genannten Probleme verhindert werden. Mit einer folgenden
kieferorthopädischen Behandlung und Sprachtherapie werden spätere Gebiss- und Phonetikdeffekte weiterführend abgewendet. Eine mit
einem Er:YAG-Laser vorgenommene Frenotomie stellt eine besonders einfache und unkomplizierte Behandlungsmethode dar, welche viele
unnötige Beeinträchtigungen resultierend aus der anormalen Struktur des Zungenbändchens verhindern kann. Der Autor stellt drei Fall
beispiele mit detaillierter Fotodokumentation aus seiner eigenen Praxis vor, bei welchen er den LightWalker ATS Laser (Fotona) verwendete.

2 2018

[20] =>

| practice management

Successful communication
in your daily practice
Part VI: Economic crisis
Dr Anna Maria Yiannikos, Germany & Cyprus

Hi! I am Dr Anna Maria Yiannikos and I am very happy
to share the 6th part of this new loved series filled with
communication protocols with you. This series includes
the most popular and challenging scenarios that might
occur in your dental practice and presents successful
ways of how to deal with them—so your patients will always leave your practice feeling satisfied and thinking:
“My dentist is THE BEST!”
Each article of this series will teach you a new, easy
to use specialised protocol, which can easily be customised and adapted to your own dental clinic’s requirements and needs right from day one.
Let’s start with today’s challenging topic which is …
how to deal with economic crisis. If we have a look on
how patients and their habits change during a depressed
economic period, you will notice that your patients will:
–– reduce their spending,
–– set stricter priorities, and
–– feel anxiety and anger regarding the near future.
But, they will still spend their money … Your goal thus
is, to encourage them to have their treatments done,
to offer them different services, to promote your
services with a unique attitude and last but not
least to maintain or even increase
your income.

5 effective ideas
Yes, you can still increase your income. Are you wondering how? Discover five effective ideas on how to do
so immediately.

2 2018

1. Make the appropriate changes without having
a panic attack
If these changes include reducing
the prices of your treatments,
which one will you choose?
Will you reduce
the price of

[21] =>

practice management

fillings or crowns? Make the right choice based on price
elasticity rules. The right answer is, to decrease the
price of crowns, otherwise your revenues will reduce
enormously. Do not reduce the salaries of your talented
employees, but let the unproductive ones or the one
who you feel is an obstacle for you and your clinic go.
2. Introduce special services
Increase the value of your treatment by introducing
special package services, for example, offer laser cavity preparation with no extra charge or combine dental
cleaning with fluoridation without any additional cost for
the fluoridation.
3. Extend credit periods
Offer layaway plans or extend the credit periods and
ask your suppliers for the same for yourself. However, remember to negotiate profitably!
4. Challenge penny-wise behaviour
If you realise, for example, that the patient could afford to have the crown done, but chooses to postpone
it due to fear of the future, explain in detail what the consequences and the costs of postponing the treatment
will be. Highlight the fact that the tooth might break
and the cost would be tripled when treating it then instead of now.
5. Continue educating your patients
Share your knowledge with your patients through your
YouTube videos or by giving VIP seminars. What is your
ultimate goal? It is, to emphasise the quality and the differentiation of your services, and to clearly show that you
are THE expert and that the treatments you offer your
patients are so special and valuable that they need to
have them, now!

Are you ready?
This is very useful insight, don’t you think? I am sure
that you are looking forward to the next issue of laser
magazine, where I will present the 7th part of this unique
new series of communication concepts to you, teaching you how to offer VIP services for your distinguished
patients. You want these patients to choose you, so, I
will share 5 revolutionary tips with you that will guarantee
you this delicious outcome.
Until then, remember that you are not only the dentist of your clinic, but also the manager and the leader.
For further questions and requests for more information and guidance, keep in touch by sending me an
e-mail to dba@yiannikosdental.com or via our website
www.dbamastership.com. I am looking forward to our next
trip of business growth and educational development!

Author details

contact
Dr Anna Maria Yiannikos
Adjunct Faculty Member of AALZ
at RWTH Aachen
University C
ampus, Germany
DDS, LSO, MSc, MBA
dba@yiannikosdental.com
www.dbamastership.com

Kurz & bündig
Im sechsten Teil ihrer Serie „Erfolgreiche Kommunikation im Praxisalltag“ widmet sich Dr. Anna Maria Yiannikos fünf effektiven Ideen,
um Praxiserträge in Zeiten finanzieller Krisen konstant zu halten oder sogar zu steigern. Wichtig ist es dabei, zunächst nicht in Panik zu
verfallen, sondern kosteneffektiv zu denken. Das heißt, nicht etwa den Lohn der besten Mitarbeiter zu senken, sondern stattdessen die
Kosten für beispielsweise Kronen den Regeln der Preiselastizität entsprechend zu reduzieren.
Idee zwei betont die Möglichkeit, besondere Zusatzleistungen, wie z. B. eine laserbasierte Kavitätenvorbereitung, kostenfrei in eine
bestimmte Behandlung zu integrieren, um diese attraktiver zu gestalten. Zusätzlich können Sie Patienten mit verlängerten Zahlungs
perioden entgegenkommen. Es ist jedoch wichtig, dabei die eigenen Zahlungsverpflichtungen nicht außer Acht zu lassen und weiterhin
gewinnbringend zu agieren.
Idee vier und fünf konzentrieren sich vor allem auf die Patientenbildung und eine öffentlichkeitswirksame Kommunikation. Das be
deutet zum einen, Patienten zu Behandlungen zum gegenwärtigen Zeitpunkt zu ermutigen und zu verdeutlichen, welche Extrakosten
entstehen würden, sollten diese weiter verschoben werden. Zum anderen ist es stets wichtig, die Qualität des eigenen Angebots zu
kommunizieren und sich von Mitbewerbern zu differenzieren, sodass die Patienten erkennen, Sie sind der Experte und Ihre Leistungen
sind jeden Cent wert.

2 2018

[22] =>

| practice management

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22

2 2018

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[23] =>

practice management

Six Sigma in the management of
laser-assisted dental practices
Dr Imneet Madan, UAE

Every organisation has to have a source of income in
order to stay in business. Thus, dentistry is facing the
same challenge as businesses in the manufacturing industry are. This challenge is being profitable at what the
company is doing. Without a proper focus on the financial aspects, which are, indeed, the key performance indicator, the management of the organisation will drift to
trivial, unproductive issues.

The Six Sigma principles
Commitment
Persistence and diligence are the two underlying keys
for the success of any business idea. Knowledge gained
must be shared among those that are involved in the
application. This is the reason the Six Sigma philosophy
says that there is no “I” in the “team”. It is always about
“we” moving ahead together.
When the master black belt executes the project, the
rest of the team needs to be incorporated in order to
understand and pursue the same principles and objectives. Six Sigma brings in a breakthrough change that
then needs to be incorporated as a lasting strategy in order to gain long-term results. At least two years of commitment are documented to be essential in order to see
the development of work. The most common cause of
organisations failing at Six Sigma application is a lack of
commitment to true process improvement.
The entire team that is on board for Six Sigma must
be trained to carry out the implementation of the tools
learnt, the process charters and the improvement strategies—even after the project is over. Commitment to Six
Sigma needs to be long term in order to see the continual improvement.
Unique selling proposition (USP)
The USP of Six Sigma is: “Do the right thing first the very
first time.” Anything else is considered to be a waste and a
non-value-added service that does not improve the financial inputs of the organisation. According to lean principles,
any form of waste, or “muda” (Japanese for “futility”) should
be eliminated from the service or manufacturing company
in order to generate revenue from the existing resources.

In dental practice, muda may include the following:
–– retreatment of cases with no extra payment;
–– improper use of material and dental supplies;
–– front desk staff not scheduling recalls or poor appointment scheduling systems;
–– improper use of existing data from patients;
–– lack of team spirit, which lowers interteam referrals;
–– referring patients outside the practice brings the market
value of the clinic down, especially if it is a multi-specialty practice; and
–– inadequate use of the marketing team.
Muda in all of these situations can be extensive, as a
great deal is spent on building up the patient base of the
practice. Reverting the order of this and then taking steps
to rebuild is a classic example of muda in dental practice.
Muda should be avoided at all times in order to improve
the financial inputs of the company.
Philosophy
The key philosophy of Six Sigma is that each company
whether it is manufacturing cars or healthy teeth, can
be considered a process. A process has two components: input and output. If inputs are controlled, outputs
are controlled automatically. This is generally expressed
as the y = f(x) concept. According to Six Sigma, any process can be defined, measured, analysed, improved and
controlled (DMAIC).
Set of tools
Six Sigma works with multiple sets of tools. A few of
them applicable to dental practice are control charts, failure mode and effect analysis, and process mapping.
Methodology
DMAIC defines the steps that the Six Sigma practitioner has to follow in the organisation. It starts with identifying the problem and ends with implementation of
long-lasting solutions.
Metrics
Six Sigma quality performances mean 3.4 defects per
million opportunities, accounting for a 1.5 sigma shift
in the mean. The idea is to reduce the variation in the
process.

2 2018

[24] =>

| practice management
Implementation of the Six Sigma principles
in laser-assisted dental practices
The DMAIC model of Six Sigma needs time and resources for implementation. Parallel support from all the
units in the organisation is essential for the accomplishment of the Six Sigma project, in terms of having the information technology group supply the data and the financial unit give data in the form of cost of quality analysis.
The DMAIC model can be applied to the dental clinic
as follows:
Define
There can be no solution if the problem is not known.
The most pivotal part of Six Sigma is defining the problem in a specific manner. It involves the proper study of the
whys and hows of the problem. In a dental practice, one
of the key concerns can be the flow of patients. There is a
certain amount of focus on establishing an inflow of new
patients, but there can be a substantial amount of market
that can be created with the existing data. When it comes
to controlling the outflow of cash from the office, inventory
control can also be looked into. Specific concerns can
only be addressed if the problem has been well defined.
Measure
As Robin Sharma, the author of the multiple award-winning book The Monk who Sold his Ferrari, stated, “What

gets measured gets improved”. In order to measure the
defined problem, the practice needs to look into specific
and relevant data. Six Sigma focuses on collecting the
required data with check sheets, Pareto charts, histograms, scatter diagrams and many other tools. The collected data can be helpful in establishing the amount of
variation. In the measure phase, a current baseline is set
up for the purpose of later reference.
Analyse
Analysis of the data, either with experimental measures
or with audits, helps to rule out the root of the existing
problem. Once a definitive, measurable figure can be
given to the problem, it becomes easy to work towards
the solution.
Improve
The improve phase of the problem requires the conduction of failure mode and effect analysis (FMEA). FMEA
is the road map to figuring out all the possible modes
of failure and then working backwards in order to avoid
them or find solutions in case they still occur.
FMEA is a very helpful tool, as it allows a 360° evaluation of the possible failures in the project. Once the problems that could potentially occur become evident, the
idea is to have the exit strategy or solutions already in advance. These backward steps from the possible failures
prepare the team to execute the project better.

2 2018

[25] =>

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practice management

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sustainable, the organisation must follow the DMAIC
model and celebrate the success at the end. Once one
phase has been completed, it is good to start all
over again for continual improvement, and
this is then conducted with a plan-dostudy-act cycle.

Conclusion
Any organisation that has an improvement-based corporate culture will imbibe
the DMAIC philosophy of Six Sigma and
will be consistently able to improve and eliminate problems. If, however, on the other hand, an
organisation becomes trapped in the pitfalls of difficult situations or mired in bureaucracy, it could lose its
edge and reduce its overall effectiveness and motivation to improve.

Control
Once the Six Sigma steps have been brought forward and executed, it is absolutely important that the
entire team participates and keeps the measures taken
in place. Many organisations execute Six Sigma, but the
problems return, as the system itself does not generate Six Sigma unless the people who operate the system have completely adopted it. There must always be
a dynamic control plan, including a mistake proofing
approach, process behaviour charts and updating of
lessons learnt.

Six Sigma road map
The Six Sigma journey is a breakthrough and not a
continual improvement. In order to make the system

contact
Dr Imneet Madan
Laser Pediatric Dentist
NLP Coach
Six Sigma Green Belt
MDS (Pediatric Dentistry)
MSc (Laser Dentistry, AALZ, RWTH Aachen University)
Children’s Dental Center, Dubai
Author details
Villa 1020 Al Wasl Road
Umm Suqeim 1, Dubai
United Arab Emirates
Tel.: +971 506823462
imneet.madan@yahoo.com
www.drmichaels.com

Kurz & bündig
Six Sigma als Managementsystem dient der kontinuierlichen Prozessverbesserung und Qualitätssteigerung. Die Philosophie des Six
Sigma sieht jedes Unternehmen, ob Industrie oder Dienstleister, als Prozess, welcher definiert, gemessen, analysiert, verbessert und
kontrolliert (defined, measured, analysed, improved, controlled = DMAIC) werden kann. Jedes erfolgsorientierte Unternehmen kann von
dieser DMAIC-Methode profitieren. Die Autorin stellt die sechs wichtigsten Prinzipien des Six Sigma dar und erläutert im Folgenden, wie
diese sowie die DMAIC-Methode in der zahnärztlichen Praxis Anwendung finden können. Ein bleibendes Engagement ist entscheidend,
mindestens zwei Jahre sollten für die erfolgreiche Implementierung angedacht sein und die Strategie dauerhaft inkorporiert werden, um
langfristige Ergebnisse zu erzielen. Dinge von Beginn an richtig zu machen, gilt als USP des Six Sigma; so sollen keine Ressourcen für
sogenanntes muda (japanisch für „sinnlose Tätigkeit“) verschwendet werden.
Ziele der Prozessoptimierungen sind eine kontinuierliche Verbesserung und Eliminierung von Problemen. Dabei ist es besonders wichtig, dass alle Teammitglieder über den gleichen Wissensstand verfügen und gemeinsam in die gewünschte Richtung arbeiten. Austausch
und gegenseitige Unterstützung zwischen allen Unternehmenseinheiten sind dabei unerlässlich. Um die Qualität langfristig zu steigern,
müssen Erfolge zwar gefeiert, optimierte Prozesse jedoch auch stets erneut der DMAIC-Methode unterzogen werden.

2 2018

[26] =>

| interview

Technology, innovation and passion
Laser devices bring improvement to the daily practice
Timo Krause, Germany

MEDENCY is a dynamic and innovative dental equipment and technology company privately owned and
based in Vicenza, Italy. Since its founding, CEO Alessandro Boschi has driven the company forward through his
unique passion and profound experiences in the field of
laser dentistry. Prior to MEDENCY, Boschi had taken up

26

2 2018

many important leadership roles in various dental businesses over the past 15 years, forming an in-depth understanding of business as a dedicated team effort.
Hence, MEDENCY presents an utterly talented team with
global expertise in the field of dentistry and, in particular,
dental lasers. The overall objective and ultimate mission

[27] =>

interview

is to provide a combination of cutting-edge products and
services like tailor-made educational courses as well as
a high-level of customer exchange, while drawing on a
wide network of academic partners. laser had the opportunity to speak with Alessandro Boschi about his ideas
and thoughts regarding laser dentistry and the benefits
of utilising lasers in daily practice.
Mr. Boschi, what makes MEDENCY a leading force in
the ﬁeld of dental lasers?
Technology, innovation and passion are the main features of MEDENCY. We are creating solutions to make
comfort more widely available without compromising quality—that is our major challenge. All our products arise from
the highest dedication to research and development. We
are therefore setting the highest standards in manufacturing our medical devices, dental lasers, and electronic systems. We are extremely proud of the fact that our medical
devices and their applications are employed by professionals and specialists in their respective fields worldwide.
We think, first and foremost, of others, and take a sincere
interest in all points of view. Freedom of ideas is, in our understanding, an absolute prerequisite for innovation.
What are the challenges dentists face today in their
daily practice?
The rapidly growing demand for high quality and professional treatment is a big and driving factor for dentists
all over the world. Hence, whatever their specialty may
be, they have to acknowledge those needs and demands,
act on them and even foresee trends and developments.
Therefore, the dental industry’s focus must be on these
constant and fast developments. Dentists have to leave
their comfort zone behind, learn about new technologies
and techniques in order to provide patients with the best
and most up-to-date solutions available on the market.

The PRIMO dental laser device is one of your key
products on the market. What are the major advantages and beneﬁts for users?
Lasers have several uses for dental surgery, periodontics, endodontics, implantology, cosmetics, and further therapy. PRIMO combines state-of-the-art diode
laser technology with the innovation and experiences
MEDENCY has gained in the dental industry. Thanks to
its intuitive interface and the easily accessible wide touch
screen, the device is very easy to use. This small portable
unit comes with variable tips and hand pieces for multiple
treatment procedures. Currently, new models are being
finalised in the last stages of development. Among them
is a new device that shall help implantologists fight the
new “tsunami” of the dental field—called peri-implantitis.
Furthermore, in the near future, we are going to launch
a unit specifically for hygienists as an adjunct device for
scaling and root planing.
In your opinion, how have lasers changed the dental
market so far, and what are your future plans?
Laser is one of the newest developments in dentistry,
and has stimulated growth in the medical and dental
equipment market. Particularly in dental surgery, laser offers numerous benefits, rendering treatment more effective for the dentist and less painful for the patient, accelerating treatment options and leading to significantly
improved patient outcomes. I am convinced that dental
lasers will be utilised more and more in dental practices.
Therefore, we will continue our efforts to show, how lasers
make the practice life easier for dentists and their teams.
Our aim is to inform dentists of all the benefits arising from
using lasers in their daily routine. Furthermore, we will
increase our current full support of academic and university programmes aimed at studying new instruments and
possible fields and indications of use.

contact
Alessandro Boschi, CEO of MEDENCY
at the ADF 2017 in Paris, France.

MEDENCY Srl
Piazza della Libertà 49
36077 Altavilla – Vicenza, Italy
Tel.: +39 0444 371462
info@medency.com
www.medency.com

2 2018

[28] =>

| events

Fig. 1

“The Future of Dentistry is Here”
Dr Diana Constantinescu, Romania

From 23 to 25 March 2018, the Romanian Association
of Minimally Invasive Dentistry (ARSMI) hosted the first
edition of the “The Future of Dentistry is Here” Symposium in Brasov, Romania. The two-day symposium was
thus set in Transylvania—Dracula’s country (Fig. 1). More
than 150 clinicians from Bulgaria, Hungary, Germany,
Spain, Iraq, the Netherlands, Greece and Romania,
among others, attended the programme concentrating
on dental specialties with lasers.
Our special thanks goes to Prof. Dr Norbert Gutknecht
(Germany) for his participation and his support in making this event happen. He is a wonderful source of
scientific information and a great inspiration to all of us.
We also owe special thanks to all the speakers for their
great lectures and for managing to cover 360 degrees of
laser dentistry. Not only did all the doctors find useful information in each lecture, it was also a true pleasure listening to them.
The first day of the symposium started with a short
opening ceremony held by Prof. Gutknecht. In the first
lecture, Dr Dimitris Strakas (Greece) presented the topic
“The Dracula’s smile project: The truth behind the myth
of laser bleaching”. Dr Strakas shared insights on the
bleaching mechanism and techniques using both diode
and Er,Cr:YSGG laser.

2 2018

Prof. Gutknecht dedicated the following session to
“Lasers in endodontics—facts or fiction?” (Fig. 2). He
spoke about the promising capacity of lasers in achieving the decontamination of the endodontic system. It was
a great lecture that held everyone on the edge of their
seats. After lunch, Prof. Gutknecht further presented on
“Peri-implantitis: The tsunami in modern dentistry” and
how it can be approached with the aid of lasers. Again,
the decontamination effects that laser light has on both
tissue and the implant surface and the minimally invasive
techniques were in the spotlight.
The following lecture was given by Dr Monika
Masilionyte (Lithuania) on “Saving compromised teeth:
940 nm diode laser assisted endodontic treatment”. In
the afternoon Dr Codruta Ciurescu (Romania), one of
the first to achieve the Romanian Master of Science in
Laser Dentistry spoke about “Laser periodontics” as a
particular approach achieving remarkable results. Further
Dr George Mihai (Romania) reported on “The benefit of
the laser treatment in edentulous abscission of gum hyperplasia” with a case presentation.
The scientific programme of the day ended with Dr
Alida Moise (Romania) presenting on “Conscious sedation in dentistry”. Dr Moise spoke about the nitrous oxide
sedation in the dental office covering sedation mecha-

[29] =>

events

Fig. 2

Fig. 3

Fig. 4

Fig. 5

Fig. 1: Impression of the symposium venue: Bran Castle near Brasov, Romania—Dracula’s castle. Fig. 2: Prof. Gutknecht presenting on “Lasers in endodontics—facts or fiction?”. Figs. 3 & 4: Conference participants gaining further practical experience during the workshop sessions. Fig. 5: Closing party with
wonderful people, good wine and great music.

nisms and techniques, the indication for this type of sedation and the legal aspects of performing it. In the evening e
veryone enjoyed a well-deserved cocktail party.
The second day of the symposium was characterised
by further scientific insights of the invited experts. Dr
Moise started the day, this time presenting on “Allergies,
accidents, incidents, resuscitation”. The next speaker
was Dr Pierre Bruet (France) who reported on “Soft- and
hard-tissue management after extraction” sharing his
vast experience in the classical approach of surgery and
implantology with the audience.
The following presentation was held by Dr Gilles Chaumanet (France), who spoke about “Predictable implantology using the new minimally invasive techniques strategy
and dual wavelength procedure”. Dr Chaumanet described surgical techniques as well as the applications
and the benefits of combining the 940 nm diode laser and
Er,Cr:YSGG in implantology.
After the lunch break Dr Youssef Sedky (Egypt) concentrated on the topic “940 nm diode laser: My magic wand
in orthodontics”. Dr Sedky highlighted how orthodontic
treatments can be accelerated by using the bio-stimulation effect of the 940 nm diode laser and also emphasised
the soft-tissue surgical applications of this laser.
Laser pain therapy specialist Dr Maria Pilar Martin
(Spain) concluded this day of conferences with two presentations. The first one was called “LLLT in dentistry”, in
which Dr Martin spoke about the benefits of light for the
human body and how to integrate this bio-stimulating effect of lasers in treatment. The second lecture focused on

“Lip repositioning and dermatology with laser”. Here, Dr
Martin explained her multidisciplinary approach on solving aesthetic pathologies, facial asymmetries, postural
problems, gummy smile and rejuvenation treatments.
She demonstrated that lasers can be very effective and
at the same time minimally invasive in these types of
treatment—summarising how the proper use of lasers
can lead to life-changing results for the patients.
In addition to the scientific lectures, the practical aspect of the treatments was also not neglected. Workshop sessions on laser application skills and implantology were offered during the first and the second day of
the symposium (Figs. 3 & 4). The last day of the conference ended with a gala dinner. It was a great party
that had all the right ingredients: wonderful people, good
wine and great music (Fig. 5).
Needless to say that the first edition of the “The Future
of Dentistry is Here” Symposium was a success, a true
learning experience and a nice occasion to meet great
doctors from around the world. Once again, we congratulate all the speakers, we thank all the doctors that
joined us and we are looking forward to doing it all again
next year.

contact
Cristina Toader
ARSMI
Bd. Corneliu Coposu Nr. 7
030602 Bucharest, Romania
cristina@laser-stomatologic.ro

2 2018

[30] =>

| events

WFLD’s Pearl Anniversary
World Congress 2018
Dr Dimitris Strakas, Greece & Leon Vanweersch, Germany

Fig. 1

Our laser scientific world will once more be uniting for
the most well-known event of its kind—the 16th dental
laser congress of the World Federation for Laser Dentistry. WFLD, formerly known as International Society for
Laser Dentistry (ISLD), was established back in 1988.
The scope was always the same: to serve as a non-profit
medium for the exchange, advancement and dissemination of scientific knowledge on the use of lasers for treatment and research in the oral and dental environment.

From 1 to 3 October 2018, the 30th anniversary
of WFLD will be held at the RWTH Aachen University
Hospital, under the wings of WFLD, DGL and WALED.
It is our goal to achieve the highest attendance of all
times for this milestone event—also gaining confidence
and momentum from last year’s very successful WFLD
European Congress in Thessaloniki, Greece.

Starting with the first world congress that was held in
Tokyo, Japan, it became evident that this society would
have a bright future. These highly scientific events have
been recurring every two years since and have become
the meeting point for the global laser family. The cities
Tokyo (Japan, 1988), Paris (France, 1990), Salt Lake
City (USA, 1992), Singapore (1994), Jerusalem (Israel,
1996), Hawaii (USA, 1998), Brussels (Belgium, 2000),
Yokohama (Japan, 2002), São Paulo (Brazil, 2004), Berlin (Germany, 2006), Hong Kong (China, 2008), Dubai
(UAE, 2010), Barcelona (Spain, 2012), Paris (France,
2014) and Nagoya (Japan, 2016) have been the 15 stops
that this federation has offered to the world of laser
science so far.

The organising chairman, Prof. Dr Norbert Gutknecht,
stated: “It is my intention to make this congress a turning
point in the set-up and structure of executing such congresses. This congress will integrate science and practical experience on different levels through presentations
and demonstrations like high-ranked international keynote speakers, on stage live patient demonstrations, interactive digital poster presentations, oral presentations
combined with clinically relevant skill training, short presentations of latest research findings, outstanding clinical
case presentations, rotating company-supported workshops, and last but not least the option of gaining continuous education certificates. I also cordially invite all dental
laser companies to seize this opportunity to present and
demonstrate their products during this special anniversary world congress!”

But this year—2018—the venue is of even greater value
for two reasons. Firstly, the 16th World Congress will be
celebrated as the WFLD’s pearl anniversary as we will be
completing 30 years since its foundation in 1988. Moreover, the event will be held in the city of Aachen, Germany, which is not only at the heart of Europe, but its university, RWTH Aachen University, is also considered to
be one of the most respected and prominent academic
names in laser science.

The programme set-up and the evaluation of a large
number (over 200 so far) of abstract submissions is a
huge task for the scientific committee. The whole procedure is led by the scientific committee chairman Prof.
Dr Lynn Powell, who stated: “Thank you all for the so
far great number of submissions. We have extended the
deadline to 14 May 2018. You can still submit an abstract
for presentation to share your research results, clinical
experience, new techniques and your knowledge with

2 2018

[31] =>

events

Preliminary
Programme

16th World Congress WFLD 2018
Check out the detailed Preliminary Congress Programme
by scanning the QR above.
Fig. 1: Venue of the 16th WFLD congress: the RWTH Aachen University Hospital. Fig. 2: Evaluation of abstract submissions by Prof. Dr Norbert Gutknecht, Prof.
Dr Lynn Powell and Dr Dimitris Strakas (from left).

others. Everyone is welcome to attend and participate
no matter what organisation you belong to, or whether
a laser user or not. I look forward to greeting you in a
warm, friendly, sharing environment in Aachen, Germany,
this October.”
Visit our official website www.wfld-aachen2018.com
for online abstract submissions, secure online registrations via credit card or bank transfer, scientific and social
programme details, hotel accommodation options and
all related information about the beautiful city of Aachen.
Last but not least we would like to thank all our current
sponsors for supporting this event. We are proud of having the leaders of the laser device market on our side.

Fig. 2

We are looking forward to meeting you all in Aachen,
Germany, this October and welcome you to be part of
this epic scientific event.

contact
World Federation for Laser Dentistry
Aachen University Hospital
Pauwelsstraße 30
52074 Aachen, Germany
membership@wfldlaser.com

|

[32] =>

| manufacturer news
Fotona

Dual wavelength laser system
Following its launch at IDS in March 2011, Fotona’s dual wavelength (Er:YAG and Nd:YAG) LightWalker laser system quickly
earned widespread industry appreciation and highly respected
technology and innovation awards. Today, it is a preferred laser
system of dental perfectionists and forward-thinking professionals
who wish to upgrade their dental experience with new treatment
possibilities that only the latest technology can offer. Owing to
Fotona’s advanced R&D capabilities which regularly introduce new
features, software updates and usability improvements that further enhance the system’s comprehensive feature set, it remains
one of the most leading edge and reliable laser systems on the
market. With the most state-of-the-art design, engineering and
patented technologies, offering a wide range of highly effective
TwinLight® hard- and soft-tissue treatments, aiming at providing
the most extensive list of applications of any dental laser made
today, LightWalker will continue to set standards for cutting-edge
laser technology in years to come.
Fotona d.o.o.
Stegne 7
1000 Ljubljana, Slovenia
www.fotona.com

MEDENCY

State-of-the-art diode laser technology
The Italian company MEDENCY has been built upon profound
global expertise in the dental market and dental lasers in particular. “Our flagship product PRIMO combines state-of-the-art diode
laser technology with innovation and the experience of MEDENCY
in the dental industry. PRIMO provides a variety of applications and
is thus a viable alternative to conventional surgical methods like
electrocautery and the scalpel. Owing to its intuitive interface, the
device is easy to use,” stated the
company’s general manager,
Alessandro Boschi.
All products are designed,
engineered and manufactured in
Italy—with passion and commitment. “Our
overall mission is to deliver a
combination of cutting-edge
products, services and interaction with customers drawing
on a wide network of academic
partners,” said Boschi.
The company supports its partners with tailor-made educational courses in different countries in order to gain practical

2 2018

experience in the use of the system in daily practice. Using dental
laser technology has never been so easy.
MEDENCY Srl
Piazza della Libertà 49
36077 Altavilla – Vicenza, Italy
www.medency.com

[33] =>

international news

Dentsply Sirona as Gold Sponsor at

WFLD congress 2018
As the market leader in innovative dental
products and technologies, Dentsply Sirona
will be present at this year’s World Federation for Laser Dentistry (WFLD) congress
in Aachen with its SiroLaser Blue. With
three different wavelengths, this dental
laser is a versatile laser therapy device. Dentists from all over the world
will be able to find out more about
the quality of the treatment results
for a range of indications at numerous
specialist lectures, a workshop and a
treatment carried out live on site.
The first dental diode laser to feature blue, infrared and red
wavelengths; the SiroLaser Blue can be used to treat more than
20 indications. That can also be seen from the many different
specialist lectures which Dentsply Sirona will be supporting as a
Gold Sponsor at the 16th WFLD congress from 1–3 October 2018
in Aachen, Germany.
Attendees will be able to learn about the advantages of laser applications in clinical settings. The short wavelength of the blue 445 nm
diode improves the results of surgery thanks to its high absorption
even though it requires less power. Moreover, after surgery there
is often no need for sutures, usually allowing the wound to heal
without scarring. In endodontics and paradontology, the infrared
970 nm diode helps to reduce germs right into the dentinal tubules
during adjuvant therapy. Another advantage is that it may be pos-

sible to dispense
with antibiotics.
Congress attendees
will also be given an insight into how well suited
the red 660 nm diode is
for photobiomodulation treatments: This
light therapy combats inﬂammation
that occurs in connection with oral mucosa diseases, supports wound
healing after surgery and helps reduce postoperative pain.
Practical workshop:
Try out the SiroLaser Blue for yourself
Any dentists wanting to try out the SiroLaser Blue for themselves
are warmly welcome to join the practical workshop. Whether
they experience the clean, usually bloodless incision achieved
in microsurgery, the procedure for treating mucous membrane
alterations, or adjuvant therapy following root canal preparation,
after the presentation attendees can test out the many different
applications of the dental laser very simply, under guidance on a
porcine jaw, and see the excellent results first hand.
Source: Dentsply Sirona

Kangaroo ancestors identiﬁed by

Fossil molars
Kangaroos are icons of Australia’s unique living fauna whose earliest ancestry has yet to be discovered. However, using archaeological findings that were unveiled in Australia approximately
30 years ago, researchers from Uppsala University in Sweden recently identified the most distant ancestor of today’s kangaroos
with the help of new technology.
In the early 1980s, palaeontologists excavated a few enigmatic
molars around a dry salt lake in northern South Australia. The rare
specimens were recognised as belonging to an ancient kangaroo
ancestor and stored in a museum collection for more than three
decades until modern computer-based analysis enabled scientists

to confirm the significance of the discovery. The kangaroo ancestor was named Palaeopotorous priscus, which is Latin for “ancient
rat-kangaroo”.
“Our results showed that Palaeopotorous was most similar to living
rat-kangaroos, as well as some other extinct kangaroo relatives.
Using information from fossils, and the DNA of living species, we
were able to further determine that at around 24 million years old,
Palaeopotorous is not just primitive, but likely represents the most
distant forerunner of all known kangaroos, rat-kangaroos and
their more ancient ancestors,” said lead author
Dr Wendy den Boer, recent doctoral
student at the university and current staff member of the Swedish
Museum of Natural History.
Source: DTI

2 2018

[34] =>

| news international
Laser-supported treatment shall improve

Peri-implantitis therapy

Scientists of the University of Greifswald are currently working
on developing a plasma-supported method that can be used for
the cleaning of infected implants. Implants, just like teeth, have
to be properly maintained, regularly checked and professionally
cleaned in order to prevent health issues like peri-implantitis. This
disease, if untreated, can lead to tissue infection, bone reduction and
ultimately implant loss. A three-year project funded by the Federal
Ministry of Education and Research to explore new approaches
for proper cleaning of infected implants was thus initiated. In a
cooperation between scientists from Greifswald and two medical
technology companies the PeriPLas project is aiming at establishing a basis for a safe and effective method for curing peri-implantitis that can eventually be used in daily clinical practice. The
advantages of efficient therapy methods like mechanical cleaning with abrasive systems, treatment with a diode laser and with
an atmospheric-pressure plasma jet shall be analysed and most

indl

ena

/ Sh

u t te

c k .c

Source: University of Greifswald

Periodontal treatment improved

Child’s first trip to dentist

Control of type 2 diabetes

Source: DTI

r s to

promisingly combined. “Mechanical cleaning is necessary to remove the biofilm. The reduction of living microorganisms can be supported with the diode laser. Cold plasma
can eliminate remaining bacteria and activate the implant surface
in order to favour osseointegration […],” stated project manager
Dr Lukasz Jablonowski. A large clinical pilot study at the end of
the project is intended to test the efficiency and safety of such a
combined treatment.

Lack of guidance may delay

Parents should start taking their child for regular dental check-ups
as soon as the first tooth appears. What seems like a logical step to
secure a child’s oral is, however, not evident to all parents as a poll on
children’s health conducted by the University of Michigan C.S. Mott
Children’s Hospital demonstrated. It was found that without a
doctor’s or dentist’s guidance some parents do not follow the
updated national recommendations for early dental care to start
around age 1, when the primary teeth emerge. One in six parents
who did not receive such advice believed they should delay dentist
visits until age 4 or later. “Parents hear clear guidelines on when
they should begin well-child visits for their child’s health and often
schedule the first visit before they even bring their baby home from
the hospital. Parents get much less guidance, however, on when
to start taking their child to the dentist […]. This lack of guidance
may mean many parents delay the start of dental visits past the
recommended age,” said poll co-director Sarah Clark.
c k .c o m
o
t
The nationally representative poll was
rs
t te
hu
S
based on responses from 790 parh/
ia
ar
ents with at least one child under 5.
m
60 per cent of the parents reported that their child had had
a dental visit. Among the remaining 40 per cent common
reasons for not going to the
dentist were that the child
was not old enough, and the
child would be scared of the
dentist.

©K

Spanish researchers have now discovered further evidence for the
connection between periodontitis and type 2 diabetes. Their study
“Benefits of non-surgical periodontal treatment in patients with
type 2 diabetes mellitus and chronic periodontitis (…)” showed
that control of type 2 diabetes improved notably after the patient
underwent scaling and root planing using ultrasound and curettage. Head of the study Dr Miguel Viñas, Professor of Microbiology at the University of Barcelona stated that a relation does not
only exist between going from diabetes to periodontal diseases,
but also from periodontal disease to diabetes. 90 patients with
type 2 diabetes participated and were randomly assigned to either
the treatment or the control group. Treatment group participants
received oral hygiene instructions, scaling and root treatment. “The
main conclusion of the study is that nonsurgical treatment of periodontitis improves the glycaemic status and the levels of glycated
haemoglobin, and therefore proves the great importance of oral
health in diabetic patients,” summarised Prof. José López, medical
director of the university’s dental clinic.

[35] =>

international news

Botulinum toxin injection promises

Improvement of sleep bruxism
A new pilot study currently investigated the positive effects of
onabotulinum toxin-A (BoNT-A) as a possible treatment for bruxism. The study titled “Onabotulinum toxin-A injections for sleep
bruxism: A double-blind, placebo-controlled study” focused on
determining the safety and efficacy of such a treatment. 22 patients, between 18 and 85 years of age, with clinically diagnosed
sleep bruxism, confirmed by polysomnography, participated.
13 participants were injected with 200 BoNT-A units (60 into each
masseter and 40 into each temporal muscle) and the remaining
patients with the placebo. After the four- and eight-week checkups, participants who were given the placebo injection recorded
no improvement to their bruxism condition. However, those who
were injected with BoNT-A reported a positive effect with minimised tooth grinding and clenching, as well as a reduction of the
associated pain.
Head researcher Dr William Ondo specified that, owing to the
muscle relaxation effect of the botulinum toxin, the movements
causing the condition are reduced. According to the researchers

from the Houston Methodist Neurological Institute, this indicates
BoNT-A being an effective and safe way to improve sleep bruxism;
however, a large multicentre trial to confirm the initial findings is
recommended.

Application form

Join DGL!
Register now at www.qr.oemus.com/6152 or scan the QR on the right and
become a member of the German Association of Laser Dentistry (DGL).
Wine polyphenols may

Prevent caries and periodontal disease
The Spanish researchers studied the effect of two red wine
polyphenols, as well as commercially available grape seed
and red wine extracts, on Porphyromonas gingivalis, Fusobacterium nucleatum and Streptococcus mutans bacteria,
which are associated with dental caries and periodontal
disease. Working with cells that model gingival tissue,
they found that the two wine polyphenols—caffeic and
p-coumaric acids—in isolation were generally better
than the total wine extracts at reducing the bacteria’s
ability to adhere to the cells. When combined with
Streptococcus dentisani, which is believed to be an
oral probiotic, the polyphenols had an even better
anti-adhesive capacity. The research also showed
that metabolites, formed when digestion of the
polyphenols begins in the mouth,
might be responsible for some of
these effects.

©A

frica

S tu d

i o / S h u t t e r s t o c k .c o m

Evidence suggests that drinking red wine has several health
benefits. The study titled “Inhibition of oral pathogens adhesion to human gingival fibroblasts by wine polyphenols alone
and in combination with an oral probiotic”, published through
the American Chemical Society, now has reported that wine
polyphenols might also be good for oral health by preventing
the adhesion of bacteria that
could cause periodontitis
and other diseases.
Study author Dr M. Victoria Moreno-Arribas, Director of the Instituto de
Investigación en Ciencias
de la Alimentación, Madrid,
Spain, and her colleagues aimed
to investigate whether wine and
grape polyphenols would also protect teeth and gingivae, and how this
could work on a molecular level.

Source: DTI

2 2018

[36] =>

| editorial

Prof. Dr. Norbert Gutknecht
Präsident der Deutschen Gesellschaft
für Laserzahnheilkunde e.V. (DGL)

DGL-Jahreskongress in Aachen
am 2. und 3. Oktober 2018
Liebe DGL-Mitglieder, liebe Laserfreunde,
bevor Sie das offizielle DGL-Kongressprogramm auf
unserer Webseite unter www.dgl-online.de abrufen
können, darf ich Ihnen schon vorab zwei ganz wichtige
Informationen unseren bevorstehenden Jahreskongress
betreffend, zukommen lassen.
Wie auf unserem letzten Kongress von Herrn Priv.-Doz.
Dr. Rene Franzen vorgetragen, wird aufgrund der neu
herausgegebenen Lasersicherheitsleitlinien gefordert,
dass die Inhaber der Qualifikation zum Laserschutzbeauftragten nach BGV B2 einen aktuellen Kurs absolvieren, welcher der aktualisierten Verordnung OStrV
genügt. Dies hat den Hintergrund, den gestiegenen
Anforderungen an die gesetzlichen Grundlagen gerecht
zu werden. Hier wollen wir Sie als DGL bestmöglich
unterstützen und bieten Ihnen daher, wie bereits im letzten Jahr mit großer positiver Resonanz angekündigt,
diesen Workshop auf dem vor uns liegenden Jahreskongress für unsere Mitglieder an.
Insbesondere, wenn Sie Ihre Laserschutz-Qualifikation vor 2010 erworben haben, empfehlen wir Ihnen
dringend, an diesem Workshop teilzunehmen. Der
Workshop schließt mit einer obligatorisch gewordenen
Prüfung ab und geht auch auf das schwierige Thema
der Gefährdungsbeurteilung ein.
Bei erfolgreicher Teilnahme am Workshop wird ein
Zertifikat erworben, das den Sachkundenachweis nach
OStrV darstellt. Normalerweise werden für diese Kurse
allein ca. 400 € erhoben. Als DGL-Mitglied dürfen wir Ihnen jedoch die überaus positive Ankündigung machen,
dass dieser Kurs in den Kongressgebühren von 290 €

2 2018

inkl. MwSt. enthalten ist. Für Nichtmitglieder der DGL entstehen Kongressgebühren in Höhe von 350 € inkl. MwSt.
Darüber hinaus ist in diesen Kongressgebühren auch
das Galadinner im Schloss Rahe in Aachen sowie die
Bewirtung in den Kongresspausen (Getränke, Kaffee,
Kuchen, Snacks und Mittagessen durch einen Catering-Service) an beiden Tagen inkludiert. Diese überaus positive mitgliederfreundliche Preisgestaltung war
uns nur deshalb möglich, weil wir unseren deutschsprachigen DGL-Jahreskongress in den gleichzeitig und
am gleichen Ort stattfindenden Jubiläumskongress der
WFLD (ehemals ISLD) integrieren konnten.
Wie der ein oder andere von Ihnen möglicherweise
schon vernommen oder gelesen hat, wird unser DGLKongress speziell auf anwendungsbezogene Indikationen der unterschiedlichen Laserwellenlängen in der
Praxis ausgerichtet sein. Deshalb haben wir für Sie
vortragsbezogene Workshops und Live-Demonstrationen von Behandlungen vorbereitet. Ein großes Schwerpunktthema unseres Kongresses wird die Anwendung
von Lasern in den verschiedensten Bereichen der Implantologie sein. Auch dazu werden spezielle Workshops
und klinische Demonstrationen angeboten. Alle namhaften Laserhersteller werden auf unserer Kongressausstellung und in den Workshops vertreten sein.
Wir haben auch an Ihre Zahnmedizinischen Fachangestellten (ZMF) gedacht. Daher haben wir einen
halbtägigen Workshop am 3. Oktober ins Leben gerufen, der nicht nur Ihren ZMF einen Einblick in die sichere
Handhabung von Lasergeräten geben soll, sondern auch
einen Überblick über gesicherte Laserindikationen bietet
und im dritten Teil des Workshops spezielle Anregungen

[37] =>

editorial

zum Marketing von Laserleistungen gegenüber Patienten
vermittelt. Die Absolventinnen und Absolventen erhalten
nach erfolgreicher Teilnahme ein entsprechendes Zertifikat. Der Preis für diesen Workshop inklusive Kongressbesuch an diesem Tag beträgt 90 € inkl. MwSt.
Ich bin sicher, dass Sie von der Vielfalt unseres Kongressangebotes nicht nur überzeugt, sondern auch
begeistert sind und sich in den nächsten Tagen mit einem Klick zu diesem außerordentlichen Event anmelden werden.

Wenn die Farben der Natur unser DGL-Logo widerspiegeln, würde ich mich freuen, Sie hier in Aachen begrüßen zu dürfen.
Ihr,

Prof. Dr. Norbert Gutknecht

Einladung zur DGL-Mitgliederversammlung
Mittwoch, 3.10.2018, 12.00 – 13.00 Uhr
Aachen – Universitätsklinikum
Tagesordnung:
TOP 1
TOP 2
TOP 3
TOP 4
TOP 5
TOP 6
TOP 7
TOP 8

Genehmigung der Tagesordnung
Bericht des DGL-Vorstandes
Bericht des DGL-Kassenprüfers
Wahl Nominierungsausschuss
DGL-Kongress 2019
DGL-Kongress 2020: 6.-7.11.2020 in Bremen
Anträge zur Mitgliederversammlung
Verschiedenes

DGL c/o Universitätsklinikum Aachen, Klinik für ZPP, Pauwelsstraße 30, 52074 Aachen

Assoziierte Gesellschaft
der DGZMK

|

[38] =>

Laser statt Schmerzmittel?
Kieferorthopädische Behandlungen, beispielsweise bei einem
Bogenwechsel im Rahmen von Multibandbehandlungen, können
Patienten unangenehme Schmerzen bereiten. Mitunter werden
bei kieferchirurgisch-kieferorthopädischen Kombinationstherapien oder bei Fällen mit skelettaler Verankerung Schmerzmittel
angewendet, allerdings treten dabei zum Teil Nebenwirkungen
und Allergien auf. Ersten Hinweisen zufolge, können sich NSAID
(non-steroidal anti-inflammatory drugs) wie Ibuprofen zudem – wenn
auch minimal – negativ auf die Zahnbewegung auswirken. So hat
das Hemmen der Prostaglandinesynthese, der Botenstoffe bei der
Schmerzentstehung, Einfluss auf die Knochenresorption. Eine potenzielle Alternative zur medikamentösen Schmerzbehandlung stellt
die Low-Level-Laser-Therapie (LLLT) dar, deren Wirksamkeit bereits
in verschiedenen Studien analysiert wurde. Alle Untersuchungen
zeigten, dass LLLT zur Schmerzlinderung bei kieferorthopädischen
Behandlungen beiträgt. Forschern der Universidade Luterana do
Brasil gelang es, mit einer AIGaAs-Diode schmerzlindernde Effekte
zu evaluieren. Eine chilenische Studie der Universidad de La Frontera
konnte des Weiteren die Reduzierung von Spontan- und Kauschmerzen nach 24 und 72 Stunden nachweisen.
Weniger eindeutig fielen die Ergebnisse einer Analyse verschiedener medikamentfreier Methoden aus, die von Cochrane Oral Health

k.c

Ma
r

i an

/
yo

st
te r

Kieferorthopädische Behandlungen

| news germany

veröffentlicht wurden. Bei der Behandlung von 118 Patienten mit
LLLT wurde zwar eine Reduzierung der Schmerzen festgestellt, die
Resultate waren jedoch sehr schwach ausgeprägt.
Lasertyp, Wellenlänge und Intensität der Behandlung sind wichtige Einflussfaktoren auf die Wirksamkeit der LLLT. Es bedarf
daher weiterer Untersuchungen, bevor sich LLLT als alternative
Methode etablieren kann.
Quelle: ZWP online

27. DGL-Jahreskongress
Scannen Sie den nebenstehenden QR-Code für Details zum vorläufigen Programm
des DGL-Jahreskongress am 2. & 3. Oktober 2018 im Universitätsklinikum Aachen.

Forschungsprojekt

Neuartige biobasierte Fasern
Das Projekt „Herstellung von biobasierten Polyester-Urethan-Fasern (PEU-Fasern) für
medizinische Anwendungen“ hat zum Ziel, ein biobasiertes, biokompatibles und bioresorbierbares chirurgisches Nahtmaterial für medizinische Anwendungen zu entwickeln. An die
Fasern werden Anforderungen gestellt, die mit bisherigen Materialien nicht oder nur zum Teil
erreicht werden. Vor dem Hintergrund effizienter Ressourcenschonung, sowie dem Wunsch
erdölbasierte Roh- und Werkstoffe durch regenerative biobasierte Materialien nachhaltig
zu ersetzen, rücken diese immer mehr in den Fokus der Forschung. Das Projektkonsortium vereint Kompetenzen aus mehreren Unternehmen und einem Forschungsinstitut
und wird durch das Netzwerkmanagement der IBB Netzwerk GmbH unterstützt. Dr.
Rüdiger Strubl vom Thüringischen Institut für Textil- und Kunststoff-Forschung e.V.
erklärt: „Im Projekt entwickeln wir neuartige Fasern aus Biopolymeren, die den Patienten den Vorteil bieten, dass sie für die Menschen besonders verträglich sind und mit der Zeit
vom Körper abgebaut werden, ohne dass dabei toxische Nebenprodukte anfallen.“
Quelle: IBB Netzwerk GmbH

2 2018

Photo /Shutterstoc

k.com

[39] =>

th
h

11. – 3.
3 OCTOBER
Oktober 2018,
2018
RWTH Aachen,
AACHEN UNIVERSITY
RWTH
AACHEN, GERMANY
Aachen

The 16th Congress of the
World Federation for Laser
Dentistry (WFLD)

The 27th Annual Meeting of
the German Society for Laser
Dentistry (DGL)

The 6th Annual Congress
of the World Academy for
Laser Education
in Dentistry (WALED)

This congress
willverbindet
integrate science
and practical
experience
Dieser
Kongress
Wissenschaft
und Praxis
auf on
different levels
of presentation
demonstrations, like: durch:
diversen
Präsentationsund and
Demonstrationsebenen

Kontakt
WFLD
2018 Hauptsitz Aachen
CONTACT
Herr
Leon Vanweersch
Headquarters
WFLD 2018 Aachen
Stellvertretender
Vorsitzender
Mr. Leon Vanweersch
des
Organisationskomitees
Vice-Organizing
Chairman
Telefon:
+49151
15150610781
50610781
Phone: +49
headquarters@wfld-aachen2018.com
www.wfld-aachen2018.com

ranked international
keynote speakerKeynote-Referenten
lectures
- High
Hochwertige
Vorträge internationaler
stage life patient demonstrations
- On
Live-Demonstrationen
am Patienten
digital
poster
presentations
- Interactive
Interaktive
digitale
Posterpräsentationen
presentations
combinedmit
with
clinical relevanten
relevant skillFähigkeiten
training
- Oral
Vorträge
in Kombination
klinisch
presentations of latest
research
findings
- Short
Kurzpräsentationen
aktueller
wissenschaftlicher
Ergebnisse
caseFallpräsentationen
presentations
- Clinical
Klinische
company
supporting workshops,
gaining
continuous
- Rotating
Rotierende,
firmenunterstützte
Workshops
zum
Erwerb
education
certificates.
von Weiterbildungszertifikaten

[40] =>

| news germany
S3-Leitlinie

„Zahnärztliche Chirurgie unter oraler Antikoagulation“
Erstmals ist nach den Regularien der AWMF (Arbeitsgemeinschaft
der Wissenschaftlichen Medizinischen Fachgesellschaften) eine
S3-Leitlinie zu der präoperativen Vorbereitung, den intraoperativen Kautelen und der postoperativen Nachbetreuung von Patienten unter oraler Antikoagulation/Thrombozytenaggregationshemmung entwickelt worden.
Federführend durch die Deutsche Gesellschaft für Zahn-, Mundund Kieferheilkunde (DGZMK) und die Deutsche Gesellschaft für
Mund-, Kiefer- und Gesichtschirurgie e.V. (DGMKG) wurden in Zusammenarbeit mit 13 weiteren beteiligten Fachgesellschaften und
Organisationen evidenzbasierte, breit konsentierte konkrete Handlungsempfehlungen vorgelegt, die Behandler und Patient dabei unterstützen sollen, in der operativen Zahnheilkunde sowie der Mund-,
Kiefer- und Gesichtschirurgie unerwünschte Blutungsereignisse zu
vermeiden und die Komplikationsraten zu verringern.
© Iryna Imago/Shutterstock.com

Quelle: DGZMK

Neue Volkskrankheit: Kreidezähne

MIH überholt Karies

u s tr

a ti o n

st
Fo r e

/ Sh

u t te r s to

c k .c o m

1987 wurde die Molaren-Inzisiven-Hypomineralisation (MIH)
erstmals wissenschaftlich beschrieben, heute lässt sich bereits
von einer neuen Volkskrankheit sprechen: im Durchschnitt leiden
10 bis 15 Prozent der Kinder an MIH, bei den 12-jährigen sind es
laut der 5. Deutschen Mundgesundheitsstudie
sogar über 30 Prozent. MIH verursacht eine
systemisch bedingte Strukturanomalie des
Zahnschmelzes, die auf eine Mineralisationsstörung zurückzuführen ist. Diese sogenannten „Kreidezähne“ sind äußerst schmerzempfindlich und reagieren sehr sensibel auf Hitze,
Kälte und Zähneputzen.
Als potenzielle Ursachen gelten u. a. Weichmacher aus Kunststoffen wie Bisphenol A,
Probleme in der Schwangerschaft und Infektionskrankheiten. Diskutiert wird ein
multifaktorielles Geschehen, dennoch
gilt die präzise Ätiologie weiterhin
als ungeklärt. Da die Schmelzentwick-

lung der ersten Molaren und der Inzisivi zwischen dem achten
Schwangerschaftsmonat und dem vierten Lebensjahr erfolgt,
muss die Störung in dieser Zeitspanne stattfinden.
Häufig weisen die bleibenden Frontzähne und zunehmend
auch die zweiten Milchmolaren bei MIH
Fehlstrukturierungen auf. Die milde Form
zeigt eher weißgelbe oder gelbbraune,
unregelmäßige Opazitäten, während bei
der schweren Form abgesplitterte oder
fehlende Schmelz- und/oder Dentinareale
unterschiedlichen Ausmaßes auftreten. Die
raue Zahnoberfläche und schlechte Substanz
begünstigen die Kariesanfälligkeit. Eine besonders intensive Prophylaxe beispielsweise
durch Fluoridierungsmaßnahmen ist
daher notwendig, um die Zähne ein
Leben lang zu erhalten.
Quelle: DGZMK

Werden Sie DGL-Mitglied!
Registrieren Sie sich jetzt unter www.qr.oemus.com/6153
oder scannen Sie den nebenstehenden QR-Code und werden Sie Teil
der Deutschen Gesellschaft für Laserzahnheilkunde e.V.

2 2018

Aufnahmeantrag

[41] =>

Deutsche Gesellschaft für Laserzahnheilkunde e.V.
Abt. für ZPP/ DGL
Frau Eva Speck
Pauwelsstraße 30
52074 Aachen

Bitte ausgefüllt an E-Mail:
sekretariat@dgl-online.de
especk@ukaachen.de
oder Fax: 0241 803388164
per Post: Uniklinik Aachen

27. DGL-Jahreskongress
2. und 3. Oktober 2018 im Universitätsklinikum Aachen
16thh WORLD CONGRESS
WF
FLD 2018
1 – 3 OCTOBER 2018
RWTH AACHEN UNIVERSITY
AACHEN, GERMANY

The 16th Congress of the
World Federation for Laser
Dentistry (WFLD)

The 27th Annual Meeting of
the German Society for Laser
Dentistry (DGL)

Vorläufiges Programm

The 6th Annual Congress
of the World Academy for
Laser Education
in Dentistry (WALED)

Hiermit melde ich mich verbindlich zum 27. Jahreskongress der DGL im Universitätsklinikum Aachen an (inkl.
Galadinner und Catering).

DGL-Mitglied 290,– € inkl. 19 % MwSt.
Name:

Straße/Nr.:

Vorname:

PLZ/Ort:

Unterschrift:

Datum:

Status:

DGL-Mitglied 290,– €

Nichtmitglied 350,– €

Ich nehme am aktualisierten Lasersicherheitsworkshop gemäß der neuen Verordnung OStrV teil:

nein

Meine ZMF nimmt am Laserworkshop zum Preis von 90,– € inkl. MwSt teil:

nein

Name ZMF:
Die Bestätigung Ihrer Anmeldung erfolgt nach dem Eingang Ihrer Kongressgebühren auf das Konto der DGL/
WFLD: Sparkasse Aachen, IBAN: DE54 3905 0000 1073 0886 90, BIC: AACSDE33
Allgemeine Bedingungen
Anmeldeschluss ist der 31. Juli 2018. Anmeldungen nach diesem Zeitpunkt können nur noch vor Ort bearbeitet
werden (bis zur max. Teilnehmerzahl). Nach Zugang der Anmeldung ist diese für den Teilnehmer verbindlich. Bei
Stornierung der Teilnahme bis zum 30.06.2018 wird ein Betrag von 50,– € p. P. als Bearbeitungsgebühr einbehalten.
Nach diesem Zeitpunkt erfolgt keine Rückerstattung. Die Gestaltung und Durchführung des wissenschaftlichen
Programms obliegt der Deutschen Gesellschaft für Laserzahnheilkunde e.V. Für die Durchführung der Workshops
während der Dentalausstellung übernimmt die Deutsche Gesellschaft für Laserzahnheilkunde e.V. keine Verantwortung.
Bankverbindung: Sparkasse Aachen, IBAN: DE54 3905 0000 1073 0886 90, BIC: AACSDE33

[42] =>

| about the publisher

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terms and conditions apply, legal venue is Leipzig, Germany.

42

2 2018

[43] =>

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[44] =>

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) [page_count] => 44 [pdf_ping_data] => Array ( [page_count] => 44 [format] => PDF [width] => 595 [height] => 842 [colorspace] => COLORSPACE_UNDEFINED ) [linked_companies] => Array ( [ids] => Array ( ) ) [cover_url] => [cover_three] =>

[cover] => Laser International No. 2, 2018

[toc] => Array ( [0] => Array ( [title] => Cover [page] => 1 ) [1] => Array ( [title] => Editorial [page] => 3 ) [2] => Array ( [title] => Content [page] => 4 ) [3] => Array ( [title] => Minimally invasive dentistry with Er,Cr:YSGG [page] => 6 ) [4] => Array ( [title] => Peripheral giant cell granuloma surgery with diode laser [page] => 10 ) [5] => Array ( [title] => Erbium laser in ankyloglossia therapy [page] => 16 ) [6] => Array ( [title] => Successful communication in your daily practice Part VI: Economic crisis [page] => 20 ) [7] => Array ( [title] => Six Sigma in the management of laser-assisted dental practices [page] => 22 ) [8] => Array ( [title] => Technology, innovation and passion - Laser devices bring improvement to the daily practice [page] => 26 ) [9] => Array ( [title] => “The Future of Dentistry is Here” [page] => 28 ) [10] => Array ( [title] => WFLD’s Pearl Anniversary World Congress 2018 [page] => 30 ) [11] => Array ( [title] => Manufacturer News [page] => 32 ) [12] => Array ( [title] => International News [page] => 33 ) [13] => Array ( [title] => Editorial [page] => 36 ) [14] => Array ( [title] => News Germany [page] => 38 ) [15] => Array ( [title] => Imprint [page] => 42 ) ) [toc_html] =>

Table of contents

[toc_titles] =>

[cached] => true )