DT Middle East & Africa No.6, 2020
CAPP November Dental Livestream sets record attendance
/ Industry
/ News
/ HuFriedyGroup introduces Harmony Ergonomic Scaler designed with TrueFit Technology
/ Simplified protocol for adjacent Class II direct resin restorations
/ The future is now: Revolutionising dentistry with digital dentures
/ Clinical conduct for restoration of non-carious cervical lesions – Case report
/ Study shows concerning levels of dental patient aggression
/ Still leading the pack: New studies confirm exceptional accuracy of Primescan
/ Benefits of a fully integrated digital workflow – clinical focus
/ Interview: Consulting the Internet should in no way replace visiting the dentist
/ Mental health in the dental profession during the COVID-19 pandemic
/ WHO and dentistry: moving on from misinformation
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NL
Y
O
LS
NA
IO
SS
FE
O
PR
NT
AL
DE
www.dental-tribune.me
PUBLISHED IN DUBAI
November-December 2020 | No. 6, Vol. 10
ENDO TRIBUNE
LAB TRIBUNE
IMPLANT TRIBUNE
ORTHO TRIBUNE
HYGIENE TRIBUNE
Palliative care successful for
endodontic emergencies during
lockdown
Interview: “Dental laboratories
will be left in an extremely
vulnerable position”
CBCT bone-densitometry
for pre-surgical decision-making
Orthodontists should see their
patients through the eyes of a
periodontist
The dental hygienist in times of
COVID-19
ÿA1-2
ÿB1-4
ÿC1-4
ÿD1-4
ÿE1-4
CAPP November Dental Livestream attendance:
30,546 dental professionals from 149 countries
DENTAL TRIBUNE
By Dental Tribune MEA | CAPPmea
DUBAI, UAE: CAPP November Den-
tal Livestream, a month full of continuing dental education, featured
CAPP’s two annual conferences, subspecialty seminars and 25 multidisciplinary dental hands-on training
courses. A total of 30,547 international dental professionals registered
and attended the various dental CE
programmes between 05th – 28th
November 2020. The highlights
of the month were the two annual
dental conferences which gathered
virtually 20,910 unique dental professionals from 149 countries. The
15th CAD/CAM & Digital Dentistry
and the 12th Dental Facial Cosmetic
international conferences lasted a
total of 8 days and were accessible
on complimentary basis due to the
ongoing COVID-19 global pandemic.
Additionally, 9,636 dental professionals attended the various courses
and seminars made available during
November 2020.
The World’s Dental Newspaper Middle East & Africa Edition
Centre for Advanced Professional
Practices (CAPP) was founded in
2005 in Dubai, UAE by Dr Dobrina
Mollova with the purpose of delivering excellence in CE in dentistry
in the Middle East, Africa, Asia and
beyond. CAPP is an American Dental
Association Continuing Education
Recognition Programme recognised
provider.
In 2020, despite the effects of the
COVID-19 global pandemic, CAPP
was committed to continue organis-
ÿPage 2
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[2] =>
2
NEWS
Dental Tribune Middle East & Africa Edition | 3/2020
◊Page 1
ing its two annual world-class scientific conferences, supporting dental
professionals globally. When initial
plans to host this year’s in-person
events were disrupted, CAPP swiftly
redirected its efforts towards the organisation of two of the largest-ever
virtual, scientifically accredited dental conferences instead – eight days,
11 hours per day, 56 continuing education (CE) credits, over 90 speakers
from six continents. Delegates also
received dedicated sponsored virtual infomercials during the breaks
with the latest updates on the innovations from the dental industry.
The two conferences were successfully broadcasted as part of the CAPP
November Dental Livestream, between 05th – 28th November 2020.
Simultaneously two sub-speciality
events also took place on 20th November 2020, the Dental Hygienist
Seminar, and the Dental Technician
International Meeting. Furthermore,
a total of 25 multidisciplinary dental
hands-on training courses were organised virtually, face-to-face or in a
hybrid format at the CAPP Training
Institute in Dubai, UAE. A total of 20,
910 unique dental professionals attended the 2 conferences from 149
countries. Both conferences included 11 hours per day lecture sessions
to cater to the numerous time zones
across the globe. The seminars and
courses were further attended by
9,636 dental professionals.
15th CAD/CAM & Digital Dentistry Conference from 12th to
15th November (28 CE credits)
The four-day scientific programme
was chaired by Dr. Munir Silwadi,
UAE and Dr. Nadim Aboujaoude,
Prof. Ziad Salameh, Dr Mona Sayegh
Ghoussoub all from Lebanon. The
conference discussed the latest advancements in digital dentistry, the
digital workflow, and innovative
practices, while sharing latest clinical cases, research, and best practices. Topics covered included digital
workflow, digital orthodontics, CAD/
CAM chairside and in-laboratory applications, digital and conventional
impressions (intra-oral, laboratory
and face scanners, new materials in
digital dentistry and 3-D printing),
laboratory and clinical options, digital and conventional restorations,
digital imaging, computer-guided
implantology, clear alignment treatments, practice software, one-day
restorations and CAD/CAM software.
This edition of the conference once
again proved that dentistry is transforming at a ground-breaking speed
towards digitalisation, including advancements in digital dentistry procedures, techniques, and materials.
Among these wide-ranging developments are digital dental impressions,
intra-oral scanners, dental prosthodontics, imaging systems, smile design, orthodontics, treatment planning and materials for CAD/CAM
systems.
12th Dental Facial Cosmetic
Conference from 19th to 22nd
November (28 CE credits)
The 12th edition of the annual Dental
Facial Cosmetic International Conference was once again chaired by Dr.
Munir Silwadi, UAE and Dr. Nadim
Aboujaoude, Prof. Ziad Salameh both
from Lebanon throughout the four
days. The main aim of the conference was to provide a practical overview of the latest in aesthetic dentistry; to be a stimulus for improved
ÿPage 28
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Dental Tribune International GmbH makes
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[3] =>
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Axeos.
Experience the difference.
A new generation of progressive imaging is here – experience the difference with Axeos.
• 2D/3D hybrid device equipped with new technology and a broad Field of View (FoV) range,
from a focused FoV (Ø5 x 5.5 cm) for endodontic cases up to a large FoV (Ø17 x 13 cm)
that covers complete dentition, including both TMJs
• Seamless connectivity and individualized treatment workflow with Sidexis 4 Software
• Patient Positioning and Image Assistant (PIA) for increased patient comfort and image accuracy
Because every patient deserves a healthy, happy smile and every practice team deserves the tools
to make this a reality. It’s time to elevate and expand your treatment offer. It’s time for Axeos.
For more information on Axeos please contact your local dealer,
Dentsply Sirona sales representative or visit
dentsplysirona.com/axeos
THE DENTAL
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3M, ESPE, Express, Lava, Protemp and RelyX are trademarks of 3M or 3M Deutschland GmbH. Used under license in Canada. © 3M 2017. All rights reserved.
Cement
3M™ RelyX™ U200
Self-Adhesive Resin Cement
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3
Syringe
3M™ Intra-oral Syringe
Impress
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Impression Material
3M
M and Imprint are trademarks of 3M or 3M Deutschland GmbH. Used under license in Canada. © 3M 2018. All rights reserved.
1
[6] =>
6
INDUSTRY
Dental Tribune Middle East & Africa Edition | 6/2020
Dentsply Sirona is celebrating
35 years of CEREC: Innovative technology
for excellent results
The market launch of CEREC in 1985
marked the beginning of digitalisation in dentistry. Dentsply Sirona
was the first company in the world
to recognize the revolutionary significance of CAD/CAM technology
for modern dental treatment and
make it widely available for dental
practices. Today, CEREC makes it
easy to quickly produce restorations
of excellent quality. The recently revised components make the system
a set-up for an entirely new chairside
experience.
This year, Dentsply Sirona is celebrating the anniversary of CEREC, a digital system that has fundamentally
changed dentistry. Digitalisation was
just beginning in 1985, however, and
was accompanied by scepticism and
reservations. Dentsply Sirona believed in this idea and showed it had
perseverance. In constant discussions with the inventors of CEREC,
Prof. Werner Mörmann and Marco
Brandestini from the University of
Zurich, and with users in practices,
Dentsply Sirona engineers contin-
ued to develop CEREC, setting new
standards in digital dentistry.
This is still succeeding in the 35th
anniversary year: Nearly all components of the unique CEREC workflow
were completely revised within just
a short time. The new CEREC now
features a sophisticated set-up that
enables users to continuously and
predictably achieve clinically reliable results, now even faster and
easier. With the CEREC Primescan,
the state-of-the-art intraoral scanner, a demonstrably high level of accuracy in digital impressions can be
achieved1. The latest CEREC software
uses artificial intelligence to support
the production of restorations. It
also features a high level of automation and intuitive touch functionality. It is also used to control CEREC
Primemill, the grinding and milling
unit that can make restorations very
quickly (full zirconia crown in approx. five minutes) and extremely
precisely. It is easy to operate via
a touchscreen and can be used for
many indications and a large variety
of materials. The CEREC SpeedFire,
the sintering furnace for chairside
treatment, completes the system.
© Dentsply Sirona
By Dentsply Sirona
"35 years ago, people laughed at our
idea for digital dentistry, but today it
has become a standard in treatment
and documentation," says CEREC
inventor Prof. Dr. Dr. Werner Mörmann. "And I stand by my prediction that by the 50th anniversary of
CEREC, if not sooner, every practice
will have CEREC or at least an intraoral scanner."
ceptively more comfortable treatment experience for patients.
The new CEREC – all users benefit
CEREC as a system has become firmly established in the market – the
new CEREC makes it even easier for
more dentists to decide to implement these modern digital technologies in their own practice quickly and
cost-effectively.
The individual components of
CEREC are optimally coordinated to
allow the unique seamless workflow.
This makes digital chairside dentistry faster, easier, and more reliable
than ever before, and it continues to
deliver high quality results and a per-
Intuitive workflows and user-friendly operation now make it even easier
for new users to explore the world of
chairside dentistry. Experienced users especially appreciate the faster
process speed and the exceedingly
high quality of the restorations.
More information about CEREC is available at www.dentsplysirona.com/cerec.
For more information about the full
Dentsply Sirona portfolio, please contact
your local representative.
Dentsply Sirona
21st Floor, The Bay Gate Tower
Business Bay, Al Sa’ada Street
Dubai, United Arab Emirates
Tel.: +971 (0) 4 523 0600
Web: www.dentsplysirona.com/en
E-mail: MEA-Marketing@dentsplysirona.com
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[7] =>
[8] =>
8
NEWS
Dental Tribune Middle East & Africa Edition | 6/2020
Ultradent debuts Opalescence PF
Whitening for Aligners
By Ultradent Products, Inc.
Ultradent Products, Inc., a leading developer and manufacturer of hightech dental materials, is introducing
the newest member in the Opalescence whitening family, Opalescence
PF Whitening for Aligners.
Opalescence PF Whitening for Aligners is ideal for use with orthodon-
tic aligner trays and features all of
the benefits of the award-winning,
original Opalescence PF whitening:
high water content to keep teeth
hydrated, neutral pH for oral health
and safety, and potassium nitrate
and fluoride for patient comfort. It
is available in a convenient, portable
4-syringe kit so patients can carry
their whitening gel with them and
whiten at their convenience.
With Opalescence tooth whitening
gel, patients don’t have to worry
about gel ending up where it’s not
supposed to go. The PF formula is
sticky and viscous—it stays where
it’s placed, preventing the gel from
migrating during treatment. Opalescence PF Whitening for Aligners is
available in 10% concentration for
day or night wear.
For more information about Opalescence PF Whitening for Aligners,
contact sophia.yadi@ultradent.com
For more information contact
Ultradent
505 West Ultradent Drive
South Jordan, UT 84095
Web: www.ultradent.com
Opalescence PF Whitening for Aligners
Introducing the award-winning Axeos:
Dentsply Sirona’s latest imaging solution
In this year marking the 125th anniversary of Wilhelm Conrad Röntgen’s discovery
of the first X-ray image, Dentsply Sirona has launched its new top-of-the-line,
2D/3D imaging solution called Axeos.
By Dentsply Sirona
Axeos gives the user excellent image quality and is a great addition for
clinics that offer a broad spectrum
of treatments. Four volume sizes
are available, from a focused Field
of View (Ø5 x 5.5 cm) for endodontic
cases up to a large FoV (Ø17 x 13 cm)
that covers the complete dentition,
including both temporomandibular
joints. Its Intelligent Low Dose mode
helps minimise the necessary exposure to patients while still giving
clinicians the ability to capture 3D
information at the dose level of a 2D
image.
Smart connectivity is another distinguishing feature of Axeos. It comes
with the highly intuitive Sidexis 4
imaging software and seamlessly
© Dentsply Sirona
Three principles underscore the benefits of Dentsply Sirona’s imaging
solutions: clinical confidence, smart
connectivity, and an excellent user
and patient experience. The newly
launched Axeos represents these
principles with remarkable image
quality for greater reliability when
diagnosing, seamless integration
and treatment planning, and an
award-winning design.
works with many other treatment
planning softwares such as SICAT®
Implant, SICAT® Air, SICAT® Function and SICAT® Endo. PACS and RIS
connectivity make it easy for Axeos
to be integrated into a clinic’s own
network.
Imagine the amount of time that a
clinic or hospital would save if X-ray
equipment could set its height for
the individual patient even before
they enter the X-ray room. With
the Patient Positioning & Image
Assistant feature “smart height adjustment”, Axeos does exactly that.
Cutting edge features make the user
experience excellent, while the wellthought-through design helps to create a relaxing and confidence-inspiring atmosphere for the patient.
When the University of Otago in
New Zealand built their new facility
designed around the best possible
education environment and patient
experience, they chose to work with
Dentsply Sirona. The International
Special Clinic Solutions Team provided the equipment they needed
but also the consulting expertise to
help make their forward-thinking
concept a reality. Imaging is an essential component of diagnosing
and determines the initial treatment
plan for a patient. It is also critical
for monitoring the treatment’s success. As the clinic continues to look
towards the future, they are getting
ready to receive the new Axeos. It
will be the excellent addition to the
clinic and the University of Otago’s
patient-centered concept.
Find out more about Axeos by visiting
www.dentsplysirona.com/axeos.
For more information about the full
Dentsply Sirona portfolio, please contact
your local representative.
Dentsply Sirona
21st Floor, The Bay Gate Tower
Business Bay, Al Sa’ada Street
Dubai, United Arab Emirates
Tel.: +971 (0)4 523 0600
Web: www.dentsplysirona.com/en
E-mail: MEA-Marketing@dentsplysirona.com
[9] =>
Opalescence PF
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© 2020 Ultradent Products, Inc. All rights reserved.
[10] =>
10
INDUSTRY
Dental Tribune Middle East & Africa Edition | 6/2020
HuFriedyGroup introduces
Harmony Ergonomic Scaler designed with
TrueFit Technology
Innovative new scaler scientifically proven to relieve pressure in the hand
By HuFriedyGroup
HuFriedyGroup, the dental division of Cantel Medical Corp., and a
global leader in infection prevention,
dental instrument manufacturing,
and instrument reprocessing workflows for the dental market, today
introduced the new line of Harmony
Ergonomic Scalers and Curettes designed with TrueFit Technology. This
latest addition to the best-in-class
instrument portfolio from HuFriedyGroup is a truly ergonomic scaling
solution backed by scientific innovation.
“We set out with the goal of developing a new scaler that would provide
scientifically proven ergonomic
benefit for clinicians, improving
their experience and that of the patient as well,” said Stacie Barth, Vice
President, Global Strategic Business
Unit, HuFriedyGroup. “Our rigorous, data-supported design process
is a novel approach for the industry,
and the results speak for themselves.
More than ever, clinicians and dental
hygienists need to feel comfortable
with their instruments, and the new
Harmony Scaler is designed precisely to improve their daily working
experience.”
HuFriedyGroup developed the Harmony Scaler using TrueFit Technology to provide true ergonomic benefits driven by scientific evidence.
This advanced, sensor-based testing
system measures pinch force in the
finger and pressure applied to the
tooth when scaling. With over 2.8
million data points recorded, HuFriedyGroup researchers and engineers utilised TrueFit Technology to
develop a scaler handle with optimal
proportions and ideal width that
provides a secure and nimble grasp.
HuFriedyGroup relied on a broad,
globe-spanning group of hygienists
to participate in testing and development as part of an iterative design
process. To ensure a scientific perspective and accurate representation
of the data collected, HuFriedyGroup
worked with a world-renowned
third-party analytics firm to review
and analyse the resulting 2,878,320
data points.
The result was pure harmony, a handle that reduces pinch force up to
65% compared to other leading scaler designs. This reduces the amount
of pressure a clinician needs to apply
when using the instrument, which
may alleviate hand fatigue and injury risk due to repetitive motion.
With up to 37% less pressure against
the tooth surface during scaling
compared to other leading scaler
handle designs, Harmony Ergonomic Scalers and Curettes can increase
patient comfort and reduce clinician fatigue. Furthermore, Harmony
Harmony Ergonomic Scaler
features EverEdge 2.0 Working Ends,
which are 72% sharper than the next
leading competitor, which also contributes to creating a more comfortable experience for both clinician
and patient.
The durable metal handle, which
features a recessed double-helix texture, is designed for optimal tactile
sensitivity and to reduce tactile fatigue. The comfortable silicone grip,
which has been extended by 30%,
provides a secure and nimble grasp
with a geometric pattern specifically
designed for stable grip in any direc-
tion. Clinicians can comfortably manoeuvre and roll the scaler due to the
round shape of the handle and the
smooth transition to the functional
shank.
With 30 unique working end options, including Sickles, Universals,
and Graceys, the Harmony Scaler is
immediately available for purchase
from authorized HuFriedyGroup
representatives or dental distributors.
For more information, dental professionals should contact their HuFriedyGroup
representative or visit https://www.hufriedy.eu/en/harmony-scaler .
Life-like aesthetics
powered by Beautifil IILS
By SHOFU
Beautifil IILS bioactive composite offers a smart solution for your direct
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•
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Smart Benefits for your Practice:
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Predictable aesthetics for seamless restorations
Optimal light diffusion for a
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Web: www.shofu.com.sg
For more information, please visit:
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[11] =>
HUFRIEDYGROUP INTRODUCES
HARMONY
SCIENTIFICALLY PROVEN ERGONOMIC
SCALERS AND CURETTES
Designed with TrueFit™ Technology, the optimized shape
with double helix grip reduces pinch force up to 65% 1 .
Its optimal proportions and ideal width provides a secure
and nimble grasp, which may alleviate hand fatigue and
injury risk due to repetitive motions. All Harmony™ scalers
and curettes have EverEdge™ 2.0 working ends, ensuring
you have sharp, long lasting blades to efficiently remove
calculus while applying less pinch force when holding
the handle.
Learn How to Scale in Perfect Harmony at
HuFriedy.eu/Harmony-Scaler
For more information or to place an order please contact
your local dealer or us at:
Free Call: 00800 48 37 43 39
E-Mail: info@hu-friedy.eu
All company and product names are trademarks of Hu-Friedy Mfg. Co., LLC, its affiliates or related companies, unless otherwise noted.
1. Compared to other leading scaler designs. Data on file. Available upon request.
©2020 Hu-Friedy Mfg. Co., LLC. All rights reserved. HFL-482/0820
Hu-Friedy is now a proud member of
™
[12] =>
12
RESTORATIVE
Dental Tribune Middle East & Africa Edition | 6/2020
Simplified protocol for adjacent Class II
direct resin restorations
By Dr Anand Narvekar, India
Introduction
Bioactive direct composite resin materials like the next generation high
strength injectables and low shrinkage packable composites, when
used with advanced matrix systems,
provide clinicians with an opportunity to adopt a minimally invasive
patient-centric treatment approach
while preserving sound tooth structure. Material selection is an important step in treatment planning for
posterior restorations. The use of
bioactive composites under strict
isolation with rubber dam helps to
achieve aesthetics and function with
long-term clinical success while minimising the risk of secondary caries.
Clinicians often find it challenging
to restore multiple posterior teeth
with direct resin in an efficient and
predictable manner. The key to success lies in achieving a well-sealed
restoration with good contact and
contours. Therefore, restoration of
interproximal areas on posterior
teeth requires stringent preoperative evaluation of tooth & defect size,
location of contact & tightness, adjacent tooth position & contours and
gingival location. This article aims
to provide a simple and predictable
protocol when dealing with adjacent
Class II direct resin restorations in
routine clinical practice.
Before & After - adjacent Class II restorations
Patient Case
A 21-year-old female visited the dental office with a chief complaint of
food lodgment and pain in tooth
#46 when consuming sweet or cold
food. Radiographic examination
with IOPA reveled old composite
restoration in tooth #46 and distal
decay on #45 without involving the
marginal ridge. Upon clinical examination, Class II cavities on tooth #46
& #45 were identified (Fig. 1). The
most suitable treatment approach in
this situation was direct restorations
with bioactive composite resins.
Restorative Approach
Prior to caries removal, proper quadrant isolation was done with placement of rubber dam and pre-wedging with Garrison small FXBL wedge.
Tip: Pre-wedging creates momentary tooth separation to help achieve
a more accurate proximal seal with
ideal contact after placement of the
final restoration and the teeth return
to their original position. In addition,
it helps to protect the rubber dam
when removing the caries in the cervical area.
Caries removal was completed with
a blue stripped high speed small
round bur followed by slow speed
round carbide bur. Caries detection
dye was applied to ensure complete
removal of active decay. Old composite was removed from occlusal
and buccal pit area of tooth #46.
For tooth #45, decay was initially
removed without touching the occlusal surface, however as the mar-
ginal ridge area was left with very
thin structure, the proximal box was
later extended to the occlusal surface
(C-shaped preparation) to avoid excessive stress that could lead to restoration failure (Fig. 2).
After cavity preparation and
caries removal
Smooth enamel margins were
achieved with Super Fine Diamond
Bur (yellow band) and proximal
walls were finished with Super-Snap
disk violet, to ensure optimal bonding to the enamel, avoid detachment
of unsupported enamel and potential micro leakage.
Etching & Bonding
The wedge was removed & selective
etching technique was used with
35% phosphoric acid
solution followed by
abundant rinsing with
water. It is important,
to avoid overdrying
the dentin with strong
airflow as a completely dried surface will
cause collapse of collagen affecting the penetration of adhesive
monomers resulting
in a weaker bond.
To achieve reliable adhesion, my
personal preference is to use a sixth
generation bonding system (Shofu
FL-Bond II) combined with selective
etching as the outcome is predictable compared to current seventh
generation and universal adhesive
systems in the market. Even if you
etch dentin, the primer is able to
wet the surface without collapsing
collagen and facilitate effective penetration into the demineralised area.
To maintain a humid dentinal substrate, a generous amount of primer
should be applied and left undisturbed for 10 seconds and air dried
for 5 seconds to ensure the solvent
evaporates and mild acid primes the
dentin. The bonding agent should
be carefully applied as an even layer
on the entire restorative surface and
light-cured for 10 seconds or longer
in case of deep cavities.
Matricing
Garrison Composi-Tight 3D Fusion
Matrix Ring Tall Orange (FX500)
was selected according to the height
of the cavity, in this instance we selected FX150 band for the premolar
and FX175 for the molar. Both bands
should be placed simultaneously
and secured with suitable wedges.
The wedges should be placed and
ÿPage 15
Fig. 1. MO Class II cavity along with old composite restoration on tooth
#46 and distal decay on tooth #45.
Fig. 2. Pre-wedging with removal of active decay on teeth #45, 46.
Fig. 3. Garrison FX150 band for the premolar and FX175 for the molar
was placed with the Garrison 3D Fusion Blue Wedge and the Garrison
3D Fusion Orange Ring (FX500) .
Fig. 4. Tooth #45 was restored first with Beautifil Injectable XSL shade
A2 followed by Beautiful II LS shade A2 in snow-plow technique.
Fig. 5. Band from premolar was removed and molar band burnished
with light to medium pressure on the adjacent premolar tooth to
ensure proper contour and contact.
Fig. 6. Spreading of Beautifil Injectable XSL (Self-leveling composite
resin) shade A2.
Fig. 7. Converting Class II to Class I with Beautifil II LS shade A2.
Fig. 8. Composite build-up with a combination of Beautifil Injectable
XSL and Beautifil II LS, leaving 1.5 mm.
[13] =>
13
RESTORATIVE
Dental Tribune Middle East & Africa Edition | 6/2020
◊Page 14
Fig. 9. Final occlusal morphology was achieved with build-up of each
cusp using Beautifil Injectable X shade A2.
Fig. 10. Buccal pit on tooth #46 was directly filled with Beautifil Injectable X shade A2.
Fig. 11. Graphical representation of restorative technique with incremental layering.
Fig. 12. IOPA before treatment and post-op showing natural contour
and seal achieved with a perfect contact.
Fig. 13. After treatment - immediate post-op.
Fig. 14. Post-op after 7 days - Final Invisible Restorations.
inserted from the buccal side at an
angle by holding the bands with a
finger to avoid the bands from being displaced from its ideal location.
Always good to double check the fit
and seating of the bands, specially
in the proximal box to ensure complete seal when placing the composite resin material (Fig. 3).
Tip: When restoring adjacent teeth,
place both matrix bands at once to
avoid over contour of the 1st restoration and difficult placement of second matrix band due to tight contact.
Composite resin layering
technique
To minimise the effects of polymerisation shrinkage, composite resin
layering can be performed using
different techniques: horizontal,
oblique or three-sites. In this clinical case, we used a combination of
these techniques with soft-start
curing (i.e. incremental light-curing
programmes), which starts at a low
intensity of 100 to 250 mW/cm², allowing better composite resin adaptation at the cavity margins before
increasing to a standard intensity.
Tooth #45 was restored first to help
increase visibility during restoration
of tooth #46. As the cavity on the
premolar was a shallow proximal
box, horizontal incremental layering
was used with Shofu range of Bioactive composites, Beautifil Injectable
XSL, shade A2 (Self-leveling composite resin) injected in small quantity
followed by Beautifil II LS, shade A2
(packable composite) in snow-plow
technique. In the final increment
the marginal ridge and distal pit area
were carved to achieve a more natural occlusal morphology (Fig. 4).
The sectional matrix on premolar
and ring were removed carefully
with the help of artery forceps without dislodging the matrix band
placed on molar. The band was burnished with light to medium pressure on the adjacent premolar tooth
to ensure proper contour and contact (Fig. 5).
To restore the Class II cavity of tooth
#46, a combination of vertical, horizontal and oblique layering technique was adopted. A thin layer of
Beautifil Injectable XSL (Self-leveling
composite resin) shade A2 was first
injected and spread in the proximal
box area and light cured to ensure a
complete seal (Fig. 6).
Followed by the proximal wall and
marginal ridge build-up with Beautifil II LS shade A2 to convert the original Class II into a Class I cavity. Once
the proximal wall and contact was
achieved the matrix band and ring
were removed (Fig. 7).
The Class I cavity build-up was completed using a combination of Beautifil Injectable XSL and Beautifil II LS
packable composite, leaving 1.5 mm
space for final occlusal anatomy
(Fig. 8).
Final occlusal morphology was
achieved using Beautifil Injectable X
shade A2 with build-up of each cusp
(oblique layering technique) and peripheral grooves as reference. (Fig. 9).
Buccal pit on tooth same tooth was
directly filled with Beautifil Injectable X – Universal Restorative, shade
A2.
Tip: The ideal consistency Beautifil
Injectable X enables you to inject and
shape at the same time for added
convenience (Fig. 10).
Brown resin stains were used on the
occlusal surface to mimic the adjacent teeth. High points were checked
with 40 micron articulating paper
and removed with a small round diamond bur while following the tooth
anatomy. Finishing and polishing of
composite resin, even though often
neglected, with posterior restorations remains essential to increase
longevity of the restoration.
contacts is essential to ensure predictable outcomes (Figs. 13, 14).
Simplifying the restorative process
with the following helps to increase
efficiency and save chair time. Prewedging to separate the teeth during
restoration and achieve good proximal contact, placement of both matrix bands at one time on adjacent
teeth, build-up of each tooth one at a
time, transforming Class II to Class I
makes layering and creating natural
occlusal morphology easier which
minimises numerous adjustments
in the finishing stage. The use of
Beautifil injectable X – Self-leveling
composites in combination with
Beautifil II LS packable composites
helps to achieve a better marginal
seal while minimising the intrinsic
shrinking effect. Once the restoration has been shaped and high
points checked, finishing and polishing should be performed to enhance
the aesthetics and long-term prognosis of the restorations.
Acknowledgment
Author wishes to thank Garrison
Dental Solutions and Shofu Dental
Asia-Pacific for material support.
References
1. Ferraris F. Adhesion, layering, and
finishing of resin composite restorations for class II cavity preparations. Eur J Esthet Dent. 2007 Summer;2(2):210-21.
2. Jordan RE, Suzuki M. Posterior
composite restorations. Where and
how they work best. J Am Dent Assoc
1991;122:30–37
3. Van Meerbeek B, Peumans M, Verschueren M, et al. Clinical status of
ten dentin adhesive systems. J Dent
Res 1994;73: 1690–1702.
4. Van Meerbeek B, Peumans M,
Gladys S, Braem M, Lambrechts P,
Vanherle G. Three-year clinical effectiveness of four total-etch dentinal
adhesive systems in cervical lesions.
Quintessence Int 1996; 27:775–784.
5. Fortin D, Swift EJ, Denehy GE, Reinhardt JW. Bond strength and microleakage of current dentine adhesives.
Dent Mater 1994;10:253–258.
6. Kanca J. Improving bond strength
through acid etching of dentin and
bonding to wet dentin surfaces. J Am
Dent Assoc 1992;123:35–43.
7. Tjan AHL, Bergh BH, Lidner C. Effect
of various incremental techniques
on the marginal adaptation of Class
II composite restorations. J Prosth
Dent 1992;67:62–66.
8. Feilzer AJ, Dooren LH, de Gee AJ,
Davidson CL. Influence of light intensity on polymerisation shrinkage
and integrity of restoration-cavity
interface. Eur J Oral Sci 1995;105:322–
326
9. An In-Vitro Comparison of Micro Leakage Between Two Posterior
Composites Restored with Different
Layering Techniques Using Two Different LED Modes Nikhil Relhan , K C
Ponnappa , Ashima Relhan , Anurag
Jain , Priyanka Gupta
10. Nikolaenko SA, Lohbauer U,
Roggendorf M, Petschelt A, Dasch W,
Frankenberger R. Influence of c-factor and layering technique on microtensile bond strength to dentin. Dent
Mater 2004;20:579–585.
11. Roeder LB, Tate WH, Powers JM. Effects of finishing and polishing procedures on the sur- face roughness
of packable composites. Oper Dent
2000; 25:534–543.
About the author
Dr. Anand Narvekar, India
Dr. Narvekar graduated in 1996 from
Pune India, has immersed himself in the
field of dentistry with a special focus on
aesthetic dentistry. His special interest
lies in treating complex full-mouth rehabilitation and smile design cases. His
keen eye for aesthetics extends beyond
dentistry as well as a globally acclaimed
photographer with his photographs published in industry-wide publications. He is
a fellow, advocator and trainer for MiCD
(Minimally Invasive Cosmetic Dentistry)
Global Academy, a key opinion leader for
a number of companies, and conducts
workshops for articulators, photography
and direct resin restorations.
AD
Finishing & polishing protocol
Finishing and margination of the
occlusal surface with Dura-Green
Stone, polishing with SHOFU OneGloss Midi-Points and super polishing with SuperBuff impregnated
disk to achieve a high gloss for the
extra enamel like lustre (Fig. 11).
PRINT
EVENTS
SERVICES
EDUCATION
Restorative outcome
The following graphical representation of the restorative technique
used with incremental layering
and the before / after images of the
IOPA radiographs further illustrate
the simplified protocol used to restore adjacent Class II cavities, where
natural contour and seal has been
achieved with a perfect contact (Figs.
11, 12).
Conclusion
Restoration of adjacent posterior
teeth with good contour and ideal
DIGITAL
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[14] =>
14
NEWS
Dental Tribune Middle East & Africa Edition | 6/2020
The future is now: Revolutionising
dentistry with digital dentures
Whereas it was previously impossible to imagine a dental laboratory
adopting a fully digital workflow,
digital dentistry has already redefined the previously established
dental procedures and empowered
dental professionals and clinicians
to take the leap and immerse themselves in a digital future. The benefits
of dental technology can be clearly
seen in the introduction of digital
dentures—not only has this facilitated denturists’ and dental clinicians’
work by offering more flexibility and
efficiency, but it has also improved
the patient experience and enabled
patients to become more involved in
their own care.
“I have been working with 3Shape for
about five years. In the beginning,
using denture software was not one
of my goals; nonetheless, curiosity
about the innovation and computer-aided design offered by 3Shape
© Sergii Kuchugurnyi/Shutterstock
By Iveta Ramonaite, Dental Tribune
International
Recent advancements in denture software have facilitated the transition to a fully digital workflow, and dental professionals are
invited to embrace the benefits of digital dentistry.
allowed me an opportunity to appreciate what appeared to be, for the
first time, a real game-changer,” Dr
Lucio Lo Russo, associate professor of
oral disease at the University of Foggia’s School of Dentistry in Italy, told
Dental Tribune International. “Since
then, huge developments have been
made in denture software, and it
can now be considered essential for
those who want to exploit the benefits of innovation and the related
AD
opportunities in dental practices and
laboratories,” he added.
According to Russo, using digital
dentures offers higher standardisation. This, in turn, manifests itself in
higher quality and a great reduction
in processing time and, consequently, increases efficiency and profitability. He noted that switching to
digital technology for the fabrication
of dentures also results in changes to
clinical and laboratory approaches.
He stated: “No more physical impressions, no more physical casts, no
time-demanding procedures. Each
step is precisely defined and optimised to save time and enhance effectiveness.”
A clean and enjoyable
experience
Bien-Air has always prioritized provider and patient safety by developing products that protects
against cross contamination. With the COVID 19 Pandemic, these features are more important than
ever.
Germen Versteeg, a denturist and
the owner of DTL Mediaan, one of
the first fully digital dental laboratories, told Dental Tribune International that besides obvious advantages
such as cost-efficiency, improved
denture workflow and scaled-up
production, working with digital
dentures makes the job much clean-
er. Whereas it used to be a messy
process, leaving fine layers of dust
on the working surfaces, Versteeg
compared walking into a denture
shop now with walking into a wellness centre: “It feels like home and
it’s really clean,” he said. “We have a
smile design room. So when people
come in for the first time we drink
a cup of coffee, and we discuss their
new smile.”
Using digital dentures also puts
more power into the hands of the
patients. Versteeg said: “The patients
themselves are in charge of their
aesthetics, and they can discuss the
aesthetics with the help of 3D simulations.”
Versteeg noted that fabricating a
new denture is fairly uncomplicated, since it only involves creating
a 3D picture of the patient, simulating a new smile and scanning the
mouth with an intra-oral scanner,
such as 3Shape’s TRIOS. He went on
to explain that people used to find
wearing dentures quite off-putting.
However, since it is a necessity rather
than a choice, Versteeg believes that
people should wear dentures with
confidence: “So why can’t we make
it a sexier thing, something to be
proud of?”
Endless possibilities
For those thinking about transitioning to a fully digital production
workflow, Versteeg explained that
3Shape software is highly sophisticated. Whether one wants to work
with dental models, intra-oral scanners or impressions, all these and
more options are already in the
software. “You have the flexibility
to work in your own way,” Versteeg
commented. Additionally, the software possesses older tools, making
the transition so much smoother
for more conservative dental professionals.
The high-speed dental handpiece without anti-retraction valves may aspirate and expel the debris
and fluids during the dental procedures. More importantly, the microbes, including bacteria and virus,
may further contaminate the air and water hoses within the dental unit, and thus can potentially cause
cross-infection.
Bien-Air, being conscious of cross contamination risks, has designed its electric attachments and highspeed air handpieces with anti-retractive valves which protect fluid retraction from the oral cavity into
non-sterilizable dental handpiece tubing and water lines. Having an anti-retraction valve in the body of
the handpiece, which can be autoclaved, significantly reduces the backflow of oral bacteria and viruses
into the non-sterilizable dental unit hoses.
Dr Lucio Lo Russo, University of Foggia’s School of Dentistry.
Products with anti-retraction valve :
TURBINES
COUPLING
Bora / L / LED
Unifix® (Anti-reflux valve)
CONTRA-ANGLES
CA 1:1 / CA 1:1 L
Prestige / L / LED
CA 1:5 / CA 1:5 L
Tornado X LED
CA 10:1 / CA 10:1 L
Tornado LED
CA EVO.15 1:1 L
Tornado LED
CA EVO.15 1:5 L
S
© 3Shape
As an extra preventive measure for cross infection, Bien-Air Unifix® coupling are also equipped with a
unique anti-retraction features protecting the the exhaust air tubing.
WWW.BIENAIR.COM
© 3Shape
Bien-Air Dental SA Länggasse 60 Case postale 2500 Bienne 6 Switzerland
Tél. +41 (0)32 344 64 64 dental@bienair.com www.bienair.com
Germen Versteeg, denturist.
[15] =>
+971528423659
p.mollov@cappmea.com
www.cappmea.com/implant
Dr Charlotte Stilwell
Prof Giovanni Salvi
Prof Bilal Al-Nawas
Prof Urs Brägger
Dr Vladimir Kokovic
Dr Krzysztof Chmielewski
Prof Hani A. Salam
Dr Salma Al Jahdhami
University of Sharjah
UAE
DDS, MSc
Poland
ITI President Elect, Specialist in
Prosthodontic Surgery
UK
University of Berne
Switzerland
University of Mainz
Germany
McGill University
Canada
University of Berne
Switzerland
BDS, MFD, RCSI, OMSB,
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THEORY FOUNDATION 2 I DATES TO BE ANNOUNCED I SURGICAL INTERVENTION
Programme Outline: Surgical Intervention Part 1, Surgical Intervention Part 2, Surgical Intervention Part 3 & Loading Protocols
THEORY FOUNDATION 3 I DATES TO BE ANNOUNCED I PROSTHETIC REHABILITATION
Programme Outline: Prosthetic Rehabilitation: Material Science, Prosthetic Rehabilitation: Partial Edentulous, Prosthetic
Rehabilitation: Removable Dentures Part 1 and Prosthetic Rehabilitation: Removable Dentures Part 2
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[16] =>
16
RESTORATIVE
Dental Tribune Middle East & Africa Edition | 6/2020
Clinical conduct for restoration of
non-carious cervical lesions – Case report
By Dr. Raphael Monte Alto, Dra.
Madelaine Torres da Silva, Dra.
Amanda Vaz dos Reis, Dr. Gustavo
Oliveira dos Santos, Portugal
Non-carious cervical lesions (NCCL)
are characterised by loss of dental
structure near the cementoenamel
junction, which may extend to the
coronary and radicular portion,
and by an association with dentin
hypersensitivity and gingival reces-
sion. NCCLs are not related to caries
and their etiology is multifactorial,
including both endogenous and exogenous factors related to the processes of biocorrosion, tension and
friction. NCCLs mainly affect the vestibular surface of the molars and premolars and are frequently observed
in clinical practice. This report aims
to describe the case of a 45-year-old
male patient identified as ALMM
and treated in the integrated clinic
Fig. 1. Initial appearance of NCCL (frontal view).
of the Faculty of Dentistry of Universidade Federal Fluminense with a
main complaint of dental wear.
Clinical examination revealed NCCL
and gingival recession in elements 11,
12, 13, 14, 15, 16, 33, 34 and 35, with no
complaint of dentin hypersensitivity. Rehabilitation treatment through
NCCL restorations using composite
resin was proposed, starting with anterior teeth; then, rehabilitation with
removable partial dentures was performed. The patient will be followed
up and there will be a thorough investigation to control the etiological
factors involved, thus enabling treatment success.
This case was realised at UFF (Universidade Federal Fluminense).
For further information, please contact:
Coltène/Whaledent AG
Feldwiesenstrasse 20
9450 Altstätten SG
Switzerland
Fig. 2. Initial appearance of NCCL (proximal view).
Fig. 3. Absolute isolation performed.
Fig. 4. Long diamond tip FF bevel on cervical enamel.
Fig. 5. Long diamond tip FF bevel on cervical enamel.
Fig. 6. Long diamond tip FF bevel on cervical enamel.
Fig. 7. Long diamond tip FF bevel on cervical enamel.
Fig. 8. Prophylaxis with pumice and water.
Fig. 9. Selective enamel acid etching (acid application for 30 seconds).
Fig. 10. Rinse with water for at least 30 seconds.
Fig. 11. Appearance of the enamel after acid etching.
ÿPage 20
[17] =>
POST-GRADUATE DENTAL EDUCATION
DUBAI | UAE
ITI Implant
Privilege Mastership
Organiser
Partners
[18] =>
18
RESTORATIVE
Dental Tribune Middle East & Africa Edition | 6/2020
◊Page 18
Fig. 12. Active application of ONE COAT 7 UNIVERSAL adhesive on
dentin and enamel.
Fig. 13. Active application of ONE COAT 7 UNIVERSAL adhesive on
dentin and enamel.
Fig. 14. Active application of ONE COAT 7 UNIVERSAL adhesive on
dentin and enamel.
Fig. 15. Photopolymerization of the adhesive.
Fig. 16. Measuring the depth of the lesion. Lesions up to 2 mm deep can
be restored with a single increment.
Fig. 17. Composite resin is selected (BRILLANT EverGlow – COLTENE)
Fig. 18. Application of composite resin.
Fig. 19. Application of composite resin.
Fig. 20. Application of composite resin.
Fig. 21. Application of composite resin.
Fig. 22. Removal of excess material using No. 12 scalpel blade.
Fig. 23. Appearance after removal of absolute isolation.
Fig. 24. Polishing of the cervical margin using flame tips. (DIATECH
System – COLTENE).
Fig. 25. Initial finish with lilac spiral (DIATECH Shapeguard – COLTENE).
Fig. 26. Initial finish with lilac spiral (DIATECH Shapeguard – COLTENE).
Fig. 27. Final polishing with blue spiral (DIATECH Shapeguard COLTENE).
Fig. 28. Final polishing with blue spiral (DIATECH Shapeguard COLTENE).
Fig. 29. End Result.
[19] =>
Dental Tribune Middle East & Africa Edition | 6/2020
19
NEWS
Study shows concerning levels of
dental patient aggression
By Dental Tribune International
of patients during their clinical training. Of
the students surveyed, 28% reported at least
one instance of physical aggression, whereas
36% had been victims of some form of reputational aggression.
NEW YORK, U.S.: When it comes
The study was conducted by a team
of researchers from the New York
University College of Dentistry
(NYU Dentistry), and is the first
study to measure dental patient
aggression levels in the U.S. The researchers surveyed 98 dentists who
practice in the New York City metropolitan area, each of whom completed a confidential online questionnaire concerning whether or
not they had experienced any of a
list of 21 specific forms of aggressive
behavior by their patients. Included
on this list were types of physical
abuse, such as pushing and kicking;
verbal abuse, such as swearing; and
reputational forms of abuse and
aggression, such as lawsuit threats
and detrimental comments on social media.
The surveys—which were conducted prior to the pandemic—showed
that 55% of dentists reported having experienced verbal aggression
from patients in the past year. Of
the respondents, 44% had been the
victims of reputational aggression
from their patients, whereas 22%
had been on the receiving end of
some form of physical aggression.
According to the research team,
these rates of aggression were
comparable with those reported in
other health care settings across the
U.S.
© PublicDomainPictures/Pixabaay
to dealing with behavioral issues
among dental patients, the most
common obstacle that practitioners seek to overcome is patient
anxiety. A new study out of the
U.S., however, has suggested that
levels of patient aggression toward
dentists may be a greater problem
than previously thought, signaling
an addition to the myriad problems
that dental professionals face when
providing treatment during the
COVID-19 pandemic.
The first study, titled “Patient aggression toward dentists,” was published in the October
2020 issue of the Journal of the American
Dental Association.
The second study, titled “Patient aggression
toward dental students,” was published in the
May 2020 issue of the Journal of Dental Education.
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“Dentistry is rife with situations
that can elicit strong negative
emotions, such as fear, pain, distrust, and anger,” said Dr. Kimberly Rhoades, the study’s lead
author and a researcher in the Family Translational Research Group
at NYU Dentistry. “Many patients
also experience high levels of anxiety and vulnerability, which may
increase negative responses or aggression. Establishing that aggression toward dentists is a problem
and how often it occurs can help us
develop interventions to prevent
aggression in dental practices.”
The researchers cautioned that a
larger nationwide study would be
necessary to better determine the
prevalence of patient aggression
in dental practices across the U.S.,
though they also recommended
that practices consider incorporating such measures as aggression
de-escalation training for staff
members.
Dental students also likely to
be victims of aggression
In a parallel study published earlier
this year in the Journal of Dental
Education, an NYU research team,
also lead by Rhoades, found that a
staggering 86% of dental students
reported having been subjected
to verbal aggression at the hands
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[20] =>
20
NEWS
Dental Tribune Middle East & Africa Edition | 6/2020
Still leading the pack: New studies confirm
exceptional accuracy of Primescan
By Dentsply Sirona
Our customers are our compass
Primescan, the latest generation
of intraoral scanners, is designed
for different digital workflows – in
practice with CEREC as well as with
the dental laboratory or other partners. Using the Connect software, a
digital 3D model can be transferred
directly to the laboratory of choice
for further processing. Using highresolution sensors and a short-wave
light, a scan of the tooth surfaces is
accurately captured. Up to one million 3D pixels per second are captured by Primescan, and these can be
executed more reliable than ever using optical high-frequency contrast
analysis.
© Dentsply Sirona
Dentsply Sirona presented the latest generation of its intraoral scanners at the beginning of last year:
Primescan enables users to take a
digital impression of the entire jaw
with outstanding accuracy. This has
been demonstrated by several international studies that support the extensive positive feedback on Primescan from various dental practices
with clear scientific data.
Experts once again confirm: Digital impressions made with Primescan are, fast and accurate and easy to take.1-5
New studies confirm high
performance of Primescan
Primescan enables highly precise
digital impressions to be taken over
the entire jaw, as evidenced by a 2019
University of Zurich study.1 Recently,
AD
Primescan’s accuracy has been further demonstrated once again by
national and international studies.3-5
The study of Dutton et al. demonstrates the versatility of the acquisition technology of Primescan, as it
not only records natural and prepared tooth surfaces with high precision, but also captures materials
used in dentistry with a high degree
of accuracy across all substrates and
for complete arch scanning.3 They
further tested the effect of different
substrates on the trueness and precision of eight different intraoral scanners. In 11 out of 15 categories, Primescan ranked number one, and for the
remaining four categories, Primescan ranked among the top three.3
Primescan’s impressive degree of
precision in taking digital impression over the entire jaw1 continues.
An in-vivo study done by the University of Gießen confirms the accuracy
of digital and conventional full-arch
impressions in patients, and results
show that among the tested scanners, only Primescan showed no significant deviations to long-span accuracies obtained with conventional
impressions.4
A study by Beijing University tested
the precision of Primescan and two
other intraoral scanners in edentulous jaws. The precision of Primescan was significantly better than the
other two scanners for maxilla.5 In
trueness of the three scanners, when
scanning the maxilla and mandible,
there was no significant difference.5
The results of the 2020 in vitro study
by the University of Zurich showed
that the preparation margin accuracy of Primescan was significantly
better than the other intraoral scanning systems involved in the study
in local accuracy for single-tooth
preparations.2
Dentists like the fact that, with Primescan, it is possible to scan deep
regions (up to 20 mm). This allows
a digital impression even with subgingival or particularly deep preparations. Almost all tooth surfaces are
captured, even when scanning from
a very sharp angle.
“The studies confirm again that,
with Primescan, we have provided
our customers with a high-quality
technology that delivers truly impressive results," said Dr. Alexander
Völcker, Group Vice President CAD/
CAM at Dentsply Sirona. "We continue to add and improve workflows
with Primescan as we’re convinced
Primescan’s outstanding technology
opens the doors for more applications in digital dentistry. Thanks to
the technology of high-frequency
contrast analysis, Primescan enables
our customers to achieve outstanding accuracy in digital impression.
And the extensive positive feedback
from our respected experts and users all over the world, our most important compass, encourages us to
continue to lead in this area’s development and innovation.”
“As a dentist, my expectation of myself is to deliver exceptional results
for every one of my patients.” said
Dr. Carlos Repullo, a dentist from
Seville, Spain. “And with Primescan
I can do so: the scan delivers a precision that one can scarcely imagine
being improved. And this also applies to a full jaw scan, which can be
prepared exceptionally quickly. This
is exactly the quality we need in our
practices.”
References
1. Ender A, Zimmermann M, Mehl A.
Accuracy of complete- and partialarch impressions ofactual intraoral
scanning systems in-vitro. Int J Comput Dent 2019;22(1):11-19.
2. Zimmermann M, Ender A, Mehl
A. Local accuracy of actual intraoral
scanning systemsfor single-tooth
preparations in vitro. J Am Dent
Assoc
2020;151(2):127-135
(doi.
org/10.1016/j.adaj.2019.10.022).
3. Dutton E, Ludlow M, Mennito A
et al. The effect different substrates
have on the truenessand precision
of eight different intraoral scanners.
J Esthet Restor Dent 2020;32(2):204218 (doi: 10.1111/jerd.12528. Epub 2019,
Sep 30).
4. Schmidt A, Klussmann L, Wöstmann B, Schlenz MA. Accuracy of
Digital andConventional Full-Arch
Impressions in Patients: An Update. J Clin Med 2020;9(3):688 (doi:
10.3390/jcm9030688).
5. Cao Y, Chen JK, Deng KH et al. [Accuracy of Three Intraoral Scans for
PrimaryImpressions of Edentulous
Jaws.] Beijing Da Xue Xue Bao Yi Xue
Ban 2020;52(1):129-137.
More information about Primescan at
www.dentsplysirona.com/primescan.
For more information about the full
Dentsply Sirona portfolio, please contact
your local representative.
Dentsply Sirona
21st Floor, The Bay Gate Tower
Business Bay, Al Sa’ada Street
Dubai, United Arab Emirates
Tel.: +971 (0)4 523 0600
Web: www.dentsplysirona.com/en
E-mail: MEA-Marketing@dentsplysirona.com
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22
NEWS
Dental Tribune Middle East & Africa Edition | 6/2020
Benefits of a fully integrated
digital workflow – clinical focus
How digital impressions will help you rebuild: As we all try to find ways to bounce back
from COVID-19, could digital dental impressions be just the boost your practice needs?
By Dentsply Sirona
As dental professionals across the country
plan a tentative path out of lockdown, many
are looking for new ways to deliver dental care.
New guidelines have forced practices to operate in a different way, but forward-thinking
dentists are seeing these adjustments as an opportunity to bring about change for the better.
Key, amongst the long list of priorities in this
new COVID-19 era, is keeping chair time to a
minimum, so anything that achieves this and
makes procedures more efficient, is extremely
valuable. Digital impressions do both, and also
deliver a substantial amount of business-building potential. So, what’s not to like?
More efficient, more hygienic, more
comfortable
Digital impressions can be taken with a Primescan intraoral scanner in a matter of seconds.
Simply use the sleek scanner wand, which
comes with a choice of removable sleeves (autoclave, wipe-down and single-use), to sweep
AD
around the mouth, capturing outstanding
quality, digital scans in less time than it would
take to prepare for and take a traditional impression.
The digital impression is saved as a high definition, 3D image within the CAD/CAM software,
whilst the patient is in the chair for considerably less time than for conventional impressions, and the whole experience is far more
comfortable.
Access all areas
Once captured, digital impressions open up access to a range of efficient, income-generating
workflows that are much easier to achieve than
using traditional methods.
intelligent solutions
For instance, you can offer patients clear aligner treatment through digitally enabled services
such as SureSmile Aligner treatment. Clear
aligner treatments such as this have soared in
popularity recently and offering this service
will help keep your patients loyal and ensure
you are responding positively to patients’ demands.
The advantage of
with Interchangeable Articulators
Add a chairside milling unit to your workflow
and you have opened the door to a whole
new world of digital design and manufacture.
Dentsply Sirona’s CEREC single visit restorative
workflow creates fast, efficient single-tooth
restorations, reducing the risk of cross-contamination and giving patients the safest, most
comfortable experience possible, all achieved
in a single visit. Additionally, it opens up new
revenue streams, whilst containing costs within the practice.
Accurate
t r a n s f e r
Labs get digital
Even if you don’t want to move straight into
a full digital workflow in your practice, digital
impressions can still open up opportunities
with other providers; one of the most important being your dental laboratory. More and
more labs are now adopting digital processes
and are able to receive digital impressions from
dentists. The digital technologies also improve
communication between clinician and technician, which is achieved via instant, efficient and
secure software.
DENTIST
LAB.
workflow
Enable interchangeability of stone models between
articulators of the same brand (when calibrated) providing
convenience in handling and clinical communication x
laboratory and digital equipment.
Many of the articulators on the market are not calibrated. In this
way, stone models mounted on a given SAA cannot be
transferred to another SAA with guaranteed accuracy, even
though they are from the same brand. Bio-Art developed a
standardization kit consisting of tools used to calibrate the
articulators (models A7Fix and A7Plus). Using this resource is
essential for the professional who has more than one
articulator, as well as for use between dentists and dental
technicians without the need to keep the models always in the
same articulator. The calibration allows the interchanging of the
models previously mounted on calibrated articulator plates.
The gauging device (calibration column) must be used
periodically to check the accuracy between the articulators.
In a pre-COVID world, digital impressions were
slowly gaining in popularity. Now, with the
need to reduce patients’ time in practice and
with infection control stakes much higher, intraoral scanners are becoming an essential tool
for dentists who want to not only survive, but
also thrive in the new world of dentistry. And
what’s even more exciting is the range of opportunities that are at your command once
you’ve made that first step.
Find out more by
scanning the QR code.
For more information about the full Dentsply Sirona
portfolio, please contact your local representative.
Extracted article from the book:
Logical - A clinical approach to occlusion
Dentsply Sirona
21st Floor, The Bay Gate Tower
Business Bay, Al Sa’ada Street
Dubai, United Arab Emirates
Tel.: +971 (0)4 523 0600
Web: www.dentsplysirona.com/en
E-mail: MEA-Marketing@dentsplysirona.com
[23] =>
[24] =>
24
NEWS
Dental Tribune Middle East & Africa Edition | 6/2020
Interview: Consulting the Internet should
in no way replace visiting the dentist
By Dental Tribune International
es are very common. What do
you think the reasons are for
so many people consulting the
Internet?
Everyone has done it—searching
for symptoms on the Internet. Recent statistics show that searches
for dental and mouth-related problems are very common in Europe.
On average, Europeans generate
over 200,000 searches per month
for toothache alone. This benefits
patients by assisting them in taking
responsibility for their own health,
but unfortunately self-diagnosing
on the Internet can sometimes do
more harm than good. Self-diagnosis
can fuel anxiety and hypochondria,
and some websites provide unreliable information. In an interview
with Dental Tribune International,
Dr Chun Tang, of Pall Mall Medical in
Manchester in the UK, shared some
tips for dental professionals on how
to educate patients about this matter.
Easy accessibility is just one of the
many reasons why dental and oral
health-related searches are common.
Not everyone has access to a dentist,
and the Internet has given patients
the ability to find information at
their own convenience, especially
during a global pandemic where
many feel uncomfortable going to
a clinic or are unable to make an appointment. Furthermore, searching
for information on symptoms allows patients to take some responsibility for their own health. They
can reassure themselves by finding
relevant information written by
healthcare professionals on a variety
of reliable websites.
Dr Tang, according to the statistics released by Lenstore, dental
and oral health-related search-
What advice would you give
to dentists who are dealing
with patients who search for
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If patients insist on researching their
symptoms online, make them aware
of the websites they should avoid.
Encourage them to use only reliable
websites that provide helpful information, as these sites will usually
tell them what the red flags are and
when they should contact a healthcare professional.
Dentists can also offer patients different ways in which to contact them in
order to prevent them coming in too
often. Offering patients the chance
to have consultations via email, text
or even video call can be a great way
to determine whether further action
is required, and this is beneficial for
both dentist and patient. It is important to remember that prevention is
the key with most diseases—if something is caught early, it can be managed better. Reaffirm to patients that
there is nothing wrong with checking their symptoms on the Internet,
but this should only be done in order
to assist their understanding of their
condition and should in no way replace the dentist.
People will probably continue
to check online for information
about their symptoms despite
the risks, simply because it is
so tempting and convenient.
How can dental healthcare
professionals help guide their
patients to the right resources?
What should be the ultimate
goal in the dentist–patient relationship?
professionals guide their patients to
correct and reliable sources of information in order to ensure that they
are not harming themselves. Secondly, patients should be made aware of
recognised and trustworthy websites
as well as the ones that they should
avoid as biased. The latter could be
promoting their own products and
presenting incorrect information
that does not have patients’ best
interests at heart. Lastly, open communication is the most important
factor for both patients and dentists
and should be the ultimate goal. People will always research their symptoms online, but giving patients the
correct information about how to do
it properly can prevent many unnecessary problems.
As millions of people now own a
smartphone, researching symptoms
on the Internet has become second
nature to so many of them. Firstly, it
is important that dental healthcare
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information about their symptoms on the Internet and either
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26
NEWS
Dental Tribune Middle East & Africa Edition | 6/2020
Mental health in the dental profession
during the COVID-19 pandemic
By Monique Mehler, Dental Tribune International
Even though millions of people suffer from anxiety and depression, according to the World Health Organization, psychiatric
disorders often remain under-recognised and underdiagnosed.
The persisting stigma around mental health issues exacerbates
the problem, since those suffering feel shame and guilt on top
of their existing condition and may therefore fail to seek the
appropriate help. Because of the chronic stress associated with
their profession, dentists are especially prone to occupational
burn-out and depression, as studies have shown. Now, with the
spread of SARS-CoV-2, there is an even greater physical and psychological burden among dental professionals.
The profession of dentistry has long been claimed to have a high
suicide rate owing to a range of physical and mental stressors. A
feature article by orthodontist Dr Randy Lang from 2007 sums
up statistics which he collected from several studies that indicate that dental professionals are indeed at higher risk of stressrelated mental and physical illnesses. For example, Lang stated
that “dentists suffer psycho-neurotic disorders at a rate of 2.5
times greater than physicians” and “coronary disease and high
blood pressure are over 25 per cent more prevalent among dentists than in the general population”.
In a more recent investigation, a feature article by Vice Media
reported on the significant occupationally linked pressure in
the form of “money trouble, physical and emotional stress, isolation, and the unfavourable public perception of dentists in
general”.
Consequences of the coronavirus pandemic
In addition to the pre-existing stressors of their jobs, dental professionals have been particularly burdened by the challenges
arising from SARS-CoV-2. Dentistry has been reported to be one
of the most high-risk occupations regarding infection potential,
since the virus is airborne and dentists work in very close proximity to their patients. Furthermore, practices have been forced
to close during lockdowns in many countries, adding immense
financial pressure and leading to the retrenchment of staff in
some cases.
In a recently published paper, Dr Andrea Vergara Buenaventura
and her research team from the Universidad Cientificadel Sur
in Lima in Peru have provided a comprehensive review of the
consequences of past epidemics for mental health and have assessed possible aspects that might be associated with mental
implications for dentists owing to the COVID-19 pandemic.
In an interview with Dental Tribune International, Vergara Buenaventura shared that the idea for the article came up during
a video call with colleagues who all shared similar worries and
fears. “In the beginning, when we started with the literature
review, we only had few references on COVID-19 and mental
health and much less about mental health in dentists. We just
found data about past epidemics, but it was precisely the same;
the same feelings were reported,” she explained. Surveys conducted in India and Israel, for example, confirm the psychological distress being experienced by dental professionals in
response to the COVID-19 pandemic.
Despite the challenges, Vergara Buenaventura is hopeful that
this pandemic “will strengthen us as individuals and as a system”. “In my country, Peru, this pandemic has brought out
the weaknesses of the Peruvian health system and has shown
that dentists have to be part of the healthcare system. Dentists
must be prepared to play a more critical role and to fight against
emerging life-threatening diseases,” she concluded.
The challenges so far
Dr Sujata Basawaraj runs a private practice in Lewisville in Texas
in the US and has first-hand experience of the challenges posed
by SARS-CoV-2. “Mentally, working during a pandemic has been
very stressful and tiring owing to the number of additional tasks
that go into creating a safe environment for myself, employees
and patients in my practice.
We have to treat every patient with the possibility that he or
she may have contracted SARS-CoV-2,” she explained to Dental
Tribune International. She continued: “I feel like a level of communication that was imperative for dentists has been removed
owing to the new gear we need to wear. It isn’t as easy
AD to talk to patients, but at the end of the day, I believe
that everyone’s safety should come first.”
Basawaraj went on to say that, as medical professionals, she and her colleagues are responsible for taking
care of their patients’ health, which is something they
have always been accountable for. She added: “I hope
that people will continue to, or start to if they do not
already, follow safety and social distancing guidelines
as well as be patient with us doctors as we work to provide care during the pandemic.”
Despite the difficulties she has encountered, Basawaraj remains positive and takes care of her mental
health as well as possible: “At the moment, spending
time with my family, cooking, going on walks in the
park while wearing a mask and social distancing (...)
have been my way of relieving some of the stress that
comes from working during this pandemic. (...) All we
can do at this point is hope for the best.”
Creating a healthier work environment
A study by researchers from London has investigated
mental healthcare for medical staff and affiliated
health-care workers during the COVID-19 pandemic
and how they can be supported. The authors report
that “rapid access to counselling, psychiatry and contingency for time off work” is important, but “prevention and mitigation is far more important than cure”.
Experts from several universities across the US have
published a review paper in which they report that
psychological flexibility and self-care are fundamental aspects of psychological health in general. Also, exercising regularly has a positive influence on overall
well-being, according to researchers from Italy who
specifically looked at how activity levels among the
population changed during the pandemic. Owing to
physical isolation and distancing, feelings of loneliness and anxiety may arise, and these should be addressed. It is key to reach out to family and friends in a
safe manner, for example by keeping in touch via the
phone or video calls.
In the pursuit of psychological health, it should be realised that the COVID-19 pandemic is unprecedented
and each individual experiences and responds very
differently. For these reasons, going at one’s own pace
and taking care of oneself as well as possible are absolutely crucial.
Many dental associations offer resources, support
and advice for dental professionals who are affected
by work and personal stress. For instance, the British
Dental Association gives its members access to 24-hour
counselling and emotional support via Health Assured’s helpline, and the American Dental Association
offers COVID-19 mental health resources on its website.
Another helpful tool is a platform called Confidental,
which aims to provide emotional first aid for UK dentists in distress.
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28
NEWS
Dental Tribune Middle East & Africa Edition | 6/2020
WHO and dentistry:
moving on from misinformation
By Jeremy Booth, Dental Tribune International
GENEVA, Switzerland: The World
Much of the criticism that has been
directed at WHO during the SARSCoV-2 pandemic has been in reaction
to guidance about practices that are
unfamiliar to the citizens of many
countries, such as the wearing of
masks in public and the need to reduce social contact. Dentists around
the world reacted defensively when
the agency called for the delay of
routine dental care in interim guidance issued on 3 August, with many
fearing that further postponement
of elective care would damage oral
health and compound the damage
that had already been done to their
businesses during the first wave of
the virus. Some dentists felt that it
was an attack on the effectiveness
of infection prevention measures
within dentistry.
Florida dentist Dr Greg Prior told
ABC Action News in late August that
the timing of the WHO recommendation had made no sense, as dentists in the state had been allowed
to resume the provision of oral care
in April. Since emergency measures
were put in place in the state in
March, Prior has implemented even
greater infection control measures
at his dental practice, including the
installation of air purifiers and air
filters. “Dentistry is so important for
people’s overall health,” Prior told
the news agency. “It seems untimely
they would’ve [made that recommendation], especially since we’re
all coming back to work and we’re all
putting in the protocols.” The American Dental Association (ADA) had
© Firmbee/Pixabay
Health Organization’s (WHO) handling of the global pandemic has
brought it more criticism than praise,
and dentists are among those who
have denounced public health guidance from the UN agency. According
to dental associations contacted by
Dental Tribune International (DTI),
WHO has been the subject of unbalanced media coverage relating to its
guidance on dental practice.
WHO interim guidance issued in August was misunderstood by many dentists and dental patients owing to media reports.
said in mid-August that it “respectfully yet strongly disagrees” with the
WHO guidance.
A long list of news agencies reported
on the WHO recommendation, and
it was also covered by publishers
from the dental industry press, including DTI. In an email to dental
associations on 13 August, Dr Benoit Varenne, a WHO dental officer,
expressed concerns about the way
that the guidance had been interpreted by the media. “Unfortunately,
a number of media headlines intentionally or not—when they are
referring to the WHO guidance, did
not mention that the recommendation to delay routine oral healthcare
is only suggested in an intense un-
controlled community transmission
scenario,” Varenne wrote. He asked
dental leaders to be aware of incomplete reporting, and the fact that it
could heighten the concerns that
many patients already had with regard to visiting their dental practice
during the pandemic.
According to the British Dental Association (BDA), incomplete reporting
on the WHO guidance by the media had caused confusion about the
agency’s recommendations in the
area of oral healthcare.
ments should be postponed but
suggested that some treatments
be delayed until there has been a
sufficient reduction in SARS-CoV-2
community transmission rates. It
also stated that ‘adequate ventilation in oral healthcare facilities
reduces the risk of transmission in
closed settings’. This principle has
been taken up by the profession
in order to reduce fallow time and
to make it possible to see more patients.”
A BDA spokesperson told DTI:
“Contrary to media reports, the
guidance did not say categorically that all non-urgent treat-
The spokesperson added that WHO
“could not necessarily provide a
one-size-fits-all solution, and it was
considered inappropriate to apply
this advice in the UK’s current context, where dentists already have
presented “Does Dynamic Navigation Represent a New Era in Digital
Dentistry”.
• 2nd Place - Dr Amruth Ganesh, India, who presented “Vista – The Present and Future of Periodontal Plastic Surgery: A Case Report”.
• 3rd Place - Dr Les Kalman, Canada,
who presented “In Vitro Assessment
of a Novel Additive Manufactured Titanium Implant Abutment”.
Dental, NextDent by 3D Systems,
Aidite, Shofu, Scorpios International
LLC, BOREA, GSK, Coltene, SDI, Fondaco, Vital Alliance Co. Ltd, MDent,
3Shape, ORMCO, Ultradent, Curaden,
Curaprox, Philips Sonicare, VITA, GC,
Zirkonzahn, Hu-Friedy, EMS, Southern Implants, Castle General Trading, Acteon, FKG, ClearSmile Aligner,
Bausch, DynaFlex, Medit, Maptec
and Formlabs Dental.
All participating delegates received a
certificate of attendance. The awards
were sponsored by Philips Sonicare,
Shofu and Castle General Trading.
CAPP November Dental Livestream
was supported by the following scientific partners: Saudi Dental Society, Singapore Dental Association,
Kuwait Dental Association, iDentalCourses, International group for Oral
Rehabilitation, Lebanese Dental Association, The Lebanese Orthodontic
Society, Oman Dental Society, Iraqi
Dental Association, Saudi Orthodontic Society (Digital Orthodontics Scientific Partner), Association
of Orthodontists (Singapore), AALZ
Aachen Dental Laser Center, British
Academy of Restorative Dentistry
(BARD), British Academy of Dental
Implantology (BADI), Tipton Train-
extremely high levels of infection
prevention and control in place.”
The
Bundeszahnärztekammer
(BZÄK) (German dental association) told DTI that it also felt that
media reporting had led to the interim guidance from WHO being
misunderstood. “The WHO recommendation is essentially the same
as the BZÄK recommendations.
Only a postponement of dental
visits in an uncontrolled transmission scenario is recommended, and
otherwise the official health policy
recommendations at national, regional or local level should be followed,” the association said.
◊Page 2
adoption of the areas that have been
proven and to aid the integration of
new technologies that benefit dental
professionals in all dental disciplines.
The scientific programme included
topics on dental sleep medicine,
bone regeneration and soft tissue
management, laser dentistry, prevention and oral hygiene, surgical
regenerations in periodontal defects,
aesthetic and digital smile design, occlusion, material selection for high
performance rehabilitation and
dental facial cosmetic surgical procedures related to grafts, implants as
well as non-surgical periodontal and
endodontic treatments.
Dental facial cosmetic treatments remain one of the most popular treatments in the middle east region and
the conference surpassed expectations through its 40+ lecture presentations.
Total of 25 multi-disciplinary
hands-on training courses
In addition to the two conferences
and two sub-specialty seminars,
over 25 multidisciplinary hybrid
hands-on training courses took
place, catering to dental professionals, and showcasing the latest trends
in restorative, aesthetic, and digital
dentistry, as well as implantology,
facial aesthetics, orthodontics, endodontics, dental technologies, dental
hygiene, and product innovations.
The courses were organized through
online livestreaming as well as face
to face interaction at the CAPP Training Institute in Dubai, UAE.
Poster presentations
The annual poster presentations
were hosted virtually as part of the
two conferences. The competition
was open to all dental students, interns, graduate students, general
dentist, or dental specialists who had
submitted their entries. Each participant presented during the event and
was reviewed by the scientific committee live online. CAPP and the scientific committee had the pleasure
to congratulate the winners:
• 1st Place - Dr Eman Maged Fouad &
Dr Aya Mohamed Fawzy, Egypt who
Thank you to all sponsors, media, and scientific partners
CAPP would like to thank all sponsors, media publishers and scientific
partners for supporting the CAPP November Dental Livestream continuing dental educational programme.
The sponsors included Dentsply Sirona, Oral-B, Straumann Group Digital Solutions, Ivoclar Vivadent, Henry Schein Connect Dental, NSK, 3D
Middle East, 3D Systems, Carestream
ing, International College of Dentists,
Emirates Dental Hygienist Club, FDC
Academy, Q & M Dental Group and
Association for Oral Health Therapists Singapore.
CAPP Dental ConfExpo 2021 to
take place in November 2021
CAPP will be organising the CAPP
Dental ConfExpo on 17-19 November 2021 in Dubai, UAE. During these
three days, the 16th CAD/CAM Digital Dentistry and 13th Dental Facial
Cosmetic International Conferences
will take place in collaboration with
World Expo 2020. The World Expo
2020 is a global event taking place
01 October 2021 – 31 March 2022 and
is important as the initiative promotes preserving the planet as well
as sustainability, mobility, and opportunity. Expo 2020 Dubai will be
a celebration of the UAE Vision 2021.
[29] =>
[30] =>
[31] =>
Scan and connect
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Enjoy the scan.
With the connectivity options of Primescan.
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Are you ready for CEREC?
For CEREC users, it’s simple: CEREC makes even the best dentists better. So going
digital was a great decision, but until they did it they too had their doubts. Would
everything go smoothly straight away? No. Could they learn to handle the technology?
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[title] => News
[page] => 08
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[title] => HuFriedyGroup introduces Harmony Ergonomic Scaler designed with TrueFit Technology
[page] => 10
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[4] => Array
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[title] => Simplified protocol for adjacent Class II direct resin restorations
[page] => 12
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[5] => Array
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[title] => The future is now: Revolutionising dentistry with digital dentures
[page] => 14
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[6] => Array
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[title] => Clinical conduct for restoration of non-carious cervical lesions – Case report
[page] => 16
)
[7] => Array
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[title] => Study shows concerning levels of dental patient aggression
[page] => 19
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[8] => Array
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[title] => Still leading the pack: New studies confirm exceptional accuracy of Primescan
[page] => 20
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[9] => Array
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[title] => Benefits of a fully integrated digital workflow – clinical focus
[page] => 22
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[10] => Array
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[title] => Interview: Consulting the Internet should in no way replace visiting the dentist
[page] => 24
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[11] => Array
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[page] => 26
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[toc_html] =>
[toc_titles] => CAPP November Dental Livestream sets record attendance
/ Industry
/ News
/ HuFriedyGroup introduces Harmony Ergonomic Scaler designed with TrueFit Technology
/ Simplified protocol for adjacent Class II direct resin restorations
/ The future is now: Revolutionising dentistry with digital dentures
/ Clinical conduct for restoration of non-carious cervical lesions – Case report
/ Study shows concerning levels of dental patient aggression
/ Still leading the pack: New studies confirm exceptional accuracy of Primescan
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