digital international No. 4, 2022
Cover
/ Editorial
/ Content
/ News
/ Guided one-stage and two-stage implant placement in the anterior zone
/ Immediate implant placement and provisionalisation of a mandibular first molar
/ A multidisciplinary digital approach to a complex case - Surgical, aesthetic and occlusal procedure planning for implant-supported full-arch prostheses
/ Dentist–technician communication: We can all do better!
/ If I could see through your eyes, I wonder what I would see?
/ “Psychological knowledge and techniques will save time, money and frustration in the long run” An interview with Lena Myran
/ Building a sustainable dental practice
/ Study examines public perceptions regarding sustainable dentistry
/ Dental Thermal App offers “a simple, yet intuitive, clinically based workflow” An interview with Dr Les Kalman
/ “The beauty of exocad is that it’s a universal open platform” An interview with Dr Miguel Stanley
/ Unboxing the 3Shape TRIOS 5 intra-oral scanner
/ Manufacturer news
/ Meetings
/ “Gaining this international recognition means receiving an important responsibility” An interview with Dr Tiziano Testori
/ International events
/ Submission guidelines
/ International imprint
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[1] =>
issn 2193-4673 • Vol. 3 • Issue 4/2022
digital
international magazine of digital dentistry
news
Artificial intelligence
and augmented reality
in implant planning
case report
A multidisciplinary
digital approach
to a complex case
practice management
Dentist–technician
communication:
We can all do better!
4/22
[2] =>
DIGITAL DENTISTRY –
VERSATILE AND
CONVENIENT.
The Ceramill DRS system for the dental practice and the laboratory!
CONNECTION KIT
PRACTICE
PRODUCTION KIT
PRACTICE
HIGH-SPEED ZIRCONIA KIT
PRACTICE
LABORATORY
FALL-SHARING
With its Ceramill DRS system, Amann Girrbach offers a future-oriented, convenient and versatile
solution for digital dentistry. As open and flexible as you want it to be.
It provides for convenient CAD/CAM workflows in your own practice as well as for interdisciplinary
collaboration with the laboratory, thus giving you more freedom for the essentials.
www.ceramill-drs.com/en
Amann Girrbach AG
Tel +43 5523 62333-105
www.amanngirrbach.com
[3] =>
editorial
|
Dr Scott D. Ganz
Editor-in-Chief
Choices
Another year has passed, and 2022 will soon be history. As we look forward to 2023, we should appreciate
how technology and innovation have impacted our world
of dentistry. So much has changed, and yet so much remains the same. While it is clear that digital dentistry has
evolved from a concept to a reality for many dental practitioners worldwide, many have elected not to move from
an analogue workflow to a digital workflow. Whether it
be for general dentistry, crown and bridge restorations,
endodontic treatment, oral surgery, dentures or dental
implants, a digital solution is available. Although digital
imaging has taken the place of film for necessary focused
imaging for everyday dentistry, there are still those who
have not parted with their developers for financial reasons or owing to old-school philosophical reasoning or
fear of change.
When it comes to patients who require complete dentures, the conventional training for understanding lip support, centric occlusion and vertical dimension of occlusion is still provided in dental schools around the world
despite the fact that new digital protocols are available. However, it is still important to note that we must
follow sound prosthodontic protocols to ensure success. Denture fabrication has been greatly impacted
by new and improved materials that offer excellent
strength and acceptable aesthetics produced by milling or
3D-printing modalities. The art of the denture impression
with heat-activated border moulding, custom trays and
wax rims has been replaced with intra-oral scanning
and advanced software applications to aid in the virtual
design of the definitive prosthesis.
The use of CBCT can provide 3D diagnostic imaging,
which can be combined with other digital data to fully
appreciate the patient’s unique anatomical presentation.
It is the complete assessment of the patient that will become the foundation for the treatment recommendations
which become the plan to be completed by one or more
practitioners. Yet, many dentists still live in a 2D world and
have yet to appreciate the world of 3D imaging for dental
implants, endodontic treatment, oral surgery, temporomandibular disorder, aesthetic smile design and much
more. Unfortunately, there is both a financial cost as well
as a cost in time for the clinical team to utilise technology correctly. As an example, we can use CBCT and interactive treatment planning software to assess implant
receptor sites, merge the data with that obtained from
the intra-oral scan and plan for implant placement and
still place the implants utilising a freehand protocol, or we
can use all of that information to elevate treatment and
fabricate a surgical guide to accurately place the implant
based on the 3D planning, taking the guesswork out of
the process.
What does all this mean? We must decide which road to
take when addressing the needs of our patients. As analogue methods are being replaced with digital workflows,
we can either choose to be on board with a full commitment or we can adapt slowly after becoming educated
and trained in the various protocols. Our end-of-the-year
publication of digital may provide information to help
clinicians learn more about what leaders in the field are
doing so that an educated decision can be made.
Happy holidays!
Dr Scott D. Ganz
Editor-in-Chief
4 2022
03
[4] =>
| content
editorial
Choices
03
Dr Scott D. Ganz
news
What is driving the European dental implant markets?
06
Simon Trinh
Artificial intelligence and augmented reality
in implant planning
08
page 06
Dr Francesco Mangano
case report
Guided one-stage and two-stage
implant placement in the anterior zone
10
Dr Paula Corvello
Immediate implant placement
and provisionalisation of a mandibular first molar
16
page 16
Dr Mischa Krebs & Alexander Müller
A multidisciplinary digital approach to a complex case
Dr Antonio Lipari, Dr Mario Perotti, Marco Marzolla & Dr Valerio Bini
practice management
Dentist–technician communication: We can all do better!
26
If I could see through your eyes, I wonder what I would see?
30
“Psychological knowledge and techniques
will save time, money and frustration in the long run”
34
Dr Joseph Fava & Karim Sahil
Jerko Bozikovic
page 26
An interview with Lena Myran
features
Building a sustainable dental practice
36
Study examines public perceptions regarding sustainable dentistry
38
Dr Sanjay Haryana
Brendan Day
opinion
Dental Thermal App offers “a simple, yet intuitive,
clinically based workflow”
An interview with Dr Les Kalman
40
“The beauty of exocad is that it’s a universal open platform”
42
Unboxing the 3Shape TRIOS 5 intra-oral scanner
44
manufacturer news
meetings
46
An interview with Dr Miguel Stanley
Dr Mona Thygesen
Cover image courtesy of
nuclear_lily/Shutterstock.com
4/22
issn 2193-4673 • Vol. 3 • Issue 4/2022
digital
international magazine of digital dentistry
18
Registration for 2023 Chicago Dental Society
Midwinter Meeting is open
IDS organisers herald beginning of post-COVID-19 era
International events
51
52
56
interview
“Gaining this international recognition means
receiving an important responsibility”
news
An interview with Dr Tiziano Testori
case report
about the publisher
Artificial intelligence
and augmented reality
in implant planning
A multidisciplinary
digital approach
to a complex case
submission guidelines
international imprint
practice management
Dentist–technician
communication:
We can all do better!
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4 2022
54
57
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[5] =>
simply.TRIOS 5
Intraoral scanning that simply makes sense
Hygienic by design for minimal risk of
cross-contamination. Smaller and lighter
than ever for next-level ergonomics. And
a ScanAssist engine with intelligent-alignment
technology that makes precision scanning
effortless, every time.
[6] =>
| news
What is driving the European
dental implant markets?
By Simon Trinh, Canada
Unsurprisingly, the COVID-19 pandemic crippled the
entire dentistry industry in 2020 and 2021, when elective medical surgeries such as dental implant and bone
grafting procedures were postponed. Some countries,
namely Switzerland, Belgium and the Netherlands, recovered more quickly than others, and others were heavily
affected by extended shutdowns, particularly those that
rely on patients from abroad, such as Italy. However, this
impact on the market is relatively straightforward and
predictable, devastating as it may be, and recovery will
be a linear process. What is far more intricate to uncover
are the factors that are driving the industry on a broader
scale, looking years ahead instead of months.
governments do provide some form of reimbursement for
dental implant procedures. However, coverage is usually limited and partial reimbursement is only so useful
when the cost of a typical procedure is already so high.
Furthermore, most private health and dental insurance
policies do not cover dental implants. This is a severe
hinderance for procedure growth, particularly in the
younger demographic who cannot easily afford a
procedure costing thousands of euros compared with
people in their 50s or 60s.
It would be foolish to begin a discussion of market drivers
for dental implants without addressing the most obvious
factor: an ever-growing ageing population that naturally
has a higher incidence of missing teeth and the need
for aesthetic dentistry procedures. Once again, however,
this is an obvious avenue of growth. A far more compelling patient-driven trend to discuss is cost and its
implications.
The use of cheaper implants is driving market growth, not
in terms of sheer market value but in terms of procedure
numbers. Nowhere is this more evident than in the Italian
market, where there is a perfect storm of cost sensitivity
and massive demand for aesthetic dentistry. Previously,
patients had no alternative to expensive, premium implants, but dentists are now able to offer significantly discounted products at a fraction of the cost. Implants were
once dominated by European products, but companies
from South Korea, Israel and Argentina, to name a few,
have emerged in great numbers in the market. Opening
the market up to patients who could previously not afford
such treatments has contributed to a substantial increase
in potential procedure volume.
It is not surprising that implant procedures are expensive by nature; however, it comes as more of a shock
that there is almost no insurance coverage or reimbursement for such procedures. It is true that in some countries, such as Sweden, Germany and the Netherlands,
1
Value segment companies flooding
the European implant market
2
Fig. 1: Dental implant market growth in Europe. Fig. 2: Overview of the surgical guide market by manufacturer type. (Source: © iData Research)
06
4 2022
[7] =>
|
© Pixel-Shot/Shutterstock.com
news
Increasing number of general practitioners
placing implants
Many would assume that the materials are only a fraction of the cost of the procedure and that the majority
of the expense comes from treatment by a specialised dental implant professional, particularly in light of
the limited availability of such practitioners. That was
the case until recent years. Much more evident in the
US but still a growing trend in Europe is the increased
number of general practitioners who are able to perform dental implant procedures. Many postgraduate
education programmes and training courses have
gained popularity among general practitioners seeking
to broaden their skills and increase the services they
can offer.
This has had two major benefits:
a sizeable increase in the number of professionals who
are able to offer dental implant services and the potential
for longer-term decreased costs to patients as a result
of this growing supply.
It is all about digital technology
Lastly, and certainly not a trend on the forefront of everyone’s mind, is the slow but steady development and integration of digital dentistry. Over the course of the last two
decades, digital dentistry has revolutionised the industry.
While dental professionals are not known for their technological literacy or desire to be on the front lines of digital
innovation within their practices, sentiment has dramatically changed in recent years, and this trend is an inevitability over time. This is particularly true for new dentists
entering the market who are increasingly aware of the
digital technologies available to them, such as treatment
planning software, CAD/CAM, and software supporting
the design of surgical guides and their use during procedures.
Additionally, an increasing number of dental schools
are incorporating the latest technological advancements
into their curricula, exposing prospective dentists to a
wider array of available tools and reducing the time and
effort needed to learn to use these. Also, of course,
while an investment in computer technology such as
treatment planning software greatly benefits dental
professionals in terms of both efficiency and scope of
services they can offer, it ultimately improves the quality
of service delivered to the patients. The use of computer
aids allows for maximum customisation for each individual patient case and higher levels of accuracy during
procedures.
about
Simon Trinh is a research analyst
at iData Research. He develops and
composes syndicated research projects
regarding the medical device industry.
For over 15 years, iData Research has
been a strong advocate for data-driven
decision-making within the global medical
device, dental and pharmaceutical
industries. By providing custom research and consulting
solutions, iData empowers its clients to trust the source of data
and make important strategic decisions with confidence.
More information can be found at https://idataresearch.com.
4 2022
07
[8] =>
| news
Artificial intelligence and augmented
reality in implant planning
Dr Francesco Mangano, Italy
CBCT (root) and intra-oral (crown) scans. The segmentation and alignment are automated, being the result of
a learning process (machine learning) which represents
the basis of AI.
It is a real revolution that has opened the door to changes
in all fields of dentistry: from the possibility, for example,
of planning a 3D orthodontic set-up that is truly safe for
the bone to the planning of prosthetic complex cases.
In implantology, AI-assisted software such as Virtual
Patient Creator (Relu) allows us to enhance our diagnostic
and planning skills.
Dr Francesco Mangano.
Technology is now pervasive in dentistry, and implantology is no exception. Intra-oral and face scanners, CBCT
and digital condylographs allow us to acquire 3D images
and videos of our patients, useful not only for diagnosis but
also for treatment planning. The patient becomes virtual.
Until recently, however, this information was difficult
to segment and assemble, and this limited the patient
virtualisation process. Obtaining the virtual patient was
difficult and costly, needing time and effort, since segmentation and alignment were essentially manual, and
operator-dependent.
Today, thanks to artificial intelligence (AI), it is possible
to use cloud-based software capable of returning to the
clinician, in a few minutes and at very low cost, the entire set of 3D files of the patient (derived from intra-oral,
face and CBCT scanning). These files, in STL format, are
perfectly aligned and segmented, eliminating any possible
error by the operator. Each tooth, for example, is the result
of the perfect fusion, segmentation and alignment of
08
4 2022
In particular, the use of 3D files in STL format processed by
Virtual Patient Creator (Figs. 1 & 2), combined with modern virtual reality and augmented reality (AR) systems,
creates new possibilities. In fact, it is possible to upload
all files derived from AI-assisted software directly into
apps specifically designed for AR, such as HoloDentist
(FifthIngenium). Thanks to these apps, wearing an AR device
such as HoloLens 2 (Microsoft), the dentist can view the
holographic 3D models of the patient and use them to
make a correct diagnosis and for communication with
the dental laboratory, colleagues or patients in order to
illustrate to them the selected treatment plan.
The use of AI and AR technologies transforms the manner
of not only diagnosis and communication but also of implant planning. On the basis of the set of files segmented
and aligned via AI, the surgeon wearing AR glasses such
as HoloLens 2 or Magic Leap 2 (Magic Leap) can plan
the positioning of one or more implants in the correct
3D position, inclination and depth, using holograms.*
Basically, it is no longer necessary to use software dedicated to guided implant surgery: the surgeon drags and
drops the desired fixture from a 3D library provided by the
HoloDentist app and positions it within the holographic
model of the bone. The surgeon can also enlarge the
holographic models to such an extent that they have the
same dimensions as the operator, and the same applies
for the hologram of the implant. Finally, by navigating
inside these models, the surgeon can tilt, rotate and
otherwise move the implant within the bone hologram.
This process is also guided by other masks and holograms,
which can be on or off during 3D planning, for example that of
the teeth and soft tissue or that of the prosthetic wax-up. This
is authentic 3D planning, without the need for any guided
[9] =>
news
|
1
Fig. 1: Automatic segmentation from CBCT in Relu’s artificial intelligence-assisted, cloud-based software.
implant surgery software or conventional 2D radiographic sections. This allows planning in a fast, intuitive
and fun way, drastically reducing costs. The spatial position of the implant thus designed is saved
and exported, together with the other files, for
the design of the surgical guide, in open-source
software. The next future development will be
the import of this planning into a dynamic implant navigation system.
* Scan QR code to watch a video on 3D implant
planning with holograms using HoloDentist and
HoloLens 2.
2
Fig. 2: Fusion and automatic alignment and superimposition of 3D files from the intra-oral scan over the CBCT data.
4 2022
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[10] =>
| case report
Guided one-stage and two-stage
implant placement in the anterior
zone
A three-year follow-up
Dr Paula Corvello, Brazil
Certain situations do not allow for immediate placement of implants in the anterior region, mainly when the
buccal plate is absent and/or the periodontal phenotype
is very thin. In these cases, choosing the surgical technique and biomaterials based on the clinical situation is
critical. Furthermore, it is crucial to respect tissue healing
times before proceeding to the next phase of treatment.
The following case report describes one-stage and twostage guided implant placement in a patient with high
aesthetic expectations who had to have his maxillary
central incisors extracted owing to vertical fractures. The
Straumann Bone Level Tapered (BLT) implant, which has
an apically tapered and self-tapping design, was used in
this clinical case. Its features make it particularly suitable
for situations involving poor bone quality or, fresh extraction sockets, where primary stability is critical.
1
Initial situation
A healthy 72-year-old non-smoking male patient who
took no medication came to our clinic having noticed gingival inflammation and bleeding in the area of his two
central incisors a few months before. He had previously
visited another dentist, who concluded after the clinical
and radiographic assessments that the teeth presented
vertical fractures and, therefore, needed to be extracted.
The patient stated that he would like to have them restored in the shortest possible time and for pleasing aesthetics to be maintained until the end of treatment. The
extra-oral examination revealed a low smile (Fig. 1). The
intra-oral and CBCT examination showed the vertical root
fractures of teeth #11 and 21. Moreover, tooth #21 presented with an active fistula and loss of the buccal bone
plate (Figs. 2 & 3).
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2
3
5
Fig. 1: Initial image of the patient’s smile. Fig. 2: Clinical image of the maxillary dental arch. Fig. 3: CBCT image of tooth #21. Fig. 4: Final SAC classification.
Fig. 5: Intra-oral scan image, occlusal view.
10
4 2022
[11] =>
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LASTING BONE CARE
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SEAMLESS WORKFLOW INTEGRATION
Follow Dentsply Sirona for
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dentsplysirona.com/implants
[12] =>
| case report
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Fig. 6: Digital treatment planning. Fig. 7: Immediate screw-retained splinted provisional restoration. Fig. 8: Atraumatic extraction of tooth #21. Fig. 9: Jason
membrane in the mouth. Fig. 10: Jason membrane covering the cerabone used together to preserve the extraction socket.
The case was assessed using the SAC classification,
which provides an objective, evidence-based framework for assessing the potential difficulty, complexity
and risk of an implant-related treatment involved in individual implant dentistry cases in an easy-to-use process. It also helps clinicians with patient selection and
treatment planning. The patient was classified as a
complex surgical case and advanced prosthodontic
case (Fig. 4).
Treatment planning
After a thorough discussion of the various treatment options with the patient, it was decided to perform digital
planning, which included guided immediate implant
placement in one site and guided delayed implant placement in the other (Figs. 5 & 6). The workflow included the
following steps:
11
12
– minimally invasive extraction of tooth #21 with alveolar
curettage, followed by socket preservation with the
bone substitute cerabone and Jason membrane (both
botiss biomaterials);
– minimally invasive extraction of tooth #11, followed by
immediate placement of a Straumann BLT implant (diameter: 4.1 mm; length: 12.0 mm; SLActive; Roxolid)
into the site and filling of the gap between the implant
and buccal bone with cerabone, and delivery of provisional screw-retained splinted crowns on implant #11
in the same visit (Fig. 7);
– placement of a Straumann BLT implant (diameter:
3.3 mm; length: 12.0 mm; SLActive; Roxolid) in site #21
after tissue healing;
– delivery of the final screw-retained crowns on implants
#11 and 21; and
– yearly follow-up visits for clinical and radiographic assessment and reinforcement of oral hygiene instructions.
13
Fig. 11: Atraumatic extraction of tooth #11. Fig. 12: Placement of the implant during the guided procedure. Fig. 13: Clinical occlusal view after immediate
implant placement in tooth #11 and socket preservation of tooth #21.
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4 2022
[13] =>
case report
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Fig. 14: Immediate screw-retained splinted provisional restoration placed. Fig. 15: Clinical occlusal view four weeks post-op. Fig. 16: Customised new provisional restoration. Fig. 17: Frontal view of provisional restoration. Fig. 18: Placement of scan bodies on the implants.
Surgical procedure
The surgical guide was checked for proper fit before administering local anaesthesia with 2% lidocaine with
1:100,000 adrenaline. Tooth #21 was extracted gently in
order to preserve the remaining bone, and careful alveolar curettage was done to remove all infected tissue
(Fig. 8). The socket preservation was performed with
cerabone and a Jason membrane (15 × 20 mm), which
was stabilised with sutures (Figs. 9 & 10). Afterwards,
tooth #11 was also extracted with minimal trauma
(Fig. 11). The surgical guide was then seated. The implant axis and depth were defined, and the drilling protocol was performed following the manufacturer’s instructions. The implant was placed considering the high
gingival margin of the lateral incisors. Finally, the gap
between the implant and buccal bone was filled with
cerabone (Figs. 12 & 13). After implantation into site #11
19
and confirming optimal primary stability, an immediate
screw-retained splinted provisional restoration was
placed (Fig. 14). The appropriate occlusal load was
checked.
The patient came back four weeks after surgery for a
follow-up visit. The soft-tissue healing was uneventful.
Following our treatment plan, an implant was inserted
into site #21, taking into consideration a minimal distance
of 1.5 mm from the implant shoulder to the adjacent tooth
at the bone level and a minimal distance of 3.0 mm between the implants (mesiodistally; Fig. 15).
After the soft-tissue healing, a new provisional restoration
was individualised and polished on an analogue of implant #11 before being placed to a torque of between
15 Ncm and 35 Ncm. The aesthetic result was very satisfying for the patient (Figs. 16–18).
20
21
Fig. 19: Occlusal view of digital impression. Fig. 20: Final abutments. Fig. 21: Final crowns.
4 2022
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[14] =>
| case report
22
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Fig. 22: Clinical frontal view of the final crowns. Fig. 23: Final image of the patient’s smile.
Prosthetic procedure
Three months later, scan bodies were placed directly
on the implants, and a digital impression was taken
(Figs. 19 & 20). The colour for the final crowns was chosen with the patient. The STL files, colour assessment
and laboratory prescription were sent to the dental technician. The master model was 3D-printed, and the
crowns were fabricated. The substructure and emergence profile of the crowns were optimal and met the
patient’s expectations; thus, the final crowns were
screwed in, and a radiographic control was performed.
The periapical radiograph demonstrated an optimal fit
(Figs. 21–25). Instructions on oral hygiene were given,
and the occlusion was checked.
Treatment outcomes
For cosmetic reasons, the patient was very concerned
about losing both anterior teeth. He thought that the
treatment was going to be long owing to the reconstruction required. For him, it was a relief to have a provisional
restoration at all times. It has been three years since we
treated him with dental implants, and he is very satisfied
with the treatment outcome. Oral hygiene is not an issue
for him, and this restoration allowed him to smile and talk
with confidence again.
Author’s testimonial
In my daily practice, the Straumann BLT implants enable
me to achieve optimal primary stability in fresh extraction
sockets and immediate aesthetics owing to the possibility of placing a provisional restoration with confidence. As
a result, high patient satisfaction is obtained. Furthermore, in cases of patients with limited anatomy, it is the
ideal implant to provide a less invasive and time-saving
treatment.
Editorial note: This article was first published in implants—
international magazine of oral implantology, Vol. 23, Issue 4/2022.
about
A specialist in temporomandibular
dysfunction and orofacial pain,
Dr Paula Chiattone Corvello Vidal
graduated from the Federal University
of Pelotas in Brazil in 2005 and in
2007 became a specialist in oral and
maxillofacial surgery and traumatology
at the Lutheran University of Brazil.
In 2009, she defended her master’s
degree in oral rehabilitation with an emphasis in implantology
at the same university. Since graduating, she has
worked in her own private clinic. She has taught in the
specialisation course in implantology at the Associação
Brasileira de Odontologia, seção Rio Grande do Sul
(Rio Grande do Sul section of the Brazilian association of
dentistry) since 2009 and is a member of the postgraduate
faculty of IMED Porto Alegre. She is an International Team
for Implantology fellow and speaker and director of the
International Team for Implantology Porto Alegre II study club.
contact
24
Fig. 24: Periapical radiograph four months post-op.
14
4 2022
Dr Paula Corvello
Porto Alegre, Brazil, www.vidalodontologia.com.br
[15] =>
Soft tissue augmentation
NovoMatrix™
Reconstructive Tissue Matrix –
the next generation material
NovoMatrix™ Reconstructive Tissue Matrix is an acellular dermal matrix
derived from porcine tissue intended for soft tissue applications. The proprietary
LifeCell™ tissue processing is designed to maintain the biomechanical integrity of the tissue,
which is critical to support tissue regeneration.
Indications
Localized gingival augmentation to increase keratinized tissue (KT) around teeth and implants
Alveolar ridge reconstruction for prosthetic treatment
Guided tissue regeneration procedures in recession defects for root coverage
Product features
Consistent thickness (1 mm)
Pre-hydrated
Controlled source
www.biohorizonscamlog.com
Before use, physicians should review all risk information, which can be found in the Instructions for Use attached to the packaging of each NovoMatix™
Reconstructive Tissue Matrix graft. NovoMatrix™ is a trademark of LifeCell™ Corporation, an Allergan affiliate. ©BioHorizons. All rights reserved.
Not all products are available in all countries.
Bone tissue augmentation
MinerOss™ A
The allograft for outstandingly
fast bone remodeling [1]
The scientific evidence shows that allografts are the second best option to patient‘s
own bone compared to other bone substitutes. [2]
Benefits of MinerOss™ A human bone substitute [1, 3–5]
Optimal osteoconductivity
Fast graft incorporation
Complete remodeling potential
www.biohorizonscamlog.com
[1] Wen et al. J. Periodont. 2019, 1, 734.
[2] Schmitt et al. Clin Oral Implants Res. 2013, 24, 576.
[3] Kloss et al. Clin Oral Implants Res. 2018, 29, 1163.
[4] Solakoglu et al. Clin Implant Dent Relat Res. 2019, 21, 1002-1016.
[5] Kloss et al. Clin Case Rep. 2020, 8, 5.
References available at: www.biohorizonscamlog.com/references_minerossa
MinerOss™ is a trademark of BioHorizons®. BioHorizons® is a registered trademark of BioHorizons.
©BioHorizons. All rights reserved. Not all products are available in all countries.
[16] =>
| case report
Immediate implant placement
and provisionalisation
of a mandibular first molar
Dr Mischa Krebs & Alexander Müller, Germany
1
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4
7
8
6
5
Fig. 1: Deeply fractured mandibular first molar. Fig. 2: Implant site preparation. Fig. 3: Placement of implant. Fig. 4: Final torque of 45 Ncm. Fig. 5: Implant in
final position. Fig. 6: Intra-oral scan with Primescan (Dentsply Sirona) immediately after implant placement. Fig. 7: Socket grafted with Symbios and healing
abutment placed. Fig. 8: Post-op radiographic evaluation. Fig. 9: Design of Atlantis abutment and provisional crown.
The aim of this article is to present a case of immediate implant placement and provisionalisation of
a m
andibular molar with the PrimeTaper EV implant
(Dentsply Sirona). This case report is published as an
inspiration for dental professionals and not necessarily
as a recommendation.
9
16
A 39-year-old male patient presented with a deeply fractured mandibular first molar two years after hemisection
(Fig. 1). After the patient had opted for an implant-borne
solution, an immediate implant placement and restoration with a PMMA provisional crown on a final Atlantis
abutment (Dentsply Sirona) was planned.
[17] =>
case report
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Fig. 10: Clinical situation one week after surgery. Fig. 11: Abutment and provisional crown manufactured within one week of surgery. Fig. 12: Abutment seating
using insertion guide. Fig. 13: Abutment in place. Fig. 14: Provisional crown seated. Fig. 15: Healed site with provisional crown eight weeks after implant
placement. Fig. 16: Healed soft tissue around abutment eight weeks after implant placement. Fig. 17: Clinical situation after seating of final zirconia crown.
Fig. 18: Radiographic evaluation eight weeks after implant placement with final zirconia crown.
The implant site was prepared following the recommended drilling protocol for the planned PrimeTaper EV
4.2 mm diameter implant (drills #1, 3 and 4; Fig. 2). After
cortical preparation with drill #5, the implant was placed.
The preparation was finalised with a tap, owing to dense
trabecular bone (Fig. 3). The implant was inserted to
a torque of 42 Ncm (Fig. 4).
Immediately after implant placement (Fig. 5), the abutment position was registered with an intra-oral scan
using Primescan (Dentsply Sirona; Fig. 6). At the end
of the surgical procedure, the socket was grafted with
Symbios (Dentsply Sirona) and a healing abutment was
seated (Fig. 7). Radiographic evaluation was performed
on the same day (Fig. 8).
On basis of an intra-oral scan, an Atlantis abutment
and Atlantis provisional crown were designed and
fabricated with an Atlantis IO FLO (Fig. 9). One week
after implant surgery, healing was satisfactory and
the abutment and provisional crown were inserted
(Figs. 10–14).
(Figs. 15 & 16) and was ready for the final zirconia crown
(Fig. 17). Radiographic evaluation with the final restoration confirmed the successful outcome of the treatment
(Fig. 18).
about
Dr Mischa Krebs is in private
dental practice, Dr. Krebs & Kollegen,
in Alzey in Germany.
Alexander Müller works in a private
dental laboratory, Müller & Edelhoff
Dentallabor, in Wörrstadt in Germany.
During the healing period, the final crown was manufactured based on the Atlantis Core File. Eight weeks
after implant placement, the soft tissue had healed well
4 2022
17
[18] =>
| case report
A multidisciplinary digital
approach to a complex case
Surgical, aesthetic and occlusal procedure planning
for implant-supported full-arch prostheses
Dr Antonio Lipari, Dr Mario Perotti, Marco Marzolla & Dr Valerio Bini, Italy
1
2
Introduction
would have required a great deal of time and resources to
achieve. This article reports a digital approach that makes
a complex workflow easier to manage and that has the
advantage of wider access to high-quality customisation of
surgical management and aesthetic and occlusal design.
Thanks to digital technology, a growing number of edentulous or partially edentulous patients with residual malocclusion and dysfunction can now be offered a goodquality customised and aesthetically pleasing prosthesis
as well as long-term restoration of occlusal function. The
surgical planning and execution required to achieve correct occlusion can now be realised with the assistance of
a variety of digital tools, with an accuracy that in the past
3
Case presentation
The case concerns a 58-year-old male patient (Fig. 1)
with no relevant medical history. There was clinical evi-
4
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4 2022
[19] =>
case report
5
6a
6b
6c
dence of tooth and bone loss as result of periodontitis
and previous poor-quality dental treatment, the use of
inappropriate removable dentures with compromised
aesthetics, and crossbite malocclusion (Fig. 2) with dysfunctional symptoms. Edentulism and bone loss in the
maxillary arch and the presence of three teeth and two
implants with a poor periodontal prognosis were evident
in the clinical examination and radiographic images
(Fig. 3). The patient required fixed maxillary and mandibular implant-supported full-arch protheses.
7
8
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11
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After removal of the residual teeth and implants, the
patient was fitted with two removable dentures in the
reference position, which improved jaw alignment, vertical dimension of occlusion, overbite, overjet, speech
and aesthetics.
A cephalometric tracing on a lateral radiograph was
done to obtain an initial aesthetic and functional evaluation of the case (Fig. 4), and this was followed by
prosthetic and surgical (Fig. 5) planning.
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The characteristics of the prostheses determined
the surgical plan (SMOP, Swissmeda; Figs. 6a–c) and
two surgical guides were subsequently laser-sintered
(2INGIS), locating both implant positioning and, for the
maxillary arch, the bilateral maxillary sinus lift sites.
Implants were thus positioned as planned (Figs. 7 & 8),
except for those in the posterior maxilla, where maxillary
sinus lifts were bilaterally performed (Fig. 9).
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After two months, an intra-oral scan (Fig. 10) was taken
and the 3D-printed models subsequently obtained
were stone-based and re-virtualised (Fig. 11) using
a desktop scanner (inEos X5, Dentsply Sirona).
Jaw alignment and implant positioning were also
accurately recorded by duplicating the interim prostheses and intra-orally fixing the transfer positions
on to the copies, whose fit and occlusion had to be
[21] =>
case report
17
checked for complete accuracy. The jaw relation
was used for mounting the casts, which were fixed
on mounting blocks with a facebow in a fully adjust
able arcon articulator (Reference SL, GAMMA). The
central incisors and first molars were assembled
bilaterally at an inclination of 12° to the occlusal plane
(Fig. 12), which was previously defined using cephalo
metric tracing.
The teeth were then scanned with a desktop scan
ner, and using the positions of the central incisor
and distal first molar cusps for reference, they were
imported in the correct spatial positions into the
CAD module (DentalCAD Virtual Articulator, exocad;
Fig. 13). Not having a virtual Reference SL articulator
18
available in the CAD software, a virtual SAM system
(SAM Prä
zisionstechnik) was used, because both
the articulators have the same axio-orbital reference
plane, and it is possible to superimpose the
geometry of the SAM on to the Reference SL. Bor
der movement condylography (CADIAX Compact,
GAMMA; Figs. 14 & 15) was also produced for setting the virtual SAM as indicated by the software
(CADIAX software, GAMMA), both for the setting
of the condylar and incisal guides and for the adjust
ment of the sagittal condylar inclination and Bennett
angles.
The aesthetic digital smile design and the CAD for
the patient were therefore done starting with the vir-
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[22] =>
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25
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| case report
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14
The characteristics of the prostheses determined
the surgical plan (SMOP, Swissmeda; Figs. 6a–c) and
two surgical guides were subsequently laser-
sintered
(2INGIS), locating both implant positioning and, for the
maxillary arch, the bilateral maxillary sinus lift sites.
Implants were thus positioned as planned (Figs. 7 & 8),
except for those in the posterior maxilla, where maxillary
sinus lifts were bilaterally performed (Fig. 9).
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After two months, an intra-oral scan (Fig. 10) was taken
and the 3D-printed models subsequently obtained
were stone-based and re-virtualised (Fig. 11) using
a desktop scanner (inEos X5, Dentsply Sirona).
Jaw alignment and implant positioning were also
accurately recorded by duplicating the interim prostheses and intra-orally fixing the transfer positions
on to the copies, whose fit and occlusion had to be
[24] =>
| case report
Copying back the wax-up by scanning to the CAD
software (Fig. 20), the virtual prostheses were checked
again regarding thickness, the surface and shape of
the connections, and the adjustment of the offsets for
the fit on the abutments. The file was then imported
into the CAM machine (CAM 5-S1, VHF) in order to
mill an interim complete denture for the maxillary
arch and to mill a screw-retained full-arch prosthesis
with a milled titanium mesostructure for the lower
jaw (Fig. 21). Both were milled in PMMA with
high-stability ceramic micro-fillers (breCAM.multiCOM,
bredent).
After some months, another four implants were placed
in the maxilla using the same laser-sintered surgical guide (Fig. 22), and after a further six months, the
maxillary arch was ready for loading. All the mandibular procedures were repeated for the maxillary arch
(Figs. 23 & 24), refining the aesthetic digital smile design
and checking occlusal accuracy. Subsequently, we
did another condylographic analysis of the CAD’s virtual
articulator settings (Fig. 25), as after the many months
that had passed, the oral function had changed, and
a sequential waxing for the maxillary arch was also
made (Fig. 26).
about
Dr Antonio Lipari obtained his DDS
from the University of Bologna and MSc
in Digital Dentistry from the University
of Insubria in Varese in Italy.
He is in private practice in Bologna
in Italy and lectures internationally
on digital dentistry.
Dr Mario Perotti obtained his MD
and DDS from the University of Turin
in Italy and MSc in Digital Dentistry
from the University of Insubria.
He is in private practice in Turin in Italy
and is a member of the research
centre for innovative technology
and engineered biomaterials at the
University of Insubria. He lectures
internationally on digital dentistry and is an active member of
the Digital Dentistry Society.
Marco Marzolla is a master dental
technician who specialises in
CAD/CAM. He lectures digital
dentistry at the University of Insubria.
A full-arch screw-retained prosthesis with a titanium
mesostructure (Figs. 27 & 28) was placed in the maxillary arch. During the follow-up period, the patient
reported great satisfaction with both aesthetics (Fig. 29)
and function (Figs. 30a–d).
Discussion and conclusion
The use of digital tools described in this article for surgical planning, aesthetic digital smile design and the
planning of a canine-dominant occlusal sequential
function proved to be convenient for the clinician and
the patient, allowing a reduction in working time and
a simplification of the procedures involved, as well as
significantly facilitating greater customisation. The CAD
prostheses can be milled in different materials, with high
precision and repeatability in mock-ups and try-ins at
lowered costs.
Furthermore, the opportunity to scan the casts, the
wax-ups, the mock-ups and the interim prostheses
allows for the acquisition of a large amount of valuable
information regarding the patient’s anatomy, aesthetic
considerations and tooth function data.
Editorial note: This article was first published in CAD/CAM—
international magazine of digital dentistry, Vol. 10, Issue 4/2019.
A list of references is available from the publisher.
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4 2022
Dr Valerio Bini obtained his DDS
from the University of Genova and
is also qualified as a master dental
technician. He is in private practice in
Cavaglià and Biella, where he offers
aesthetic digital smile design.
He also is a member of the research
centre for innovative technology
and engineered biomaterials
at the University of Insubria. Bini is an active member
of the Digital Dentistry Society and of the Italian Academy
of Esthetic Dentistry. He lectures internationally on
digital dentistry and aesthetic dentistry and has authored
a number of research articles on these topics in
international journals.
contact
Dr Mario Perotti
drperotti@drperotti.it
[25] =>
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[26] =>
| practice management
Dentist–technician communication:
We can all do better!
Dr Joseph Fava & Karim Sahil, Canada
Introduction
In the past few decades, dentistry and dental technology
have advanced by leaps and bounds. These advances
have been driven by improvements in computer processing power leading to advances in digital technology
(e.g. CAD/CAM). The evolution in biomaterials has led to
the development of zirconia. However, the communication
between dentists and their dental technologists seems
to be lagging. We can all do better!
Anyone who has visited a dental laboratory or had a frank
discussion with a dental technician would have seen firsthand the good, the bad and the ugly of the dentist–technician
relationship. It essentially boils down to trust that each party
will listen to the other’s challenges and will work together to
achieve a common goal. Working together as a team from the
treatment planning stage to final insertion can eliminate problems by considering both clinical and laboratory issues simultaneously. This will lead to a result that creates predictable
success for the dentist and, most importantly, produces a
satisfied patient. Essentially, effective communication results
1
in a win–win–win situation: a happy patient, increased productivity for the clinician and significant reduction in remakes
and/or modifications for the laboratory.
The goal of this article is to discuss the main aspects of the
communication process between the dentist and the laboratory. What is the most effective method of communication
available to the dentist? How can the laboratory assist the
dentist in the treatment planning and treatment execution
phases? What are the responsibilities of the clinician to the
patient and the laboratory? What are the responsibilities of
the laboratory to the prescribing dentist?
Methods of communication
To effectively treat cases involving multiple teeth, altering
the vertical dimension of occlusion, and/or highly sensitive
aesthetic situations, involving the laboratory earlier on in
the treatment planning phase will allow for a greater chance
of a successful treatment outcome (Fig. 1). Communication between the dentist and the patient is critical during
the treatment planning phase of a large aesthetic case.
2
Fig. 1: Consultation with the patient and the laboratory technician. Fig. 2: Shade discussion and selection.
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practice management
The patient’s expectations may not match the dentist’s
expectations. Furthermore, the patient may have specific
ideas about how his or her smile should look. If the patient’s vision does not match the final result, he or she will
most likely be disappointed and then become dissatisfied.
To ensure that this does not happen, it is important to plan
effectively. This means taking time with your patient to make
sure that his or her vision is understood. It has been said
that beauty is in the eye of the beholder. As such, we are beholden to the patient to ensure he or she is satisfied. Asking
the patient to bring in historical photographs or photographs
of someone whose smile he or she would like to have mimicked can be very insightful. Ask the patient about shade
preference during the consultation period and accurately
capture it (Fig. 2). The patient’s presenting condition should
be captured as well, both for communication with the laboratory and for medico-legal purposes. This includes the
necessary radiographs, accurate impressions (either analogue or digitally captured) to produce models, stable interocclusal records at the correct vertical or horizontal position
for accurate articulation, facebow records when required
and representative digital photographs to convey both dental and facial parameters (Fig. 3). With this information in
hand, the savvy clinician should consult with the laboratory technician to discuss the occlusal scheme, biomaterial
selection, and overall size, shape, shade and contours of
the teeth to start developing a plan that will achieve the
patient’s aesthetic goals while allowing for a predictable
outcome in practice (Fig. 4).
Working as a team member, the laboratory can assist in
several ways. First, the material selection process is a ser-
|
3
Fig. 3: Initial situation.
vice that a laboratory can provide. Often, the difference between success and failure with biomaterial technologies is
their proper selection for the case circumstances. The dental laboratory is uniquely positioned to experience success
or failure with the myriad of dental restorative materials and
their use in particular cases. The laboratory technician is
able to offer valuable input as to the material properties and
their intra-oral applications and limitations, as well as techniques for success. The goal in selecting the most appropriate biomaterial is to optimise the balance between the
aesthetic quality of the restoration and its long-term clinical performance and predictability. Simply put, we want
the result to be aesthetic enough to satisfy the patient and
strong enough to last.
Second, the best way to communicate with the technician
is to allow him or her to see what you see. If you have an
4
Fig. 4: Design consultation.
4 2022
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| practice management
5
6
7
8
her vision in his or her own words and allow the laboratory
technician the opportunity to meet the patient virtually so
that the casts being worked on will come to life. Armed with
this information, a laboratory-fabricated diagnostic wax-up
can be created (Fig. 5). A wax-up is an excellent tool for
the treatment planning phase. It can demonstrate for the
dentist and the patient what the laboratory can accomplish with specific restorative materials. Many contours can
be created in wax, but the specific dimensions required
for a given material are an important consideration. Third,
the choice of the restorative material combined with the
wax-up can guide the dentist in the amount of preparation required to duplicate the result created in wax. Once
the dentist, laboratory technician and patient are happy,
the diagnostic wax-up can be approved and the reparation
or reduction guides can be fabricated, as well as matrices
or provisional shells for making temporary restorations.
A highly aesthetic outcome satisfactory to the patient is
dependent on communicating colour (chroma, hue and
value), translucency and surface texture. The underlying
challenge for the clinician is to determine all these parameters accurately and then to successfully communicate the
details and expectations for the patient case. The challenge for the laboratory team is to understand exactly what
the dentist is asking for and to successfully implement the
information received into the restorative product. In order to
facilitate communication, the dentist will provide the laboratory technician with a written prescription describing what
is expected. Of course, the detailed prescription needs to
be accompanied by impressions, diagnostic casts, a bite
registration, facebow records and clinical photographs.
What is expected of the dentist?
9
Fig. 5: Laboratory design proposal or digital wax-up. Fig. 6: Digital scan.
Fig. 7: Tooth preparation. Fig. 8: Try-in restoration in the patient’s mouth.
Fig. 9: Final restoration, close-up smile.
in-office laboratory, then the laboratory technician should
have an opportunity to interview the patient at the consultation appointment. However, in most cases the laboratory
is off-site. As a result, good photographic documentation
is crucial. In addition, it would be incredibly valuable to record and share a video of the patient speaking and going
through multiple continuous chewing motions to observe
the patient in function. Allow the patient to describe his or
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1. The dentist must provide a well-written prescription
providing the patient’s name, age, sex and mastication habits and the type of restoration needed (fixed or
removable).
2. The clinician should provide accurate final and opposing
arch impressions, either analogue or digital (Fig. 6), that
duplicate the intra-oral tooth preparations (Fig. 7). Analogue impressions should be free of bubbles, have visible margins and be taken on a stable impression tray.
All outgoing materials should be disinfected according
to current infection control standards, placed in an appropriate container, packed properly to prevent damage
and transported.
3. Accurate bite registrations are essential, using a more
rigid material to aid with proper articulation.
4. Digital photographs are important and necessary to
create a precise dental prosthesis. A proper shade guide
that is identical to the one being used by the dental
laboratory is needed. Chairside custom shade taking,
including the stump shade for the anterior region, or
sending the patient to the dental laboratory is recommended for anterior restorations.
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practice management
|
10
Fig. 10: Satisfied patient, clinician and laboratory technician.
5. In restoring implants, it is important to mention the type of
implant being used, how long the patient will be wearing
temporary prostheses and whether the final prosthesis
will be screw- or cement-retained.
6. A radiograph showing the placement of the implant is
extremely important for the dental technologist. A stone
model does not provide adequate information regarding bone level. A radiograph of the patient allows for
the proper selection of the correct stock abutment or to
customise one to achieve a successful final restoration.
What is expected of the laboratory technician?
1. The laboratory technician should custom manufacture
dental prostheses or appliances which follow the written
instructions provided by the dentist and should fit properly on the casts and mounting.
2. The laboratory should return the case to the dentist to
verify the mounting if there is any question regarding the
accuracy of the bite registration provided by the dentist.
3. The laboratory or technician should match the shade
which was described in the original written instructions.
4. After acceptance of the written instructions, the laboratory or technician should custom manufacture and
return the prostheses or appliances in a timely manner.
5. The laboratory should follow current infection control
standards with respect to personal protective equipment and disinfection of prostheses or appliances and
materials. All materials should be checked for breakage
and immediately reported if found.
6. The laboratory or technician should inform the dentist
of the materials used to prepare the case and suggest
methods to properly handle and adjust these materials.
7. All incoming and outgoing items from and to the dentist’s
office (impressions, occlusal registrations, prostheses, etc.)
should be cleaned and disinfected according to current
infection control standards, placed in an appropriate
container, packed to prevent damage and transported.
The dentist has overall responsibility for the treatment rendered. The laboratory will produce the prosthetic resto-
rations for try-in (Fig. 8), but whether to finalise the case
(Fig. 9) is the clinician’s decision. Delegating many procedures to auxiliary team members is possible if all the necessary information is provided to enable them to deliver a
high-quality service. When working with a laboratory, however, errors such as insufficient tooth reduction, ambiguous
margins, unstable interocclusal records and articulations,
and poor communication of the desired shades for aesthetic restorations to the technician will lead to unhappy patients, unproductive practices and a laboratory technician
who feels defeated. Good communication coupled with
good clinical and technical skills is the winning formula for
success (Fig. 10). We can all strive to do better.
Editorial note: A list of references is available from the publisher. This
article originally appeared in Oral Health Magazine, and an edited
version is provided here with permission from Newcom Media.
about
Dr Joseph Fava earned his DDS, MSc
and prosthodontic specialty
certificate from the University of
Toronto in Canada. He is a clinical
instructor in the university’s graduate
prosthodontic programme and
co-director of its implant residency
programme. Dr Fava is clinical
director of Yorkville Village Dentistry
and Forest Hill Prosthodontics, where he maintains
a specialty prosthodontics practice.
Karim Sahil acquired his dental
technology certificate from George
Brown College in Toronto in Canada.
He earned his master dental
technologist certificate from New York
on the study of mandibular physiology,
occlusion and full-mouth reconstruction.
He maintains an in-house dental
laboratory at Yorkville Village Dentistry.
4 2022
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| practice management
If I could see through your eyes,
I wonder what I would see?
By Jerko Bozikovic, Belgium
Ever wondered why some things are very clear, very natural, even very normal for you, yet someone else thinks
exactly the opposite, or you see or hear something and of
course expect that everyone else sees or hears the same
thing? Well, many of us live in an illusion, the illusion that
how we perceive the world is reality. In fact, it is never
the reality, but it is definitely your reality. Let us consider
together how this can be, how this affects our communication and our collaboration with our teams and patients,
and how we are influenced on a personal level.
“The same information
can be perceived differently
by a patient, team member,
or clinician, and still
be true from the
perspective of each.”
We all have a model of the world (MOW). An individual’s
beliefs, values, desires, expectations, experiences, culture,
education, age, family background, relational status,
sexual and gender identity, work experience, etc. help
create and define his or her MOW, acting as filters through
which he or she perceives, lives and acts. Filters are like
sunglasses: if it is sunny outside and you put on browncoloured sunglasses, the world appears brownish; however, if you put on blue, yellow or pink ones, the world will
look blueish, yellowish or pinkish. The world is not brown,
blue, yellow or pink, but your perception of the world is.
Our filters colour our perception of reality.
We perceive reality through our five senses, our brain
interprets what we perceive through our filters, including
our values, experiences and how we feel at that moment (mentally, physically, emotionally), and we behave
accordingly. Sometimes we do not understand where
our behaviour comes from or where the other person’s
behaviour comes from. Now you understand that it is
related to your and/or his or her MOW.
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4 2022
Impact on communication
We may think that how we communicate is very clear;
however, we may notice sometimes that the other person
did not understand what we said the way we intended it.
I am sure that many of us remember the telephone game
we played as children: in a circle of children, the first
would whisper something in the ear of the second child,
who would whisper it to the next one and so on until the
sentence arrived at the last child. Very seldom was the
final sentence the same as the initial one. This shows the
many levels of interpretation but also of loss, during that
transmission.
An informative check to do in your clinic would be to give
clear instructions to a patient about a treatment plan and
care of his or her teeth, then ask your assistant at the front
desk to ask that patient what you said regarding the treatment plan and dental care, and then compare what you
said with what the patient said. Do not be surprised that
in too many cases it might be that what you said was not
heard the same way as you meant it, let alone remembered to be able to repeat it to your assistant. That is
because all our filters influence what we hear, see and
experience around us, linked to our MOW.
Therefore, being a good communicator is crucial, and
here are some tips:
– Repeat your messages.
– Do not speak too quickly. It is not what you say that
matters but what the other person hears, understands
and remembers.
– Keep your message short and simple. The more you
say, the more that can be lost; the more complicated,
the easier for the other person to zone out and stop
listening.
– Ask people to write down the instructions you give
them—make sure pen and paper are always available
for patients and your team encouraging them by saying
that writing down the exact instructions, what the treatment will involve, etc. will help them recall this better
at home.
– We communicate through words but also through our
body language and our tone of voice, and that too affects
what the other person will hear, understand and remember.
Make sure that all three ways of communicating (the way
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© VLADGRIN/Shutterstock.com
practice management
you use your body and voice and the words you use)
are aligned in giving the same message—avoid looking
at your screen while conveying an important message,
because the other person will perceive it as less important, since there was no eye contact.
Impact on collaboration with your team
and colleagues
Of course, your team members and colleagues also have
their MOW, and so trying to understand how someone
is perceiving the world around him or her will help you to
make sure things are done the way you want them to be
done. A great way of understanding how people perceive
the world is through various personality models, such as
the Myers-Briggs Type Indicator, Herrmann Brain Dominance Instrument, DISC and Insights Discovery.
These models give some insight into how you and others see
the world. I have used several of these models with entire
teams in team building, but also when there was conflict
and frustration in teams, for example. These models can
help us understand why somebody gives more attention to
relationships, while others are more scientific and factual.
Some love and need structure and security, while others
just long for change and creativity.
Seeing and experiencing that we all have our own MOW
helps collaboration tremendously. I even know of several
companies who categorise their clients or patients based
on these different personality models and know exactly how
they need to communicate with them to motivate them and
to really connect with them. It is not about putting people into
boxes; it is about understanding why someone acts or reacts
in certain ways and what we can do in our collaboration and
communication to create a more desirable outcome.
Of course, this also helps with personal and family relationships. You can avoid falling into the trap of thinking that how
you see the world is how everyone sees the world. Rather
you can try to understand why someone has a certain reaction or certain understanding of what you have said, in order
to see how you could make yourself clearer by consciously
applying the NAAA technique: Never Assume, Always Ask.
Impact on yourself
Put two people across each other at a table and draw the
number six on a piece of paper. For one, it will look like
the number six, but the person opposite will see a nine.
Who is right? Both are; both just have a different perspective
on reality. As mentioned before, reality how you perceive
it is always your reality, but never the reality.
We can take this much further in respect to our daily lives.
How often are relationships affected because both people have a different way of looking at things? Insisting on
being right can be a reason why friends and families do
not communicate with each other. This is the reason for
ugly divorces and the division in society we have seen
4 2022
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| practice management
in the past two years over vaccination. Even wars are
a clash of different MOWs. Who is right and who is wrong?
Honestly, nobody really is. So, a good thing you can try
to do for yourself is to look at the world outside your box,
outside your MOW, outside your ways of looking at, thinking about and perceiving things in and around you.
Maybe you think that you are not that influenceable, but
do you respond differently when a patient is friendly or
unfriendly to you? Might your behaviour be affected by what
you see? Might it be that because you have a belief (conscious or unconscious) that, if someone is friendly to you,
you should be friendly back, but if someone is unfriendly,
that person should not see the friendliest you? Of course,
we do not know why someone is unfriendly, and what does
unfriendly mean anyway? Is it an interpretation through
your filters of a certain situation or behaviour happening
outside of you? Consider whether receiving things from
providers (material, trips, money, opportunities, invitations,
etc.) might influence your MOW and thus your reaction,
your preferences, your neutrality? Or do you believe that
you are not affected by this? Just some food for thought...
A good tip I can give you is to from now onwards consider
that what you are experiencing or perceiving is your reality,
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4 2022
and to ask what it might be like for the other person.
Thinking this way will help you to learn more about the
other person’s MOW and to share yours. This way we’ll
get closer to each other, collaborate better and understand each other better.
Editorial note: This article was published in aligners—
international magazine of aligner orthodontics, Vol. 1,
Issue 2/2022.
about
Jerko Bozikovic is a specialist
in communication skills, emotional
intelligence, time and stress management,
leadership, and change management.
He is fascinated by human behavior
and finds working with people
on personal development to be
a daily challenge and blessing.
He speaks seven languages and has
offered his training courses in four languages since 2001.
He embraces and embodies the motto “Love the life you live;
live the life you love”. Jerko can be contacted via LinkedIn.
[33] =>
[34] =>
| practice management
“Psychological knowledge and
techniques will save time, money
and frustration in the long run”
An interview with Lena Myran
By Anisha Hall Hoppe, Dental Tribune International
with dentists for many years. In my country of Norway,
I have been working specifically on a project offering
facilitated dental care for people who have experienced
torture or sexual abuse or who have odontophobia.
Anxiety, however, has many expressions. When anxious
patients enter the examination room, tears, outbursts,
avoidance or forced talkativeness is normal. These anxiety
expressions might make the dental team insecure and
lead its members to question how they can best understand the patient and handle the patient’s behaviour.
Lena Myran
When it comes to collaboration with psychologists in a
dental setting, many clinicians think simply of writing referrals for patients with anxiety. Dental Tribune International
spoke with Lena Myran, a clinical psychologist and PhD
student who specialises in oral health psychology, about
the profound impact that a working relationship with a
psychologist can have on a dental practice. The following conversation is based on a recently published textbook chapter titled “Working in Partnership for Better
Oral Health Care”.
Ms Myran, in your chapter “Working in Partnership for
Better Oral Health Care”, your team acknowledged
that teamwork between a dental practice and a
psychologist could provide significant improvement
in patient care. Could you share with our readers
how your team initially identified the potential for
psychological care within dentistry?
All of the chapter co-authors are psychologists working
in dental healthcare or they have worked in collaboration
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4 2022
Psychologists working closely with dental teams and
their patients can help make these behaviours understandable, explaining seemingly irrational behaviour in
comprehensible terms. Effective treatment for anxiety
has been well documented. In this respect, it is rewarding to apply exposure therapy and to see a client being
able to successfully make progress in dental treatment.
For those who have not yet read the chapter, could
you outline why understanding patient behaviour and
psychological illnesses is so vital to successful treatment and also to running a successful practice?
For anxiety in general and dental anxiety in particular, the
underlying mechanism that maintains and enhances the anxiety, is avoidance. Avoidance is the action that keeps the
patient from turning up at dental appointments or prevents
him or her complying to dental treatment. The cognitive psychologist Dr Scott Barry Kaufman put it well: “It’s perfectly
human to fluctuate between fear and growth. However as
Maslow said, ‘One can choose to go back toward safety or
forward toward growth. Growth must be chosen again and
again; fear must be overcome again and again’”. Avoidance,
therefore, costs a considerable amount of money owing to
missed appointments and prolonged treatment and causes
frustration both inside and outside the dental practice.
Even though psychological interventions and alliance-building
conversations are costly, psychological knowledge and
techniques will save time, money and frustration in the long
run. Satisfied patients tend to come back for treatment.
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© VectorMine/Shutterstock.com
practice management
The chapter talks about the benefits of building a
multi-disciplinary team. As some dentists might not
have previously considered involving a psychologist
in patient treatment, what tips could you offer to a
practice owner as he or she seeks out a good psychologist to work with?
I do not know how mental health systems are built in Europe,
but many countries already have multi-disciplinary teams
which include available psychologists or dental healthcare professionals with special training for dealing with dental anxiety.
They are often happy to discuss patient-related cases with you
or accept your request to short internships or collaborations.
If you are really interested in developing your own practice
into a trauma-sensitive specialised practice, contact general
practitioners. They are usually updated on available healthcare
services and thus will know where to find psychologists.
What would an ideal practice look like to you in terms of
teamwork and the utilisation of a multi-disciplinary approach
to both enhance patient care and build a healthy team?
One of the most important factors building a healthy team
is the acknowledgement that we all have important roles
and distinct competences. No one can manage all parts
of dental anxiety treatment alone; we need each other to
be able to provide the best service possible. Mutual respect is therefore of the essence. The role of the dental
secretary, for example, is important to a practice because
of their facilitating and sensitive contributions.
Another factor important to building an ideal practice is the
establishment of a safe environment where it is normal for both
patients and members of the dental team to experience strong
feelings and make daily mistakes. Those feelings and mistakes should be addressed with curiosity and enthusiasm,
and not as something to be ashamed of or scared of. Making
mistakes is often the best way to learn new skills.
“No one can manage
all parts of dental anxiety
treatment alone; we need each
other to be able to provide
the best service possible.”
Working with abstract concepts like relationships and
human behaviour makes it necessary to abandon the
urge to make things perfect. The team should be trained
to find success in every session. Did the patient use
the stop signal more often today? Did the patient give
more honest feedback? It can be difficult to recognise
the successes during treatment, as it is never purely
success or defeat. We should think in terms of degrees
of success.
Do you have any other perspectives you would like to
share with our readers?
Working in partnership with psychologists is important
in the treatment of patients having severe dental anxiety.
However, as famous clinical psychologist Dr Marsha
Linehan put it, “A good professional relationship is one
human being trying to help another human being”.
Establishing an environment where your patients feel safe
is half the job of getting dental treatment done with
anxious patients. Reading this article makes it likely you
already have a special interest in helping anxious patients.
Trust yourself and your gut feeling. You will come a long
way by being an authentic, accepting and empathic
human who is using his or her knowledge to help another
human being.
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| features
Building a sustainable dental practice
Dr Sanjay Haryana, Sweden
Sustainable dentistry’s two major outcomes, namely
good oral health and reduced environmental impact,
could be achieved by focusing on preventive care and
quality operative care. However, the large amount of
waste produced by the dental office daily is a problem
that needs immediate attention.
take advantage of the trickle-down effect—the spreading
of attitudes and behaviours through the core of the
organisation. The team members must understand
why the change is necessary, feel responsible for their
roles and be inspired to take part in the sustainability
journey.
Reducing emissions—a complex task
For example, switching to green energy leads to a great
impact, requires little effort and minimises interruption to
day-to-day practice. To make sustainable procurement
more manageable, it can be divided into buying less,
wasting less and switching to products and services with
a lower carbon footprint.
Dental caries and periodontitis are two of the most
common diseases globally. Thus, the primary aim of sustainable dentistry is to improve the quality of life through
preventive care and quality operative care. In order to be
able to offer this to the underprivileged part of the global
population, increased emissions are inevitable.
However, from an environmental perspective, we want
the population to have immediate access to dental care,
but we do not want patients to visit the dental practice
too often. After the manufacturing of dental supplies
and the dental waste generated in daily practice, patient
and staff travel are the largest emitters of greenhouse
gases within dentistry. Since dental appointments accumulate over a patient’s lifetime, total emissions end up
being extremely high compared with those resulting from
other healthcare treatments.
In order to decrease emissions, FDI World Dental Federation promotes source reduction through good oral
health or prevention. This is because preventive dentistry
results in fewer appointments, fewer recall visits, a reduction in materials and, consequently, less clinical waste.
Dental diseases that are preventable or are in the early
stages of progression should be targeted using individualised maintenance plans where home care should be
the centre of attention.
Sustainable procurement
Why should dental professionals strive towards sustainable dentistry? Firstly, it is the right thing to do ethically;
secondly, it is a great marketing tool; and finally, it creates
an attractive workplace for new colleagues. Before taking
steps towards creating a green dental practice and
practising green dentistry, the practitioner should understand that sustainability minimises pitfalls and simplifies
the process.
To build a sustainable dental practice, it is essential to
establish the coming change with management and
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4 2022
“The primary aim of
sustainable dentistry is to
improve the quality of life
through preventive care and
quality operative care.”
Healthcare waste—a major problem
Medical and dental care generate substantial waste. The
healthcare sector is responsible for 5% of all the greenhouse gas emissions in the EU. Dental waste management
has been primarily focused on amalgam disposal, but this
is no longer the main issue. Even though it is well known that
dental practices generate great amounts of waste, there is
limited data available on the effect of this on the environment. Similarly to sustainable dentistry, dental waste management lacks a global consensus on how to tackle certain
environmental issues that are associated with dentistry.
In the day-to-day running of a dental practice, waste is
generated from all parts of the business and can be divided into three categories: household waste, hazardous
waste and clinical waste. Household waste is similar to
that which is generated in a residential environment and
should, if possible, be recycled. Hazardous waste is
considered harmful to people and/or damaging to the
environment and must be disposed of through the appropriate facility. It includes clinical waste, radiographic
solutions, amalgam and gypsum, which generates a toxic
gas during degradation in landfills.
[37] =>
© IR Stone/Shutterstock.com
Clinical waste is defined as “any waste which consists
wholly or partly of human or animal tissue, blood or other
body fluids, excretions, drugs or other pharmaceutical
products, swabs or dressings, syringes, needles or other
sharp instruments”. It is also classified as hazardous and
should be incinerated.
The four Rs in dentistry
Waste management aims to protect humans and the
environment. If correctly done, it can also reduce costs
since most of the waste produced is clinical waste and
is more expensive to dispose of than household waste.
A popular way to manage waste has been to employ the
four Rs—reduce, reuse, recycle and rethink.
1. Reduce in the surgery
Many practices work with preset trays containing certain
instruments and disposable material, such as plastic
tray liners, gauze, cotton rolls and polishing paste. As
soon as the tray has been contaminated, all materials,
both used and unused, are classified as clinical waste.
Practices should review their set-up routines to minimise
the waste of unused material.
2. Reuse in the surgery
Most of the waste in dentistry consists of single-use
equipment designed to minimise cross-contamination.
There is a need for the development of novel solutions
allowing sterilisation and reuse. However, practices must
consider whether the equipment is safe for patients and
personnel and whether its production and use have
a positive impact on the environment.
3. Recycle in the surgery
This is the most challenging area since clinical waste
cannot be recycled. The most common materials found
in clinical waste are tissues, gloves and sterilisation
pouches. We should be able to establish routines that
allow us to open the pouches with clean gloves, separate
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the plastic from the paper and recycle appropriately.
Small actions like this can have a positive impact on the
environment and save costs for dental practices.
4. Rethink in the surgery
Rethinking is the most important of the four Rs. Even
though reducing, reusing and recycling are the most
discussed, they do not adequately address the clinical
reality of dentistry or medicine. In order to meet the
Sustainable Development Goals of the United Nations as
set out in Agenda 2030, our suppliers must understand
the waste management system and align their dental
products and materials with the most appropriate
end-of-life procedure—incineration, landfill or recycling
(chemical or mechanical).
Moving forward
All clinical waste is destined for incineration and should,
therefore, be bio-based instead of fossil-based to reduce
net emissions. Additionally, a consensus is needed on
how to safely minimise single-use equipment. There are
many different types of plastics used in the healthcare
system, and a circular approach will never be accomplished
if they are recycled together. Our efforts in the clinical
setting will have little impact on sustainability unless there is
an alignment of equipment production, waste management
and end-of-life procedures. Only then can good oral health
and reduced environmental impact be achieved.
about
Dr Sanjay Haryana
is an education and
odontology specialist at
TePe Oral Hygiene Products.
4 2022
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[38] =>
Study examines public
perceptions
regarding
sustainable dentistry
By Brendan Day, Dental Tribune International
Given the relatively high levels of material waste produced during the course of dental procedures, a more
sustainable approach to dentistry has been advocated
by many within the industry. A study from researchers at
the University of Sheffield has sought to examine how the
general public perceives the push for sustainability within
the profession and to better understand what compromises will be accepted in the name of environmentally
friendly dentistry.
The research team, which is spread across the university’s Department of Psychology and School of Clinical
Dentistry, set up an online questionnaire for participants
recruited via private dental practices and by other means.
Data regarding the participants’ views about sustainable
dentistry, as well as demographic data and information
about the participants’ overall oral health, was collected
between August 2020 and February 2021. In total,
344 adults responded to the survey.
Positive attitudes towards sustainability
Overall, the researchers found that participants responded quite positively to sustainable dentistry and
were “moderately willing to compromise time and convenience”. In addition, they were somewhat likely to agree
to pay more and receive potentially less durable dental
treatment if it meant that the treatment would be more
environmentally conscious. Respondents were least
likely to accept compromises regarding the appearance
of their teeth or their oral health status, whereas those
having better self-rated oral health were more likely to
view sustainable dentistry in a positive light.
“Participants’ ethnicity, level of education and employment status were not found to be associated with their
attitudes towards, or willingness to make compromises
for, sustainable dentistry,” the authors noted. However,
they added that, similarly to the results of previous
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4 2022
studies conducted on attitudes about sustainability, significant differences were present in accordance with age
and gender. Older respondents were less likely to want
to compromise their time and convenience than younger
respondents, whereas women displayed more positive
attitudes regarding sustainable dentistry than men did.
Survey respondents who were registered with a dentist
recorded more positive attitudes towards sustainable
dentistry than those who were unregistered. Whereas
the frequency of dental visits did not appear to affect
these attitudes among participants, the authors found
that those who visited more frequently for routine dental
check-ups stated that they were more likely to pay more
to reduce the ecological footprint of their visits.
In their discussion, the authors recognised a number of
limitations regarding their study, including the relative
homogeneity of respondents, the lack of measuring
household income or socioeconomic status and the
focus on participants’ willingness to make compromises
rather than on their actual behaviour. This focus was justified by the reasoning that “there is currently little choice
for the public when it comes to reducing the impact of
their dental treatments on the environment”.
“[F]uture research may want to use environmental assessment (for example, Life Cycle Assessment), in order to
inform which types of compromises would have a beneficial impact on the sustainability of dental services,”
the authors stated. “Such research would inform what
changes should be made, while our research can inform
whether such changes would likely be accepted by the
public,” they added.
The study, titled “Exploring attitudes towards more
sustainable dentistry among adults living in the UK”,
was published online on 26 August 2022 in the British
Dental Journal.
© Iryna Mylinska/Shutterstock.com
| features
[39] =>
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[40] =>
| opinion
Dental Thermal App offers “a simple,
yet intuitive, clinically based workflow”
An interview with Dr Les Kalman
By Iveta Ramonaite, Dental Tribune International
Dentistry, just like other medical fields, is not immune to
digital disruption, and significant
technological advancements
have taken place in recent decades. Dr Les Kalman is an assistant professor in restorative
dentistry at Western University
in Canada and a researcher
with a dedicated focus on
innovation in medical devices
and technologies, and in this
interview with Dental Tribune
International, he discusses the
benefits of developing new
tools and workflows to advance healthcare. He also talks
about his novel dental software, the Dental Thermal App,
and explains how it could
enhance the clinical experience
of dental professionals.
Dr Kalman, what is thermogDr Les Kalman.
raphy, and what use does it
have in dentistry?
Thermography is a process whereby a thermal camera
captures and produces an image by using infrared
radiation emitted from an object. The image provides
an opportunity to visibly record infrared energy or heat
that is invisible to the human eye. Thermography is a
non-invasive, non-contact and portable imaging method.
It has been used in various industrial fields, such as
engineering and construction.
Thermography is now an evolving field in medicine, and
its use as a possible diagnostic tool is being investigated.
It is currently used to aid in the diagnoses of vascular
malformations, thyroid nodules and different intra-ocular
tumours.
Thermography has had only limited use in dentistry until
now but, with recent advances in technology, it has
been employed to assess changes in the temperature of
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4 2022
restorations, to monitor inflamed
periodontal tissue and disease
of the temporomandibular joints
and to identify intra-osseous
temperature changes during
dental implant placement.
Thermography has also recently
been used to monitor inflammation after dental surgeries
and has shown promise as a
tool to diagnose pathological
conditions.
What motivated you to develop the dental thermal
app, and what specific applications does the app have
in dentistry?
My motivation has always been
to improve the clinical experience
and explore new possibilities.
Our research has focused on
the development of medical
devices and mobile technologies to provide novel workflows and applications. At a
pre-pandemic Consumer Electronic Show where we were
pitching our SmileShade app, I had the opportunity to
meet and engage with the Teledyne FLIR team, who are
arguably the leaders in thermography. After some discussion, it was apparent that FLIR did not have a dental
application. And so, the collaborative relationship began.
We worked for several years to develop the software. Its
initial application was aimed at additive manufacturing
and 3D printing as a novel method to assess the fit of
printed implant bars with dental implants. As we expanded testing, we soon realised that there were so many
other possible applications in dentistry and teledentistry.
We have explored a few notable applications. These include using the thermal app as an alternative method
for visualisation, providing an unconventional method of
identification and assessment of the patient’s surface
[41] =>
opinion
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According to Dr Les Kalman, thermography can facilitate novel clinical workflows and will be gaining increased use in dentistry. (Image: © Les Kalman)
temperature and temperature generated from surgical
procedures. Another possible application is in infection
control. Hard surfaces can be imaged to assess disinfection and the fit of KN95 masks can be assessed. The thermal app can be used in education to assess procedural
metrics. It can also be used to evaluate the fit of prostheses.
We are thrilled to have had the app approved by the
Teledyne FLIR Developer Community and Google Play!
Why should dental professionals be excited about
this technology, and how will it facilitate clinical
workflows?
Digital dentistry is exciting, and there have been remarkable developments in image acquisition, digital design and
output. Technology can improve the clinical experience for
both the patient and clinician while maintaining or exceeding the standard of care. That is exhilarating! I hope that
clinicians and technicians welcome the new technologies
with open arms and assess their value in their workflows.
Digital technology continues to change the future of
dentistry, offering novel ways to diagnose dental
conditions and plan treatments. How did these advancements shape your career as a dental professional, and do you think that change always equals
progress?
As a lifelong technology enthusiast and a researcher in
the dental device space, I believe advancement is the
key. If advancements can improve efficiency and patient
experience and reduce costs, then that is a win-win
situation for both the clinician and the patient. These
advancements also have the opportunity to improve
sustainability and accessibility for patient care. These
factors foster passion and excitement, and that fuels
my career!
“Dentistry needs
to be well represented
on the tech stage.”
We developed the Dental Thermal App with a simple, yet
intuitive, clinically based workflow. It provides the tools
needed for a novel approach to imaging and the appropriate documentation. How this technology will have an
impact on clinical workflows is the most important question. The pandemic has disrupted dentistry and steered
us to a digitally connected space. There is now a remarkable opportunity to explore this space by developing
new tools and workflows to expand the connected oral
healthcare platform.
Change does not always equal progress. We have to
evaluate all drivers of change and ensure that the standard
of care is maintained, sustainability is improved and that
new ideas are supported by scientific evidence. But let
us not be too rigid, as change has to start somewhere,
and not all new ideas are bad ideas.
Are there any challenges that may impede the use
of the app by dental professionals?
Change is always a challenge. Dentistry is grounded on
tradition and history. Many people, including clinicians,
do not like to change their way of doing things. However,
we should be mindful of new technologies and workflows
that may improve the clinical experience. Any new technology will require evaluation, feedback, revision and
support from the dental community. Keeping an open
mind and being aware of possibilities is crucial. If we think
back to the original iPhone, we will realise that technology
evolves as we embrace it.
Would you like to add anything else?
I would like to stress that the more tools we have in our
toolbox, the better. Tools provide alternative methods of
imaging, assessment and documentation. However, they
cannot be a substitution for principles and fundamentals.
They are just tools, and as clinicians, we need to know
when to use them. However, let us not fear technology
but embrace it. Dentistry needs to be well represented
on the tech stage. Just think back to film cameras, and
consider how taking pictures and recording videos has
evolved. Let us bring this evolution to our profession in
the hope of improving the clinical experience!
4 2022
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[42] =>
| opinion
“The beauty of exocad is that it’s a
universal open platform”
An interview with Dr Miguel Stanley
By Franziska Beier, Dental Tribune International
At exocad Insights 2022, Dental Tribune International
sat down with Dr Miguel Stanley, who is a passionate advocate for high-quality dental care and the clinical director of
the White Clinic in Lisbon in Portugal. In this interview, he
shares how exocad supports him in treating his patients
with personalised solutions and how the open exocad
software ultimately supports beginners and advanced
practitioners in improving patient care.
Dr Stanley, to what extent do you use exocad solutions in your daily workflows?
We started working with exocad in 2017/18. We didn’t
have a laboratory per se and only started working with
exocad when we acquired an in-office milling machine.
With this, we started gradually making small crowns and
learning to use the technology, because integrating a
new technology or software in the clinic requires new
staff and keeping those people happy and trained. You
have to slowly integrate new solutions into a team and
understand and find the ideal workflow.
Today, we do everything digitally, having a fully integrated
in-house laboratory. We have two milling machines, three
exocad stations, tabletop scanners and several furnaces.
The only thing we don’t fabricate in the clinic is large
metal structures, but mostly because we have phased
out metal almost completely. We produce zirconia, lithium disilicate, and nanohybrid composite dentures, zirconia abutments, surgical
guides, impression trays, the whole gamut.
We are very happy with the software.
Do you use exoplan for your implant treatments?
We actually want to get more involved with
it based on a lecture that I saw at exocad
Insights. It seems like exoplan just did a
massive leap into simplifying and reverseengineering the whole process, including the
dental design. As an implant surgeon, I’ve always believed that implants should be placed
in function of the prostheses. Having a surgical guide that does optimal placement for the
later prostheses—which exoplan can do—
is very clever. The system that I’m currently
working with has its own implant guided
system. We’ve been pretty much very fluidly
outsourcing that.
And what about Smile Creator?
We use this a lot; I would say that we use it for
100% of our full-arch cases. I couldn’t imagine
beginning a major reconstruction without it.
It offers so many possibilities. Sometimes, we
scan a family member of the patient in order
to use his or her smile as a donator, which is
Dr Miguel Stanley at exocad Insights 2022 in Palma de Mallorca in Spain. (Image: © exocad) really cool. We even had one case of a patient
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4 2022
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opinion
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According to Dr Miguel Stanley, Smile Creator allows patients to test whether the new tooth shape fits aesthetically but also emotionally. (Image: © exocad)
who was in transition, gender-wise, and we had designed
masculine shaped teeth for the patient because at first
we weren’t aware of the transition. After we had found
out, we used the software to give the patient more
feminine shaped teeth.
you don’t get good service. The thing about exocad
is that it’s an open platform. Tillmann [Steinbrecher,
CEO and co-founder of exocad] had the vision of creating
something that was ubiquitous and fair and democratic,
so exocad is a tool for everybody.
Moreover, the shape and angulation of the teeth can
be directly correlated to the patient’s character, for ex
ample triangular or square or rectangular teeth. Without
exocad, there is only the archaic technique of a dental
technician fabricating the teeth by hand in a lab. That is
still happening today. Most dental technicians have their
signature shape. What happens is that patients receive
a shape that looks beautiful, but it’s not their shape.
For example, if the patient is organised, structured and
methodical, but gets teeth of a triangular shape, which
is more extroverted, more dynamic, she or he will have
a smile that isn’t hers or his. Even though everybody’s
saying it’s fantastic and it looks okay, it doesn’t feel right
for the patient. I call this depression induced by poor
design.
What would you tell dentists or dental technicians
who are still struggling to enter digital dentistry or
go fully digital, and can you share some examples
of how your work has improved by using digital
workflows?
The thing about going digital is that you can’t just think
about it. You actually have to do it. The beauty of exocad
is that it’s a universal open platform for the beginner or
advanced practitioner. It can be tailored to how you want
to practise. If you don’t want to buy it, then find a planning
laboratory, for example, and pay the lab to do the design
for you. However, you need to get your physical impres
sion digital, for which you have to get or rent an intra-oral
scanner. Once that impression has been scanned,
then you’re a digital dentist. You don’t have to own the
machines; you can partner with people who do.
Let’s take Johnny Depp as an example, because he was
the first method actor who changed his tooth shape
for every major role he took on, be it Willy Wonka in
Charlie and the Chocolate Factory or Captain Jack Sparrow
in Pirates of the Caribbean. These tooth shapes were
central to him being in character, something Hollywood
understood early on. That is why exocad is really cool:
its smile design software allows you to test not just aes
thetics but an emotional connection to the tooth shape.
This sounds really interesting. So, what would you
say is your favourite exocad product? Is it Smile
Creator?
Actually, the greatest product is the people. I really do
mean it, because I don’t just like a product and I don’t
just like a service; I like the people behind that product
and that service. There are some companies that suffer
from corporate arrogance. I’ve been doing this for long
enough to know that if you’re not an important person
If there’s any issues with the final product, the reason is
your impression. In the past, you could have blamed the
laboratory, but you can’t blame exocad. The restoration
will be fabricated precisely unless the milling machine
is broken or the printer is terrible. However, the design,
which is based on that STL file, is accurate.
Even at my clinic, we don’t always take the best impres
sion because maybe we are treating a difficult patient.
If that impression goes into exocad and has an issue,
it is flagged straight away. We know we have to go back
and take a new impression; there’s no discussion.
With analogue dentistry, however, sometimes you can
fake it: you might make a bad crown and get away with it.
Inevitably, the digital industry is improving the quality of
patient care because you can’t hide your defects any
more. It is a great equaliser. So, I think that if you’re a
bad dentist, you might want to stay away from exocad.
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| opinion
Unboxing the 3Shape TRIOS 5
intra-oral scanner
Dr Mona Thygesen, Denmark
the case. The box includes five scanner tips but no
calibration tool, since TRIOS 5 does not need to be
calibrated. I think that this is a fantastic addition or, in
this case, subtraction. It is a pain in the neck having to
calibrate a scanner every week, including after vacation,
so not having to ever calibrate TRIOS 5 was a big plus
for me right from the start.
Intra-oral scanning with TRIOS 5
for the first time
After taking the scanner out, you notice immediately that
it feels lighter and smaller. Because I am used to working
with TRIOS scanners, I was able to immediately set it up
with the PC and start scanning. Within minutes, we had
it ready for scanning. It worked perfectly. I was ready to
use it on patients in no time.
Dr Mona Thygesen is co-owner of the Valby Tand practice
in Copenhagen in Denmark. She is also a beta-tester for
3Shape and has played an important role in helping 3Shape
to evaluate the TRIOS 5 intra-oral scanner pre-release.
Even as a beta-tester, Dr Thygesen says she experienced
the thrill of unboxing a brand-new TRIOS 5 when it was
brought to her by one of 3Shape’s clinical product managers.
In this article, she shares her thoughts on the new product.
First impressions of TRIOS 5
When I was given the TRIOS 5 to test, it felt like I was
getting a new toy. The scanner comes packed in a nicely
designed box that the user will want to keep and put away.
All the TRIOS 5 components are well organised in the
case. The actual scanner body is in a separate box within
44
TRIOS 5 is high quality. It is small, stylish, highly comfortable to hold in your hand and lighter compared with other
scanners, and even more features stood out for me once
I began using it.
TRIOS 5 is 30% more compact, only weighs 300 g
(with battery) and is 26.7 cm long.
LED ring and haptic feedback
Two interesting additions to the TRIOS 5 are its LED ring
and haptic feedback. The LED ring lights up once the
scanner is ready or connected, for example. The haptic
feedback is similar to the one found on an Apple Watch.
The scanner vibrates when the user loses focus when
scanning. Thanks to both of these features, it is no
longer necessary to have to continually pay attention to
the PC screen while scanning.
[45] =>
opinion
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technology that 3Shape calls ScanAssist. The technology helps to stitch the images together and to repair
missing areas.
I believe that ScanAssist can be a huge help to those
who have never scanned before. I have been doing this
for ten years, but it will definitely be of great assistance to
those who are new to using intra-oral scanners.
The scanner also has a second button that can be used
to navigate with on the PC. I am still getting used to
using it, but I can certainly see the advantage it offers,
especially in terms of hygiene.
TRIOS 5’s focus on hygiene
TRIOS 5 is a highly optimised scanner. It is evident that
3Shape has tried to think of everything it could to facilitate the scanning and sending of files. From its design
to the way it works, TRIOS 5 is a very elegant tool that is
also a lot of fun to use!
ScanAssist intelligent alignment technology minimises
distortion and misalignment in 3D models.
The TRIOS 5 has no cracks or crevices on the scanner’s body. There really is no place for it to collect contaminants. The tip window is sealed with sapphire glass,
providing more hygiene protection.
TRIOS 5 has been cleared by the U.S. Food and Drug
Administration.
This makes the scanner extremely easy to wipe down
and sterilise. In addition, the pod or stand that the TRIOS
sits on is incredibly smooth and easy to clean. It is also
well designed. The TRIOS sits securely in it so that the
user does not have to worry about someone knocking
it off the counter.
Another interesting addition to TRIOS 5 is the plastic sleeves
that cover the scanner around the handle. Other tools in
our practice also come with hygienic sleeves, but the ones
from TRIOS fit very snugly and seamlessly over the scanner
body. I wonder why other scanner makers are not doing
this, since it seems like a logical step in terms of hygiene.
TRIOS 5 batteries
TRIOS 5 comes with three batteries. Like the scanner,
they are smaller and have LED lights on them that light
up to show the battery’s charge level. This is an excellent feature because the user no longer needs to be
concerned about the battery charge level while working.
It is so easy to check.
TRIOS 5 has also added a sleep mode. When not in use,
it automatically goes into sleep mode. The 3Shape team
told me that it can stay asleep for seven days. We have
not tried that—we use it too often.
Why TRIOS 5 is so easy to scan with
Besides the fact that TRIOS 5 is smaller and lighter and
has haptic feedback, TRIOS 5 includes a new scanning
about
Dr Mona Thygesen graduated
from the University of Copenhagen
in Denmark in 2003 with a degree
in dentistry. She furthered her dental
education at the Dawson Academy
in England with a special interest
in advanced mouth rehabilitation.
Dr Thygesen specialises in
cosmetic dentistry and clear aligner
therapy and has practised digital dentistry since 2012.
4 2022
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[46] =>
| manufacturer news
Ceramill DRS Production Kit
Fabricating simple restorations in the dental practice
and placing them immediately
Fast and uncomplicated patient care with the Ceramill DRS
Production Kit from Amann Girrbach
High-quality milling results and fast patient care have long been a
contradiction in terms. However, with Amann Girrbach’s Ceramill
DRS Production Kit, dentists are now able to achieve both. Simple
restorations, such as crowns, inlays and onlays, can be fabricated
directly in the practice and placed in the patient’s mouth within the
same session.
The Ceramill DRS Production Kit is part of the Ceramill Direct
Restoration Solution (DRS) from Amann Girrbach. The production
kit builds on the Ceramill Connection Kit and consists of the
Ceramill Motion DRS milling machine and the Ceramill Mind DRS
design software. This intuitive CAD software enables dentists
to design a crown chairside in just three simple steps, and the
customisable blank library provides a very good overview of the
blanks. Production is performed by a self-contained four-axis
CNC machine. It features a touch display that guides the user
through the process with illustrated work steps. Validated
material partnerships and innovative milling strategies ensure that, for example, molar crowns can be fabricated from
IPS e.max CAD (Ivoclar) in just 15 minutes. In addition, the
Ceramill Motion DRS has a radiofrequency identification tool
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4 2022
holder, an integrated camera, a blank scanner and its own
computing unit.
“Thanks to the connection to the AG.Live platform, dentists can
decide individually on a case-by-case basis whether fabrication
should be performed in the laboratory or in the dental practice.
All relevant data, like scans, photos and radiographs, can be
shared with the laboratory at the touch of a button. Furthermore,
it is possible to draw on the expertise of the dental technician
at any time. The technician can, for example, check the quality
of the intra-oral scan or the preparation while the patient is still
in the chair and check whether there is sufficient space for
the restoration. In future, the restoration could also be designed
in the laboratory if required, even if fabrication itself is performed
in the dental practice. The comprehensive flexibility of the
Ceramill DRS system opens up a completely new range of options
for clinicians,” explained Elena Bleil, product manager of Amann
Girrbach’s global business unit for clinical CAD/CAM. The Ceramill
DRS Production Kit can be supplemented with the Ceramill DRS
High-Speed Zirconia Kit.
www.amanngirrbach.com
[47] =>
manufacturer news
|
Optimised solutions for dental implant patients
Meet the EV implant family
Dentsply Sirona has a family of implant systems that allows dental
professionals to provide optimised solutions for dental implant
patients, including the Astra Tech Implant System EV, DS PrimeTaper
implant system and DS OmniTaper implant system.
The EV implant family is backed by science and built on four decades of pioneering work that values biology and seeks to achieve
harmony with nature to realise high aesthetics and longevity.
With one connection for restorative freedom and seamless workflows for digital dentistry, these innovative implant systems enable
confidence in digital dentistry, whatever the clinical indication.
Advancing implant dentistry
The EV implant family consists of the Astra Tech Implant System EV,
PrimeTaper EV implant and OmniTaper EV implant, representing
an advancement in efficiency and organisation for the clinician.
Clinicians can choose the implant design depending on their
surgical preference. The restorative workflow is matched across
the family and features the same hard- and soft-tissue care, the
same implant–abutment connection, the same prosthetic kit and
components, and the same access to digital planning tools and
patient-specific solutions.
The newest family member
The newest member of the EV implant family is the DS OmniTaper
implant system. The OmniTaper EV implant is naturally optimised
for digital workflows, including DS Signature Workflows. The
OmniTaper EV implant provides clinicians with reliable high primary
stability that allows for immediate loading across a range of surgical and prosthetic procedures. Furthermore, it offers efficiency
in surgery and for immediate chairside solutions.
An ecosystem of digital solutions for implant workflows
Dentsply Sirona means innovative products and a complete
ecosystem of digital solutions.
DS Signature Workflows make implant treatment simple, accurate
and efficient for enviable aesthetics and proven longevity. These
workflows used together with DS Core—a new cloud-based platform that combines products, services and technology—allow the
treatment team to focus more on treating patients. Primeprint
Solution is a highly automated medical-grade 3D printing system
for dentists and dental technicians who want to expand their treatment and service offerings, reduce handling times and maximise
productivity.
The comprehensive product and solutions portfolio is designed to
help practices excel in digital dentistry, grow their implant dentistry
business and get the best results for their patients.
www.dentsplysirona.com
4 2022
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[48] =>
| manufacturer news
Resin for high-end flexible splints
Welcome to the next level: FREEPRINT splintmaster
The new FREEPRINT splintmaster is a resin for 3D-printing high-end
flexible splints. It is available in two levels of flexibility: TAFF for
functional splints and FLEX for soft night guards.
The biocompatible material is characterised by the highest impact
strength. Splints made of FREEPRINT splintmaster are robust and flex
ible, without becoming brittle. Thanks to the material’s memory effect,
the splints always return to their original shape. The perfectly combined
properties guarantee the highest wearing comfort, easy insertion and
removal. The clear, transparent resin is colour-stable, tasteless, and
free of methyl methacrylate and tetrahydrofurfuryl methacrylate.
The DETAX FREEPRINT line offers more than 30 high performance
3D resins for all dental applications. All materials are validated for
more than 35 printers and curing devices, and the validation portfolio
is g rowing rapidly (the latest list is available on DETAX’s website).
FREEPRINT medical devices are certified under European Parliament
and Council Regulation (EU) 2017/745 and feature an extended shelf
life of 36 months. Most products, like FREEPRINT crown, temp and denture, have already received U.S. Food and Drug Administration clearance.
Make the switch and join the masterclass!
www.DETAX.com
NeoScan 1000 intra-oral scanner
Digital dentistry made easy
As part of Neoss’ milestone celebration delegates at the Neoss
Integrate 2022 congress in Gothenburg, Sweden were given
the first access to the NeoScan 1000 intra-oral scanner which
was commercially launched in September. “I am excited to
introduce the NeoScan 1000 into our range of intuitive dental solutions. The performance of the scanner is beyond my expectations
with clear competitive advantages. The scanner will allow Neoss
to significantly expand its proprietary digital dental offering,” says
Dr Robert Gottlander, CEO and president of Neoss Group. Designed
for scanning accuracy and speed, the compact, lightweight scanner provides the possibility for a flexible workflow with open and
compatible output at a competitive price. “The NeoScan 1000 is a
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4 2022
superfast, lightweight, and easy-to-use scanner. I had the pleasure
of being part of early testing and have used the scanner for
several digital impression indications at my clinic with excellent
results. Digital dentistry is in need of more cost-efficient solutions
so that clinicians can use it to its full potential. The NeoScan 1000
has the potential to do just this,” says Dr Marcus Dagnelid,
board-certified prosthodontist. With an easy USB cable connection
and full touch screen support, the NeoScan 1000 is sure to please
and excite dental professionals alike!
www.neoss.com/neoscan1000
[49] =>
manufacturer news
|
3D dental scanner with powerful functions
AutoScan-DS-EX Pro (H)—embrace the 5 MP era
SHINING 3D has always worked closely with our partners, resellers
and dental specialists to shape all feedback and ideas into
products that will help to improve the overall satisfaction of our
customers. This close collaboration has led to the development of
AutoScan-DS-EX Pro (H) to address the market’s needs in the best
possible way.
AutoScan-DS-EX Pro (H) is the latest addition to SHINING 3D’s
desktop scanners portfolio. It is a 3D dental scanner with powerful
functions that can be used for multiple applications, including
digital impressions, plaster models, articulators and implant abutments. Its high-resolution cameras, advanced algorithms and
user-friendly interface offer superior data quality—making for an
optimal experience.
Ultra-high accuracy and unparalleled detail
A scanning accuracy of ≤ 8 μm ensures reliable scanning results,
satisfying the requirements of various applications in the
dental industry. Equipped with dual 5 MP resolution cameras,
AutoScan-DS-EX Pro (H) can capture every detail.
Flexible workflow and versatile scanning modes
The user can set up his or her own preferred workflow, increasing
work efficiency like never before. All-in-one and triple trays are
available to obtain complete scan data with fewer steps. Scan
and backstage data processing can be carried out simultaneously,
making the whole process more efficient. The new software
associated with AutoScan-DS-EX Pro (H) can support versatile
s canning modes, including Multi Path Scan, High Quality Scan, AI Scan,
Texture Scan, HDR Mode Scan and Reduce High Brightness Scan.
SHINING 3D provides fully integrated 3D digital dental solutions,
from obtaining 3D data with desktop 3D scanners for laboratories
and intra-oral 3D scanners for clinics and design with professional
dental CAD software to printing dental products, including working
models, orthodontics models, implant models, surgical guides,
wax-ups and partial frameworks.
www.shining3ddental.com
4 2022
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[50] =>
| manufacturer news
A next-generation intra-oral scanner
3Shape launches the brand-new
TRIOS 5 Wireless intra-oral scanner
Dr Carsten Blok of Colosseum Tandlægerne Palæklinikken in
Denmark recently shared a review about the new 3Shape TRIOS 5.
In it, he wrote: “With a digital impression solution, you assume
that there’s not that much that can be done with a scanner.
You cannot make it much faster or more accurate, so what is
there left to improve?” He then answered this: “Well, before I go
into detail, let me just say that TRIOS 5 is pretty much a whole
new ball game.”
The brand-new TRIOS 5 has been five years in the making. It
comes housed in a completely new and redesigned compact and
hygienically optimised body—a body created to deliver the highest
standard in imaging performance and infection control.
The desired changes in size and design required 3Shape engineers
first to discover how to fit the scanning technology into a smaller
body. This led to our new ScanAssist intelligent alignment technology, among other innovations.
Making intra-oral scanning simple
At the heart of TRIOS 5, ScanAssist technology minimises misalignment and distortion in 3D models to help make impression
taking so easy that dental professionals can create their own scan
strategy or scanning routine. This, coupled with a new built-in LED
ring and haptic sensory feedback that guides the dentist while
scanning, means that TRIOS 5 delivers an unprecedented level of
scanning simplicity.
In fact, Danish dentist Dr Mona Thygesen, who tested TRIOS 5,
said that “if you are new to using intra-oral scanners, ScanAssist
will do just what its name says: assist you when you scan”.
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4 2022
More than 50 improvements
TRIOS 5 Wireless introduces a significant number of meaningful
enhancements in ease of use and design. For example, because of
the new scanner tip design, TRIOS 5 no longer needs to be calibrated.
If you have experienced weekly calibration sessions at your practice,
then you will appreciate the huge benefit of never having to calibrate
the scanner. TRIOS 5 also introduces all-day battery life with smart
power management, which automatically switches TRIOS 5 into sleep
mode when not in use. Also, the new batteries last for up to 66 minutes and feature embedded LED lights to indicate their charge level.
A new standard in patient protection and infection control
When COVID-19 hit, 3Shape engineers reimagined intra-oral scanner
design with a focus on hygiene. TRIOS 5 has an easy to clean body that
is hygienically sealed up to its battery inlet, having no cracks or crevices
to accumulate any contaminants. A sapphire glass window now encloses the tip to create a sturdy microbial barrier between patient and
scanner. TRIOS 5 includes single-use body sleeves that cover the entire
area touched by the operator and protect against contamination. TRIOS 5
has received 510(k) clearance from the U.S. Food and Drug Administration.
Maximising your investment
Besides the advantages that come with all our award-winning
TRIOS scanners, such as patient engagement apps, the 3Shape
Unite platform and TRIOS Care service agreement options, TRIOS 5
introduces a game-changing solution: TRIOS Share.
In short, TRIOS Share enables you to scan and plan on any PC in
your practice with just a single TRIOS wireless intra-oral scanner.
www.3shape.com/en/software/trios-share
[51] =>
|
© YaromirM/Shutterstock.com
meetings
Registration for 2023 Chicago Dental
Society Midwinter Meeting is open
By Dental Tribune International
The Chicago Dental Society (CDS) has recently announced that registration for its 158th Midwinter Meeting
is now open. The premier dental meeting, which attracts
attendees from around the globe, will be held at McCormick
Place West in Chicago on 23–25 February 2023.
“The Midwinter Meeting will once again be the place to
learn from the brightest minds in the industry and earn
valuable CE (continuing education) credit,” CDS Presidentelect Dr Michael Durbin said in a press release. “We’ve
scouted and vetted a roster of more than 120 renowned
clinicians and leaders in dental education to deliver hundreds of CE-accredited courses across a variety of topics
to help all members of the dental team advance their
careers and provide the best patient care possible.”
The Midwinter Meeting is known for attracting top-tier
speakers in the field of dentistry from across the country.
The upcoming 158th edition of the event will offer attendees more than 240 CE-accredited courses, including
45 workshops. Additionally, it will provide dentists and their
teams with the latest practice management solutions and
evidence-based clinical knowledge.
The expansive exhibition hall will feature hands-on access
to the latest dental products and technologies. Here,
attendees can expect to experience the latest 3D-printing
and laser technologies, as well as practice management
and restorative dentistry solutions, available to help dental teams provide the best care possible for their patients.
“It’s always fascinating to see and test the latest innovations from both the biggest household brands and the
new, up-and-coming companies. You never know what
you’ll find in the exhibition hall, but there’s always something beneficial for every dental practice and team
member,” Dr Durbin added.
Rounding out the Midwinter Meeting experience will be
a series of social and networking events, including
a general session, Brews and Bargains happy hour, an
ice cream social, dedicated networking events for early
career dentists and dental students, a Friday night
concert at Park West headlined by Tributosaurus and
the President’s Dinner Dance.
More information on the event, including registration fees,
can be found at cds.org/mwm.
4 2022
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[52] =>
| meetings
More than 23,000 trade show visitors from 114 countries attended the International Dental Show 2021 in Cologne, Germany.
IDS organisers herald beginning of
post-COVID-19 era
By Dental Tribune International
52
The countdown to the International Dental Show (IDS)
2023 has begun, and the organisers have set the bar
high by stating that the forthcoming IDS will return to
its pre-pandemic form and size. IDS 2023 is set to take
place on 14–18 March next year in the western German
city of Cologne.
IDS 2023 will be the 40th instalment of the event, and it
will mark 100 years since the establishment of the trade
fair in 1923. The organisers commented on the forthcoming event during a press conference on 8 October
in Singapore, where co-organiser Koelnmesse was
holding IDS’s sister event, the International Dental
Exhibition and Meeting (IDEM).
“IDS 2023 will be the
40th instalment of the event,
and it will mark 100 years
since the establishment
of the trade fair in 1923.”
Dr Markus Heibach of the Association of the German
Dental Industry (VDDI) opened the press conference
by explaining that the dental industry in Germany and
abroad had recovered well during the first half of this
year, despite economic fallout from the war in Ukraine.
“Overall, there are very positive signals, both domestically and also abroad across all areas,” Dr Heibach
explained. He added: “In particular, we see an increased
demand for high-quality restorations, for ‘high-end’
4 2022
[53] =>
meetings
dentistry.” Dr Heibach drew a connection between the
pandemic and an increased awareness of oral health
and general appearance, stating: “Clearly, the constant
preoccupation with health issues has reminded many
people of the value of personal health and quality
of life.”
The exhibition floors at IDEM were open as Markus
Oster, vice president for trade fair management at
Koelnmesse, took to the podium. According to Oster,
his experiences with IDEM 2022 were significant for the
forthcoming 40th IDS. Oster said: “Although the pandemic situation has not yet been overcome, I associate
this trip and developments in general with the beginning
of the post-corona era and a return to normality. I am
also completely convinced that the IDS, as the world’s
most important industry platform, will once again take
place in the coming year with the dimensions we were
last able to experience at the 2019 edition.”
Oster said that he expects IDS 2023 to operate under
“normal” conditions with a proven hygiene concept in
place. It will also be a hybrid event, offering remote participation through the virtual trade fair platform IDSconnect.
Oster pointed out that the Koelnmesse trade fair grounds
|
“IDS 2023 will be staged
across seven halls, and a total
exhibition space of 180,000 m²
will make it larger than
pre-pandemic events.”
were reachable by more than 1,500 daily rail connections and that travel between Cologne and surrounding
metropoles like Düsseldorf, Essen or Dortmund is free
of charge for holders of a valid IDS ticket.
IDS 2023 will be staged across seven halls, and a
total exhibition space of 180,000 m² will make it larger
than pre-pandemic events. In 2019, the 38th IDS
covered 170,000 m² of exhibition space and featured
2,260 vendors from more than 60 countries. In 2021,
the 39th IDS was downsized to 115,000 m² and took
place without a number of its stalwarts. It featured
830 exhibitors from 59 countries. IDS is organised by
Koelnmesse and VDDI.
From left to right: Prof. Christoph Benz, Mark Stephen Pace, Gerald Böse, mayor Henriette Reker, Dr Markus Heibach, Dr Gerhard Seeberger, Oliver Frese
and Lutz Müller. Opening ceremony IDS 2021. (All images: © Koelnmesse)
4 2022
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[54] =>
| interview
“Gaining this international
recognition means receiving
an important responsibility”
An interview with Dr Tiziano Testori
By Lake Como Institute
Dr Tiziano Testori.
Lake Como Institute, which has been a centre for advanced training in implantology for more than 30 years and
which has played a part in the education of national and
international implantologists, has now been recognised as
an approved international training centre by the Academy
of Osseointegration (AO). Currently, AO has three approved
international training centres that meet its strict academic
and training criteria, and Lake Como Institute is the only
one in Europe, the others being in Taiwan and Malaysia.
We caught up with Dr Tiziano Testori, who is the founder,
CEO and scientific director of Lake Como Institute.
Dr Testori, what does this recognition mean for you
and Lake Como Institute?
It means the confirmation of a path that began many
years ago when, by founding Lake Como Institute,
I wanted to set up and transfer a teaching model which
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4 2022
I had appreciated in my professional training overseas.
It is based on just a few solid principles: scientific research, clinical experience and sharing the knowledge
of leading international experts. Gaining this international
recognition means receiving an important responsibility—
that of training the next generation of implantologists by
preparing them to approach their profession according
to the standards of the Academy of Osseointegration.
What does the AO Master Certificate programme,
organised at Lake Como Institute, consist of?
It is a certified master certificate programme in implantology that, in addition to awarding a very prestigious
international qualification, allows the participants to receive comprehensive training in the field of implant prosthetic surgery. Moreover, we have chosen to make use
of internationally recognised experts in order to offer the
[55] =>
|
Como Lake, Varenna, Italia © shirmanov_aleksey/Shutterstock.com
interview
trainees an excellent educational experience and the opportunity to truly benefit from the most current knowledge
in the field of implant-supported prostheses.
Are we then talking exclusively about implantology?
Implant prosthetics, a term widely used, is one of the
treatment options available to us as clinicians for patient
rehabilitation. However, without the clinician having fundamental surgical knowledge, it can be just a sequence
of manual actions that could result in harmful consequences. We have chosen to start from the physiological and pathological bases of bone healing and anatomy
to arrive at modern, effective and efficient diagnosis and
design. In the various modules that make up the master
certificate course, we will accompany the trainees in the
gathering of all the information needed and help them
to classify this information according to scientifically established protocols. We will address various clinical scenarios and their solutions, including simple clinical cases
and complex unpredictable rehabilitations. We will also
give considerable space to everything that happens after
implant placement, including soft-tissue management
and both provisional and definitive prosthetic protocols.
We have decided to pay special attention to the management of complications. When our trainees return to their
practices, they should be able to handle each situation
knowledgeably and independently.
Is this a theoretical master certificate course, or will
there be practical sessions as well?
The entire course is designed under the supervision of the
Academy of Osseointegration and according to its strict rules.
Each teaching module will consist of an evidence-based
theoretical section and include the use of special hands-on
ASTM-certified models that recreate in vitro the clinical
situation that will be encountered in the operating room.
There will be workshops on animal models and the opportunity to attend Lake Como Institute. Finally, each trainee will
be assisted in planning the clinical cases involved.
How long does the master certificate programme
last and how is it structured?
The duration of the programme is about one year. It is
specifically organised to allow students to follow cases
from planning to prosthetic finalisation. The programme
will be divided into five sessions. The first four will last one
week each, and each will be a full immersion experience.
The last session, which will take place at the AO Annual
Meeting, will be a final examination and will include discussion of the clinical cases prepared by the learners.
To whom would you recommend considering such
an ambitious programme?
There are no particular requirements expected from
those attending other than curiosity and a desire to participate in a very high-profile educational programme.
A dentist who aspires to address all aspects of implant
prosthetic rehabilitation scientifically and to adopt an
in-depth approach can find everything he or she needs in
this programme. I will be accompanied by distinguished
lecturers and will be supported by a large team of tutors
from Lake Como Institute faculty. They will all help me to
present this fascinating master certificate programme
to the best of my ability.
4 2022
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[56] =>
| meetings
International events
CIOSP 2023—
40th Sao Paulo International
Dental Meeting
18th IDENTEX—
International Oral and
Dental Health Exhibition
25–28 January 2023
Sao Paulo, Brazil
https://www.ciosp.com.br/pt
4–7 May 2023
Antalya, Turkey
https://cnridentex.com
7–9 February 2023
Dubai, UAE
https://aeedc.com/
see-you-at-aeedc-dubai-2022
4 2022
11–13 May 2023
Torino, Italy
www.eas-aligners.com
158th Chicago
Dental Society
Midwinter Meeting
The British Dental Conference
& Dentistry Show
23–25 February 2023
Chicago, USA
www.cds.org/midwinter-meeting
12–13 May 2023
Birmingham, UK
https://birmingham.dentistryshow.co.uk/
IDS 2023
56
4th EAS Congress
FDI World Dental Congress
14–18 March 2023
Cologne, Germany
www.ids-cologne.de
24–27 September 2023
Sydney, Australia
www.fdiworlddental.org/
world-dental-congress-2023
ICOI World Congress
36th International Dental
ConfEx CAD/CAM Digital
& Oral Facial Aesthetics
13–15 April 2023
Sydney, Australia
www.icoi.org/events
27–28 October 2023
Dubai, UAE
https://cappmea.com
© 06photo/Shutterstock.com
AEEDC Dubai 2023
[57] =>
|
© 32 pixels/Shutterstock.com
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[58] =>
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58
4 2022
[59] =>
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[60] =>
© MIS Implants Technologies Ltd. All rights reserved.
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Learn more about MIS at: www.mis-implants.com
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/ Editorial
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/ News
/ Guided one-stage and two-stage implant placement in the anterior zone
/ Immediate implant placement and provisionalisation of a mandibular first molar
/ A multidisciplinary digital approach to a complex case - Surgical, aesthetic and occlusal procedure planning for implant-supported full-arch prostheses
/ Dentist–technician communication: We can all do better!
/ If I could see through your eyes, I wonder what I would see?
/ “Psychological knowledge and techniques will save time, money and frustration in the long run” An interview with Lena Myran
/ Building a sustainable dental practice
/ Study examines public perceptions regarding sustainable dentistry
/ Dental Thermal App offers “a simple, yet intuitive, clinically based workflow” An interview with Dr Les Kalman
/ “The beauty of exocad is that it’s a universal open platform” An interview with Dr Miguel Stanley
/ Unboxing the 3Shape TRIOS 5 intra-oral scanner
/ Manufacturer news
/ Meetings
/ “Gaining this international recognition means receiving an important responsibility” An interview with Dr Tiziano Testori
/ International events
/ Submission guidelines
/ International imprint
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