DT Middle East & Africa Edition No. 1, 2023
“The future of dentistry is digital”: Dentsply Sirona’s plans for the Middle East
/ Part 6: Sustainable dentistry in 500 words or more
/ Industry
/ Treatment of a carious lesion with a composite with a single posterior shade
/ Restorative aesthetics at the gingiva
/ An interview with Dr Kyoo-Ok Choi, founder of Osstem Implant: “Our aim is to become a total service provider”
/ Event
/ Starlynr: A new revolution in aligners
/ News
/ The important things in dental sutures production
/ Preparation of complex canal systems in primary and secondary treatment with the aid of a martensitic file system
/ DS World Premiere in Dubai – February 2023
/ News
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[1] =>
DENTALTRIBUNE
The World’s Dental Newspaper · Middle East & Africa Edition
PUBLISHED IN DUBAI
ENDO TRIBUNE
Endodontics fine motor skills
with the use of conventional
and 3D microscopy
www.dental-tribune.me
LAB TRIBUNE
Researchers suggest their
3D-printed veneers are the future
” Insertion A
” Insertion B
IMPLANT TRIBUNE
Clinical and radiographic success
of injection-molded two-piece
zirconia implants submitted to...
” Insertion C
VOL. 13, NO. 1
ORTHO TRIBUNE
Scientists analyse bacteria
on clear aligners
HYGIENE TRIBUNE
Study links oral microbiome to
depression and anxiety
” Insertion D
” Insertion E
“The future of dentistry is digital”:
Dentsply Sirona’s plans for
the Middle East
By Dental Tribune MEA
Dental Tribune Middle East &
Africa spoke with Rajender Kumar,
general manager for the Middle
East and North Africa (MENA) at
Dentsply Sirona, on continuing
dental education and training activities, including the first Dentsply
Sirona World in Dubai, and the
company’s short- and long-term
strategies in the region. In the interview, he also expanded on
Dentsply Sirona in MENA considering the recent global changes in
company management.
Would you give us a short introduction to yourself?
I’ve been working for Dentsply
Sirona for more than ten years now.
I was based in India for approxi-
mately four years as a finance director, and then I moved to the
MENA region in Dubai, working as
the finance director for the MENA
region. Then I moved to financial
planning and analysis director for
the eastern region, which includes
Russia, countries of Common-
” Page 02
Rajender Kumar, general manager for the Middle East and North Africa (MENA)
at Dentsply Sirona. (Photo: Dentsply Sirona)
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13.06.2022 11:04:37
[2] =>
INTERVIEW
02
Dental Tribune Middle East & Africa Edition | 01/2023
IMPRINT
“ Page 01
PUBLISHER AND CHIEF EXECUTIVE OFFICER:
Torsten OEMUS
and their team members so that
they also feel comfortable with our
products. Our third target is the
market. We are going to have a lot of
hands-on sessions and product
demos. Those types of activities
will help us to grow the business in
this region.
In this regard, would you like
to say a bit about Dentsply Sirona
World in Dubai and how it could
support that?
Dentsply Sirona World is one of
the activities that we will be hosting in the MENA region—for the
first time! It is being held in Dubai
in early February 2023. The idea is
to have our own Dentsply Sirona
event where we can invite people
who are really dedicated to
Dentsply Sirona’s products where
we can showcase our product portfolio and can educate them so that
they can take this forward to improve the oral health of patients in
the region.
(Photo: Marko AliaksandrShutterstock)
wealth of Independent States,
MENA countries, Turkey, India and
South Africa. In the last 15 years, I
have worked very closely with vice
presidents and the general managers and had very close collaboration with all the business partners
in the region, and I feel like I have a
good standing in terms of knowledge of the business. Since 1st of
November, I have been appointed
general manager for the MENA region, and I am glad to be in this position. I’m hopeful that Dentsply
Sirona will do even better in the future.
where would you like to see it go
from here?
The future of dentistry is digital, and this is not different for the
Middle Eastern region. We are
working towards the situation in
which more and more dentists will
be going increasingly digital in the
coming years, and digital solutions
will integrate itself in each dental
treatments. We as a company and
as management in the MENA region are working on educating our
customers on our digital offering
and how it can help to provide better solutions for patients.
In light of the shift in management, will we be seeing any pivotal changes in direction and
strategy?
Indeed. Whenever there is
change, one can expect this because different people have different perspectives, different ways of
thinking. We as a company are also
thinking a little bit differently than
before. Three things are very important for the company to grow, in
any of the regions , The first is dedicated, motivated and long-term
team members. The second is trustworthy, sustainable business partners. The third is ground-level activities, our team members reaching out to dentists so that we can
talk to them about our products,
the opportunities we provide for
better solutions for patients and
how we can improve the oral health
of patients. This has been a particular focus in the MENA region for the
last month or so. We have also been
working on ensuring a stable team,
putting the right structures in
place and filling positions that have
been open for the last few months.
Plus, we have made a little bit of
change to the structure overall that
will help us to grow the business
more sustainably.
How important is continuing
dental education for Dentsply
Sirona in the MENA region?
I believe that clinical education
is one of the best tools to grow the
business in any country. If dental
professionals have not been exposed to our products, if they have
not touched the products and, it
makes it very difficult to build
adoption of our solutions in everyday treatments of their clinics.
What are your thoughts on
dentistry in the Middle East, and
The pandemic resulted in a
move to online education. What
are your thoughts on this, and
how do you see the future of dental education in the MENA region?
There are pros and cons for
both online and in-person sessions
and training, but I feel that a
blended approach would be more
successful, giving the options to
our customers and allowing them
to choose whatever they feel comfortable with. Online sessions offer
the benefits of saving time, being
able to choose according to interest
and being able to view the recordings at a later stage. I think that online education is the future for any
of the topics, but a physical presence is also very important because
the human aspect is very important for good relations with any person and for any activity.
As the largest manufacturing
company in the world in dental
products and technology, how do
you continue to keep the company
consistently strong in terms of
strategy and culture in the Middle
East?
We have structures in place at
each level, including at the corporate level and at the regional level.
These ensure that we have all the
processes in place to enable cultural diversity, including feedback
mechanisms, such as surveys
among all the employees to ensure
that all voices are heard. If they
have any concern or anything to
share which could be better for the
company, we are always open to
that.
Which product lines do you
feel are best represented in the
Middle Eastern region, and which
ranges still require more awareness?
In the Middle East specifically,
we are very strong on the equipment side, and we have already
identified growth opportunities
areas especially from the implant
side, and we are already working in
that direction. This is also our focus
for the future regarding digital
dentistry, including combination
with scanners. We continue to
focus on the consumables part
along our strong focus on digital.
Consumables is the bread and butter of every dentist and guarantee
our presence in a majority of clinics
and to identify when they’re ready
to move to digital with us.
What activities are you planning to run to achieve greater
awareness of your products?
We have just started training
our staff members. We have a lot of
new team members in the region,
and we are bringing them to the
Dubai office for training. Once our
team is fully trained, our target is
to train all our business partners
What are the short- and longterm strategies for Dentsply
Sirona in the MENA region for the
coming years?
The short-term strategy is making sure that we are growing our
existing business segments with
our business partners and our
team based in the different countries in the region. In the long run,
we want to grow into a very sustainable business, and to that end,
we need to identify long-term sustainable partners. We need to identify untapped markets, and we
have a lot of scope to grow because
we are not yet in the full MENA region. There are a lot of countries to
which we can expand, and we need
to invest in terms of employees, resources, clinical education, marketing activities and so on.
Are you allowed to share with
us any new countries that you’re
thinking of entering in the region?
Yes. We have already started focusing on North African countries,
including Morocco, Senegal, Tunisia and Algeria, for the last few
months. This is in addition to our
expanded focus on markets in
which we already operate, particularly Saudi Arabia, the UAE, Egypt
and Kuwait.
Do you intend offering your
entire product portfolio in these
new markets, or are you going to
select specific products that you
feel are best suited for those markets?
In the beginning, we are not
going to focus on each product
there but on the digital part of the
business.
What about SureSmile?
The strategy for SureSmile in
the Middle East is first in the UAE
and then in the Saudi Arabia, and
maybe in a couple of years’ time, we
will launch the product in another
Middle Eastern country.
CHIEF CONTENT OFFICER:
Claudia DUSCHEK
MEA EDITORIAL BOARD:
Dr. Aisha Sultan ALSUWAIDI, UAE
Prof. Paul TIPTON, UK
Prof. Khaled BALTO, KSA
Dr. Ninette BANDAY, UAE
Dr. Nabeel Humood ALSABEEHA, UAE
Dr. Naif ALMOSA, KSA
Dr. Mohammad AL-OBAIDA, KSA
Dr. Meshari F. ALOTAIBI, KSA
Dr. Jasim M. AL-SAEEDI, Oman
Dr. Mohammed AL-DARWISH, Qatar
Dr. Dobrina MOLLOVA, UAE
Dr. Ahmed KAZI, UAE
Dr. Munir SILWADI, UAE
Dr. Khaled ABOUSEADA, KSA
Dr. Rabih ABI NADER, UAE
Dr. Ehab RASHED, UAE
Dr. Mohd Dashti, Kuwait
Aiham FARRAH, CDT, UAE
Retty M. MATTHEW, UAE
PARTNERS:
Saudi Dental Society
Saudi Ortho Society
Lebanese Dental Association
Lebanese Orthodontic Society
Qatar Dental Society
Oman Dental Society
Kuwait Dental Association
International Federation of Dental
Hygienist
British Academy of Restorative Dentistry
British Academy of Dental Implantology
AALZ - Aachen Dental Laser Center
Singapore Dental Association
Saudi Dental Hygienist Society
MEA PUBLISHER:
Dr. Dobrina MOLLOVA
SALES:
Tzvetan DEYANOV
Petar MOLLOV
EDITING & DESIGN:
Kinga MOLLOV
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Find out more by scanning
the QR Code
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[4] =>
04
GENERAL DENTISTRY
Dental Tribune Middle East & Africa Edition | 01/2023
Part 6: Sustainable dentistry in 500
words or more
and energy, and multi-use products are not always the best solution. Bio-based single-use products
might be a better and safer option
for our patients, but this needs further investigation. Home care also
requires water, and there is a substantial waste of water during
toothbrushing and other oral
home care routines.
A third challenge that is mentioned is the dental profession’s
“set behaviours and attitudes”, but
there is no further in-depth explanation regarding the issue in the
consensus. Being a dental professional myself, I can identify with
set behaviours and particular attitudes. We work in a high-stress environment, and much of the operative success depends on paying attention to detail, choosing the appropriate material and following a
rigid workflow. For dental professionals, changing set behaviours
could affect treatment outcomes,
which we are not willing to risk.
In this six-part series, Dr Sanjay Haryana writes in brief about different aspects of sustainability in dentistry. (Image: geralt/Pixabay)
By Dr Sanjay Haryana
SINGAPORE: A year ago, we started
this article series with FDI World
Dental Federation, announcing its
new initiative to “lead the charge
on sustainability in dentistry” by
uniting five leading sustainable
dental industry partners, including the company that I work for,
TePe Oral Hygiene Products. In
April 2022, the first Consensus
Statement on Environmentally
Sustainable Oral Healthcare was
released, and it seems appropriate
to complete this six-part series
with some of the findings gathered
in this 70-page consensus report
published by FDI.
The consensus is aimed at the oral
healthcare community and has a
cradle-to-grave methodology that
includes the entire supply chain,
that is, manufacturers, suppliers,
dental professionals and waste
management. Even though the
consensus is relevant for everyone
within the oral health industry,
some sections can be perceived as
irrelevant to those who are not devoted to sustainability.
The aim of this article is to provide
a brief overview of the consensus,
particularly the parts that are pertinent to the dental profession, and
to discuss how to put the preventive aspects covered in the report
into practice. It also offers steps to
achieve patient compliance, which
is both most challenging and rewarding from a dental professional’s point of view.
in sustainable practices with all
stakeholders for the benefit of society. We recognise the need to establish a strategy to achieve meaningful and measurable environmental
outcomes throughout the oral
healthcare supply chain.
A Joint Stakeholder Statement
Through this statement, we recognise that the oral healthcare sector—as a whole supply chain—has
a responsibility to undertake its activities in a manner that seeks to
improve the sustainability of oral
healthcare products and interventions.
The consensus starts with this
joint stakeholder statement, which
recognises the complexity of sustainability in the oral healthcare
industry, involving not just our
clinical setting but rather the
whole cycle, from the sourcing and
manufacturing to the disposal of
dental products. To foster a sustainable industry, dental professionals need to work together to decrease the negative impact of dentistry on the environment and to
create a circular economy without
compromising the quality of our
care.
Through our collective ambition to
reduce the environmental impact
of oral healthcare, we recognise
that there is a substantial opportunity and desire to work collaboratively across the sector, to engage
The consensus is based on scientific publications. To be able to shift
the oral care industry towards a
sustainable future, the FDI panel
sets out six routes to sustainability
in the consensus. These include the
four Rs (reduce, reuse, recycle and
rethink); legislation, policy and
guidelines; waste management;
procurement and logistics; research and education; and materials for clinical use. A three-step
process was suggested to address
each of these.
Step 1: Create awareness in the
oral care community and identify
the challenges it involves
Dentistry’s impact on the environment is not clearly documented.
However, it has been established
that patient and staff travel account for two-thirds of the total
emissions. This is valuable knowledge for the dental profession,
since it demonstrates that our impact on the environment starts
outside the dental practice.
Water usage is also highlighted in
the consensus. Dental treatments
are heavily dependent on water,
from treatment to sterilisation. We
should take this into account when
choosing between single-use and
multi-use products, since every
sterilisation cycle requires water
Step 2: Identify drivers and opportunities
Drivers are motivators for change.
One of the drivers for the dental
profession is the desire to be portrayed as a positive influence when
it comes to sustainability, that is, to
be a part of the solution instead of
being a waste management problem. Our commitment to preventive dentistry will eventually lower
emissions by reducing operative
treatment in our patients and
thereby decreasing travel and material usage. Additionally, the dental profession improves the quality
of life for billions of people through
bringing pain relief, creating beautiful smiles and regaining function for our patients. Sustainable
workspace is also high on the list
for the younger generation and is a
great attraction factor for recruiting valued members of staff and
marketing a dental practice.
Step 3: Create a strategic action
framework for specific recommendations and identify best
practices
Towards the end of the consensus
report, there is a strategic action
framework for each of the six
routes to sustainability in oral
healthcare. For dental professionals, the route of the four Rs is the
most relevant one, especially reduce and recycle. Reduction
through prevention focuses on reducing carbon emissions through
fewer appointments, which results
in fewer patient journeys and thus
lower environmental impact, and
on reducing material, since there
will be less intervention if we keep
our patients healthy.
” Page 06
[5] =>
Your Endo Guide
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[6] =>
06
NEWS
“ Page 04
“The only side effect of preventive
dentistry is its positive impact on the
environment”
The consensus covers the complexity of sustainability from all possible angles. However, how should
we employ it in the dental practice,
and where should we start? I believe that we should go back to the
basics and focus on oral home care,
which is the bedrock of all dental
treatment and disease control.
After all, all success stories are dependent on plaque control. Oral
hygiene information and instruction are a very small portion of our
daily work, but can greatly impact
our decisions and interventions.
Therefore, there is a strong need to
refresh our knowledge, starting
from professional training, including ways to achieve compliance,
which is considered one of the
most complicated tasks in dentistry.
Reduction through prevention
using compliance: Tips and tricks
1.
Use a dental model to explain
oral disease, the maintenance
of a new dental construction
and the impact of dental
plaque on teeth. There are several such models available at
dental dealers that are well
worth the investment, such as
caries, periodontal disease,
fixed orthodontic appliance
and implant models.
2. Select a suitable toothbrush
(regular or compact size; soft
or extra-soft, flat-trimmed or
Dental Tribune Middle East & Africa Edition | 01/2023
3.
multilevel bristle design) for
use on the dental model and
pay special attention to the
brushing technique. The most
recommended one is the
modified Bass technique, but
there are several techniques
to choose from, including the
Fones technique, scrub technique and Stillman technique.3
Select a suitable interdental
cleaning device (floss, soft
picks or interdental brushes) to
show on the dental model, and
pay special attention to the
cleaning technique. Oral hygiene tools that are easier to
use can be a good starting
point for patients. For floss beginners, a preloaded floss stick
or dental tape is a good start.
For patients who require interdental brushes, a soft pick can
be a great start. After teaching
them the correct technique,
upgrade to interdental brushes
4.
5.
at the next appointment. Interdental brushes are essential for
managing periodontitis.
Demonstrate best oral hygiene practices in the patient’s
mouth and the areas that
need extra attention while the
patient observes in the mirror. Visuals are important, but
the main advantage of the
demonstration is the sensation and feel of the proper
brushing technique, how the
floss slides through the contact and continues along the
tooth and under the gingival
margin, and how much pressure to apply with an interdental brush. It is also important to instruct the patient to
work the interdental brush on
each tooth surface three to
five times.
Let the patient repeat the oral
hygiene practice in his or her
mouth with the help of a mirror.
6.
Write down the instructions
on an oral hygiene prescription pad, including information on what products to buy
and where in the mouth to use
them. This is especially important
for
interdental
brushes. Since many patients
forget to buy the products,
dental practices that can directly supply patients with
oral care products as part of
the service can maximise patients’ chance of performing
home care.
It might seem like a time-consuming exercise, but the demonstration only requires 5–10 minutes,
depending on disease severity and
patient motivation. Incorporating
these steps into the routine and
following them systematically will
improve patients’ oral health and
offer cleaner mouths for us to work
in. Less bleeding and better visibility can only lead to better opera-
tive dentistry. Good home care facilitates the minimisation of failures and redo’s of our work. The
only side effect of preventive dentistry is its positive impact on the
environment.
To make the oral care industry sustainable, we must reduce emissions and waste and strive towards
a circular approach. It requires a
change in global legislation to get
manufacturers, suppliers, dental
professionals and waste management companies to work in the
same direction and towards the
same goal. Meanwhile, the dental
profession should focus on what
we do best, which is practising preventive and quality operative dentistry, and remember that reduction through prevention starts
with plaque control.
Editorial note: In this six-part series,
Dr Sanjay Haryana will give an overview
of different aspects of sustainability in
dentistry. A list of references is available
from the publisher.
About the author:
Dr Sanjay Haryana is an Education
and Odontology Specialist at TePe
Oral Hygiene Products.
Close to 300 dental professionals
attended the clear aligners conference
by Straumann Group and Al Hayat
By Dental Tribune MEA
DUBAI, UAE: “ClearCorrect
Contemporary Approach to Clear
Aligners – the Past and the Future”
capped off the first month of 2023
in the world of clear aligners at the
Le Meridien Dubai Hotel & Conference Centre on 27 January 2023.
The event featured two parallel sessions – one for GP dental
professionals and other specialists
and one for Orthodontists. The
guest speaker for the GP session
was Dr. Tif Qureshi who is the past
president of the British Academy
of Cosmetic Dentistry (BACD) and
spoke about the biomechanics of
tooth movement, the importance
of pre-alignment of teeth, case selection, case submission & clear
aligner software overview and
case examples & troubleshooting.
Dr. Ly Mar who is a Certified
Specialist in Orthodontics and
Dentofacial Orthopedics was the
speaker for the Orthodontics ses-
sion. He lectured on diagnosis &
treatment planning, clear aligner
materials, shapes & their impact
on success, trim line debate, aligner biomechanics, posterior & anterior anchorage, engagers, case
submission & clear aligner software overview, treatment of Class
II, III & complex malocclusions,
traditional braces v/s clear aligners
(auxiliaries) and troubleshooting
& retention.
Participants of the ClearCorrect Contemporary Approach to Clear Aligners – the Past and the Future during one of
the scientific lectures. (Photo: ClearCorrect)
[7] =>
Dental Tribune Middle East & Africa Edition | 01/2023
07
INDUSTRY
Gemini EVO Laser: The next evolution
in Laser Dentistry
By Daniel Lewis, USA
Diode lasers are reshaping how
many dental procedures are performed and continued innovation
is creating avenues for improved
quality of patient care. The Gemini
EVO diode laser sets new watermarks when it comes to efficiency
and ease of use in laser dentistry.
“To tell you the truth, we have
[redacted] lasers in our office, and
we are boxing them up right now.
We aren’t going to use them any-
more,” says Dr. Jaimeé Morgan,
DDS, after using the Gemini EVO
laser in her office.
Building on the foundation of
the original Gemini laser, the Gemini EVO laser offers an enhanced
user interface with dozens of presets, additional power, and first-ofits-kind analytics to refine your experience while tracking performance and revenue.
“The Gemini EVO laser is one of
those pieces of equipment that I
would like to surround in a big gold
The standard tip for the Gemini EVO laser. (Image: Ultradent Products)
box and tour it around my office to
show everyone this cool piece of
equipment I have,” Morgan says of
the sleek visual appearance. While
it’s sure to garner attention from
your patients, what’s ‘under the
hood’ is even more impressive.
The simplicity of the Gemini
EVO laser stands out to Dr. Morgan.
Presets allow users to seamlessly
switch between a wide variety of
functions without tinkering with
settings. “This is so nice because of
its ease of use. And dentistry is hard
enough, even if you love your job.
At the end of the day, clinicians
have stress. So why would I want a
piece of equipment that I really
have to think about every time I
use it? With the Gemini EVO laser
it’s just ‘turn it on, enter your password, and go to a preset.’ And then
if it’s not cutting fast enough you
up it, if it’s cutting too fast you take
it down. It’s just so, so, so simple.”
The revolutionary app and
Dashboard included with the Gemini EVO laser give real-time data to
measure and improve usability.
The laser interfaces with an app on
your desktop or phone, showing details on performance and procedures. This data allows users to
track revenue generated from the
Gemini EVO laser. “It’s really cool to
have it keep track [of revenue],”
Morgan says. “This is something
that’s going to allow you to provide
more, and better, services for your
patients and you’ll actually recoup
the money you invested... I mean,
you know a lot of those fancy machines dentists have around their
offices? Do they ever recoup their
investment on those? Probably
not,” she says with a chuckle. “But
with the Gemini EVO laser, you
most definitely will, in a short period of time.”
The increased power of the
Gemini EVO laser over its predecessor translates to faster cutting for
the clinician. “With the original
Gemini laser, I never had a problem
with cutting speed. And this new
one cuts better than that,” Morgan
says, stressing other factors play a
big role in cutting speed. “Using
[the Gemini EVO laser] isn’t a matter of going in there and sprinkling
laser dust on a patient and you can
just say ‘oh look! It got done!’ It still
comes down to the clinician and
how stable their hand is, like with
any cutting instrument, because
you can only cut so fast on a human
body. But there’s no drag with the
Gemini EVO laser.”
“I’ve had doctors say ‘Yeah, I
have lasers and they’re in my closet.
I tried to use them and they they
never work so I just tossed them in
the closet.’ And I think, ‘well that’s
sad, because now you have one that
really cuts,’” Morgan says. “You
should just try it,” she adds emphatically. “I’m a true believer.”
Ultradent
For more information please contact
sophia.yadi@ultradent.com
Photobiomodulation tips included with the Gemini EVO laser.
(Image: Ultradent Products)
[8] =>
08
GENERAL DENTISTRY
Dental Tribune Middle East & Africa Edition | 01/2023
Treatment of a carious lesion with a
composite with a single posterior shade
By Dr Nicola Scotti, Italy
When restoring posterior teeth
with resin composite, functional
aspects such as tight and anatomically correct proximal contacts and
a naturally shaped occlusal surface
that is wear-resistant and antagonist-friendly are even more im-
portant than perfect optical integration. This is why every dental
practitioner should avoid spending
a great deal of time on shade selection in these cases and focus on the
factors that have an impact on the
reliability and longevity of the restoration. Great support in accomplishing this task is offered by
CLEARFIL MAJESTY ES-2 Universal
(Kuraray Noritake Dental), a resin
composite with a single universal
shade (U) for the posterior region
that eliminates the need for shade
taking and selection. It offers good
marginal adaptation, low shrinkage stress and high wear resistance,
necessary for great long-term results.
The initial situation presented
a wide primary carious lesion in
the distal aspect of the second premolar (Fig. 1). The working field of
the premolar was first isolated
with a dental dam, and caries excavation and cavity preparation were
Fig.1: Initial situation.
Fig. 2: The premolar after isolation with a dental dam, caries excavation and cavity preparation.
Fig. 3: Placement of a sectional matrix and a wedge to optimise the fit.
Fig.4: Build-up of the proximal wall with CLEARFIL MAJESTY ES-2 Universal
(Shade U).
Fig.5: A thin layer of flowable composite (CLEARFIL MAJESTY ES FLOW High) applied to the cavity floor.
Fig.7: Treatment outcome immediately after removal of the dental dam.
Fig.6: Restoration completed with CLEARFIL MAJESTY ES-2 Universal (Shade U).
Fig. 8: Final situation.
performed (Fig. 2). A sectional matrix and a wedge were then placed
to optimise the fit. Both were held
in place with a separation ring,
which increases the inter- proximal space and hence ensures tight,
anatomically correct proximal
contacts (Fig. 3). Build-up of the
proximal wall with CLEARFIL MAJESTY ES-2 Universal (Shade U) was
then done, after selective enamel
etching with phosphoric acid
(K-ETCHANT Syringe, Kuraray
Noritake Dental) and bonding with
CLEARFIL SE BOND (Fig. 4). After
that, a thin layer of flowable composite (CLEARFIL MAJESTY ES Flow
High) was applied to the cavity
floor to act as a resin coat (Fig. 5).
Restoration was completed with
CLEARFIL MAJESTY ES-2 Universal
(Shade U). Although this composite
blends in very well with the surrounding tooth structure, the natural look was finished off by adding a tiny bit of brown tint to the
fissure (Fig. 6).
The restoration and soft tissue
looked natural and healthy immediately after removal of the dental
dam. The proximal contact was
tight, and the occlusal anatomy
well shaped for the patient’s individual masticatory dynamics. The
margin of the restoration was virtually invisible, but the buccal cusp
appeared lighter because of dehydration of the natural tooth structure (Fig. 7). The final treatment
outcome was very satisfying
(Fig. 8).
Conclusion
The case presented demonstrates that the selected composite
is well suited for simplified restorative procedures in the posterior
region. The material handles well,
offers the same mechanical properties as other materials from the
CLEARFIL MAJESTY ES-2 series and
blends in harmoniously with the
surrounding structures without
being too translucent. This way, it
is possible to waive the shade taking process without compromising
the treatment outcome. The time
saved in this context may be spent
on functional aspects—or even on
another patient.
Editorial note: This article was published
in cosmetic dentistry vol. 16, issue
1/2022.
Dr Nicola
Scotti is an
associate
professor at
the Department of Surgical Sciences
at the University of Turin’s dental
school in Italy. His main interests
are dental biomaterials, resin-based
composites, CAD/CAM materials
and adhesive dentistry.
[9] =>
Straumann Group
AEEDC Dubai
7 – 9 February 2023
Visit us at booth 7B10
[10] =>
10
GENERAL
XXXXXXX
DENTISTRY
Dental Tribune Middle East & Africa Edition | 01/2023
Restorative aesthetics at the gingiva
By Drs George Freedman
& Paiman Lalla, Canada &
Trinidad and Tobago
Aesthetic dilemma of the gingival margin
The data is clear: porcelain and
composite resin are both biocompatible at the gingival margin and
well tolerated.1–3 The caveat is that
composite tends to cause tissue irritation if it directly impinges on
the gingiva. 4–6 This ultimately
causes unesthetic gingival recession. Porcelain is less problematic,
but marginal plaque build-up, initiated by the thin layer of resin cement, leads to a similar irritation
of the free gingiva and eventually
recession.7,8
Even skilful subgingival margin placement will typically,
within three to five years, because
of ageing, gingival irritation or lack
of home maintenance on the patient’s part, lead to unesthetic recession and full visible exposure of
the darker dentinal tissue.9,10 Thus,
the restorative conclusion is location of the composite margins supragingivally,3,11 placing the resin
material a reasonable distance
(0.25–0.50mm) from soft periodontal structures and thereby
unlikely to cause tissue irritation.
Today’s adhesives and restorative materials make this a rather
straightforward task.12–19 Newer
-generation
adhesives
bond
equally well, and predictably, to
both enamel and dentine.14, 15 Significantly, seventh- and eighthgeneration adhesives have similar
bonding strengths to both enamel
and dentine, eliminating the potential stresses caused by unequal
polymerisation contraction.17–19 It
is clinically possible to create a continuous restoration through the
dentino-enamel junction (DEJ),
covering as much of the enamel
and the dentine as necessitated by
caries or abfraction (or both).
Fig. 1: Normal-length maxillary central incisors—expected appearance.
A significant aesthetic predicament quickly presents, however.
Dental restorative materials are
designed to match the shade of the
enamel position of the tooth. Although some manufacturers offer
dentine shades, these hues typically do not closely match the
darker coloration of exposed dentine, particularly those observed in
endodontically treated teeth. A
typical central incisor measures
approximately 10.5mm cervicoincisally.20 A substantial increase
in the apparent length of a tooth,
specifically in the anterior labial
region, detracts from the aesthetic
smile.
When restoring a tooth with
Class V caries or abfraction, or perhaps a small gingival recession, an
enamel-coloured resin is commonly placed at the labial DEJ. Increasing the maxillary central incisor’s vertical aspect (Fig. 1) by a
mere 3mm adds 30% to the apparent vertical dimension, significantly altering the cervico-incisal–
mesiodistal ratio, totally upsetting
the aesthetic parameters of the
smile (Fig. 2).
In situations where there is
moderate recession, the visual imbalance is even further impaired.
The impact of the cervico-incisal–
mesiodistal ratio is even greater on
maxillary lateral incisors and
mandibular incisors (average of
9mm cervico-incisally). Maxillary
and mandibular canines (aver- age
of 10–11 mm cervico-incisally) are
often the teeth most affected by
gingival recession and are highly
visible, both anteriorly and laterally.
Individuals who have gingival
recession, abfraction and/or caries
tend to look older than they really
are (long in the tooth). Covering
the darker root dentine with an
enamel-like resin simply makes
their teeth more visible, seemingly
longer, and correspondingly less
aesthetic.
The practitioner must solve
this problem practically, aesthetically and with minimum invasiveness. The restoration must be functional, replacing missing dental
structures to natural dimensions
and contours. The restoration
should replace lost enamel with
enamel-shaded composite resin
and receded gingiva with gingivashaded composite resin. By creating an artificial enamel–gingiva
junction in composite restorative
material, the patient’s aesthetics
and smile can be restored.
Solving the gingival aesthetic
dilemma
Beautifil II Gingiva (SHOFU)
has been specifically designed for
the rebalancing of pink aesthetics
in the cervical areas of the dentition (Fig. 3). It is indicated for
wedge-shaped defects, cervical caries, the aesthetic rectification of
gingival recession, shielding exposed cervical areas and splinting
of mobile teeth. The resin material
is available in five tones (Dark Pink,
Light Pink, Brown, Orange and Vio-
Fig. 3: Beautifil II Gingiva shades. (Image: © SHOFU)
Fig. 2: Maxillary incisors with apparent length increased by 30%—very unnatural and unaesthetic.
let; Fig. 4), which can be layered
and/or blended to achieve custom
shades that allow the treatment of
patients with various hues of gingival pigmentation, according to
their clinical needs (Fig. 5).
Beautifil II is a highly aesthetic,
fluoride-releasing composite resin
material indicated for all classes of
restorations. Numerous studies
over the past 20 years have shown
no secondary caries, no failures, no
postoperative sensitivity and a
high retention of both shade
matching and surface lustre. The
material is based on SHOFU’s proprietary giomer technology. The
significant advantage of the giomer class of resins is not only that
they release fluoride to protect the
tooth at the restorative margin,
but that their fluoride content can
be recharged by toothpastes, fluoride rinses and varnishes (Fig. 6).
Thus, a giomer’s fluoride-releasing
capacity does not decrease over
time.
Another important consideration is that the gingival margin of
the restorative material (whether
pink or enamel in colour) must be
kept supragingival and slightly
away from the free gingival margin.3,4,6 Although a very narrow
band of darker root structure may
be visible towards the apex, the
restoration’s enamel (coronal) and
pink gingival (radicular) coloration
will focus attention away from this
area. With gingivally blended restorations, the dental professional
can deliver both aesthetic and supragingival margins within the
same restoration. A supragingival
margin facilitates ready access and
effective home maintenance for
the patient.
Fig. 4: The five shades of Beautifil II Gingiva. (Image: © SHOFU)
It is imperative that a restoration that is so close to the free
gingival margin be placed under
conditions controlling moisture
and bleeding. Dental dam placement is impractical (the target area
is positioned apically), and retraction cord may physically or chemically compromise the working
area. Ideally, the patient’s oral hygiene would have created a healthy
gingival microenvironment with
minimal pocketing and no bleeding on probing. In most cases, however, the practitioner must modify
the actual situation to increase the
likelihood of clinical success. The
easiest and best technique for predictable tissue sculpting is the use
of the diode laser.21–23 Utilising low
power (1.0–1.5 W), the dentist can
produce an ideal—dry, clean and
blood-free—working area in less
than a minute.
Clinical cases
Visible recession and caries
Remarkably, the patient’s chief
concern was the gingival recession
on the maxillary left lateral incisor, not the mesial caries (Fig. 7).
Fortunately, the patient’s oral hygiene was relatively good, and restoring the MLB caries was straightforward using BeautiBond (SHOFU;
Fig. 8) and Beautifil Flow Plus X. The
steps for the aesthetic rectification
of the buccal recession are as follows:
1. Gently micro-abrade the receded area and the apical enamel
to remove food debris and plaque.
The nozzle of the abrader should be
angled incisally to prevent gin-
” Page 12
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12
GENERAL
XXXXXXX
DENTISTRY
Dental Tribune Middle East & Africa Edition | 01/2023
“ Page 10
of missing gingival structures with
composite resins is a novel solution that restores the patient’s
smile and facial aesthetics.
Editorial note: This article was published
in cosmetic dentistry vol. 16, issue
1/2022.
Fig. 5: Mixing chart showing the resins layered and/or blended
to achieve custom gingival shades (1:1 mixing ratio).
(Image: © SHOFU)
Fig.7: Maxillary left lateral incisor with caries and recession
(photograph taken using the EyeSpecial, SHOFU).
gival irritation and bleeding. Rinse
thoroughly and lightly air-dry,
leaving the surface slightly moist
(although the degree of moistness
is not critical).
2. Apply BeautiBond, a seventh-generation dental adhesive,
and leave on for 10 seconds. Thoroughly air-dry the adhesive (very
critical). Light-polymerise with the
FUSION 5 curing light (DentLight),
offering deep polymerisation of
composite resins within 3 seconds
with a uniform 4,000 mW/cm2
output.
3. Select the appropriate
Beautifil II Gingiva shade (Light
Pink and Violet for this patient),
apply to the receded area to restore
the buccal dimension and contour
of the original soft tissue, and
light-polymerise. It is important to
leave a small (0.25–0.50 mm) gap
between the apical margin of the
restoration and the free gingival
margin (Fig. 9). This space prevents
gingival irritation, is easily maintainable by the patient and is gen-
Fig. 6: Fluoride release and recharge from giomers.
Fig.8: BeautiBond seventh-generation dental adhesive.
(Image: © SHOFU)
erally not visible even with
close-up photographs.
Mandibular anterior recession
This is the most commonly encountered recession in the oral
cavity. The mandibular anterior
teeth are small, close together and
not effectively cleaned at the
tongue and the lower lip (Fig. 10).
Owing to gravity, food debris and
plaque tend to accumulate labially
and interproximally (Fig. 11). In this
case, the major culprit of the recession was the frenum pulling the attached gingiva apically. The preliminary process is a diode laser
frenectomy to eliminate the muscular forces.21–23 The steps for the
aesthetic rectification of the buccal
recession are as follows:
1. Gently micro-abrade, in an
incisal direction, the receded areas
and the enamel nearest to the DEJ
to remove food debris and plaque.
Rinse thoroughly and lightly airdry, leaving the surface slightly
moist.
Fig. 10: Mandibular anterior teeth with labial gingival recession.
Fig.9: Maxillary left lateral incisor with mesial restoration
and gingival restorative rectification (photograph taken using the EyeSpecial, SHOFU).
2. Apply BeautiBond and leave
on for 10 seconds. Thoroughly airdry the adhesive and light-polymerise.
3. Select the appropriate
Beautifil II Gingiva shade (Light
Pink in this case), apply to the receded area to restore the buccal dimension and contour of the original soft tissue, and light-polymerise. Leave a small (0.25–0.50 mm)
gap between the apical margin of
the restoration and the free gingival margin (Fig. 12). This procedure
restores the expected gingival
height and contributes to making
the patient’s smile look younger.
Long-term at-home maintenance is best accomplished with
procedures that are familiar to the
patient and easy to implement.
Regular toothbrushing is effective
and practised by most dental patients, interdental string flossing
less so. Though the advantages of
flossing are well established, patient resistance to the process and
irregular application limit its ben-
efits. Water flossing (Waterpik) not
only facilitates the interdental
cleaning process, but has been
shown to improve the results.24
There are several models available,
but the Sonic-Fusion offers simultaneous water flossing and sonic
toothbrushing.
Conclusion
Beautifil II Gingiva enables the
practitioner to overcome the gingival aesthetic dilemma. The gingival rectification technique is predictable and can typically be accomplished without the need for
local anaesthetic and without discomfort to the patient. These restorations are completely functional
and replace both hard and soft
missing dental structures to natural dimensions and contours with
minimum invasiveness. The restoration of the coronal anatomy with
tooth-coloured composite resins is
well established. The development
of an artificial enamel–gingiva
junction and the reconfiguration
Fig. 11: Mandibular anterior teeth close-up. (Photographs taken using the EyeSpecial, SHOFU).
Dr George
Freedman
maintains a private practice in Toronto in Canada limited to aesthetic dentistry. He is adjunct
professor of dental medicine at Western University of Health Sciences in
Pomona in California in the US and a
visiting professor and director of the
MClinDent programme in restorative
and cosmetic dentistry at BPP University in London in the UK. He is the author
or co-author of 14 textbooks, and of
more than 800 dental articles and numerous webinars.
He serves on the editorial team of REALITY and is the international editor-inchief of 3D printing—international
magazine of dental printing technology. Dr Freedman is a regent and fellow
of the International Academy for Dental-Facial Esthetics and a diplomate
and chair of the American Board of Aesthetic Dentistry. He is a founder and
past president of the American Academy of Cosmetic Dentistry and a
founder of the Canadian Academy for
Esthetic Dentistry and the International Academy for Dental-Facial Esthetics. Dr Freedman is a recipient of
the Smigel Prize in Aesthetic Dentistry
(New York University College of Dentistry).
Dr Paiman
Lalla, a graduate of the University of the West Indies, practises
dentistry in Trinidad and Tobago and
has a special focus on cosmetic and
implant dentistry. After completing
the Advanced Education in General Dentistry program at Lutheran
Medical Center in Wheat Ridge in
Colorado in the US, he was awarded
fellowships in the International
Congress of Oral Implantologists and
the American Academy of Implant
Prosthodontics. Dr Lalla serves on the
medical panel of Trinidad and Tobago’s ministry of national security.
Fig.12: Mandibular anterior teeth with gingival restorative rectification (photograph taken using the EyeSpecial, SHOFU).
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14
INTERVIEW
Dental Tribune Middle East & Africa Edition | 01/2023
“Our aim is to become a total service
provider”
An interview with Dr Kyoo-Ok Choi, founder of Osstem Implant
By Osstem Implant
South Korea has one of highest
rates in the world of the number of
patients receiving implant surgery
per 100,000 inhabitants, and Dr
Kyoo-Ok Choi has played a significant role in developing implant
dentistry in South Korea and
around the world. As an experienced dentist and the founder of
Osstem Implant, Dr Choi says that
increasing training opportunities
for dentists and keeping prices reasonable are keys to broadening the
reach of implant treatment. Dr
Choi spoke to Dental Tribune International about dentistry, the implant business, and Osstem Implant’s plans for the future.
Dr Choi, does being a dentist
change your approach to customer relations?
As a dentist and the founder of
Osstem Implant, I understand better than anyone else the difficulties
that dentists face. I think that this is
the greatest factor differentiating
our company from others—our
understanding and consideration
of the needs of dentists.
All dentists want to have good
results. We provide excellent products, including implants and a series of related products and services, and we do this to the best of
our ability so that dental professionals can achieve good treatment
outcomes. We also provide educational training to improve dentists’
clinical competency in implant
therapy, and this is our top priority.
Dr Kyoo-Ok Choi is at the helm of one of the fastest growing implant companies
in the world. (Image: Osstem Implant)
Since the late 1990s, I have performed dental implant surgery and
developed the curriculum of a clin-
ical training course that aims to
promote the advantages of implant
treatment. The ten-day, 80-hour
clinical training programme includes a live surgical demonstration, and it has helped dentists
throughout South Korea to competently perform implant surgery.
We recruited dentists as faculty
members to lecture on implant-related topics, and we built an education center where dentists could
complete their training. Osstem
Implant’s active promotion of the
clinical implant training programme has been a decisive factor
contributing to the widespread use
of dental implants in South Korea.
Today, 85% of all dentists in the
country can perform implant surgery, meaning that it is no longer a
special category of treatment that
is performed only by oral surgeons.
As a result, South Korea has a high
ranking in the number of patients
receiving implant surgery per
100,000 inhabitants.
Osstem Implant’s training
course curriculum has now been
expanded to a 24-day programme
having three parts: basic, surgery
and prosthodontic. This programme, known as the Master
Course, was officially launched in
2018 under the slogan “D.I.Y (do implant yourself)” and is now being
offered by 30 overseas branches in
26 countries.
Another factor that differentiates Osstem Implants is the company’s variety of products. Every person has a unique oral environment
and supplying only a few products
to the market can lead to difficulties in selecting what is required for
an individual case. Therefore, Oss-
tem Implant has diversified its
product line-up to better suit each
clinical case.
Osstem Implant’s value for
money is impressive. Do you consider yourself a supplier of value
implants?
That is true. However, to be
more precise, Osstem products
meet both premium and value criteria. The product quality is premium, but the price is comparable
with prices in the value category.
We believe that Osstem Implant
supplies the highest quality products at the best price. Osstem Implant’s wide-ranging clinical applications, osseointegration performance, long-term stability and excellent clinical cases are comparable
with—if not superior to—any other
implant product in the world. Nevertheless, we set the prices low so
that customer accessibility can be
maximized. As the number of implant patients and dentists’ incomes have fallen around the world
owing to the pandemic, more dentists have sought cost-effective
solutions, and our sales have increased.
There is no doubt that a dental
implant is the most ideal treatment
option for missing teeth. However,
there are still not many patients
who opt to receive implant treatment, and the implant uptake rate
around the world is lower than you
would expect. The two reasons for
this are that the proportion of dentists who can perform implant surgery remains low and the average
cost of the treatment is a burden.
Our solution to these problems is to
actively offer clinical education
and to keep the price of implant
materials low, thereby broadening
the expertise of dentists to include
implant surgery and supplying the
most cost-effective products on the
market.
What are some of the specific
characteristics of dentists in Middle East and Africa, and how do
they influence your business on
the continents?
I think that dentists in Middle
East and Africa highly value not
only academic research, proven
data but also reasonable price
range. They tend to adopt a product
only when there is scientifically
and clinically proven data. We do
have data, mainly from South
Korea and the US; however, that has
not proved to be sufficient. We
have, therefore, been expanding
our research projects in MEA with
the help of our local key opinion
leaders.
Key Solution (KS) implant. (Image: Osstem Implant)
” Page 16
[15] =>
[16] =>
16
INTERVIEW
Dental Tribune Middle East & Africa Edition | 01/2023
“ Page 14
Moreover, considering that
awareness of our brand is relatively
low in MEA compared with the rest
of the world, we are working to
strengthen our marketing activities with the help of our media
partners.
Training and education are
key topics for dentists working in
Middle East and Africa. What does
Osstem offer in this regard?
The number of implantations
in Middle East and Africa is high
but not as high as in South Korea.
There are dentists who want to perform implant surgery but apparently lack the necessary training.
We would like to help all dentists in
Middle East and Africa to be able to
perform implant surgery.
To this end, Osstem’s clinical
training programme concentrates
on both theory and practice, with a
particular focus on practical training. The goal is that dentists can
apply their newly gained knowledge in the clinic. Together with
our partners and subsidiaries, we
provide local clinical training
courses to dentists in all parts of
the continent.
Our goal is to introduce the full
Master Course, which I already
mentioned, in Middle East and Africa. Currently, the programme are
already being offered in Korea, Europe, and the United States, expanding all over the world.
For those dentists who are unable to attend in-person courses, we
continue to offer online educational content together with our
key opinion leaders.
Our academic symposium, the
Osstem World Meeting, will take
place in early May this year in Istanbul, Turkey, and next year, Osstem Meeting will be held in Dubai,
UAE. I am looking forward to meeting you in Dubai!
Osstem offers more than implants. Do you believe that the future will involve total solutions as
workflows, rather than individual
implants?
Yes. Although Osstem Implant
is widely known as an implants
manufacturer, we will ultimately
supply software—the driving force
behind digital dentistry. We will
also supply input equipment, such
as CBCT units and scanners, and
output equipment, such as milling
machines and 3D printers. In this
way, we will assist dentists in providing better care to their patients
with the help of digital dentistry.
Regarding our dental unit chair,
which is already available on the
MEA market, we will continue to
offer prompt technical support
and the timely supply of related
equipment and parts so that there
is no inconvenience to our customers.
When it comes to software, we
aim to develop and supply patient
management software and software for medical imaging equipment that can diagnose the pa-
tient’s condition and interpret diagnostic data, as well as the CAD
software needed for designing dental treatment devices such as surgical guides, dental prostheses, and
orthodontic appliances.
In terms of hardware, we will
build a worldwide service network
that provides the fastest possible
shipment of medical equipment so
that there is no forced downtime at
dental clinics.
Of particular note is our intention to provide a total solution of
interior services to dental offices.
Considering our wide knowledge of
the needs of dentists and their clinics, we will provide design and
floor-plan services that guarantee
quality and short construction periods. If problems occur, we will
provide our services as quickly as
possible so that there is no effect on
clinical operations. Ultimately, our
aim is to become a total service
provider.
Lastly, can you tell us about
the very latest dental implant
products in your portfolio?
Numerous products have been
developed recently, and we are especially proud of our successful development of the BA implant surface treatment using the bio-absorbable material hydroxyapatite,
the SOI surface treatment, and the
KS implant, which features a new
connection. As for a new guided
bone regeneration (GBR) product,
we are excited about TissueMax,
which has been in development for
four years.
Let me give you some more information about these products.
On the BA surface, the hydroxyapatite nano-coating acts as a catalyst
and increases the initial osseointegration speed of the implant. By
promoting platelet coagulation,
blood clot formation is accelerated,
and bone formation is promoted so
that bone develops even in the partially exposed area of the implant.
Also, the osseointegration is improved even in the area where the
bone is thin, thus increasing the
implant’s success rate.
The SOI surface, which is coated
with a surface energy protection
substance, exhibits a performance
that is similar to that of the BA surface. The SOI surface shortens the
initial osseointegration time by
over 35% compared with a conventional implant surface. The BA and
SOI surfaces, which convert the
sand-blasted with alumina and acid-etched surface (SA surface) to
hydrophilic, are applied to all Osstem Implant products, and both
have received favorable reviews in
South Korea.
The KS Implant is a product
that has reduced the diameter of
the screw connecting the implant
and the abutment by a total of
0.4 mm—from 2.0 mm to 1.6 mm.
By reducing the screw diameter,
the thickness of the implant neck is
increased by 0.2 mm, which significantly improves the fatigue
strength of small diameter implants. By lengthening the connection between the abutment and the
implant, the degree of attachment
between the suprastructure and
the implant has been substantially
improved, and this, in turn, has
dramatically reduced screw loosening and thereby also reduced the
chance of screw and implant fracture.
Finally, TissueMax is a product
based on technology that in 2020
featured on the cover of Clinical
Oral Implants Research. TissueMax
is the first approved self-inflating
oral tissue expander in South
Korea, and the technology is
mainly used in orthopaedics and
plastic surgery. When TissueMax is
used in a patient who cannot receive implant treatment owing to
gingival recession, it increases the
soft tissue of the exposed gingiva
and improves the success rate of
GBR, a procedure that facilitates
gingival augmentation.
For more information, readers
in Middle East and Africa an contact Osstem Middle East.
Osstem Middle East FZCO
LIU Area G-23, Dubai Airport Free Zone,
Dubai, U.A.E
Tel. : +971 4 349 1922
Email. : info.mea@osstem.com
For more information, visit
https://en.osstem.com/
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• Ergonomically designed to conform to you
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The power of the Plus made portable:3
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Invisalign, iTero, iTero Element, the iTero logo, among others, are trademarks and/or service marks of Align Technology, Inc. or one of its
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20
EVENT
Dental Tribune Middle East & Africa Edition | 01/2023
The 34 Saudi International Dental
Conference 2023
th
By Dental Tribune MEA
The 34th Saudi International
Dental Conference (SIDC) took
place on 19 – 21 January 2023 at the
Hilton Riyadh Hotel and Residence,
Riyadh, KSA.
The event is a premier occasion
intended for dental professionals,
experts and leaders providing an
international forum that addresses
the key challenges and controversial topics in dentistry.
The SIDC featured 124 speakers
from various countries and 150 lectures across three days of the event.
There were 27 sessions ongoing at
three parallel halls all taking place
simultaneously.
During the event, important aspects were featured such as job opportunities for dental professionals
and the FDI World Dental Federation meeting to discuss and address the global challenge of reducing sugar consumption.
(Photo: SIDC)
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22
INTERVIEW
Dental Tribune Middle East & Africa Edition | 01/2023
Starlynr: A new revolution in aligners
By Dental Tribune MEA
Established in Barcelona in
Spain in 2021, starlynr offers an
aligner system developed by a
group of dentists over the past 23
years. The state-of-the art aligner is
twice as strong and ten times
clearer than other brands, and the
starlynr system creates customised
treatment plans using the most reliable artificial intelligence (AI)
software, for anatomically correct
tooth movement that lasts. The
company’s mission is to enable
faster, easier and high-quality
treatments. It operates via satellite
clinics under the supervision of its
experts, enabling dentists to treat
patients with starlynr anywhere in
the world. To learn more about
starlynr and its plans for the Middle East, Dental Tribune Middle
East & Africa spoke with Dr Fady
Yaacoub, founder and chairperson,
and Dr Amro Adel, who has been
the company’s CEO since November.
Dr Yaacoub, how did the idea
for starlynr come about?
Starlynr wasn’t a planned project but a personal interest that
came to life about 23 years ago. A
group of general dentists, orthodontists and I were in contact for almost two decades, sharing what
we’d personally experienced with
patients and the results of our
treatment modalities. With every
year that passed, we made sure to
remain up to date with the latest
technologies introduced in our segment and the effectiveness of these
products, all while sharing our
findings and limitations with one
another.
It was important for each of us
to give our patients the best solutions and results in hope that some
day we could provide better solutions not only for our patients but
to other dentists. Through AI and
oral health solutions, we managed
to create a breakthrough in orthodontics, developing an innovative
solution for dentists and labs across
the world for affordable, flexible
and more predictable care—all in
less time and with guaranteed results.
Why do you think that starlynr
is a success story?
With every possible situation
carefully studied and tested with a
team of highly qualified professionals, we made sure that starlynr
would be market-ready before its
launch.
Starlynr is a success because it
simply works for all general dentists and orthodontists. We’ve managed to reduce chair time for dentists, enabling them to treat more
patients, and to provide patients
with quicker results and greater
comfort. Our main mission is to
allow individuals to embark on this
journey in the simplest way possible.
Dr Fady Yaacoub, founder and chairperson at Starlynr. (Photo: Starlynr)
Our easy-to-use step-by-step
online guide has helped dentists
document and assist patients faster
than ever. Our introduction and invitation to satellite clinics through
our personalised customer support
has made life easier for general dentists and orthodontists everywhere.
Our success can be seen in the
demand for starlynr by dentists
looking for alternative aligner solutions and in our personal experiences with our patients, encouraging our movement even further.
Where was starlynr first
launched, and what are your plans
for expansion?
Starlynr started off in two very
different markets at once: in Slovakia and Egypt. We chose these two
extremely different markets, as we
knew that these countries were
ready to take on this journey and
were in great need of it. Egypt having over 64,000 highly qualified
dentists, we thought that this
would be a great country to which
to bring our innovative solution to
assist dentists and in return to receive a large community of prospective pioneers who have been
excited to get started.
Although aligners had been
available in Slovakia for quite some
time, we thought that we needed to
introduce a more effective and customised aligner solution. We were
happy to see the high interest in
the market as a result and the patient demand.
Our next steps are to expand
our community in nearby countries in Europe and the Middle East.
Three complementary markets in
our scope are Saudi Arabia, Qatar
and the UAE. In the future, we hope
to bring our findings into academia
and educational systems. This is
the only way that we as dentists can
pave the way for future generations
in dentistry to find new advancements and breakthroughs in oral
health.
What do you hope dentists
will be able to achieve through
this journey?
Our mission has always been to
optimise dentists’ time and facilitate their work. That is what we collectively feel as a team and that is
what I believe makes us stand out
as a company. We are not selling a
product; we are offering a solution
that we hope can change the lives
of both dentists and patients. We
believe that everyone deserves to
have a beautiful smile they can
truly be happy and confident with.
Through our solutions and our satellite clinics—the number of which
is rapidly increasing—we can simply say that our mission is to add
star smiles to our orbit.
Dr Adel, congratulations on
your recent promotion to CEO!
How did you come to hold this position?
I met Dr Yaacoub years ago
when we initially became friends
and shared similar ideologies and a
mutual interest in the latest innovations in oral health. We found
that our values and ethics around
the industry were aligned. For us
and the members of the starlynr
community, our mission is more
than just providing a solution; our
mission is to cater to like-minded
dentists and bring together our
findings for the benefit of patients.
What surprised you when you
saw starlynr from the inside?
When I was first approached by
starlynr I can openly say that I had
my doubts. As aligners had been in
the market for some time, my main
concern was making sure that this
Dr Amro Adel, CEO at Starlynr. (Photo: Starlynr)
version had all the advancements
needed to fit today’s world. The new
world is digital and in it AI has application in daily life, and this applies to the dental industry too.
What I found interesting about
starlynr is that its systems cater to
all old and new dental clinic software, enabling more dentists to
embark on this journey and treat
more patients—all in less time.
Starlynr was established after
COVID-19 took its toll on the world,
and the developers made sure to
make this alternative as seamless
as possible for both patient and
dentist.
How do you see starlynr evolving in the next few years, and
what are your plans for expansion?
Starlynr launched in Slovakia
and Egypt only a year ago and is already expanding to neighbouring
countries in both Europe and the
Middle East. With our various laboratories in the region, the demand
from both dentists and patients is
the cornerstone for our expansion.
The solution, its practicality and
demand from clinics are what
makes us believe in starlynr. As interest in starlynr is expanding
among clinics and patients, we
have no doubt that starlynr will
soon be available worldwide. Our
network isn’t limited to patients
and general dentists, but can be accessed by various professionals, including orthodontists. We can only
hope that our vision can expand
with continuous goodwill and
more smiles!
Can you tell us more about
starlynr’s presence in the Middle
East, and how the system works?
As our website shows, we enable
both the dentist and patient to
apply to the starlynr journey on-
line, enabling both to start their
journey and get informed wherever they are. Dentists then go
through a protocol in order to become a professional starlynr provider via starlynr satellite clinics.
This certification assures patients
that their provider is qualified to
carry out their treatment. With
every patient case, starlynr aligners
are customised via AI and supported by starlynr laboratories
available in every region. The
starlynr software then works on
precise 3D fabrications, enabling
the patient to see his or her future
smile even before treatment starts.
The patient is then provided with a
starlynr start-to-finish kit and a
simple step-by-step guide on how
to use the aligners.
From the moment a patient
finds his or her nearest satellite
clinic (also available for directions
online), we secure the patient with
a treatment plan, send update notifications and are available to the
patient at all times via our online
customer support. Further to our
security protocol on patient care,
our international dentists oversee
every case with maximum care
every step of the way.
Is there anything else you’d
like to share with our readers?
We believe in the future of orthodontics. Just like old solutions
no longer serve the current world,
we need to make room for possibilities for new oral health solutions
and help make these available to
the mass public. It is our belief that
everyone deserves to have a beautiful smile, and we hope that starlynr
satellite clinics can bring more
smiles to earth.
[23] =>
BE THE
BEST
PRACTICE
FOR YOUR
PATIENTS
VISIT OUR
WEBSITE:
LET’S STAY CONNECTED:
[24] =>
24
NEWS
Dental Tribune Middle East & Africa Edition | 01/2023
2 SHOFU Scientific Symposium in Cairo
nd
By SHOFU
SHOFU INC., one of the top
manufacturers of superior dental
products, pioneering the development of Japan’s first high-quality
porcelain teeth in 1922, is consistently leading the industry in research & development.
For over 100 years, SHOFU has
built a strong reputation in providing, high quality Clinical & Laboratory products to dental professionals all over the world. As SHOFU
continues to expand its presence in
the Middle East, the company held
its second annual Scientific Symposium at Fairmont Nile City Hotel,
Cairo, Egypt, on 25 and 26 Novem-
ber 2022, in collaboration with Nile
Dental, SHOFU’s Egypt clinical
partner.
The symposium featured some
notable international guests like
Mr. Toyokazu Fukuyama, Managing Director of JETRO, Cairo (Japan
External Trade Organization), Dr.
Junji Tagami, Professor Emeritus of
Tokyo Medical and Dental University, Dr. Carlos Torres, Professor of
UNESP Brazil, as well as professional speakers in Dentistry field in
Egypt.
Over 200 professionals participants from across the Egypt, take
part on the key discussions highlighting Bio-active innovation of
Giomer S-PRG and its clinical impact on Minimal Invasive Den-
More than 200 dentists participated in the event.
Dr. Ahmed El Sayed during his lecture.
Professor Carlos Torres.
tistry by Professor Junji Tagami;
The everyday Bio-active Composite
Restorations by Professor Ahmed
Zohairy; Adhesive indirect workflow : Make it Simple and Bio-active
by Dr. Ahmed Tarek Farouk; From
Prevention to Restoration by Professor Elham Fawzi; Bio-active materials for long lasting aesthetic
Restorations by Prof. Carlos Torres;
Challenges behind perfect Anterior
Composites by Dr. Ahmed Saad;
Free Hand Artistry Backed with 3D
Digital Technology by Dr. Ahmed El
Sayed.
SHOFU continues to engage in
activities informing professionals,
the importance of product innovation in restorative materials referred to as Giomer, which has a
bioactive effect by sustained release of multi-ions, (Sodium, Boron,
Aluminum, Strontium, Fluoride,
Silicate), giving the teeth continual
protection against caries.
The event approaches company
commitment to continue leading
the industry in research & development. SHOFU believes to keep up
educating professionals as part of
their social responsibility towards
the dentistry community. The
company aims to contribute awareness on changes in people’s needs
through providing innovative
products that can protect natural
teeth that supports health over the
long term.
Mr. Tetsuo Takami, President
and COO said, “Shofu aims to help
fill the world with full smiles of
sparkling teeth”. A society that is
prosperous and in which people
live long and healthy lives requires
a greater focus on teeth, which
serves as a gateway to the food that
sustains lives. Especially with recent research confirming how dental disease can affect overall health,
you can expect the role of dentistry
to grow even more critical.
As a result, the symposium
aims to advocate preventions and
restorations of natural teeth using
Bio-active materials and longs to
continue contributes to a better
dentistry.
Key note speakers of the event.
Professors of Cairo University during the event.
Dr. Ahmed Saad during his lecture.
Dr. Junji Tagami during his lecture.
Professor Ahmed Zohairy.
[25] =>
[26] =>
26
INDUSTRY
Dental Tribune Middle East & Africa Edition | 01/2023
The important things in dental sutures
production
Photo: HuFriedyGroup
By HuFriedyGroup
Developing medical devices,
such as surgical sutures, is a lengthy
and costly process. Review cycles,
for example, can take months.
Added to this, the shift to remote
working at the start of the Covid-19
lockdown made it difficult for medical device companies to collaborate successfully. Medical device
manufacturing will continue to expand geographically to important
markets where medical technology
is needed and continue to source
both globally and locally based on
robust, cost-effecting sourcing
strategies.
Medical device manufacturers
face a high of important numbers
of challenges. Perhaps the most important are the supply chain disruption and the new MDR regulation.
One of the most important
benefits of the large entities is that
they contain a global supply chain
organizations and collecting data
and provide effective forecast and
strategic response planning. Without these capabilities, smaller medical devices companies are more
likely to struggle to response effectively. An increased level of engagement and frequency in sharing
forecasts is key to synchronizing
the material supply chains and production. A slow response on that
issue, will result in shortages or
costly excess inventories and both
will affect the performance.
The new European Medical Device Regulation (MDR) 2017/745 is
perceived as one of the most extensive and robust regulations in the
world. One of the most significant
changes and challenges concerns
the way in which medical devices
are classified and the scope was to
include products that do not have
an intended medical purpose but
carry similar risks to medical devices. Furthermore, all currently
certified medical devices must be
recertified in accordance with the
new requirements.
Finally, we can say that medical
device industry is facing a strong
supply chain challenges across the
globe and is require a closer monitoring and decisive action to meet
the growing market demand
during the next decade.
HuFriedyGroup has the answer
to all your sutures supply demand,
thanks to our long expertise and
high standard production facilities.
Our Production – 4 steps for perfect sutures
The entire manufacturing area
is designed to meet cleanliness
standard equivalent to ISO Class 8.
This provides an environment
which protects from external contamination. Our plant has implemented clean room manufacturing process according to ISO 14644-1
standard. The production area is
controlled in terms of air filtering
and ventilating system, which provides constant concentration of
particles inside the two different
spaces of our clean room. In every
space of the cleanroom different
production processes are per-
formed in order to ensure a
high-quality end product.
Step 1: Cutting + Tipping
The process of cutting and tipping the surgical sutures. A smooth
cut of sutures to the desirable
length and stiffening of the threads
end secure an easy attachment into
drilled needles.
Step 2: Attaching Process
Surgical sutures attaching machine provides a secure way to attach drilled end needles. The operation is performed by placing the
needle between the attaching dies
and the suture material is inserted
into the needle hole. Then, thanks
to the pressing machine, the needle
is crimped to the suture.
Step 3: Quality Control
Quality control is introduced in
all aspects of production. Each production process is subject to a strict
quality control. Quality inspections and tests are conducted
throughout the entire production
flow.
Step 4: Packaging + Sterilization
Medical device packaging and
sterilization. Certified medical
packaging materials and efficient
ethylene oxide sterilization process ensure the production of an
excellent quality product.
The importance of a complete
portfolio
Our surgical sutures portfolio
covers the full range of the absorbable and non-absorbable main cate-
gories with a huge variety and assortment combination of needles
and thread sizes in order you can
find the ideal suture for each of
your surgical procedures.
Absorbable:
•
PGA (Polyglycolic Acid)
•
PGLA RAPID (Polyglactin 910
fast absorption)
•
PGCL (Polyglycolide -co-caprolactone)
Non-Absorbable:
•
Silk
•
Polyester
•
Polyamide
•
Polypropylene
•
PTFE
(Polytetrafluoroethylene)
Why choose us – 360° Service
We are Safe: Factory built according to European and International
Standards. Raw materials from reliable suppliers, chosen through rigorous selection processes.
We are Fast: Easy and convenient
delivery. Wide range of standard
and customized solutions. Supply
through reliable and authorized
partners.
We are Easy: Easy access to our facilities and our people with immediate information’s. Permanent
and on-time information updates
to our customers. Complete training of our customers and partners,
with auxiliary materials such as
brochures and skin trainers.
To learn more about our suture portfolio, get more information, test them live
and get a sample, come and meet us at
AEEDC booth 6F06.
References:
1. Jack Sabdahl, (2020). Shaking the
supply chain, Medical Devices Development, vol. 2 2020, UK
2. Gabriel Adusei, (2021). A seismic shift,
Medical Devices Development, vol. 1
2021, UK
3. Website Ideagen, https://www.ideagen.com/ [18/12/2022]
4. Website Columbus Global, https://
www.columbusglobal.com/ [18/12/2022]
5. Website FTI Consulting, https://www.
fticonsulting.com/ [18/12/2022]
6. Website CAMARK SA, https://www.
camark.gr [19/12/2022]
Follow us on
@HuFriedyGroupMiddleEast
@HuFriedyGroupEurope
@HuFriedyGroup Europe
Hu-Friedy Mfg. Co., LLC.
European Headquarters
Astropark - Lyoner Str. 9
60528 Frankfurt am Main
Tel.: +49 (0)69 24753640
Fax: +49 (0)69 25577015
Free Call: 0080048374339
For more information, visit
www.hufriedygroup.eu
[27] =>
TAPER
CUT
ROUND
BODY
REVERSE
CUTTING
EXTRA
REVERSE
CUTTING
ALL THE SUTURES
YOU NEED
POLYPROPYLENE,
POLYAMIDE
SILK
PGCL
PTFE
POLYESTER
PGA, PGLA,
PGLA RAPID
In HuFriedyGroup portfolio you can find
the ideal suture for each of your surgical procedures.
With our combinations of high quality needles
and biologically inert threads, you will find the one
that suits your surgical needs.
Hu-Friedy Mfg. Co., LLC. • European Headquarters • Lyoner Str. 9 • 60528 Frankfurt am Main, Germany • HuFriedyGroup.eu
All company and product names are trademarks of Hu-Friedy Mfg. Co. LLC, its affiliates or related companies, unless otherwise noted.
©2022 Hu-Friedy Mfg. Co., LLC All rights reserved. HFL-771/1222
For more information on HuFriedyGroup products
call at 00800 48 37 43 39 or visit HuFriedyGroup.eu
COME
VISIT US AT
AEEDC
2023
Dubai
Booth 6F06
[28] =>
28
NEWS
Dental Tribune Middle East & Africa Edition | 01/2023
Large-scale study links periodontitis and
inflammatory bowel disease
By Franziska Beier, Dental
Tribune International
MALMÖ, Sweden: Even though previous research has suggested a link
between periodontitis and inflam-
matory bowel disease (IBD), the relationship and its impacts have not
been fully explored. In a largescale study—the first of its kind in
a European population—researchers from Malmö University, in col-
laboration
with
other
Europe-based
researchers,
have
found evidence for a strong connection between the two diseases.
IBD is a group of inflammatory disorders of the gastrointestinal tract,
principally Crohn’s disease and ulcerative colitis. The incidence of
IBD is increasing worldwide, and
more than 1.3 million people in Eu-
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rope suffer from it. Its cause remains unknown, but an inappropriate immune response is considered to be involved.
Periodontitis and IBD are chronic
inflammatory diseases with similarly complex pathogeneses. “Both
diseases can be described as a
strong overreaction of the immune system against a theoretically relatively mild bacterial trigger. You can say that the immune
system attacks one’s own body,”
explained co-author Prof. Andreas
Stavropoulos from the Faculty of
Odontology in a university press
release.
The study was conducted in Denmark and the data collected via an
online questionnaire answered by
around 1,100 patients with IBD (of
whom approximately half had
Crohn’s disease and the rest ulcerative colitis) and around 3,400
matched controls without it.
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The evaluation of the survey responses showed that patients with
IBD had a higher probability of perceiving the overall health of their
teeth and gingivae as worse and of
having severe periodontitis. Those
patients diagnosed with Crohn’s
disease reported worse oral health
than those diagnosed with ulcerative colitis and had higher odds of
having lost more teeth than the
control group.
“The study shows that patients
with IBD have more periodontitis
and fewer teeth compared to people without IBD. We also see that
patients with IBD and periodontitis have an aggravated intestinal
disease with a higher activity than
patients with IBD who have no oral
health issues,” commented Prof.
Stavropoulos.
Based on the study results, the research team concluded that patients with IBD should be kept
under close surveillance in order to
prevent the development of periodontitis and/or to slow down its
progression. “Similarly important,
it may be that treatment of periodontitis has a positive impact on
the management of IBD,” emphasised Prof. Stavropoulos.
The study, titled “Periodontitis
prevalence in patients with ulcerative colitis and Crohn’s disease—
PPCC: A case–control study”, was
published in the December 2022
issue of the Journal of Clinical Periodontology.
[29] =>
29
NEWS
Dental Tribune Middle East & Africa Edition | 01/2023
Dentists express limitations in treating
patients with disabilities
By Dental Tribune
International
AJMAN, UAE: A study by researchers in Iraq and the UAE has found
that dentists working in these
countries feel ill-equipped to provide optimal oral care to patients
with disabilities. The reasons include anxiety among clinicians
and a lack of adequate treatment
time and training. According to the
researchers, targeted educational
opportunities are required in order
to improve clinicians’ confidence
and ability to treat patients with
disabilities. A sample of 150 dentists in Ajman completed a
cross-sectional survey that aimed
to investigate clinicians’ competency in treating patients with disabilities and the factors that influence their delivery of care and perceived competency.
The majority of respondents (75.3%)
had between one and five years of
clinical experience and 46.7% of
the sample group described their
experience of treating patients
with disabilities as minimal. Just
2% said that they had significant
experience of treating patients
with disabilities. The lead author of
the study, Dr Afraa Salah, who lectures paediatric dentistry and psychology and behavioural sciences
for dental students at Ajman University, confirmed to Dental Tribune International (DTI) that older
dentists in the sample group also
lacked confidence and experience
in treating patients with disabilities.
options for this population depend
on their lack of adequate time and
training, limited capacity to communicate with patients, patient adherence and the constant situational awareness of how to avoid
unintentional injuries to patients
that can lead to possible injuries to
their clinical staff”.
Dr Salah told DTI: “I think that we
need to establish and implement
educational courses on treating
these patients in the undergradu-
ate programme, as well as through
a required live course. In particular, I personally think that training
on how to best treat patients who
are on the autism spectrum would
be very valuable.”
The study, titled “Dentists’ attitude
towards dental treatment of disabled patients”, was published in
Advances in Medical Education and
Practice on 14 December 2022.
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Nearly three-quarters (73.3%) of respondents said that they would attempt treatment of patients with
disabilities, but that they would
refer the patient to another clinician if the therapy became too difficult. One-fifth of respondents
said that they would not provide
treatment and would instead refer
the patient to a specialist. When
asked how comfortable clinicians
felt when providing treatment,
45.3% of respondents gave a neutral response, 32.7% responded
positively and 14.7% responded
negatively. Strongly positive or
strongly negative responses were
given by 4.7% and 2.0% of respondents, respectively.
A significant number of respondents (44.0%) felt that they were
only somewhat able to provide
ideal oral care to patients with disabilities, and 35.5% said that the
time required for treatment was a
concern. Concern about their ability to interact with the patient was
mentioned by 38.0% of those surveyed, and concern about the treatment resulting in an injury to the
patient or the treating dentist was
expressed by 34.7% and 30.7%, respectively.
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03/08/2021 16:21
[30] =>
30
GENERAL DENTISTRY
Dental Tribune Middle East & Africa Edition | 01/2023
Preparation of complex canal systems
in primary and secondary treatment
with the aid of a martensitic file system
By Dr Philipp Eble, Germany
The chemomechanical preparation of the root canal system is an
elementary part of endodontic
therapy. The purpose of mechanical preparation is to remove infected dentin and make the canal
system accessible for cleaning and
disinfection with irrigation fluids.
The success of endodontic therapy
depends largely on the complete
cleaning of the entire root canal
system. The preparation should always be adapted to the degree of infection of the endodontic. Severe or
abrupt curvatures, calcification of
the canals or similar anatomical
peculiarities can make it difficult
to produce an adequate apical diameter and cone thus placing high
requirements on the file systems.
Heat treatment of endodontic nickel-titanium file systems can decisively change the material properties to avoid iatrogenic damage
through increased flexibility and
reduced recovery effect. In the following, the systematic preparation
of complex root canal systems is
demonstrated using three case
studies.
Fig. 1: Preoperative diagnostic image
Case 1: Primary treatment of a
first lower molar with radix entomolaris
A 34-year-old female patient
was referred to us for further treatment of tooth 36. After the diagnosis of irreversible pulpitis by the
general dentist, initial pain therapy
was carried out in the form of caries excavation, trephination of the
pulp chamber, medicinal insertion
and adhesive build-up filling. The
patient presented to our practice
with significantly reduced symptoms.
Clinical findings
Tooth 36 had no increased
probing depths circularly and was
conservatively restored with an adhesive pre-endodontic build-up
filling.
Radiographic findings
The diagnostic radiograph
taken preoperatively shows an insufficient amalgam filling in the
distal proximal space. The mesial
root shows periapical osteolysis
(Fig. 1).
Fig. 2: View of the mesial canal system after preparation
Therapy
The endodontic treatment took
place in one session. After anaesthesia and placement of the rubber
dam, the provisional filling was removed and the initial intracoronal
diagnosis was made. A mesiobuccal, mesiolingual, distobuccal and
distolingual root canal was probed
using a microopener. The preparation of the primary access cavity
for better accessibility of the canals
was carried out with long-neck carbide round bur. Based on the preoperative diagnostic X-ray, the length
of the root canals could be preliminarily approximated. The canals
were continuously rinsed with 6%
NaOCl during the further course of
therapy. After preparation of the
access cavity, coronal expansion of
the root canals followed using EdgeEndo X7 files size 17.06. Electrometric determination of the canal
length using a Morita Root ZX Mini
Apex Locator was performed with
C-Pilots size 8-10. After the working
length was determined, the glide
path was rotationally extended
with EdgeFile X7 size 17.04 and
25.04 and finally prepared to 30.04
(Fig. 2).
The preparation was followed
by a rinse with 17% EDTA for 60 seconds per canal, followed by the
final sound-activated rinse with 6%
NaOCl for 60 seconds per canal.
The preparation and the fit of the
congruent EdgeEndo X7 gutta-percha tips were confirmed with the
help of a master point image (Fig. 4).
After drying the canals and access
cavity with microsuction and
paper tips, the obturation of the
canal system followed using the
warm vertical compaction technique. A heat-resistant bioceramic
sealer was used for this purpose
(Fig. 3). The subsequent closure was
done with a bulk fill flow composite
(Fig. 5).
Fig. 3: View after obturation
Fig. 4: Masterpoint image
Case 2: Primary treatment of
an upper second molar.
Medical history
The 61-year-old patient presented for primary root canal treatment at 27 after referral by his general dentist. The tooth had been
crowned about 2 years ago and the
patient was symptom-free. In the
course of the radiological check-up
after apicoectomy of tooth 26, a
periapical osteolysis had been detected on tooth 27.
Clinical findings
Tooth 27 showed a sufficient
restoration. No increased probing
depths were palpable and both cold
and percussion tests were negative.
Radiographic findings
Tooth 27 shows periapical osteolysis in the sense of chronic apical
periodontitis (Fig. 6).
Therapy
The primary endodontic treatment of tooth 27 was also performed in one session. After trephination, the initial intracoronal diagnosis and visualisation of the
four canal orifices was performed
using a long-neck carbide round
bur. An EdgeFile X7 size 17.06 was
used for coronal expansion of the
canals. The creation of the glide
path could be done purely mechanically. For this purpose, EdgeFile X7
sizes 17.04, 17.06 were used in an alternating manner until the approximately radiographically determined preliminary working
length was reached. After electro-
Fig. 5: After root filling and adhesive
closure
metric determination of the working length with C-Pilot files size 8
and 10, further preparation was
carried out with EdgeFile X7 size
20.06, 25.06 and 30.06. After final
preparation, the canals were rinsed
with 17% EDTA for 60 seconds. As a
final rinse 6% NaOCl was sonically
activated. A masterpoint image
was taken to verify the preparation
and the fit of the adapted guttapercha tips (Fig. 7). After drying
with micro aspiration and paper
tips, all canals were obturated with
bioceramic sealer using a warm
Fig. 6: Preoperative diagnostic image
Fig. 7: Masterpoint image
Fig. 8: Control image after root canal
filling
Fig. 9: Control image after adhesive
closure
” Page 32
[31] =>
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[32] =>
32
GENERAL
XXXXXXX
DENTISTRY
Dental Tribune Middle East & Africa Edition | 01/2023
“ Page 30
Fig. 10: Preoperative diagnostic image
Fig. 11: After working out the
primary access cavity; showing the mb2 near the palatal
canal
vertical filling technique (Fig. 8).
Adhesive closure was carried out
with Bulk Fill Flow composite
(Fig. 9).
Case 3: Revision of an upper
second molar
Case history
A 54-year-old patient presented
with acute complaints on tooth 27.
He had been referred by his general
dentist for further treatment after
he had, according to his own statement, unsuccessfully searched for
a second mesiobuccal canal.
Clinical findings
Tooth 27 had a provisionally
closed access cavity. The tooth responded positively to the percussion test and palpation of the vestibule revealed a pressure dolence in
the area of the mesiobuccal root.
Radiographic findings
The preoperative radiograph
(Fig. 10) shows tooth 27 already trephined by the previous practitioner. The root filling appears inhomogeneous. The root filling material in the mesiobuccal canal is
extended beyond the radiographic
apex and there is periapical osteolysis of the mesiobuccal root.
Fig. 12: Masterpoint image
Therapy
The revision treatment was carried out in two sessions. After placing the rubber dam, the temporary
filling was removed, and the access
cavity was cleaned. This was followed by intracoronal diagnostics
(Fig. 11). Bacterial colonized root filling material was found in the mesiobuccal, distobuccal and palatal
canals. The orifice of the mesiobuccal canal was widened in the palatal
direction. Removal of a mesial dentin overhang with a long-shaft
round bur exposed the orifice of
the second mesiobuccal canal,
which was displaced far in the palatal direction. The root filling material was removed using EdgeFile X7
size 25.06 and 17.06 in a crowndown technique to reduce the
spread of germs and bacterial colonized root filling material apically.
The opening and initial preparation of the second mesiobuccal
canal was carried out using the
EdgeFile X7 size 17.04, 17.06 in an alternating manner as described
above. After electrometric determination of the working length of
all canals, the preparation was continued with EdgeFile X7 at full
working length. In the first mesiobuccal canal, distobuccal and palatal preparation was completed with
EdgeFile X7 size 40.06, while the
second mesiobuccal canal was pre-
Fig. 13: Root canal system after treatment
pared to 30.06 (Fig. 13). After completion of the preparation, the canals were dried, calcium hydroxide
was placed to full working length
and the tooth was provisionally
closed with an adhesive composite
filling. Further treatment took
place after two weeks when the patient was symptom-free. After renewed electrometric control of the
working length, preparation of a
master point image (Fig. 12) and
sound-activated final rinsing with
17% EDTA and 6% NaOCl, the canals
were filled with bioceramic sealer
using the warm vertical filling
technique (Fig. 15). The direct adhesive closure of the access was carried out with a bulk fill flow composite (Fig. 14).
Discussion
Systematic preparation of the
root canal system includes opening
up the canal system and securing a
glide path as well as consecutive
expansion of the canal system
from coronal to apical. Minimally
invasive endodontic concepts focus
on preserving the coronal pericervical dentin. However, a rational approach to a minimally invasive
endodontic procedure should include sufficient preparation of the
apical zone in addition to reduced
coronal substance removal. It
should allow sufficient contact
Fig. 14: After obturation and
adhesive closure
with irrigation fluids for tissue dissolution and disinfection and
should therefore be adapted in size
and conicity to the degree of infection of the endodontic site. A
coronal-to-apical approach offers
the advantage of increased tactility
and reduced stress on the file due to
reduced contact with the canal wall
and can also reduce the spread of
bacteria to the apical side. Newer
heat-treated file systems with reduced maximum diameter such as
EdgeFile X7 from EdgeEndo offer increased safety and efficiency due to
their improved material properties
and geometry. In our practice, initial mechanical glide path setting
with EdgeFile X7 size 17.04 and 17.06
has proven to be particularly effective in canal systems that are difficult to access. The files are used alternately for this purpose. After
coronal expansion of the 17.06, the
change to the file of size 17.04 is
made, which is used in short pecking working movements until the
preliminary radiographically determined working length is
reached. In case of resistance, the
file 17.06 is passively brought to the
previously achieved length and
then allows further advancement
of the 17.04. In many cases,
time-consuming manual glide
path preparation can thus be dispensed with. Further preparation is
Fig. 15: Access cavity after obturation
carried out in taper 04 or 06, depending on the anatomical situation, the degree of infection and
the planned filling technique. The
maximum cross-section of the
EdgeFile X7, reduced to 1 mm, allows the substance of the pericervical dentin to be preserved even
when preparing large apical diameters and offers increased flexibility
in curved root canals. In the present cases, due to the above-mentioned advantages, both difficult-to-access and multiplanar
curved root canals could be prepared in a safe, efficient, and rational minimally invasive manner
with the help of a simple file protocol.
Dr. med.
dent. Philipp
Eble
Euregio Endodontie
Lousbergstraße 1
52072 Aachen
Germany
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Internet www.promedica.de
[33] =>
33
XXXXXXX
EVENT
Dental Tribune Middle East & Africa Edition | 01/2023
DS World Premiere in Dubai –
February 2023
Find out more by scanning
the QR Code
AD
By Dentsply Sirona
For the first time ever, Densply
Sirona World comes to Dubai! In
the wake of the 2022 DSW success
in Las Vegas, Madrid and Fethiye,
Dentsply Sirona changes scenery in
early 2023 and heads to the Middle
East.
From 5 to 6 February, Dentsply
Sirona will create a new opportunity for dental professionals in the
MENA region to join the Ultimate
Experience in Digital Dentistry – at
the iconic Atlantis, The Palm hotel.
The event is in collaboration with
AEEDC Dubai, scheduled February
7-9, 2023 after DS World, so attendees can benefit from the maximum
educational experience.
DSW Dubai will bring exciting
mainstage presentations, live
demonstrations, and over 30 clinical education courses. Led by an
impressive lineup of 11 international dental experts, the sessions
will cover a broad range of topics
across nearly all dental disciplines,
such as:
•
Root to crown digital workflow: from diagnosis to restoration: Dr. Marco Martignoni
(Italy)
•
Full digital workflow in implant dentistry: New perspectives and challenges: Dr. Carlos
Repullo (Portugal)
•
Empowering orthodontists in
a complete digital workflow:
Dr. Daniela Aggio (Brazil)
Furthermore, DSW Dubai participants will have the chance to
experience the latest digital dentistry solutions from Dentsply
Sirona, including:
•
PrimePrint Solution: a highly
automated, end-to-end, medical-grade 3D printing system
for dental practices and labs.
•
Primescan Connect: a highly
connected and easy-to-use
laptop-based version of the
fast and accurate Primescan
intraoral scanner.
Dentsply Sirona will also mark
another premiere at the 2-day
event with our innovative implant
system DS PrimeTaper launching
for the first time in the MENA region.
DS World has always provided an outstanding opportunity for dental professionals to come together and learn
from one another. Now, we are bringing
it to new corners of the world to reach a
wider community! For more information, go to DSW Dubai webpage.
Dr. Carlos
Repullo
(Spain)
Dr. James
Gutmann
(USA)
Dr. Carlos
Sabrosa
(Brazil)
Dr. Marco
Martignoni
(Italy)
Dr. César
de Gregorio
(Spain)
Dr. Michael
Norton
(UK)
SCAN THE QR CODE TO REGISTER
**CME accreditation available as per session participation
Dr. Roberto
Molinari
(Italy)
Dr. Daniela
Aggio
(Brazil)
Dr. Simone
Grandini
(Italy)
Dr. Ehab
Heikal
(Egypt)
Dr. Calin
Pop
(Romania – UAE)
[34] =>
34
NEWS
Dental Tribune Middle East & Africa Edition | 01/2023
Primeprint Solution Campaign Film
wins corporate Media & TV Award in
Cannes
By Dentsply Sirona
Dentsply Sirona’s short film,
“The Magic Inside – Primeprint 3D
Printing Solution”, has earned the
Silver Dolphin at this year's Corporate Media & TV Awards in Cannes
– impressing the expert jury in the
“Health, Medicine & Life Sciences”
category. Released earlier this year
to mark the launch of Primeprint
Solution, the film offers an insight
at the new 3D printing system’s innovative interiors.
“The Magic Inside – Primeprint
3D Printing Solution” sees fictional
characters Daniel Prime and Dr. Isabelle Quinn present Dentsply
Sirona’s latest Primeprint Solution
as a "masterpiece of engineering
art" through an exciting virtual
journey. The short film features
well-known international actors Seumas Sargent and Annabelle Mandeng and was created with Dentsply
Sirona’s production partner and
digital agency LINGNER.COM,
which was in charge of the launch
communication of Primeprint.
“We are thrilled to receive one
of the most coveted international
marketing awards – for the second
time – with Primeprint as the star
of the film,” said Swen Deussen,
Vice President Marketing Digital
Platforms & Solutions at Dentsply
Sirona. “LINGNER.COM did a fantastic job of bringing the state-ofart Primeprint Solution to life, explaining all its great features in a
clear and incredibly engaging way
for the dental community.”
“We are proud to be recognized
for such a special project, which
The fictional characters Daniel Prime and Dr. Isabelle Quinn present Primeprint Solution as a "masterpiece of engineering art". (Photo: Dentsply Sirona)
blurs the real and virtual worlds to
show the magic of dental technology,” added Christian Laurin of
LINGNER.COM. “We enjoyed partnering with Dentsply Sirona on this
project.”
The latest accolade is the second Corporate Media & TV Award
for Dentsply Sirona, with the Primescan launch film “It’s Prime
Time” also winning a Silver Dolphin from the Cannes jury in 2019.
Primeprint Solution, unveiled earlier this year by Dentsply Sirona, is a highly automated, end-to-end, medical grade 3D printing system for dental practices and labs. (Photo: Dentsply Sirona)
The international marketing festival takes place annually, honoring
the best corporate films, online
media productions, and documentaries. It is widely considered as one
of the most important international events in the corporate film
industry.
Primeprint Solution sets out
to simplify 3D printing
Launched earlier this year,
Primeprint Solution is a highly automated, end-to-end, medical
grade 3D printing system for dentists and dental technicians who
want to expand their treatment or
service offerings. Its elevated level
of automation helps reduce handling times, allows for delegation,
and increase the productivity for
the dental practice.
Primeprint Solution integrates
seamlessly with DS Core, Dentsply
Sirona’s first interconnected, cloudbased platform designed to support dental professionals in the entire treatment journey – from diagnosis to final care and treatment.
With DS Core Create, practices can
order ready-to-print designs created by expert lab technicians.
Dr. Mike Skramstad, dentist
from Orono (Minnesota, USA), said:
“3D printing has just taken the next
leap forward with Primeprint. With
the combination of complete integration, enclosed automated workflow, and industry defining efficiency, Primeprint gives me and
most importantly my staff confidence that we are delivering very
good and safe 3D printed parts to
our patients.”
For more information, visit:
dentsplysirona.com/primeprint
Find out more by scanning
the QR Code
[35] =>
Dental Tribune Middle East & Africa Edition | 01/2023
35
NEWS
Periodontal treatment ineffective
for heavy smokers with severe
periodontitis, study finds
By Iveta Ramonaite, Dental Tribune
International
AARHUS, Denmark: Smoking can greatly
affect periodontitis treatment—these are
the findings of a recent study that investigated the influence of different levels
of exposure to smoking on the clinical
results of non-surgical periodontal treatment. Besides highlighting the adverse
effect of tobacco use on oral health, the
study highlighted the need to rethink
current practices for periodontal treatment.
The study was conducted at Aarhus University and involved 80 smokers with
periodontitis who were offered an individualised voluntary smoking cessation
programme and underwent periodontal
therapy. According to their smoking patterns, the participants were categorised
as light smokers or quitters (i.e. those who
quit during the study), moderate smokers
and heavy smokers. The researchers then
observed their periodontal healing for 12
months with regard to clinical periodontal parameters such as clinical attachment level, periodontal pocket depth and
bleeding on probing, and they provided
supportive periodontal care every three
months.
The researchers noted that heavy smokers began the study with a higher average
clinical attachment level of 1.1 mm and
ten more sites with severe periodontitis
compared with light smokers or quitters.
They stated that light smokers or quitters
and moderate smokers obtained an average reduction of 0.6 mm in periodontal
pocket depths and an average gain of 0.7
mm in clinical attachment levels, respectively, whereas heavy smokers experienced a 0.5 mm attachment loss
improving patients’ response to periodontal
treatment and thus such counselling must
form part of therapy.
“This is completely new knowledge for the
country’s dental clinics, and it should be
taken into account when treatment is be-
ing planned for the individual patients,” she
commented. “As a heavy smoker with periodontitis, it is very important to understand
that working towards stopping smoking is a
crucial step in the effective treatment of the
disease,” she concluded.
The study, titled “Effect of smoking exposure
on nonsurgical periodontal therapy: 1-year
follow-up”, was published online on 4 November 2022 in the Journal of Dental Research
ahead of inclusion in an issue.
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The findings show that heavy smokers
with the most severe forms of inflammation did not benefit from the treatment
and that the periodontal parameters of
heavy smokers with moderate periodontitis only improved by 50% compared
with those who smoked less
“To our surprise, we could see that the
disease had actually grown worse in some
parameters in the hardest-hit group, despite the fact that this particular group
had received the most extensive, individually designed treatment,” co-author
Julie Pajaniaye, a dental hygienist and
teaching assistant professor in the Department of Dentistry and Oral Health at
the university, said in a press releas
Severe periodontal disease is estimated
to affect around 19% of the global adult
population, representing more than one
billion cases, the World Health Organization reports. According to the Danish
Health Authority, around 18% of Danes
smoked tobacco daily or occasionally in
2020.
Dentists and dental hygienists may or
may not refer patients to smoking cessation programmes as part of periodontitis
treatment. In light of the study findings,
Pajaniaye believes that taking steps towards smoking cessation is essential for
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/ Industry
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/ Restorative aesthetics at the gingiva
/ An interview with Dr Kyoo-Ok Choi, founder of Osstem Implant: “Our aim is to become a total service provider”
/ Event
/ Starlynr: A new revolution in aligners
/ News
/ The important things in dental sutures production
/ Preparation of complex canal systems in primary and secondary treatment with the aid of a martensitic file system
/ DS World Premiere in Dubai – February 2023
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