CAD/CAM international No. 1, 2024
Cover
/ Editorial
/ Content
/ Major contributors revitalise WHO global strategy for oral health
/ News
/ Industry news
/ Trends & applications
/ CAD/CAM NobelProcera abutments demonstrate excellent prosthetic survival and low complication rates - An interview with Dr Ian Lane
/ Digital workflow of immediate implantation and immediate restoration in the aesthetic zone
/ Bimaxillary prosthetic reconstruction with implant-supported overdentures using novel materials and digital technology
/ Monolithic multilayer zirconia crowns in the aesthetic zone
/ Back and neck pain in dentistry: A new reality
/ Eco-friendly dentistry: “The best time to start was yesterday. The next best time is now.”
/ Motivating your team
/ Meetings
/ Imprint
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[1] =>
issn 1616-7390 • Vol. 15 • Issue 1/2024
international magazine of dental laboratories
F
N TA L T R
IB
RS
O
DE
U
N
E
R
OF
E
D
EA
IA
& 2
. • 30 Y
0 YEA
INT
S
OEMUS
M
industry news
Quality and inventory
management in the
dental laboratory
case report
Monolithic multilayer
zirconia crowns
in the aesthetic zone
features
Back and neck pain
in dentistry:
A new reality
1/24
[2] =>
[3] =>
editorial
|
Magda Wojtkiewicz
Managing Editor
Exploring the power of
CAD/CAM technology
Welcome to the latest issue of our CAD/CAM magazine,
where we delve into the exciting advancements and
applications shaping the modern dental landscape.
As digital technology continues to revolutionise dentistry,
it has become increasingly indispensable for both dentists
and dental technicians alike.
In recent years, CAD/CAM technology has undergone
remarkable development, transforming the way dental
professionals approach treatment planning, restoration
fabrication and patient communication. Embraced by
dentists and dental technicians worldwide, CAD/CAM
technology has become an integral component of
modern dental practices and laboratories.
The growing adoption of digital workflows has paved
the way for enhanced precision, efficiency and aesthetic
outcomes in dental treatments. With CAD/CAM technology,
dental professionals can now design and fabricate restorations with unparalleled accuracy, ensuring optimal fit,
function and aesthetics for their patients.
Industry has played a pivotal role in driving the advancement of CAD/CAM technology. Many companies globally
have launched cutting-edge surgical guides, milled implant abutments, and milling blocks and discs, among
other products, offering dental professionals innovative
solutions for restorative dentistry. Additionally, advancements in quality and inventory management have
streamlined workflows in dental laboratories, optimising
efficiency and productivity.
Digital workflows have simplified complex treatments
such as implant treatment, and several platforms offer
comprehensive digital solutions that enhance treatment
planning, surgical precision and prosthetic outcomes.
Similarly, new digital solutions have expanded options
for orthodontic treatment, providing patients with more
efficient and discreet alternatives.
As digital technology continues to evolve, so too do the
trends and applications shaping modern dentistry. This
CAD/CAM issue explores the Personal Oral Protocol
concept, pioneered by dental technician Eric Berger,
which exemplifies the personalised approach enabled
by digital technology, tailoring treatment plans to individual
patient needs and preferences.
In this issue of CAD/CAM magazine, we also present captivating case reports, showcasing the digital workflow of immediate implant placement and restoration, full-mouth prosthetic
reconstruction with implant-supported overdentures and the
use of monolithic multilayer zirconia crowns in the aesthetic
zone. We also address important topics like ergonomic considerations in dentistry, featuring an interview with physical
therapist Timothy Caruso on managing back and neck pain,
and we highlight the growing trend of eco-friendly dentistry,
giving insights from Peter Suresh on sustainable practices in
dental care. Lastly, our practice management section offers
valuable advice on motivating dental teams, courtesy of
productivity expert Jerko Bozikovic, and our meetings section
provides a list of upcoming international events and a review
of the recent exocad Insights 2024 conference.
In this issue of our magazine, we celebrate the transformative power of CAD/CAM technology and its profound
impact on modern dentistry. We hope you find inspiration,
innovation and practical insights to elevate your practice
or laboratory to new heights of excellence.
Sincerely,
Magda Wojtkiewicz
Managing Editor
CAD/CAM
1 2024
03
[4] =>
| content
editorial
Exploring the power of CAD/CAM technology
03
news
Major contributors revitalise WHO global strategy for oral health
New study shows bacteria love some restorative materials
more than others
Asia Pacific’s digital dentistry renaissance
page 18
06
08
10
industry news
HASS Bio announces global launch of Amber Mill H block and disc
Quality and inventory management in the dental laboratory
Making implantology simple with the MIS digital workflow
ClearCorrect launches new digital solutions globally
12
14
16
18
trends & applications
page 40
Personal Oral Protocol concept
20
interview
CAD/CAM NobelProcera abutments demonstrate
excellent prosthetic survival and low complication rates
24
An interview with Dr Ian Lane
case report
page 50
Digital workflow of immediate implantation
and immediate restoration in the aesthetic zone
Bimaxillary prosthetic reconstruction
with implant-supported overdentures
Monolithic multilayer zirconia crowns in the aesthetic zone
26
32
40
features
Back and neck pain in dentistry: A new reality
44
An interview with Timothy Caruso
Cover image courtesy of
sunlight19/Shutterstock.com
Splash template courtesy of
© gfx_nazim – stock.adobe.com
issn 1616-7390 • Vol. 15 • Issue 1/2024
1/24
DE
F
N TA L T R
IB
U
RS
E
R
E
D
EA
IA
& 2
. • 30 Y
0 YEA
INT
OEMUS
M
manufacturer news
48
practice management
50
meetings
O
N
OF
46
An interview with Peter Suresh
Motivating your team
international magazine of dental laboratories
S
Eco-friendly dentistry: “The best time to start was yesterday.
The next best time is now.”
industry news
Quality and inventory
management in the
dental laboratory
case report
Yes, we CAD!—exocad Insights 2024
54
International events
56
about the publisher
Monolithic multilayer
zirconia crowns
in the aesthetic zone
features
Back and neck pain
in dentistry:
A new reality
international imprint
04 CAD/CAM
1 2024
58
[5] =>
The
Partnership
that Elevates
ClearCorrect® is excited to
unveil new products and
features designed to elevate
your practice to its full potential.
Updates to our Empowering
Digital Workflow and Practice
Growth Resources all work
together, putting your needs
front and center.
To become a partner
or learn more visit:
clearcorrect.com
©2024 ClearCorrect | Approved for global use | Acc.1901_en_01
[6] =>
© BUTENKOV ALEKSEI/Shutterstock.com
| news
Major contributors revitalise
WHO global strategy for oral health
Anisha Hall Hoppe, Dental Tribune International
The World Health Organization (WHO) has unveiled
a new global oral health action plan, seeking to improve
oral health outcomes and reduce the burden of oral
disease worldwide by 2030. Part of a greater plan to
integrate oral health into the universal health coverage
framework and address the social and commercial determinants of oral health, the new action plan aims to enable
people to achieve the best possible standard of oral
health, thus improving their overall well-being and ability
to participate fully in society.
Oral disease affects around 3.5 billion people worldwide
and, despite being preventable for the most part, remains widespread owing to various risk factors and
socio-economic variables.
The WHO strategy is the first concrete step towards
implementing the World Health Assembly’s resolution
on oral health, which was adopted in 2021. It outlines
actions for WHO member states, international partners,
civil society and the private sector. The overarching goal
is to foster a comprehensive and coordinated approach
to improving oral health around the world.
06 CAD/CAM
1 2024
The actions the WHO will take according to the plan:
1. developing ambitious national responses to promote
oral health;
2. reducing the incidence of oral disease and oral health
inequalities;
3. s trengthening efforts to integrate oral health into
universal health coverage; and
4. establishing a framework for tracking progress, including
specific targets and indicators, by 2030.
It will take serious collaboration with a number of stakeholders, according to WHO, to achieve a global difference
in oral health. One key stakeholder, FDI World Dental Federation, has contributed to the action plan, helping to ensure that the strategy is effective and can better meet the
diverse needs of different populations.
More information and access to the documentation of
the WHO 2023–2030 global oral health agenda, including the
resolution on oral health, the global strategy on oral health
and the global oral health action plan, can be found online:
www.who.int/publications/i/item/9789240090538.
[7] =>
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Features
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Made of biocompatible PEEK
Can be ordered individually or from the same
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in all countries. Please ask your local Camlog / BioHorizons® representative if you have
access to our CAD/CAM services.
DEDICAM®, CAMLOG®, CONELOG®, iSy® and CERALOG® are registered trademarks of
CAMLOG Biotechnologies GmbH. BioHorizons is a registered trademark of BioHorizons.
All rights reserved. Not all products are available in all countries.
[8] =>
| news
New study shows bacteria
love some restorative materials
more than others
Dental Tribune International
The study investigated three grades of yttria-stabilised
zirconia and a CAD/CAM composite resin. Bovine
dentine served as the control. The surface roughness of
all materials was maintained at a highly polished level.
The materials were tested against the strains of five
bacterial species: Porphyromonas gingivalis (implicated
in periodontal disease), Streptococcus oralis,
Streptococcus sanguinis, Streptococcus gordonii (all
three early-colonising bacteria) and Streptococcus mutans
(associated with dental caries).
The results showed that there were no significant differences in surface roughness among the highly polished
samples. Surface wettability varied, but no correlation was
found between surface energy and bacterial adhesion.
The yttria content in the zirconia did not significantly
affect bacterial adhesion. However, the composite resin
exhibited higher bacterial adhesion compared with zirconia,
attributed to its higher carbon, oxygen and silicon
contents.
Bacterial adhesion patterns differed among the materials.
For P. gingivalis, the control group showed the
highest adhesion and the composite resin the lowest.
08 CAD/CAM
1 2024
For S. oralis, S. sanguinis and S. gordonii, the highest adhesion
was observed on the control and composite resin surfaces, followed by the zirconia samples. For S. mutans,
the control group showed significantly higher adhesion
compared with the experimental groups. The researchers
noted that “the results clearly show that the material
type strongly affects bacterial adhesion during the first
hour of incubation, which is an important factor for
clinical use”.
This study confirms that dental material type significantly
influences bacterial adhesion, even when surface
roughness is controlled. The composite resin, despite its
polished surface, showed higher bacterial adhesion,
similar to the control with a rougher surface. Considering
both mechanical and biological properties when selecting
materials for dental restorations is key, according to
the researchers.
They recommended further research, including co-culturing
models and long-term studies, to fully understand the
biocompatibility and clinical performance of these
materials. “Given the complexity of the physicochemical
properties of different materials, we suggest that biological
indicators related to bacterial adhesion should be explored
for optimal clinical outcomes,” wrote the researchers.
Employing bioactive agents and superhydrophobic
surfaces in restorative materials may offer future solutions
for reducing bacterial adhesion and improving clinical
outcomes.
Editorial note: The study, titled “Does dental material
type influence bacterial adhesion under the same polishing
conditions? Direct observation using a fluorescent
staining technique: An in vitro study”, was published
online on 1 June 2024 in Dental Materials Journal, ahead
of inclusion in an issue.
© ImageFlow/Shutterstock.com
Although various synthetic materials have achieved
near-perfect results in dental restorations, they cannot
completely replicate natural tooth structure, often resulting
in clinical failure due to secondary caries and periodontal
disease. Two major contributing issues are the formation
of biofilm and bacterial adhesion to restorative materials.
Using single-strain bacterial adhesion models, researchers
in Japan have investigated the influence of dental
material type and surface properties on bacterial adhesion.
The findings suggest that the chemical composition
of the material plays a crucial role in bacterial adhesion,
potentially more than surface roughness or surface
energy.
[9] =>
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nobelbiocare.com/procera
GMT 90209 GB 2405 Printed in the EU © Nobel Biocare Services AG, 2024. All rights reserved.
Nobel Biocare, the Nobel Biocare logotype and all other trademarks are, if nothing else is stated or
is evident from the context in a certain case, trademarks of Nobel Biocare. 3Shape® and 3Shape
Dental System™ are trademarks of 3Shape A/S. Please refer to nobelbiocare.com/trademarks for
more information. Product images are not necessarily to scale. All product images are for illustration
purposes only and may not be an exact representation of the product. Disclaimer: Some products
may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare
sales office for current product assortment and availability. For prescription use only. Caution:
Federal (United States) law restricts this device to sale by or on the order of a licensed clinician,
medical professional or physician. See Instructions For Use for full prescribing information, including
indications, contraindications, warnings and precautions.
[10] =>
© Sergey Ryzhov/Shutterstock.com
| news
Asia Pacific’s
digital dentistry renaissance
Ali Arabnejad & Dr Kamran Zamanian, Canada
In the 1980s, Dr François Duret pioneered the integration of
CAD/CAM technology into dentistry, introducing the revolutionary
CEREC system. This marked the beginning of a transformative
journey in the dental industry. The first 3D printers for dental
applications appeared in the early 2000s, expanding the capa
bilities of CAD/CAM to support the precise and efficient produc
tion of dental components. Today, the dental industry thrives on
continuous innovation in CAD/CAM technologies, offering unpre
cedented possibilities and transforming market dynamics.
The Asia Pacific region’s adoption of CAD/CAM technology
in dentistry follows a trend similar to that of more developed
countries. What sets the Asia Pacific market apart, and
underscores its significance, is the sheer number of people
impacted by these technological changes. Japan and South
Korea emerged as pioneers in incorporating CAD/CAM systems
into dental practices, having a strong focus on precision and
technological advancements.
Japan, in particular, played a crucial role in refining CAD/CAM
applications for dental prostheses, and the rapid growth of
technology hubs in countries such as China has contributed
to the proliferation of 3D-printing applications. The collaborative
efforts between academic institutions, dental practitioners
and technology developers in Asia Pacific have fostered
a dynamic environment, driving the evolution of CAD/CAM
technologies, including 3D printing. The digital dentistry
market for the Asia Pacific region is expected to experience
significant growth by 2030 (shown in the figure).
Ageing population and culture
In the Asia Pacific region, an average of 17% of the
population is aged 65 and above. This, coupled with an
10 CAD/CAM
1 2024
increasing focus on oral well-being, has driven a significant
demand for advanced dental solutions. For example,
in Japan, while overall dental expenditure rose from
¥1.96 trillion in 1984 to ¥3.00 trillion in 2020, spending
on dental care for older individuals escalated from
¥185.00 billion to ¥1.18 trillion overall and from ¥15,500
to ¥32,800 per capita.1
In many Asia Pacific societies, there is a strong cultural
emphasis on aesthetics and personalised healthcare solu
tions. This is particularly evident in South Korea and Japan,
where the adoption of digital dentistry seamlessly aligns
with cultural preferences for natural-looking treatment
results, fostering acceptance and growth of these tech
nologies in these markets.2
Education, research
and government support
Asia Pacific’s commitment to education and research,
particularly in Japan and South Korea, has played a pivotal
role in the growth of digital dentistry. Leading dental
institutions are driving the development and dissemination
of knowledge related to applications of CAD/CAM subtractive
and additive technologies, ensuring dental professionals
are able to adopt these technologies successfully in their
practices.
Government healthcare policies and initiatives in certain
Asia Pacific countries have also contributed significantly
to advancing digital dentistry, for example by expanding
dental coverage; however, there is variability in this regard
across the region.3 India, for instance, does not have
robust nationwide coverage for elective dental procedures.
[11] =>
news
|
Technological innovations
and industry collaboration
In various Asia Pacific countries, a synergy between dental
laboratories and dental practices is driving technological
advancements in digital dentistry, seeking to enhance the
quality of dental prostheses fabricated using 3D-printing
technologies. Technological innovations, especially in China,
are driving international market supply through substantial
exports of advanced CAD/CAM materials and 3D printers.
Together, these efforts, by leading to improved products
and enhanced patient outcomes, have positioned Asia Pacific
at the forefront of global dental technology markets and
are boosting the value of the Asia P
acific dental prosthesis
4
and 3D-printing printer markets.
Challenges and prospects
While the digital dentistry market in Asia Pacific is experi
encing notable growth, a range of often interconnected
factors are constraining its expansion, particularly re
garding adoption of advanced digital dentistry pro
cedures and prostheses. These include economic
considerations and technological nuances.5 In certain
Asia Pacific countries, patients’ limited purchasing power
may restrict access. Furthermore, although competitive
pricing is a normal part of market dynamics, aggressive
pricing strategies, especially in tender processes—
a significant aspect of China’s market dynamics—may
lead to compromised product quality and may hinder the
growth of competitors.
Cost pressures and the scarcity of well-educated, skilled
technicians contribute to compromises in the quality of
the manufactured prosthetics can affect the effectiveness
and longevity of dental prosthetics. Such compromises
can undermine the effectiveness and durability of these
pros
thetics, resulting in less-than-optimal patient out
comes. This situation not only affects patient satisfaction
but also challenges the integrity and perceived value of
digital dentistry solutions in the region.
To elevate the digital dentistry sector in the Asia Pacific,
a two-pronged strategy is essential: first, enhance the edu
cational framework for technicians by extending program
lengths and enriching curricula with comprehensive, up-to-date
content to ensure a highly skilled workforce.
Second, align the quality standards for dental materials with
those of European and American markets (EMA and FDA)
through adoption and enforcement of quality and safety
standards. This dual approach, supported by collaboration
among educational institutions, industry stakeholders,
and regulatory bodies, will significantly improve the quality,
effectiveness and trust in digital dentistry solutions, setting
the Asia Pacific on a path to significant improvements in
dental care quality and innovation.6
Value of the Asia Pacific digital dentistry market in 2020–2030: A visual
journey through the growth of the markets in Australia, China, Japan, India
and South Korea. (Image: © iData Research)
Summary
In the Asia Pacific, the integration of CAD/CAM technology
and 3D printing into dentistry marks a significant leap
forward, positioning the region as a pivotal player in the
global dental industry. Spearheaded by countries like
Japan’s and South Korea’s in CAD/CAM, along with China’s
rapid growth in 3D printing in particular, position the
region as a unique hub for technological advancements.
Despite the rapid advancements and potential for sub
stantial market growth, the sector faces hurdles including
economic barriers, the need for improved educational
standards for technicians and aligning material quality
with international norms. Addressing these challenges
through strategic collaboration among industry players,
educational institutions and regulatory bodies is crucial for
leveraging digital dentistry’s full potential in the Asia Pacific.
Editorial note: This article was first published in
today IDEM Singapore 2024. Please scan the
QR code for the list of references.
about
Ali Arabnejad is a research analyst
at iData Research, where he is
responsible for developing and
compiling syndicated research projects
focused on the medical device industry.
His publications report on the dental
prosthesis and digital dentistry markets
in Asia Pacific, among others.
Dr Kamran Zamanian is the CEO
and a founding partner of
iData Research. He has spent
over 20 years working in the market
research industry and is specifically
focused on medical devices
used to promote the health
of patients all over the globe.
CAD/CAM
1 2024
11
[12] =>
| industry news
HASS Bio announces global launch
of Amber Mill H block and disc
HASS Bio
This expansion ensures a wider range of options to
accommodate diverse dental needs.
To complement these sizes, Amber Mill H offers a selection of ten shades across two categories. The high-
translucency category features Shades A1, A2, A3 and B1,
and the low-translucency category includes Shades W2,
A1, A2, A3, A3.5 and B1. These shades are meticulously
designed to naturally match the patient’s existing teeth,
thus enhancing aesthetic outcomes.
Innovative features and superior material properties
HASS Bio’s new product offerings represent a breakthrough in dental
prosthetic materials. (Images: © HASS Bio)
HASS Bio, a leader in innovation in dental ceramics, is
proud to announce the expansion of its product line with
the introduction of the Amber Mill H block and disc.
Building on the success of the previously released
Amber Mill H ceramic-based hybrid block, this new product
will be available in block and disc form, thus broadening
the options for dental prosthetic solutions.
Expanded product sizes and shades
for customised dental solutions
Amber Mill H will now be available not only in the
original C10, C12 and C14 sizes (offered in packs of five
blocks each) but also in two additional sizes, 8T and 10T.
The innovative Amber Mill H uses a unique bonding
technology, which incorporates fine crystalline ceramic
particles with polymers. This advanced composition
not only provides high initial bond strength during the
polymerisation of resin cement, but also significantly
increases indirect tensile strength up to 75 MPa. Additionally,
its biaxial flexural strength is approximately 190 MPa and
its three-point flexural strength about 204 MPa, reducing
the risk of prosthesis dislodgement.
Enhanced processing capabilities
and aesthetic properties
The disc form of Amber Mill H allows for the efficient
processing of approximately 30–35 restorations per disc
and is suitable for both wet and dry methods. Dental professionals can choose between hydrofluoric acid etching
or sandblasting for pretreating the inner surface of the
prosthesis, enhancing user convenience and efficiency.
An outstanding feature of Amber Mill H is its high light transmission rate of approximately 35%, supporting the strength of
initial bonds. Moreover, its controlled opacity and fluorescence
make it an ideal choice for aesthetic restorations.
Precision and quality in every detail
Amber Mill H ensures exceptional precision in milling and
marginal reproduction, significantly improving the fit and
adhesion at the tooth–prosthesis boundary. This precise
engineering results in a superior fitness gap, promoting
long-lasting durability and patient satisfaction.
Amber Mill H block.
12 CAD/CAM
1 2024
More information about Amber Mill H and other HASS Bio
products can be found at www.hassbio.com.
[13] =>
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[14] =>
| industry news
Quality and inventory management
in the dental laboratory
How choosing high-quality universal materials can
optimise costs and support highly aesthetic restorations
Kuraray Noritake Dental
in order to meet various requirements for strength and
aesthetics in different settings, enabling them to fabricate
all kinds of restorations for excellent patient outcomes.
Universal solution for dental laboratories
At Kuraray Noritake Dental, we take pride in our commitment to delivering only the highest-quality materials, and to
that end, we developed the first-ever multilayered zirconia,
K ATANA Zirconia ML. KATANA Zirconia YML, our latest addition
to the KATANA Zirconia portfolio, exemplifies this dedication
and offers users universal applicability. This impressive feature
is made possible by KATANA Zirconia YML’s colour gradation,
flexural strength gradation of up to 1,100 MPa and translucency
gradation of up to 49% translucency.
Delicate balance between costs and
aesthetics in the dental laboratory
In-house production:
The path to high-quality zirconia discs
When you are a laboratory owner striving to achieve
high-end results using modern digital techniques, the
initial investment in CAD/CAM technology is significant
and is followed by ongoing costs for consumable items
such as milling tools and blanks. That cost can be reduced
by selecting high-quality universal materials.
Like all our zirconia offerings, KATANA Zirconia YML begins
its journey to the dental laboratory at our Japanese facility,
starting from freshly produced zirconia. This meticulous
process supports the maintenance of the highest quality
from the outset. The process involves purification and
refinement before the addition of essential components.
Undoubtedly, zirconia stands out as one of the most
popular materials on the market. From an inventory
perspective, however, laboratory owners may need to
purchase multiple discs of the same shade and thickness
Once the material has undergone this thorough initial
stage of production, discs are formed from it in the pressing
and pre-sintering phase. For KATANA Zirconia, this phase
of the process takes over seven days, underscoring
14 CAD/CAM
1 2024
[15] =>
industry news
|
our insistence on the quality of the manufacturing process to achieve the most aesthetic product and optimal
mechanical properties.
High-precision shrinkage and stable coefficient
of thermal expansion values for exceptional fit
Outstanding deformation stability during the sintering procedure contributes to the stability during the final sintering
process in the dental laboratory, providing for an exceptional fit of large-span bridges and other restorations.
High-speed sintering program
The unique powder formulation, refinement process,
and pressing and pre-sintering technique are crucial for
enabling our customers to produce up to three-unit
bridges without compromising on aesthetics or mechan
ical properties using the 54-minute high-speed sintering
process.* This high-quality production method results in
an exceptionally dense material that ensures that the
quality and aesthetics are already present at the point
of manufacture and are maintained during milling.
Once the discs have been sintered, their characteristics
support the delivery of high-strength final restorations
with excellent aesthetics.
Multilayered structure and ease of
positioning of restorations in the blank
To enhance the aesthetic qualities, KATANA Zirconia YML
discs are designed using ratios rather than fixed measurements of different layers in the multilayered structure.
This means that regardless of disc thickness, there is
always a consistent ratio of 35% of raw material that
constitutes the translucent enamel zone. Hence, discs
with an increased height—which are typically used for
the production of larger restorations—always offer sufficient space in the enamel zone, whereas smaller discs
are optimised for smaller restorations.
This single material is suitable for everything from single
crowns to full-arch prostheses and for full-contour designs
to conventional frameworks, without compromising on
aesthetics. For finishing, we offer a well-coordinated
portfolio of solutions designed for internal and external
staining, micro-layering and full layering.
Explore our website for a wealth of resources,
clinical cases and FAQs
KATANA Zirconia YML: One disc for all indications
Visit our website to discover more about KATANA Zirconia
YML. Among the many useful materials we provide are a brochure, a technical guide and in-depth technical information.
If you would like to see the material in action, browse the
blog section of our website for a variety of clinical cases and
articles by world-renowned experts showcasing and proving
the versatility and aesthetics of KATANA Zirconia YML.
The qualities of KATANA Zirconia YML empower dental
laboratory owners to deliver a wide range of restorations.
* The material is removed from the furnace at 800 °C.
A furnace with a configurable YML firing program is r equired.
CAD/CAM
1 2024
15
[16] =>
| industry news
Making implantology simple
with the MIS digital workflow
MIS Implants Technologies
Digital workflows connect the dots in modern dentistry by merging several connected procedures into
one complete treatment. The harnessing of digital
tools facilitates accurate diagnosis and treatment
planning, significantly improving patient outcomes
and clinical efficiency. Being part of Dentsply Sirona,
MIS Implants Technologies is uniquely positioned to
offer its customers comprehensive digital workflows,
combining MIS solutions with the latest Dentsply
Sirona equipment and materials.
MIS has been investing in digital solutions for many
years, and the company has watched with enthusi-
16 CAD/CAM
1 2024
asm as its digital workflow has been adopted by clinicians around the world. The workflow incorporates
digital imaging, intra-oral scanning, guided surgery
and CAD/CAM technologies designed to enhance
every step of the treatment process. According to
Orit Kario, digital solutions product manager at MIS,
the aim is to simplify treatment for clinicians, laboratories and patients through seamless communication
and data transition.
MIS offers workflows for single-tooth, partial-arch and
full-arch procedures that are tailored to general dentists and specialists and the setting, whether chairside
[17] =>
industry news
|
“MIS has been investing in digital solutions for many years,
and the company has watched with enthusiasm as its digital
workflow has been adopted by clinicians around the world.”
or laboratory. They include implant-level and tissue-
level solutions and enable implant-to-crown procedures.
For example, the company’s workflow for conical
connection implants begins with a Primescan intra-
oral scan and efficient prosthetically driven MSOFT
planning, assisted by the MCENTER team, which
provides comprehensive digital dentistry services and
detailed surgical plans. In the surgical step, bone augmentation is done with the use of OSSIX biomaterials,
and clinicians benefit from the advantages of the
unique MGUIDE surgical guides. The C1 implant and
MIS CONNECT stay-in abutment provide primary and
long-term stability and offer the ability to maximise tissue-
level restoration, and the use of a computer-guided
approach contributes to the reduction of patient visits,
treatment steps and corrections. For final restoration,
MIS customers are offered a wide range of implant-level
and tissue-level digital prosthetic solutions, all implemented in leading CAD software.
Kario said that being a Dentsply Sirona company
allows MIS to offer clinicians significant advantages.
She explained: “MIS can offer its customers a complete digital workflow that incorporates the MIS guided
surgery system, the unique implant connections and
the comprehensive digital prosthetic line, in combi
nation with Dentsply Sirona equipment and materials,
all under one roof. We believe that providing tools of
this quality strengthens the brand and contributes to
customer trust.”
What can clinicians and laboratories gain from
adopting the digital workflow? Kario emphasised:
“Digital workflows address procedural challenges that
impact clinical efficiency, may improve profit potential
and drive actual practice growth.”
To learn more, visit www.mis-implants.com/products/
digital-workflow.
CAD/CAM
1 2024
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[18] =>
| industry news
1
Fig. 1: The expanded Virtuo Vivo workflow can be connected to all ClearCorrect workflows. (All images: © ClearCorrect)
ClearCorrect launches
new digital solutions globally
ClearCorrect
ClearCorrect recently unveiled a new suite of products
and features aimed at supporting clinicians in their pro
vision of orthodontic care and in their practice efficiency.
This launch includes improvements to the ClearCorrect
digital workflow, helping dentists to advance their digital
orthodontic treatment. Upgrades to the Virtuo Vivo scanning
workflow and ClearCorrect Sync mobile app optimise
efficiency, streamlining record collection, case submission,
and case review and management. A new version of
ClearCorrect’s treatment planning tool, ClearPilot, has also
been released, offering enhanced features and improved
set-up control and accuracy.
Expanded Virtuo Vivo workflow
The expanded Virtuo Vivo workflow supports all ClearCorrect
workflows, including new aligner orders, new retainer orders
and case revisions, giving clinicians maximum flexibility and
empowering them to do their best work. Virtuo Vivo also now
offers a fast scanning feature for ClearCorrect cases.
The latest integrations of ClearCorrect with intra-oral
scanners, including the expanded Virtuo Vivo workflow,
make it easy for clinicians to delegate operational steps
in the intra-oral scanning process to their staff.
Fig. 2: ClearCorrect Sync mobile app. Fig. 3: ClearPilot 8.0 software experience.
2
3
[19] =>
4
5
6
Fig. 4: Florian Kirsch, head of the orthodontic business unit and Connected Customer Solutions at the Straumann Group. Fig. 5: ClearCorrect’s new practice
growth resources include designated kits and handy guides. Fig. 6: Dr Mostafa Altalibi, chief orthodontist at the Canadian dental practice Transforme Ortho.
ClearCorrect Sync 2.0
Practice growth offering
Clinicians can further simplify their workflows with the
latest version of the ClearCorrect Sync app, digitising
their operations for greater efficiency in practice man
agement. The app now has an expanded range of
features that enable clinicians to start, review and
manage cases easily:
ClearCorrect’s practice growth offering provides a
comprehensive suite of marketing, education and busi
ness resources to empower clinicians and their staff to
offer ClearCorrect with confidence and to grow their
practices. These resources include a patient marketing kit,
a patient conversion kit, and practice growth education
and guides.
– View all cases from the Doctor Portal.
– Receive notifications for cases that need attention.
– Access case details, such as shipment tracking.
– Access the Doctor Portal and ClearPilot directly in
the app.
ClearCorrect Sync 2.0 offers clinicians a seamless digital
end-to-end experience, streamlining the collection and
submission of records and the review and management
of cases.
ClearPilot 8.0
ClearPilot 8.0 gives clinicians greater control and an
improved user experience. The latest version of the
software empowers clinicians in their treatment planning
with advanced editing tools. Bite jump editing allows the
position of the jaw to be adjusted in order to more accu
rately visualise potential treatment outcomes when using
advanced techniques.
Tilt/cant positioning allows adjustment of the 3D model’s
position to more accurately reflect the jaw position
and match the patient’s facial lines. Multiple inter
proximal reduction editing applies and distributes
interproximal reduction values among several teeth
at once. The user interface of ClearPilot 8.0 has
also been improved with a keyboard shortcut guide,
enhanced visualisation and optimised utility for a better
user experience.
“This launch is about transforming smiles and lives.
I am excited to witness the positive impact that
ClearCorrect’s digital workflow and practice growth
offering will have on clinicians, their staff and their
patients,” said Florian Kirsch, head of the orthodontic
business unit and Connected Customer Solutions at
the Straumann Group.
The partnership that elevates
“As an orthodontist, ClearCorrect has been my trusted
ally in crafting countless smiles, each one a testament
to its power and reliability. Now, with the launch of the
new software, I cannot wait for even more precision and
efficiency that it will bring to my treatments, enabling
me to do more, in less time and with less effort,” said
Dr Mostafa Altalibi, chief orthodontist at the Canadian
dental practice Transforme Ortho.
Created by dentists for dentists and aspiring to be the
world’s most customer-centric aligner brand, ClearCorrect
carefully listens to the needs of clinicians, swiftly responding
with solutions they need to reach their practice goals,
ultimately changing patients’ lives. With a foundation
clinicians can trust, along with comprehensive continuing
education options, ClearCorrect is proud to offer a part
nership that helps clinicians build a thriving practice.
ClearCorrect is committed to the empowerment of
clinicians, development of their staff and elevation of
their practices.
ClearCorrect is backed by the Straumann Group, which
encompasses brands with a history of over 70 years
of research and innovation. This support enables the
creation of cutting-edge products featuring advanced
technology and fully integrated digital workflows. These
products are complemented by outstanding service, support
and educational offerings. All of this had established
ClearCorrect as the partner in clinical excellence.
To date, the company has supported partners across
more than 60 countries and transformed over a million
smiles. Together with clinicians, ClearCorrect looks
forward to creating healthier, more confident smiles
around the world.
CAD/CAM
1 2024
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| trends & applications
Personal Oral Protocol concept
Eric Berger, France
1
2
Fig. 1: Case example in Smile Designer Pro (Tasty Tech). Fig. 2: Case example of digital photography expressed in CIELAB colour space values.
In the field of dental prosthetics, digital communication has
undergone a major revolution in recent years, transforming
how dental technicians interact with dentists, laboratories and
patients. Thanks to technological advancements and innovative
digital tools, digital communication in dental prosthetics has im
proved treatment efficiency and the accuracy and quality of the final
results. The Personal Oral Protocol (POP) in dental prosthetics
employs digital communication tools to personalise prosthetic
treatment based on the specific needs of each patient.
This article discusses the POP approach, describing its advantages,
the information required and the process, and explores the imme
diate future of digital communication and developmental trends
in the field of dental prosthetics. It is important to note that the
POP protocol may vary based on the specific needs of each patient.
sionals to create customised solutions for each individual,
taking into account his or her anatomical characteristics,
facial morphology and aesthetic preferences.
Improved patient experience
Digital communication has a positive impact on the overall
patient experience in dental prosthetics. CAD allows pa
tients to visualise their future smile and actively participate
in the aesthetic and functional choices for their prostheses.
This involvement strengthens patients’ confidence in the
treatment and increases their long-term satisfaction.
Advantages of the POP
Better aesthetics
The POP aims to create prostheses that perfectly harmonise with
the patient’s appearance and smile. By considering individual
facial features, tooth colour and other aesthetic elements, pros
theses made using the POP offer a more natural and aesthetic result.
Personalisation of treatment
The most obvious advantage of the POP is the personali
sation of prosthetic treatment. Each patient has unique
needs, aesthetic preferences and objectives regarding his
or her dental prostheses. The POP allows dental profes
Functional improvement
In addition to aesthetics, the POP takes into account the
masticatory and phonetic function of the patient. A customised
prosthesis provides better occlusion and articulation, improving
masticatory function and the patient’s quality of life.
3
4
Fig. 3: Beginning of layering according to the CIELAB colour space values. Fig. 4: Results after colorimetric analysis.
20 CAD/CAM
1 2024
[21] =>
trends & applications
5
8
6
|
7
9
Fig. 5: Plurality in the choice of intra-oral scanner. Fig. 6: Shade taking with a spectrophotometer using the Rayplicker Cobra (Borea) or VITA Easy-Shade V (VITA Zahnfabrik).
Fig. 7: Mandibular dynamics in Twim (Modjaw). Fig. 8: Synchronisation of 2D and 3D images. Fig. 9: Smile design in inLab CAD SW 22.0 (Dentsply Sirona).
Optimisation of the design process
The POP uses advanced digital tools such as CAD and
3D printing to facilitate the design and fabrication process
of prostheses. This ensures more precise results and
reduces manufacturing times.
Adaptability to changes
The POP allows for treatment adjustments based on changes
in the patient’s oral health. If adjustments are needed over
time, the personalised treatment facilitates modifying the
prostheses to meet the patient’s evolving needs.
Necessary information
Detailed prescription
A precise prescription must be provided by the dentist,
clearly describing the patient’s aesthetic expectations and
technical specifications for the prosthesis.
Accurate digital impressions
High-quality digital impressions of the patient’s oral cavity
must be taken to obtain an accurate model of the teeth
and gingivae.
10
Objective colour measurement
A spectrophotometer is used to objectively measure the
colour of the patient’s teeth. Unlike visual observation,
which can be subject to subjective interpretations, the
spectrophotometer provides precise quantitative data,
ensuring an accurate match between the colour of the
prosthesis and that of the patient’s natural teeth.
Comparison with reference samples
The spectrophotometer compares the measured colour
with reference samples, such as standardised shade
guides, to find the closest match to the patient’s natural
tooth colour. This ensures an accurate match with the
colour desired by the patient or prescribed by the dentist.
Intra-oral photographs
Detailed intra-oral photographs of the patient can be
useful for the dental technician to better understand the
morphology and colour of the patient’s teeth.
Smile line indications
The dentist can indicate the smile line, that is, the alignment
and desired position of the edges of the teeth when smiling.
11
Fig. 10: Mandibular dynamics in inLab CAD SW 22.0. Fig. 11: Complete prosthetic simulation.
CAD/CAM
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[22] =>
| trends & applications
and considering their specific wishes. This collaborative
approach gives patients a sense of control over their treatment
and confidence in their new smile.
12
13
Fig. 12: 2D, 3D and 4D imaging combined in DentalCAD 3.1 Rijeka (exocad).
Fig. 13: Face scan in exocad 3.1 Rijeka.
Occlusal dynamics data
Information on occlusion is essential for a prosthesis that
integrates perfectly with the teeth.
Materials and techniques
The dentist and dental technician should discuss the
materials and techniques to be used.
Use of 3D and 4D smile designers
Smile designers perform a comprehensive aesthetic analysis
of the patient’s face, taking into account facial shape, facial
features, lips, eye colour and other elements. This holistic
approach allows for the design of prostheses that perfectly
harmonise with the patient’s overall appearance.
Personalised design
Using CAD tools and 3D printing, smile designers can
create digital models of personalised prostheses based on
the patients’ aesthetic preferences. These models enable
visualisation of the final result before manufacturing, allowing
for adjustments if necessary.
Patient involvement
Smile designers actively involve patients in the design
process by consulting them on their aesthetic preferences
Patient’s smile simulations before treatment
Smile designers use advanced software to simulate the appear
ance of the smile after prosthetic treatment. These simulations
allow the patient to see the potential result before making a
definitive decision, thereby increasing treatment compliance.
Communication between the dentist
and dental technician
Smile designers act as mediators between the dentist and
dental technician, communicating essential information for
the prosthesis realisation. This effective communication
ensures that the patient’s aesthetic expectations are met.
Optimisation of function and aesthetics
Smile designers aim to balance masticatory function with
the aesthetics of the smile. They ensure that prostheses
are not only beautiful but also functional and comfortable
for the patient.
Chronological process
Precise data collection
The POP begins with the precise collection of patient data,
including digital dental impressions, intra-oral and extra-oral
photographs, and information about the patient’s aesthetic
preferences and specific needs. This digital data provides
a comprehensive basis for the design of the prosthesis.
In-depth case analysis
The digital data collected is thoroughly analysed by the
dental professionals. They use specially developed CAD soft
ware for the POP, allowing them to visualise the data in 3D
and gain a detailed understanding of the patient case.
Precise and personalised design
Using digital data and advanced digital tools, the dental
technician creates a customised prosthesis for the patient.
He or she can precisely adjust the shape, size, colour
and occlusion of the prosthesis based on the patient’s
individual characteristics and aesthetic preferences.
Simulation and patient validation
Once the initial design has been completed, a digital
simulation can be performed to show the patient what the
final result is expected to look like. This allows the patient
to validate the design and give approval before the physical
fabrication of the prosthesis.
14
Fig. 14: Use of augmented reality in the dental laboratory.
22 CAD/CAM
1 2024
Precise fabrication using 3D printing
The optimised digital data is used to guide the 3D-printing
process of the prosthesis. This technology allows for the
manufacture of prostheses with high precision, providing
a perfect fit and better aesthetics.
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trends & applications
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Follow-up and prosthesis adaptability
Digital data is also useful for patient follow-up and prosthesis
adaptability over time. If adjustments are necessary, digital
data allows the dental professional to quickly make the
required modifications.
Patient data back-up
The POP allows for the back-up of the patient’s digital data,
making it easier to create replacement prostheses if
needed. The data can be used as a reference for future
prosthetic interventions.
The immediate future:
Collaborative telecommunication—POP 2.0
Digital communication facilitates collaboration between
dental technicians, dentists and laboratories. Digital files of
prostheses can be instantly shared via secure platforms,
allowing the different actors involved in the process to work
synchronously and efficiently, even if they are geographically
distant.
Developmental trends
Real-time communication
Collaborative telecommunication enables real-time ex
change, meaning participants can communicate instantly
through messaging or voice or video calls. This realtime communication fosters quick problem-solving and
informed decision-making, leading to better coordination in planning and executing prosthetic treatments.
Asynchronous communication
In addition to real-time communication, collaborative tele
communication facilitates asynchronous communication.
This allows users to share information and collaborate at
their own pace.
File and document sharing
Collaborative telecommunication tools allow for easy
sharing of files and other digital resources. This enables
members to work together on projects, review documents
and access relevant information.
Online collaboration tools
Collaborative telecommunication often includes online
collaboration tools, such as project management plat
forms, virtual whiteboards and shared storage spaces,
which facilitate activity coordination and information
visualisation.
Multiplatform accessibility
Collaborative telecommunication solutions are generally
accessible on various platforms, including desktop
computers, mobile devices and tablets, allowing users to
collaborate anytime and anywhere.
15
16
Fig. 15: Final CIELAB colour space check of a prosthesis. Fig. 16: Satisfied patient,
the result of good collaboration between the laboratory and dental office
(Drs Christian Moussally and Ty Vallée).
Security and privacy
Collaborative telecommunication prioritises the security
and confidentiality of data exchanged between users.
Security measures are often put in place to protect sensitive
information.
Summary
In summary, the POP optimises the employment of digital
data in dental prosthetics, allowing for precise data collec
tion, personalised and accurate design, patient validation,
high-quality 3D-printing-based fabrication, and long-term
follow-up and prosthesis adaptability. By closely collaborat
ing and providing comprehensive information, the dentist
and dental technician can improve the quality, efficiency and
overall satisfaction of prosthetic treatments for patients.
about
Eric Berger is a dental technician
who graduated from the Institut
Supérieur National de l’Artisanat in Metz
in France and is recognised as a master
dental prosthetist. After completing his
education, he pursued further training
and specialisation in Germany before
establishing his own laboratory, which
has since evolved into a VITA Master Lab.
At his laboratory, he and his team specialise in various aspects
of prosthesis creation. They emphasise close collaboration
between dentists and prosthetists as a key factor in achieving
exceptional quality. The laboratory’s expertise in dental
ceramics, including metal–ceramic and CAD techniques,
has led to the development of unique ceramic materials.
Since 2006, Berger has served as a trainer for what is now
Dentsply Sirona and was the first in France to test and approve
its Sirona Connect system. His commitment to excellence and
continuous innovation has established him as a respected figure
in the field of dental technology. Throughout his career, Berger
has been dedicated to upholding high standards of quality in
denture craftsmanship. He can be contacted at dtbfrance@aol.com.
CAD/CAM
1 2024
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| interview
CAD/CAM NobelProcera abutments
demonstrate excellent prosthetic
survival and low complication rates
An interview with Dr Ian Lane
Nobel Biocare
Dr Ian Lane has more than 20 years of
experience as a clinician at Queensway
Dental Clinic in the UK under his belt.
In this interview, he outlines the promising
results at up to 6.4 years of follow-up
of a retrospective, multicentre clinical
study of Nobel Biocare’s individualised
NobelProcera abutments with four
different designs.1
Dr Lane, would you please tell us
a bit about yourself and your Dr Ian Lane.
professional background?
I qualified with an honours degree from Newcastle
University in Newcastle upon Tyne in the UK in 1998.
In 2001, I was awarded the Membership of the Faculty of
General Dental Practice (UK) qualification, and this was
followed by the diploma in conscious sedation in 2002
from Newcastle University. I developed an interest in
implant and reconstructive dentistry and have been very
active in postgraduate education in this field since attending
a Nobel Biocare implant introductory course in 2002.
Since 2006, I have been a partner at Queensway Dental
1a
Clinic and responsible for ensuring
that high standards of dental care are
provided for all National Health Service
and private patients. I have been involved
in some university research projects
in implant treatment and conscious
sedation.
What was the aim of this study?
This was a multicentre retrospective
study looking at the complication rates
for customised prosthetic abutments using
real-world data from four centres in Italy,
Germany, the Netherlands and the UK.
Why is a fully screw-retained solution important?
Is there any indication for potential long-term
outcomes?
As a clinician, it is really important to try and have a fully
screw-retained solution in nearly all cases. In our practice, the NobelProcera angulated screw channel (ASC)
abutment is something that we have used for a long time.
Alongside our clinical observations, we have a laboratory
1b
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1 2024
[25] =>
interview
1c
|
1d
Figs. 1a–d: NobelProcera abutment designs in the study. NobelProcera full-contour/cutback zirconia implant crown (n = 105; a). NobelProcera customised zirconia
angulated screw channel abutment (n = 117; b). NobelProcera customised zirconia abutment (n = 146; c). NobelProcera customised titanium abutment (n = 95; d).
that beta-tested this abutment in 2014. Since then, we
have routinely used it in our restoration for many implant
cases. In fact, in the last five years, the laboratory
delivered over 2,000 single-unit ASC abutments to
internal clinicians and external clients.
It is a very stable and well-tested solution for us. In our
study, we’ve investigated over 460 abutments across
a wide range of implant types, all from Nobel Biocare, and
a wide range of abutment types as well: NobelProcera ASC,
titanium, zirconia, full-contour (Figs. 1a–d & 2a–h).
What are the study’s conclusions?
The conclusions really match with the very low complication rates that we’ve found in our own clinical practice.
There was a 98% prosthetic survival rate and only
nine failures. In clinical practice, we have also audited
nearly 1,300 ASC abutments and found very similar low
complication rates. Finally, patient and clinician satisfaction is high at 96% and 98%, respectively. In summary,
industrially manufactured individualised abutments offer
excellent prosthetic stability and retrievability and
2a
2e
2b
Results of the study
98.1% prosthetic survival rate after up to 6.4-year follow-up
96.5% of the patients and 98.3% of the clinicians
were satisfied with the restoration
1.5% technical complications, which were repaired
intra-orally or after temporary removal
a low rate of complications, providing great patient and
clinician satisfaction.
Reference
1. Fabbri G, Staas T, Lane I, Pitino A, Fossati E, Aghasadeh A, Kübler F. Factors
associated with prosthetic complications with individualized abutments: real-world
data. Clin Oral Implants Res. 2022 Sep [cited 10 Jun 2024];33(S24):66–7.
Available from: https://www.for.org/en/learn/scientific-poster/factors-associatedprosthetic-complications-individualized-abutments-real-world-data
2c
2f
2d
2g
2h
Figs. 2a–h: Demonstration of the study results through the case of a non-smoking 34-year-old female patient with a missing maxillary central incisor.
Radiograph (a) and clinical view at insertion of a narrow-platform 15 mm NobelActive implant (b). Immediate temporary crown (c) and intra-oral view 32 weeks
post-op (d). Healing abutment (e) and the resulting contoured tissue at 12 weeks post-op (f). Radiograph (g) and clinical view at the seven-year follow-up (h).
CAD/CAM
1 2024
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| case report
Digital workflow of immediate
implantation and immediate
restoration in the aesthetic zone
Drs Gang Chen & Jingyi Zhang, China
1
2
3
4
Figs. 1 & 2: Initial situation. Maxillary left incisor discoloured and displaced to the midline. Soft-tissue defect in the distal area of the tooth. Fig. 3: Radiographic status at implantation site. Tooth after failed root canal therapy showing external apical root resorption. Small but intact buccal plate of > 1 mm.
Fig. 4: CBCT scan with a fiducial clip for navigated surgery.
I found my way to digital dentistry as a result of dissatisfaction and the desire to improve. As an experienced oral surgeon, I usually inserted implants freehand and considered this approach to be convenient
and fast for a long time. However, implant position
mistakes occurred occasionally when solely relying on
experience and sometimes not taking the adequate
time for thorough analysis and planning. These nega-
5
6
Figs. 5 & 6: Preparation of the digital model. The data captured at the implant site was erased to prepare for rapid capture of the implant position during the surgery.
26 CAD/CAM
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[27] =>
case report
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tive experiences at times resulted in untreatable aesthetic complications as well as a few sleepless nights. At
the beginning, the restorative process was dominated
by time-consuming chairside fabrication of provisional
restorations, and there was a high risk of contamination
of the surgical site.
I learned that these major shortcomings can be overcome when adopting a reasonable digital workflow and
soon started utilising a CAD/CAM-fabricated surgical
guide as a first step into digitalisation. This was followed
by the preoperative fabrication of provisional restorations.
As I gained experience in digital methods, I tried to inte
grate all digital methods into my portfolio of problem
solvers in order to find suitable treatment options for different clinical situations and patient demands.
The following case report could have been finished in
different ways, choosing other digital methods. I choose
this workflow for several reasons:
1. An intra-oral scanner and CBCT device can acquire
digital data directly.
2.
Dynamic navigation is an efficient and time-saving
method for guided surgery.
3.
Digital design and production of immediate restorations after implant insertion is more accurate than
a surgical guide, as with a guide small deviations from
the planned implant position may cause major diffi
culties in placing the prefabricated restoration.
8
11
7
Fig. 7: Planning for implantation via dynamic navigation. A CONELOG
SCREW-LINE implant with integrated platform switching was to be placed
immediately, slightly below bone level.
4. D
igital duplication of the transitional emergence profile
is very predictable for the final abutment and crown.
Clinical case
A 38-year-old male patient presented to our dental clinic seeking therapy for a discoloured central inci
sor which, according to the patient, had increasingly
been moving mesially since a trauma 20 years before.
The displacement of the tooth towards the midline of
the upper jaw had led to closure of an originally existing
diastema and caused loss of papilla distal to the central
incisor (Figs. 1 & 2). The CBCT scan showed that the tooth
9
10
12
Fig. 8: Occlusal view after careful tooth extraction. Fig. 9: Occlusal view after immediate implant placement (the insertion post was still in place). Compared with
the position of the tooth, the implant was placed in a little more palatal position and in a more distal position to correct the displacement of the tooth after trauma.
Fig. 10: Preparation for the intra-oral scan just after implant placement. With the CONELOG scan body, only the position of the implant needed to be captured (as the
scan of the complete intra-oral situation had been performed prior to surgery). Fig. 11: A xenograft was used to fill the gap between the implant and the buccal wall.
Fig. 12: A healing abutment was placed temporarily to avoid collapse of the soft tissue during the production process of the provisional restoration (about 30 minutes).
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15
16
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case report
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Fig. 13: The digital model imported into 3Shape Dental Manager. Fig. 14:
Matching of the CONELOG scan body. Figs. 15 & 16: Selecting a titanium
base with a 2 mm gingival height for model-free design. Fig. 17: Emergence
profile design. Figs. 18 & 19: The provisional restoration. Symmetry was
established between the central incisors. Fig. 20: The crown was fabricated
and bonded to the titanium base.
had undergone endodontic treatment in the past and
suffered external apical root resorption. The buccal wall
appeared to be small in width (> 1 mm) but intact (Fig. 3).
Based on the clinical symptoms of increased mobility of
the tooth, the radiographic findings of a failed endodontic treatment and the patient’s willingness to have the
aesthetic anterior area restored, it was decided to extract the hopeless tooth and replace it with an implant.
The prerequisites were promising. Enough bone volume
apically if additional stability was needed through apical
anchoring, an intact buccal wall and a thick gingival biotype supported immediate placement as our first choice.
Combined with an immediate provisional restoration, this
would help us to maintain the soft-tissue contour in the
aesthetic zone. The patient was informed about the risks,
the cost and alternatives of the planned procedure and
gave written consent.
Preparation before surgery
Implant selection was made based on the need for integrated platform switching and proven effectiveness in preserving marginal bone level. I defined the exact 3D position
of the chosen implant, and the data acquisition was
initiated to prepare for dynamic navigation. Compared
with working with a surgical guide—and its fabrication
21
Figs. 21 & 22: Provisional restoration in place. Note the preservation of soft tissue.
leading to additional cost and delay in the treatment
process—dynamic navigation is for us a more effective
way to plan and perform surgery in the same clinical visit.
A CBCT scan with a fiducial clip was taken for navigation surgery (Fig. 4). A digital model was prepared on the
basis of an intra-oral scan before surgery. At the implant site, data was erased to enable for rapid capture of
the implant position during the surgery (Figs. 5 & 6).
The 3D position of the CONELOG SCREW-LINE implant
(CAMLOG) was carefully designed in dynamic navigation
software before surgery (Fig. 7).
Day of surgery
The hopeless tooth was carefully extracted atraumatically
(Fig. 8). Immediately after the extraction, a CONELOG
SCREW-LINE implant of 3.8 mm in diameter and 13.0 mm
in length was placed, guided by the navigation system
(Fig. 9).
Before simultaneous augmentation with biomaterial, the
CONELOG scan body (3.8 mm) was placed to capture
23
25
22
24
26
Figs. 23 & 24: The CBCT scan scan after immediate implantation and restoration confirmed that the 3D position of the implant was as planned.
Figs. 25 & 26: Labial and occlusal views after three months. Note the symmetry of the gingival contour.
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27
28
29
31
30
32
Fig. 27: Geometry from contralateral incisor as basis for design of the situation to be restored. Fig. 28: Position of the implant and coping.
Figs. 29 & 30: To close the diastema, the contralateral incisor was to be restored with a veneer and the implant-borne restoration enlarged in the mesiodistal
direction. Figs. 31 & 32: Design of the CONELOG CAD/CAM titanium-based customised final abutment.
the position of the implant quickly. As the whole arch
and relation to the opposite jaw had been scanned
before, it took us only a few seconds to finalise the total
scan by just scanning the implant site (Fig. 10).
A xenograft (Geistlich Bio-Oss, Geistlich Pharma) was
used to fill the gap between the implant and the buccal
wall, and a healing abutment was placed temporarily
while waiting for the provisional restoration to be finalised
(Figs. 11 & 12).
In the laboratory
The data from both the preoperative and intra-operative
scans was matched and sent to the dental laboratory,
where a full-contour screw-retained provisional restoration was prepared model-free.
30 CAD/CAM
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The provisional restoration was designed in the software
step by step:
1) the digital model was imported into 3Shape Dental
Manager (3Shape; Fig. 13);
2) the CONELOG scan body was matched with the model (Fig. 14);
3) the CONELOG CAD/CAM titanium base with a gingival height of 2 mm was selected for model-free design
(Figs. 15 & 16);
4) the emergence profile was designed with a concave
contour at the subcritical area, supporting the existing gingival margin at the critical area (Fig. 17) and the
contour of the provisional restoration mirroring that of
the contralateral incisor (Figs. 18 & 19);
5) the screw-retained full-contour crown was fabricated
and bonded to the titanium base (Fig. 20).
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“By using digital methods
reasonably, mistakes can
effectively be avoided.”
After surgery
Approximately 30 minutes after surgery, the healing
abutment—which was intended to prevent collapse of the
soft tissue—was removed and the provisional crown was
fixed in the patient’s mouth (Figs. 21 & 22). A CBCT scan
captured after immediate implantation and restoration
confirmed that the implant had been placed correctly
in the planned 3D position (Figs. 23 & 24).
33
34
Fabrication of final crown
Three months after surgery, the labial gingival contour
of both central incisors was symmetrical (Figs. 25 & 26).
The patient wanted the diastema to be closed with the
final restoration. As the provisional restoration had preserved the soft-tissue contour, we considered it unnecessary to recapture the implant position and emergence
profile. We used the immediate implant scan and provisional restoration design, adopting the data, to design the
final restoration accordingly (Figs. 27 & 28).
Figs. 33 & 34: The final abutment in place and preparation for the veneer.
Figs. 35: Labial view of the restorations in place. Note the symmetry of the
two incisors. Figs. 36: Radiographic view after three months. Note the perfect
integration of the CONELOG implant and bone growing over the implant shoulder.
It proves that the perfect design of the outer geometry and connection and
the availability of comprehensive digital workflow components are crucial for the
final results of an immediate placement protocol in the aesthetic zone.
To close the diastema and to minimise the lack of soft tissue, we marginally increased the mesiodistal dimensions
of both the restoration on the implant and the contralateral
central incisor. To increase the gingival volume, a veneer
was planned for the other central incisor (Figs. 29 & 30).
the path we use to treat our patients in comparison with
several years ago. With that in mind, I hope I can take you on
the journey and share the positive impact this development
can have on more complicated cases in the near future.
A titanium base-supported customised final abutment
was created to maintain the emergence profile, and the
crown and automatic cut-back were designed to accommodate the zirconia mesostructure (Figs. 31 & 32). The
customised abutment was placed and the mesial area
of the right central incisor prepared, based on a silicone
impression (Figs. 33 & 34). The final implant-borne restoration and the veneer on the right central incisor were
placed (Figs. 35 & 36).
Conclusion
Experience is important but not always reliable. By using
digital methods reasonably, mistakes can effectively be
avoided. It is not always about the digital equipment you
own; it is about thinking differently, assessing a challenge
from an alternate angle. It is the desire to start digitalising
your workflow, step by step, perhaps starting with one small
step at the beginning but with the mindset of doing more.
In this manner, I am convinced you will explore the digital
world and find it more and more beneficial.
Although the case presented can be classified as a routine
example of our daily work, we have significantly changed
35
36
Editorial note: This article was first published in digital—
international magazine of digital dentistry, Vol. 3, Issue 1/2022.
about
Dr Gang Chen is the director of
U-dental implant centre and U-dental
implant training centre in Shenzhen
in China. He received his PhD in oral
and maxillofacial surgery from Peking
University in China and since then has
focused on restoring implant cases
efficiently using digital techniques.
He has been a visiting dentist at Implant
and Prosthetic Department of Tuebingen University in Germany and
Okayama University’s dental school in Japan and holds certification
in implantology from the European Association for Osseointegration.
Dr Chen spends almost half of his time giving training and
lectures on how to perform digital dentistry and aesthetic
treatments on international level.
Dr Jingyi Zhang is a renowned implantologist from China.
She advocates for science-based education through her numerous
publications and presentations at national conferences.
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Bimaxillary prosthetic reconstruction
with implant-supported overdentures
using novel materials and digital technology
Dr Said Sánchez, Mexico
1
2
3
4
5
6
Figs. 1–3: Baseline situation, extra-oral aspect. Figs. 4–6: Baseline situation, intra-oral view.
Introduction
The prosthetic rehabilitation of the fully edentulous patient with implant-supported overdentures has many
7
Fig. 7: Baseline situation, panoramic aspect obtained by CBCT.
32 CAD/CAM
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advantages in comparison with conventional tissuesupported dentures in terms of retention, stability and
masticatory efficiency, resulting in high patient satis
faction. Nevertheless, a proper diagnosis identifying
the aetiology of edentulism, appropriate treatment planning according to the patient’s profile, and the incorporation of novel technologies and materials in combination with evidence-based concepts are critical for
obtaining highly successful results for the benefit of our
patients.
This clinical report describes the surgical and prosthetic
management in the rehabilitation of a fully edentulous patient, using narrow-diameter Roxolid implants (Straumann),
allowing us to exploit the alveolar bone available and
thereby avoid augmentation procedures. We applied
the Novaloc retention system (Straumann) to restore the
edentulous mandible in combination with advanced digital technology. Together, this allowed us to perform accurate full-mouth implant restorations with highly aesthetic
and functional results.
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8
9
|
10
Fig. 8: Transitional complete dentures, extra-oral frontal view. Fig. 9: Transitional complete dentures, extra-oral three-quarter view showing the adequate lip
support provided by the buccal flange of the denture. Fig. 10: CBCT panoramic view showing gutta-percha points in the sites of interest.
Clinical case
Initial situation
A 65-year-old female patient with a medical history of
Type 2 diabetes controlled with medication presented to
the clinic with severe aesthetic and functional problems
due to complete edentulism as a result of generalised
Stage IV periodontitis (Figs. 1–3).
revealed alveolar ridge deficiency attributed to extraction
of the remaining teeth several months before (Figs. 4–7).
Her chief complaint concerned impaired mastication of
all types of food and a compromised aesthetic appearance. Clinical examination and CBCT digital analysis
Treatment planning
Based on the initial intra-oral and extra-oral clinical assessment, CBCT digital analysis, the patient’s functional
and aesthetic requirements, and financial aspects, a definitive treatment plan was created. The proposed treatment plan was the prosthetic reconstruction of both the
maxilla and mandible with prostheses that the patient
would be able to remove and easily maintain and that
would simultaneously fulfil the high functional and aes-
11
12
13
14
Fig. 11: Maxillary implant surgery. Occlusal view of the alveolar ridge before implant placement. Fig. 12: Maxillary implant surgery. Occlusal view of the implants
placed, one in the position of the right central incisor, two in the positions of the right and left canines, and two in the positions of the second premolar sites.
Fig. 13: Mandibular implant surgery. Frontal view of the four implants placed. Fig. 14: Mandibular implant surgery. Occlusal view of the four implants placed.
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15
16
17
18
19
20
22
21
Fig. 15: Panoramic radiograph after the eight-week post-op healing period. Fig. 16: Occlusal view of the five uncovered maxillary implants. Fig. 17: Occlusal
view of the four uncovered mandibular implants. Fig. 18: 3D digitisation of the patient’s face in the natural head position with maxillary and mandibular
baseplates and wax rims with the correct intermaxillary parameters. Fig. 19: Facial data integrated into the virtual articulator with final virtual design of the
restorations. Fig. 20: Facial data integrated into the virtual articulator with final virtual design of the maxillary restoration. Fig. 21: Facial data integrated into
the virtual articulator with final virtual design of the maxillary restoration. Fig. 22: Facial data integrated into the virtual articulator with final virtual design of
the maxillary and mandibular restorations.
34 CAD/CAM
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23
|
24
Figs. 23–25: Virtual design of the maxillary telescopic crowns.
thetic expectations. Therefore, an implant-supported
fixed/detachable maxillary overdenture with a palate-less
design and an implant-supported overdenture employing the Novaloc system were selected as definitive restorations.
The fabrication of transitional acrylic complete dentures
(Figs. 8 & 9) with customised teeth and the proposed
functional and aesthetic parameters was carried out in
order to set the final tooth position before implant placement. This restoration-driven concept aims to optimise
implant planning and placement according to the desired prosthetic reconstruction. The transitional dentures
were duplicated in clear radiographic guides with guttapercha points. These were placed in the potential areas
of interest and served as surgical templates as well
(Fig. 10).
Surgical procedure
After local anaesthesia, a crestal incision in the maxilla
was performed slightly palatally in order to preserve the
attached gingiva, and a full-thickness flap was raised with
26
25
the purpose of reducing the alveolar ridge to create an
adequate platform, assuring the vertical space required
for the definitive prostheses (Fig. 11). After the osteotomy, five implants (four Straumann Bone Level Tapered,
Roxolid SLActive; diameter: 3.3 mm; length: 12.0 mm; and
one Straumann Bone Level Tapered, Roxolid SLActive;
diameter: 4.1 mm; length: 8.0 mm) were placed in a
straight position well distributed across the arch (Fig. 12).
27
Fig. 26: Polished maxillary telescopic zirconia crowns cemented on to Variobase abutments (Straumann). Fig. 27: Secondary friction elements milled in PEEK
material, ultimately cemented on to the final denture base structure.
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28
29
30
31
32
33
34
35
Figs. 28–31: Final virtual design in the CAD software of the maxillary overdenture before the CAM procedure. Fig. 32: Maxillary overdenture base material
milled in reinforced PEEK. The customised ceramic denture teeth were milled in lithium disilicate glass ceramic and finally were bonded to the reinforced denture
base structure. Fig. 33: Final characterisation with pink veneering composite. Figs. 34 & 35: Final telescopic maxillary complete overdenture customised with
pink veneering composite.
36 CAD/CAM
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case report
36
|
37
Fig. 36: Intra-oral occlusal view of the five telescopic abutments screwed in and torqued to 35 Ncm. Fig. 37: Intra-oral occlusal view of the maxillary implant
overdenture incorporated.
The primary wound closure was performed with a modified continuous sling suture using non-resorbable PTFE
monofilament suture material.
After four weeks, in the second implant surgery, four
narrow-diameter implants (Straumann Bone Level Tapered,
Roxolid SLActive; diameter: 3.3 mm; length: 10.0 mm)
were placed in a straight position in the mandible in inter-
foraminal distribution (canine and second pre
molar),
avoiding important anatomical structures in the molar
sites and the severely reabsorbed anterior mandible
(Figs. 13 & 14).
The implants were left with closure screws for twophase submucosal healing (Fig. 15), and a conventional
loading protocol was selected for both the maxilla and
the mandible according to the International Team for
Implantology consensus statement on loading protocols for implant-supported overdentures in edentulous
jaws.
After eight weeks of healing, a second surgery was
performed to uncover the implants and place healing abutments to preserve the attached gingiva
(Figs. 16 & 17).
38
39
40
Figs. 38 & 39: Novaloc abutments (Straumann) presented in the model with artificial soft tissue showing the correct abutment gingival height. Fig. 40: Novaloc retention system.
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41
42
43
44
Fig. 41: Intra-oral occlusal view of Novaloc abutments screwed in and torqued to 35 Ncm. Fig. 42: Intra-oral direct pick-up procedure. Titanium matrix housings
in situ. Fig. 43: Intra-oral direct pick-up procedure. Block-out rings placed over the abutments to prevent excess dual-polymerising resin processing material
below the matrix housings. Fig. 44: Intra-oral direct pick-up procedure. After adequate passive seating of the definitive prosthesis had been checked, the final
pick-up was performed with finger pressure using dual-polymerising self-adhesive resin material.
Prosthetic procedure
The first step was to accurately transfer the implant 3D
position to the laboratory through conventional impressions with the open-tray technique using polyvinylsiloxane and customised trays. Cast models with implant analogues were obtained, scanned and digitised. From this
point, a completely digital workflow for the production
of the definitive restorations was employed. Posteriorly,
the craniomandibular jaw relation was registered using
a specific system (PlaneSystem by Udo Plaster, Zirkon-
zahn), which is based on the patient’s natural head position and the ala-tragal line allowing an accurate transfer
of this information to the physical and virtual articulator.
45
46
Eventually, the patient’s facial 3D recording was taken
using an optical face scanner with a bite plate for image
merging and 3D patient analysis (Fig. 18). The application
of a 3D face scanner is an important tool that provides the
clinician and laboratory with valuable patient information
and better communication with the patient.
Figs. 45 & 46: Final intra-oral aspect of the bimaxillary implant rehabilitation after six months.
38 CAD/CAM
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47
48
49
|
50
Figs. 47–50: Final extra-oral view. A very pleasant and natural smile was achieved with the implant-supported prosthesis.
After data acquisition (with a laboratory scanner) and
merging in the CAD software, the digital design process
of the definitive restorations was initiated. The CAD software allows full control of the prosthesis with 3D data
of the aesthetic and functional parameters, verifying occlusal contacts and excursive movements in the virtual
articulator (Figs. 19–22).
The intra-oral pick-up process of the abutments was performed using dual-polymerising self-adhesive pink composite (Figs. 41–44). Subsequently, finishing and polishing
were done, and PEEK Novaloc retention inserts with light
retention force (white colour) were placed.
For the maxillary arch, five monolithic zirconia telescopic
crowns were designed and milled according to the previous digital set-up (Figs. 23–27) and cemented on to
Straumann Variobase abutments (four Narrow CrossFit;
diameter: 3.8 mm; height: 3.5 mm; gingiva height: 1.0 mm;
and one Regular CrossFit; diameter: 4.5 mm; height: 3.5 mm;
gingiva height: 1.0 mm). The definitive prosthesis consisted
of an overdenture CAD/CAM base material milled in ceramic-
reinforced PEEK with anatomical reduction to receive
customised monolithic ceramic denture teeth (Figs. 28–31).
Lastly, indirect pink veneering composite was used to
reproduce the gingival anatomy (Figs. 32–35). The telescopic crowns were screwed on and torqued to 35 Ncm,
the access holes were blocked with PTFE and the definitive
prosthesis was incorporated (Figs. 36 & 37).
Final intra-oral and extra-oral views six months postoperatively illustrated the very pleasant and natural result
achieved (Figs. 45–50). The patient was very satisfied with
the aesthetic outcome and, more importantly, the functional outcome and reported her ability to chew different
types of food, describing it as a life-changing experience.
The fabrication of the definitive restoration for the mandible included a milled implant-supported overdenture in
pink PMMA denture base material with CAD/CAM polymer
denture teeth customised with layering composite. Four
straight Straumann Narrow CrossFit Novaloc abutments
(diameter: 3.8 mm; height: 3.0 mm) were selected as the
retention system for definitive prosthesis (Figs. 38–40).
These abutments have the advantage of requiring minimal vertical prosthetic space, have high patient satisfaction owing to excellent and long-lasting retention
properties, and have significantly higher wear resistance
in comparison with other stud-type attachments.
Treatment outcomes
Editorial note: This article was first published in digital—
international magazine of digital dentistry, Vol. 2, Issue
1/2021.
about
Dr Said Sánchez is a dentist
specialised in prosthodontics and oral
implantology. His areas of focus are
implant dentistry, aesthetic dentistry,
digital technology and adhesive oral
rehabilitation. He is a lecturer in the
postgraduate department of
prosthodontics and implant dentistry of
the University of De La Salle Bajío in
León in Mexico and is in private practice limited to prosthodontics
and implant dentistry in León. He is a fellow of the
International Team for Implantology (ITI), joint director of the
ITI study club in León, an ITI speaker, and communications officer
of the ITI Mexican, Central America and Caribbean section.
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| case report
Monolithic multilayer zirconia crowns
in the aesthetic zone
Dr Wissam Dirawi, Sweden
1
2
3
4
Fig. 1: Initial situation, facial view. Fig. 2: Initial situation, occlusal view of the maxilla. Fig. 3: Initial situation, occlusal view of the mandible. Fig. 4: Chairside-
produced temporary bridge in the patient’s mouth.
Introduction
During the last decade, zirconia has increasingly become
established as the material of choice in prosthodontics.
5
Its excellent mechanical and inert properties are the
main reason for this trend. Since the introduction of
multilayered zirconia blanks more than ten years ago,
the material’s optical properties have been improved
6
Fig. 5: Printed model with gingival mask. Fig. 6: Printed model with splinted PMMA crowns.
40 CAD/CAM
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case report
|
7
Fig. 7: Laboratory-made temporary restorations.
“During the last decade,
zirconia has increasingly
become established
as the material of choice
in prosthodontics.”
8
dramatically. The multilayered zirconia used nowadays
(e.g. KATANA Zirconia YML, Kuraray Noritake Dental)
offers well-balanced mechanical properties, trans
lucency and colour. It allows dental technicians all over
the world to produce aesthetic full-contour restorations
that only require staining.
9
Even in the anterior region, stained monolithic restorations may be an option. Factors such as the age of
the patient, the internal colour structure of the adjacent
dentition, the number of teeth to be restored (one versus four or all six maxillary anterior teeth), the aesthetic
demands of the patient and financial aspects should
be taken into account in the material selection process.
In the case described in this article, full-contour zirconia
was selected for several reasons.
Fig. 8: Long-term temporary restorations in place, lateral view from the right.
Fig. 9: Long-term temporary restorations in place, frontal view. Fig. 10: Long-term
temporary restorations in place, lateral view from the left.
10
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11
Fig. 11: Final restorations on the model.
Background
Material selection
The 71-year-old female patient presented in the clinic
owing to aesthetic concerns in the maxillary anterior
region. Her oral hygiene was good, and she was a
non-smoker. Infraposition of the existing implant-based
crown (Brånemark regular platform, Nobel Biocare)
in the position of the right central incisor was evident.
Moreover, gingival retraction was observed on the
maxillary right lateral incisor, and the left lateral incisor
(tooth #22) had a major composite filling with discoloration (Figs. 1–3). The patient expressed the desire to
have the gingival margin differences adjusted and the
four maxillary incisors restored with ceramic crowns
for optimal aesthetics.
Owing to the decision to restore all four anterior incisors,
monolithic zirconia was deemed a suitable material
option. It would allow the team to obtain the desired
results within the financial requirements. In order to meet
the aesthetic demands of the patient, provide for the
required mechanical properties and allow for proper
masking of the underlying structures, KATANA Zirconia YML
was selected. It offers colour, translucency and
flexural strength gradation throughout the multilayered
blank.
Treatment procedure:
From preparation to temporisation
In order to design the indirect restorations, a digital
impression was taken with an intra-oral scanner, and
the data was transferred to the dental laboratory
(Teknodont, Sweden). The laboratory created a digital
wax-up. After the patient’s approval, a matrix was produced and sent to the clinic. The old restorations were
removed and the three maxillary incisors (all but the
one replaced by an implant) prepared for complete
crowns. A healing abutment was placed on the implant and a temporary bridge produced chairside
from Protemp 4 temporisation material (3M ESPE)
in Shade A3 using the matrix (Fig. 4). Subsequently,
a gingivectomy was carried out with a ceramic bur
12
Fig. 12: Intra-oral situation prior to restoration placement.
42 CAD/CAM
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case report
13
14
|
15
Fig. 13: Immediate treatment outcome, facial view. Fig. 14: Immediate treatment outcome, frontal view. Fig. 15: Immediate treatment outcome, occlusal view.
(KT.314.016 CeraTip, Komet) at the buccal aspect of
teeth #21 and 22.
After the patient’s approval of the aesthetics, phonetics
and function of the temporary restoration, the situation was captured with an intra-oral scanner again.
This allowed the team to duplicate the shape of the
restoration. Based on the data acquired, two pairs of
splinted temporary crowns were milled from PMMA
(HUGE Multilayer PMMA, HUGE Dental) in Shade A3 in
the laboratory (Figs. 5–7). They were placed to allow
the patient to further evaluate the appearance and
function for several weeks (Figs. 8–10). The patient was
happy with the phonetics, function and appearance of
the crowns, noting only that they were slightly too bright
in comparison with the adjacent teeth, and she approved the shape for the production of the permanent
restorations.
Final restoration:
Production and cementation
Based on the data set of the temporary restorations,
four separate crowns—one for the implant and three
for the teeth—were designed in full contour. Without
any anatomical reduction, the restorations were milled
from K ATANA Zirconia YML. Based on the evaluation
of the temporary restorations, the shade selected this
time was Shade A3.5. CERABIEN ZR FC Paste Stain
(Kuraray N
oritake Dental) was used for external
staining and glazing of the surface. The laboratory also
cemented the implant-based crown to the gold-shaded
titanium abutment (Elos Medtech) with PANAVIA V5
(Kuraray Noritake Dental) in the shade Opaque for
an improved masking effect (Fig. 11). In the office, the
abutment–crown was screwed on to the implant and
the screw access hole closed with composite, and the
three tooth-based crowns were then placed using
PANAVIA SA Cement Universal (Figs. 12–15).
Conclusion
Multilayered zirconia is a suitable material for many
clinical situations. Owing to the availability of highly
“The patient was happy
with the phonetics,
function and appearance
of the crowns [...].”
translucent multilayered blanks, it is now possible to
produce aesthetic outcomes even when using the
material monolithically, and this is true not only in the
posterior region but in the aesthetic zone in some
cases too. The present case demonstrated that very
good results and patient satisfaction can be obtained.
Moreover, as a result of the material’s outstanding
mechanical properties, these outcomes may be
expected to last for a long time.
about
Dr Wissam Dirawi is prosthodontist
and a senior adviser at the Swedish
dental care chain Aqua Dental.
He holds a DDS and obtained his
master’s degree in dentistry in 2000.
Having over two decades of experience
in the field, Dr Dirawi worked as a
general dentist in both public dental
care and private practice from
2000 to 2018. Additionally, he has contributed to education
and research, having worked as a part-time teacher and
researcher at the Faculty of Odontology of Malmö University
in Sweden from 2011 to 2018. In 2018, Dr Dirawi attained
the status of specialist in prosthodontics and assumed
the role of senior clinical adviser and lecturer,
sharing his expertise with his peers and students alike.
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| features
Back and neck pain in dentistry:
A new reality
An interview with Timothy Caruso specialist in
manual therapy, orthopaedics and ergonomics
Iveta Ramonaite, Dental Tribune International
to the shortening of one’s career or to
disability.
© Timothy Caruso
Timothy Caruso is a physical therapist with
over 30 years of experience, specialising in
manual therapy, orthopaedics and ergonomics.
In this interview with Dental Tribune International,
he offers insights into the common yet often
overlooked issue of cervical and lumbar pain
among dental professionals. He also addresses
the profound impact that chronic pain can have
on both the personal and professional lives of
dentists, potentially leading to career shortening
or even disability, and discusses some preventive measures that can be integrated into daily
practice without sacrificing work efficiency.
Why are strength and flexibility import
ant for dental professionals? Can you
recommend exercises or routines to
improve strength and flexibility?
Assuming a balanced posture and working
in this posture during the working day can
be a huge help, and so is getting a good,
restful sleep at night to recharge the body
for the following day.
Some general stretches are a good start to
improve practitioners’ strength and flexibility.
More enthusiastic dental professionals
should consider doing yoga, swimming
and Pilates. The ADA website has some
excellent resources on offer to improve physical health
and ergonomics for dental professionals.
Timothy Caruso is a member of
the FDI World Dental Federation
Ergonomic Task Team.
Mr Caruso, can you share how common
back and neck pain are among dental
professionals? What factors contribute
to cervical and lumbar pain in dentistry?
Depending on the source of information, the range of
prevalence of back and neck pain has been stated as
somewhere between 50 and 80%. Back and neck
complaints are nearly evenly split, and this has held up
over the past few decades. In the past year, 84% of
dentists reported pain or discomfort while working,
according to a survey conducted by the American Dental
Association (ADA). The neck, lower back, shoulders
and upper back were the most common sites of
discomfort.
Factors that most often contribute to pain and discomfort
are poor lighting, incorrect practitioner posture, the use
of magnification loupes and having limited access to
the oral cavity.
How can chronic pain impact the personal and
professional lives of dental practitioners?
Initially, there may be increased fatigue, stiffness
and aches throughout the body. Over time, this
may lead to more chronic pain, musculoskeletal
disorders and limitations in employing certain
techniques and undertaking certain procedures.
In a worst-case scenario, chronic pain can lead
44 CAD/CAM
1 2024
What treatment options specific to dental profes
sionals are currently available for managing cervical
and lumbar pain?
Seeking out a trained professional in the care of back and
neck pain is a great place to start. Dental professionals
should always exhaust conservative treatments before
considering surgical intervention unless there are
emergency circumstances. The McKenzie Institute is
a good resource for that. After entering your zip code,
it will provide a list of trained clinicians in your area.
Without compromising work efficiency, what pre
ventive measures can dental professionals take to
avoid the onset of neck and back pain?
Dental professionals should monitor their working p
osture
throughout the day. They should incorporate chairside
stretches during the working day as well as do regular
exercise, take rest breaks, and balance difficult and easy
patients and procedures. Additionally, dental professionals
can adapt the work environment to support better
posture and reduce strain by improving the ergonomic
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|
© Marcin Balcerzak/Shutterstock.com
features
According to physical therapist Timothy Caruso, basic stretches are a good start to enhancing the strength and flexibility of practitioners.
set-up of the operatory and being mindful of maintaining
dental ergonomics throughout the day.
How do you envision the advancement of ergonomics
in dentistry?
Now, more than ever, we are working harder than
we have done in the past. The expense of running
a practice and the constraints of insurance and
reimbursement create a new reality, perhaps a new
survival of the fittest.
AD
THE GLOBAL DENTAL CE COMMUNITY
REGISTER FOR FREE
www.dtstudyclub.com
DT Study Club – e-learning community
@DTStudyClub
Tribune Group is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA
CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.This continuing education activity has been planned and implemented in
accordance with the standards of the ADA Continuing Education Recognition Program (ADA CERP) through joint efforts between Tribune Group and Dental Tribune Int. GmbH.
[46] =>
© metamorworks/Shutterstock.com
| features
Eco-friendly dentistry:
“The best time to start was yesterday.
The next best time is now.”
An interview with Peter Suresh from Dublin Dental University Hospital in Ireland
© Peter Suresh
Iveta Ramonaite, Dental Tribune International
Procurement, waste generation and water management
are three major categories where dental practices could
potentially become more sustainable. This is in line with
a new study that assessed the effectiveness of changes
suggested by the Royal College of General Practitioners’
Green Impact for Health Toolkit, which aims to help dental
practices become more eco-friendly and reduce their
carbon footprint. Dental Tribune International discussed
Peter Suresh.
46 CAD/CAM
1 2024
[47] =>
features
|
What are some of the most important findings of
your recent study?
There is a long list of small changes that can be easily
implemented in dental practices across the globe in order
to reduce the carbon footprint of dental care. If dental
professionals want to make an effort to reduce their
carbon footprint, this study provides research evidence
behind the recommendations made by the Green Impact
Toolkit and will guide them in their decision-making so
that they can make the most appropriate and effective
changes for greater sustainability in procurement, waste
and water in the dental practice.
Sustainability is a recurring topic in dentistry as the dental industry seeks to
minimise its environmental impact while maintaining high standards of patient care.
the topic further with lead author Peter Suresh, an undergraduate student in dental science at Dublin Dental
University Hospital in Ireland.
Mr Suresh, how important is sustainability in den
tistry? Have you noticed a shift in dental profes
sionals’ awareness of sustainable practice in recent
years?
Climate change is one of the biggest challenges faced by
our generation, and I think that sustainability has never
been more important. The impact of carbon emissions
and pollution on climate change has been well explored,
and it has been established in the literature that dentistry
has a significant carbon footprint.
With so much coverage of climate change in the media
in recent times, people around the world, including dentists, are becoming more aware of their carbon footprint
and more conscious of making small changes to their
everyday activities in order to become more sustainable.
The tide is turning, and there is an increased emphasis
on meeting the dental treatment needs of the present
without compromising the ability of future generations to
meet these needs.
Based on the findings, what simple steps could
dentists take to make their dental practices more
sustainable?
Making simple changes such as e-mailing appointment
notices and referral letters as opposed to using traditional
physical post, photocopying on both sides of paper instead of on one side, saving and reusing scrap paper,
shredding only confidential documents, and using and
reusing envelopes without plastic windows can reduce
the carbon impact associated with paper usage per
patient. Additionally, using water harvested from a rainwater
collection tank, having dual-flush toilets and washing
dishes with running water in the staff canteen, as opposed to using a dishwasher or filled sink, can reduce the
carbon impact of water usage in a practice. Additionally,
recycling used toothbrushes and adopting reusable
metal tips instead of single-use disposable plastic tips
in a three-in-one air–water syringe can save carbon
emissions associated with waste.
In your opinion, what is the greatest obstacle to
sustainability in dentistry?
Prevention of diseases of the oral cavity is the most
sustainable way for dentistry to progress in the future.
I believe that the biggest obstacle faced by sustainability
in dentistry is the need for dentists to treat diseases of the
oral cavity rather than preventing them from occurring in
the first place. More-complex treatment of diseases of
greater severity involves more appointments, time and
resources, thus increasing the carbon footprint asso
ciated with patient care. A preventive approach to care is
of paramount importance and will eliminate the need for
the treatment of oral disease in patients, reducing carbon
footprint and improving the quality of life of all patients.
Would you like to add anything else?
When it comes to dental practices delivering care
more sustainably, the best time to start was yesterday.
The next best time is now.
Editorial note: The study, titled “A life cycle analysis of
the environmental impact of procurement, waste and
water in the dental practice”, was published online on
12 April 2024 in the British Dental Journal.
CAD/CAM
1 2024
47
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| manufacturer news*
Visibly different, noticeably better
The new N4+ and K5+ from vhf
K5+
Vhf has redesigned its N4+ and K5+, the two bestsellers in the
German company’s PERFORMANCE CLASS, giving them a new look
and upgrading their performance. These state-of-the-art dental milling
machines for laboratories and practices were presented to the public
for the first time in February 2024 at the UAE International Dental
Conference and Arab Dental Exhibition in Dubai.
The attractive new design of the N4+ four-axis wet grinding
machine and the K5+ five-axis dry milling machine immediately
catches the eye, and their appealing modern look integrates seamlessly with the overall appearance of the vhf product portfolio.
Besides their new look, the machines have been upgraded, and
dental technicians and laboratory staff can benefit from their
optimised performance. The N4+ now has a water-cooled spindle,
ensuring greater process stability and first-class results even
during continuous operation. The company has also added a
spindle motor to the K5+ that is over 60% more powerful to further
optimise the processing of demanding materials such as cobalt–
chromium.
“Our new design has updated our proven and powerful N4+ and
K5+ machines. You can see and feel the difference in the two
bestsellers in our PERFORMANCE CLASS, and they also guarantee
superb precision in every practice, dental laboratory or milling
centre. All this, along with the customary high quality and reliability
you’ve come to expect from vhf and our machines made in Germany,”
said Lucas Kehl, head of product at vhf.
Wet grinding and milling with extra cooling: The new N4+
Since 2020, the N4+ has proven itself a high-performance
partner for laboratories and practice laboratories. This updated
version stands out with its new design and will impress even the
48 CAD/CAM
1 2024
most demanding of users in the wet processing of glass-ceramic,
composite and zirconia blocks, as well as titanium abutments.
The machine’s highly compact housing contains a powerful 800 W
spindle motor that can operate at up to 80,000 rpm to guarantee
powerful and efficient wet processing of three blocks up to
45 mm in length or three prefabricated abutments simultaneously.
The new water-cooled spindle ensures process stability, even during
continuous operation. Eight fine nozzles on the spindle precisely
direct the coolant between the tool and workpiece to ensure
optimum cooling. No abrasive additives are required with the
PUREWATER cooling system, unless machining titanium.
The proven machine technology and the familiar intuitive
vhf DENTALCAM software with DIRECTMILL technology ensure
high precision, reliability and first-class results.
Dry milling with added power: The new K5+
A contemporary design and enhanced performance—this is the
new K5+ model in a nutshell. With its more powerful spindle motor
of 820 W, the new K5+ raises the bar for dry milling and can
effortlessly mill even the hardest materials in the form of discs,
blocks and abutments, operating at up to 60,000 rpm. Its increased performance enables users to optimise the processing of
metals such as cobalt–chromium. Another advantage for dental
technicians and laboratory staff is that the new K5+ builds on the
proven machine technology of its predecessor, and its high precision and reliability set high standards in daily continuous operation.
Further highlights are its wide range of applications for dry milling,
the DIRECTDISC technology for tool-free disc fixing and its
simple operation via the integrated DENTALCAM software with
DIRECTMILL technology.
www.vhf.com
* The articles in this category are provided by the manufacturers or distributors and do not reflect the opinion of the editorial team.
N4+
[49] =>
manufacturer news*
|
Custom indirect bonding tray
* The articles in this category are provided by the manufacturers or distributors and do not reflect the opinion of the editorial team.
V-Print IBT from VOCO—precise bracket positioning, shorter
treatment time and maximum comfort
A digitally designed indirect bonding tray (IBT) enables the precise
transfer of orthodontic brackets to the ideal positions on the teeth
based on the virtual planning. This enables not only more accurate
positioning but also a more efficient treatment procedure. The data
set for the IBT is generated from dedicated software, and then in
hardly any time at all, a custom IBT can be fabricated from VOCO’s
specially developed 3D-printing material V-Print IBT.
Easy handling with V-Print IBT
For the indirect bonding process, easy handling of the tray is
essential. The translucent V-Print IBT is flexible, allowing easy tray
placement in and removal from the patient’s mouth. The optimised
flexibility makes V-Print IBT a reliable solution, even for the
treatment of patients with severe dysgnathia. In combination with
the high degree of elastic recovery, the reversible deformation
of the tray allows precise bracket positioning without requiring
a common direction of insertion.
Enhanced treatment ergonomics
The indirect bonding technique significantly improves the ergonomics of treatment, in both the planning and implementation
phases. In addition, compared with conventional methods, the
clinical phase of bonding is significantly shortened, saving both
patients and orthodontists a great deal of time.
No shaking needed
Requiring no shaking, V-Print IBT is ready for use, supporting its
ease of use and speeding up the production process.
Further information on V-Print IBT can be found online.
www.voco.dental
CAD/CAM
1 2024
49
[50] =>
© Raywoo/Shutterstock.com/Shutterstock.com
| practice management
To motivate a team effectively, it is crucial to recognise individuality, maintain clear communication and understand the distinction between motivators and hygienic factors.
Motivating your team
Jerko Bozikovic, Belgium
In training sessions, managers, dentists, leaders often
ask me how they can motivate their team and keep them
motivated. This is a million-dollar question, since so many
leaders struggle to keep their staff motivated, connected
and engaged. Over my more than 22 years of experience
as a trainer and coach and having held the role of manager of a team myself, I have gained a number of insights
in this regard and I share some of the most pertinent
in this article.
Teams are a combination of individuals
Everybody wants to be heard, to be seen and to be
respected, and these are key elements to consider in
relation to motivation. On one hand, people want to be
authentic and unique, and on the other hand, they want
to blend in with others, with a group. It is this constant
dynamic of finding a balance that we need to work with.
As a team, we want everybody to be aligned, but we need
to consider that everybody is an individual, so a one-sizefits-all approach does not work, even though sometimes
it might feel that this is what society expects from people.
So how can you cherish the individuality in your team?
Every team member has their own talents, qualities and
value, and as a manager, you want to start recognising
what these are and to start nurturing these qualities and
talents. You will find that some staff members are aware
of their own abilities and are waiting for opportunities to
50 CAD/CAM
1 2024
fully express and use them, but some are not at all aware
of their own capabilities, and this is where you as a manager can step into a coaching role to try to empower them
and create awareness of their talents in order to hopefully
start giving them the confidence to be the best version of
themselves. If all team members are able do to this, then
TEAM (Together Everyone Achieves More)—a wordplay
that I love, will come into place.
Communication is key
In my 22 years of experience working with companies
and teams as a trainer and coach, I have often heard from
employees leaving the company that a lack of (clear)
communication is one of their top three reasons for
doing so.
Be clear in communicating your expectations and obtain
a commitment to these from your employees. Ensure
communication is a two-way process by involving your
team in making decisions about the future direction of
the dental practice.
Establishing clear communication includes creating an
open feedback culture. How has that been rolled out in
your practice? Are there regular feedback moments
during the day/week/month with your staff? Does feedback include good points, compliments as well as
points of improvements? This feedback can be given in
[51] =>
|
© Skyline Graphics/Shutterstock.com
practice management
an informal way, in between patients, for example, or at
the start or end of the working day, as well as in a formal
way individually or in a group during meetings.
Regarding meetings, do you have a clearly set-out
meeting structure? The other day I was working on team
communication with a practice in Belgium, and one of
the major takeaways for management was that they had
no structured meeting culture, so feedback was given
sometimes and sometimes not. Decisions were shared
sometimes and sometimes not. Half of the staff were
aware of certain information, decisions and changes,
and the other half not.
The staff thus decided to establish different meeting
structures with different time frames: meetings in smaller
groups, depending on roles and responsibilities, on a
more regular basis, and then entire staff meetings on
a monthly basis. They decided not to book patients during
the timings of these meetings in order to be completely
focused. The encouraging thing about that team communication day was that it was the team members who
asked to set up more meetings, and the orthodontists
and management staff listened.
How you motivate your team matters
How do you motivate your team? This question is one
I love to ask during training and coaching sessions.
I ask people to write down all the things they do, or their
clinic does, to motivate their team. Actually, you might
want to do this exercise as well quickly. The answers
we normally get—and maybe you will give similar ones—
are things like:
– offering good working hours;
– providing an adequate salary;
– respecting employees;
– listening to employees;
– giving employees the flexibility to choose their holiday
dates;
– giving employees nice work clothing;
– arranging team-building activities;
– celebrating birthdays and big holidays, such as with
the giving of Christmas gifts;
– communicating a clear vision of the direction the clinic
is evolving in;
– being open to feedback;
– empowering employees by giving them responsibilities
and autonomy; and
– offering employees training.
Do you have any others?
Now let me introduce you to the motivation–hygiene theory.
Frederick Herzberg et al. developed this theory and
published it in the book Motivation to Work. Influenced
by Maslow’s hierarchy of needs, Herzberg et al. concluded
CAD/CAM
1 2024
51
[52] =>
© Plateresca/Shutterstock.com
| practice management
that satisfaction and dissatisfaction could not be measured reliably on the same continuum and conducted
a series of studies in which they attempted to determine
what factors in work environments cause satisfaction or
dissatisfaction.
On the basis of their findings, they grouped these factors
into motivators and hygienic factors. Motivators are
aspects that are intrinsic to the work itself, fulfilling needs
concerning achievement and recognition, for example,
and really motivate people, keep their focus and energy
high, create a good work atmosphere and increase
job satisfaction. Hygienic factors are basic needs that
must be met at work to enable people to do their jobs.
These are assumed to be obligatory and are extrinsic to
the work itself, such as salary and work environment.
When fulfilled, they can prevent dissatisfaction, but do
ecessarily increase satisfaction.
not n
– Respect: Is this a motivator or a hygienic factor?
For most people, it is usual to be respected, but if they
are not treated with respect, then that is a cause of
demotivation.
– Celebrating birthdays and big holidays: Is this a
motivator or a hygienic factor? For most people, it is
a motivator, a plus that goes beyond what is expected
at work.
– Being open to feedback: Is this a motivator or a
hygienic factor? For most people, it is normal for
a workplace to have an open feedback culture with
clear communication, but a lack in this regard is a
cause of demotivation.
– Giving responsibilities: Is this a motivator or a hygienic
factor? For most people, it is a motivator in that they
perceive this as demonstrating particular trust in them
and giving them opportunities to grow and learn.
Consider the categorisation of some of the examples
listed earlier regarding whether they are motivators or
hygienic factors:
As you can see—and I suggest you do this exercise with
your list of what you believe are motivators—what we
all thought were motivators are only partly motivators,
and often the majority are hygienic factors.
– Good working hours: Is this a motivator or a hygienic
factor? Most people take good working hours for
granted, but poor working hours are a cause of demo
tivation.
– Adequate salary: Is this a motivator or a hygienic factor?
Most people expect to have an adequate salary, so
poor remuneration may make them feel unappreciated
and taken advantage of, leading to a lack of motivation.
I remember a client who owned a wonderful restaurant
telling me in a training session that every year she invested in new work uniforms for her staff. She would
select the best materials and have the staff’s names
embroidered on the uniforms. She spent quite a large
amount on doing this and was upset that the staff did not
appear to be grateful and more motivated when they received their new uniforms. I asked her why she felt they
should be more motivated in their work because of these
52 CAD/CAM
1 2024
[53] =>
|
© Luna_2631/Shutterstock.com
practice management
Hygienic factors.
new uniforms and who wanted to have these nice uniforms in the first place. She wanted the staff to have these
uniforms and thought it was important. For her staff,
these were just an outfit they needed to wear every day at
work but not something that made them feel appreciated
or offered them additional value in the workplace.
In another example, employees had to park their cars in
an unlit parking area, so when it was dark in the m
ornings
or the evenings, they felt quite unsafe. This influenced their
energy and motivation negatively. Therefore, management
decided to install large light fixtures to illuminate the parking
area and thus create a feeling of safety for the employees.
Management was then disappointed that the team’s
motivation was not improved by this.
Why was this so? When hygienic factors are not fulfilled,
this is always a source of demotivation. Because employees expect these factors to be in place, when a lack in
this regard is addressed, employees take it for granted.
If the baseline represents zero, then a lack in hygienic
factors will reduce motivation to below zero. Solving this
lack will just bring motivation back to zero. If you want
to go above zero, you need to employ motivators, such
as providing growth opportunities, celebrating achievements, offering team-building activities, giving recognition
and creating unexpected moments.
Do you need to make some changes to how you
approach motivating your team? I hope that you will
now be able to reflect on whether you are solving hygienic
factor issues or adding motivators. I wish you all the
best in this journey of moving towards true motivators,
and both are important but have a different approach
and different outcome.
Editorial note: This article was first published in
aligners—international magazine of aligner orthodontics
vol. 3, issue 1/2024.
about
Jerko Bozikovic is a specialist
in communication skills, e motional
intelligence, time and stress
management, leadership, and change
management. He is fascinated by
human behavior and finds working
with people on personal development
to be a daily challenge and blessing.
He speaks seven languages and has
offered his training courses in four languages since 2001.
He embraces and embodies the motto
“Love the life you live; live the life you love”.
Jerko can be contacted via LinkedIn.
CAD/CAM
1 2024
53
[54] =>
| meetings
Yes, we CAD!—exocad Insights 2024
exocad
Laboratory and clinical sessions on exocad software
At exocad Insights 2024, the company’s software sessions
focused on education on and state-of-the-art workflows for
exocad DentalCAD, exocad ChairsideCAD and exoplan.
The new 3.2 Elefsina release series took centre stage.
Top international speakers
Christine McClymont, global head of marketing and communications at
exocad, and Tillmann Steinbrecher, CEO at exocad, surprised the audience
with awards in three categories. (All images: © exocad)
The biennial digital dentistry meeting and exhibition
of exocad, an Align Technology company and a leader in
dental CAD/CAM software, returned to Palma de Mallorca
on 9 and 10 May at the Palma Convention Centre. The
company’s fourth digital dentistry event, exocad Insights
2024 was themed “Network. Innovate. Lead.”
“Our goal at Insights 2024 was to gather together professionals along the dental spectrum to learn from each other,”
said Tillmann Steinbrecher, CEO of exocad. “With hundreds
of attendees, 54 industry partners and 40 expert speakers
from around the world, I can confidently say that we achieved
that. We explored the future of digital dentistry and fresh
approaches to collaboratively improve outcomes.”
The educational CAD/CAM event, presented in four
languages, was attended by dental technicians, dentists
and industry partners from more than 45 countries. They
took part in informative presentations by top industry
speakers and in-depth learning sessions run by exocad
software experts for both clinicians and laboratory technicians. First-time attendees were able to meet with an
independent certified trainer at a dedicated booth.
“This event offered attendees the chance to see which
technology and treatment approaches are available to
achieve more predictable results, faster workflows, and
ultimately higher patient satisfaction,” said Novica Savic,
chief commercial officer of exocad.
54 CAD/CAM
1 2024
At exocad Insights 2024, dental technicians and clinicians
passionate about digital workflows had access to career-
accelerating insights from top industry experts. The lectures
by well-known thought leaders from across the dental world
included a presentation on the power of avatars in dentistry
by Dr Miguel Stanley, smile design insights from international
experts such as Drs Guilherme Saavedra and Elaine Halley,
and an exciting look at occlusion with master dental technician Edris Rasta. Dr August de Oliveira lectured on 3D printing
and exocad for the general dentist. A presentation on
a cutting-edge team approach combining orthodontic and
restorative treatment planning, led by the UK dental technician
and dentist duo Kristina Vaitelytė and Dr Eimear O’Connell,
concluded the event with exocad’s vision of the future.
Partner exhibition, partner sessions
and software integrations
Over 50 top companies in dental materials, equipment and
CAD/CAM answered questions and demonstrated equipment
as part of the exocad Insights partner exhibition. The 11 diamond, platinum and gold partners each held five dedicated
sessions to showcase their innovations, present cases, launch
new products and share valuable ideas for the application of
exocad software solutions, in connection with hardware.
Insights into the future
Visitors were particularly interested in the outlook for
future products and services that exocad presented at
the event. The company previewed the next release of its
implant planning software, exoplan 3.2 Elefsina—not yet
available for sale—and announced the inclusion of a new
streamlined workflow for stackable guides. The company
also provided its vision of the future, previewing crown
design based on artificial intelligence (AI) and advanced
visualisation within exocad’s Smile Creator.
Community, collection and connection
The event provided a welcome opportunity to interact
in-person with exocad experts and other dental profes-
[55] =>
meetings
|
Master dental technician Vincent Fehmer from Switzerland opened the event by presenting the latest innovations and techniques in prosthetic materials.
sionals. After a rigorous educational agenda on the first
day, attendees were able to unwind during an evening
celebration with a “pearly white” theme.
Once again, exocad offered attendees the chance to
participate in its charity drive by buying limited-edition
exocad Insights T-shirts. The company said that the
funds collected would again go towards supporting
non-profit dental organisations.
Exocad Insights offers enhanced
opportunities for superior results
At the press briefing, Steinbrecher announced that the event
had sold out and discussed how AI can enhance dental care.
He highlighted two main benefits: improving efficiency and
increasing patient acceptance through engaging visualisations. The software produces not only attractive images of
potential treatment outcomes but also realistic video renderings that can engage patients emotionally. While AI facilitates
these realistic renderings, users maintain control, allowing
them to add their personal touch. This integration of AI and
user skills combines efficiency with personalised care.
Savic shared that the feedback from attendees had been
overwhelmingly positive, noting that the high level of insights
at the event encouraged companies to launch new products.
Evoking the event’s theme, he said, “You need to be innovative to lead,” and he stressed the importance of networking
to foster innovation and introduce new ideas.
The team presentation by Ashley Byrne and Dr Marcos White from the UK focused on the iTero-exocad Connector and its benefits for collaboration between labs and dentists.
CAD/CAM
1 2024
55
[56] =>
| meetings
FDI World Dental Congress
IAO-EAO-SIdP
Joint Meeting
12–15 September 2024
Istanbul, Turkey
www.2024.world-dental-congress.org
24–26 October 2024
Milan, Italy
www.congress.eao.org/en
MIS Global Conference
CEDE 2024
12–15 September 2024
Palma de Mallorca, Spain
www.mis-implants.com
07–09 November 2024
Łódź, Poland
www.cede.pl/en
ICOI World Congress 2024
CAD/CAM Digital
& Oral Facial Aesthetics
37th Int’l Dental
ConfEx
26–28 September 2024
Orlando, US
www.icoicampus.org/upcoming-events
15–16 November 2024
Dubai, UAE
www.cappmea.com/confex2024
17th International
Sofia Dental Meeting
French Dental Association
Annual Meeting
26–28 September 2024
Sofia, Bulgaria
www.sofiadentalmeeting.com
26–30 November 2024
Paris, France
www.adfcongres.com
DenTech China 2024
Greater New York
Dental Meeting 2024
24–27 October 2024
Shanghai, China
www.dentech.com.cn
01– 04 December 2024
New York, US
www.gnydm.com
56 CAD/CAM
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© 06photo/Shutterstock.com
International events
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REVOLUTIONISING
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S H A P I N G TO M O R R O W:
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DENTISTRY
DENTISTRY
SHOW
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R E V O L U T I O N I S I N G D I G I TA L D E N T I S T R Y • R E V O L U T I O N I S I N G D I G I TA L D E N T I S T R Y
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SAV E T H E DAT E
[58] =>
| about the publisher
international magazine of dental laboratories
Imprint
Publisher and Chief Executive Officer
Torsten R. Oemus
t.oemus@dental-tribune.com
Managing Editor
Magda Wojtkiewicz
m.wojtkiewicz@dental-tribune.com
Designer
Franziska Schmid
Copy Editors
Sabrina Raaff
Ann-Katrin Paulick
Contributors
Ali Arabnejad
Eric Berger
Jerko Bozikovic
Timothy Caruso
Dr Gang Chen
Dr Wissam Dirawi
Dr Ian Lane
Dr Said Sánchez
Peter Suresh
Dr Kamran Zamanian
Dr Jingyi Zhang
International Administration
International Headquarters
Chief Financial Officer
Dan Wunderlich
Dental Tribune International GmbH
Holbeinstr. 29, 04229 Leipzig, Germany
Tel.: +49 341 48474-302
Fax: +49 341 48474-173
General requests: info@dental-tribune.com
Sales requests: mediasales@dental-tribune.com
www.dental-tribune.com
Chief Content Officer
Claudia Duschek
Clinical Editors
Nathalie Schüller
Magda Wojtkiewicz
Editors
Franziska Beier
Jeremy Booth
Anisha Hall Hoppe
Fraser Macdonald
Iveta Ramonaite
Executive Producer
Gernot Meyer
Advertising Disposition
Marius Mezger
Art Director
Alexander Jahn
Magazine
subscription
Printed by
Silber Druck GmbH & Co. KG
Otto-Hahn-Straße 25
34253 Lohfelden, Germany
CAD/CAM
— international magazine of
dental laboratories
Scan the QR code to register and read
the magazine online free of charge.
For print subscriptions, contact
info@dental-tribune.com (fees apply).
Copyright Regulations
All rights reserved. © 2024 Dental Tribune International GmbH. Reproduction in any manner in any language, in whole or in part, without the prior written permission of Dental Tribune International GmbH
is expressly prohibited.
Dental Tribune International GmbH makes every effort to report clinical information and manufacturers’ product news accurately but cannot assume responsibility for the validity of product claims or for
typographical errors. The publisher also does not assume responsibility for product names, claims or statements made by advertisers. Opinions expressed by authors are their own and may not reflect
those of Dental Tribune International GmbH.
58 CAD/CAM
1 2024
[59] =>
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[60] =>
For details and
registration
GLOBAL CONFERENCE
September 12-15, 2024 | Palma de Mallorca, Spain
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)
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/ Digital workflow of immediate implantation and immediate restoration in the aesthetic zone
/ Bimaxillary prosthetic reconstruction with implant-supported overdentures using novel materials and digital technology
/ Monolithic multilayer zirconia crowns in the aesthetic zone
/ Back and neck pain in dentistry: A new reality
/ Eco-friendly dentistry: “The best time to start was yesterday. The next best time is now.”
/ Motivating your team
/ Meetings
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