DT Asia Pacific

No-drill restorations and amalgam equally successful / Asia News / Opinion / World News / “I want the dental profession to realise its potential” / Business / “ART has not been well received in dental schools” / Non-invasive - long-term temporisation with a high-performance polymer / “I would love to play a dentist in a movie”

Open PDF View E-paper Edit Epaper Edit Epaper ads save

Table of contents

Open Link

Open Link

Open Link

) [7] => Array ( [image_url] => Array ( [2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/54965-8c41074b/2000/page-6.jpg [1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/54965-8c41074b/1000/page-6.jpg [200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/54965-8c41074b/200/page-6.jpg ) [key] => Array ( [2000] => 54965-8c41074b/2000/page-6.jpg [1000] => 54965-8c41074b/1000/page-6.jpg [200] => 54965-8c41074b/200/page-6.jpg ) [ads] => Array ( [0] => Array ( [post_data] => WP_Post Object ( [ID] => 54970 [post_author] => 0 [post_date] => 2024-10-21 17:12:47 [post_date_gmt] => 2024-10-21 17:12:47 [post_content] => [post_title] => epaper-54965-page-7-ad-54970 [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => epaper-54965-page-7-ad-54970 [to_ping] => [pinged] => [post_modified] => 2024-10-21 17:12:47 [post_modified_gmt] => 2024-10-21 17:12:47 [post_content_filtered] => [post_parent] => 0 [guid] => https://e.dental-tribune.com/ad/epaper-54965-page-7-ad/ [menu_order] => 0 [post_type] => ad [post_mime_type] => [comment_count] => 0 [filter] => raw ) [id] => 54970 [id_hash] => 363538d25932d673b2a922e6e94b271bbc472db800da50e858bcff43f9fe57fa [post_type] => ad [post_date] => 2024-10-21 17:12:47 [fields] => Array ( [url] => http://www.dental-tribune.com/companies/content/id/1558 [link] => URL ) [permalink] => https://e.dental-tribune.com/ad/epaper-54965-page-7-ad-54970/ [post_title] => epaper-54965-page-7-ad-54970 [post_status] => publish [position] => 23.94,25.14,70.27,69.94 [belongs_to_epaper] => 54965 [page] => 7 [cached] => false ) ) [html_content] =>

Open Link

Open Link

Open Link

) ) [pdf_filetime] => 1729530767 [s3_key] => 54965-8c41074b [pdf] => DTAP0111.pdf [pdf_location_url] => https://e.dental-tribune.com/tmp/dental-tribune-com/54965/DTAP0111.pdf [pdf_location_local] => /var/www/vhosts/e.dental-tribune.com/httpdocs/tmp/dental-tribune-com/54965/DTAP0111.pdf [should_regen_pages] => 1 [pdf_url] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/54965-8c41074b/epaper.pdf [pages_text] => Array ( [1] => DTAP0111_01_Title

DTAP0111_01_Title 09.02.11 12:22 Seite 1

DENTAL TRIBUNE
The World’s Dental Newspaper · Asia Pacific Edition
PUBLISHED IN HONG KONG

www.dental-tribune.asia

ART vs. Amalgam
An interview with
Dr Phantumvanit, Thailand
4Page

NO. 1+2 VOL. 9

Trends & Applications
High-performance polymers
in dental practice
4Page

A talk about teeth
Singapore actor Nick Sheng
likes going to the dentist

4Page

No-drill restorations and amalgam equally successful Filipino teachers
could treat
school-children

Yvonne Bachmann
DTI

DUBAI, UAE/LEIPZIG, Germany:
A method used in developing
countries to restore dental cavities may be a viable alternative
for conventional tooth restorations, scientists from Johannesburg in South Africa are reporting. In a systematic review involving clinical studies in China
and the Middle East, they found
that survival rates of restorations using Atraumatic Restorative Treatment (ART) are comparable, and to some extent superior, to those placed with
amalgam.
Developed in Africa in the
mid-80s, ART is a clinical procedure based on removing carious enamel and dentine using
hand instruments only and
restoring the tooth with an adhesive filling material such as
glass ionomer. It is claimed to
be painless and require minimal cavity preparation while
conserving sound tooth tissue.
The World Health Organization (WHO) currently recommends ART for application in
regions with limited resources,
as well as for elderly patients

The Philippines Education
Secretary Armin Altamirano
Luistro has issued a request to
the Department of Health to conduct a new oral health survey of
the country’s 15 million schoolchildren. He said that oral diseases such as gingivitis or dental
caries affect the performance of
pupils and keep them constantly
away from school. Owing to the
lack of dental personnel in
the public sector, he suggested
making use of teaching personnel in place of dentists to perform initial dental checks and
other basic oral health care
measures.
A child in Afghanistan receiving ART. (DTI/Photo courtesy of Afghanistan Relief Project, USA)

and those with special needs in
industrialised countries.
In the new review, researchers from the University
of Witwatersrand in Johannesburg compared 27 datasets of
ART restorations with amalgam
fillings in Class I, II and V cavities of primary and permanent
teeth from clinics in Kuwait,
Syria and China. Most of them
found no difference in the suc-

cess rates of ART and amalgam
restorations, according to the
report. Moreover, four comparisons found better results using
ART.

in five major databases, we
were able to identify all randomised control studies that
have been conducted worldwide.”

“Our review offers the best
evidence in this clinical issue,”
says Dr S. Mickenautsch from
the University of the Witwatersrand and author of the review.
“By making use of a systematic
literature and reference check

According to WHO figures,
caries prevalence in most developing countries is still high
despite preventative measures
such as water fluoridation and
improved school-based dental
education. DT

According to the Department
of Education in the Philippines,
only 570 dentists are currently
assigned to cater children in
public schools nationwide, a figure that falls short of the 1:10,000
ratio recommended by international health authorities like
the World Health Organization.
The last national survey on oral
health conducted by the Department of Health in 2004 found
that nine out of ten school-children suffered from some kind of
dental problem. DT
AD

Masato Mugitani
to chair health
workers’ alliance

LED mouthguards that emit light are the new hip couture for Japanese night goers.
In this photo they are demonstrated by inventors Daito Manabe and Motoi Ishibashi
from 4nchor5 la6/Rhizomatiks in Tokyo. (DTI/Photo courtesy of Motoi Ishibashi)

Japan sends dental
goods to Tajikistan

Device lets patients
rest from dental drill

The Government of Japan has
donated dental goods worth over
US$80,000 to a dental center in
Dushanbe in Tajikistan. Within
the framework of The Project for
the Provision of Medical Equipment, the center was equipped
with new machineries including
dental drilling machines and digital orthopantomographs. DT

Noise-cancelling technology
could soon be available in dental
practices. Clinicians from the
Kings College in London in the
UK said to have invented a device that blocks out the shrill
sound generated by air turbines
in modern dental handpieces, a
main cause for anxiety among
patients. DT

The Japanese Assistant Minister for Global Health, Dr
Masato Mugitani, has been appointed Chair-Elect of the Global
Health Workforce Alliance at the
Second Global Forum on Human
Resources for Health in Bangkok
in Thailand. He succeeds incumbent Dr Sigrun Møgedal, former
State Secretary of Foreign Affairs and HIV/Aids ambassador
of Norway.
Established by the World
Health Organization in 2006, the
Global Health Workforce Alliance
is an international platform to
address shortages in the health
care workforce worldwide. It comprises members of governments,
the World Bank and several
non-governmental organisations.
According to figures from the
Alliance, there is a worldwide
deficit of 4.2 million in health and
dental care workers, with 1.5 million needed in Africa alone. DT

Distinguished by innovation
We shape the future of dentistry with our innovative products and systems. They
distinguish us – in the field of restoratives, all-ceramics and esthetic prosthetic
solutions. A wealth of experience, great commitment and innovative ideas help us
to always find the optimum solution for high-quality products that allow you to
make people smile.

www.ivoclarvivadent.com
Ivoclar Vivadent AG
Bendererstr. 2 | FL-9494 Schaan | Principality of Liechtenstein
Tel. +423 / 235 35 35 | Fax +423 / 235 33 60

[2] => DTAP0111_01_Title

DTAP0111_02_News 09.02.11 12:23 Seite 1

DENTAL TRIBUNE Asia Pacific Edition

Health report sheds new light
on China’s gum problems
Yvonne Bachmann
DTI

mine the efficiency of anti-gingivitis products.

BEIJING, China/LEIPZIG, Germany:
Plaque-associated gingivitis in
the Chinese population remains
high but has not changed significantly over the last two years.
According to a 2010 study conducted by Chinese and US researchers, gingivitis and plaque
levels matched those found in the
last national oral health survey
conducted by the Chinese government in 2008. As the first
study seeking to reflect the country’s demographics accurately, it
may have an impact on future
clinical trials seeking to deter-

Using clinical data from over
1,000 dental patients in three
different parts of China, the researchers found that over 82 per
cent of the patients surveyed had
gingivitis levels ranging from
marginal to moderate. Significant differences were observed
in relation to gender, race and
age. In addition, plaque-associated gingivitis was found to be
more prevalent in Nanjing, the
second largest city in Eastern
China, than in southern Guangzhou and Shenyang, a city north
of Beijing.

Previous studies conducted
in the country have indicated
the general prevalence of adult
gingivitis in China as between
50 and 100 per cent. The researchers said that their new,
more detailed findings could
help in the industrial development of better treatment methods or oral hygiene products that
allow to combat gum disease
according to its prevalence in the
Chinese population.
Mild and moderate gingivitis
has been associated with preterm birth, cardiovascular disease and diabetes, amongst other
diseases. DT

N2O anaesthesia more likely
to trigger heart attacks
Daniel Zimmermann
DTI

HONG KONG/LEIPZIG, Germany:
Nitrous-oxide anaesthesia may
increase the possibility of having
a heart attack after surgery, research from Australia suggests.
In looking at the long-term risks
of cardiovascular events, a team
from the Royal Melbourne Hospital found that the administration of nitrous oxide, commonly
known as laughing gas, was associated with myocardial infarction.
The findings may alarm dentists worldwide who still use
nitrous-oxide anaesthetics for
dental surgery, including simple
procedures like tooth extraction.
According to the study, three

times more patients of a group of
patients who had received nitrous-oxide anaesthetics died after 30 days than patients who had
been exposed to non-nitrous-oxide sedation. The trial included
over 2,000 patients undergoing
non-cardiac surgery in different
hospitals in Australia and China
between 2003 and 2004.
However, a follow-up study
after three years revealed that
nitrous oxide increased neither
the risk of death nor the risk
of having a stroke amongst
the survivors of the patients
who had received nitrous-oxide
anaesthetics. Significant predictors of death were advanced
age, male gender, abdominal
surgery and propofol maintenance. In addition, the only

significant predictor of strokes
was advanced age.
Nitrous oxide is said to increase the concentration of
plasma homocysteine in human
blood. There it induces oxidative
stress and potentially destabilises coronary artery plaques,
which can dislodge and block
life-supporting blood vessels.
Earlier studies found that the
long-term occupational exposure to nitrous oxide of medical
and dental professionals is associated with numbness, difficulty
in concentration, paraesthesias
and impairment of equilibrium.
Alternative sedations for dental surgery include drug-based
anaesthetics like lidocaine, articaine or bupivacaine. DT

International Imprint
Licensing by Dental Tribune International

Publisher Torsten Oemus

Group Editor/Managing
Editor DT Asia Pacific

Daniel Zimmermann
newsroom@dental-tribune.com
Tel.: +49 341 48474-107

Copy Editors

Sabrina Raaff
Hans Motschmann

Editors

Claudia Salwiczek
Anja Worm

President/CEO

Torsten Oemus

Editorial Assistant

Yvonne Bachmann

Marketing & Sales

Peter Witteczek

Director of Finance & Controlling

Dan Wunderlich

Marketing & Sales Services

Nadine Parczyk

License Inquiries

Jörg Warschat

Accounting

Manuela Hunger

Product Manager

Bernhard Moldenhauer

Executive Producer

Gernot Meyer

Ad Production

Marius Mezger

Designer

Franziska Dachsel

International Editorial Board
Dr Nasser Barghi, Ceramics, USA
Dr Karl Behr, Endodontics, Germany
Dr George Freedman, Esthetics, Canada
Dr Howard Glazer, Cariology, USA
Prof. Dr I. Krejci, Conservative Dentistry, Switzerland
Dr Edward Lynch, Restorative, Ireland
Dr Ziv Mazor, Implantology, Israel
Prof. Dr Georg Meyer, Restorative, Germany
Prof. Dr Rudolph Slavicek, Function, Austria
Dr Marius Steigmann, Implantology, Germany

DENTAL TRIBUNE
The World’s Dental Newspaper · Asia Pacific Edition

Published by Dental Tribune Asia Pacific Ltd.
© 2011, Dental Tribune International GmbH. All rights reserved.
Dental Tribune makes every effort to report clinical information
and manufacturer’s product news accurately, but cannot assume
responsibility for the validity of product claims, or for typographical errors. The publishers also do not assume responsibility
for product names or claims, or statements made by advertisers.
Opinions expressed by authors are their own and may not reflect
those of Dental Tribune International.

Dental Tribune International
Holbeinstr. 29, 04229, Leipzig, Germany
Tel.: +49 341 48474-302 · Fax: +49 341 48474-173
Internet: www.dental-tribune.com E-mail: info@dental-tribune.com

Regional Offices
Asia Pacific
DT Asia Pacific Ltd.
c/o Yonto Risio Communications Ltd, 20A, Harvard Commercial
Building, 105-111 Thomson Road, Wanchai, Hong Kong
Tel.: +852 3113 6177 Fax: +852 3113 6199
The Americas
Dental Tribune America, LLC
116 West 23rd Street, Suite 500, New York, NY 10001, USA
Tel.: +1 212 244 7181 · Fax: +1 212 224 7185

[3] => DTAP0111_01_Title

DTAP0111_03_News 09.02.11 12:23 Seite 1

DENTAL TRIBUNE Asia Pacific Edition

Asia News

Japanese scientists develop replacement for dental metal
Yvonne Bachmann
DTI

HONG KONG/LEIPZIG, Germany:
Scientists from the Kyoto University in Japan have developed a new
alloy similar to palladium, a rare
metal used in dental restorations.
The element was produced by
mixing molecules of silver and
rhodium, two elements chemically similiar to palladium, and

could be the first step in producing
synthetic alternatives for other
rare earths, the researchers told
the Yomiuri Shimbun newspaper
in Tokyo.
Palladium only naturally occurs in some parts of Russia, South
Africa, Canada and the US. Besides
its use in dentistry, it is found in autocatalysts, jewellery and essential
components for consumer electronic products, amongst other

things. A 2010 report by US chemical company Johnson Matthey
estimates that 5 to 6 per cent of the
annual demand comes from dentistry for crowns or bridgework.
Japan continues to utilise the
largest amount of dental palladium despite other treatment options, such as all-ceramic crowns,
according to the same report.
The researchers have begun
joint research projects with the

Japanese industry but say the new
alloy will be difficult to produce
commercially.
Metal experts, however, are
sceptical of the announcement. “It
does look like they have managed
to create ‘nanoparticles’—an often
abused phrase—of rhodium and
silver, which would normally
be using traditional melting
techniques,” Johnson Matthey
General Manager Peter Duncan

told the South African magazine
Mining Weekly. “It is very common
for Japanese academics to patent
anything vaguely new, regardless
of its potential in the commercial
world.”
Japanese experts said that synthetic replacements for rare metals
could make Japan more independent of countries like China, which
currently produces over 90 per cent
of rare metals in the world. DT
AD

Progress
on global
mercury
treaty

Meeting chair Fernando Lugris, Uruguay.
(DTI/Photo IISD Reporting Services)
Yvonne Bachmann
DTI

HONG KONG/LEIPZIG, Germany:
Representatives of non-governmental organisations (NGO) and indigenous nations have urged participants of the 2nd session of the Intergovernmental Negotiating Committee to Prepare a Global Legally
Binding Instrument on Mercury in
Chiba in Japan to adopt stringent
measures for reducing the global
supply of commodity mercury and
restricting its trade. Delegates
generally agreed that the proposed
basic framework for the reduction
of mercury pollution was adequate. However, according to the
NGOs, many substantive issues remain to be resolved to ensure that
health and environmental resources are protected worldwide.
“Governments need to step
up and take more leadership in
this debate,” Dr Linda E. Greer of
the Natural Resources Defense
Council and NGO Zero Mercury
Working Group stated.
NGOs also criticised the Japanese government for its continued
export of tons of toxic mercury.
“Japan knows more than any country in the world the terrible cost
to life and the environment that
mercury causes,” Richard Gutierrez of non-profit organisation BAN
Toxics! of the Philippines stated.
In 1956, chemical manufacturer Chisso Corp dumped mercurytainted water into the sea near Minamata in Eastern Japan, causing
the country’s worst case of pollution.
NGOs said the best way to honour
the victims of this tragedy is to
adopt a strong mercury treaty that
entails meaningful actions. The
global mercury treaty is expected to
be signed in Minamata in 2013. DT

“IT’S AN
EASY
DECISION.”
Shigeo Kataoka, Dental Technician, Japan.

If durable all-ceramic crowns are required, the
decision is easy: IPS e.max lithium disilicate. With
this material, you can fabricate robust crowns
quickly and efficiently. Given the material’s high
esthetics, veneering in the posterior region is
unnecessary.

mic
a
r
e
c
l
al
d
u nee
o
y
l
l
a
www.ivoclarvivadent.com
Ivoclar Vivadent AG
Bendererstr. 2 | FL-9494 Schaan | Liechtenstein | Tel.: +423 / 235 35 35 | Fax: +423 / 235 33 60

Ivoclar Vivadent Marketing Ltd. Singapore
171 Chin Swee Road | #02-01 San Centre | Singapore 169877 | Tel.: +65 6535 6775 | Fax: +65 6535 4991

[4] => DTAP0111_01_Title

DTAP0111_04_News_DTAP1109_04-07_News 09.02.11 12:24 Seite 1

DENTAL TRIBUNE Asia Pacific Edition

Opinion

Dear
reader,

“I guess, these new files are good
for many things.”

Let me first wish you a happy,
belated New Year and to our
readers in China, Singapore and
elsewhere, a happy New Year
of the Rabbit. Exciting months
lie ahead of us. However, while
everyone is anxious to find out
which new toys the International
Dental Show (IDS) in Germany is
going to bring to the table, projects are currently underway that
could leave a significant longterm mark on our field.

Don Perman, USA
The research of Dr. Boyd Haley, formerly of the University of Kentucky,
on human brain tissue has more than
conclusively proven that there is no genetic defense against mercury vapor.
When Dr. Haley exposed normal brain
tissue to mercury vapor, the brain tubulin was disrupted. In the susceptible
person, mercury vapor can trigger
Alzheimer’s.

Carol Ward, USA

The first one is amalgam.

In addition, comprehensive
research from South Africa suggests that restorations with
other dental materials can outdo good old silver fillings, not
only in terms of aesthetics but
also long term success (see title
story).
The second development
concerns endodontics. Specialists are divided about a new approach of using only one single
file instead of multiple files for
root-canal preparation. The IDS
in March will show if this technology has the potential to introduce a new era. One thing is for
certain, reciprocating files will
not be able to stop the triumph
of dental implants but they may
be able to put a competitive edge
to endodontics again. DT
Yours sincerely,
Daniel Zimmermann
Group Editor
Dental Tribune International

Dental Tribune
welcomes comments,
suggestions and
complaints at feedback@
dental-tribune.com

Re: “New evidence links
mercury to Alzheimer’s”
(Dental Tribune Asia Pacific
No.11,Vol.8, page 6)
Time for the American Dental Association to begin to remove the use of Amalgam in this country, it's harmful affects
on tooth structure are seen every day.
This mercury issue just puts the use of
amalgam on some very questionable
status.

Daniel Zimmermann
DTI

In the last two years, we have
reported about this issue on several occasions. However, with a
mercury treaty finally expected
to be signed in 2013, the air for
even the most dedicated amalgam supporter is becoming thin.
Despite several international
initiatives like the recently held
mercury conference in Japan, a
new regulation towards this issue is also anticipated in the US,
where political pressure from
anti-mercury groups has recently convinced the FDA to review their current guidelines.
Similar initiatives led by Sweden
and France are also being considered in the European Union.
A change of regulations or even
a ban in these two major markets could have an impact
worldwide.

To the Editor

Re: Editorial “And the battle
goes on …” (Dental Tribune
Asia Pacific No.10, Vol.7, page 4)

Reciprocal motion in endodontics:

A promising method
compared with the conventional continuous rotation.

Dr Yoshio Yahata
Japan

The objectives of root-canal
preparation are to remove all
the pulp tissue, bacteria and
their by-products and to produce sufficient canal space for
disinfection and 3-D obturation.
Many techniques have been

By using an asymmetric reciprocal motion, the technique
is claimed to have a canal-centring ability when preparing
root canals and reducing torsional and fatigue stresses,
especially in curved canals.
This might enable clinicians to
prepare the whole canal system
with only one file. In addition,
the proposed technique appar-

under reciprocal motion than
under continuous rotation.
With the newly proposed technique, the file would frequently engage dentine at its tip,
but counter-clockwise rotation
would immediately disengage
the file resulting in the reduction of deformation and torsional fracture.
As clinicians, we should
consider and weigh the advantages and disadvantages of any

“Fracture of NiTi files is still a major concern.”
introduced for proper preparation, one of which is the
balanced force technique. This
technique uses hand files with
alternating clockwise and
counter-clockwise motions in
an attempt to minimise canal
transportation and decrease
the amount of stress placed on
the file during use.
Recently, in accordance with
the notion of the balanced force
technique, a new canal preparation technique using rotary
NiTi files with a reciprocal motion has been advocated. Previous studies have demonstrated
that NiTi files used with a reciprocal motion can significantly
reduce working time, over-instrumentation, apical extrusion of debris and file fracture

ently requires no glide path and
has a lower risk of cross-contamination.
As has been indicated by
numerous studies, fracture of
NiTi files is still a major concern. Fracture of such files in
clinical use occurs in two ways:
fatigue or torsional failure.
Fatigue failure is the result of
repeated compression and tension placed on files, especially
in curved canals, while torsional failure occurs when the
file tip binds and the remainder continues to rotate. In a
clinical setting, these two failures have an influence on each
other.
The incidence of NiTi file
fracture is reported to be lower

new technique. Furthermore,
it is imperative that we constantly seek a better treatment
strategy for reducing various
risks. The proposed new system
using one file claims to be a
promising method, but few
studies have demonstrated the
effectiveness of this technique.
Therefore, further studies and
discussion on this system are
necessary. DT

Contact Info
Dr Yoshio Yahata works as a hospital staff at the Graduate School,
Tokyo Medical and Dental University in Japan. He can be contacted at y.yahata.endo@tmd.ac.jp.

Fewer GP refer their patients to endodontic specialists. Most simply say
that the tooth was inevitably damaged
and had to be extracted and replaced
by an implant. I do not understand
why don’t we search the most simple
ways to handle complex problem such
as endodontic treatment—it’s never
about one file or one guttapercha point.
Every tooth, every canal even is different from the previous one. So how are
we supposed to clean and shape those
canals with only one file, even with the
“breakthrough” design of Wave One
File or Reciproc? I hope that endodontists around the world have enough
brains to decide where the truth is.

Bojidar Kafelov, Bulgaria

Re: Editorial “Women—The
missing link in dentistry?”
(Dental Tribune Asia Pacific
No. 12, Vol.7, page 4)
I have been a practicing dentist for
25 years and the first woman dentist in
my hometown. Now there are several
women dentists in the area and I am
grateful. I also have lectured for years
on lasers in dentistry but found that on
the lecture circuit it is mostly males.
Another glass ceiling to break. But
I have contributed to dentistry and
now I am walking tall in my practice
and choosing not to attend these male
dominant venues. The Greater New
York Dental Meeting is a great meeting
but they will never have female speakers. Even the women who help run it do
not promote women on the program.
It is a shame.

Janet Hatcher Rice, USA
Yes, currently the opinion leadership is
male dominated. One of the reasons
that noted by Lucy Nichols. However,
there really is a “Boys Club”—you know
the one that women “might possibly
be as good as, know as much as”,
but certainly not better or more. I went
to Dental School with my children,
graduating in 1975. I am a diplomate of
the American Board of Implantology/
Implant Dentistry and President, yet
my colleagues tend to dismiss most
women as “doing dentistry as a hobby
business”. Our current dental school
classes are now at least 50 per cent
women, so hopefully soon there should
be an avalanche of visible accomplished women in dentistry.

Carol Phillips, USA

[5] => DTAP0111_01_Title

DTAP0111_05_News 09.02.11 12:24 Seite 1

DENTAL TRIBUNE Asia Pacific Edition

World News

Specialists quarrel over ‘single file endo’
Daniel Zimmermann
DTI

NEW YORK, USA/LEIPZIG, Germany:
Endodontic procedures that only
require one rotary instrument
are causing controversy amongst
specialists worldwide. Endodontists are actively discussing

Infections
plague
developing
world
Daniel Zimmermann
DTI

the pros and cons of the new
procedure in Internet forums.
So-called single reciprocating
file systems have been launched
by several dental manufacturers
over the last few months.
Originally developed by
Canadian and Lebanese scientists, the single file endo concept
is claimed to require only one reciprocating file and no glide path
or initial instrumentation for the

majority of root canals. According to the manufacturers, the
technique reduces working time
and lowers cross-contamination
amongst patients, a common
problem associated with the use
of multiple files.
However, specialists are not
so sure. “This current trend in
file design and philosophy is
the equivalent of doing brain surgery with a hammer and chisel.

Anyone, who truly believes that
Hess-type anatomy can be dealt
with by using one rotary file is
delusional,” a specialist in an
US-based endo forum observed.
“The technique requires a
new motor, which will turn off
many dentists who are already
working with conventional rotary
NiTi instruments,” a German Internet blogger commented. “The
bottom line is that the system has

to offer considerable advantages
or it will be rejected by the market
despite its clinical potential.”
In a recent Dental Economics
article, Manhattan-based dentist
and endo specialist Dr Barry
Musikant said that the technique
could create a new standard for
instrument use in endodontics.
“Common sense says that single
usage is a rationalisation to compensate for the weaknesses of
rotary NiTi.” Most single reciprocating file systems are already
available in major markets. DT
AD

VITABLOCS RealLife® – ingeniously three-dimensional.
At a simple mouse click: truly natural anterior esthetics with 3D dentine core-enamel structure!

LEIPZIG, Germany: Patients in
developing countries are more
likely to acquire a health careassociated infection than patients
in Europe or the US. According to
a recent study led by the World
Health Organization (WHO), infections contracted during hospital stays or surgical procedures
are significantly higher in health
care systems with limited resources. The authors called for
better surveillance and the improvement of infection-control
practices in these countries.

The innovative VITABLOCS RealLife for CEREC/inLab MC XL are
especially designed for highly esthetic anterior restorations.
Just like natural tooth structure, the three-dimensional block
structure with dentine core and enamel coat imitates the curved
shade transitions between dentine and incisal edge. The VITABLOCS have been clinically proven millions of times over.

Fax +49 (0)7761/ 562-281
Phone +49 (0)7761/ 562-0
Please send me more info!
Please arrange a consultation appointment for me!
Practice/Laboratory, Contact:
Street, Number:
Zip-Code/Town/City:

✂

She added that although there
is currently no means to determine the likelihood and magnitude of the risks in countries with
limited resources, improving surveillance, training and education
amongst health care workers
may help reduce the number of
infections. DT

3405 E

In the study, researchers from
Switzerland and the UK compared
data from hospitals worldwide
covering the period of 1995 to
2008. They found that in developing countries an average of 50 out
of 1,000 patients are infected during hospital stays and five to six out
of 100 during surgical procedures.
In some areas, this extends to even
one in three patients becoming
infected during surgery.
“Health care-associated infections have long been established
as the biggest cause of avoidable
harm and unnecessary death in
the health systems of high income
countries. We now know that the
situation in developing countries
is even worse. There, levels of
health care-associated infection
are at least twice as high,” said Dr
Benedetta Allegranzi, Technical
Lead for the Clean Care is Safer
Care programme at the WHO and
author of the study.

[6] => DTAP0111_01_Title

DTAP0111_06_WorldNews 09.02.11 12:25 Seite 1

DENTAL TRIBUNE Asia Pacific Edition

World News

UK government reviews ban on HIV-positive health staff
Lisa Townshend
DT UK

London, UK: The Department of
Health in the UK has confirmed
that the current policy of preventing HIV-positive surgeons and dentists from working in the UK is under review. Under the Department
of Health rules, HIV-positive health
workers working in surgery, dentistry and specialist nursing, as
well as obstetrics and gynaecology

are not permitted to carry out invasive surgery or “exposure-prone
procedures” that may pose a blood
contamination risk.
The announcement has been
welcomed by campaigners and
Aids charities, who say advancements in HIV therapy drugs makes
it easier for people to undertake
such clinical roles. British policy is
stricter than that of many European countries, as well as the US

and Australia—where dentists
with HIV are permitted to work. According to reports, there have been
no reported health-care worker to
patient HIV transmissions in the
UK, and only four such cases have
been recorded worldwide.
A Department of Health
spokesperson said: “There is a very
low risk of transmission of HIV
from an infected health-care
worker to a patient during cer-

tain exposure-prone procedures.
Department of Health guidance
recommends that health-care
workers infected with HIV do not
undertake these procedures.”
The guidance on the policy
is currently under review by the
UK Advisory Panel for Healthcare
Workers Infected with Bloodborne
Viruses, the Advisory Group on
Hepatitis and the Expert Advisory
Group on Aids. The Department

has said that the review is expected
to be completed within the next
few months. DT
(Edited by Daniel Zimmermann, DTI)

GSK and
DENTSPLY
cooperate
in oral health
Daniel Zimmermann
DTI

LONDON, UK/NEW YORK, USA/
LEIPZIG, Germany: DENTSPLY
has entered into a co-branding
agreement with GlaxoSmithKline,
a global health-care manufacturer
based in the UK. According to a
press note released in January, the
deal will allow the US company to
combine its NUPRO in-office prophylaxis range with Sensodyne,
GSK’s specialist toothpaste brand
for patients suffering from dentine
hypersensitivity. According to the
companies, no exchange of cash
or equity by either party is involved
in the agreement.

EMS-SWISSQUALITY.COM

SUBGINGIVAL
WITHOUT
LIMITS
THE DEEPEST
PERIODONTAL POCKETS
NOW WITHIN REACH
WITH THE ORIGINAL
AIR-FLOW METHOD

NUPRO, which consists of prophy and polishing pastes, is based
on NovaMin, a technology acquired by GSK through a multi-million dollar purchase in 2009. The
formula contains calcium sodium
phosphosilicate, a synthetic mineral found to seal dentinal tubules,
the main reason for hypersensitive
teeth. GSK currently uses the same
technology in its heavily marketed
Sensodyne toothpaste brand.

> Subgingival application of the Original AIR-FLOW® method reduces
periodontal pocket depth, removes biofilm, prevents periimplantitis

AIR-FLOW MASTER®

is the name of the world’s ﬁrst
subgingival prophylaxis unit.
With two application systems in
one. For sub- and supragingival
use with matching handpiece and
powder chamber.

The inventor of the Original
Air-Flow Method is now ﬁrst to
cross the boundaries of conventional prophylaxis.

Incred ibly ea s y to oper ate.
Uniquely simple to use.
Touch ’n’ ﬂow: Highly sensitive
3-touch panel for easy choice of
settings.

For more information > welcome@ems-ch.com

Carlton Lawson, Vice-President of Sensodyne, GSK, said
that by utilising both companies’
brands and capabilities, his company aims to build awareness of
the benefits of NovaMin and further consolidate its position as the
leader in the over-the-counter oral
health-care market.
According to the company,
90 per cent of its worldwide revenue is earned through toothpaste
sales. The company also claims
to have a global market share of
almost 10 per cent.
DENTSPLY has said it will release a co-branded toothpaste, as
well as a prophy paste for in-office
use at the Chicago Dental Society
Midwinter Meeting in February.
The company has also announced
plans to develop a complete range
of professional tooth sensitivity
products under the combined
NUPRO–Sensodyne brand. DT

[7] => DTAP0111_01_Title

DTAP0111_07_News 09.02.11 12:25 Seite 1

DENTAL TRIBUNE Asia Pacific Edition

World News

“I want the dental profession to realise its potential”
An interview with Dr Raymond Gist, new President of the American Dental Association
What’s ADA doing in terms
of ethnic diversity?
The ADA’s recent public apology reinforces its commitment to
a diverse membership. The ADA
Officers and Board of Trustees felt
compelled to act after the striking
and deeply personal testimony
presented during the June 2010
National Summit on Diversity in

Dentistry on the history of exclusion in organized dentistry.
The summit was jointly planned
and convened by the National
Dental Association (NDA), Hispanic Dental Association (HDA),
Society of American Indian Dentists, and the ADA. In July and
September, the ADA Board developed and approved resolutions

that were designed to strengthen
diversity and inclusion in the
profession.
As the first African-American president of the ADA, do you
feel political pressure?
I don’t feel a special pressure
to perform because of my race,
but I do pressure myself to deliver

because I know my capabilities.
I want the dental profession to
realize its potential, and I want to
deliver that message effectively
and consistently.
Thank you very much for the
interview. DT
(Edited by Daniel Zimmermann, DTI)
AD

Javier M. de Pison
DT Latin America

The first African-American dentist in history elected as president of the powerful American
Dental Association (ADA) started
his mandate in a decisive way.
Less than a month after assuming the presidency in October
2010, the ADA issued an official apology for “not taking a
stronger stand against discriminatory membership practices
during the pre-civil rights era.”
A native of Grand Blanc, Michigan, Dr Gist assumed office as the
147th president on 13 October, 2010,
before the ADA House of Delegates
in Orlando, Florida. In the following interview Dr Gist discusses
the programmes that ADA intends
to implement, and advocates for
oral health for underserved populations.
Javier M. de Pison: What is
your political agenda as ADA
president?
Dr Raymond Gist:My primary
objective is to help unite and amplify the voice of dental professionals in advocating for the delivery
of quality oral healthcare to those
that are underprivileged in the
United States and abroad.
We also intend to deliver a loud,
consistent message to the public
and all concerned stakeholders
that oral health is a priority. Oral
health is essential to overall health,
which is why I want to bring increased national and global attention to the need for providing and
sustaining good dental health.
What are currently the main
problems for dentists practicing
in the US?
The United States offers
tremendous opportunities for
those wanting to practice dentistry.
The US economy has affected some
dental practices more than others,
but the economy is getting better as
we slowly emerge from our recession. As for our new dentists, many
of them are facing tremendous
debt obligations from dental school
and we must look for ways to assist
them in reducing debt and also
in establishing their own private
practices if they choose to do so.

© Nobel Biocare Services AG, 2011. 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.

Dr Raymond Gist and wife Jill at 2010
FDI World Dental Congress in Bahia,
Brazil. (DTI/Photo Jan Agostaro)

NobelActive

A new direction for implants.

Dual-function prosthetic
connection.

Built-in platform shifting.

Bone-condensing property.

High initial stability,
even in compromised
bone situations.

Adjustable implant orientation
for optimal final placement.

s
M eet u
4,
in H all
91
A 0 9 0 /0

NobelActive equally satisfies
surgical and restorative clinical
goals. NobelActive thread design
progressively condenses bone
with each turn during insertion,
which is designed to enhance
initial stability. The sharp apex
and cutting blades allow surgical
clinicians to adjust implant orientation for optimal positioning of the

prosthetic connection. Restorative
clinicians benefit by a versatile and
secure internal conical prosthetic
connection with built-in platform
shifting upon which they can
produce excellent esthetic results.
Based on customer feedback and
market demands for NobelActive,
the product assortment has been
expanded – dental professionals

will now enjoy even greater
flexibility in prosthetic and
implant selection.
Nobel Biocare is the world leader
in innovative and evidence-based
dental solutions.
For more information, contact
a Nobel Biocare Representative
or visit our website.
www.nobelbiocare.com

Nobel Biocare Asia Ltd. 14/F, Cambridge House, Taikoo Place, 979 King’s Road, Quarry Bay, Hong Kong; Phone +852 2845 1266; Fax +2537 6604
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.

[8] => DTAP0111_01_Title

Unbenannt-11 1

07.02.2011 17:00:01 Uhr

[9] => DTAP0111_01_Title

DTAP0111_09_Business 09.02.11 12:25 Seite 1

DENTAL TRIBUNE Asia Pacific Edition

Business

Dental implants see Kuraray shifts dental business,
fastest growth in
Merges with Noritake
emerging markets
Daniel Zimmermann
DTI

Daniel Zimmermann
DTI

NEW YORK, USA/LEIPZIG, Germany:
Premium manufacturers are
driving the market for dental implants and bone-craft substitutes
in countries like China and India,
according to iData Research. In
a market report, the Canadabased consulting company has
also forecasted the market volume of both countries for dental
implants to exceed US$400 million by 2017. Strong double-digit
growth rates have also been predicted for Brazil, another powerful global emerging market.
The rapid growth of the dental implant market will drive the
market for dental biomaterials
and bone-craft substitutes. The
number of procedures using
these materials is expected to
reach almost 400,000 in both
countries by 2017, the report
states
Markets in China and India
are currently dominated by a few
foreign manufacturers such as
DENTSPLY Friadent, Nobel Biocare or Straumann. The last in
particular, a Swiss-based com-

pany, has increased its market
share in China and South Eastern
Asia recently with the introduction of innovative products, including the Bone Level Implant
and SLActive dental implant
surface technology.
Industry experts say that despite the high costs of dental implant procedures, demand will
increase further owing to greater
oral health awareness and the
rise of middle-class income.
“The de-regulation of dental
care services in China and India
has fuelled growth of private
dental clinics in major urban
centres,” said Dr Kamran Zamanian, CEO of iData. “In addition,
the low cost of labour has kept
implant procedural costs relatively low, promoting dental
tourism from countries such as
Japan, South Korea and Australia.”
Europe still holds the largest
share of the US$3.2 billion global
dental implant market followed
by the US, Korea and Japan. The
market itself is projected to grow
by more than 20 per cent over the
next five years. DT

Fortis Global enters
Australia’s dental
service market

Singh brothers during a press conference in
2010. (DTI/Photo Reuters, London)
Yvonne Bachmann
DTI

NEW DEHLI, India/LEIPZIG,
Germany: Fortis Global Healthcare Holdings is further expanding its business into the APAC
market. The Indian health-care
giant, which runs hospitals in
India and Hong Kong, has announced plans to acquire a 30 per
cent minority stake in Dental
Corporation, one of Australia’s
largest providers of private dental services. The transaction,
worth AU$100 million (US$101
million), is subject to stakeholder approval.
In November last year, Fortis
took over Quality HealthCare
Asia in Hong Kong, making it the

largest provider of healthcare services in the city
state. Prior to this transaction, the company sought to
take over Singapore hospital
operator Parkway Holdings
but bowed out after a twomonth battle with Malaysian investor Khazanah. The
new transaction will add
139 dental practices with a
reported revenue of AU$250
million (US$253 million) per
year to Fortis’ business.

Dental Corporation has announced that it aims to use the
multi-million investment for expanding its business domestically
and in the growing Pan-Pacific
health-care market through the
established Fortis network. While
two Fortis executives will be appointed to the Dental Corporation
board, all operational functions
and management of the Dental
Corporation business will remain
unchanged, the company said.
Fortis Global is owned by the
brothers Malvinder Mohan Singh
and Shivinder Mohan Singh of
Delhi. They formed the company
late in 2001. Last year, the group
achieved a turnover of Rs 35,7 billion (US$753 million), according
to financial reports. DT

HONG KONG/LEIPZIG, Germany:
A new dental device giant is
taking form in Japan. According
to business reports, Kuraray and
Noritake are to merge their dental operations. The transaction
has been filed for clearance by
the Japan Fair Trade Commission
and is expected to be finalised
in early 2012, representatives of
both companies said.

fillings based on polymer
and organic synthetic
technology. Noritake Dental Supplies currently distributes dental ceramics
in over 90 countries. Both
companies are reported
to have combined sales
of approximately ¥8.5
billion (US$104 million)
worldwide and to hold
a share of 40 per cent in
their respective market
segment in Japan.
Noritake President Yoshiharu Ogawa and Sadaaki
Matsuyama. (DTI/Photo Kuraray, Japan)

Under the agreement, both
businesses will be joined in a new
holding company and effectively
merged with a basic capital of
¥5 million (US$61.000) by April
2012. It is also reported that
Kuraray will hold a two-thirds
majority stake in the new company.
Kuraray’s dental business,
which is owned by Kuraray Medical, a fully owned subsidiary,
comprises bonding agents and

Kuraray Medical President Sadaaki Matsuyama told
the website nikkei.com that his
company wishes to strengthen its
share in domestic and overseas
markets through the merger.
Overall, the new company aims
to boost sales to almost ¥20 billion (US$245 million) in the next
seven to eight years, he added.
According to industry experts, domestic medical and
dental device sales in Japan have

declined as a result of reduced
demand for dental services. Premium products in particular,
such as implants and ceramics,
are being brushed off by dental
patients.
With an annual turnover of
US$20 billion, the Japanese market for medical and dental equipment is the second largest in the
world. The country only imports
20 per cent from overseas. DT
AD

[10] => DTAP0111_01_Title

DTAP0111_10-11_Art 09.02.11 12:26 Seite 1

DENTAL TRIBUNE Asia Pacific Edition

10 Trends & Applications

“ART has not been well received in dental schools”
An interview with Dr Prathip Phantumvanit, Thailand
Dental Tribune Asia Pacific
spoke with Atraumatic Restorative Treatment founder
Dr Prathip Phantumvanit
from Thailand about the
procedure and the manner in
which it may help to overcome the dental caries epidemic.

Dr Prathip Phantumvanit

Dental caries is considered
one of the major public
health problems in most
Asian countries. A simple
restoration method developed in Africa in the 1980s
based on glass-ionomers is
often recommended when it
comes to the treatment of
widespread carious dentine.
AD

DT Asia Pacific: Dr Prathip
Phantumvanit, a new systematic review conducted in
South Africa is supporting
Atraumatic Restorative Treatment (ART) as an alternative
to tooth restorations with
amalgam. Have you read the
report?
Dr Prathip Phantumvanit:
This review confirms more or
less the field tests on ART we
have conducted in Thailand
and other countries in recent
years. When we compared
the results with amalgam, we
found that ART restorations
were more successful than

Fig. 1a

Fig. 1b

Fig. 2a

Fig. 2b

Fig. 1a and b: Before.—Fig. 2a and b: After „preventive restauration“ with ART.

amalgam up to eight years of
follow-up.
While amalgam is just a
normal restoration, ART is a socalled “preventive restoration”

owing to the fluoride released
from the glass-ionomer re storative material used in the
procedure. In addition, glassionomers are able to chemically seal and fuse with the
tooth composition of both
enamel and dentine. Amalgam
cannot do that and, therefore,
can easily cause micro-leakage. ART is also considered environmental friendly, whereas
the mercury used in amalgam
has been shown to be hazardous to both the environment and our health.
With this in mind, we believe that ART will be an alternative to amalgam restoration
especially in the primary teeth,
whose life span is less than ten
years.
How commonly is the
method used in countries like
Thailand?
In Thailand, it is mainly
used in primary health care and
in rural settings where access to
oral health services is limited.
Here, three-year olds have an
average of three carious teeth

Fluoride released from
glass-ionomer restorative materials, which is directly active
in the oral cavity in the area
next to the tooth structure, as
well as in the adjacent teeth,
is very similar to any other
prevention measures based
on fluoride. Moreover, glassionomers on the tooth surface
work as a fluoride reservoir in
the oral cavity and are slowly
released, as well as possibly
recharged through the daily
use of fluoride toothpaste.
Another advantage of ART is
the preventive restoration of
the existing carious teeth to
enhance the rehabilitation of
the function of the teeth and to
halt the progression of the
caries in order to prevent pain
and discomfort or even early
extraction.
The only possible disadvantage I can think of is that dental health care personnel have
to be involved in the procedure, which is slower, more expensive and time-consuming
compared with mass public
prevention measures such as
water fluoridation.
Are there any factors inhibiting the implementation
of ART in public oral health
services in Asia?
Aside from paediatric dentists, community dentistry and
public health departments,
ART has not been well received
in dental schools, especially in
the field of operative dentistry.
Some dental associations do
not recognise ART as standard
procedure for carious restoration and only recommend it
for temporary or second-class
restorations.
I believe that owing to its
simplicity, with no need for
rotary drilling instruments and

“ART will be an alternative
to amalgam restoration
especially in the
primary teeth.”
that need restoration and this
number even increases further
at the age of six. It is absolutely
necessary to tackle the caries
problem at village-based daycare centres with alternative
practical approaches like ART.
The simple caries removal
without anaesthesia injection
and no drilling make it more
acceptable, especially for the
treatment of young children.
What are the advantages
and disadvantages of ART
compared with other preventive measures such as water
fluoridation?

other sophisticated dental
equipment, many old-school
dentists hesitate to accept ART
as a correct approach to treating caries and I know that
some colleagues even consider
it a laborious and tiresome
process. Others still associate
glass-ionomers with lower
strength and high wear in comparison with other restorative
materials such as amalgam
and composite resin.
Glass-ionomers have significantly improved in recent years. Have you noticed
any changes in the long-term

[11] => DTAP0111_01_Title

DTAP0111_10-11_Art 09.02.11 12:26 Seite 2

DENTAL TRIBUNE Asia Pacific Edition
outcome of ART restorations
as a result of these developments?
The current high-strength
glass-ionomer is accepted for
simple posterior teeth restorations, but not yet for complex cases. Many dentists who
do restorations regularly are
awaiting improved glassionomers in terms of wear resistance, flexural strength and
aesthetics.
Manufacturers have added
ceramic or nano-apatite to the
material in an effort to improve
its mechanical properties, but
as far as I know these developments have not reached market readiness. However, any
improved or cheaper glassionomer or adhesive restorative material would certainly
be welcomed as an alternative
to dental restoration with mercury fillings.
Critics also claim that
hand instruments cannot
remove carious dentine completely. What are the limits
of ART?
The overall question is: how
clean must a cavity be before
restoration? Edwina Kidd, Professor of Cariology at King’s
College in London, put forward
this question in 2004.
What she found was that
a certain amount of softened
and demineralised dentine
can be safely left under glassionomer restorations, provided the margin is completely
sealed around its full circumference. Glass-ionomers can
completely seal at the margin
between the glass-ionomer
and the tooth structure.
Coincidently, Prof. Kidd’s
findings support ART, which
has used glass-ionomer material from the very beginning.
Moreover, an increasing number of papers support that
partial caries removal can
prevent accidental exposure of
the pulp and cause less pain to
patients. More important is
that ART is a most conservative
technique that saves sound
tooth structure, which is now
considered minimally invasive
dentistry.
There is definitely a limitation to ART, which is similar to
any dental restoration. For example, ART cannot be applied
to completely exposed teeth,
a fistula opening or in the case
of a patient with a history of
gum swelling or severe pain
that needs endodontic treatment rather than normal
restoration.
It is claimed that ART
was developed in such a way
that it can also be performed
by non-dental health care
workers. Is there any evidence that supports this?
Owing to the simple procedure of ART, it has been
suggested that it could be performed by non-dental health
workers to make the restoration more accessible to remote
populations. However, those
health care providers need to

Trends & Applications 11

“The overall question is:
how clean must a cavity be
before restoration?”
be well trained and carefully
monitored especially in terms
of case selection, handling of
the instruments and mixing
of the glass-ionomer. To my
knowledge, most countries do

not allow non-dental personnel
to perform any procedure in
the oral cavity currently. Therefore, dental auxiliaries, such as
dental therapists, dental nurses
or even dental hygienists, are

still the key performers of ART
besides dentists.
The WHO and the FDI
World Dental Federation consider dental caries a chronic
disease, especially in developing countries. Do you think
that ART could help to overcome the epidemic?
WHO has put much effort
into health promotion as key
to overcoming the epidemic of
tooth decay, but there is already an existing caries prob-

lem in almost every age group,
especially in children. ART
could definitely be a suitable
method for making dental
restoration more accessible to
people in developing countries. Joint initiatives between
health promotion and ART for
the future of cavity-free communities will definitely support
the Global Caries Initiative put
forward by the FDI.
Thank you for this interview. DT
AD

[12] => DTAP0111_01_Title

DTAP0111_12-14_Edelhoff 09.02.11 12:28 Seite 1

DENTAL TRIBUNE Asia Pacific Edition

12 Trends & Applications

Non-invasive, long-term temporisation
with a high-performance polymer

Fig. 1

Fig. 2a

Fig. 2b

Fig. 3

Fig. 1: Initial situation: severely discoloured teeth and disharmony in the size and shape of the teeth owing to congenital dysplasia.—Figs. 2a & b: Teeth #16 and 46
are severely damaged. The enamel was chipped off.—Fig. 3: Try-in of the mock-up. A diagnostic template (Duran thermoforming foil, 0.5 mm) was created from the
wax-up, filled with temporary material and placed on the teeth, which had been isolated with liquid Vaseline.
Prof. Daniel Edelhoff
& Josef Schweiger
Germany

New manufacturing technologies have paved the way for
completely new treatment strategies. High-performance polymer materials allow a relatively
rapid improvement of the initial
clinical situation. These materials are instrumental in the longterm development of functional
and aesthetic characteristics.
The following case report deAD

As the dentition had already
undergone extensive aesthetic
and functional changes and the
patient was still undergoing
growth processes, appropriate
treatment planning was not an
easy task. After the clinical findings had been evaluated in the
laboratory and practice, and all
advantages and disadvantages of
alternative restorative treatment

scribes the rehabilitation of a
general malformation of the
dental hard tissues. The young
patient received non-invasive,
long-term temporary restorations; hence, the teeth did not
have to be invasively prepared.
The restorations were CAD/
CAM manufactured using the
high-performance polymer Telio
CAD (Ivoclar/Liechtenstein). This
approach allowed us to achieve
an improvement in the initial clinical situation while the patient was

Fig. 4a

Fig. 4b

Fig. 5

Figs. 4a & b: The long-term temporaries were CAD/CAM manufactured using the high-performance polymer Telio CAD on
the basis of the study wax-up. They helped to improve the aesthetic appearance and evaluate the vertical bite dimension during
the growth stages of the patient.—Fig. 5: The long-term temporaries were trial fitted using try-in pastes of various colours.
The sectioned Michigan splint enabled an accurate transfer of the vertical bite height.

still in his growth years. The longterm temporisation phase forms

the basis for the final restoration at
a later stage.

Initial situation
A 13-year-old male patient
came to our practice with his
parents because of severely discoloured and malformed teeth.
His desire to have a “new” aesthetic appearance was quite understandable (Fig. 1). The patient
said that he was pain free but complained about the social stress that
he experienced because of the
unpleasant look of his teeth. After
an evaluation of the clinical findings and the patient’s case history,
he was diagnosed with dentinogenesis imperfecta type II.
The challenge we faced in his
treatment was his age, as he was
still in his growth years. Our aim
was to achieve an immediate improvement of the situation, which
meant that we had to establish an
appropriate morphology of the
teeth and adjust the vertical dimension of occlusion. In addition,
reliable retention of the restorations in the pre-damaged tooth
structure had to be ensured.

Treatment planning
The aim of the treatment was to
establish an appropriate morphology of the teeth with an anterior/
canine-protected dynamic occlusion and to adjust the vertical
dimension accordingly. Further
destruction of the teeth, which
had already been damaged, had to
be prevented to give the patient
the opportunity to have a pleasant
social and professional future.
Before completing the final
stages of therapy planning, we removed the caries from teeth #16 and
46, and filled the cavities with restorative material (Tetric EvoFlow/
Ceram, Syntac; Figs. 2a and b). Portrait and intra-oral photographs
were taken to provide the dental
technician with a first impression
of the initial situation. Alginate impressions of the upper and lower
jaw were taken to create diagnostic models. In addition, a centric
bite record and an arbitrary facebow registration were taken.

options had been considered, the
patient with his family and the
practice team settled upon the
following therapy plan:
1. Study wax-up to establish an
aesthetic and functional morphology of the teeth;
2. Evaluation of the aesthetics by
means of a mock-up, using the
wax-up as a basis (Fig. 3);
3. Functional evaluation of the
situation: transfer of the newly
established vertical dimension
to a modified Michigan splint;
4. Precision impressions of the
uncut teeth;
5. Wax-up digitisation and fabrication of CAD/CAM-manufactured, long-term temporary
restorations using Telio CAD;
6. Try-in and final aesthetic incorporation of non-invasive temporaries.

Preliminary treatment
After the wax-up had been
adjusted to meet the envisaged
aesthetic criteria, the 12-week
splint therapy began, which also
served as a functional evaluation
phase. The vertical dimension
established in the wax-up was
accurately transferred to the oral
cavity of the patient. During this
phase, the patient had the opportunity to become accustomed
to the new vertical occlusal
height.

Long-term temporisation
Following the functional evaluation phase, both maxillary and
mandibular, high-precision impressions of the uncut teeth were
taken. The impressions were sent
to the laboratory together with
a face bow. A centric bite record
was taken to ensure an accurate
transfer of the occlusal dimension
—for this purpose, the Michigan
splint was sectioned.
The temporary restorations
were fabricated using Telio CAD
(A2 shade). The study wax-up,
which served as the basis for
the CAD/CAM manufacture of
the restorations, was digitised.
‡ DT page 14

[13] => DTAP0111_01_Title

Anschnitt_DIN A3

04.12.2009

9:11 Uhr

Seite 1

Healthy choices for a
healthy practice.

A-dec 300

A-dec 500

Thanks to its progressive design and integration capabilities, A-dec 500® has become
a top choice in the industry. Now we’re happy to introduce another member to our
product family: A-dec 300TM. A complete system of dental equipment, A-dec 300
features a robust design with an ultra-thin profile. As one of the most compact dental
equipment systems available today, its minimal moving parts simplify maintenance
and cleaning. Simple. Smart. Stylish. It’s everything you need, nothing you don’t,
and it’s all A-dec.

Contact A-dec at 1.800.547.1883 or visit www.a-dec300.com to learn more about A-dec 300 and our complete family of healthy solutions.

[14] => DTAP0111_01_Title

DTAP0111_12-14_Edelhoff 09.02.11 12:28 Seite 2

DENTAL TRIBUNE Asia Pacific Edition

14 Trends & Applications
ﬂ DT page 12

Fig. 6a

Fig. 6b

Fig. 7a

Fig. 7b

Fig. 8a

Fig. 8b

Figs. 6a & b: Non-invasive rehabilitation of the dentition: clinical situation after adhesive cementation of the posterior restorations. The correct selection of the appropriate luting composite shade helped
to mask the severely discoloured tooth structure almost entirely.—Figs. 7a & b: Situation before and after adhesive cementation of the long-term temporaries. A slight trace of discoloration can be noticed only
at the restoration margins. The reason for this is the thinness of these veneer-shaped restorations.—Figs. 8a & b: Pre- and post-treatment portrait photographs. The aesthetic and functional expectations were
met promptly using a non-invasive approach in the interest of the patient.

This procedure resulted in formidentical, long-term temporaries
(Figs. 4a & b).

It was difficult to mask the extremely discoloured tooth structure with the thin temporaries.

To check the accuracy of fit and
shade match, the restorations
were trial fitted in the patient’s

mouth using glycerine gel of various colours (High Value +2 and
High Value +3 try-in pastes of the

Variolink Veneer Professional Set;
Fig. 5).

Seating
Based on the try-in with the
try-in pastes, the dual-curing, lowviscosity “basic white opaque” shade
(Variolink II Professional Set) was
selected for the final placement of
the temporaries. Before they were
incorporated, the inner surfaces of
the restorations were silicoated using the Rotatec system (Rotatec Soft
30 µm; distance to nozzle: 10 mm;
blast pressure: 1 bar; blast time per
unit: 10 seconds). Subsequently, the
restorations were silanised using
Monobond-S and coated with a layer
of Heliobond bonding agent. The
natural tooth structure was conditioned using the total etch technique and the Syntac dentine adhesive system. Final polymerisation
was performed with a bluephase
G2 light-curing unit (Figs. 6a & b).

Str ength
of a Hybrid ...

...Deli v e r

The temporisation phase with
the new vertical bite dimension allows a good prediction of the final
rehabilitation planned for once
the patient has reached full growth
(Figs. 7a & b). The immediate
treatment with long-term temporary restorations enabled us to
meet the needs of the patient at
this stage already using a non-invasive technique, and the patient
was most satisfied with the result
(Figs. 8a & b). DT

like a ﬂow
BEAUTIFIL Flow Plus

Contact Info

Yet another milestone in the Giomer family of restoratives, BEAUTIFIL Flow
Plus is an injectable hybrid aesthetic restorative that exhibits superior strength,
durability and aesthetics for enhanced applications in direct cosmetic dentistry.

...

The Plus EHQH¿WVIRU\RX

• Ideal density and stackability for effortless sculpting
• Remarkable mechanical properties
• Easy injectable delivery
• Extensive application capabilities including load-bearing surfaces
• Simulates life-like aesthetics with excellent shade match
%HQH¿WVRIÀXRULGHZLWKDQWLSODTXHHIIHFW

Ofﬁcial Partner

Prof. Daniel Edelhoff is a Senior
Dental Surgeon and Chair of the
Policlinic for Dental Prosthetics
at the Ludwig Maximilians University in Munich in Germany. He
can be contacted at daniel.edelhoff
@med.uni-muenchen.de.

For further information, contact your Shofu dealer
TODAY!

Singapore Branch 10 Science Park Road, #03-12 The Alpha, Science Park ll, Singapore 117684
Tel: 65-6377 2722 Fax: 65-6377 1121 eMail: mailbx@shofu.com.sg www.shofu.com.sg

Josef Schweiger is a dental technician and Head of the Dental
Laboratory of the Policlinic for
Dental Prosthetics at the Ludwig
Maximilians University.

[15] => DTAP0111_01_Title

DTAP0111_15_Shen 09.02.11 14:05 Seite 1

DENTAL TRIBUNE Asia Pacific Edition

Off time 15

“I would love to play a dentist in a movie”
An interview with actor Nick Shen, Singapore
Nick Shen is a well-known
actor, singer and entertainer
from Singapore who rose to
fame when he won Star Search
Singapore, a TV talent show, in
1999. In addition to having
acted in more than 20 drama
series during his career, the
35-year-old has a deeply rooted passion for Chinese opera,
which he regularly performs
on stage and at workshops.
During a dental visit to Singapore’s Specialist Dental Group,
Dental Tribune Asia Pacific
had the opportunity to speak
with Nick about the importance of aesthetic teeth and the
portrayal of dentists in movies.
DT Asia Pacific: Mr Shen, do
you like visiting the dentist?
Nick Shen: A great smile is
extremely important for me as
an actor and thus I do not mind
making regular trips to the dentist. I always make a point of
seeing a dentist twice a year to
ensure that all my teeth and gums
are in top condition.

In the entertainment industry, always looking your best is
a necessity. Being camera ready
with a great smile plays an important role in presenting an
actor in his best light.
With regard to your appearance (including good teeth), do
you consider yourself a role
model?
I do consider myself to be
a positive role model especially when it comes to a healthy
lifestyle. For example, I was
lucky, as a Singapore artist, to
be able to endorse healthier
meal choices and health sup-

I have not considered travelling so far afield for my cosmetic
dental treatment. Considering
the distance, time off work
needed, and the fact dentists here
are also able to offer high quality
dental work, I’ve decided to have
my dental treatment done in
Singapore. In fact, many patients
from the region travel to Singapore for complex dental treatment.
Cosmetic dental procedures are booming in Singapore. Are you aware of the
recent developments and techniques?

“I do consider myself to
be a positive role model.”
plements such as Avalon Ginseng for my fans. In addition,
I also worked as ambassador for
the Anti-Smoking Campaign of
the Health Promotion Board in
Singapore.

Have you paid more attention to your teeth since you won
Star Search Singapore?
Definitely! A great smile can
make such a big difference to one’s
overall appearance. I have invested a great deal of time and effort
in my career, and I am constantly
working on improving myself,
whether in the areas of gaining
more knowledge, honing my craft
or ensuring that I am looking and
feeling my very best. However,
what I did not realise until more
recently was that healthy teeth
and gums are also closely related
to the health of the rest of the body.

Many dental patients in the
US are longing for the so-called
Hollywood Smile. Have you
noticed similar trends here in
Singapore or elsewhere in Asia?
Indeed, the trend is spreading
rapidly in Singapore, as well as
in other regions in Asia, such
as Japan, China and Korea. I’ve
noticed that in recent years a
greater number of dentists are
beginning to offer cosmetic dentistry solutions in response to
increasing interest from people
here.

How important are aesthetic teeth for an actor nowadays?

Have you ever considered
undergoing cosmetic dental
treatment in the US?

Nowadays, people in this
country are more aware that
good oral health can enhance
their appearance and boost their
confidence. The public is more
educated on dental solutions,
although we might not be in a
position to decide whether such
treatment would be suitable for
us without seeing a professional.
As a consumer, I am definitely more knowledgeable going in for a consultation today,
than I was several years ago,
when there was not so much
information available on the
Internet, for example. However,
I learnt more about the recent
developments and techniques in
cosmetic dental procedures
when I went through these procedures myself. My veneers,
which I had done in a neighbouring country, failed and I had

to consult specialists here in
Singapore.
At Specialist Dental Group,
I was able to gain an appointment
with both the periodontist and
the prosthodontist in the same
visit, which was important to me,
given my busy schedule. Apart
from providing me with different
options to correct my problem,
the dentists here were able to coordinate my treatment so that
it was seamless. I also went
for gum surgery, and had
zirconium crowns and veneers to correct the shape
and shade of my teeth. It
was interesting for me to
visit a dental laboratory
during the procedure
and to discuss my preferences with the dental
technician.
Have you ever
had an accident
(on set or on
stage) that involved your
teeth?
No…and I
hope never to experience this!
In movies, dentists are often
portrayed as being antisocial
or psychopaths. Could you
imagine playing a dentist
yourself?
Sure, I would love to play
a dentist in a movie. That would
be quite a challenge. However,
from my interaction with dentists, I found that this picture of
dentists in movies is just wrong.
Real dentists are neither antisocial nor psychopaths. They
actually take away the pain, and
if people were to go for their
check-ups more regularly, it is
most likely that they would be
pain free, as there would not

Actor Nick Shen, Singapore

be any major dental problems
to resolve.
Your last movie was nominated for Best Short Film at the
Cannes Film Festival in 2009.
What other projects are you
working on at the moment?
I am going to appear in the
comedy My Ghost Partner, which
is scheduled to be released in
Singapore theatres soon. In this
movie, I play a triad leader, and I
had to dye my hair red for this role!
Thank you very much for
the interview and good luck
for the future! DT
AD

Highest quality made in Germany
All our products convince by
excellent physical properties
easy handling
perfect aesthetical results
more information:
www.promedica.de












Nano-C
eramTechn
ology


  

  
 

:
New ade!
h
S
ach
Ble

Temporary crown and bridge material
– particular fracture and wear resistance
– now available in 6 attractive shades

Light-curing nano-ceram composite
– highly esthetic and biocompatible
– universal for all cavity classes
– comfortable handling, easy modellation
– also available as flowable version

Glass ionomer luting cement
– very low film thickness
– perfect occlusal accuracy

PROMEDICA Dental Material GmbH
    
 $#      
! !!!""" $ 

Light-curring micro-hybrid composite
– excellent handling facilities
– universal for all filling classes
– also available as flowable version

Glass ionomer filling cement
– perfect packable consistency
– excellent durable aesthetics
– also available as handmix version

[16] => DTAP0111_01_Title

See four times more

He
lp

us

su 1
pp 20
or Ye
t S ar
OS s W
Ch &H
ild .
re
n’s
V

illa

ge
s!

The new Synea range with LED+

Optimal
illumination

+

Small
head

+

High
colour rendering
index

+

Perfect
LED positioning

One light – four advantages, the perfect combination. Optimal illumination;
a colour rendering index of more than 90; a perfectly positioned LED; and a
small head: Four reasons why you should use the new Synea turbines with LED+.
People have Priority! W&H supports the humanitarian organization SOS Children’s Villages.
Get involved! Further information at wh.com

Ready for imitation.

) [page_count] => 16 [pdf_ping_data] => Array ( [page_count] => 16 [format] => PDF [width] => 884 [height] => 1233 [colorspace] => COLORSPACE_UNDEFINED ) [linked_companies] => Array ( [ids] => Array ( ) ) [cover_url] => [cover_three] =>

[cover] => DT Asia Pacific

[toc] => Array ( [0] => Array ( [title] => No-drill restorations and amalgam equally successful [page] => 01 ) [1] => Array ( [title] => Asia News [page] => 02 ) [2] => Array ( [title] => Opinion [page] => 04 ) [3] => Array ( [title] => World News [page] => 05 ) [4] => Array ( [title] => “I want the dental profession to realise its potential” [page] => 07 ) [5] => Array ( [title] => Business [page] => 09 ) [6] => Array ( [title] => “ART has not been well received in dental schools” [page] => 10 ) [7] => Array ( [title] => Non-invasive - long-term temporisation with a high-performance polymer [page] => 12 ) [8] => Array ( [title] => “I would love to play a dentist in a movie” [page] => 15 ) ) [toc_html] =>

Table of contents

[toc_titles] =>

[cached] => true )