DT Asia Pacific No. 1+2, 2014

Universal health care scheme launched in Indonesia / Opinion / World News / Good oral health is not a luxury but a necessity of life / Business / Facing new challenges in sales and marketing / Ultra-thin veneers in clinical practice / Current perspectives on oral surgery / “I would like to start a revolution” / today ADX show preview

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DTAP0114_01_Title 10.02.14 16:42 Seite 1

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

www.dental-tribune.asia

Dental industry
New challenges in sales
and marketing
4Page

NO. 1+2 VOL. 12

Double teeth craze
An interview with
Dr Taro Okamoto, Japan
4Page

today ADX
A preview of Australia’s
largest dental show

4Page

Universal health care scheme
launched in Indonesia

Dentist from
Pakistan passes
RCSEd exam

Implementation overshadowed by inequalities in country’s health care system

The first dental implant surgeon in Pakistan to do so, Dr Irfan
Qureshi has received a Diploma
in Implant Dentistry from the
Royal College of Surgeons of
Edinburgh (RCSEd) in the UK.
He passed the course, which requires candidates to pass written
and oral exams, as well as defend
their own submitted clinical
cases, recently with top marks in
the respective test categories.
Held annually over the course of
three days in the Scottish capital,
the RCSEd diploma recognises
clinical experience and excellence in the field of dental implantology.

DT Asia Pacific

JAKARTA, Indonesia: Aiming to
improve access to health care
services for millions of people, the
government in Indonesia rolled
out the first stage of its universal health care coverage scheme
in January. The new insurance, called Jaminan Kesehatan
Nasional, replaces all previous
national and local health care
programmes and is intended to
provide initial coverage for people
who were members of the previous public health insurance for
the poor or who have a monthly income of less than 233,000 rupiah
(US$24).
Indonesia’s Minister of Health Nafsiah Mboi (left) talking to doctors during a press event on the occasion of the implementation
of the new universal health care scheme in late December. (DTI/Photo Kegiatan Lainnya, Indonesia)

With the first phase implemented this year, slightly over
120 million or approximately half
of the country’s population will be
automatically covered by the new
scheme. Coverage for all 240 million
Indonesians is anticipated by 2019.

increase the number of health care
workers and make improvements
to the country’s deficient health infrastructure, such as the construction of 150 new state-run hospitals.

In addition to higher health
care spending this year, the government has announced plans to

According to World Bank estimates, the scheme will cost
Indonesia up to US$16 billion each

year once fully implemented. The
country currently only spends an
estimated US$800 million in this
sector, which has raised concerns
among health care professionals
about the government’s ability to
pay out premiums to those health
care workers enrolled in the new
programme.

“Hospitals are afraid they will
lose money by not being reimbursed like in the past, while
health workers are afraid they will
make mistakes. As a result, quality
of treatment has been compromised,” a neurosurgeon recently
‡ DT page 3

Qureshi is one of the main
advocates for the specialty in his
country. Besides operating a dental practice specialised in dental
implant surgery in Karachi, he
lectures internationally and is
a diplomate of the International
Congress of Oral Implantologists. The founder and President
of the Federation of Implant
Dentistry Pakistan, he also helped
organise the first international
congress for dental implantology
in Pakistan in January 2012. DT
AD

Rise in
female
dentists
Sirona representatives from Asia and China receiving a “Top Employer
China 2014” award during a ceremony in Shanghai, China, in January.
4BUSINESS, page 9
(DTI/Photo Sirona Dental, Austria)

Meeting
postphoned

Childrens teeth
examined

The Centre for Advanced
Professional Practices has announced that its next CAD/CAM
and Digital Dentistry International Conference will be held
in Singapore in 2015. Their last
edition, which took place in October, saw a record attendance of
570 dental professionals visiting
the two-day event. DT

Four years after the fall-out
from the Fukushima nuclear
plant in Japan, the Fukushima
Prefecture Dental Association
will be conducting a large-scale
examination on the teeth of children. Testing for presence of the
radioactive isotope strontium-90,
the project is going to commence
in April. DT

The number of dentists in
Australia has increased, as well
as the number of women working in the field in particular. Today, more than a third of dentists
registered in the country are female, according to a recently
published employment report by
the Australian Institute of Health
and Welfare in Canberra.
A total of 19,462 dental practitioners were registered by the
Dental Board of Australia in 2012,
of whom 14,687 (75.5 per cent)
were dentists. The report also
showed that 1,600 (8.3 per cent)
worked as dental hygienists,
1,276 (6.6 per cent) as dental
therapists, 1,161 (6 per cent) as
dental prosthetists and 738 (3.8
per cent) as oral health therapists. DT

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at your disposal to help people regain a beautiful smile.

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Ivoclar Vivadent AG
Bendererstr. 2 | FL-9494 Schaan | Liechtenstein | Tel.: +423 / 235 35 35 | Fax: +423 / 235 33 60

[2] => DTAP0114_01_Title

DTAP0114_02_News 10.02.14 16:42 Seite 1

DENTAL TRIBUNE Asia Pacific Edition No. 1+2/2014

U P C O M I N G

WEBINARS German professor replaces
Samaranayake as dean
of HK dental school

Prof. Thomas Flemmig to assume top position in July
and communication skills, we have
high hopes that
the faculty will
continue to excel
in research, education and dental
care under his
leadership,” HKU
Vice-Chancellor
and President Prof.
L a p - C h e e Ts u i
commented.

Daniel Zimmermann
DTI

DENTAL TRIBUNE AMERICA IS AN ADA CERP RECOGNIZED PROVIDER

17
DEC

AN OVERVIEW OF MINIMALLY
INVASIVE
Periodontal Surgery Using
Er,Cr:YSGG Laser Technology
Dr. Rana Al-Falaki
01:00 PM (EST)

This webinar course is a clinical overview of the use of the
Er,Cr:YSGG laser in the management and treatment of Advanced
Chronic Periodontitis and Aggressive Periodontitis. Traditional
methods to treat such cases usually involve extensive periodontal surgery, along with the use of regenerative bone substitutes
to manage the disease process, at the same time resulting in
prolonged side effects of sensitivity, pain and recession, as well
as the inevitable need for systemic antibiotics. This lecture will
take you through an overview of aetiology and risk factors associated with periodontal disease, provide you with an overview of
available and current treatment modalities, and demonstrate a
minimally invasive technique using Er,Cr:YSGG lasers to achieve
favourable outcomes with minimal adverse side effects.
Learning objectives:
• Gain a better understanding of how lasers work on soft
tissues and bone
• Gain an understanding of the use of Er,Cr:YSGG laser in
periodontics for the management of periodontitis.
• Gain an understanding of the mechanisms through which the
Er,Cr:YSGG laser can be effective in the periodontal pocket.
• Gain an understanding of the criteria needed for periodontal
regeneration, and how the Er,Cr:YSGG laser can help to
achieve this goal.
• Be able to describe laser periodontal treatment to their
patients.

HONG KONG: The
University of Hong
Kong (HKU) has announced the appointment of Prof. Thomas
Flemmig from the University of Washington
School of Dentistry in
the USA as the new dean
of its dental faculty.
The German expert in
periodontology will asFlemmig is the
faculty’s seventh
sume his new position by
dean since its inthe middle of the year and
replaces Prof. Lakshman Flemmig (left) is succeeding Samaranayake (right) as dean of the HKU auguration in 1982.
Samarana yake, who Faculty of Dentistry. (DTI/Photos courtesy of Hong Kong University) He is also the first
moved on to head the
German to assince 1990. Speaking to Dental
sume the prestigious position,
University of Queensland School
Tribune Asia Pacific in January,
which has been held by denof Dentistry in Australia at the
he stated that he was unwilling
tal professionals from Great
beginning of the year.
to comment on his appointment
Britain and Sri Lanka, among
for the moment.
others. According to the univerFlemmig’s appointment ends
sity, his contract with the Faca worldwide search by HKU for
HKU officials thanked
ulty of Dentistry will be limited
a new faculty dean that started
Samaranayake, who headed
to a period of five years.
in late 2012. According to unithe dental faculty from 2004,
versity officials, Prof. Edward
and welcomed Flemmig, reHong Kong’s only institution
C.M. Lo, Chair of Dental Public
marking that he is a “highly acfor higher dental education, the
Health, is serving as interim
complished scholar of internaschool currently provides sixdean until Flemmig assumes
tional standing and a renowned
year undergraduate training in
his new position in July.
periodontist.”
dental specialties such as oral
and maxillofacial surgery and
Prior to his tenure in the
paediatric dentistry. According
USA, Flemmig held academic
“He possesses rich experito university figures, 110 stupositions in several dental
ence in working with governdents were enrolled in the Facschools in Germany, including
ment agencies and professional
ulty at the end of 2013, which
those of Würzburg and Münsorganisations. With this comhas an intake of 50 students per
ter. In addition, he has mainbination of academic achieveyear. DT
tained an intramural practice
ments, management experience

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

Clinical Editor

Magda Wojtkiewicz

President/CEO

Torsten Oemus

Online Editors

Yvonne Bachmann
Claudia Duschek

Media Sales Managers

Matthias Diessner
Peter Witteczek
Maria Kaiser
Melissa Brown
Weridiana Mageswki
Hélène Carpentier

CFO/COO

Dan Wunderlich

Marketing & Sales Services

Esther Wodarski

Accounting

Karen Hamatschek

Business Development

Claudia Salwiczek

Executive Producer

Gernot Meyer

Ad Production

Marius Mezger

Designer

Franziska Dachsel

13
FEB

TIPS AND TRICKS FOR
MAXIMUM SUCCESS
Ron Kaminer, DDS
08:30 PM (EST)

This program will cover clinical tips in day to day restorative
dentistry. It will systematically discuss, new materials, and
their impact on operative dentistry and crown and bridge.
Some of the topics covered will be:
• Universal Adhesives – Why should I switch to these
type of adhesives?
• The newest era of flowable composite.
• The ten minute bonded post and core
• Esthetic splinting of periodontally involved teeth.

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.
© 2014, Dental Tribune International GmbH. All rights reserved.

BECOME A FREE MEMBER:
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Dental Tribune makes every effort to report clinical information
and manufacturer’s product news accurately, but cannot assume
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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.

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Tel.: +49 341 48474-302 · Fax: +49 341 48474-173
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Tel.: +1 212 244 7181 · Fax: +1 212 224 7185

[3] => DTAP0114_01_Title

DTAP0114_03_News 10.02.14 16:42 Seite 1

DENTAL TRIBUNE Asia Pacific Edition No. 1+2/2014
ﬂ DT page 1

told the United Nations news
agency Integrated Regional Information Networks.
Under the scheme, medical
care providers at primary care
level are entitled to 8,000 rupiah
(US68¢) per month for each
patient they see regardless of
whether they treat the patient.
According to reports by the Indonesian Dental Association,
dentists receive a monthly payment of 3,270 rupiah (US 20¢) per
patient.
Professional organisations
and health experts have warned
that these amounts might be too
low for guaranteeing long-term
quality care. They also pointed

North Korea
opens new
dental centre

out the problem of unequal distribution or simply the lack of
health care service providers and
facilities throughout the country.
Millions of people in the central
and eastern parts of the island
state, for example, are not able to
see a doctor regularly.
According to figures from the
World Health Organization, the
country also has a shortage of
about 4,000 dentists. In order to
receive even basic treatment,
millions of people have to rely
on tukang gigi, a group of an

Asia News

estimated 75,000 unregistered
street dentists, who offer lowcost dental procedures, such as
extractions and fillings, without
approval from health authorities.
A government regulation to ban
these people from practising was
overturned by the constitutional
court in Jakarta last year.
Owing to the lack of manpower, the prevalence of dental
diseases remains high in Indonesia, with almost 70 per cent of
adults suffering from caries and
other oral lesions. DT

Rural workers in Central and Eastern Indonesia have limited access to health
care services. (DTI/Photo Gnomeandi)
AD

N-Cement Collection
Luting materials from Ivoclar Vivadent

DT Asia Pacific

PYONGYANG, DPRK/TOKYO,
Japan: Amid political tensions
on the Korean Peninsula, the
government of Democratic People’s Republic of Korea (DPRK)
has recently opened a new advanced dental clinic in the eastern part of the capital Pyongyang.
Located in the Taedonggang
district, the Ryugyong Dental
Hospital was constructed in
record time and has the capacity
to treat 300 people a day, according to official reports.
In a video released by the
DPRK news channel in Tokyo in
Japan, a clinic employee stated
that the infrastructure of the
centre is comparable to Western
standards and offers a dental laboratory and paediatric dentistry
department. It also seems to be
equipped with dental equipment
from leading dental manufacturers from Europe, which includes
digital imaging systems, apex
locators and caries detection
technology.
Similar to other matters regarding the country, little is
known about the size and quality
of North Korea’s oral health care
system. Estimates about the
country’s dental work-force are
only available from the WHO,
which estimates that the country
employs slightly more than 8,000
dentists, or charity organisations
such as Samaritan’s Purse in the
US, which supports the isolated
country with a number of dental
care-related projects. Speaking
to Dental Tribune Asia Pacific
in 2012, its board member
Dr Melvin Cheatham said that
there is reason to believe that
dental care, which is provided
solely by the North Korean government, is lacking in labour and
proper training. He admitted,
however, there have been initiatives under the new regime to
improve dental services in the
recent past, particularly in urban
areas like Pyongyang. DT

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[4] => DTAP0114_01_Title

DTAP0114_04_News 10.02.14 16:43 Seite 1

Opinion

DENTAL TRIBUNE Asia Pacific Edition No. 1+2/2014

Dear
reader,

Clinical
fantasy

Daniel Zimmermann
DTI

Prof. Beena Rani Goel
India

In a few week’s time, dental
professionals from the Asia Pacific
region will once again have the
opportunity to get a sneak peak of
the latest innovations in dental
products and technology, when the
next International Dental Exhibition and Meeting (IDEM) opens its
doors in Singapore. Held in a completely refurbished Suntec Center,
the show promises to be bigger and
better than ever before. The dental
exhibition, for example, has been
enlarged and is now being held in
two separate halls. Subsequently,
there will be a wider range of products on display including advanced
biomaterials and integrated digital
solutions. Educational offers are
plenty with our Middle East partner
CAPP to present the Dental Technicians Forum at IDEM for the first
time. Live presentations will be also
available from the Dental Tribune
Study Club, which is holding its live
symposium for the third consecutive time. With all this on offer,
I look forward to meet you there. DT

The root canal system of a
tooth is complex and pulp infection once established is often
difficult for the body to eliminate.
While root canal treatment remains the primary choice for
treatment, the potential of pulp
regeneration and revascularisation has been discussed lately.
Many factors are vital to success.
First, complete elimination of
microbes is mandatory. Even in
root canal treatment, this cannot be achieved fully, although
a hermetic seal gives the body
time to establish a calcific barrier.

Yours sincerely,
Daniel Zimmermann
Group Editor
Dental Tribune International

Dental Tribune welcomes comments,
suggestions and complaints at
newsroom@dental-tribune.com.
For quick access to
our contact form,
you may also scan the
following QR code.

An overwhelming task
Dr Diah Ayu Maharani
Indonesia

The implementation of a
universal health care scheme in
January is widely considered a significant step forward for increasing
the quality and access to medicines
and medical treatment for the entire Indonesian population. Policymakers are committed to covering
every citizen through the reform by
2019. But how may the recent introduction of universal health care
coverage affect dentistry? Providing dental care to 240 million people who are widely geographically
dispersed appears to be an overwhelming task. All stakeholders in
Indonesia’s dental sector, including
politicians, health care providers,
and dental manufacturers and distributors, are now facing the critical
task of having to redefine their role
within this changing environment.
The latest figures demonstrate
that the prevalence of dental dis-

eases in the country remains considerably high. Previous government policies have not improved
the oral health of Indonesians
significantly. Universal health care
coverage may reduce the economic
barriers to accessing dental care,
which will improve the country’s
overall oral health status.
These efforts however will not
diminish the uneven distribution
of dental care services. At the moment, they are primarily concentrated in the western part of the
country. Owing to this disparity,
citizens who live in remote areas
in the central and eastern parts of
Indonesia have very limited access
to a dentist.
Universal health care coverage
is expected to increase dental care
utilisation at public facilities, particularly primary care facilities, by
the poor. Concerns of the Ministry
of Health concerning the poor state
of Indonesia’s health care facilities
have encouraged the government
to focus on better access to care.
At the same time, the Ministry of
Health aims to improve the quality

of care, as it would not make sense
to provide health care to everyone
in the country if the quality remains
poor.
The professionalism of dental
health practitioners depends not
only on their skills but also largely on
the quality and availability of dental
equipment. Currently, the majority
of dental instruments and materials
in Indonesia are imported. The absence of local production of and
price control regulations on dental
instruments and materials might
cause high and unstable costs,
which could place the long-term
success of universal health care
coverage at risk. Analysing and
overcoming these challenges is
necessary to achieve efficient and
effective dental care in the future. DT

Contact Info
Contact Info
Dr Diah Ayu Maharani is a lecturer and researcher at the University of Indonesia’s Faculty of
Dentistry in Jakarta. She can be
contacted at diah.ayu64@ui.ac.id.

gzhou/Chin

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In the presence of microbes,
whether the cells from induced
bleeding can function in an adult
tooth is to be seen. It may be
possible in partially vital pulp
with no apical periodontitis. For
such cases, an approach using
stem cells has shown potential.
Expecting revascularisation in
an infected case simply by making “tiny cuts into the root canal
system until the tissue starts to
bleed” however is still a clinical
fantasy because there is no pulp
in the case of an established
infection inside the tooth. DT

Dental desensitising varnish
• treatment of hypersensitive dentine
• fast desensitisation
• fluoride release
• easy and fast application

Prof. Beena Rani Goel is the
President of the International
Academy for Rotary Endodontics
and a well-known endodontist
from India. She can be contacted
at profgoel@gmail.com.

[5] => DTAP0114_01_Title

DTAP0114_05_News 10.02.14 16:43 Seite 1

DENTAL TRIBUNE Asia Pacific Edition No. 1+2/2014

World News

Procedure could replace root canal treatment
DTI

LIVERPOOL, UK: Researchers
at the University of Liverpool are
currently testing a new procedure to treat infected pulp.
Revascularisation can be performed in just two visits and
could spare patients from under-

going the long and much disliked
root canal treatment.

the tissue starts to bleed, which
triggers a blood clot.

factors, compounds that help repair damaged tissue.

As reported by MailOnline,
the first step of the new procedure
entails drilling into the tooth and
applying an antibiotic paste to
disinfect the root canal. A second
visit to the dentist follows approximately two weeks later. Using
a tool, the dentist makes tiny cuts
into the root canal system until

The clot encourages the
growth of new blood vessels.
This boosts oxygen and nutrient
supply and helps the pulp repair
itself. The mechanism is not
clearly understood, reported the
website; however, one suggestion is that a blood clot contains
a high concentration of growth

Studies have already found
the technique to be successful.
The scientists at the University
of Liverpool are testing revascularisation on 15 patients. The
outcomes will be compared with
a control group of 15 patients
undergoing conventional root
canal treatment.

Commenting on the new
treatment in MailOnline, Dr Hugh
Devlin, Professor of Restorative
Dentistry at the University of
Manchester’s School of Dentistry,
said: “It’s an excellent technique
and is getting a lot of interest
in the academic journals. Traditional treatment eliminates
bacteria, but prevents growth
of a new blood supply to the
root.” DT
AD

New bacteriafighting agent
patented
SEATTLE, USA: Researchers at
the University of Washington’s
School of Dentistry have received
a patent for a new way of using
titanium-based materials to control bacterial infections. They believe that the substances could be
used in a patient’s mouth after
dental procedures to reduce the
risk of infection or in mouthwashes and toothpastes to limit
bacterial growth prophylactically.
Over several years, the researchers have studied titanates
and peroxo-titanates, inorganic
compounds that can inhibit bacterial growth when bound to metal
ions. They found these substances
to be effective against endodontic,
periodontic and cariogenic bacteria, indicating that these substances could be incorporated
into gels or solutions that can be
applied by dentists after treatments such as root canals or dental
fillings.

ORTHOPANTOMOGRAPH ® is a registered trademark of Instrumentarium Dental, PaloDEx Group Oy.

DTI

The One
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GO FOR INSTRUMENTARIUM DENTAL

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professionals. We’re ready for the next 50 years.
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Dr. Whasun Oh Chung, research associate professor at the
school, explained that metals
have been known to have antibacterial properties, but when
used in concentrations high
enough to be effective, they also
carry the risk of toxic side effects.
Using the new agent, however,
therapeutic benefits can be
achieved with less risk of toxicity.

Currently, the researchers
are conducting human trials.
They expect to finish them in
spring. If proven effective, the
new agent could even be used
in narrowly targeted treatments
for internal organs, as well as in
dental or medical materials and
devices, Chung said. DT

1961 | ORTHOPANTOMOGRAPH® OP1

Correction
In Dental Tribune Asia Pacific
No.12, Vol. 11, the article titled
“Report about sterilisation incident”
on page 1 misstated the year in
which the incident at the University
of Hong Kong Health Service’s
Dental Unit took place. In fact, patients were treated with improperly
sterilised instruments between
30 October and 2 November 2012.

www.instrumentariumdental.com

2011 | ORTHOPANTOMOGRAPH® OP300

2013 | The journey continues

[6] => DTAP0114_01_Title

DTAP0114_06-07_News 10.02.14 16:44 Seite 1

World News

DENTAL TRIBUNE Asia Pacific Edition No. 1+2/2014

Good oral health is not a
luxury but a necessity of life
Ben Adriaanse
DT Netherlands

“The neglect of global oral health”
is the thought-provoking title
of the thesis of Habib Benzian.
Has dentistry remained so inadequate and poorly developed
worldwide despite all the medical advances? Benzian believes
so, as does Bella Monse, both of
whom concurrently conducted
doctoral research on initiatives
to improve oral health in the
Philippines and developing countries. After reading their theses,
Dental Tribune Netherlands interviewed the authors on the eve
of their doctoral defences at two
Dutch universities.
The interest of both PhD candidates in oral health in developing
countries goes back a long way.
Monse (born in 1959, Innsbruck,
Austria) worked as a volunteer in
the Philippines in the early 1990s.
“What I found there was humbling;
much worse than I could ever have
imagined,” Monse recalled.
Children with completely destroyed dentition and with resulting dental infections are commonly
seen in developing countries. This
shocking experience remained a
profound memory, with the result
that, ten years ago, she decided to
work full time as an adviser to the
Department of Education’s School
Dental Health Services in the
Philippines. Although at first she
AD

was working to improve oral health
only, she soon realised that this was
not enough and that the general
health of schoolchildren needed
to be improved as well.
Benzian (born in 1963, Bonn,
Germany) worked as a volunteer oral surgeon at the Albert
Schweitzer Hospital in Gabon.
There he was “overwhelmed by the
burden of disease”, as he was the
only dentist for 450,000 people.
“I could have worked day and
night, but gradually I realised that
I was powerless to make a real impact and that only by working at
a different level, with a different
approach, would I be able to improve oral health.” For this reason,
Benzian held various health policy
positions after completing his postgraduate studies in dental public
health, including a position as
Development and Public Health
Manager at the FDI World Dental
Federation in Geneva.
How did these two international
researchers come to do their PhD’s
at Dutch universities? The deciding
factor was Professor Emeritus Wim
van Palenstein Helderman from
the Netherlands, who gave a presentation on the Basic Package of
Oral Care at the FDI congress in
2000. “By chance I sat next to Bella
in the audience,” Benzian recalled.
“We had a similar vision and that
is how it all began.” After years of
working closely together, Monse

and Benzian eventually undertook PhD’s at Radboud University
Nijmegen and the University of
Amsterdam, respectively.

Quality of life
The title of Benzian’s thesis
might appear to be rather negative.
Have dental care and oral health
not improved significantly worldwide? “Not for everyone,” Benzian
emphasised. “In Western highincome countries, major improvements have been achieved, although there is more that can be
done, but for the rest of the world,
oral health care remains largely
inadequate. In addition, chronic
and infectious diseases, other than
those affecting the mouth, often
rank higher on the priority list of
many governments. In fact, oral
health often does not even feature
on those lists.”
Benzian has repeatedly been
told by ministers of health that oral
health care “is simply not affordable”. At first glance, this belief
might be understandable, since a
Western-based form of dental care
is expensive, oral diseases are not
life-threatening, and the burden
of other severe diseases, such as
diabetes and HIV/AIDS, is high.
Yet, it is a misconception to consider oral health a negligible issue,
Monse believes.
“Its impact on quality of life is
enormous. Dental caries is a major
problem in low- and middle-income countries because it usually
remains untreated. This results in
chronic inflammation in the dentition with pain that affects school
attendance and child development.” All of this has a significant
impact on general well-being.
“Anyone who has ever had severe
toothache will agree,” Monse said.

Relationship between healthy
teeth and development
Both PhD candidates emphasised that untreated dental problems can result in a number of
medical complications. “Our concerns do not focus so much on the
cavities themselves, but on the consequences of the cavities that are
left untreated,” Benzian explained.
He also said that many policymakers lack knowledge about these
consequences because reliable
data is limited.
Monse and Benzian developed
the PUFA index, which offers a new
measure for capturing the extent
of the consequences of untreated
caries. “Previously we only counted
the number of cavities, but actually
that does not tell us much,” Monse
explained. “It was only when I was
able to say that 85 per cent of schoolchildren had infections in the
mouth, such as infected pulps and
abscesses, that the Philippines
government realised the severity
of the situation.”
Based on epidemiological research, Monse and Benzian also

Bella Monse (left) and Habib Benzian on the eve of their promotion.
(DTI/PhotoBen Adriaanse, DT Netherlands)

found a significant association between severe caries and a (too) low
body mass index (BMI). This is an
important finding because the
growth and development of children and combating underweight
are important issues for politicians
in developing countries.
Is the association between
caries and a low BMI not simply
due to a common cause, such as a
low socio-economic status? Monse
acknowledged that the relationships are complex. There is indeed
a link between low socio-economic
status and caries, but also between
low socio-economic status and a
low BMI. However, in her thesis,
Monse showed a causal link between severe untreated caries and
a low BMI. Children with a very low
BMI and severe dental decay that
had been left untreated quickly
caught up in their growth after
treatment with tooth extraction.
“Without toothache, children
sleep better and sleep stimulates
growth. But healthy food and clean
water are also important for development. This demonstrates that
childhood diseases, including oral
diseases, should be addressed in
an integrated approach. Teeth that
are free of pain and good oral health
are not luxuries but necessities of
life,” she said.

Self-care
Even if governments in developing countries wanted to recognise the importance of good oral
health, there is hardly any funding
available. According to Benzian,
“Many countries without a tradition of public or private oral health

care look at health systems in highincome countries as models, although it is neither attainable nor
realistic for them.”
What can policymakers in poorer countries with a stretched health
budget do? “The key lies not in oral
health care itself. For those who do
not have access to a dentist, self-care
is of great importance. In the areas
of prevention and education, much
can be achieved with relatively little
means,” said Benzian. Examples include large-scale school health programmes, such as the Fit for School
programme that Monse initiated in
the Philippines. This programme
includes some simple preventive
activities that take place in schools
under the supervision of teachers,
such as daily handwashing with
soap and daily toothbrushing with
fluoride toothpaste.
Legislation too can lead to improvements in personal oral health.
“The government must create an
environment in which the public
is encouraged and supported to
stay healthy,” stated Benzian. Thus,
self-care products should be as
affordable as possible and harmful products that pose risks to
health, such as tobacco, sugar and
alcohol, should be subject to tight
government regulation. Furthermore, especially in the developing
world, it is important to monitor
the quality of fluoride toothpaste.
“In a country like the Netherlands,
you do not need to be concerned
about this, but in many low- or
middle-income countries, for example, many of the toothpastes
available contain only little or no
fluoride. Therefore, they are in-

[7] => DTAP0114_01_Title

DTAP0114_06-07_News 10.02.14 16:44 Seite 2

DENTAL TRIBUNE Asia Pacific Edition No. 1+2/2014
effective against caries,” Benzian
explained.
In early November 2013, a typhoon swept across the Philippine
mainland and claimed around
6,000 victims. Does Monse’s call for
improving oral health come at an
inappropriate time? The PhD candidate sees it differently: “The Fit
for School programme is integrated
and part of the Philippine education
sector, and activities and funding
for the programme are sustainable
long-term commitments that do
not stop owing to an emergency
situation. Furthermore, the programme aims at promoting good
health in general. Especially in the
disaster areas residents are reaping the fruits of that now.” Monse
highlighted the role schools have
played as emergency shelters, providing clean water and sanitation.

World News

“...much can be achieved with
relatively little means.”
treatment’ are understandable. But
that way you don’t improve the
system. You have to realise that
you are just a visitor and therefore
you need to support long-term solutions, such as training and education of local health care providers.
That way you contribute to sustainable local capacity.”

If you are a dentist and you
have the opportunity to speak to
policymakers, seize the chance
with both hands. “Most important
of all is not to follow the blame approach but to identify the problems
in a diplomatic manner and contribute to possible solutions. That
way you subtly plant a seed in

yourself and can relate to an issue
on a personal level, the urgency of
the problem becomes more concrete,” Benzian advised.

somebody’s mind. Furthermore,
a positive ‘trigger’ can play an
important role. I know of cases
where decision-makers suddenly invested significantly in oral
health care because, for example,
their daughter was relieved of
her chronic toothache by a dentist.
If you experience something

However, he emphasised that
the political priority of oral health
in most countries remains low
and every effort should be made
to change this situation. “It starts
with each and every one of us;
talk and seek collaboration with
your medical colleagues, work
with a paediatrician to raise
awareness of oral health wherever
possible.” DT
AD

According to van Palenstein
Helderman, Benzian’s and Monse’s
supervisor, providing for this type
of basic need is a prerequisite for
the success of education. “It makes
no sense to educate children on
healthy behaviour if the environment is not supportive.” However,
two-thirds of schools globally have
no access to clean water and have
no proper sanitation.

Ret
in t racti
he on
USA Pas
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1

Long-term solutions
Among Dutch dental care professionals, there are many examples of colleagues performing valuable work in developing countries.
What can a dentist do to make
a relevant contribution in these
countries? Monse noted that initiatives do not necessarily need to
be carried out in faraway places.
“Each country has its own ‘developing world’. Look for the vulnerable
and disadvantaged groups in your
immediate environment. Since you
are familiar with the system, you
can achieve a lot.”
Anyone wanting to work abroad
should do so in a responsible way.
van Palenstein Helderman describes the wrong way: “In the past,
some dentists have set up their
entire practice in a developing
country and started to provide the
type of care with which they were
familiar during a short-term campaign. That way you create dependencies among the local communities and devalue the existing health
care system because once you’re
gone, no one can continue the work
you’ve started.” Instead, he refers
dental professionals to an organisation like Dental Health International Nederland (DHIN), which
assists local organisations in developing countries in oral health projects. DHIN is often the starting point
for Dutch oral care professionals
for their activities as a volunteer.
Benzian believes that volunteers should not provide substandard dental care. “The developing
world is not a playground for undergraduate dental students or an area
to try out treatments or act without
due care. You have the responsibility to help each patient the best
way possible, otherwise you cause
damage.” In addition, he warned
against well-intended enthusiastic
action without first carrying out the
necessary introspection, planning
and co-ordination with local stakeholders. “Thoughts like ‘the situation is so bad, I provide nonstop

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[8] => DTAP0114_01_Title

Bio-Emulation Colloquium
TM

The Santorini Experience

June 21-22, 2014, Santorini Greece
Go ahead and treat yourself to a world class dental colloquium
at a top 10 vacation destination! Be part of the Bio-Emulation movement.
Mentors

Pascal Magne

Michel Magne

Francesco Mangani

Francesca Vailati

Gaetano Calesini

Jason Smithson

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Emulators

Panos Bazos

Gianfranco Politano

Gil Tirlet

Javier Tapia Guadix

David Gerdolle

Leandro Pereira

Sascha Hein

Lucas Zago Naves

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Registration information:

June 21-22, 2014, Greece

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Details on www.TribuneCME.com
contact us at tel.: +49 341 48474 302
email: request@tribunecme.com
Tribune America LLC is the ADA CERP 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.

[9] => DTAP0114_01_Title

DTAP0114_09_Business 10.02.14 16:44 Seite 1

DENTAL TRIBUNE Asia Pacific Edition No. 1+2/2014

Business

“Take CAD/CAM to the next level” Sirona recognised
Planmeca’s vice-president on the company’s
as top employer
strategic investment in E4D Technologies
in China
lucencies, dental restorations,
models and impressions. It is
the world’s first dental unitintegrated intra-oral scanner
and can be used through a laptop
as a standalone version. Together with our Planmeca Romexis
software, the system supports an
ideal digital treatment workflow.

Finnish dental technology
manufacturer Planmeca has
recently made a significant
equity investment in the USbased high-tech medical device
company E4D Technologies.
In this interview, vice-president at the Planmeca Group
and acting CEO for E4D Technologies Tuomas Lokki sheds
light on this new venture.
Mr Lokki, why did Planmeca choose to invest in E4D
Technologies?
We believe in the tremendous possibilities and future
growth of CAD/CAM dentistry.
As dentistry will be completely
digital in the future, we believe it
is vital to invest in the development of new and efficient practices. E4D is a long-term leader
in advancing modern CAD/CAM
dentistry, so we knew that joining forces with this high-tech
medical device company would
be a valuable addition to our
own leading expertise in 3-D
imaging and software solutions.

Tuomas Lokki (DTI/Photos courtesy
of Planmeca, Finland)

How will this improve the
daily workflow at clinics?
One great advantage is the
integration of X-ray imaging and
CAD/CAM into a single software
platform, Planmeca Romexis.
For the first time, customers will
have the option of one software
interface for both X-ray imaging
and CAD/CAM work. All patient
data is also saved in the same

How will both Planmeca
and E4D benefit from this
investment?
On the one hand, this investment strengthens Planmeca’s
position in the fast-growing CAD/
CAM business and Planmeca benefits from E4D’s cutting-edge solutions and long-term CAD/CAM
expertise. On the other hand,
Planmeca’s extensive distribution network enables E4D Technologies to grow globally and our
leading dental imaging solutions
will be a valuable addition to the
E4D CAD/CAM platform.

DTI

Has this venture created
any new needs for your company?

“...our leading dental imaging solutions will be a
valuable addition to the E4D CAD/CAM platform.”
Their special expertise and innovative ideas provide a great
foundation for future projects
that will combine the know-how
of both companies.
What advantages will this
investment offer dental customers worldwide?
The new partnership with
E4D Technologies will enable us
to offer our customers the most
modern CAD/CAM innovations.
Our product distribution in over
120 countries combined with the
cutting-edge E4D innovations
will increase global product
availability and take computeraided dentistry to the next level.
Our customers will also benefit
from the innovative combination
and seamless integration of
Planmeca’s and E4D’s products
and services.

database and it can be shared
immediately and easily through
the clinic’s network or with the
Planmeca Romexis Cloud service. Furthermore, the restorations designed in the CAD module can easily be combined with
the patient’s 3-D X-ray images
for implant planning purposes,
for example. For the patients,
this means convenient same-day
dentistry.
Can you also tell us about
the brand new intra-oral scanner that you launched recently?
Our new Planmeca PlanScan
intra-oral scanner is an ultrafast, powder-free and open solution for 3-D digital impressions.
Its advanced blue laser technology accurately captures hard
and soft tissue of various trans-

Photo shows Sirona employees with representatives of other Chinese companies,
who were recognised as the top 40 top employers in the country. (DTI/Photo
courtesy of Sirona, Austria)

Definitely, as we need to provide extensive CAD/CAM training
for our distribution and customer
network in over 120 countries.
Therefore, we have recently invested in new training, warehouse and production facilities
alongside our Helsinki headquarters. These new 10,000 sqm
facilities will help us address the
growing need for training and
education in this new field of
dentistry.
We are thrilled to be able to
take CAD/CAM to the next level.
Our innovations will change the
concept of same-day dentistry
completely and facilitate the
workflow of dental professionals
worldwide.
Thank you very much for
the interview. DT

SHANGHAI, China: Sirona China
has been recognised as Top
Employer China 2014. Based on
a multistage analysis and audit
process, the award is presented
annually to outstanding employers around the world by the Top
Employers Institute. Excellent
working conditions, talent promotion and continuous development of personnel are the main
criteria.
Sirona China was among
40 employers in the country that
were honoured with the award.
“Employees are the heart of our
company,” Michael Elling, VicePresident of Corporate Human
Resources at Sirona Group, said.

In 2006, Sirona began establishing its base in China with just
30 employees. Today, more than
150 employees work for the company at that office—a success
story also in terms of staff development. Sirona China is number
one in treatment chairs for dentists. Its digital dentistry and
CAD/CAM products have gained
significant importance over the
past two years. DT

Roland DG
Australia expands
into dental business
DTI

SYDNEY, Australia: Roland DG
Australia, a provider of milling
and 3-D engraving technologies,
has opened a 3-D and dental
creative centre at its headquarters in Sydney. The facility
was established to strengthen
the company’s position in the
dental and manufacturing industries throughout Australia,
New Zealand and the ASEAN
region.

Planmeca Romexis allows the integration of X-ray imaging and CAD/CAM into a single software platform.

“The Top Employer award for
Sirona China is a recognition of
our local and global employee
development. The award is part
of our global growth strategy,
reinforces our attractiveness as
an employer and encourages
employees to be active for Sirona
at home and abroad.”

The new facility is mainly
focused on Roland’s Easy Shape
Dental Solution and the DWX
range of dental milling machines, including the DWX-50,
which was specifically designed
for dental laboratories and technicians for the production of
dental prostheses, including
crowns, bridges and abutments,
and the DWX-4, which was released last October as the world’s

smallest dental milling machine
by the company.
The facility was officially
opened at the company’s 25th
anniversary event in November.
In addition to a vast range of
equipment set up for live demonstrations and product development, the facility has an adjacent
training room equipped for interactive training sessions and
seminars. An array of application
samples are also on display, the
company stated.
Roland DG Corporation, which
has its headquarters in Japan, is
a global manufacturer of inkjet
devices, milling and engraving
devices, 3-D scanners, and a number of other products. The company entered the health care market only recently by introducing
milling machines designed for
creating dental prostheses. DT

[10] => DTAP0114_01_Title

DTAP0114_10_Business 10.02.14 16:44 Seite 1

DENTAL TRIBUNE Asia Pacific Edition No. 1+2/2014

10 Business

A-dec celebrates 50 anniversary
th

DTI

NEWBERG, Ore., USA:
Dental manufacturer
A-dec is celebrating its
50th anniversary this
year. Founded in 1964
by Ken Austin and the
late Joan Austin in Newberg, Ore., in the USA,
the company is one of
the best-known manu-

facturers of dental chairs, delivery systems, and dental lights
worldwide today.
In addition to its 50-acre US
headquarters, which employs
more than 1,000 people, A-dec
currently maintains operations
in Australia, China and the UK,
cooperating with an extensive
network of dealers in more than
100 countries worldwide.

Over the last few decades, the
company has developed a number of innovations used in dental
practices worldwide. In 1964, for
example, the first vacuum ejector, patented by A-dec, replaced
belt-drive devices in treatment
rooms.
The company also introduced
the first compact delivery system, revolutionizing treatment

of patients by making it making
more efficient and ergonomic.
A-dec products recently won
Townie Choice awards in the
categories Best Patient Chairs,
Best Operatory Delivery Systems,
Best Dental Cabinetry, Best Operatory Lights, Best Stools and
Best Waterline Systems for the
tenth consecutive year.
“A-dec began with a simple
idea,” said co-founder Ken Austin.
“Our approach then and today is
to create a better solution that’s
simple and easy to use.” DT

www.idem-singapore.com

THE BUSINESS OF DENTISTRY
Dental
portfolio
united

DTI

APRIL 4 - 6, 2014
Pre-Congress Day: April 3, 2014
ONE-STOP SHOPPING AND BUSINESS NETWORKING
With more than 450 exhibitors from over 36 countries in one location - See, learn and shop for the latest and best deals in dental
technology at IDEM Singapore 2014. For the traders and distribution houses, this edition will also feature many new exhibitors globally,
using this exhibition as a platform to seek distributors in Asia. Establish contacts, exchange ideas and socialise with colleagues both
familiar and new from the regional dental fraternity. For a full list of exhibitors, please visit our website. Register online to visit the trade
exhibition for free.

A CONTINUAL EDUCATION PROGRAM THAT IS TAILORED TO YOUR NEEDS
In four power-packed days of lectures and workshops, IDEM Singapore 2014 caters to Dentists and the rest of the dental team, including
Dental Technicians, Dental Hygienists and Dental Therapists. A diverse range of topics and educational sessions will be presented, so you
can tailor a valuable program that is relevant to your needs.
Planned Topics Include:
Regenerative Endodontics • Making “Real World” Practice Productive and Enjoyable • Future of Dental Implants • Developing your Ideal
Practice • Multidisciplinary Approach to Periodontal Therapy • Adult Orthodontics Today
Speakers Highlights:
David
Bartlett

John O.
Burgess

Gordon J.
Christensen

Barry K.
Freydberg

Ken
Hargreaves

Samuel
B. Low

United Kingdom

USA

Chatchai
Kunavisarut

Chun-Pin
Lin

Will Martin

Thailand

Taiwan

David W.
Paquette

Nigel Pitts

John
Molinari

Dean
Morton

Young
Guk Park

USA

South Korea

Benoît
Philippe

Derrick
Setchell

Ray
Williams

France

United Kingdom

USA

United Kingdom

USA

NEW Programmes for 2014:
#NewDentistForum • Dental Technician Forum • Dental Hygienist and Dental Therapist Forum
Endorsed By

Supported By

Held In

In Co-operation With

All operating companies
within KaVo Kerr Group share
the values of trust, experience,
choices, quality and smart innovation, according to President
of KaVo Kerr Group Henk van
Duijnhoven. While part of this
larger group, they will however
continue to market themselves
under their current brands and
go-to-market strategies with firm
commitments to their customers
and local markets, he said.
“The formation of KaVo Kerr
Group enables us to better serve
dental professionals and healthcare providers who purchase
a broad range of products and
brands. The combined group
also helps to accelerate our innovation, clinical workflow products and solutions, as well as the
rate of new product introductions by better leveraging our
respective clinical, technology and
R & D capabilities,” Van Duijnhoven commented.

Co-organizer

Singapore Dental Association

Koelnmesse Pte Ltd
Andrea Berghoff
Tel: +65 6500 6706
a.berghoff@koelnmesse.com.sg

WASHINGTON, DC, USA/SINGAPORE:
As one of the largest dental product conglomerates worldwide,
KaVo Kerr Group now unites
more than 15 global leading
brands for dental products and
services. Formed as the global
dental segment of Danaher Corporation, an umbrella corporation based in Washington DC in
the US, the aim of the group is to
strategically combine leading
dental consumable, equipment
and specialty brands, such as
KaVo, Kerr, SybronEndo and
Gendex, and operating companies under one global platform.

KaVo Kerr Group’s products
and services primarily serve the
general practitioner, dental specialist, hygienist, institutional
and special markets customers.
They are currently available in
virtually every dental market in
the world, including Asia Pacific,
Europe, North and Latin America,
as well as the Middle East. DT

[11] => DTAP0114_01_Title

P R O F E S S I O N A L

M E D I C A L

C O U T U R E

EXPERIENCE OUR ENTIRE COLLECTION ONLINE
WWW.CROIXTURE.COM

[12] => DTAP0114_01_Title

DTAP0114_12_Bordon 10.02.14 16:45 Seite 1

DENTAL TRIBUNE Asia Pacific Edition No. 1+2/2014

12 Business

Facing new challenges in sales and marketing
How the dental industry can maintain economic success
chases or co-operation will open
up new opportunities here. At the
heart of manufacturers’ portfolio
strategy considerations are work
processes that are more efficient,
offering customers added value
(e.g. guarantees regarding quality and reproducibility of results),
differentiating from competition,
reducing simple replaceability,
as well as exploiting up-selling
and cross-selling potential.

Karin Laupheimer & Jan Bordon
Germany

Price pressure and competition
are on the rise in the dental
industry. In order to maintain
their success in the future, manufacturers of dental products
and services will have to rethink their current approaches
and structures in sales and
marketing, for instance.
Influenced by significant
changes in the market, business
expectations for the dental industry in Europe, for example, are
cautiously positive, as leading
dental manufacturers there anticipate single-digit revenue and
profit growth for the next two
years. Under these conditions, rising customer demand and highly
innovative manufacturers, which
will in turn drive growth from
the supply side, are considered to
be two main factors for growth.
Demand-driven industry growth
has resulted primarily from
stronger customer interest in
cosmetic treatments and dental
implants owing to higher patient
awareness and the availability of
treatments that are more affordable. The increasing number of
qualified and specialised dentists
who perform these types of treatments has further driven this
growth. Moreover, manufacturers
are experiencing higher demand
for services and integrated solutions. The reason for this is the
shifting service spectrum and
higher demand for process optimisation in dental practices and laboratories. An increasing number
of manufacturers are therefore
seeking to differentiate themselves from competitors by extending their existing portfolio
and offering integrated solutions
to meet the changing demands of
their customers.
According to leading dental
manufacturers, product and service innovations in core competencies and related product areas
(synergies) will also play a critical
role in achieving sustainable
business growth. Ongoing digitalisation in areas such as prosthetics, IT solutions to enhance
process efficiency, and new materials are among the main areas of
growth and innovation (Table I).

Increasing competition and
constant price pressure
Despite solid market growth,
businesses are expecting slightly stronger competition saddled
with constant price pressure over
the next three years. In particular, many regard the competitive
pressure from wholesalers that
develop and market their own
brand and, to some extent, practise vertical integration as a
crucial factor of the competitive
dynamics in the dental industry.
Wholesalers with their own
brands have continuously improved their position in the European dental materials market

Table I: Examples of important growth areas.

over the last few years. While they
may have considerably lower
market share compared with that
of manufacturers of dental products, their growth rates are significantly higher than those of
the rest of the industry.

and offer sophisticated consulting
services and training seminars,
placing them in direct competition
with manufacturers. While manufacturers are dependent on wholesalers as their main sales channel,
they also want to distinguish them-

for dental practices, is another option for manufacturers in innovative product areas to address these
challenges. In market segments
with comparatively low service
and consulting effort, the wholesaler will retain its importance.

Improve value selling
and value communication
Manufacturers are increasingly initiating qualification
measures in marketing and sales
with the aim of improving value
selling and value communication. In parallel, they are developing a new way of thinking,
moving from a traditional product sales approach to one that
focuses on solutions for customers. Economic value drivers,
for example total cost of ownership of integrated solutions versus the cost of individual products
or demonstrating cost and timesavings in workflows, are gaining
importance. In order to achieve
this, manufacturers provide sales
with better support by means of
case studies and simulation tools.

Recognising what needs to
be done and acting on it
Fig. 1: Challenges in marketing and sales facing the dental industry.—Fig. 2: The industry’s reactions and solutions.

Low-cost providers are another source of competitive pressure, especially those from nonEuropean markets such as Asia.
Their influence however will remain marginal for the time being
owing to their inability to guarantee short turnaround order processing times and to their sometimes suboptimal product quality.
As low-cost providers continuously improve their quality, manufacturers assume that the price
level, especially for standard segments, will drop further.
Ongoing market price pressure will also be influenced by
increased customer price sensitivity. Manufacturers expect
stronger price pressure in market
segments in which wholesalers
offer their own brands than in
other segments.

Supply and demand
challenges
The market developments
yield four primary challenges for
manufacturers of dental products
(Fig. 1), which require adaptations in their portfolio, as well
as in their marketing and sales
approaches.
On the supply side, the rising
competition from wholesalers at
product and service levels presents a considerable challenge.
With regard to products, they offer
their own brands, as well as an expanding product spectrum. They
are also increasingly investing in
developing integrated process solutions (IT/workflow integration),

selves from them as far as possible.
It comes down to creating a balance between efficient wholesaler
management and the highest possible level of differentiation.
On the demand side, consolidation and integration of dental
practices and laboratories (e.g.
dentists joining laboratory chains
or practice laboratories) pose new
challenges for manufacturers.
End-customers’ escalating cost
pressure and market competition,
but also their increasing levels of
digital and international integration are undoubtedly responsible
for these developments. In this
context, manufacturers will have
to deal with the growing negotiating power of providers and their
increasing price sensitivity, making the battle over customers increasingly tougher.

Need for action
In order to compete successfully in a changing market environment, manufacturers of dental products have identified the
need for action in four main areas
(Fig. 2).
Rethink sales structures
and push forward integration
Manufacturers of complex
products and solutions (e.g.
CAD/CAM and imaging) particularly are planning on introducing
or strengthening direct sales structures to better meet the demandand supply-side challenges in the
dental market. Forward integration, for example taking over laboratory or manufacturing services

A trend towards direct sales, primarily via the Internet and e-mail, can
still be observed in these segments.
Redefine customer segmentation
and channel management
In order to adjust to the changing dental practice and laboratory
environment, manufacturers are
relying mostly on marketing and
sales strategies tailored to customer types and needs. This involves, for example, segmenting
customer types according to
portfolio coverage and potential.
It also involves developing innovative offer models that meet specific customer needs (e.g. partnership models and consulting
services ensuring individual and
targeted customer development).
In this context, implementing
structured key account management is regarded as another important success factor. Manufacturers that sell primarily through
wholesalers are currently being
confronted with the question of
how to optimise their management of wholesalers, for instance
in selecting, steering, developing
and incentivising, plus pricing,
and controlling cross-channel
and cross-border activities.
Expand portfolios and develop solutions for customers
Manufacturers will continue
to offer integrated solutions to
stand out from competitors. In
doing so, they will expand their
portfolios from products to IT
solutions and from product-related services to IT and process
consulting services. Added pur-

Manufacturers of dental products are looking ahead with cautious optimism. In the next few
years, they will continue to focus
on innovation as their number one
growth driver. At the same time,
the industry is facing substantial
changes in both supply and demand. While most companies
already recognise what must be
done to overcome these problems,
many still lack significant progress
in appropriately changing sales
and marketing approaches. For
sustainable success in the dental
industry, it is now time for manufacturers to proactively address
growing competitive pressure, increasing customer consolidation
and changing customer needs
with smart portfolios, sales and
price strategies, as well as effective
organisational changes. DT

Contact Info
Karin Laupheimer
is a director in the
Medical Technology
Competence Center
of global marketing
and strategy consultancy Simon-Kucher
& Partners. She can be contacted at
karin.laupheimer@simon-kucher.com.

Contact Info
Jan Bordon is a
senior consultant
in Simon-Kucher
& Partners’ Medical Technology
Competence Center. He specialises
in the dental industry.

[13] => DTAP0114_01_Title

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[14] => DTAP0114_01_Title

DTAP0114_14-16_Sande 10.02.14 16:53 Seite 1

14 Trends & Applications

DENTAL TRIBUNE Asia Pacific Edition No. 1+2/2014

Ultra-thin veneers in clinical practice
Aesthetic dental restorations with lithium disilicate materials

Fig. 2

Fig. 3

Fig. 4

Fig. 5

Fig. 6

Fig. 7

Fig. 8

Fig. 9

Fig. 10

Fig. 11

Fig. 12

Fig. 13

Fig. 14

Fig. 15

Fig. 16

Fig. 1
Dr Rafael Piñeiro Sande
Spain

With the advent of new materials such as lithium disilicate, the fabrication of very
thin veneers that require only
minimal removal of natural
tooth structure has become
a clinical reality. The IPS
e.max all-ceramic system
from Ivoclar Vivadent, for
example, covers all current
all-ceramic indications and
is suitable for use with the
CAD/CAM and press techniques.
The IPS e.max Press product
range comprises ingots in four
levels of translucency (HT, LT,
MO and HO) and Impulse ingots
in three different values (Value
1, 2 and 3) and two opal shades
(Opal 1 and 2). These materials
are particularly useful for fabricating single-tooth restorations
in cases of damaged or stained
dental enamel, as described
in detail in the following case
report.
A 39-year-old female patient
consulted our clinic to improve
the appearance of her anterior
teeth (Fig. 1). Apart from slight
periodontal problems, which
were confirmed by a radiographic examination, we diagnosed
proximal caries in the first incisors, as well as Class III dental
and skeletal malocclusion with
an open bite (Fig. 2). Moreover,
we found peri-apical infections
around teeth 31 and 32.
Based on these findings, a
two-stage treatment plan was
developed to eliminate caries
and the infection by periodontal
curettage and planing of root
surfaces to control the underlying disease. The malocclusion
was corrected with orthodontic
treatment. The second stage
of the plan focused on aesthetics and started with a clinical,
radiological and photographic
analysis (Figs. 3 & 4). An impression was taken and the
maxillomandibular relationship was recorded by means of
an arbitrary facebow. The gingival margin was adjusted with
the help of connective-tissue
transplants and the mandibular
arch was bleached. Finally,
ultra-thin veneers (< 0.5 mm)
made of IPS e.max Press Impulse
Opal 2 were placed.

Fig. 1: The patient wanted a more attractive smile.—Fig. 2: A close-up of the teeth before treatment.—Fig. 3: Tooth analysis after the first treatment phase.—
Fig. 4: Smile analysis.—Fig. 5: Three-dimensional assessment of the preparation with a perforated tray.—Fig. 6: The silicone matrix for checking the vertical
dimension of occlusion.—Fig. 7: Inspection of the incisal reduction.—Fig. 8: The light-body impression material is syringed into the sulcus.—Fig. 9: The die with defined
preparation margins.—Fig. 10: Divestment of the pressed restorations.—Fig. 11: The completed veneers.—Fig. 12: The veneers are tried in with Variolink Try-In.—Fig. 13:
Adjustment of a veneer to the vestibular margin.—Fig. 14: The seated veneers.—Figs. 15 & 16: The broad and satisfied smile of the patient at the conclusion of treatment.

After the teeth had been
thoroughly analysed, a wax-up
was fabricated, which was subsequently used to create a mockup. A 2 mm-thick perforated tray
(Fig. 5) and two silicone matrices were produced to check the
vertical dimension of occlusion
during preparation (Fig. 6) and
to fabricate the chairside temporary. A retraction cord was
placed along the gingival margin to protect the gingiva during
the preparation procedure.
A depth marker was used to
ensure proper reduction of the
vestibular tooth surface. This
bur cut orientation grooves
with a depth of 0.3 mm. The
incisal edge was reduced with
a diamond bur (0.6 mm), which
was also used to remove the
ridges between the grooves and
completely level out the surface. The proximal and gingival
areas were prepared with the
same bur. The marginal and
proximal areas were prepared
and then polished. The entire

preparation surface was completely smoothed with a polishing disc and a medium-grit
polishing paste to eliminate all
grooves and edges. The silicone
matrix was then inserted to
check the correct dimensions
of the prepared teeth (Fig. 7).
In a final step, the retraction
cord was removed.
Using the double-cord retraction technique, the first
retraction cord (size 000) was
individually packed into the
sulcus of each prepared tooth
and a second continuous retraction cord (size 00) was placed
on top. With this method, the
gingiva is completely displaced
from the prepared dental hard
tissue or any blood and saliva,
which could adversely affect
the precision of the impression.
The heavy/light dual-phase
impression was taken with a
customised tray coated with an
adhesive to increase the adhesion of the impression material
to the tray. The heavy/light

dual-phase impression technique makes use of impression
materials with different viscosities. Accordingly, a heavybody material was loaded into
the tray, while a light-body
material was syringed around
the prepared teeth (Fig. 8).
The precision of the impression was checked and
temporary restorations were
produced chairside by mixing
and syringing two-component
composite resin into the previously fabricated silicone matrix. Once the composite resin
was of the ideal consistency,
the matrix was placed in the
patient’s mouth. The provisional
material was subsequently cured
and the matrix was removed.
Excess composite was removed
with rotary instruments. The
temporary restorations were
characterised with staining and
glazing materials.
In the laboratory, a cast was
made from the disinfected

impression using Class IV plaster. After the models had hardened, the preparation margins
were defined (Fig. 9). The veneers were waxed up, removed
from the die and then invested.
They were subsequently reproduced with IPS e.max using the
press technique, then divested
(Fig. 10), finished and individually characterised (Fig. 11).
In the second clinical phase,
the veneers were tried in and
cemented in place. First, the
temporary restorations were
removed and the prepared
teeth were cleaned. Each veneer was tried in individually
to ensure correct fit. Next, the
proximal fit was checked by
positioning one veneer correctly
and then placing the adjacent
veneer. The position of the first
veneer was examined very
closely after the adjacent veneer
had been placed to determine
and correct any changes.
‡ DT page 16

[15] => DTAP0114_01_Title

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DTAP0114_14-16_Sande 10.02.14 16:54 Seite 2

DENTAL TRIBUNE Asia Pacific Edition No. 1+2/2014

16 Trends & Applications
ﬂ DT page 14

The veneers were placed
with Variolink Veneer (Ivoclar
Vivadent) after selecting the
shade of the adhesive. Variolink
Try-In pastes (Ivoclar Vivadent)
were used because they help
simulate the final shade of the
restoration (Fig. 12). The adhesive cementation procedure
was performed in three stages:
pretreatment of the veneers,
conditioning of the prepared
teeth, as well as placement
and finishing of the veneers.

A rubber dam was placed with
a retentive clasp for each preparation. The veneers were tried
in with the Variolink Try-In
pastes, rinsed with a water
jet and dried with oil-free air.
For optimal cleaning results,
Ivoclean (Ivoclar Vivadent) was
applied for 20 seconds and then
removed with a water jet.
The ceramic surface, which
has to be kept free from contamination, was treated with
5 per cent hydrofluoric acid (IPS
Ceramic Etching Gel, Ivoclar

Vivadent) for 20 seconds. The
restorations were cleaned with
a water jet and immersed in an
ultrasonic bath for 5 minutes.
The veneers were then dried
and conditioned with the silane
coupling agent Monobond Plus
(Ivoclar Vivadent) for 60 seconds. The excess was dispersed
with a strong stream of air.
The prepared teeth were then
cleaned with brushes and
fluoride-free prophy pastes.
The enamel was etched with the
37 per cent orthophosphoric acid
Total Etch (Ivoclar Vivadent)

for 30 seconds and then cleaned
with a water jet and uncontaminated oil-free air.
Shortly before the veneers
were placed, ExciTE F adhesive
(Ivoclar Vivadent) was applied
thickly to enamel and dentine,
and carefully scrubbed in for
at least 10 seconds. The excess
was dispersed to a thin layer
with a weak stream of air.
In the process, it is very important to avoid pooling. A shiny
surface showed that the tooth

was completely sealed. The adhesive was cured for 10 seconds
with a light intensity of above
500 mW/cm 2 and Variolink
Veneer was applied directly to
the preparation.
In the final luting phase, the
veneers were placed on the prepared teeth with consistent pressure and then polymerised for
2 seconds (Fig. 13). As the luting
material had not yet completely
cured, it was easy to remove
the excess with a probe. The margins were previously isolated
with Liquid Strip glycerine gel
(Ivoclar Vivadent), which prevents
the formation of an oxygeninhibited layer during polymerisation and enables the luting
material to cure properly. Finally,
the restorations were cured for
90 seconds from all sides.
The excess was removed
with a scalpel. Fine-grit burs
and silicone polishers were
used at the palatal margin. The
rubber dam was then removed
and the occlusion inspected
(Fig. 14). After the treatment,
the patient received instructions on maintaining her restorations and she was scheduled
for a recall examination one
month later (Figs. 15 & 16).

Conclusion
The topic of aesthetics continues to grow in importance in
dentistry and the development
of innovative materials such as
IPS e.max Press Impulse allows
dental professionals to use new
techniques for non-invasive
preparation of teeth. In addition, such materials provide
aesthetic benefits and eliminate the difference in quality
between the press-on and the
layering techniques.

6 Months Clinical Masters Program
in Aesthetic and Restorative Dentistry
29 January - 01 February and 24-27 April 2014,
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Learn from the Masters of Aesthetic and Restorative Dentistry:

Registration information:
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a total of 8 days of intensive live training with the Masters in Dubai (UAE)

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Collaborate
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ADA CERP
C.E. CREDITS

Tribune America LLC is the ADA CERP 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.

Specialist knowledge of
the adhesive cementation of
lithium disilicate restorations
gives dentists the professional
edge needed to address the
challenges associated with this
type of treatment. The treatment protocol is firmly established today. It is of utmost importance for dentists and dental
technicians to perform their
work with great precision. In
order to jointly have a positive
impact on the results, both parties must be familiar with the
entire procedure. Teamwork
and a meticulous approach during the individual treatment
phases are required to achieve
aesthetic outcomes.

Acknowledgement
I would like to thank Roberto
Portas Moure for the excellent
dental laboratory work, and the
patient for her confidence and patience during the treatment. DT
Editorial note: A list of references is
available from the publisher.

Contact Info
Dr Rafael Piñeiro
Sande maintains
his own dental clinic in Pontevedra
in Spain. He can
be contacted at
info@pineirosande.com.

[17] => DTAP0114_01_Title

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[18] => DTAP0114_01_Title

DTAP0114_18_Noujeim 10.02.14 16:54 Seite 1

18 Trends & Applications

DENTAL TRIBUNE Asia Pacific Edition No. 1+2/2014

Current perspectives on oral surgery
How to improve consistency and implementation of contemporary
treatment recommendations and options in general dental practice

Dr Ziad Noujeim, Lebanon
Dr Ziad Noujeim
Lebanon

The term “surgery” is derived
from the Greek words “chir”
(hand) and “ergos” (work).
According to this etymology,
surgery should include any
clinical work implemented
with our hands. In daily clinical
practice, however, the use of
this word is often limited to
practical therapeutic acts,
such as those involving cutting
soft tissue (incisions), flap raising, osteotomies and reconstruction, as well as repairing
and dressing living tissue.
The term “oral” pertains to
the mouth (or oral cavity), and
AD

oral surgery would consequently
encompass maxillary sinus
membrane lifts, onlay and inlay
bone grafts, the placement of
dental osseointegrated implants,
exodontia (including surgical
extraction of impacted teeth and
tooth-like structures), as well as
the incision and drainage of cellulitis, just to name a few. Despite
these different fields of use, the
limits of oral surgery are not yet
well defined and may reach maxillofacial surgery, a term that implies a greater scope of surgical
interest, such as temporomandibular joint surgery, orthognathic
surgery, the treatment of head
and neck trauma, as well as cancer surgery.
General dental practitioners
are only required to undertake
surgical treatment of teeth,
tooth-like structures, and soft
tissue surrounding teeth. In this
regard, the UK General Dental
Council defines “surgical dentistry” as “those surgical procedures within the mouth which
would normally be accomplished
for a cooperative patient under
local anaesthesia, with or without sedation, in a tolerably short
operating time.”
In the past 30 years, oral surgery has progressed significantly
in the diagnosis and treatment
of dental and jaw pathology.
Dentistry, particularly surgical
dentistry, is rapidly changing and

evolving, and dentists worldwide
are attempting to adapt to the
revolutionary changes and new
opportunities resulting from
globalisation of dental and medical surgical specialties. New
insights and discoveries related
to oral surgery are indeed astonishing and many of them have
already been applied in everyday
practice, and addressed in textbooks and at international conventions.
The near future will probably
witness Er:YAG laser bone ablation replacing surgical drill osteotomy in oral surgical practice.
Indeed, scanning electron microscope observations have deter-

benign jaw tumours, and placement of dental implants.
While oral surgery continues
to develop further with new technologies and visions, the assessment and diagnosis of patients
will still form the cornerstone of
any surgical specialty. Decisionmaking, a complex cognitive
process that involves consideration of surgical patients’ complaints and preferences, the
availability of evidence-based
data, as well as practitioners’
case-specific clinical judgement,
consequently remains an ongoing challenge for oral surgeons
and dental general practitioners
alike.

most popular intra-lesional
steroids, and weekly injections
with these are common practice
not only for CGCGs, but also for
solitary jawbone lesions of Langerhans cell histiocytosis, a proliferative disease of the macrophage/
dendritic cell lineage.
CGCGs, considered troublesome pathologies, are also currently medically managed by calcitonin, a polypeptide hormone
produced in humans primarily
by parafollicular cells of the
thyroid gland, C cells. Calcitonin
is known to counteract parathyroid hormone, inhibit osteoclast
activity and increase calcium
influx in bones. In this regard,

“CBCT is becoming the main imaging
armamentarium of oral surgeries ...”
mined that Er:YAG laser treatment produces well-defined
edges. Melting and carbonisation
associated with carbon dioxide
lasers could not be observed on
sites irradiated with Er:YAG
lasers. In addition, F T I R spectroscopy revealed that the chemical composition of bony surfaces
after ablation with an Er:YAG
laser was almost the same as
that after conventional drilling
with a bur, proving that the
use of Er:YAG laser ablation
can be an alternative to traditional bur ablation in oral and
periodontal osseous surgeries,
particularly in mandibular ramus onlay block harvesting,
apicectomy, cysts and benign jaw
tumour surgery, or the irradiation
of bisphosphonate-associated
jaw osteonecrosis.
Dental pulp stem cells (DPSCs)
can nowadays be cryopreserved
and stored for years, while still
retaining their multipotency and
bone-producing capacity. These
highly specialised cells show
very low morbidity and are easy
to collect from extracted wisdom
teeth or buds, for example. They
also interact with bone biomaterials and substitutes, which
makes them an ideal cell population for jaw reconstruction. In
addition, stromal bone-producing DPSCs, a multipotent stem
cell subpopulation of DPSCs, are
capable of differentiating into
osteoblasts, and they are claimed
to possess immune privilege and
exert anti-inflammatory abilities
like many other mesenchymal
stem cells.
Introduced in the late 1990s,
CBCT is becoming the main imaging armamentarium of oral
surgeries, as it provides more
and comprehensive anatomical
information and data that help to
improve preoperative and peroperative clinical implementation of the extraction of impacted
teeth, cystectomies, removal of

Inter-clinician variability and
disparity in decision-making
are very well known in dentistry
and medicine.1–5 In oral surgery,
treatment recommendations,
options and decisions can vary
widely among practising dentists. In many cases, they are
based more on personal values
and expertise than on objective,
rigorous or evidence-based
analysis of treatment alternatives, risks, prognosis and benefits. There are treatment guidelines for the management of
impacted teeth but none for
aggressive and relapsing jaw
cysts and odontogenic tumours,
for which documented longterm treatment success has not
yet been achieved. Owing to this
lack, the treatment planning
process in oral surgery remains
a dilemma and warrants further
interest and research.
As a matter of fact, regional
differences in training, education, and dental school treatment
philosophy, the “schools effect”,
may significantly influence decision-making processes.6, 7 It
seems likely that specialists are
much more confident in their
ability to manage surgical cases
successfully. A better understanding of inter-clinician variability in collaborative decisionmaking will definitely help the
oral health community in improving consistency and implementation of oral surgical treatment recommendations and
options.
One of the most promising
approaches is probably the nonsurgical medical treatment of
tumours and lesions of the jaws,
as reported by Marx and Stern in
2003.8 They found a 65 per cent
rate of complete resolution of
central giant cell granulomas
(CGCGs) in the jaws through
intra-lesional corticosteroid injections. Dexamethasone and
triamcinolone are currently the

salmon calcitonin, which is used
in postmenopausal osteoporosis,
hypercalcaemia, Paget’s disease
and bone metastases, is considered to be more active than human
calcitonin and to be an important
tool in the medical treatment of
jaw tumours and lesions. The
main question is whether intranasal salmon calcitonin is as
effective as subcutaneous human calcitonin in the medical
treatment of CGCGs of the jaws.
Finally yet importantly, many
clinicians and clinical investigators believe in the radical
treatment of ameloblastomas,
odontogenic tumours well known
for their aggressiveness and high
recurrence after conservative
treatment. For these reasons, en
bloc resection is often implemented, which includes a resection of at least 1–2 cm of normal
sound jawbone beyond the tumour’s margins. Such a radical
surgical procedure is unacceptable in children with growing
jaws though because segmental
resection often leads to jaw deformity and dysfunction, which
in turn may hamper physical
growth and the mental wellbeing of the child/adolescent.
At the very least, conservative
treatment of an ameloblastoma,
if indicated, will gain time until
growth of the jaw is finally
complete.9 Considering that the
majority of ameloblastomas in
children are unicystic and have
a very low rate of recurrence,10
they can be managed by enucleation, a conservative form of
surgical treatment.11–14 DT
A complete list of references is available from the publisher.
Dr Ziad Noujeim is a currently Director of the Oral Pathology Postgraduate
Programme at the Lebanese University’s
School of Dentistry in Beirut in Lebanon
and a Diplomate of the European Board
of Oral Surgery. He can be contacted at
ziadnari@hotmail.com.

[19] => DTAP0114_01_Title

[20] => DTAP0114_01_Title

DTAP0114_20_Okamoto 10.02.14 16:57 Seite 1

DENTAL TRIBUNE Asia Pacific Edition No. 1+2/2014

20 Trends & Applications

“I would like to start a revolution”
An interview with dentist Dr Taro Okamoto about the double teeth craze in Japan
nines to make them look imperfect. Dental Tribune Japan
recently had the opportunity to
speak with Dr Taro Okamoto,
head cosmetic dentist at the
Pure Cure cosmetic dental
clinic in Tokyo and manager of
tsuke-yaeba pop group TYB48,
about the procedure and why
the trend might be here to stay.

Dr Taro Okamoto (DTI/Photos courtesy of Pure Cure, Japan)

In almost all Western countries,
crooked teeth are considered
unattractive. In Japan, however, fake double teeth called
tsuke-yaeba have risen to popularity, particularly among teenage girls and young women,
transforming their upper ca-

DT Japan: Tsuke-yaeba have
gained widespread popularity
in your country. How do you
explain the appeal of having
imperfect teeth?
There is a long tradition of
the love of imperfect beauty in
Japan. People here admire the
aesthetics of asymmetry, as well
as perfection. Sen no Rikyū,
a sixteenth-century master of
the tea ceremony, for example,
praised the beauty of chipped
tea bowls, which he considered
a humble and simple form of the
original thing. The concept of
fake double teeth is largely based
on this notion.

Is tsuke-yaeba a permanent
procedure or can it be reversed?
We currently offer a permanent option, involving the direct
build-up of composite resin or the
use of laminate veneers. There
is also a reversible option where
the fake teeth can be worn like
normal dentures through the application of an adhesive. I advise
my customers to maintain proper
oral hygiene to avoid the development of periodontal disease, as
well as to consult with us in case of
any pain or discomfort associated
with tsuke-yaeba.
You are one of the main
providers of the tsuke-yaeba
procedure in Japan. How many
procedures do you perform
daily at present?
Since our clinic started operating two years ago, we have
performed more than 500 tsukeyaeba procedures, with probably
one procedure per day on average. The age of our customers
ranges from 14 to 40 years. Most

2013 - 2014

Figs.1 & 2: Before and after picture of a female patient having received
tsuke-yaeba smile treatment.

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nique itself is very versatile, as
I can use the same direct build-up
method to straighten teeth.

Why is tsuke-yaeba of particular interest to women?
Actually, girl idols (a kind of
female celebrity in Japanese
culture) with double teeth have
enjoyed popularity since the
1970s. They are usually associated with being young, cute and

Trends from Japan are often
not widely adopted overseas.
Do you see tsuke-yaeba making
it to Western dentistry soon?
Actually, I read a survey in
which people from different
countries were asked whether a
girl idol with double teeth looked

Centre for Advanced Professional Practices (CAPP) 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.

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requests however are from girls
in their late teens and women in
their early twenties.

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“There is a long tradition
of the love of imperfect
beauty in Japan.”
coquettish, which are all features
believed to give them a special
charm and boost their popularity.
Women decide to wear double
teeth for the same reasons they
have piercings, or wear fake eyelashes or coloured contact lenses.
As these items have become common fashion accessories, attention naturally moved on to teeth.
How long do you expect the
tsuke-yaeba trend to continue
in Japan?
Grinding down healthy teeth
and covering them with ceramics is a common misperception
about aesthetic dentistry in Japan. By spreading the concept of
tsuke-yaeba, I would like to start
a revolution in this field, so that
tsuke-yaeba will not be a fad only
but become popular enough to be
considered an everyday cosmetic
item like fake eyelashes. The tech-

cute or dreadful. Most of the respondents considered it cute.
With the concept of “Cool Japan”,
Japanese fashion and values have
spread all over the world. So far,
I have treated customers from
countries like Taiwan.
You also manage a tsukeyaeba pop group called TYB48.
How do you balance this with
your work as a dentist?
Currently, there are two girls
in the group, who are both students and part-time idols. We
usually do a live event, have
recordings or appear in the media
once a month. Being the producer
of the group too, I compose music
when I am not working at the
clinic. When I have to accompany
the group for an event, I sometimes have to take a day off.
Thank you very much for
the interview. DT

[21] => DTAP0114_01_Title

DTAP0114_21_today 11.02.14 11:23 Seite 1

ADX · Sydney · 21–23 March, 2014

Independent news for visitors and exhibitors

SHOW
PREVIEW

ADX booms in challenging times

ADX14
Sydney

Record numbers expected for Australia’s largest dental exhibition in Sydney
n Despite another decline in sales of
dental materials and equipment in Australia last year, the organisers of the
country’s largest dental exhibition have
reported that they have sold out all
available booth space for this year’s
ADX14, one month before the event.
They also said that they expect a record
number of dental professionals to attend the show, which will be held at
the Sydney Exhibition Centre @ Glebe
Island from 21 to 23 March 2014.

See. Buy. Learn.
Date:
21–23 March, 2014

Organiser:
Australian Dental Industry
Association
GPO Box 960
Sydney
NSW 2001
Phone: +61.2.9319.5631
Fax: +61.2.9319.5381
Web: www.adia.org.au

Exhibitors will be showcasing the
latest dental products from Australia
and overseas at ADX14, including new
materials and solutions for an improved
workflow in dental practices and laboratories. According to the Australian Dental Industry Association (ADIA), which
stages the biennial event, many of these
products will be available to dentists in
Australia for the first time.

Strategic Partner:
•National Dental Foundation

Partner Associations:
•Australian Academy of Dental
Sleep Medicine
•Australian Association of
Practice Managers
•Australian Dental Association, NSW Centre for professional development
•Australian Dental & Oral
Health Professionals Association
•Australian Dental Prosthetists
Association
•Oral Health Professionals Association
•Royal Australian College of
Dental Surgeons
•Therapeutic Goods Administration

Media Partners:
•Dental Tribune International
•Dental Asia
•Bite Magazine
•Australasian Dentist

In focus will be Dental CAD/CAM
and new digital practice solutions,
which have become common in many
dental practices. Visitors will be eligible
for discounts offered by several manufacturers for on-site purchases.
In addition to the industry showcase,
the event will feature an extensive continuing professional development programme, which is supported by dental
associations and suppliers of dental
equipment from Australia and abroad.
These seminars are free to visitors and
will cover a wide range of dental topics,
including oral surgery, implant dentistry and practice management. Wellknown oral health care professionals
from universities in Australia and other
countries will give presentations on
issues in aesthetic and preventative
dentistry, such as restoration with new
ceramic materials, over the course of
three days.
“There is no mistake about it: this is
the event that provides dentists and
allied oral health care professionals
with the best opportunity to see more,

buy more and learn more,” ADIA CEO
Troy Williams commented.
According to him, the upcoming
ADX14 is shaping up to be the largest
edition ever in the short history of the
event, which has seen increasing twodigit participation since it was first held
in 2008. The latest show in 2012 in
Sydney attracted slightly more than
6,000 visitors, according to ADIA figures, which the association expects will
be exceeded this year by a 17 per cent
increase in attendees. In order to make
it easier to join the event, discounted
airfares, hotel rooms and car hire are
on offer for interstate and international
visitors, Williams said.
Dental equipment manufacturers
and dealers in Australia currently face
a challenging environment, as sales
of dental products declined in the
last fiscal year for the third consecutive year. The market value of consumables and laboratory products in
particular suffered from the effects
of the global financial crisis and cuts

to public dental services made by
the previous Australian government,
a recently published report by ADIA
states. Significant growth was only
observed in the over-the-counter products segment, such as toothpaste

and toothbrushes, which grew by
almost 4 per cent in 2013. The total
market for dental products, including
over-the-counter products, was worth
almost A$2 billion, according to the
document.
AD

FDI 2014 · New Delhi · India
Greater Noida (UP)

Annual World Dental Congress

11-14 September 2014
Deadline for
early bird registration
31 May 2014

About the Publisher
Editorial/
Administrative Office
Phone
Fax
Internet
Publisher
Director of Finance
and Controlling
Managing Editor

Dental Tribune International
GmbH
Holbeinstraße 29
04229 Leipzig, Germany
+49 341 48474-302
+49 341 48474-173
www.dti-publishing.com
www.dental-tribune.com
Torsten Oemus
Dan Wunderlich
Daniel Zimmermann

Product Manager
Production Executive
Production

Claudia Salwiczek
Gernot Meyer
Franziska Dachsel

today ADX14 Show Preview appears in advance of the ADX in Sydney,
21–23 March, 2014.
The magazine and all articles and illustrations therein are protected by
copyright. Any utilisation without prior consent from the editor or publisher is inadmissible and liable to prosecution. No responsibility shall
be assumed for information published about associations, companies
and commercial markets. General terms and conditions apply, legal
venue is Leipzig, Germany.

A billion smiles welcome the world of dentistry
www.fdi2014.org.in
www.fdiworldental.org

[22] => DTAP0114_01_Title

DTAP0114_22_Williams 11.02.14 10:44 Seite 1

news

ADX Sydney 2014 Show Preview

“An industry in transition”
ADIA Chief Executive Officer Troy Williams on ADX14 and the state of the dental industry in Australia
nThe upcoming ADX14 in Sydney will
offer dentists from Australia the opportunity to get hands-on the latest dental
materials and technologies available
on the market. Today international had
the exclusive opportunity to speak
with Troy Williams, Chief Executive
Officer of the Australian Dental Industry Association (ADIA) about this
year’s show and the state of the dental
market in Down Under.
today international: Sales of
dental materials and equipment in
Australia were reported to have
declined in 2012. Has the situation
changed in 2013 and what are the
prospects for the industry this year
and the years to come?
Troy Williams: Last week, ADIA
released the latest edition of the
Australian Dental Industry Intelligence
Report, accepted by government and
industry stakeholders as the nation’s
most authoritative assessment of the
market for dental products. Covering
the 2012–13 financial year, the report
found that the total market for dental products was AUS$1,495 million
(US$1,331 million) and that the market
for products supplied to dental service
providers was AUS$765 (US$681 million), a figure that has fallen for the third
consecutive year. The drop is partly
attributable to the flow-on effects of
the global financial crisis but probably
more significantly, coincides with large
cuts to public dental services by the
previous Australian Government.
Although the sales of products over
the previous three years have declined,
there is considerable optimism about
the coming year. The preliminary results that have come in thus far from
the latest ADIA Australian Dental
Industry Business Conditions Survey
show that ADIA member businesses
expect modest growth in sales over
the coming quarter.
ADIA’s ability to provide accurate
assessments of past and present market conditions is a result of a considerable investment by the association
research into the market for dental
products. This information allows our
members to grow, create jobs and operate sustainably in Australia’s dental
industry.
How would you generally describe
the state of the industry right now?

the TPP negotiations will further
strengthen the dental industry’ relationship with these key trading partners. That the new Australian Government has committed to continuing the
TPP negotiations is welcomed by ADIA.
What dental products are currently in high demand in Australia
and is ADX going to reflect these
trends?
The ADX14 Sydney dental exhibition enjoys a long-standing reputation
as Australia’s premier dental event
given that is serves as a springboard
to launch many new products into the
Australian/New Zealand market.
5

Troy Williams (DTI/Photos courtesy of ADIA, Australia)

It is an industry in transition, emerging from three difficult years and looking to the future with confidence. The
ADIA Dental Industry Business Conditions

nation’s total expenditure on dental
services, with obvious secondary benefits for the ADIA member businesses
that supply quality dental products.

The interest in the dental laboratory
pavilion, a first for this series of exhibitions, allows dentists to review the
work from the leading laboratories
that manufacture their products in
Australia. This pavilion will also show-

“Given that around 95 per cent of dental
products in Australia are imported the industry
is highly sensitive to currency fluctuations...”
Survey reflects this, showing that the
decline has been arrested and that businesses across the dental industry are
generally positive about the year ahead.
There are some challenges which
will need to be carefully managed.
Given that around 95 per cent of dental
products in Australia are imported the
industry is highly sensitive to currency
fluctuations, so the fall of the Australian dollar from historical highs is
likely to test the industry’s resilience.
At ADIA, our focus has been on driving underpinning demand for dental
services as a means of supporting our
members. Our work with government
and professional stakeholders is showing results, and we welcome the new
Australian Government’s commitment
to retention of new programmes to provide public funding of limited dental
services to children. If the Australian
Government’s programme is a success,
it will add around 7 per cent to the

One of the most discussed issues in
recent years was product regulation,
previously overseen by the Therapeutic Goods Administration in Canberra.
With a new organisation taking over
its responsibilities, what changes do
you expect for the industry and will
they of benefit or disadvantage for
providers of dental equipment?
At the end of January, ADIA held yet
another meeting with the new Minister
for Health, the Honourable Peter Dutton MP. As a result of this engagement,
I believe that the Minister shares ADIA’s
commitment to a regulatory framework
for dental product that is based on a
risk management approach designed to
ensure public health and safety, while
at the same time freeing industry from
any unnecessary regulatory burden.
Over the coming twelve months, a
major priority for ADIA is to support
the transition to the Australia New
Zealand Therapeutic Products Agency
(ANZTPA), the proposed successor to
the TGA which will administer medical device regulatory standards in
Australia and New Zealand. At its last
meeting, the ADIA Board recommitted
to supporting ANZTPA as it offers
considerable scope for dental product
suppliers to grow their business.
ADIA is also actively engaged in
negotiations to support the Trans
Pacific Partnership (TPP) free trade
agreement, viewing this as a viable
pathway for realising the vision of
a free trade area of the Asia-Pacific region. For manufacturers and suppliers
of dental products, the TPP negotiations are exciting as it includes five
of Australia’s top ten trading partners
including the United States of America,
Japan, Singapore, New Zealand, and
Malaysia. Australia’s participation in

case the latest CAD/CAM technology,
something sure to be of interest to dental laboratories.
What has been surprising is the
strong interest in restorative products.
The fact that we have an all-time high
number of registrations from dentists
and allied oral healthcare professionals
planning to attend the ADX14 Sydney
dental exhibition reflects awareness
in this sector.

in Australia, so naturally that’s where
most exhibitors come from. That said,
businesses from New Zealand to the
Netherlands are represented, as those
from Peru to Poland.
Owing to the reconstruction of
the Sydney Exhibition Centre until
2016, ADX will be held in another
venue this year. Will this have any
impact on visitors or exhibitors?
ADX14 Sydney will be held at the
new Sydney Exhibition Centre @ Glebe
Island, the new home for Sydney’s major trade shows during the redevelopment of the Darling Harbour entertainment precinct. Getting to the new venue
is easy with a host of transport options.
The Sydney Exhibition Centre @ Glebe
Island is ideally located close to the
heart of Sydney’s central business
district making it a quick trip by road.
Visitors can also enjoy the beautiful
waterways of Sydney on a short but
scenic ferry ride. For those travelling
by train, there will be free shuttle services to take you directly to the venue.
For those coming from outside of
Sydney, ADIA have partnered with Qantas to offer visitors discounted airfares
plus the major hotels for discounted
accommodation close to Sydney Exhibition Centre @ Glebe Island. These can
be booked through the ADX website.
Visitors from outside of Sydney can
also take advantage of their visit to
ADX14 Sydney and use it as an opportunity to see the harbour city and take
part in activities such as climbing the
harbour bridge, seeing a show at the
opera house or going to the many beautiful beaches Sydney is famous for.
Will there be also opportunities
for professional development and
what will be the main topics discussed there?

“What has been surprising
is the strong interest
in restorative products.”
Attention in the latest digital imaging products are seeing specialists from
around the nation book their flights and
accommodation to attend ADX14 Sydney,
Australia’s premier dental event.
You reported high interest in
booth space last year. Can we expect
more exhibitors to attend ADX this
year and, if so, where do they mainly
come from?
The answer to that question takes
only two words—sold out. Australia’s
largest dental exhibition attracts more
exhibitors than any other event in the
region, however this event is shaping
up to be something special with all of
the nearly five hundred booths sold.
Local requirements generally require businesses supplying dental
products to have an existing presence

The ADX14 Sydney dental exhibition is supported by an extensive free
seminar program that includes free
CPD, featuring international speakers.
To make it convenient for visitors to
participate, the program has been
organised into topics of interest with
seminars under each topic to be run
in grouped times. These topics include
implants, orthodontics, practice optimization, prevention and a number of
other dental areas. The seminars are
sure to be of interest to everyone in
the dental industry. They have been
designed with dental professionals in
mind with topics that will engage and
inform, making it easy for everyone
in the dental team to meet their CPD
obligations and to expand their clinical
and non-clinical professional skills.
Thank you very much.

[23] => DTAP0114_01_Title

DTAP0114_23_Info 11.02.14 10:44 Seite 1

travel

ADX Sydney 2014 Show Preview

Useful information
Congress venue
Sydney Convention
& Exhibition Centre
Darling Dr, Darling Harbour
NSW 2000
AUSTRALIA

On-site registration

clothing is highly recommended.
Air conditioning is common in most
public places.

Most shops in Sydney accept all major credit cards. Banks are open from
09.30 a.m. to 4.00 p.m. on weekdays.

Banking and currency

Foreigners are entitled to a tax
refund for certain purchased items
through the Tourist Refund Scheme,
which can be collected at the custom
offices at the airport.

The legal tender is the Australian
Dollar (AUD), which has an exchange rate to the US dollar of about
AUD1.11 (as at 10 February 2014).

23

Airport transfer
A taxi ride to Sydney’s city
centre is approximately AUD$45–55.
While it may be the easiest way
to get around, there are plenty of
other transport choices, like the Airport Link, which takes travellers
to the city centre in only 13 minutes.
It departs from the Domestic Terminal train station located directly
between T2 and T3 Terminals and is
accessible from within the terminals
from the Arrivals level. A one-way
ticket currently is AUD$16.40 (price
can be subject to change).

Registration for ADX14 is free.
Visitors can register online in advance through the ADX website.

Official languages
of the congress

AD

AUSTRALIA
S E E B U Y L E A R N ²
² SYDNEY

• English

Continuing education
The Continuing Development
Programme at ADX14 has been assessed by the programme sponsor
and deemed to be clinical/scientifically based in accordance with
Guidelines On Continuing Professional Development published by
the Dental Board of Australia. Delegates who have registered for the
programme can earn 60 minutes
worth of CDP hours for each session
they attend during the meeting.

TED
OUN ND
C
S
I
A
D
ARE
ON
AIRF MODATI
M
4
O
1
ACC R ADX
FO
NEY
SYD RS
O
VISIT

S E E B U Y L E A R N ²
²  S Y D N E Y

ADX14
A
D X14 Sydney
S y dney
Dental
D
ent al Exhibition
Exhibi tion

Press and media
Free copies of the today international congress newspaper will be
available daily during the congress,
and will provide visitors with the latest news from the congress, information about new products and what to
do in Sydney. Additional coverage
will also be available on DTI’s news
website, www.dental-tribune.com.
You can also access the news feed directly by scanning the QR code below.

AUSTR
AUSTRALIA’S
A LI A’S
’ PREMIER DENT
DENTAL
A L EVENT
21–23
21– 23 MARCH
MARCH 20
2014
14 – S
SYDNEY,
YDNEY, AUSTR
AUSTRALIA
ALIA

Exhibition


Australia’s
Australia’s Largest
Largest Dental Exhibition
Product Categories
Categories




All Major Brands And Product
counted Airfare
Airfare And Accommodation
Accommodation




Discounted
xtensive Professional
Professional Skills Program
Program




Extensive
www.adx.org.au
www.adx.org.au

ADX14
ADX
14 Sydney ²
more,
more
learn
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All travellers other than Australian and New Zealand citizens
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and signed Incoming Passenger Card,
including health and character declaration, to officers in immigration
clearance. Anyone who arrives without a valid travel document, visa or
authority to enter Australia, may be
refused entry to Australia or delayed
until their identity and claims to enter Australia have been confirmed.
An online form for requesting an
invitation letter is available on the
ADX website. For more details and
immigration requirements, you may
also visit the Australian Government
Department of Immigration and Border’s website at www.immi.gov.au.

Weather and climate
In late March, temperatures can
still exceed 25 °C during the day in
Sydney. The chance of rain is highest
at that time of year, and the air can
be very humid. Light and breathable

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[24] => DTAP0114_01_Title

DTI_Mediamix2014_A3_NEU_Layout 1 22.01.14 10:19 Seite 1

Dental Tribune International
The World’s Largest News and
Educational Network in Dentistry
www.dental-tribune.com

) [page_count] => 24 [pdf_ping_data] => Array ( [page_count] => 24 [format] => PDF [width] => 913 [height] => 1262 [colorspace] => COLORSPACE_UNDEFINED ) [linked_companies] => Array ( [ids] => Array ( ) ) [cover_url] => [cover_three] =>

[cover] => DT Asia Pacific No. 1+2, 2014

[toc] => Array ( [0] => Array ( [title] => Universal health care scheme launched in Indonesia [page] => 01 ) [1] => Array ( [title] => Opinion [page] => 04 ) [2] => Array ( [title] => World News [page] => 05 ) [3] => Array ( [title] => Good oral health is not a luxury but a necessity of life [page] => 06 ) [4] => Array ( [title] => Business [page] => 09 ) [5] => Array ( [title] => Facing new challenges in sales and marketing [page] => 12 ) [6] => Array ( [title] => Ultra-thin veneers in clinical practice [page] => 14 ) [7] => Array ( [title] => Current perspectives on oral surgery [page] => 18 ) [8] => Array ( [title] => “I would like to start a revolution” [page] => 20 ) [9] => Array ( [title] => today ADX show preview [page] => 21 ) ) [toc_html] =>

Table of contents

[toc_titles] =>

[cached] => true )