DT Asia Pacific No. 3, 2012
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DTAP0312_01-02_Title
DTAP0312_01-02_Title 13.03.12 08:41 Seite 1
DENTAL TRIBUNE
The World’s Dental Newspaper · Asia Pacific Edition
PUBLISHED IN HONG KONG
www.dental-tribune.asia
NO. 3 VOL. 10
Orthodontics
Dental occlusion/TMJ
and general body health
Tooth transplantations
Aestethic reconstruction
of premolars
North Korea
An interview on dental
relief efforts
4Page
9
4Page
10
4Page
12
FDA investigates handheld dental X-ray devices Waiting times
accumulate
Daniel Zimmermann
DTI
People living in Morley, Western Australia, should better take
their dental hygiene seriously.
Latest statistics by the Government of Western Australia Department of Health have revealed that
getting an appointment for a nonemergency dental procedure in
the small suburb near the city of
Perth can toll up to three years.
SILVER SPRING, Md., USA: The
Food and Drug Administration
is advising dental professionals
and veterinarians in the US to
stay away from handheld X-ray
devices that are being offered by
online sellers and shipped from
abroad. At least one of these devices was recently found not to
comply with safety standards and
therefore to be potentially hazardous for dentists and patients,
the organisation said.
FDA officials told Dental
Tribune Asia Pacific that they are
currently monitoring handheld
dental X-ray units throughout
the United States. Information
about the device in question
were recently send to the organisation by the Washington State
Department of Health in Tumwater, Washington, which found
during an inspection that a device purchased from a seller
outside the country did not fulfil
the FDA’s X-ray performance
standards.
The organisation said to have
notified state regulators as well
as dental and other health organisations about the potential
According to figures of the latest Western Australia Health Performance report, similiar waiting
times have recently been observed throughout the state ranging between one and a half and
two years on average. Besides
Morley, patients from Amadale
and Fremantle also had to wait
18 months for a dental appointment. Overall, more than 24,000
patients are waiting for treatment
in public dental clinics.
The FDA is warning of handheld dental X-ray devices offered by online sellers outside the United States. (DTI/Photo sevenke)
health risks. Dentists will be also advised to verify whether the
devices they are using have the
required labelling and to contact
state officials in case they are
unsure if their device is safe.
The organisation refused to
disclose further information
about the extend of the problem
or when and where these devices
could have entered the country.
However, this newspaper found
that several devices produced
in Asia are directly offered via
internet to customers in the
West including those in North
America.
FDA-approved devices are
currently available from a dozen
manufacturers including Sigma,
Digimed or Aribex. It’s president and CFO Ken Kaufman welcomed the investigation while
emphasising that these systems
‡ DT page 2
Health officials said that the
latest increase in dental appointments was due to rising awareness of people that are eligible for
subsidised dental treatment including low-income families and
pensioners. More than 400,000
people or one fifth of the population are currently estimated to
fall into that category. DT
AD
Poor oral
health among
trekkers
This wireless intraoral device developed by scientists in the US is supposed
to enable people with high-level spinal cord injuries to control an electric
wheelchair by simply moving their tongue. (DTI/Photo courtesy of Georgia
4WORLD NEWS, page 5
Institute of Technology, USA)
Rapist gets
Morita receives
40 years in prison design awards
A judge in the Philippines has
sentenced a 32-year old man to
a maximum of 40 years in prison and a P180,000 (US$4,200)
fine for raping and robbing two
female dentists in the capital
Manila last May. The man is also
facing charges for having committed sexual crimes against
23 other dentists. DT
Morita has been awarded
the renowned iF Design Gold
Award for Product Design for its
Soaric dental treatment unit. The
Japan-based provider of dental
equipment also received two
Communication Design Awards
for Soaric’s user interface and for
the Soaric catalogue, advertising
and printed media design. DT
German researchers have
evaluated the mouth and tooth hygiene of trekkers in the Himalaya
and discovered that their oral
flora changes significantly while
travelling. Among others, they
found elevated levels of the bacteria typically responsible for dental
infections, such as periodontitis
and gingivitis.
Their study also found that
trekkers who had had a dental
check-up within the previous six
months were less likely to have
dental problems and bleeding
gums in particular. In addition,
they determined that 16.5 per cent
of the trekkers reported problems that could have been treated
with a dental emergency kit. Although thousands of tourists go
on trekking vacations every year,
there is no information regarding
the procedure to follow in case of
dental emergencies or no systematic guidelines for prevention. DT
Distinguished by innovation
Healthy teeth produce a radiant smile. We strive to achieve this goal on a daily basis. It inspires
us to search for innovative, economic and esthetic solutions for direct filling procedures and
the fabrication of indirect, fixed or removable restorations, so that you have quality products
at your disposal to help people regain a beautiful smile.
www.ivoclarvivadent.com
Ivoclar Vivadent AG
Bendererstr. 2 | FL-9494 Schaan | Liechtenstein | Tel.: +423 / 235 35 35 | Fax: +423 / 235 33 60
[2] =>
DTAP0312_01-02_Title
DTAP0312_01-02_Title 13.03.12 11:02 Seite 2
DENTAL TRIBUNE Asia Pacific Edition
AD
Bad breath gas used to make
liver cells from teeth
DTI
TOKYO, Japan: A team of Japanese researchers has demonstrated that hydrogen sulphide,
one of the main causes of bad
breath, could be a key component
in developing future medical
therapies. In a recent study conducted at the Nippon Dental University in Tokyo, they reported
that stem cells isolated from dental pulp transformed into liver
cells after being incubated with
the characteristically foul smelling gas for at least three days.
While dental pulp stem cells
have been found to have the ability to transform into a number
of different cells, including muscle and blood cells, this is the
first time that researchers have
claimed to have produced a huge
number of cells that were able
to store glycogen and collect urea
—the two main functions of the
liver. They said that although
more research might be needed
on the possible carcinogenic effects of the method, results indicate that it produced cells with
little potential to differentiate,
hence limiting the risk of developing tumours after transplantation.
Microscope picture of normal human liver. (DTI/Photo Convit)
“Hydrogen sulphide did not
cause apoptotic changes in the
cells,” they stated in the report.
Common methods of producing hepatic cells for human
transplantation include the use
of foetal bovine serum, which is
heavily regulated worldwide.
The researchers however extracted stem cells for their study
from patients undergoing regular tooth extractions. These were
then divided into two groups, of
which one was incubated with
hydrogen sulphide and the other
with a different medium.
including the company’s NOMAD
unit have generally proven safe
and effective.
distributing our handheld X-ray
device,” he said. “We are disappointed to learn that other manufacturers may not share a similar
perspective.”
“Clinician and patients safety
have always been our numberone priority in developing and
Aribex received FDA clearance for NOMAD in 2005. Since
then, the company has been able
fl DT page 1
Commonly associated with
the smell of rotten eggs, hydrogen sulphide is produced in
small amounts by the human
body for signalling and other
biological functions. In the
oral cavity, where it is considered highly toxic to tissue, it is
produced by forms of bacteria
that do not require oxygen to
grow.
It is estimated that between
20 and 50 per cent of people in
developed countries suffer from
halitosis, the main side-effect of
this process. DT
to sell 8,000 pieces of its handheld system worldwide.
Research has found that radiation from handheld dental X-ray
devices is below recommended
levels and pose no greater risk
that standard dental radiography
like CT’s. DT
International Imprint
Licensing by Dental Tribune International
Publisher Torsten Oemus
Group Editor/Managing
Editor DT Asia Pacific
Daniel Zimmermann
newsroom@dental-tribune.com
Tel.: +49 341 48474-107
Copy Editors
Sabrina Raaff
Hans Motschmann
Editors
Claudia Salwiczek
President/CEO
Torsten Oemus
Editorial Assistant
Yvonne Bachmann
Marketing & Sales
Matthias Diessner
Vera Baptist
Peter Witteczek
Director of Finance & Controlling
Marketing & Sales Services
License Inquiries
Accounting
Product Manager
Executive Producer
Ad Production
Designer
Dan Wunderlich
Nadine Parczyk
Jörg Warschat
Manuela Hunger
Bernhard Moldenhauer
Gernot Meyer
Marius Mezger
Franziska Dachsel
International Editorial Board
Dr Nasser Barghi, Ceramics, USA
Dr Karl Behr, Endodontics, Germany
Dr George Freedman, Esthetics, Canada
Dr Howard Glazer, Cariology, USA
Prof. Dr I. Krejci, Conservative Dentistry, Switzerland
Dr Edward Lynch, Restorative, Ireland
Dr Ziv Mazor, Implantology, Israel
Prof. Dr Georg Meyer, Restorative, Germany
Prof. Dr Rudolph Slavicek, Function, Austria
Dr Marius Steigmann, Implantology, Germany
DENTAL TRIBUNE
The World’s Dental Newspaper · Asia Pacific Edition
Published by Dental Tribune Asia Pacific Ltd.
© 2012, Dental Tribune International GmbH. All rights reserved.
Dental Tribune makes every effort to report clinical information
and manufacturer’s product news accurately, but cannot assume
responsibility for the validity of product claims, or for typographical errors. The publishers also do not assume responsibility
for product names or claims, or statements made by advertisers.
Opinions expressed by authors are their own and may not reflect
those of Dental Tribune International.
Dental Tribune International
Holbeinstr. 29, 04229, Leipzig, Germany
Tel.: +49 341 48474-302 · Fax: +49 341 48474-173
Internet: www.dental-tribune.com E-mail: info@dental-tribune.com
Regional Offices
Asia Pacific
DT Asia Pacific Ltd.
c/o Yonto Risio Communications Ltd, 20A, Harvard Commercial
Building, 105-111 Thomson Road, Wanchai, Hong Kong
Tel.: +852 3113 6177 · Fax: +852 3113 6199
The Americas
Dental Tribune America, LLC
116 West 23rd Street, Suite 500, New York, NY 10001, USA
Tel.: +1 212 244 7181 · Fax: +1 212 224 7185
[3] =>
DTAP0312_01-02_Title
DTAP0312_03_News 13.03.12 08:41 Seite 1
DENTAL TRIBUNE Asia Pacific Edition
Asia News
3
Indian dental clinic chain aims for expansion
DTI
HYDERABAD, India: India’s rising dental health-care sector is
expected to receive another significant investment, as Alliance Dental Care has announced that it will
triple its number of dental clinics
Dutch
supplier
acquired by
SomnoMed
Daniel Zimmermann
DTI
SYDNEY, Australia/ZURICH,
Switzerland: SomnoMed has expanded its own distribution network in Europe through a new acquisition. According to the terms
of an agreement closed between
the Australian-based company and
Goedegebuure Slaaptechniek B.V.
(GS) in Loenen aan de Vecht near
Amsterdam, GS will market and
distribute SomnoMed’s range of
dental solutions for the treatment
of sleep breathing disorders exclusively in the Netherlands.
by mid-2013. The expansion is
intended to serve different market
segments, including dental spas,
regular dental clinics, as well as
express cleaning and whitening
spots located in public places like
airports and shopping malls.
Alliance Dental Care was
founded in 2002 as a subsidiary
of Alliance Medicorp, a joint venture between Apollo Hospitals
and medical equipment provider
Trivitron. Both companies have
been reported to seek private investors in order to raise Rs 0.5 trillion
(US$10 million) for the first phase
of the expansion in 2012. The new
clinics, as well as the existing ones,
have been re-branded as White
Dental Clinics, they said.
Alliance Dental Care currently
maintains over 20 dental clinics in
major Indian cities like Chennai,
Bangalore and Hyderabad. In ad-
dition to its Indian business, the
joint venture is also eyeing potential markets overseas, including
South-East and West Asia, Africa
and Eastern Europe.
According to the latest financial reports, Apollo boasted revenues of Rs 23 trillion (US$460.4
million) in 2010/2011. Once the
expansion has been completed,
the company will hold a 70 per cent
share in Alliance Dental Care. DT
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The SomnoDent MSA device has seen
increasing sales in the Netherlands.
(DTI/Photo SomnoMed, Switzerland)
Currently, GS is one of the leading Dutch suppliers of mandibular repositioning appliances. With
the take-over, SomnoMed intends
to boost its presence and business
development in Europe, particularly in important Central European markets, CEO Ralf Barschow
said. He told Dental Tribune Asia
Pacific that sales have jumpstarted in the Netherlands because
devices for the treatment of conditions like obstructive sleep apnoea
syndrome have been reimbursed
by the country’s health insurance
companies since 2010.
The acquisition will be paid
half in cash and half in shares and
is expected to be completed by
2019. SomnoMed stocks listed
on the Australian Securities Exchange reacted positively to the
announcement.
According to Barschow, sales
in Europe contribute approximately 25 per cent to SomnoMed’s
global business results. Last year,
revenues in the region grew by
over 30 per cent.
He confirmed that the company is also in talks with other suppliers in Europe. Since 2008, the company has been operating actively
in Europe through its subsidiary
in Zurich in Switzerland. DT
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[4] =>
DTAP0312_01-02_Title
DTAP0312_04_News 13.03.12 10:53 Seite 1
4
DENTAL TRIBUNE Asia Pacific Edition
Opinion
Dear
reader,
“Looks like we have our new Bond.”
Decaying
health care
Rajiv Narayan
UK
Daniel Zimmermann
DTI
Relief efforts are laudable as it
goes some way towards helping
the North Korean government ensure that it meets its obligations to
respect, protect and fulfil the right
to health of its citizens.
When I got the chance to
interview Dr Melvin Cheatham
for this edition’s article on dentistry in North Korea (page 9),
I was impressed with the voluntary work his charity organisation, Samaritan’s Purse, has done
and is currently doing in many
underprivileged parts of the
world.
It remains a sad and not
widely known fact that in the
DPRK and many other countries
in Asia, public health-care systems are heavily dependent on
help from outside organisations
in order to provide even the most
basic level of medical or dental
care. Moreover, their assistance
has become increasingly essential
during widespread emergency
situations like natural disasters,
which most of these systems,
I think we can agree, are not able
to handle adequately.
During my work for this
newspaper, I have found that
dentists are generally very open
to using their professional skills
for the greater good, for example,
by forming part of a temporary
dental relief workforce. Without
their enthusiasm and willingness
to spend a significant amount of
their time in far-off places, there
would be fewer smiles in the
world today. DT
Not all hand-helds are created equal
Dr Joel Gray
USA
There are two sources of radiation from an X-ray system—leakage
radiation from the X-ray tube and
scattered radiation from the patient. The leakage radiation is minimised by placing highly absorbing
material, such as lead, around the
X-ray tube. The major issue with
the hand-held X-ray units is the
scattered radiation, that is X-rays
that are scattered from the patient
towards the operator. In fact, about
20 to 30 % of the X-rays are scattered
from the patient towards the person
holding the device.
Yours sincerely,
Daniel Zimmermann
Group Editor
Dental Tribune International
The X-ray units from outside the
USA, which are under FDA scrutiny,
do not provide any protection from
X-rays scattered from the patient.
These systems look like a large camera that you hold with both hands.
There is no shielding provided by
these hand-held systems, that is the
user’s hands are exposed to all of the
X-rays scattered from the patient.
Consequently, the user’s hands are
going to receive a radiation dose
that will probably exceed the radiation-protection limits for skin and
extremities. Therefore, these units
should not be hand-held.
We evaluated one hand-held
X-ray unit manufactured in the
USA (Nomad, Aribex Inc.) and compared staff doses with those for the
same staff using conventional wallmounted systems prior to acquiring
the hand-held systems (Gray et al.
2012). This hand-held system uses
a proprietary shielding material
around the X-ray tube, resulting in
leakage radiation levels that are
virtually immeasurable. In addition, it has an integral leadedacrylic shield that protects the user
from radiation scattered from the
patient. The results of our study indicated that the users of the handheld X-ray system received lower
radiation doses than they did when
they were using conventional wallmounted systems.
Buyers should be beware that
not all hand-held X-ray systems are
created equal and not all of those
being sold on the web have been
reviewed by the FDA. Hand-held
X-ray units should have sufficient
shielding to minimise leakage radiation and an integral shield to
protect from radiation scattered
from the patient. DT
Exhibitions
Dr Joel Gray is a medical physicist
from the USA with over 30 years’ experience in medical imaging. He can
be contacted at joelgray@diquad.com.
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To this end, Amnesty International has urged the North Korean
authorities and its new leader Kim
Jong-un to address severe shortages
in the healthcare system including
through accepting international
humanitarian assistance and for
providing full cooperation and
access (to efforts by organizations
like Samaritan Purse) to ensure that
care reaches those most in need. DT
Contact Info
AD
Several
In its report, “The Crumbling
State of Health Care in North Korea”, (ASA 24/001/2010), Amnesty
International documented the
devastating impact of long-term
food insecurity on the population’s
health and concluded that the
North Korean state bears the responsibility for the country’s decaying health care infrastructure,
failure to provide basic health care,
and a lack of public health education and information. Food shortages and a more general economic
crisis persist to this day. Health
facilities are rundown and operate
with frequent power cuts and no
heat. Medical personnel often do
not receive salaries, and many hospitals function without medicines
and other essentials.
Dental desensitising varnish
s TREATMENT OF HYPERSENSITIVE DENTINE
s FAST DESENSITISATION
s FLUORIDE RELEASE
s EASY AND FAST APPLICATION
Contact Info
Rajiv Narayan is a researcher for
Amnesty International in London.
[5] =>
DTAP0312_01-02_Title
DTAP0312_05_News 13.03.12 08:42 Seite 1
DENTAL TRIBUNE Asia Pacific Edition
World News
5
Dentists patent novel soft-tissue augmentation technique
Daniel Zimmermann
DTI
ALEXANDRIA, Va., USA: An invention from Saudi Arabia that
could help more patients to get
dental implants is reported to
have been granted patent status
by the US Patent and Trademark
Office. The new method, called
Intraoral
device
manœuvres
wheelchair
DTI
the tunnelling technique, is
claimed to increase the thickness of soft tissue prior to block
grafting procedures using an
acellular dermal matrix.
Developed by implant specialist Dr Ali Thafeed AlGhamdi,
who is also head of the Periodontic Division at King Abdulaziz
University’s Faculty of Dentistry
in Jeddah in Saudi Arabia, the
technique was first filed for
patent application in February
last year by a Virginia law firm.
In the application, the researchers explain how to position
an acellular dermal matrix over
the recipient site and fix it coronally via a tunnel that is formed by
making two incisions through the
mucosa. Using this method, the
researchers detected an increase
of 1 to 2 mm in soft-tissue thickness following allografts.
The acellular dermal matrix
has been successfully applied in
many surgical fields, including
cosmetic procedures and regenerative medicine. It has been on
the market since the early 1990s.
Al-Ghamdi told the Saudi
Press Agency in Riyadh that he
started looking into the technique when he noticed rapid
healing in dental implant patients who had been treated with
allografts for soft-tissue augmentation prior to symphysial
block grafts. He said that his invention could contribute significantly to the improvement of
block graft surgery in diseased
jaws.
According to the latest research, thin soft-tissue biotypes
affect implant success significantly by failing to maintain the
required crestal bone level. DT
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ATLANTA, Ga., USA: Researchers at the Georgia Institute
of Technology have developed
the latest version of the intraoral
Tongue Drive System, which is
embedded into a dental retainer
and is worn inside the mouth.
The system, which only requires
free movement of the tongue,
allows people with high-level
spinal cord injury to control a
powered wheelchair.
The user receives a clinical
tongue piercing, with which he
can control the magnetic field
sensors mounted on the device’s
four corners. The sensors track
the relative location of the magnetic piercing and transmit the
data wirelessly to an iPod or
iPhone. Software installed on this
computer device interprets the
user’s tongue position and moves
the wheelchair accordingly.
In earlier versions, the sensors
were attached to an externally
worn headset. “One of the problems we encountered with this
earlier version was that it could
shift on a user’s head and would
need to be recalibrated,” said
Maysam Ghovanloo, associate
professor at the institute. The new
device sits tightly against the roof
of the mouth because it is moulded
from dental impressions. As it is
worn inside the mouth, it is protected against such disturbances
and is less conspicuous.
The new device includes a
lithium-ion battery and an induction coil to charge the battery.
It is covered with an insulating,
water-resistant material and
vacuum moulded inside standard dental acrylic.
The researchers also created a multifunctional interface,
which holds the iPod, receives
and delivers the sensor data,
charges the iPod and is fitted with
a holder for charging the dental
retainer at night. The system can
be hooked up to any standard
electric wheelchair.
Ghovanloo and his team plan
to begin testing the usability of
the system by able-bodied individuals soon and then move onto
clinical trials. DT
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[6] =>
DTAP0312_01-02_Title
DTAP0312_06_Business 13.03.12 08:42 Seite 1
6
DENTAL TRIBUNE Asia Pacific Edition
Business
3Shape releases Dental System 2012
DTI
COPENHAGEN,
Denmark: 3Shape,
a Danish company
specialising in 3-D
scanners and CAD/
CAM software solutions, has released its
next-generation Dental System 2012 to the
market. For the first time,
it offers
different scanner models and Stan-
dard or Premium
software versions
in order to provide
a flexible and scalable solution that
can be matched to
labs of any size or
business model with
upgrade possibilities
for future requirements. 3Shape offers a
wide range of new digital work-
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flows and communication tools
designed to help labs expand their
range of services to dentists.
3Shape’s Dental System 2012 introduces a variety of scanner/software
combinations so that labs, regardless of their size or business model,
can find suitable CAD/CAM tools
to match their business needs and
ambitions. 3Shape recently declared its new mission, “Helping
labs to help their dentists”.
“In today’s competitive climate,
labs that shift from productiononly to service-provider profiles
are winning market share. With
Dental System 2012, 3Shape is
bringing labs solutions designed
to help them build new services
and stronger business relationships with their dentists,” stated
Tais Clausen, CTO of 3Shape.
The new Dental System 2012
features 3Shape Communicate,
which enables labs to send their
dentist clients 3-D design visualisations for use in their discussions
with the lab and with their patients; ModelBuilder, which allows
technicians to design lab models,
including implant models, for an
extensive range of indications
directly from intra-oral scans and
conventional impression scans;
TRIOS integration, which enables
labs to receive TRIOS digital impression scans from the clinic directly to their Dental System inbox;
Texture Scanning, which enhances
visualisation of surface details
and allows technicians to incorporate hand-drawn design guidance
markings into the digital design
(texture scanning is available on
D800/810 scanners); and Dynamic
Virtual Articulator, which offers
support for the market’s most
widely recognised articulators,
providing the optimal user experience. In addition, with Occlusion
Compass functionality, the colours
of contact points are mapped to
specific occlusal movements.
Furthermore, the Dental System 2012 features Temporaries and
Diagnostic Wax-ups, a revolutionary workflow solution for producing temporary crowns and diagnostic wax-ups (including Virtual
Prep, Virtual Gingiva, CAD Temporaries and Virtual Diagnostic
Wax-up design); Multilayer Design,
which enables highly productive
bridge design for pressing or combinations of milled glass-ceramics
and zirconia, and automatically
splits full anatomy designs into two
true and entire parts, without undercuts or lost areas; the Improved
SmileComposer, which enables
optimised auto-placement of
crowns and morphing to preparation; as well as Advanced Telescope
design, new software for optimised
creation of telescopic crowns, including sophisticated primary telescope modelling and improved
edge design.
3Shape has also introduced a
new scanner: the new D500 model
and impression scanner, which
was developed based on 3Shape’s
advanced scanning technologies
for full and accurate capture. The
D500 was designed specifically to
fulfil the needs of labs seeking to
enter CAD/CAM manufacturing
equipped with the latest and best
technologies. Additionally, 3Shape
offers 5.0 MP D700 and D800 scanners with extensive indications
and texture-scanning capabilities
for medium to large labs.
According to 3Shape, its solutions are timeless because the
company ever strives for innovation and continues to provide major
feature-packed upgrades for its
users every year. 3Shape backs its
Dental System users with an extensive support network and comprehensive training package. DT
[7] =>
DTAP0312_01-02_Title
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[8] =>
DTAP0312_01-02_Title
Cap_ad 297_420.pdf 1 3/9/2012 2:36:56 PM
C
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[9] =>
DTAP0312_01-02_Title
DTAP0312_09_Cheatham 13.03.12 08:43 Seite 1
DENTAL TRIBUNE Asia Pacific Edition
Business
9
“Units are considered a national treasure
by the North Koreans”
An interview with Samaritan’s Purse’s Dr Melvin Cheatham, USA
appropriately respond through
providing training, supplies
and equipment. All work in the
DPRK is done in a spirit of
friendship, and aimed toward
building further upon the special relationship that has been
established through Samaritan’s Purse with government
and with medical and dental
care officials.
Through its World Medical
Mission programme, the USbased Christian charity Samaritan’s Purse provides health
care by means of medical and
dental volunteers in developing countries around the
world. It is also one of few
organisations that maintain
relations with the Democratic
People’s Republic of Korea,
also known as North Korea.
DTI’s Group Editor Daniel
Zimmermann spoke with Dr
Melvin Cheatham, member of
the advisory board, about the
organisation’s projects there
and the state of dental care in
the communist state.
Your organisation, led by
Reverend Franklin Graham,
is supporting the country
through a number of dental
care-related projects. When
did these start?
The relationship between
the Graham family and the
DPRK dates back to the 1930s
when Franklin Graham’s mother Ruth Belle Graham, who
was born in China, attended
a missionary school in Pyongyang, which was then under
Japanese occupation. Wanting
to go there himself, her husband Billy Graham, a world
renowned religious leader and
founder of the Billy Graham
Evangelistic Association, first
met with the DPRK’s leader Kim
Il-sung before his passing in
1994.
During this visit, the organisation equipped the first mobile
dental vehicle, which was intended to provide dental care
to those people who weren’t
able to get it, for example, in
North Korea’s countryside. A
second mobile dental unit was
equipped years later by Samaritan’s Purse, led by Billy Gra-
You are also conducting
projects in other developing
countries. How is working
in the DPRK different from
those?
Owing to the fact that the
DPRK is almost a closed country,
one always has to gain permission for a delegation to visit far
ahead of time. The visits themselves are also limited to several
days or just one or two weeks, so
Dr Melvin Cheatham unpacking dental supplies during a visit to the DPRK.
(DTI/Photo courtesy of Samaritan’s Purse, USA)
ham’s son Franklin at the request of the DPRK. Both units
are considered a national treasure by the North Koreans, as
they were given to them with
the blessings of their beloved
leader.
Are these units still operational today?
Although these services are
still operational, the focus has
lately shifted towards developing permanent dental care in
the capital. A few years ago,
the DPRK’s Ministry of Public
Health asked Samaritan’s Purse
for assistance in equipping a
dental centre in Pyongyang that
would not only serve as a place
where dental care was given
but also where dentists could
obtain continuing education on
the newest dental procedures
and techniques with the goal
of improving oral health care
throughout the country.
This centre is now well
equipped with six complete
operatories, teaching facilities
and materials as well as laboratory equipment to manufacture
dentures and crowns.
What is the relationship
with your Korean partners
like?
I think they appreciate both
the supplies and teaching opportunities very much. The
needs for dental care are substantial in that country, which
is supported by the fact that
the Ministry of Public Health
asked for assistance in that area.
Similar to dental communities
in most countries around the
world, there is obviously great
interest in learning, for example, on how to perform more
sophisticated procedures like
dental implants. From my point
of view, it has always been a
warm and friendly relationship.
Samaritan’s Purse works
closely with officials and with
dentists and other professionals
in the DPRK in order to be able
to identify and understand the
Have you noticed any
change in light of the recent
death of Kim Jong-il and the
passing of power to his son
Kim Jong-un?
With the 100th birthday of
Kim Il-sung coming up in April,
this is a very important time for
the country. A lot is going on and
whether there will be political
changes owing to the recent passing of Kim Jong-il has to be seen.
From the standpoint of communication that we have on behalf of
our president with the DPRKS’s
leadership and those involved in
the work that is being done, I expect it to remain very productive.
opportunities for development
in that country and to be able to
Dr Cheatham, thank you
for this interview. DT
AD
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Leading the World to Optimal Oral Health
2012 Hong Kong
FDI Annual World Dental Congress
29 August - 1 September 2012
Join us in Hong Kong, world capital of oral health 2012
for a
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29 August to 1 September 2012
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Deadline for abstract submission: 30 March 2012
Early Bird registration until 31 May 2012
Design: b’com · +33 (0)6 50 46 60 70
Daniel Zimmermann: Dr
Cheatham, like many things
that concern the Democratic
People’s Republic of Korea,
very little is officially known
about the dental infrastructure there. How would you
describe the level of dentistry
in the country?
Dr Cheatham: Although I
have been to the DPRK more
than 20 times and met with people at the highest level, it is very
difficult to identify the current
depth and availability of dental
care and education. Obviously,
dentistry there is performed
on a much lower level than in
Germany, the US or in any other
country in the developed world.
If you also look to another developing countries as an example,
there is reason to believe that
dental care is being provided
by people who do not have the
level of education which is
normally required to perform
dentistry.
staying for a longer period of
time is not possible.
Leading the world into a new century of oral health
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[10] =>
DTAP0312_01-02_Title
DTAP0312_10-11_Lee 13.03.12 08:44 Seite 1
DENTAL TRIBUNE Asia Pacific Edition
10 Trends & Applications
Dental occlusion/temporomandibular
joint and general body health
Clinical evidence and mechanism of an underestimated relationship
tions in order to increase motor
performance.24 It has also been
reported that proper teeth
clenching plays an effective
role in the enhancement of
physical performance.25
Drs Yong-Keun Lee
& Hyung-Joo Moon
South Korea
During the treatment of
symptoms originating from
disorders of the temporomandibular joint (TMJ) and
occlusion, it was found that
restoring the TMJ to its normal condition resulted in a
change of general body health.
In most cases, the change of
health was for the better.
Owing to similar reports, a
connection between TMJ status and general body health
was therefore hypothesised.
However, the mechanism of
this relationship remains unclear.
In this article, the relationships between dental occlusion/TMJ status and general
body health are reviewed with
reference to peer-reviewed
papers. A conceptual theory is
proposed that may explain this
mechanism.
TMJ and myofascial pain
Dental occlusion is the relationship between the maxillary
and mandibular teeth when
they approach each other.1 The
TMJ is the joint of the jaw,
which is unique in that it is the
only bilateral joint that crosses
the midline.2 As the treatment
of dental diseases aims to
achieve harmony within the
entire stomatognathic system,
teeth could be literally considered to be a set of gears
anchored in bone, while the
upper and lower jaws are attached to each other by the
TMJ.3
The causes of TMJ disorders can be divided into five
categories: dental, trauma,
lifestyle habits, stressful social
situations and emotional factors.4 Trauma can be in the
form of whiplash, traction appliances and blows to the head,
face or jaw.4 Evidence of significant trauma to the TMJ
has also been found following
hyperextension of the cervical
spine.5 With regard to habits,
bad posture, bad ergonomics
at work, oral and childhood
habits, as well as poor diet
and strenuous activities such
as heavy lifting, have been
cited.4
Myofascial pain, deriving
from the hyperalgesic trigger
points located in skeletal muscle and fascia, is commonly
characterised by persistent
regional pain.6 The myofascial component has generally
been considered to be part of
pain syndromes that involve
TMJ. Trigger points in masticatory muscles are presumably
caused by malocclusion, mis-
The relationship between
the presence of occlusal support in edentulous subjects
and their capacity for physical exercise has been investigated, and it was concluded
that reconstruction of occlusal
support holds significance not
only for the restoration of masticatory function but also for
the maintenance of physical
exercise.26
Mechanism of relationship
between the TMJ and
general body health based
on the myofascial aspect
alignment and habitual parafunction of the jaws, abnormal
head and neck postures, or
trauma.6
Relationship between TMJ
and general body health
There have been several
studies on the relationship between occlusion/TMJ and general body health. Among other
findings, it has been found
that lesions in the masticatory
muscles or dento-alveolar ligaments can perturb visual sta-
The functional coupling of the
stomatognathic system with
the neck muscles is well
known. Patients suffering from
occlusal or TMJ disorders have
frequently reported dysfunction and pain in their neck
muscles.12, 13 An imbalance of
sternocleidomastoid muscle
activity, often leading to neck
pain, can be induced by a unilateral loss of occlusal support.14
The biomechanical impact
on cervical vertebrae during
mation from the ocular region,
the three semicircular canals
and anti-gravity muscles.18
It has been suggested that
occlusion and head position
affect the centre of gravity, resulting in an increased risk of
falling when abnormal.19 Poor
or absent dental occlusion may
decrease proprioception in
this area, interfering with the
proper stability of the head
posture.7 It is thought that tooth
loss is a risk factor for postural
instability. 20 Physiologically,
“...lesions in the masticatory muscles
or dento-alveolar ligaments
can perturb visual stability.”
bility and thus generate postural imbalance.7 The position
and functioning of the mandible also have an effect on the
centre of gravity.8, 9
Dental occlusion is associated with reduced lower extremity strength, agility and
balance in elderly people.10
The proper functional occlusion of natural or artificial
teeth has been shown to play an
important role in generating
an adequate postural reflex.10
The subgroups of general body
conditions associated with
TMJ may be divided into the
following three categories:
1) Synchronisation of the
head and jaw muscles
with other muscles
There is a necessary systematic synchronisation of the
head and jaw muscles with the
other muscles of the body to
maintain proper body posture.
mastication has been calculated, which confirmed that
vertical occlusal alteration can
influence stress distribution in
the cervical column.15 Possible
associations between trunk
and cervical asymmetry and
facial symmetry have been reported.16 For example, it has
been found that visual perception control is most important
in orienting the head in the
frontal plane.16 A relationship
between dental occlusion and
postural control has also been
postulated.17
2) TMJ and body stability
Dental occlusion/TMJ condition exerts an influence on
body stability. Human beings
assume a relatively unstable
postural state when in the
standing position; therefore,
the maintenance of a standing
position is related to fluctuation in the centre of gravity,
which is controlled by infor-
mechanical receptors in the
periodontal membrane control
mandibular movements and
coordinate masticatory function,21 and this is related to the
motor activity of the neck muscles.22
Fluctuation in the centre of
gravity caused by altering the
occlusal contact area experimentally was examined experimentally, and the results
confirmed that occlusal contact affects gravity fluctuation
and that appropriate occlusion
attained by maintaining even
occlusal contact in the posterior region is crucial for gravity
fluctuation.23
3) TMJ and physical
performance
TMJ conditions can influence physical performance.
Trainers often advise athletes
to wear occlusal splints or
mouth guards during competi-
It is the first hypothesis
of this article that TMJ and
other parts of the body are
connected through fasciae,
which is a connective element
between various anatomical
structures,27 very similar to
a three-dimensional network
extending throughout the
whole body.28, 29 This network
can be stretched by the contraction of underlying muscles
and transmit tension over a
distance.30, 31
The fascial tissues are
arranged vertically, from head
to toe, and four interconnected
transverse fascial planes crisscross the body. Therefore,
should an injury occur in one
part of the body, pain and dysfunction may occur throughout the body.32
Mechanism based on qi and
the meridian aspect
The second hypothesis is
that the TMJ and other parts
of the body are connected
through the meridian system,
which is constituted of the fasciae.
Traditionally, acupuncture
meridians are believed to form
a network throughout the
body, connecting peripheral
tissues to each other.33 Studies
that seek to understand the
acupuncture point/meridian
systems from a Western perspective have mainly focused
on identifying distinct his tological features that dif ferentiate acupuncture points
from surrounding tissue.34 One
of the histological and anatomical associations with the
meridians is intermuscular or
intramuscular loose connective tissue (fascia).
Ancient acupuncture texts
contain several references to
“fat, greasy membranes, fasciae and systems of connecting
membranes” through which
[11] =>
DTAP0312_01-02_Title
DTAP0312_10-11_Lee 13.03.12 08:44 Seite 2
DENTAL TRIBUNE Asia Pacific Edition
the qi is believed to flow.35 In
terms of connective tissue
associations, several authors
have suggested that a connection may exist between the
acupuncture meridians, which
tend to be located along the
fascial planes between muscles or between a muscle and
bone or tendon, and the connective tissue.34, 35
In view of experimental
evidence, it has been hypothesised that the network of the
meridians can be viewed as a
representation of a network of
interstitial connective tissues.
These findings are supported
by ultrasound images showing
connective tissue cleavage
planes at the acupuncture
points in human beings. 34
Rather than viewing acupuncture points as discrete entities,
it has been proposed that these
points might correspond to
sites of convergence in a network of connective tissue permeating the entire body, similar to highway intersections in
a network of primary and secondary roads.34
Trends & Applications 11
Editorial note: This article is a summary
of two review papers recently published
in the Journal of Alternative and
Complementary Medicine 17 (2011):
995–1000 & 1119–24. A complete list of
references is available from the authors.
“...the traditions of acupuncture
and myofascial pain therapies share
fundamental similarities...”
ger points and the acupuncture points clearly need to
be further investigated in the
future.
The fascial connection theory we propose can explain
the functional connection between dental occlusion/TMJ
and other parts of the body
based on either myofascial release or the qi and meridian
system, or a combination of the
two. Therefore, dental occlu-
Contact Info
sion should be built up and
maintained in a normal natural condition, while causes for
deterioration of the TMJ status should be treated in an
effort to restore the natural
condition. DT
Drs Yong-Keun Lee and HyungJoo Moon are practicing dentistry at the Moon Dental Hospital and ICPB in Seoul in South
Korea. They can be contacted at
ykleedm@gmail.com.
AD
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ScienƟĮc MeeƟng:
Friday - Wednesday,
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Correlation between trigger
points and acupuncture points
Although separated by two
millennia, the traditions of
acupuncture and myofascial
pain therapies share fundamental similarities in the treatment of pain disorders.36 Recent reports have suggested
substantial anatomic, clinical
and physiological overlap of
the myofascial trigger points
and acupuncture points.36 The
analogy between the trigger
points and acupuncture points
has been discussed since
1977,37 when 100 % anatomic
and 71 % clinical pain correspondences for the myofascial
trigger points and acupuncture
points in the treatment of pain
disorders were reported.
Exhibit Dates:
Sunday - Wednesday,
November 25 - 28
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A number of similarities
between them were also suggested. The two structures
have similar locations and needles are used at either point to
treat pain. The pain associated
with the local twitch response
at trigger points is similar to
the de qi sensation, and the
referred pain generated by
needling trigger points is similar to the propagated sensation
along the meridians.
It was pointed out, however,
that the acupuncture points
located at the trigger points
are not frequently used by
acupuncturists, and do not
share the same clinical indications as the trigger point therapy.38 It was further argued that
the claim of 71 % correspondence between the acupuncture points and the trigger
points37 is conceptually impossible.
Furthermore, even putting
this conceptual problem aside,
no more than 40 % of the
acupuncture points correlated
with the treatment for pain
and, more likely, only approximately 18 to 19 % of the points
are actually correlated.39 The
correlation between the trig-
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[12] =>
DTAP0312_01-02_Title
DTAP0312_12-14_Edelhoff 13.03.12 08:46 Seite 1
DENTAL TRIBUNE Asia Pacific Edition
12 Trends & Applications
Aesthetic reconstruction of
a transplanted premolar tooth
Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 1: Initial situation showing transplanted
premolar in place of tooth #11.—Fig. 2: Incisal view of the initial situation on the stone
model.—Fig. 3 & 4: Wax-up for the intra-oral
transfer to a mock-up.—Fig. 5: Mock-up in
place in the patient’s mouth.—Fig. 6:Fabrication of the working model with removable
dies.—Fig. 7: The refractory dies can be directly repositioned in the working model.
which was individually layered in
the incisal area.
Fig. 5
Prof. Daniel Edelhoff, Björn Maier,
M.D.T. & Dr Hela Ihloff
Germany
Several therapeutic approaches
are available for restoring missing anterior teeth. The most commonly used involve the placement
of implants or the fabrication of
resin bonded bridges. Another
option is tooth transplantation.
In this article, an alternative approach will be presented to provide a suitable restorative solution
for a young female patient who
had lost an anterior tooth by using
a rather unconventional concept.
Restoring upper anterior teeth
has proven to be a challenging task
for the dental team. Criteria such
as aesthetics, function and strength
have to be individually assessed in
each case. Owing to the advancements in the field of dental materials,
however, dental teams nowadays
have many all-ceramic restorative
options at hand, ranging from zirconium oxide-based framework materials to press ceramics and layer
ceramics for individualised layering
on refractory dies. The selection of
materials for the fabrication of dental restorations is immense.
The lithium disilicate-based
IPS e.max Press ceramic (Ivoclar
Vivadent) has proven to be an ideal
material for those cases in which
Fig. 8
Fig. 6
Fig. 7
single-tooth restorations with demanding aesthetics are required.
With this material, the wax model
can be reproduced precisely with
the ceramic material. The fully anatomical restoration is characterised
with stains and then fired. A more
exacting option would be the cut-back
technique, in which Impulse and
Incisal materials (IPS e.max Ceram
range, Ivoclar Vivadent) are applied
to the occlusal and incisal areas of
the pressed framework. By applying
small amounts of layering material,
highly aesthetic restorations can be
achieved in just a few steps.
The same principle applies to
the fabrication of ceramic veneers.
Based on a wax model, partially or
fully anatomical restorations are
pressed with ceramic and subsequently characterised by means of
stains and layering materials. The
individual build-up of the veneers
with layering materials from the
IPS e.max Ceram range on refractory dies is a more time-consuming
and demanding option. However,
the outcome makes the effort worthwhile.
The female patient discussed
here lost tooth #11 (FDI) owing to an
endodontic complication. When this
tooth was extracted, tooth #15 was
transplanted into the space left by
tooth #11 and the gap was preserved
by means of orthodontics (Fig. 1).
Fig. 9
Following successful healing, the
32-year-old expressed her wish to
have the transplanted tooth modified for obtaining an impeccable
aesthetic appearance. We relied on
preoperative models to visualise
the case and discussed the various
options on the basis of a wax-up. As
shown in Figure 2, the transplanted
premolar had a strong vestibular inclination as a result of its specific
anatomy. This was a factor that made
the goal of achieving a harmonious
outcome more complicated. When
the preoperative model was evaluated, the orthodontically modified gap
was identified to be somewhat too
large in relation to the width of tooth
#21. The immediate solution considered by the restorative team was to
build up the mesial aspect of tooth
#12 with the help of composites in order to restore the harmonious relationship between the central incisors.
Unfortunately, this procedure
would have caused the lateral incisors to be disharmonious. Another
criterion was the length/width ratio
of the anterior teeth (odontometrics). In order to achieve a harmonious appearance that matched the
age of the patient, the incisal areas
of the anteriors would have had to
be lengthened by 1 to 1.5 mm. These
aspects were discussed with the
patient and visualised with the help
of various models and the wax-up.
A treatment goal was agreed upon
with the patient, and it was decided
that one crown (tooth #11) and three
veneers (teeth #12, 22 and 21) were
required. The wax-up was optimised accordingly and an aesthetically pleasing outcome was created
(Figs. 3 & 4). In order to provide a
better preview of the restoration, the
final wax-up was transferred to a
mock-up by means of a template.
The patient was thus able to gain a
more detailed idea of the planned
outcome before treatment commenced (Fig. 5). She agreed to have
the final restorations fabricated on
the basis of this mock-up.
When a restoration has to be
made in a largely healthy masticatory system like the one presented
in this article, the question of how
it should be fabricated remains.
Whenever possible, an adhesively
cemented, conservative, all-ceramic solution should be the first
choice. Veneers made by layering
ceramic, such as the nano-fluorapatite glass-ceramic IPS e.max Ceram,
on refractory dies can be fabricated
with very thin wall thicknesses and
with pleasing optical effects. If a
non-invasive approach is pursued,
this type of restoration allows clinicians to make use of its full potential
in terms of aesthetics and function. In this case, tooth #11 was prepared according to morphological
guidelines and conditioned for the
placement of an all-ceramic crown,
Fig. 10
Fig. 8: The preparation margin was marked on the refractory dies.—Fig. 9: Firing of the ceramic materials on the refractory dies.—Fig. 10: Mamelon structures were created.
After the preparation and impression taking, the restorations
were fabricated on the model. As refractory dies were needed to complete the individually layered veneers, a model with removable dies
was prepared (Fig. 5). As a result, it
was possible to reposition the doubled dies in the model of the initial
situation precisely when the materials were fired. It is crucial, however,
that the dies are fabricated with utmost precision and undercuts have
to be prevented at all costs. For an
optimal fit of the dies on the model,
parallel surfaces that do not allow
for any torsion movement of the dies
were created. A guidance groove was
therefore not necessary (Fig. 7). If
the work is carried out precisely, this
method allows a high accuracy of fit
to be achieved. After the glaze firing,
the completed restorations showed
an accurate fit in the vertical dimension too almost from the beginning.
The information gathered in the
previously completed wax-up was
transferred to the working model
through a silicone template, which
was additionally adjusted to the situation. Then, another silicone template was prepared, which served
as a reference for the subsequent
ceramic layering.
Depending on the material
used, the refractory dies are left to
dry without additional heat for one
day after fabrication. If required,
they may be degassed. It is important that the dies are immediately
removed from the silicone matrix
after a setting time of 45 minutes, as
[13] =>
DTAP0312_01-02_Title
DTAP0312_12-14_Edelhoff 13.03.12 08:46 Seite 2
DENTAL TRIBUNE Asia Pacific Edition
Fig. 11
Trends & Applications 13
Fig. 12
Fig. 13
Fig. 11–13: Much attention was also paid to the creation of the surface texture.
AD
the material may start to dissolve the
silicone. Subsequently, the preparation margin of the veneers is marked
on the dies with a refractory pencil
and wash firing is conducted (Fig. 8).
Thin application of material ensures that the ceramic layer is even
and homogeneous, which is important for the fit of the veneers. A
clear, transparent material for wash
firing, like the IPS e.max Ceram
Transpa clear or IPS e.max Ceram
Add-On Incisal was used. In order
to keep the shrinkage as low or as
constant as possible during the main
firing cycle, it is possible to create
an isthmus with ceramic material.
In this case, this structure was created in the cervical area (Fig. 9).
LED’s be independent
Layers of even thickness were
then applied. Starting in the cervical
area, dentine materials were used
first. The incisal portion was created in accordance with the patient
situation and supplemented with
the appropriate Incisal and Transpa
materials (Fig. 10). This procedure
was used to create individual characteristics (for example mamelons,
opalescent areas) against a translucent background. The intensity of
the materials could be controlled
precisely while not being hampered
by the opaque effect that is sometimes caused by an underlying layer
of dentine material.
The crown on tooth #11 was
fabricated using the cut-back technique. The IPS e.max Press lithium
disilicate framework required that
the crown be fabricated at the same
time as the veneers. Subsequently,
the incisal third of the framework
was individually layered with IPS
e.max Ceram veneering materials.
With this procedure, optimum integration of the restoration into
the surrounding tooth structure was
achieved, as well as a shade effect
that was identical to that of the
veneers.
After the dentine firing process,
in which the shade was adjusted, the
crown and the veneers were fitted
on the model. The proximal contacts were designed, and the shape
and the surface structure of the
restorations were created according to the situation using silver
powder (Figs. 11–13). With the final
glaze firing, the ceramic layering
was completed. The investment
material was removed using 50-µ
glass polishing beads at a pressure
of 0.5 bar or 7.25 psi (Fig. 14).
A water-soluble gel that burns
out without leaving residue was
used to secure the sand-blasted
restorations in place on the model.
This method allowed us to check
‡ DT page 14
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[14] =>
DTAP0312_01-02_Title
DTAP0312_12-14_Edelhoff 13.03.12 08:46 Seite 3
DENTAL TRIBUNE Asia Pacific Edition
14 Trends & Applications
Fig. 14
Fig. 15
Fig. 16
210mmx297mm
DTI APAC5
Ad.ai
1/16/12 15
4:30:49
PM outcome was precisely in accordance with the treatment plan and made both the patient and the treatment team happy.
Fig. 14: TheIDEM12
completed
restorations
prior to
seating.—Figs.
& 16: The
AD
fl DT page 13
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• Source from more than 380 international exhibitors from over 30 countries and network with the top names in the
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the laterotrusive and protrusive
movements, as well as adjust the
restorations with rubber instruments. Taking the functional aspects already incorporated into the
wax-up into account, the canines
were built-up with composite material. A canine-based dynamic occlusion that relieved the anterior
restorations was thus ensured.
Prior to being seated, the veneers were etched with hydrofluoric acid, which was carefully
rinsed off after 20 seconds. The restorations were then silanised and
seated according accurately to the
established protocol for adhesive
cementation. At the recall appointment after seven days, the teeth
were rehydrated, and the soft tissue
had recovered from the intervention (Figs. 15 & 16).
Conclusion
The case described in this article
demonstrates that complex treatment concepts can be systematically
implemented by the dental team
with the help of detailed planning.
Owing to the intensive counselling
of the patient and treatment planning by means of the transfer of
the mock-up to the patient’s mouth,
a high quality, aesthetically satisfactory outcome was achieved. DT
Contact Info
Featured Speakers:
Derek K. Hein
Michel Magne
Chief Operations Officer,
Gordon J. Christensen,
Clinicians Report, CR Foundation,
USA
President,
901 Michel Magne LA, Dental
Laboratory and Teaching Facility,
USA
Pascal Magne
Urs Belser
Associate Professor, The Don and Sybil
Harrington Professor of Aesthetic Dentistry,
Herman Ostrow School of Dentistry,
University of Southern California,
USA
Professor and Head of the
Department of Fixed
Prosthodontics and Occlusion,
School of Dental Medicine,
University of Geneva
For the list of speakers and their topics, visit www.idem-singapore.com now.
Endorsed By
Supported By
Held In
In Co-operation With
Prof. Daniel Edelhoff is working as
tenured associate
professor at the
Polyclinic of Prosthodontics, LudwigMaximilians-University, Munich, Germany. He can be contacted at daniel.
edelhoff@med.uni-muenchen.de.
Contact Info
Björn Maier is a
Master Dental Technician at the Polyclinic of Prosthodontics,
Ludwig-MaximiliansUniversity. He can be
contacted at info@bjoern-maier.com.
Co-organiser
Contact Info
Singapore Dental Association
Koelnmesse Pte Ltd
Ms. Ziqi Zielinski
Tel: +65 6500 6721
idem-singapore@koelnmesse.com.sg
Dr Hela Ihloff is
Academic Director
of the Polyclinic of
Orthodontics, Ludwig-MaximiliansUniversity. She can
be contacted at hela.ihloff@med.unimuenchen.de.
[15] =>
DTAP0312_01-02_Title
DTAP0312_15_Acteon 13.03.12 08:47 Seite 1
DENTAL TRIBUNE Asia Pacific Edition
Advertorial 15
“Our growth is definitely driven by
innovation and quality”
An interview with Gilles Pierson, CEO of the Acteon Group
During the 2011 conference
of the Association Dentaire
Française (ADF) in Paris,
Gilles Pierson, CEO of the
Acteon Group, gave insight
into his company’s history, new
products and future strategies.
Your business units Satelec,
Pierre Rolland and Sopro
were unified under the Acteon
Group in 2003, followed by
your Italian business unit,
De Götzen, which joined the
group in 2006. At IDS Cologne
2011, you introduced your
new corporate identity and
the new Acteon logo. What was
the main reason for this rebranding?
The change in the group’s
name is due to the fact that at the
very beginning in 1980, Satelec
existed on its own. Pierre Rolland
merged with Satelec in 1985 to
become Satelec–Pierre Rolland.
After 1995, we decided to grow
the company through acquisitions, so we acquired different
companies like Sopro and De
Götzen.
It would not have been feasible to have named the group
Satelec, Pierre Roland, Sopro,
De Götzen and so on. We saw the
necessity for a group name while
maintaining the companies’ individual names. So the group is
now named Acteon but the different companies that we acquired
and that merged are identified as
companies with their own history and their own products. This
is also good for the employees,
who still identify with their original companies while belonging
to a large group.
So we have kept the history
of each company, but we have
grouped them under the umbrella of Acteon. Satelec is still
known in countries like France.
Pierre Rolland, which is a 60year-old company, is still famous,
so it’s a little bit difficult to introduce the name of Acteon. Eight
years on, awareness is growing,
although the individual company
names of Pierre Rolland and Satelec are still better known than
the umbrella group of Acteon.
In countries where our history is shorter, like the USA, Asia
or Australia, Acteon is now
known as a company, and the different companies like Satelec,
Pierre Rolland and Sopro as divisions. We found a way to keep
the identity of each company in
the group, while building a brand
name that encompasses all of
them.
With a turnover of €113 million and a growth rate of 16 %
in 2010, last year was a tremendous success for the Acteon
Group. Over two third of sales
were recorded in France. How
was 2011 for you, and which
the dental assistant is playing an
increasingly important role in
decision-making when it comes
to new acquisitions.
markets do you consider most
important for the group?
The year 2010 was another big
and successful year with a 16 %
increase. In 2011, we expect another 9 % increase in sales, which
is good if you consider the economic situation. Europe will account for a stable 2 % and the US
for 10 %. But the highest growth
we are experiencing is in China,
at approximately 20 %. In general, Asia currently accounts for
20 % of our global sales, so if we
achieve a 20 % increase, we will
be very satisfied. Countries like
Japan and India in particular are
very strong markets for us, as was
Thailand until November, before
floods plagued the country.
2011 and the coming years
will definitely be driven by Asia,
and especially by China, where
we have been doing business
since 1987. We now have a team
of 40 people there and expect an
average growth of 30 % over the
next five years. China is definitely a booming market.
When we talk to other European companies that sell on
the Chinese market, they often
mention price sensitivity and
the need to adapt to the local
price level.
No, I don’t think it’s a question
of price—it’s a question of mentality in China. They have cheap
copies of all our products there.
Twenty years
ago, we sued
the copycats. However, we
realised
that this
was not
productive
because if the
company simply closes and reopens in the next garage, you are
fighting a lost cause. More importantly, we realised that the
Chinese copies are our best advertising because the quality is
very poor and the design is just
ridiculous. Dentists first buy a
Chinese copy but then they experience so many problems. As soon
as they have the money to buy a
European product at a European
price, they will buy it. The fake
Rolex made in China is sold in Europe, but the real Rolex made in
Switzerland is sold in China. And
the proper business-orientated
Chinese client with a long-term
plan will never buy a fake product.
On the other hand, we are
seeing an alarming trend reversal in Europe. There are so
many fake or copy products from
China imported into Europe with
The WhiteFox was very well
received by the market. The design is nice, but the technology
is really advanced. For example,
WhiteFox is the only scanner of
its kind to feature a Hounsfield
units calibration. This calibration is used for measuring bone
density in order to allow for
perfect planning and, if needed,
for bone grafting prior to implantations.
Since the introduction of
cone-beam technology to general dental and maxillo-facial
surgery, ENT surgeons have become increasingly attracted to
this form of technology and are
thus becoming a very important
market segment for this kind of
product.
Gilles Pierson, CEO of the Acteon Group.
a fake CE number or with a fake
ISO 9000. The customs duties in
the Shenzhen area do not block
these fake products, so any kind
of product can enter into Europe.
These are healthcare devices to
treat patients and they should not
put patients in danger.
Do you believe that you will
still be able to manufacture
in France or in Europe in the
future?
Acteon’s policy is to manufacture and conduct research in
Western Europe, and not to manufacture in China, South-East
Asia, Brazil, India, or anywhere
else. Our policy is to produce continuously in Western Europe. Our
factories are in France, Italy and
Germany. Acteon has established
itself in a niche of the health-care
point where we are able to offer
more or less the complete range
of products. Only the panoramic
is missing; however, within the
next five to six years, the panoramic might disappear from
the market and be replaced by
the flat panel instead of the linear panel. We therefore prefer
to concentrate on the flat panel,
with a 2-D or 3-D reconstruction.
No one can deny any longer
that the future of dentistry is digital. For example, at Sopro, we
manufacture a camera to detect
tooth decay with fluorescence
technology. So imaging is one
thing, but with imaging you can
go to diagnosis. Imaging for a
diagnosis is really the key point of
imaging, and if you have a good
diagnosis, you can have a good
treatment.
Over the past 30 years, we
have invested a large amount of
the company’s profits in R&D.
We currently have a total of 70
people in our R&D departments
in the different companies, and
our growth is definitely driven by
innovation and quality.
Your new CBCT System,
WhiteFox, received the red dot
design award in 2011, which
recognises exceptional industrial design. What is the response from the market, and
how are the sales figures for
the WhiteFox system?
We place a heavy emphasis
on design at Acteon for three
reasons. The first reason is that
the dental clinics are usually well
designed because the patient is
awake. It is not like a hospital,
where the patient is under anaesthesia and asleep and does not
care about his environment. In a
dental clinic, patients like to have
a nice environment to lower the
stress of the experience.
You have invested in the digital dentistry market in particular…
We invest a lot in the digital
dentistry market indeed. This is
one of the fastest-growing markets today and we have reached a
Another point is that the dental assistant is participating increasingly in the choice of products. The clinical team likes nice
designs and colours, whereas
the dentist tends to be more attracted by technical features. But
market. This market is driven
by quality and innovation.
Western Europe is best known
for these qualities and, consequently, you have to have your
factory here to produce at such a
level and to generate innovation
based on the technology. This is
Acteon’s philosophy.
The large viewing area for
the ear, nose and throat is especially convenient. We have good
synergies with our medical division, which is also specialised in
the ENT area. You see, there are
many bridges between the dental
and medical fields, between endoscopy in the medical and imaging in the dental field, between
radiology in the dental and imaging in hospitals or ENT.
We are pleased with the cone
beam, and the sales figures are
within our expectations.
You are Platinum sponsor
of the upcoming Europerio
Congress in Vienna. What can
visitors expect from Acteon
there?
Basically, we are very involved in preventive and conservative dentistry. Periodontics
has always played a major role
in these areas and Europerio is
considered to be the leading congress in this specialty worldwide.
We have purposefully chosen to
become Platinum sponsor of the
congress because of the quality
of its scientific programme and
the excellent standing of the congress in the dental community.
Acteon will stage sponsored
sessions on Wednesday, 6 June,
from 16:00 to 17:00 (this includes
a session hosted by Dr Bennani
entitled “A new gingival retraction technique for implants”).
On Friday, 8 June, from 12:15 to
13:45, there will be a novel procedure for evaluating plaque status and soft-tissue inflammation
using an intraoral camera. These
sessions will be of interest to dental hygienists, general dentists as
well as periodontists. The crème
de la crème of international
speakers will reveal tips and
tricks from their professional
lives, and we invite everyone cordially to join us in Vienna. DT
[16] =>
DTAP0312_01-02_Title
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3D X-ray • 3D photo • panoramic • cephalometric
Romexis® software completes 3D perfection
Scan™ • ProMax®
Plan bination for op 3D • Pr
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More information
www.planmeca.com
Planmeca Oy
Asentajankatu 6, 00880 Helsinki, Finland
tel. +358 20 7795 500, fax +358 20 7795 555
sales@planmeca.com
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