DT Canada No. 2, 2015

Connect - learn - excel / Events / Esthetical and functional treatment with implantsupported bar on an incongruous prosthesis carrier / Implant Tribune Canada Edition

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DENTAL TRIBUNE
The World’s Dental Newspaper · Canada Edition

April 2015 — Vol. 9, No. 2

www.dental-tribune.com

Too much dentistry? Time to Head
for the trees.

Creative, EFFICIENT rebuild of worn, illfitting protheses

While at ASM15 in Toronto,
consider a break from
downtown and dentistry to
visit Toronto Islands for a
self-guided tree tour.

Esthetical and functional
treatment is provided with
implant-supported bar on
an incongruous prosthesis
carrier.

” page A2

” pages A8–A9

Connect,
learn, excel

Implant Tribune
Achieving stability
Occlusal stability in
implant prosthodontics:
Clinical factors to consider
before implant placement.
” page B1

ODA
Annual
Spring
Meeting,
May 7–9,
Toronto

Publications Mail Agreement No. 42225022

” See CONNECT, page A2

A4–A6

• Journées Dentaires Internationales
du Québec, in Montréal, May 22–26,
presents courses in French/English
• Pediatric dental meeting will be in
Seattle, May 21–24
• Academy of General Dentistry
meeting to feature new C.E. tracks
• American Dental Association
meeting, in Washington, D.C.,
Nov. 5–8, has global focus

Industry CLINICAL a8–a9

Ontario Dental Association expecting 11,700
attendees and 300 exhibitors at ASM15
The Ontario Dental Association’s 148th Annual Spring Meeting (ASM) is from
May 7–9, attracting dentists and their dental teams to Toronto with an agenda of renowned speakers sessions covering the latest clinical, practice management and personal development topics.
The meeting also features an exhibit floor covering more than 75,000 square feet,
packed with the latest dental innovations. There will be more than 300 exhibiting
companies who are there to demonstrate and teach attendees about new products,
services and technology from across the globe. Attendees have the opportunity to
touch, test drive and compare the newest materials and technology in the dental industry.
Meeting organizers expect approximately 11,700 attendees at the ASM’s host location, the Metro Toronto Convention Centre, South Building, in Toronto.
For the past 14 decades the Ontario Dental Association has focused on three core concepts to
guide the purpose of the ASM: “Connect. Learn.
Excel.” Toward that end, meeting organizers have
created an agenda of wide-ranging and topical lectures presented by nationally and internationally
renowned speakers in a variety of formats. Lectures, hands-on workshops and other interactive
sessions are designed to deliver high-value knowledge — and C.E. credit.
But it’s not just all work. Nowhere is that philosophy more apparent than in the selection of
the opening keynote speaker: one of Canada’s top
comedians, Ron James. Also speaking will be Craig
Kielburger, the social entrepreneur, New York
Times best-selling author and globally syndicated
columnist, who promises to share some insights
on ways to improve our world. Even the exhibit
hall floor is designed to offer some breaks from
dental overload, with its Health Check Zone (to
make sure you’re taking care of yourself) and the
Relaxation Zone (to help you take care of yourself).
The exhibit hall also has two cocktail receptions
scheduled.
The meeting presents a great opportunity to explore one of Canada’s most popular cities during
one of the most appealing times of the year: Toronto in spring. The trees are leafing out, the cafes
are inviting, a variety of shows are in town and the
galleries and shopping provide endless opportunity for exploration.

EVENTS

• Esthetical and functional treatment
with implant-supported bar on an
incongruous prosthesis carrier

Industry a9
• Endodontic Photon Induced
Photoacoustic Streaming

IMPLANT TRIBUNE B1–B5

The latest advancements in products and
services in dentistry are on display in the
Metro Toronto Convention Centre South
Building, home of the Ontario Dental
Association Annual Spring Meeting. Photo/
Provided by Metro Toronto Convention Centre

• Occlusal stability in implant
prosthodontics: Clinical factors to
consider before implant placement
• Five days of implant training with
the American Academy of Implant
Prosthodontics
• See the ‘Visible Difference’ with
Designs for Vision
• Isolite Systems delivers dentalisolation technology
• Position yourself for long career
with Posiflex

[2] =>

A2
“ CONNECT, page A1
Among your choices: international
cuisine, unique shopping venues, diverse cultural facilities and events, trails,
parks, distinctive architecture and nonstop top-caliber entertainment.

Take a break in the trees
For a break from the downtown bustle, Toronto Islands offers a respite, a
10-minute ferry ride away. Catch the
ferry at the Toronto Ferry Docks west
of the Westin Harbour Castle Hotel, between Yonge and Bay streets. Ferries travel to the three main islands, which are
connected by bridges. There are plenty of
ways to spend money on the main island,
including a children’s amusement park,
children’s garden, cafes, food vendors,
canoe rentals and weekend bike rentals.
The islands are home to about 800
people (comprising Canada’s highest per

EVENTS

capita population of artists). They are
considered to be North America’s largest
urban community that is car-free. Worth
consideration is the self-guided Toronto
Island Tree Tour, part of the Canadian
Tree Tours program. You can download
a sheet listing the tour’s 54 trees, or pick
up a tour sheet at a tourism-brochure
display.
The trees have identification plaques
and the tour sheets include GPS coordinates for each tree. So you can pick
out a few that you’d like to hone in on,
consult your smart phone and make a
beeline from tree to tree on your own
self-guided mini-tour. Among the possible candidates: Kentucky coffee-tree,
Swedish whitebeam, Japanese zelkova,
London plane-tree, European larch and a
Schubert cherry.
Sources: Ontario Dental Association
and www.torontoharbour.com.

Dental Tribune Canada Edition | April 2015

DENTAL TRIBUNE
The World’s Dental Newspaper · Canada Edition

Publisher & Chairman
Torsten Oemus t.oemus@dental-tribune.com
President/Chief Operating Officer
Eric Seid e.seid@dental-tribune.com
Group Editor
Kristine Colker k.colker@dental-tribune.com
Editor in Chief
Dr. Sebastian Saba feedback@dental-tribune.com
Managing Editor
Robert Selleck r.selleck@dental-tribune.com
Managing Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.com

The Toronto skyline is framed by trees on
Toronto Islands. The urban sanctuary is a
10-minute ferry ride across Toronto Harbour.
Among the many attractions is a self-guided
tree tour. Photo/Benson Kua, Toronto

Managing Editor
Sierra Rendon s.rendon@dental-tribune.com
Product/Account Manager
Will Kenyon w.kenyon@dental-tribune.com
Product/Account Manager
Humberto Estrada h.estrada@dental-tribune.com
Product/Account Manager
Maria Kaiser m.kaiser@dental-tribune.com
Marketing DIRECTOR
Anna Kataoka
a.kataoka@dental-tribune.com
Education Director
Christiane Ferret c.ferret@dtstudyclub.com
Accounting Coordinator
Nirmala Singh n.singh@dental-tribune.com
Tribune America, LLC
Phone (212) 244-7181
Fax (212) 244-7185
Published by Tribune America
© 2015 Tribune America LLC
All rights reserved.
Tribune America strives to maintain the utmost accuracy in its news and clinical reports. If you find a factual error or content that requires clarification, please
contact Managing Editor Robert Selleck at r.selleck@
dental-tribune.com.
Tribune America cannot assume responsibility for the
validity of product claims or for typographical errors.
The publisher also does not assume responsibility for
product names or statements made by advertisers.
Opinions expressed by authors are their own and may
not reflect those of Tribune America.
Editorial Board
Dr. Joel Berg
Dr. L. Stephen Buchanan
Dr. Arnaldo Castellucci
Dr. Gorden Christensen
Dr. Rella Christensen
Dr. William Dickerson
Hugh Doherty
Dr. James Doundoulakis
Dr. David Garber
Dr. Fay Goldstep
Dr. Howard Glazer
Dr. Harold Heymann
Dr. Karl Leinfelder
Dr. Roger Levin
Dr. Carl E. Misch
Dr. Dan Nathanson
Dr. Chester Redhead
Dr. Irwin Smigel
Dr. Jon Suzuki
Dr. Dennis Tartakow
Dr. Dan Ward

Tell us what you think!
Do you have general comments or criticism you would like to share? Is there
a particular topic you would like to see
articles about in Dental Tribune? Let us
know by emailing feedback@dentaltribune.com. We look forward to hearing from you!
If you would like to make any change
to your subscription (name, address or
to opt out) please send us an email at
database@dental-tribune.com and be
sure to include which publication you
are referring to. Also, please note that
subscription changes can take up to six
weeks to process.

.
.

[3] =>

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EVENTS

Dental Tribune Canada Edition | April 2015

JDIQ courses in French/English
The Journées Dentaires Internationales du Québec, Canada’s largest bilingual dental meeting, according to organizers, is from May 22–26 (Friday through
Tuesday) in Montréal. Online registration is available at www.odq.qc.ca.
Meeting apps for Apple and Android
phones and tablets can be downloaded
through www.odq.qc.ca, the App Store
or the Play Store. On-site at the meeting,
free WiFi will be available to all delegates
and exhibitors at the venue, the Palais
des congrès de Montréal.
The meeting’s educational program
has more than 125 prominent speakers
from Canada, the United States and Europe presenting approximately 175 educational sessions in English and French

during the five-day convention.
Among the educational sessions:
“Lights, Camera, Action! Patient Photography Made Easy — A Hands-On
Workshop,” “Endodontics for General
Dentists: Advanced, Comprehensive and
Practical Hands-On Training,” “Oral Surgery for the General Dentist: Faster, Easier, and More Predictable” and “Hands-on
Infection Control Workshop.”
Many other lectures and workshops
are scheduled, with details in the program online.

225 companies, 500 booths
The exhibition hall will feature more
than 225 companies in 500 booths in the
133,563-square-foot space.

More than 2,000 company representatives will be on hand to help you see,
compare and make decisions on new furniture, equipment, instruments, techniques and other products and services
— all under one roof.
One C.E. hour per day can be earned by
visiting the exhibit hall. Just be sure to
have your badge scanned at the entrance.
The exhibition hall hours are 8 a.m. to
6 p.m. on Monday, May 25, and 8 a.m. to
5 p.m. on Tuesday, May 26.
The organizers invite you to join the
more than 12,000 expected delegates to
meet, learn, share and enjoy this gathering of friends and colleagues.
(Source: JDIQ)

JDIQ is May 22–26 at the Montréal Convention Centre (Palais des congrès de Montréal.
Photo/MTTQ/Marc Cramer, Tourism Montréal

AAPD to be
in Seattle,
May 21–24
Pike Place Market, the Space Needle,
the EMP Museum and some of the top
thought leaders in pediatric dentistry
are among the reasons to be in Seattle
May 21–24 for the American Academy of
Pediatric Dentistry (AAPD) annual session.
Scientific sessions are at the Washington State Convention Center, in the heart
of downtown, adjacent to hotels, restaurants, nightlife and shopping. Taking
advantage of the location, the welcome
reception on Thursday, May 21, features
exclusive access to the Space Needle,
EMP Museum and Chihuly Gardens.
The keynote, on May 22, features Frank
Abagnale with “The True Story of Catch
Me If You Can.” An authority on forgery,
embezzlement and secure documents,
Abagnale became an expert of sorts 40
years ago as a world-famous con man, as
depicted in his best-selling book, “Catch
Me If You Can.” Leonardo DiCaprio and
Tom Hanks starred in a Steven Spielberg
film based on the book.

Three-day exhibit hall
Products and services in the meeting’s
exhibit hall will be geared toward pediatric dental practices. An AAPD booth
will have a bookstore, which will have
copies of the Coding Manual, the new
pediatric dentistry handbook. Also in
the exhibit hall will be the Healthy
Smiles, Healthy Children Donor Lounge,
where you can learn more about Access
to Care Grants and donate to its supporting foundation.
A hospitality area on the exhibit hall
floor will offer a continental breakfast,
and there will be complimentary beverages each morning and afternoon and
lunch available for purchase.
You can register for the meeting online by visiting www.aapd.org/annual.
(Source: AAPD)

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EVENTS

Dental Tribune Canada Edition | April 2015

AGD gathering features new continuing education tracks
At AGD 2015, from June 18–21 in San Francisco, the Academy of General Dentistry
(AGD) intends to not just embrace “constant change,” but celebrate it. The meeting,
at the Moscone West Convention Center in
San Fransisco, will showcase new technologies and C.E. courses for dentists and staff.
Keynote speaker Terry Jones, founder of
Travelocity.com and Kayak.com and execu-

tive chairman of Wayblazer, will share insight on creating a culture of innovation
and embracing opportunities in today’s
age of information. Innovation will be on
display at “Modern Practice for Today’s
Patients,” presented by Henry Schein Inc.
New C.E. tracks will enable dental team
members to focus on specific subject areas,
such as endodontics, implants and special-

patient care. Also new will be a 90-minute
live-patient dental implant course hosted
by Engel Institute founder Todd B. Engel,
DDS, and fundamental and intermediate
Invisalign® courses for dentists and their
teams.
Friends and family can attend the
“President’s Celebration to Honor Fellows
and Masters” for dining and live music and

the AGD Foundation’s “5K Fun Run/Walk”
for oral cancer awareness and research.
Register at www.agd2015.org. The official
hotel is the San Francisco Marriott Marquis. Early reservations are encouraged, at
resweb.passkey.com/go/AGD2015, (877) 6223056 or (415) 896-1600 (international).
(Source: AGD)

Ski, golf and C.E. — all at the ’16 Pacific Dental Conference
Vancouver’s Pacific Dental Conference
is scheduled a bit later next year, running
from March 17–19, 2016, at the Vancouver
Trade and Convention Centre. The late date
means you will be able to experience the

festive spirit of St. Patrick’s Day in the true
flavour of the West Coast, while earning
C.E. credits. The conference has assembled
a lineup of local, North American and international speakers. With more than 130 pre-

senters, 150 open sessions and 36 hands-on
courses covering a variety of topics, there
should be something for every member of
the dental team.
The conference’s two-day dental trade

show provides the year’s first opportunity
to see the newest equipment in Canada. A
spacious exhibit hall invites attendees to
see innovative new techniques in use on
the Live Dentistry Stage and products from
more than 300 exhibiting companies. Sessions are designed to engage attendees in
discussions on creating real-practice solutions. Lunches and highly popular exhibit
hall receptions are included as part of the
trade show.
At the conclusion of the conference, you
can take a day to relax and revitalize by
exploring some of the many tourist attractions in Vancouver. The ocean is just steps
from the Vancouver Convention Centre,
pristine snow capped mountains offer enticing spring-like skiing conditions, and
numerous lush golf courses are available.
(Source: Pacific Dental Conference)

Annual ADA
meeting has
global focus
The annual meeting of the American
Dental Association, ADA 2015: America’s
Dental Meeting, will be in Washington,
D.C., from Nov. 5–8. As one of the largest
dental meetings in the United States, the
meeting offers more than 300 C.E. courses,
550 exhibits and — new this year — a welcome reception for all attendees.
The meeting includes courses and events
tailored to international attendees, including a designated registration area, a
special networking cocktail reception and
an “International Learning Lounge” with
courses in multiple languages, including
Spanish and Chinese. Dentists can join the
ADA as an international member to receive
discounts on registration. The exhibit hall
includes the ADA Member Center, which
showcases essential resources to help
members grow their practice.
As the government center of the United
States, Washington, D.C., is a city rich in history and culture. There are numerous museums, memorials and historical monuments to visit. Additionally, the city boasts
more than 100 free attractions. The ADA
looks forward to welcoming dental professionals from around the world to Washington, D.C., for ADA 2015. Registration will
open in the coming months. You can learn
more at www.ada.org/meeting.
(Source: American Dental Association)

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INDUSTRY CLINICAL

Dental Tribune Canada Edition | April 2015

Esthetical and functional treatment with implantsupported bar on an incongruous prosthesis carrier
Quick lab work creates complete denture-retention system on implants
By Carlo Borromeo, Dental Technician, Italy

Introduction
The patient, a 74-year-old female with
an older, total prosthesis, asked us to improve its esthetics and function. In the
initial exam, we noticed a marked difference between the total upper prosthesis
(all but ruined) and the lower total prosthesis (recently manufactured across
four implants). We also saw immedi-

ately that the prosthesis was incorrectly
mounted, occupying too much space and
leaving the teeth too exposed (Fig. 1).
After discussions with the patient, we
agreed to remount both the upper and
lower teeth to obtain optimal esthetic
results and restore mastication function. Based on the specific demands of
the case, we identified the best retentiveconnection system to connect with the
implants and provide the necessary
over-structure, support and thickness.

Case planning
Impressions were taking to obtain vertical and centric dimensions. Once the design met the patient’s need for improved
esthetics and function, the dental technicians created vestibular and lingual
silicon masks to guide the building of
the structure and over-structure. Space
availability was evaluated with teeth
and implants position. These analyses

Fig. 1: Patient during first clinical session.
Photos/Carlo Borromeo

” See PROSTHESIS, page A9

Fig. 2: Positioning of the ‘OT Bar.’

Fig. 3: Checking of the dimensions using the
vestibular plaque

Fig. 4: Check of the precision of the bar on
the model before finishing.

Fig. 5: Check of the spaces for pipe cleaner.

Fig. 6: Superstructure completed on model.

Fig. 7: Spruing of superstructure on model.

Fig. 8: Re-application of teeth using plaques.

Fig. 9: Positioning of model in the mitten for
creation of a resin-made prosthesis.

[9] =>

INDUSTRY

Dental Tribune Canada Edition | April 2015

Endodontic Photon Induced Photoacoustic Streaming
Treatment uses Lightwalker
AT laser with contact H14-C
handpiece and PIPS fiber tip
By Prof. Giovanni Olivi, MD, DDS
University of Genoa, Italy

ODA
BOOTH
1028

A patient asked for the
option to save her teeth
that were scheduled for extraction by another dentist.
The lower left first and second molars
had high mobility (grade 2), were necrotic, with significant probing depths in the
buccal aspect.
The teeth were diagnosed for endo/
perio treatment. Difficulties with this
case included complex radicular anatomy, long anatomical measurements (26
and 27 mm, respectively for #36 and 37)
and the presence of a deep vertical bone
loss in the buccal aspect. After scaling
and root planning, the teeth were scheduled for root–canal therapy.

Before treatment: PIPs
Before each treatment the PIPS™ tech-

“ PROSTHESIS, page A8
enabled identification of the proper prosthetic treatment to choose.
A working model was placed under the
parallelometer to identify the proper
insertion plan. Different aspects were
evaluated: the horizontal line of the incisors, the occlusion line of the posteriors, the under spaces by the areas under
the frontal ridge and the implants’ angulation. Once the insertion plan was finalized, castable pivots were regulated with
proper height and screwed, guided by the
silicon mask. Next came creation of the
castable bar by setting it — area-afterarea — using resin to fix it at the external
areas (Fig. 2).
Once all the parts of the structure
were connected, we regulated the areas
over the implants using a two-degree
bur. The technician then checked everything using the silicon masks (Fig. 3).
After we confirmed that the bur met all
our expectations, we started the sprue
procedure. We proceeded with the fusion through a special press-fusion procedure. Once it was verified that the bar
respected all the desired characteristics,
we continued with the spruing, directly
on the model to avoid distortions during the cooling of the wax. We then proceeded with the melting, using the “diecasting” technique. We conducted a first
test immediately after cleaning the coating (Fig. 4).
The finished artifact was delivered to
the clinic, where the necessary tests and
radiographs were obtained. Once verified
that all the parameters were correct and
that the structure was passive, the bar
was milled and polished at the lab. On
the model, spaces were verified for the
application of pipe cleaners. This same
test would be conducted later in the patient’s mouth (Fig. 5).
Using the silicon plaques, we built the
superstructure directly on the bar, starting by positioning the containers of the

Fig. 1: Pre–op, before the PIPS.

Fig. 2: Post–op, after PIPS.

Fig. 3: One month post–op.

Fig. 4: Four months post–op.

Photos/Provided by Dr. Giovanni Olivi

nique was applied into the periodontal
pockets of each tooth for refining the debridement, removal of biofilm from the
root surfaces and pocket disinfection.
The root canal treatments were performed using PIPS–specific irrigation
protocols with 5 percent NaOCl and
17 percent EDTA.

Obturation with resin sealer
The canals were obturated with a flowable
resin sealer (Endoreze Ultradent, South
Jordan, Utah) and gutta–percha points.
A final treatment of the pockets using
PIPS for disinfection was performed after
completing each root canal therapy to
remove any extruded sealer or residual
biofilm.

caps. Castable boxes were applied onto
those, always using the silicon plaques.
After avoiding the undercuts with wax,
we isolated the bar and the model and
then built the superstructure using resin
(Fig. 6). We removed it from the superstructure and pasted the retentions.
Everything was set up to proceed with
the spruing directly on the model (Fig. 7).
After the coating was melted off, precision and friction was verified using a revealing-paint on the bar. The teeth were
applied with the aid of silicon masks
(Figs. 8, 9). The containers of the clips
continued to be replaced with pink caps.
Everything was delivered to the clinic
for the final test. With the prosthesis
back at the laboratory, wax fittings were
converted to resin fittings and the superstructure was finished and polished (Fig.
10). After applying it again on the superstructure, undercuts were closed with
some wax, and the resin was applied to
the prosthesis (Fig. 11). All the components of the prosthesis were polished and
delivered to the clinic for the final test
(Figs. 12, 13).

No post–op symptoms were reported
and the mobility of the teeth progressively disappeared up to grade 0.
The follow-up X–rays performed after
one and four months showed healing in
progress for both the teeth. Lightwalker
AT laser device with contact H14–C handpiece and PIPS fiber tip was used for the
treatment.
The Lightwalker parameters are: laser
source: Er:YAG; wavelength: 2940 nm;
pulse duration: SSP; energy: 15 mJ; frequency: 15 Hz.
Disclosure: Dr. Olivi has relationships
with several laser companies (including
AMD-DENTSPLY, Biolase and Fotona) but
receives no financial compensation for his
research or for writing articles.

Dr. Giovanni Olivi is
an adjunct professor of
endodontics at the University of Genoa School
of Dentistry and a
board member and professor in its master
course in laser dentistry. He completed the
postgraduate

course at the University
of Firenze and earned laser certification from the
International Society for Lasers in Dentistry.
Olivi has advanced proficiency mastership from the
Academy of Laser Dentistry and is the 2007 recipient
of ALD’s Leon Goldman Award for Clinical Excellence.
His private practice in endodontics, restorative and
pediatric dentistry is in Rome.
You can contact Olivi at olivilaser@gmail.com.

Fig. 10: Polishing of the structure.

Fig. 11: Insertion of the pink caps in the structure.

Conclusions
With adequate components, retention
systems on implants and readily available technical and clinical knowledge
and resources on complete dentures, you
can obtain excellent results in short work
times, using both traditional systems
and CAD/CAM.

Carlo

Borromeo

founded

Fig. 12: Finished prosthesis and bar

Dental Laboratory Borromeo in
Italy in 1988, specializing in the
construction of prosthesis for
implants using CAD/CAM. He
collaborates with Nobel Biocare
Procera, Dental Wings, Rhein’83
and other companies to improve his expertise with
their materials. He is a highly published industry
author and presents and participates in many dental
lab courses and conferences.

laser

Fig. 13: Final results after screwing bar into the mouth and applying prostheses.

[10] =>

[11] =>

IMPLANT TRIBUNE
The World’s Dental Implant Newspaper · Canada Edition

April 2015 — Vol. 3, No. 1

www.dental-tribune.com

Clinical

Occlusal stability in
implant prosthodontics
Clinical factors to
consider before
implant placement

Fig. 1

Fig. 2

Fig. 3

Fig. 4

By Sebastian Saba, DDS, Cert. Pros.,
Dental Tribune Canada Editor in Chief

he success of any prosthetic design depends on proper management of the occlusion. The clinical
variables influencing occlusal stability must be determined and considered
in the design of the final prosthesis. This
paper outlines some of these variables.

Occlusal diagnosis
Dental implant-supported restorations
may develop complications for different
reasons: some biological in origin1,2 (Fig. 1)
and others mechanical. The prosthetic design should respect the biomechanical factors that can contribute to prosthetic complications. Occlusal stability is achieved
when the variables contributing to failure
are identified and corrected or compensated for in the final prosthetic design.
The most significant factor affecting
stability is occlusal loading. Excess loading may lead to loosening of abutment
screws3,4 and, if undetected, to possible
fracture. Overloading may also damage
the implant5 (Fig. 2) and superstructure
and lead to loss of osseointegration.6
Overloading may occur if the implant

Fig. 5

Fig. 6

prosthesis is designed with inadequate
implant-fixture support under normal
occlusal loading. The key is to place a sufficient number of implants to support the
prosthesis.7 The conventional ratio of implant to prosthetic unit is 1:1 (Fig. 3). However, for posterior restorations, the ratio
may vary. Variable bone quality or lack of
bone width may require two implants per
unit molar replaced.8 Two can be placed in
narrower ridges and will provide greater
antirotational and occlusal support and
an increased surface area for osseointegration. Two positioned off angle will also
provide counter support and reduce stress
on the angled abutment screws.9
If the ridge height is diminished, the use
of a standard- diameter short implant (<10
mm) is not usually recommended in posterior restorations (Fig. 4). A wide-diameter
implant (Fig. 5) may provide adequate sur-

Fig. 7

face area for osseointegration and provide
an alternative for support.10
Ridge diameter, bone height and quality
will be determining variables. The width of
the proposed restoration will also dictate
the amount of support required. The widediameter implant provides a larger abutment screw connection (for strength)11 and
a wider implant table for occlusal support.
The wide-diameter implant has gained
popularity in cases where the edentulous area does not provide space for two
standard-diameter implants, and a single
standard-diameter implant has been determined to be inadequate for support.
Abnormal occlusal forces, such as those
caused by bruxism or clenching, may also
contribute to prosthetic complications.12
These habits are not a contraindication for
implant dentistry, but must be compensated for in the final prosthetic design. Ad-

Fig. 1: Radiograph demonstrating bone loss due to periimplantitis. Fig. 2: Radiograph
showing a fractured implant.
Fig. 3: Bridge demonstrating 1:1
implant-to-crown ratio. Fig. 4:
Bone loss around a short dental
implant. Fig. 5: Wide-body
implant fixture to replace
molar tooth. Fig. 6: Ill-fitting
posterior bridge and prosthetic
design. Fig. 7: Non-ideal
cantilever: long distal
cantilever demonstrating bone
loss and poor support. Photos/
Provided by Dr. Sebastian Saba

junctive protective guards are mandatory.
The stability of existing teeth must also
be confirmed before placement of any
fixed partial implant-supported prosthesis. Any mobility in the existing dentition must be diagnosed and corrected.
Clinical mobility of existing dentition
will result in added occlusal strain on the
implant-supported prosthesis. The presence of any interocclusal interferences
must also be corrected. Frequently these
are detected too late and compromise occlusal design of the new prosthesis. Stable
centric contacts, good excursive guidance
of choice and sound periodontal support
are required to achieve a stable occlusion.

Occlusal design and guidance
Occlusal design in partial fixed-implant” See STABILITY, page B2

Five days of implant training

Photo/ Provided by AAIP

The American Academy of Implant
Prosthodontics (AAIP) will join with its affiliates, Atlantic Dental Implant Seminars
(ADIS) and the Linkow Implant Institute, to
present a five-day comprehensive implant
training program in Kingston, Jamaica, at
the University of Technology, School of
Oral Health Sciences, from July 1-5.
The course will include a half day of
lectures, surgical and prosthodontic demonstrations and a half day of hands-on
participation on anatomic manikins and

cadavers, diagnosis and treatment planning of implant cases for a minimum of
six patients, the construction of surgical
templates, diagnostic wax-ups, and the
insertion of a minimum of 10 implants by
each participant. Qualified participants
will perform sinus lifts, immediate implant placement and ridge splitting under
supervision of the course faculty.
Upon completion of the 40-hour comprehensive implant training program,
participating clinicians will be able to

accomplish the following tasks: identify
cases suitable for dental implants; diagnose and treatment plan for preservation
and restoration of edentulous and partially edentulous arches; demonstrate competency in the placement of single-tooth implants, soft-tissue management and bone
augmentation; obtain an ideal implant
occlusion; work as part of an implant team
with other professionals; and incorporate
” See TRAINING, page B2

[12] =>

FROM PAGE ONE

Implant Tribune Canada Edition | April 2015

IMPLANT TRIBUNE
Publisher & Chairman
Torsten Oemus t.oemus@dental-tribune.com
President/Chief Operating Officer
Eric Seid e.seid@dental-tribune.com

Fig. 8

Fig. 9

Fig. 11

Fig. 10

Fig. 8: Ideal cantilever: mesial cantilever implant prosthesis. Fig. 9: Radiographic view of restoration in Fig. 8. Fig. 10: Non-ideal cantilever: long
anterior cantilever due to poor implant location, incorrect prosthetic work-up, inadequate lip support and compromised design. Incisal loading
will lead to prosthetic failure. Fig. 11: Lateral view of restoration in Fig. 10.

“ STABILITY, Page B1
supported prosthetics is based on conventional restorative principles. The key is to
provide proper anterior excursive guidance. Minimize any lateral forces on any
implant-supported prosthesis, especially
in the posterior area (where lateral forces
are greater).13 For anterior fixed partial
prosthetics, this may be difficult. The occlusion on any anterior implant-supported
prosthesis should obtain guidance from
the existing anterior or posterior dentition (anterior disclusion, canine guidance
or group function occlusal philosophies),
which provide proprioceptive feedback,
helping to control the intensity of lateral
forces.
For complete-arch fixed prostheses, the
occlusal design is much more complicated
and controversial. Occlusal guidance will
depend on implant size, number, location,
angulation, quality of bone, characteristics of opposing dentition, parafunctional
history and occlusal characteristics.
The provisional stage of implant therapy
is critical in diagnosing the static and dynamic variables of occlusion.14
A fixed detachable provisional model
will help determine occlusal habits that
are not readily identifiable otherwise.
These can be corrected and compensated
for in the final prosthesis. The provisional
stage will also be a testing ground for your
occlusal hypothesis.15 Abutment selection,
length, contour of the restoration and size
of the occlusal table will all influence the
occlusal design.

Prosthetic design
Not all patients can be treated with the
same type of restoration or design. In
certain cases, a screw-retained prosthesis
may be preferred; in others, a cemented
prosthesis may be appropriate.
Variables such as esthetics, occlusion,
angulation of implants, mechanism of
retrievability and implant location will in-

“ TRAINING, Page B1
implant treatment into private practice
with quality results, cost effectiveness and
profitability.

40 hours of C.E. credit
Implant treatment will be performed on
provided patients in the dental clinic of
the University of Technology, School of
Oral Health Sciences, Kingston, Jamaica,
with personalized training in small-group
settings. The course is a cooperative effort
of the Jamaican Ministry of Health, the
University of Technology, School of Dental
Sciences, Kingston, Jamaica, and the American Academy of Implant Prosthodontics.
A dental degree is required for all participants. The course is tax deductible and
40 hours of dental continuing education

fluence and guide design of the prosthesis.
The key to a stable implant/prosthesis relationship is to achieve a passive fit16 of the
framework during try-in. A non-passive fit
will create stresses17 in the connecting and
abutment screws and on the implant.18
This can lead to premature screw failure,
damage to the prosthesis and complications of osseointegration. A positive correlation exists between the discrepancy
of fit and stress in the prosthesis.19 Proper
seating of abutments or impression copings before impressions will minimize
clinical and laboratory complications20
(Fig. 6). Laboratory technique should
minimize casting shrinkage and inaccuracies, and a non-passive framework try-in
technique should achieve a stable and passive fit.21
The cantilever prosthesis has been used
in prosthodontics with guarded success
for many years. This design has had a
resurgence in implant dentistry.22 Frequently it is not possible to achieve an
implant-to-prosthetic-unit ratio of 1:1 for
anatomical reasons. In posterior sextant
implant-supported restorations, a distal
cantilever prosthesis is common. The lack
of quality and quantity of bone in the
posterior sextants has created the need
for this design. Cantilevers must be used
with caution23 (Fig. 7). The weakest links in
the cantilever design are the location and
size of the pontic and the intensity of occluding masticatory forces.24 These forces
tend to be greatest in distally located
pontic cantilevers.25 A mesial cantilever is
favoured over a distal cantilever for this
reason (Figs. 8, 9). A narrow occlusal table
is recommended for the pontic.
An overcontoured anterior or posterior
restoration will also act as a cantilever
and increase stress within the framework
during loading (Figs. 10, 11). The abutment
selection should compensate for minor irregularities in implant angulation to help
compensate for occlusal factors. A wider
occlusal table will increase stress on the

credits is awarded on course completion.
No malpractice insurance is required for
course participants.
Dr. Mike Shulman is course coordinator,
Dr. Leonard I. Linkow is course director,
and Dr. Sheldon Winkler is course advisor.
Course faculty, in addition to Shulman,
Linkow and Winkler, include Drs. Robert
Braun, Ira L. Eisenstein, E. Richard Hughes,
Charles S. Mandell, Virgilio Mongalo, Harold F. Morris and Robert Russo. The number of instructors participating in each
course is dependent upon the registration.
Implants and components for AAIP/
ADIS implant seminars are provided by
Optimum Solutions Group. Dental laboratory support is provided by DCA Laboratory Inc., Citrus Heights, Calif., and Dani
Dental Studio, Tempe, Ariz.
Founded by Dr. Maurice J. Fagan Jr. in

abutment screws. Severe angulation problems may be a contraindication for a fixedtype of implant-supported prosthesis.
A significant improvement in abutmentimplant stability has been achieved with
preloading or torquing of components.
Hand torquing has been shown to be unreliable,26 but mechanical torquing has
proven to be predictable and has significantly reduced loosening of implant components. The torque wrench is now the
standard for insertion and tightening of
implant components. Several abutment
systems available today clearly indicate
the amount of torque that is required for
proper stabilization.

Conclusion
Occlusion has been an important variable in the success or failure of most
prosthodontic reconstructions. With natural teeth, a certain degree of flexibility
permits compensation for any occlusal
irregularities. Implant dentistry is not as
forgiving. The status of the occlusion must
be properly diagnosed, corrected or compensated for, and properly integrated into
the design of the definitive restoration.
The occlusion must be more rigorously
evaluated with implant- supported prosthodontics adjacent to natural dentition.
Originally printed in the Journal of the Canadian Dental Association.
” See STABILITY (for references), page B4
Sebastian Saba, DDS,
Cert. Pros., FADI, FICD,
is a graduate of the
Goldman School of
Dental Medicine, Boston
University. He has
published extensively on
the topics of prosthetic
and implant dentistry
and has a private practice in Montreal limited to
prosthetic and implant dentistry.

1982 at the School of Dentistry, Medical
College of Georgia, the objective of the
Academy of Implant Prosthodontics is to
support and foster the practice of implant
prosthodontics as an integral component
of dentistry.
The academy supports component and
affiliate implant associations around the
world, including organizations in Egypt,
France, Italy, Israel, Jamaica, Jordan, Kazakhstan, Paraguay, Peru and Thailand.
The academy has published two textbooks, “The Dental Implant,” in 1985 and
“Implant Prosthodontics,” in 1990. The
Journal of Oral Implantology is the official
publication of the academy
American Academy of Implant Prosthodontics is designated as an approved
PACE program provider by the Academy of
General Dentistry. The formal continuing

Editor in Chief
Dr. Sebastian Saba feedback@dental-tribune.com
Group Editor
Kristine Colker k.colker@dental-tribune.com
Managing Editor Implant Tribune Canada
Robert Selleck, r.selleck@dental-tribune.com
Managing Editor Implant Tribune U.S.
Sierra Rendon s.rendon@dental-tribune.com
Managing Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.com
Product/Account Manager
Will Kenyon w.kenyon@dental-tribune.com
Product/Account Manager
Humberto Estrada h.estrada@dental-tribune.com
Product/Account Manager
Maria Kaiser m.kaiser@dental-tribune.com
Marketing DIRECTOR
Anna Kataoka
a.kataoka@dental-tribune.com
Education DIRECTOR
Christiane Ferret c.ferret@dtstudyclub.com
Tribune America, LLC
Phone (212) 244-7181
Fax (212) 244-7185
Published by Tribune America
© 2015 Tribune America, LLC
All rights reserved.
Tribune America strives to maintain the utmost accuracy in its news and clinical reports. If you find a
factual error or content that requires clarification,
please contact Managing Editor Robert Selleck at
r.selleck@dental-tribune.com. Tribune America cannot assume responsibility for the validity of product
claims or for typographical errors. The publisher also
does not assume responsibility for product names or
statements made by advertisers. Opinions expressed
by authors are their own and may not reflect those of
Tribune America.
Editorial Board
Dr. Pankaj Singh
Dr. Bernard Touati
Dr. Jack T. Krauser
Dr. Andre Saadoun
Dr. Gary Henkel
Dr. Doug Deporter
Dr. Michael Norton
Dr. Ken Serota
Dr. Axel Zoellner
Dr. Glen Liddelow
Dr. Marius Steigmann

Corrections

Implant Tribune strives to maintain the
utmost accuracy in its news and clinical
reports. If you find a factual error or content
that requires clarification, report the details
to managing editor Robert Selleck, r.selleck@
dental-tribune.com.

education programs of this program provider are accepted by AGD for fellowship,
mastership and membership maintenance
credit. The current term of approval runs
from Jan. 1, 2014, to Dec. 31, 2015.
Complete information on the AAIP/ADIS
Jamaica implant continuing education
programs, including tuition, faculty lectures, transportation and hotel accommodations, can be obtained from the course
website, www.adiseminars.com, or by calling (551) 655-1909.
AAIP membership information can be
obtained from the AAIP headquarters at
8672 East Eagle Claw Drive, Scottsdale, AZ,
85266-1058; telephone (480) 588-8062; fax
(480) 588-8296; or from the AAIP website
at www.aaipusa.com.
(Source: AAIP)

[13] =>

[14] =>

INDUSTRY

Implant Tribune Canada Edition | April 2015

See the ‘Visible Difference’
ODA
BOOTH
410

At the Ontario Dental Association Annual Meeting, Designs
for Vision is launching its Micro 3.5ef Scopes and featuring
the Nike Retro and DVI Sport frames. Also in the company’s
booth (No. 410) will be the new NanoCamHD loupemounted video camera. Photo/Provided by Designs for Vision

Designs for Vision is introducing the Micro 3.5ef Scopes
at the Ontario Dental Association Annual Spring Meeting. The Micro 3.5ef Scopes use a revolutionary optical
design that reduces the size of the prismatic telescope by
50 percent and reduces the weight by 40 percent while
providing an expanded field full oral cavity view at 3.5x
magnification.
“We listened to dentists who wanted the field of view
of an expanded field 3.5x telescope, but were concerned
about wearing them all day because of the size and
weight,” said company president Richard Feinbloom
“Designs for Vision was started by my father, Dr. William
Feinbloom, as an optical company in 1961 to design innovative head-borne optical devices, and the new Micro
3.5ef Scopes continue that tradition of optical innovation.
The Annual Spring Meeting has always provided a great
place to showcase new technology, and we are pleased to
be debuting the Micro 3.5ef Scopes at the Annual Spring
Meeting along with our other new products.”
Designs consistently looks to showcase its new products

at ASM and this year is featuring its new NanoCamHD™
loupe-mounted video camera and two new frames.
“This is a unique opportunity to reach an important target market to introduce a major electro-optical
innovation,” Feinbloom said. Designs for Vision’s new
NanoCamHD records digitally at 1080p high definition
resolution. As an added feature, still photographs can be
taken from live video feed or during playback mode.

Two new frames
The two new frames are the DVI Sport and the Nike® Retro. The Nike® Retro frames are available in tortoise shell,
black and translucent gray. The DVI Sport frames can be
used for all magnifications and can incorporate eyeglass
prescriptions, providing a protective wrap that is free of
any fision distortion.
Visit Designs for Vision at the Annual Spring Meeting
at booth No. 410 to “See the Visible Difference®” yourself.
(Source: Designs for Vision)

Isolite adds to
dental-isolation
mouthpieces
By Isolite Systems Staff

ODA
BOOTH
204

Dental isolation is one of the most common and ongoing challenges in dentistry. The
mouth is a difficult environment in which to work.
It is wet and dark, the tongue is in the way, and there is the
added humidity of breath, which all make dentistry more
difficult. Proper dental isolation and moisture control are
two often overlooked factors that can affect the longevity
of dental work — especially with today’s advanced techniques and materials.
Leading dental isolation methods have long been the
rubber dam — or manual suction and retraction with the
aid of cotton rolls and dry angles. Both of these methods
are time and labor intensive, and not particularly pleasant
for the patient.
Enter Isolite Systems, a dental isolation system that deliver an isolated, humidity- and moisture-free working
field as dry as the rubber dam but with significant advantages, including better visibility, greater access, improved

“ STABILITY, Page B2

ÿ References
1.

Becker W, Becker BE, Newman MG, Nyman S.
Clinical and microbiological findings that may
contribute to dental implant failure. Int J Oral
Maxillofac Implants 1990; 5(1):31-38.
2. Salcetti JM, Moriarty JD, Cooper LF, Smith FW,
Collins JG, Socransky SS, and other. The clinical,
microbial, and host response characteristics of
the failing implant. Int J Oral Maxillofac Implants 1997; 12(1):32-42.
3. Hurson S. Practical clinical guidelines to prevent
screw loosening. Int J Dent Symp 1995; 3(1):22-25.
4. Dixon DL, Breeding LC, Sadler JP, MacKay ML.
Comparison of screw loosening, rotation, and
deflection among three implant designs. J Prosthet Dent 1995; 74(3):270-278.
5. Morgan MJ, James DF, Pilliar RM. Fractures of
the fixture component of an osseointegrated
implant. Int J Oral Maxillofac Implant 1993;
8(4):409-414.
6. Davies JE. Mechanisms of endosseous integration. Int J Prosthodont 1998; 11(5):391-401.
7. Davidoff SR. Restorative-based treatment plan-

Isolite
Mouthpieces
are now
available in
six patientfriendly sizes.
Photo/Provided
by Isolite
Systems

patient safety and a leap forward in comfort. And it allows dentists to work in two quadrants at a time.
The key to the technology is the Isolation Mouthpiece.
Compatible with Isolite’s full line of products, the mouthpiece is the heart of the system. It is specifically designed
and engineered around the anatomy and morphology of
the mouth to accommodate all patients, children to elderly.
The single-use Isolation Mouthpieces are now available
in six sizes and position in seconds to provide complete,
comfortable tongue and cheek retraction while also shielding the airway to prevent inadvertent foreign body aspiration. Constructed out of a polymeric material that is softer
than gingival tissue, the mouthpieces provide significant
safety advantages, and their ease-of-use can boost your
practice’s efficiency, results and patient satisfaction.
Isolite Systems provides three state-of-the-art product
solutions for every practice, every operatory: Isolite, illuminated dental isolation system; Isodry, a non-illumin-

ning: determining adequate support for implant-retained fixed restorations. Implant Dent
1996; 5(3):179-184.
8. Bahat O, Handelsman M. Use of wide implants
and double implants in the posterior jaw: a clinical report. Int J Oral Maxillofac Implants 1996;
11(3):379-386.
9. Balshi TJ, Ekfeldt A, Stenberg T, Vrielinck L. Threeyear evaluation of Brånemark implants connected to angulated abutments. Int J Oral Maxillofac Implants 1997; 12(1):52-58.
10. Becker W, Becker BE. Replacement of maxillary
and mandibular molars with single endosseous
implant restorations: a retrospective study. J
Prosthet Dent 1995; 74(1):51-55.
11. Rangert B, Krogh PH, Langer B, Van Roekel N.
Bending overload and implant fracture: a retrospective clinical analysis. Int J Oral Maxillofac
Implants 1995; 10(3):326-334.
12. Perel ML. Parafunctional habits, nightguards,
and root form implants. Implant Dent 1994;
3(4):261-263.
13. Rangert BR, Sullivan RM, Jemt TM. Load factor
control for implants in the posterior partially
edentulous segment. Int J Oral Maxillofac Implants 1997; 12(3):360-370.

ated dental isolation; and the new Isovac, dental isolation
adapter.
Using the Isolation Mouthpieces, all three dental isolation products isolate upper and lower quadrants simultaneously while providing continuous hands-free suction.
This allows a positive experience where the patient no
longer has the sensation of drowning in saliva/water during a procedure and the practitioner can precisely control
the amount of suction/humidity in the patient’s mouth.
Isolite Systems’ dental isolation is recommended for
the majority of dental procedures where oral control and
dental isolation in the working field is desired. It has been
favorably reviewed by leading independent evaluators and
is recommended for procedures where good isolation is
critical to quality dental outcomes.
Visit Isolite Systems in the exhibit hall at the Ontario
Dental Association Annual Spring Meeting, booth No. 204,
or go to www.isolitesystem.com.

14. Moscovitch MS, Saba S. The use of a provisional
restoration in implant dentistry: a clinical report.
Int J Maxillofac Implants 1996; 11(3):395-399.
15. Saba S. Anatomically correct soft tissue profiles
using fixed detachable provisional implant restorations. J Can Dent Assoc 1997; 63(10):767, 768,
770.
16. Meijer HJ, Kuiper JH, Starmans FJ, Bosman F.
Stress distribution around dental implants: Influence of superstructure, length of implants,
and height of mandible. J Prosthet Dent 1992;
68(1):96-102.
17. Watanabe F, Unu I, Hata Y, Neuendorff G, Kirsch
A. Analysis of stress distribution in a screw-retained implant prosthesis. Int J Oral Maxillofac
Implants 2000; 15(2):209-218.
18. Binon PP. The effect of implant/abutment hexagonal misfit on screw joint stability. Int J Prosthodont 1996; 9(2):149-160.
19. Jemt T, Book K. Prosthesis misfit and marginal
bone loss in edentu- lous implant patients. Int J
Oral Maxillofac Implants 1996; 11(5):620-625.
20. Assif D, Fenton A, Zarb G, Schmitt A. Comparitive accuracy of implant impression procedures.
Int J Periodont Restorat Dent 1992; 12(2):112-121.
21. Carr AB, Steward RB. Full-arch implant frame-

work casting accuracy: preliminary in vitro observation for in vivo testing. J Prosthodont 1993;
2(1):2-8.
22. Becker CM, Kaiser DA. Implant-retained cantilever fixed prosthesis: where and when. J Prosthet Dent 2000; 84(4):432-435.
23. McAlarney ME, Stavropoulos DN. Determination of cantilever length-anterior-posterior
spread ratio assuming failure criteria to be the
compromise of the prosthesis retaining screwprosthesis joint. Int J Oral Maxillofac Implants
1996; 11(3):331-339.
24. Shakleton JL, Carr L, Slabbert JCB, Becker PJ. Survival of fixed implant-supported prostheses related to cantilever lengths. J Prosthet Dent 1994;
71(1):23-26.
25. Rodriguez AM, Aquilino SA, Lund PS, Ryther JS,
Southard TE. Evaluation of strain at the terminal
abutment site of a fixed mandibular implant
prosthesis during cantilever loading. J Prosthodont 1993; 2(2): 93-102.
26. Goheen KL, Vermilyea SG, Vossoughi J, Agar JR.
Torque generated by handheld screwdrivers and
mechanical torquing devices for osseointegrated implants. Int J Oral Maxillofac Implants
1994; 9(2):149-55.

[15] =>

INDUSTRY

Implant Tribune Canada Edition | April 2015

Position yourself for long career

To learn more on ergonomics in the dental clinic, visit
entists, hygienists and dental assistants face
www.posiflexdesign.com. The source for some of the staon a daily basis all of the top conditions needtistics in this article is “Prevention of Work-Related Mused to develop musculoskeletal disorders.
culoskeletal Disorders in Dental Clinics,” by Rose-Ange
Dental work requires precision and control
Proteau. It is available free at www.asstsas.qc.ca.
in movement — so static positions can result in fatigue
in the muscles of the neck, the back and the shoulders.
(Source: Posiflex Design)
After a few years or even months, the muscle fatigue may
cause ailments, pain or even more severe
conditions, such as tendinitis, bursitis,
Factors contributing to development of musculoskeletal disorders:
neck pain, disk herniation and others.
If I work with my arms close to my body, can
I avoid muscle tension?
Even when your arms seem relaxed along
your body, the shoulder and upper back
muscles have to be contracted to keep the
stability required for the precise work of
your hands. These muscle contractions can
reduce the blood flow up to 90 percent,
which causes fatigue to accumulate and
weaken your muscles and articulations.
Why use mobile elbow supports?
The Posiflex mobile elbow support system
was developed to diminish the charge to
the upper body in order to favor a good
bloodstream. A scientific study demonstrated that using the Posiflex system
contributes to achieving a more secure
and comfortable work posture while significantly reducing muscle contractions in
the shoulders, neck and upper body. This
unique concept follows body movements.
The elbow rests offer an appropriate support of the arms while preserving the freedom of movement.
Precision work requires concentration
and effort. We forget ourselves when we are
concentrated on a task. The elbow supports
enable practitioners to keep a good posture
as they keep you in line.
Do I have to always be on the supports to get
the benefit?
It is not possible to be on the supports 100
percent of the time. The studies demonstrated that with 50 percent of the time on
the support, bloodstream is sufficient to
prevent and diminish tension. After a short
learning curve, the majority of users are on
the supports 80 to 90 percent of the time.
Why invest in a dental stool?
Dental professionals can easily spend eight
to 12 hours a day on a stool. In fact, it is the
piece of equipment you use the most and,
generally, it is also the most neglected. You
pay attention to your patient comfort, so
what about your comfort and that of your
employees?
The investment is modest and quickly
profitable compared to costs created by
medical treatments or leave from work. Do
you have to plan long procedures early in
the week because your body can’t do it on
Thursdays?
How should the patient chair be adjusted to
keep the practitioner in good posture?
Eyes-to-task distance is the key for good
posture. When the patient chair is placed
low it forces you to bend your neck, even
with loupes, creating tensions. Furthermore, because of lack of leg room, the operator must straddle the chair or worse sit on
the tip of the seat. This position does not
provide lumbar support or a safe position.
Many speakers and authors favor a higher
position of the patient chair with the patient laying flat. The arms stay close to the
body and the forearms are flexed.

Repetition.

Tempo.

Force.

Michelle Fontaine, RDH, demonstrates the ergonomic improvement in her work position enabled in part by her use of Posiflex
free motion elbow supports. Photos/Provided by Posiflex Design

Awkward movements
and posture.

Inadequate rest.
Ad

[16] =>

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[cover] => DT Canada No. 2, 2015

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Table of contents

[toc_titles] =>

Connect - learn - excel / Events / Esthetical and functional treatment with implantsupported bar on an incongruous prosthesis carrier / Implant Tribune Canada Edition

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