DT Canada No. 4, 2014
Editor in Chief / Meetings / Industry / Implant Tribune Canada Edition
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/var/www/vhosts/e.dental-tribune.com/httpdocs/tmp/dental-tribune-com/63809/DTCAN0414.pdf [should_regen_pages] => 1 [pdf_url] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/63809-15358def/epaper.pdf [pages_text] => Array ( [1] => TA DW IN TE RC LIN IC DENTAL TRIBUNE The World’s Dental Newspaper · Canada Edition November 2014 — Vol. 8, No. 4 www.dental-tribune.com PATIENT BEHAVIOUR AND TREATMENT Doing well by doing good Dr. Sebastian Saba: Dental care should not be provided without awareness of the psychological makeup and social background of the person receiving the care. Henry Schein Canada, as part of its Calendar of Caring program, shines the spotlight on various ways that its customers are ‘giving back.’ ” page A2 ” pages A8–A9 Winter Clinic: Same time, different place Implant Tribune new WAY TO GRAFT Innovative approach to immediate bone grafting and implantation when infection is present. ” page B1 Toronto Academy of Dentistry Winter Clinic, Friday, Nov. 14 Single-day meeting moves to new venue T he 77th Annual Winter Clinic is on the move, with its 2014 meeting day scheduled for Friday, Nov. 14, at the Toronto Sheraton Centre. The new venue presents a great opportunity to add an evening or even the rest of the weekend in downtown Toronto to the end of the single-day conference. The Sheraton Centre is connected to the financial and entertainment districts by way of the PATH, a 16-mile underground network of shops and services. A wide selection of shopping destinations, the Mirvish Toronto theatres, worldclass dining and major Toronto museums are steps away. Among the attractions: Art Gallery of Ontario, Royal Ontario Museum, Hockey Hall of Fame, Harbourfront, Casa Loma, Ontario Science Centre, Niagara Falls, Casino Niagara, Casino Rama, Ontario Place, Air Canada Centre, Rogers Centre (formerly SkyDome), Eaton Centre, Holt Renfrew and Yorkville Shopping District. Publications Mail Agreement No. 42225022 (Source: Toronto Academy of Dentistry) • Patient behaviour and dental treatment: ‘Meeting of the minds’ MEETINGS A4 • Greater New York Dental Meeting adds new events, Nov. 30–Dec. 3 • Expert lineup at Pacific Dental Conference, March 5–7, Vancouver Industry a6–a11 • Endodontic Photon Induced Photoacoustic Streaming (PIPS): Lightwalker AT laser with contact H14-C handpiece and PIPS fiber tip • Single-use MTA capsules extend shelf life, ensure consistent results • Doing well by doing good: Henry Schein Calendar of Caring honors dentists’ humanitarian work • Have you been waiting to implement 3-D technology? • Canadian Dental Hygienists Association honours excellence Broad spectrum of topics The Winter Clinic is the largest one-day dental convention in North America, attracting dental professionals who come to learn from world-class speakers and explore and save on products and services. This year’s clinical program covers a broad spectrum of topics and includes: “Fighting Dental Disease: Drugs, Bugs and Prescription Drugs” (also a course on over-the counter drugs); “Interceptive Orthodontics;” “Diagnosis and Management of Impacted 3rd Molars;” “The Role Of Dentists In A Sleepy World;” “Oral Appliance Therapy: The Good and Bad News About It;” “From Great Expectations to Evidence-Based Endodontics: Re-Defining Your Clinical Protocols;” “Botulinum Toxins & Dermal Fillers: A Practical Approach for the Dental Team;” “Dealing Effectively With Difficult Patients;” “Porcelain Crowns and Veneers — An Update;” “Relaxed, But Not Asleep: How to use Nitrous Oxide or Oral Benzodiazepines for Effective Minimal Sedation in your Dental Practice;” and “Enhancing the Patient-Professional Interaction Across Differences. Closing the Dental Gap: The Patient Perspective.” This year’s meeting also includes courses for the professional development of the entire dental team, with a special focus on dental hygiene. Among the offerings: “Seven Strategies for Xerostomia Management and the Future of Saliva Testing;” “Maintain Your Edge: An Instrument Maintenance and Sharpening Workshop;” and “Oral Cancer Screening for Today’s Population: The Need for Change.” You can bring the whole team to share the knowledge. The single-day event features 24 separate programmes in contemporary dentistry, offering something for all. FROM THE EDITOR IN CHIEF A2 In a new location this year — at the Toronto Sheraton Centre — the Toronto Academy of Dentistry Winter Clinic is the largest one-day dental convention in North America. Dental professionals representing all sectors of the profession attend to learn from world-class speakers and explore and save on products and services on display in a comprehensive exhibit hall. Photo/Provided by Tourism Toronto Implant tribune B1–B3 • New grafting procedure for oral implantation • Nobel Biocare joining Danaher Dental Platform •Archaeologists discover early example of dental implant • Prosper ... and be healthy with Posiflex free motion elbow supports Ad[2] => FROM THE EDITOR IN CHIEF A2 Dental Tribune Canada Edition | November 2014 Patient behaviour and dental treatment: ‘Meeting of the minds’ By Sebastian Saba, DDS, Cert. Pros., FADI, FICD D entistry is a highly skilled professional service. Its success is based on a multitude of clinical variables that need to be recognized, managed and coordinated in an appropriate way to achieve the end product of treatment. It is increasingly recognized that the provision of dental care should not be viewed in isolation from the psychological makeup and social background of the person receiving the care. Understanding your patients’ behavioural characteristics and moving beyond the narrowly conceived concept of biology and mechanics that can turn the patient into “just a mouth” will help you treat patients more successfully. The following list describes certain patient behavioural characteristics that may influence dental treatment success. Inconsistency of dental treatment It’s not unusual for people to see several dentists during the course of a lifetime. People move from area to area, thus requiring a new local dentist. Patients who see different dentists will exhibit a wide variety of dental history. The majority will demonstrate consistency in care and decision-making. But a certain percentage of individuals will change dentists on a regular basis for a multitude of reasons. Some patients in mid-treatment will opt to terminate their commitment to completion, not realizing the significant risk they assume. Many of these reasons will lead to compromised care. Some will not see a dentist for long periods of time, others will move from dentist office to dentist office. A study by Steele et al., 1996, listed the following as the main reasons for lack of dental follow-up: lack of perceived need; fear; costs; couldn’t be bothered; and distance. The lack of continuing care, especially during comprehensive phases of treatment with the diversity of today’s complex dental services, may compromise the patient’s health. We need to inform patients that continuity of their dental care will minimize risks, misdiagnoses and mistreatments. Fear and anxiety Nervous patients are the most challenging type of patients to manage. Nervous patients need more time for all procedures, and constant communication is critical. In some instances, mild sedation has proven very helpful. In certain cases, treatment-plan options are designed to shorten the chair time to minimize traumatizing patients. Coping strategies do exist and have been studied extensively. Stress is “a condition that results when the person/ environment transaction leads the individual to perceive a discrepancy between the demands of the situation and the coping resources available” (Lazarus & Folkman, 1984). Dentists can explain treatments in two ways for fearful patients: . . . Sebastian Saba, DDS, Cert. • Procedural, problemfocused approach — information about the procedure (frequently used by dentists). • Sensory, emotionfocused approach — information about the sensations that may be experienced (less frequently used by dentists). The sensory approach was more successful in reducing stress, especially in children. How much information is necessary? Thrash et al., 1982, found that more information provided a sense of control for the patients and reduced anxiety for the dental procedure. The unfortunate reality is that fearful patients visit the dentist less regularly and come only when in severe pain or dysfunction. At this stage, the dentition is usually compromised. The care required is more extensive and serves to perpetuate the negative cycle of fear. Unless you see the patient regularly and use this opportunity to support, encourage and motivate, this cycle will continue until most teeth are deemed unrestorable and extracted. In fact, this anxiety will continue even in the absence of teeth, in the edentulous state. Parafunction and smoking The physiology of the mouth is highly influenced by extrinsic and intrinsic factors. Parafunction contributes to tighter oral musculature through clenching and grinding, leading to dental breakdown. The cause of parafunction is debatable. Some believe it is stress related, others believe it’s an imbalance in neurotransmitters in the central nervous system. Parafunction and stress can reduce salivary flow rates and alter salivary content, thus reducing the protective mechanism available in saliva and increasing rates of decay. The combination of mechanical breakdown and reduced protection can lead to rapid dental destruction. Early diagnoses and treatment is critical to minimize damages. Smoking also creates an environment that can lead to dental failure. Smoking creates an oral autoimmune disorder by indirectly creating a vasoconstriction of oral blood vessels. This leads to less blood flow and reduced immunity and defense. The lack of blood flow creates tissue ischemia (lack of oxygen), which leads to tissue death. Reduced success rates with periodontal gum surgery and implant surgery have been documented in smokers. If a patient is serious about improved oral health, he or she must quit smoking. Patient satisfaction Some patients have realistic expectations and others do not. We have all seen patients who want their teeth very white. And unfortunately, in some cases, white is never white enough. Some patients feel overly qualified to guide and direct any dental work. But patients are not dentists. They can contribute to — but not control — dental Pros., FADI, FICD, is a prosthodontist and 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. treatment. An overly critical patient may never be satisfied. The key is to have what I consider a “meeting of the minds“ with your patient before treatment is started. If you don’t understand or agree with the demands and observations of the patient, if you cannot find common grounds to proceed with treatment, if the patient refuses to accept the diagnosis, if the patient has a tendency to dictate treatment: Do not proceed with treatment. It’s best to refer such patients because you will never be successful treating them. Compliance with treatment The success of complicated dental treatment is based on several broad variables: accuracy of the diagnosis, quality of the treatment and the patient’s compliance. Studies have shown multiple determinants influencing compliance: • Health beliefs: perceived necessity of treatment • Comprehension: ability to understand the need for treatment • Temperament: tendency toward compliant or noncompliant behaviour • Dentist/patient relationship • Patient satisfaction • Clinical setting A five-year study (Holt & McHugh, 1977) of more than 1,000 patients across England showed that 33 percent changed dentists for reasons other than location. Of those who changed their dentist, the most common reason was “unhappiness with previous dentist.” The most important factors for patients when visiting their dentist: Highest rated: 1) Dentist care and attention. 2) Pain control by dentist. 3) Dentist putting patient at ease. Lowest rated: 16) Waiting time. 17) Opening hours. 18) Practice décor. Compliance is critical to successful dental care. Understanding how to manage the determinates of compliance and focusing on the higher priority factors rather than the lower priority ones will lead to greater success. Dental IQ Dental IQ is the easiest variable to improve. An environment for positive reinforcement is critical to enhance a patient’s education and willingness to fully understand all aspects of treatment. ” See BEHAVIOUR, page A6 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 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 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 © 2014 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] => .[4] => MEETINGS A4 Dental Tribune Canada Edition | November 2014 Greater New York Dental Meeting adds new events A number of new events are already on the schedule for the 2014 Greater New York Dental Meeting. Some highlights: • The World Implant Expo, four days of innovations in implantology. • An expanded exhibit floor with more than 1,700 exhibit booths filled by more than 700 companies. • An expanded ColLABoration Dental Laboratory Meeting, bringing together dentists and tab techs in a highly interactive environment. Presented with Aegis Publishing, ColLABoration is expected to surpass its inaugural 2013 numbers: 1,183 technicians and technician students, 50 exhibitor booths and two classrooms for seminars and workshops. The new World Implant Expo will be An expanded exhibit floor at the 2014 Greater New York Dental Meeting will feature more than 1,700 exhibit booths with more than 700 companies. The 2014 exhibit hall dates are Nov. 30 through Dec. 3. Photo/ held simultaneously with the main Greater New York Dental Meeting, from Nov. 28 through Dec. 3. The 2014 GNYDM exhibit hall dates will be from Nov. 30 through Dec. 3. Again for 2014, the GNYDM, which is sponsored by the New York County Dental Society and Second District Dental Societies, will remain free of any registration fee. Dental Tribune File Photo Four days of exhibits Other distinctions that help make the GNYDM stand out include: • Only event with four-day exhibit hall • More than 300 educational programs • One C.E. unit for exploring the exhibit floor • Eight “Live Patient Demonstrations” • Multilingual programs (in Spanish, Russian, Portuguese, French and Italian) Three major airports — Newark Liberty (EWR), Kennedy (JFK) and La Guardia (LGA) — and hotel discounts make it easy for professionals to attend the meeting and enjoy all that New York City has to offer during the holiday season. Learn more at www.gnydm.com. (Source: Greater New York Dental Meeting) Ad Expert lineup at Pacific Dental Conference More than 130 presenters, 150 open sessions and hands-on courses, March 5-7, in Vancouver You can experience the true flavour of the West Coast — and earn C.E. credits at the same time — at the Pacific Dental Conference, March 5-7, in Vancouver. The PDC has an expert lineup of local, North American and international speakers. With more than 130 presenters, 150 open sessions and hands-on courses covering a variety of topics, the meeting should be able to offer something for every member of your dental team. According to meeting organizers, you will be able to explore the largest two-day dental trade show in Canada and have the year’s first opportunity to see the newest equipment. The exhibit hall features innovative new techniques demonstrated on the live dentistry stage, and attendees will be able to examine products and services from more than 300 exhibiting companies with representatives who are ready to engage attendees in discussions on creating practice solutions. At the conclusion of the conference, you can take a day to relax and revitalize by exploring some of Vancouver’s tourist attractions. The ocean is just steps from the Vancouver Convention Centre, and nearby pristine snow-capped mountains offer up choice late-season skiing. (Source: Pacific Dental Conference)[5] => .[6] => INDUSTRY A6 Dental Tribune Canada Edition | November 2014 Endodontic Photon Induced Photoacoustic Streaming (PIPS) Treatment uses Lightwalker AT laser with contact H14-C handpiece and PIPS fiber tip By Prof. Giovanni Olivi, MD, DDS University of Genoa, Italy 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 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™ technique was applied into the periodontal pockets of each tooth for refining the de- bridement, 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. 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. Lightwalker parameters: • Laser source: Er:YAG; • Wavelength: 2940 nm; • Pulse duration: SSP; • Energy: 15 mJ; Frequency: 15 Hz. About the author 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 laser course at the University of Firenze and earned laser certification from the International Society for Lasers in Dentistry. He has advanced proficiency mastership from the Academy of Laser Dentistry 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. 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. Contact at olivilaser@gmail.com. Isolite Systems delivers dental-isolation technology By Isolite Systems Staff Dental isolation is one of the bedrock challenges in dentistry. The mouth is a difficult environment in which to work. It is wet, 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: Its dental isolation technology delivers an isolated, humidity- and moisture-free working field as dry as the rubber dam, but with significant advantages, including better visibility, greater access, improved patient safety and a leap forward in comfort. Plus, it can do it all two quadrants at a time. The keys to the technology are the “Isolation Mouthpieces.” Compatible with Isolite’s full line of products, the mouthpieces are the heart of the system. They are specifically designed and engineered around the anatomy and morphology of the mouth to accommodate every patient, from children to the elderly. The single-use Isolation Mouthpieces are available in . . five 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 ease-of-use can boost your practice’s efficiency, results and patient satisfaction, according to the company. Faster, safer, more comfortable Isolite Systems provides three state-of-the-art product solutions: Isolite, illuminated dental isolation system; Isodry, a non-illuminated dental isoIsolite mouthlation; and the new Isovac, dental isolation adaptpieces are er. Whether you use the Isolite, Isodry or our new available in five Isovac, our mouthpieces keep the working field as sizes. dry as a rubber dam, but are easier, faster, safer and Photos/Provided by more comfortable for the patient. Isolite Systems Using the Isolation Mouthpieces, all three dental isolation products comfortably isolate upper and lower quadrants simultaneously while providing continuous hands-free suction. This allows a positive experience where the patient no longer has the senand dental isolation in the working field is desired. It sation of drowning in saliva/water during a procedure has been favorably reviewed by leading independent and the practitioner can precisely control the amount evaluators and is recommended for procedures where of suction/humidity in the patient’s mouth. good isolation is critical to quality dental outcomes. Isolite Systems dental isolation is recommended for Visit the Isolite booth at the Toronto Academy of the majority of dental procedures where oral control Dentistry Winter Clinic, or go to www.isolitesystem.com. “ BEHAVIOUR, page A2 Financial commitments Outdated dental philosophies are common, and patients need to be informed of the newer, more conservative and successful treatment options. Distribution of information pamphlets, extended times for patient discussion, and effective use of the Internet have been useful mechanisms to communicate up-to-date dental theories to patients. But not all patients are willing to improve awareness. The greatest dilemma faced by patients in need of dental treatment is the lack of funds to pay for necessary care. The need for unexpected root canal treatment or prosthetic dentistry, and/or the need for dental implant therapy, can be costly. Patients who have extensive dental problems need to understand that easy fixes don’t exist. Multiple stages of treatment may be required, each one dependant on the next. The successful completion of one stage of treatment helps determine the prognosis of the following stage of treatment. It is recommended that prior to initiating treatment, you inform the patient of all possible clinical scenarios and costs — along with the likelihood of each occurring. Record and document this discussion clearly in the file or in a patient contract. Patients frequently have difficulty recalling informed discussions about questionable prognoses especially when it comes to risks and costs. Patients must understand the issues and poten- tial consequences. They have a responsibility to themselves and to you. If you don’t have a “meeting of the minds” on these issues, they will resurface at a most unfortunate time. Do not proceed with treatment until all is clear. In conclusion: Dentists treat patients. Patients have input. Management of that input allows for success in dentistry. And management starts with a “meeting of the minds.” Sometimes no treatment is the best treatment.[7] => Dental Tribune Canada Edition | November 2014 INDUSTRY Single-use MTA capsules extend shelf life, help ensure consistent clinical results Ideal concept for clinicians who use MTA infrequently By Dr. Barry H. Korzen, Founder, Zendo Direct AG In the March 2014 issue of the Journal of Endodontics (Vol. 40, Issue 3, pages 423–426) Ha et al. wrote, “Because MTA powder is hygroscopic, when it is left exposed to atmospheric moisture, it will react in a similar way as MTA powder mixed with water.” Based on their findings, the authors conclude, “MTA undergoes an increase in particle size once the manufactured seal has been broken.” And that, “(a) larger particle would … be less reactive, which could have implications for setting time, compressive strength, and alkalinity.” The authors also noted that contrary to manufacturers’ instructions, clinicians who purchase MTA in commonly available 1-gram bottles will use the material over multiple applications. Based on these findings, after the initial use, and over a prolonged period of time, the MTA likely will not perform with the same characteristics as intended by the manufacturer. Capsule use seems most effective Even though this paper did not reference the use of MTA in single-use capsules, we can extrapolate that for the clinician, capsule use seems to be the most effective way to insure the most consistent clinical result with the added benefit of a longer shelf life, which is especially important to the clinician who uses MTA infrequently. Zendo Direct (www.zendodirect.com) is committed to delivering quality and value to the practitioner by ensuring that all its products, such as its Zendo MTA Capsules, are developed using evidence-based information. All of Zendo’s products are manufactured in Europe to the highest standards and are made available to the profession at highly competitive prices. . . A7 According to the company, all Zendo Direct products, such as its Zendo MTA Capsules, are developed using evidence-based information. The products are manufactured in Europe to the highest standards. Photo/Provided by Zendo Direct Ad[8] => INDUSTRY A8 Dental Tribune Canada Edition | November 2014 Doing well by d By Robert Selleck, Managing Editor The people at Henry Schein Canada are driven by the philosophy of “doing well by doing good.” And it’s in that spirit that the company has created its Calendar of Caring to spotlight the many charitable programs it supports. The initiative also gives Henry Schein customers the opportunity to contribute a portion of their purchases to help the charitable causes that Henry Schein supports. This extra support expands the help the company provides and, in appreciation, participating customers receive a plaque that can be displayed in the office. In recent efforts, Henry Schein distributed 325 backpacks filled with school supplies and clothing to underprivileged children and provided winter holiday gifts to fam- ilies in need across Canada. It supplied more than $240,000 of health care products to underserved people across the globe, planted more than 1,200 trees as part of its Go Green program and backed charitable causes fighting breast cancer and oral cancer. At Henry Schein, according to the com- Izchak Barzilay, DDS, Cert. Prostho., MS, FRCD(C), and Mariela Gonzalez, DPM Dr. Izchak Barzilay helps one of the 5,000 patients seen by the Bridge to Health team in Western Uganda earlier this year. Barzilay’s business manager, Mariela Gonzalez, is the team’s overall logistics coordinator. Photo/Provided by Dr. Izchak Barzilay As an educator at multiple dental schools, and with a Toronto-based practice in prosthodontics and implant dentistry, Dr. Izchak Barzilay is used to receiving lots of referrals. His skills, chairside manner and devotion to education result in a nonstop workflow. But earlier this year, those traits delivered even greater rewards. One of his former students, Dr. Ira Sankiewicz, is a founder of Bridge to Health (formerly “To the World”), a non-governmental organization providing dental and medical care in the world’s most impoverished areas. Impressed with the successes and efficiencies of Barzilay’s 30-person practice, Dr. Sankiewicz asked Barzilay to bring his skills — and the logistical genius of his business manager — to one of the world’s most underserved areas: Kabale, Uganda. In February, Barzilay and business manager Mariela Gonzalez spent two weeks in Western Ugandan villages providing care to approximately 5,000 patients, working with two other dentists, three hygienists, three physicians, three resident physicians, three medical students, two nurses, two pharmacists and three research associates. “There were many people in a lot of pain,” Gonzalez said. “Some of the children were very ill. There were many orphans. But it truly was rewarding — not just for the people receiving help, but for us — being able to give back.” The two are planning to return in February 2015, and they also want to add a Central American mission. “It immediately became part of who we are,” Gonzalez said, recounting how inspiring it was at day’s end when she would need to tell 100-plus people still in line that only the 10 most in need could be seen — and without fail everybody would point to somebody else. Veronique Benhamou, DDS, BSc, cert. Perio Nine years ago, periodontist Veronique Benhamou decided to “tag along” with a friend going to Peru on a dental mission. “It was fantastic,” Benhamou said. “I was hooked.” So hooked, in fact, Benhamou has taken trips every year since, with one big difference: Underwhelmed by the organizing on that first trip, Benhamou puts together her own. Under the auspices of Alberta-based Kindness in Action, for eight years Benhamou and fellow dentists Gérard Melki and Bob Clark have brought the latest in dental care to remote, underserved populations in Peru and Mexico. Each year the effort grows, in part because as an associate professor at McGill University Faculty of Dentistry (and former director of the department of periodontology), Benhamou has a constant source of enthusiastic volunteers: third- and fourth-year dental students. The most recent trip totaled 20 people, and the next trip is adding hy- giene students from John Abbott College. Everybody pays their own way, and many of the students return as residents and dentists. “When people come once, they often get hooked,” Benhamou said. That, despite the fact that many of the students succumb to heat exhaustion or other effects of overexertion. “It’s not a touristy trip,” Benhamou said. “It’s intense. It’s a lot of work. We come back exhausted.” The two-week trips include eight to 10 treatment days, during which up to 900 patients are seen. Repeat trips to Espita and Holca, Mexico, combined with strong local relationships, have enabled the group to open a small dental hospital. The goal is to become a trusted presence, seeing repeat patients and training local professionals. “It targets a small area of the world,” Benhamou acknowledged. “But there are lots of people doing this in lots of places.” Dr. Corinne D’Anjou treats a patient in a militarized zone in the Democratic Republic of Congo, where the population still feels threatened by the Lord’s Resistance Army rebel group. Corinne D’Anjou, DMD Photo/Provided by Dr. Corinne D’Anjou . . In 2001, after her third year of dental school at Laval University in Quebec City, Dr. Corinne D’Anjou participated in a dental mission to Paraguay, dealing with various levels of the Paraguayan government and coordinating supply deliveries to treat children at a school in Coronel Oviedo. The experience came in handy in 2010, when D’Anjou led a trip to the Democratic Republic of Congo, focusing on multiple goals: Set up a dental clinic with supplies sent in advance from Montréal; effectively manage the clinic in a challenging setting; treat as many patients as possible; and train local caregivers to ensure sustainable care. That last objective quickly emerged as top priority, and D’Anjou spent countless hours providing comprehensive training on asepsis, sterilization and treatment strategies. She helped local care providers establish an asepsis protocol to reduce contamination in a part of the world known Dr. Veronique Benhamou, standing, far left, with the team she took to Peru in 2010. Photo/Provided by Dr. Veronique Benhamou as the cradle of HIV-1. Because the trip was to a militarized zone, where the population remains deeply aware of threats from the Lord’s Resistance Army, D’Anjou had to meet several times with DRC-government and United Nations officials to evaluate security. (Indeed, future DRC trips are now on hold for D’Anjou until security stabilizes.) D’Anjou, co-owner of Centre de Santé Dentaire Candiac (Quebec), wants to give back in other ways, too. In August she graduated from the forensic dentistry program at McGill University, where she studied under renowned forensic odontologist Dr. Robert B. J. Dorion. In April she started a fellowship in forensic odontology at the University of Texas Health Science Center, San Antonio, learning from Dr. David Senn, another renowned forensic odontologist. D’Anjou wants to use her new skills to help in police investigations and disaster response.[9] => INDUSTRY Dental Tribune Canada Edition | November 2014 A9 doing good pany, “giving back” happens 365 days a year, and the Calendar of Caring initiative opens the door to expanding the help the company is able to provide. Displayed here are just a few examples of charitable and community service work by Henry Schein customers across Canada, with many of them receiving assistance from Henry Schein through the donation of dental supplies to support the noble work. For more information or to get involved with Henry Schein in these areas, please contact Peter Jugoon, vice president, marketing, at peter.jugoon@henryschein.ca. Sponsored by Matt Karavos, DDS, and staff at Crescent Heights Dental Clinic Dr. Matt Karavos and his Crescent Heights Dental team use the Alex Dental Health Bus to deliver dental care to Calgary’s most at-risk young people. Photo/Provided by Dr. Matt Karavos The Alex Dental Health Bus is impressive: a full-sized luxury coach customized with two complete dental operatories, a digital X-ray unit and an automated wheelchair lift. But to the team at Crescent Heights Dental Clinic, led by owner Dr. Matt Karavos, what’s really impressive is the vehicle’s ability to deliver oral health care to Calgary’s most at-risk young people. “When I heard about the Alex Dental Health Bus and the incredible need that its school program had uncovered, I knew we had to be involved in the solution,” Karavos said. That’s why Karavos and his team at Crescent Heights Dental partnered with the Alex Community Health Centre to provide SMILE Clinics. SMILE Clinics see children who are in need of dental treatment and are referred through the Alex Dental Health Bus school program. All treatment is provided at no additional cost to the parents, and Crescent Heights Dental Clinic donates time and supplies. A recent clinic, in April, was made possible by donations from the dental community, including a generous donation of supplies from Henry Schein. Since June 2013, Karavos and his team have partnered with the Alex to provide six SMILE Clinics, delivering treatment to more than 100 young people most in need. And there are no plans to stop. “What we saw at our first clinic brought tears to the eyes of my team, many of whom are veterans in the dental industry,” Karavos said. “We were prepared to perform a lot of minor care, but the levels of advanced decay in some of these kids is beyond what you want to see as dental professionals. We simply can’t let kids live with this kind of risk and pain.” Rolf Kreher, DDS (with Drs. Brian Eckert, Ramon Humeres and Frank Yung) Love of the wilderness brought Drs. Rolf Kreher, Brian Eckert, Ramon Humeres and Frank Yung together as classmates at the University of Toronto Faculty of Dentistry, from which they graduated in 1980. The friendship was still strong 20 years later, when, during a canoe trip in Ontario’s Temagami backcountry, conversation turned to the doctors’ varied histories with humanitarian work. Individually, they had served remote areas in Canada, South America, Africa and Asia. The idea that followed seemed inevitable: “Why not organize our own trips?” Within the year, Canadian Dental Relief International was in place, and the four Toronto-area dentists were planning a 2003 mission to Nuevo Horizontes, a cooperative community of 125 families of former rebel fighters building new lives in northern Guatemala after the peace accords. Other trips followed, as the Michelle McFarlane assists her father, Dr. R. Bruce McFarlane, with a Haitian patient undergoing a surgical extraction. Photo/By Renee Morcom Photography, provided by Dr. Bruce McFarlane . . team expanded dental care at the “Dr. Ernesto ‘Che’ Guevara” medical clinic, a six-room, concrete-block building serving the region. Other two- to three-week trips have put the team in remote areas of Bolivia, the Dominican Republic and Ecuador. Beyond providing preventive teaching and free clinical care, the main goal is to equip and teach emergency dental care (diagnosis, sterilization, etc.) to local health workers to meet basic needs in the future. Broader oral health education focuses on endemic sugar/soda pop consumption — with skits making lessons more memorable, especially for the kids. Today, they are three — after the loss of Yung to lymphoma in January 2013. “It was like losing our right arm,” Kreher said. But assisted by spouses, their children, assistants and colleagues, the friends will continue in their efforts, Kreher said. Canadian Dental Relief International founders, Drs. Brian Eckert, from left, Ramon Humeres, Frank Yung and Rolf Kreher, in Nuevo Horizontes, Guatamala. Photo/Provided by Dr. Rolf Kreher R. Bruce McFarlane, DMD Like most practitioners involved in dental missions, Dr. Bruce McFarlane has gained much from the many trips he has made to provide emergency dental care and preventive education to some of the world’s most underserved populations. But the standard comparisons end when the Winnipeg, Manitoba, orthodontist reveals what he gained from a trip a few years back: the love of his life. On a mission to a border area between Haiti and the Dominican Republic, he met the woman who would become his wife, Jintana Weerapan, a pediatric nurse practitioner from Chicago, serving as the mission’s medical director. The couple clearly captured each others’ attention. But even bigger chemistry was being generated. Here’s how the sponsoring organization’s regional medical director, Dr. Jose Garcia, took special note of the group’s efforts in a letter of gratitude: “I want to highlight this last team from March: Tremendous. Excellent. Marvellous. The doctors, the nurses, the students, those blessed dentists and their personnel. Very good people. Healthy, caring, hardworking and with a great sense of humanity.” The couple married in the midst of planning and fundraising for a return trip, this time joining a Florida group that goes to the same area two to three times per year. Prior to an earlier trip, McFarlane told a Winnipeg Free Press reporter: “Many children and adults go to bed there hungry, sick, and with dental pain and infections. A recent medical mission into Cite Soleil (Haiti) saw 1,300 patients in two and a half days. We plan to make a difference in the six days that we will be (in Haiti), and leave behind a legacy of equipment and supplies for future volunteers to provide care.”[10] => A10 INDUSTRY Dental Tribune Canada Edition | November 2014 Have you been waiting to implement 3-D technology? Because it’s designed with the space restrictions of many practices in mind, the CS 8100 3D is compact enough to fit in even the tightest locations so offices don’t have to give up precious real estate. Generalists, too, are adding new dimension in accuracy Dental technology has grown exponentially over the past few decades — paving the way for enhanced diagnoses, treatment planning and patient care. With this growth comes a new range of accessibility, and while certain technologies, such as cone-beam computed tomography (CBCT), Ad may have been reserved for specialists in the past, as 3-D imaging becomes more widespread, it has become more affordable for general practitioners. But why would a general practitioner want CBCT in his or her office? Truthfully, there are a number of reasons — the first Photo/Provided by Carestream being the technology’s diagnostic benefits. Making confident diagnosis should not be restricted to specialists; every practitioner should have the tools to provide accurate diagnoses to their patients. Of course, it’s important to remember that patients are three-dimensional, so the images used for their diagnosis should be as well. With CBCT imaging, users can look at any anatomical structure from every angle, with 1:1 accuracy and without the risk of distortion or superimposition. Threedimensional imaging also allows practitioners to uncover information — such as the presence of a fractured tooth — that would be missed with 2-D alone. As an added benefit, CBCT also improves patient care and case acceptance. When patients are able to see their mouths in 3-D, they’re not only impressed by the technology, but they also better understand their diagnosis or treatment plan. In addition, taking the 3-D image right in the office — rather than sending the patient to a specialist or third-party imaging center — eliminates the risk that the patient won’t return for treatment. The CS 8100 makes 3-D imaging accessible to practitioners For dentists who have been waiting to implement 3-D imaging in their practice, the CS 8100 3D is an attractive option, according to the company. Built on the CS 8100’s award-winning 2-D platform, this system combines panoramic imaging with CBCT for versatility — while at the same time, remaining affordable. And, because the unit was designed with the space restrictions of many practices in mind, the CS 8100 3D is compact enough to fit in even the tightest locations — so offices don’t have to give up precious real estate. According to the company, with the CS 8100 3D, the complexity of earlier 3-D imaging systems is a thing of the past, making 3-D exams even easier than taking a panoramic image. In addition, the intuitive software allows users to take advantage of 3-D technology from the very first day the unit is installed. Consistent image capture is crucial to practice productivity. To this end, the CS 8100 3D eliminates lasers in favor of a smart bite block that includes letter landmarks to help users intuitively capture the ” See 3-D, page A11 .[11] => Dental Tribune Canada Edition | November 2014 INDUSTRY A11 CDHA honours excellence in oral health, dental hygiene Program awards dental hygienists for their scholarship, leadership, community involvement, research The Canadian Dental Hygienists Association (CDHA) recently recognized 18 leaders in oral health for their outstanding contributions to the profession of dental hygiene, the association and to the overall health and well-being of the Canadian public. Since 1975, CDHA’s Dental Hygiene Recognition Program (DHRP) has honoured more than 120 dental hygienists in 14 categories for their excellence in scholarship, leadership, community involvement and research. These award winners have set high goals and achieved much in their professional and personal lives. dustry sponsors TD Insurance Meloche Monnex, SUNSTAR G•U•M, DENTSPLY, and Crest Oral-B. In addition to its Dental Hygiene Recognition Program, CDHA also offers three awards to members whose volunteer service at either the local or national level is deemed outstanding. The recipients of this year’s CDHA board of directors’ awards are: Salme Lavigne (Life Membership); Jacki Blatz (Distinguished Service Award); and Bev Woods, Carole Whitmer and Anne Caissie (Awards of Merit). See photos and more details on award winners at www.dentalhygienecanada.ca Serving the profession since 1963, CDHA is the collective national voice of more than 26,800 registered dental hygienists working in Canada, directly representing 17,000 individual members including dental hygienists and students. Dental hygiene is the sixth largest registered health profession in Canada with professionals working in a variety of settings — including independent practice — with people of all ages, addressing issues related to oral health. For more information on oral health, visit www.dentalhygienecanada.ca. (Source: Canadian Dental Hygienists Association) Ad “ 3-D, page A1o region of interest. With the bite block, it is virtually impossible to miss the area of concern, eliminating the risk of retakes. For enhanced flexibility, the CS 8100 3D also enables users to capture images based on specific needs. Selectable 3-D programs let users control image size, resolution and the dosage of each examination: • Universal field of view (5 x 5 cm) is an ideal size for most local dental exams (local pathology, single implant, endodontic, etc.). • EndoHD mode (5 x 5 cm) delivers extremely high-resolution scans (75 µm) to show even the smallest details of root and canal morphology. • Single (8 x 5 cm) and dual (8 x 9 cm) jaw modes (maximum field of view is 8 x 8 cm instead of 8 x 9 cm for Ontario) capture one or both dental arches in one scan — particularly useful for cases that involve a larger area, such as implant planning with surgical guide creation, oral surgery or larger disorder. • Pediatric program (4 x 4 cm) confines the exposure to a smaller area, making it ideal for children or for exams that don’t require the highest image quality. Patient safety is always a concern when it comes to radiographs and CBCT imaging. To address this, the CS 8100 3D allows users to collimate the imaging area based on clinical needs to limit radiation exposure and align with the ALARA (as low as reasonable achievable) principle — without sacrificing image quality. Depending on the selected field of view, images can be taken in as little as 15 seconds, while the Flash Scan mode scans patients in seven seconds to minimize patient movement and delivers a dose reduction up to 50 percent less than a standard scan. For practitioners thinking about moving to a digital workflow for impressions, or bringing the restoration process in house, the CS 8100 3D is compatible with Carestream Dental’s CS Solutions product line for restorations. In fact, adding CS Restore software and the CS 3000 milling machine gives practices everything needed to scan, design and mill crowns, inlays and onlays in one appointment. To learn more about the CS 8100 3D or Carestream Dental’s portfolio of imaging products and software, call (800) 933-8031 or visit www.carestreamdental.com. (Source: Carestream) . After reviewing 34 submissions to its 2014 program, CDHA is delighted to announce the winners of this year’s DHRP awards: Airra Custodio, Julie Farmer, Zul Kanji, Joyce Kwok, Pauline Leroux, Sue Lighthall, Niagara College, Oxford County Public Health’s Oral Health Team and Susan Young. Honourable mentions are given in the oral health promotion category to Leslie Battersby and the College of New Caledonia’s dental hygiene and dental assisting students, Olu Brown, Melissa Holmes and Vancouver Community College. CDHA’s recognition program is made possible by the support of in-[12] => .[13] => IMPLANT TRIBUNE The World’s Dental Implant Newspaper · Canada Edition NOVEMBER 2014 — Vol. 2, No. 4 www.dental-tribune.com Case study in Journal of Oral Implantology New grafting procedure for oral implantation Innovative approach to immediate treatment and implantation when infection present A goal of current oral surgery is not merely to replace a problematic tooth, but also to keep the supporting tissue structure of the mouth and jawline intact. This helps in maintaining the long-term effectiveness of the surgery and the oral cavity and jawline esthetics. However, if infection is present, surgery is usually delayed, which may compromise the supporting tissues. An innovative procedure, utilizing a single incision for access and localized antibiotics to treat infection, is being introduced that will enable immediate implantation with a bone graft harvested from a portion of the patient’s own lower jaw. A case study in the Journal of Oral Implantology provides an indepth analysis of this new approach for immediate treatment and implantation of an infected area. In oral implant surgery, immediate implantation of the area of interest is preferred, as delaying the procedure can have a negative effect on the structure of hard and soft tissues. Frequently, required surgeries coincide with oral infection and surgeons prefer to wait until the infection is resolved before performing ” See NEW, page B2 Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 1: Periapical radiograph of tooth #10, January. Fig. 2: Periapical radiograph of tooth #10, August. Fig. 3: Pretreatment frontal view. Fig. 4: Tetracycline antibiotic application. Fig. 5: Traumatic extraction of tooth #10. Fig. 6: L-shaped fracture of tooth #10. Fig. 7: Outline of symphysis block graft. Fig. 8: Anterior maxillary recipient site defect after complete debridement of the lesion and surgical procedure of implant placement with guide. Photos/ Fig. 7 Fig. 8 Provided by American Academy of Implant Dentistry Nobel Biocare joining Danaher Dental Platform Danaher Corp., a global health care conglomerate of brands from various industries, and Swiss dental manufacturer Nobel Biocare recently announced that the two companies have entered into a definitive transaction agreement. To expand its global dental business, Danaher has offered to buy Nobel Bio- care, described as the second-largest supplier of dental implants worldwide, for $2.1 billion. As reported by Dental Tribune online earlier this year, Nobel Biocare confirmed that it had been approached at the end of July by third parties with a potential interest in acquiring the business. Now, the company’s board of directors has unanimously decided to recommend that Nobel Biocare’s shareholders accept the Danaher offer, which includes the acquisition of at least 67 per cent of all shares. Danaher reports that it already reaches about 99 per cent of dental practices worldwide through an extensive network of dealers and direct sales. With the acquisition of Nobel Biocare, the company would become one of the largest consumable and equipment competitors in dentistry, with expected sales of $3 billion. Danaher also stated that it is planning more investments. Both companies disclosed that the ” See DANAHER, page B2[14] => XNEWS XXXX B2 Implant Tribune Canada Edition | November 2014 Archaeologists discover early dental implant By Dental Tribune International placed. In that case, the implant may have been placed to improve the appearance of the corpse for the funeral service, The Guardian reported on its website. Implantation would not only have been very painful but also have led to an infection. “Iron is not biocompatible and the absence of sterile conditions would have provoked an unfavourable host response,” the archaeologists stated. As reported by The Guardian, the corroded piece of metal is the same size and shape as the other incisors from the woman’s upper jaw, which was destroyed, however, when the timber tomb collapsed and crushed her skull. The appearance of the implant may originally have been im- Archaeologists have discovered a 2,300-year-old iron pin in place of an upper incisor at a La Tène burial site in Le Chêne in northern France. The body belonged to a young woman who had been buried in a richly furnished timber chamber. The pin could be one of the earliest examples of a dental implant in Western Europe. The iron pin may have been inserted during life to replace a lost tooth; however, as it was placed very deeply into the pulp canal of nerves and blood vessels, the archaeologists have suggested that the woman may already have been dead when the pin was proved by a wooden or ivory covering. The implant, found in the Celtic grave in Le Chêne, is 400 years older than one from another grave in France, found in Essonne in the 1990s. According to the archaeologists, the finding was unexpected. The concept of the dental prosthesis may have been taken from the Etruscans by returning Celtic mercenaries, although dental implants of this specific kind have not been found in Etruscan contexts. The study, titled “The earliest dental prosthesis in Celtic Gaul? The case of an Iron Age burial at Le Chêne, France”, was published in the June issue of the Antiquity journal. IMPLANT TRIBUNE Publisher & Chairman Torsten Oemus t.oemus@dental-tribune.com President/Chief Operating Officer Eric Seid e.seid@dental-tribune.com 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 “ DANAHER, Page B1 transaction is scheduled for completion by late 2014 or early 2015. Once the acquisition has been completed, Nobel Biocare will operate as a stand-alone company within Danaher’s dental platform, maintaining its own brand and identity. Since 1984, Danaher has acquired more than 400 companies. KaVo Kerr Group, which unites leading dental consumable, equipment, high-tech and specialty brands under one platform, was formed at the beginning of this year. The group includes KaVo, Kerr, Axis|SybronEndo, Instrumentarium Dental, SOREDEX, i-CAT and Implant Direct. According to a Danaher news release, the $3.5 billion dental implants market is primed for strong growth because of factors such as an aging population, growing income in high-growth mar- kets and low penetration in many geographic regions. With Nobel Biocare in the premium sector and its Implant Direct joint venture in the value segment, Danaher plans to further invest in both markets. As it has announced with regard to Nobel Biocare, Danaher has reported that Implant Direct, too, will remain as a stand-alone joint venture with no change in market strategy. Product/Account Manager Humberto Estrada h.estrada@dental-tribune.com Accounting Department Coordinator Nirmala Singh n.singh@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 © 2014 Tribune America, LLC All rights reserved. “ NEW, Page B1 the reconstructive implant surgery. This timelapse in placement of reconstructive bone grafts reduces the success rate of the implantation from 100 percent with immediate implantation, to 92 percent. In the case study, a 43-year-old female presenting with a front-tooth infection of seven months duration underwent a root canal and antibiotics. When symptoms persisted, tooth removal was recommended. Despite the presence of infection, the patient was able to receive a bone graft harvested from the symphysis of her mandible. Application of localized antibiotics was used to treat the infection. Three years postoperatively, the patient presented with no negative effects. Regarding recovery from oral surgery, immediate implantation is critical to: • Preserving the structure of the soft and hard tissue. • Shortening the recovery period. • Prevention of future corrective surgeries. Grafting procedures using bone from the patient’s own body has been the gold standard for years; therefore, it is a natural progression for oral implantation to follow suit. Full text of the article, “3 Year Follow Up of a Single Immediate Implant Placed in an Infected Area: A Clinical Report of a Novel Approach for the Harvesting Autogenous Symphysis Graft,” Journal of Oral Implantology, Vol. 40, No. 2, 2014, is available at www.joionline.org/doi/full/10.1563/ AAID-JOI-D-13-00202. 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. Fig. 9 Fig. 10 Editorial Board Fig. 11 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 Fig. 12 Corrections Fig. 13 Fig. 14 About the Journal of Oral Implantology The Journal of Oral Implantology is the official publication of the American Academy of Implant Dentistry. It is dedicated to providing valuable information to general dentists, oral surgeons, prosthodontists, periodontists, scientists, clinicians, laboratory owners and technicians, manufacturers and educators. The JOI distinguishes itself as the first and oldest journal in the world devoted exclusively to implant dentistry. For more infor- 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. Fig. 15 mation about the journal or society, please visit: www.joionline.org. (Source: Journal of Oral Implantology) Fig. 9: Autogenous bone graft placed on the labial side to cover the exposed threads and repair the bone defect. Fig. 10: The temporary abutment and crown seated on the implant. Fig. 11: Soft tissue healing three months after the implant placement. Fig. 12: Posttreatment bone sounding, midbuccal side of tooth #10. Fig. 13: The final restoration, six months after implant placement of tooth #10. Fig. 14: Periapical radiograph three years after the implant placement of tooth #10. Fig. 15: The final restoration, three years after implant placement of tooth #10. 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. 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 Implant Tribune? Let us know by emailing feedback@dental-tribune.com. If you would like to make any change to your subscription (name, address or to opt out) please send us an e-mail at database@dental-tribune.com and be sure to include which publication you are referring to.[15] => INDUSTRY Cosmetic Tribune U.S. Edition | November 2014 B3 Prosper ... and be healthy D 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/Posiflex Design Awkward movements and posture. Inadequate rest. 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