DT Middle East and Africa

More olympians screened for oral cancer / News & Opinions / Does Your Patient Suffer from Dry Mouth? / New paradigm for crown preparation: Great White Ultra carbide instruments / Clinical Matters / Dental Cafe / What you didn't learn in dental school: space maintenance / Events

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DTME template_DTME 3/8/2010 11:15 AM Page 1

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DENTAL TRIBUNE
The World’s Dental Newspaper · Middle East & Africa Edition

PUBLISHED IN DUBAI
2
Hours

March 2010

NO. 3 VOL. 8

Media CME

Dental Cafe

Great White Ultra carbide
instruments

Camel burger on menu in
Dubai

4Page

More olympians screened
for oral cancer
by Lisa Townshend
DT UK

LONDON, UK: Dentists have
screened a fifth of all athletes taking part in the 2010 Winter
Olympic Games in Vancouver,
Canada, for oral cancer. Around
800 athletes sat in the dentist’s
chair during the competition,
with more than 70 dentists and
their assistants on hand not only
to fix their teeth and mouths, but
also to practice preventative dentistry. Dental Associations have
welcomed the increased screening campaign that will also educate athletes on the importance of
applying sun-cream to help prevent developing mouth cancers.
The decision to examine 20
per cent of all athletes in the
Games has been taken by the International Olympic Committee.
At the last Winter Olympics in
Turin in Italy, only 10 per cent of
Olympians were screened for oral
cancer. Dental treatment services
at sports events like the Olympics
usually focuses primarily on
treating infections and emergency trauma cases involving
possible damage to teeth, lips,

MIDDLE EAST
EVENTS 2010

4Page

HANDS-ON
IMPLANT
Presented by Professor Stewart Harding
COURSE
This exciting new concept offers affordable part time training to
Dental Surgeons seriously intending to introduce dental implants
as a treatment modality to their practices. An important feature
of the training is the opportunity it
gives participants to place implants in
their own patients under direct one to
one mentored supervision. The
course consists of two modules
comprising of lectures and supervised clinical training involving
the hands-on placement of implants on actual patients.
Module 1(GIFT Implant Year Course)
Through lectures, group work, discussions and hands on
work shops, participants are introduced to the concept of osseointegration and given an
overview of surgical and restorative techniques. Each day of this ten day programme is based
on a specific topic that underpins the principles fundamental to the safe practice of implant
dentistry. The course is delivered over ten days, divided into five, two day units at two-monthly
intervals over the year.

This photo shows Tim Burke (USA) competing in the 4x7.5 km biathlon relay at
the 2006 Winter Olympics in Italy. Outdoor athletes like him have a higer risk of
developing oral cancers. (DTI/Photo Jonathan Larsen )

cheeks and tongues and broken
bones.
Due to their training conditions, athletes tend to neglect
their oral health, Dr Jack
Taunton, co-chief medical officer
of the Games, said. He said that
they are often so nomadic they
tend to put off having dental treatment at all. Some athletes in
Nordic events also chew tobacco,
which contains numerous carcinogens that can cause oral cancers. More danger comes from
additional reflection of ultraviolet
radiation off snow and ice, raising
the risk of developing skin and lip
cancers.

“You have to consider they are
exposed to these intense ultraviolet rays for up to 30 years, through
their training and post-competitive coaching years. The skin on
the lips is thin and poorly protected. ” said Dr Chris Zed, associate dean of dentistry at the University of British Columbia and
co-head of dental services for the
2010 Winter Games.
He added that the danger is cumulative and could lead to the development of oral cancer later in
life.
Outdoor athletes seem unaware of the elevated cancer risks
associated with their training, according to a German study DT

Module 2 (Clinical Practice of Implant Dentistry)
This part time module provides supervised clinical training and evaluates your competency.
The clinical training programme provides the opportunity to put into practice the principles of
diagnosis and treatment planning learned in module 1. Placement guidelines are put into
actual practice together with surgical anatomy. The Dental Center, DHCC provides easy
access for participants and their patients. Participants receive one to one hands-on teaching
and learn implant placement techniques on patients. Under close supervision participants treat
their own patients from initial consultation and assessment through to surgery and final
restoration.
On completion participants in the clinical programme will have:
• a thorough understanding of the principles of restorative dentistry before independently
placing implants.
• practised clinical assessment, treatment planning, and the placement of implants in the
presence of an experienced implant clinician.
Dr Stewart Harding is the Associate Director Postgraduate Dental Education Unit, Institute of
Clinical Education University of Warwick and has extensive teaching experience helping many
dentists towards their ultimate goal of placing implants for the benefit of their patients. He is
also the inventor of the Osteo-Ti implant system and practices implant dentistry in the UK
(London, Harley Street), Sudan and The Dental Center, Dubai Health Care City.

Enrolment starts January 2010, limited spaces available.
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DTME template_DTME 3/8/2010 11:16 AM Page 2

DENTAL TRIBUNE Middle East & Africa Edition

News & Opinions

Members from University of Sharjha Win
Sheikh Hamdan Bin Rashid Al Maktoum’s
Award to Support Medical Sciences
SHEIKH
HAMDAN
BIN
RASHID AL MAKTOUM AWARD
FOR MEDICAL SCIENCES has
given two faculty members from
the Medical and Health Sciences
Colleges a research grants to
support their research projects
in the University of Sharjah. The
recipients of this award are: Dr.
Sausan Al Kawas, Associate professor and Head of Oral and
Craniofacial Health Sciences Department at the College of Dentistry and Dr. Nisreen Tadmori,
Assisstant professor at the Department of Basic and Medical
Sciences, College of Medicine.
Dr. Sausan Al Kawas has received this award to support her
research about the analysis of
mercury concentration in the
waste water released from dental

clinics and its adverse effect on
environment in UAE. This research project also aims to find
corrective mechanisms in the
disposal of mercury wastes by the
dental clinics in UAE. The results
of this project will contribute to
the efforts of Ministry of Health to
reduce the mercury burden in
the waste water by monitoring
restrictions involved in the handling and discharge of mercurycontaminated waste.
Dr. Nisreen Tadmori research project about genetic diseases and it will be done by studying Diabetes Mellitus in UAE
children.
It is noteworthy that SHEIKH
HAMDAN BIN RASHID AL MAKTOUM AWARD FOR MEDICAL
SCIENCES is one of the most

HMC and CNA-Q
announce partnership
As part of its educational
strategy to help train the next
generation of professionals in
the field of dentistry, Hamad
Medical Corporation (HMC) has
entered into a partnership with
the College of the North Atlantic
in Qatar (CNA-Q) to provide a licensed supervisor under CNAQ's Dental Assistant Program.
Speaking during the signing
ceremony held in the boardroom
of Hamad Women's Hospital,
HMC Managing Director Dr.
Hanan Al Kuwari, said:
"The agreement that is being
signed is an important step in our

prestigious award in Medical Research in UAE and been awarded
to more than 50 researching scientists to support their projects
since 2000 till date.

Editorial Board
Prof. Abdullah Al-Shammary, Restorative Dentistry, KSA
Prof. Hussain F. Al Huwaizi, Endodontics, Iraq
Prof. Samar Burgan, Oral Medicine, Jordan
Dr. Abdel Salam Al Askary, Implantology, Egypt

DENTAL TRIBUNE
The World’s Dental Newspaper · Middle East & Africa Edition

Dr. Talal Al-Harbi, Orthodontist, Qatar
Dr. Mohammed H. Al Jishi, Bahrain
Dr. Lara Bakaeen, Prosthodontist , Jordan
Dr. Aisha Sultan, Periodontist, UAE
Dr. Kamal Balaghi Mobin Aesthetics, Iran

President/CEO

Yasir Allawi
y.allawi@dental-tribune.ae

Director mCME:

Dr. D. Mollova
info@cappmea.com

Marketing manager

Khawla Najib
khawla@dental-tribune.ae

Production manager

Hussain Alvi
dentalme@dental-tribune.ae

Published by Education Zone
in licence of Dental Tribune International GmbH
© 2010, Dental Tribune International GmbH. All rights reserved.
Dental Tribune makes every effort to report clinical information and manufacturer’s product news accurately, but cannot assume responsibility for the
validity of product claims, or for typographical errors. The publishers also do
not assume responsibility for product names or claims, or statements made
by advertisers. Opinions expressed by authors are their own and may not reflect those of Dental Tribune International.

PO Box 214592, Dubai, UAE, Tel + 971 4 391 0257
Fax + 971 4 366 4512 www.dental-tribune.com

continuous collaboration with
CNA-Q to provide the highest
level of education in Qatar, and to
encourage our youth to pursue
careers in healthcare, such as the
dental profession."
Dr. Al Kuwari added that
HMC is proud of its partnerships
with prestigious institutions,
which have benefited hundreds
of students and graduates over
the years. She stated further that
the mutual sharing of knowledge
and expertise has helped HMC
achieve better healthcare outcomes for its patients.

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[3] => DTME

DTME template_DTME 3/8/2010 11:17 AM Page 3

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DTME template_DTME 3/8/2010 11:17 AM Page 4

Trends & Applications

DENTAL TRIBUNE Middle East & Africa Edition

Does Your Patient Suffer from Dry Mouth?
What is dry mouth?
We can all suffer from dry
mouth at some point, for example, if we are nervous or stressed.
So most of us are familiar with the
feeling of not having enough
saliva in our mouth to keep it
moist and lubricated. For some
people, however, dry mouth can
be a regular problem. As we get
older we are more likely to experience dry mouth, but it’s also a
AD

problem that can affect people
from their 30s onwards.
What causes dry mouth?
Dry mouth occurs when the
salivary glands stop working effectively. Medicines are known
to cause over 60% of dry mouth
cases, with more than 400 different medications linked to dry
mouth. The number of medicines a patient takes is also directly related to the likelihood of

experiencing dry mouth. Health
conditions are also linked to dry
mouth, such as diabetes or Sjögren’s syndrome. People who
smoke, who are pregnant,
stressed, anxious or dehydrated
are also more likely to have dry
mouth.
What are the symptoms?
The symptoms of dry mouth
can include:

• difficulty in eating, especially
with dry foods, such as cereals or crackers • difficulty in
swallowing and speaking • a
burning sensation in the
mouth • taste disturbances •
painful tongue • dry, cracked,
painful lips • bad breath •
persistent difficulty in wearing dentures • feeling thirsty,
especially at night • dry,
rough tongue. Sometimes the

amount of saliva a person
produces may be reduced by
up to 50% before these symptoms are noticed. These
symptoms can sometimes
have a profound effect on self
confidence.
Does dry mouth cause other
problems?
Saliva plays a very important
protective role in the body. It not
only keeps our mouth moist, it
also helps to protect our teeth
from decay, helps to prevent infections and helps to heal sores in
the mouth.
Are your patients dry mouth
sufferers? •
Do they have difficulty swallowing certain foods? • Does
their mouth feel dry when eating
a meal? • Do they need to sip liquids to help you swallow dry
foods? • Are they taking multiple
medicines? If a patient answered
yes to any of these, he/she may
have dry
Products to ease dry mouth
The Biotène system is specifically designed to treat dry
mouth. The different products in
the Biotène system allow you to
choose the ones that best meet
your lifestyle and dry mouth
needs:
• 1 product specifically designed to help relieve your dry
mouth: the gel provides long lasting relief
• 2 products to help maintain
healthy teeth and prevent tooth
decay in people with dry mouth: a
toothpaste, with fluoride, and
mouthwash which can be used
twice a day in place of the usual
products. These are designed to
be gentle on your mouth as they
are alcohol-free and don’t contain harsh detergents. Biotène
supplements the make-up of normal saliva to replenish dry
mouths. It has a patented enzyme
formulation that:
• helps supplement saliva’s
natural defences
• helps maintain the oral environment to provide protection
against dry mouth
• helps supplement saliva’s
natural antibacterial system weakened in a dry mouth.
Biotène’s gentle formulation is
also free from alcohol and harsh
detergents.
What else can a patient do to
manage dry mouth? •
Sip water or sugar-free drinks
often • Avoid drinks which dry
out the mouth, such as caffeinecontaining drinks (coffee, tea,
some fizzy drinks) and alcohol •
Chew sugar-free gums or sweets
to stimulate saliva flow • Avoid tobacco as this has a drying effect •
Use a humidifier at night to keep
the air full of moisture. To help
keep healthy teeth and avoid
tooth decay: • Brush teeth with a
soft toothbrush after meals and at
bedtime • Floss teeth gently
every day. If there is bleeding
from gums when flossing, this
could be a sign of gum disease. •
Use an SLS-free, fluoride toothpaste, like Biotène, with its gentle
formulation • Avoid alcohol-containing mouthwashes as these
can dry out the mouth • Avoid
sweet, sugary foods • Visit the
dentist at least twice a year for a
check-up.

[5] => DTME

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DTME template_DTME 3/8/2010 11:18 AM Page 6

2
Hours

New paradigm for crown preparation:
Great White Ultra carbide instruments
The article has been accredited by Health Authority - Abu Dhabi as having educational
content and is acceptable for up to 2 (Category 1) credit hours.
Credit may be claimed for one year from the date of subscription.

By George Freedman DDS, FAACD, FACD

The standards of dental care have
evolved rapidly during the past 50
years.1 Today’s best practice modalities
require both tooth conservation and
clinical efficiency.2 These concepts are
not always mutually compatible. The
efficient and preferably rapid removal
of existing tooth structures and restorative materials must be accomplished
with minimal heat generation during
the preparation phase.3
As clinical efficiency is increased
with faster and more aggressive cutting tools (Fig. 1), it is clinically imperative that tooth preparation avoid the
excessive heat generation that could
possibly damage the remaining tooth
structure and endanger the health of
the pulp.4,5
In most clinical situations, water
and air coolants are utilized in conjunction with high-speed bur preparation to reduce the risk of thermal
damage to the tooth.6 The clinical efficiency of tooth preparation is largely
dependant on the shape and design
of the cutting bur, and the number of
steps that comprise the overall treatment.
The more often that the dentist
must change burs during tooth cutting,
the more time consuming the process
and the less efficient the technique.

Headline
Deck
By line

DENTAL TRIBUNE Middle East & Africa Edition

Media CME

Fig. 6

Fig. 7

Fig. 8

Practitioners use both visual and
tactile clues to determine tissues to be
removed. Darker dentin is assumed
to be affected by caries; it should be
removed (unless, of course, it is rehardened secondary dentin). Lightly
colored dentin and enamel are presumed to be healthy tissues. For the
dentist to observe color differences
during preparation, the bur’s rotation
should remove debris as quickly and
effectively as possible (Fig. 2).
The earliest dental burs were manufactured from a variety of metals
that were harder than natural tooth
structure. With time, steel became the
preferred bur metal. Developments
in particle-to-metal adhesion technology resulted in the first diamond burs.
These burs were preferable for highspeed tooth preparation to steel.
The subsequent introduction of carbide cutting instruments was a leap
forward for dentistry; carbide offered
more effective tooth preparation with
less surface striation than diamonds.
More recently, crosscuts and innovative attack angles were introduced
to the carbide cutting shank to make
preparation better, faster and easier
(Figs. 3a, b).
In the past, dentists have tended to
favor diamond burs for extra-coronal
tooth preparation while carbide burs
have been used largely for intra coronal cutting.7 The relative popularity
of carbide and diamond burs varies
considerably in various parts of the
globe, largely due to local availability,
cost and education.8
One factor that is often not considered by the clinician is that as diamond
burs are used, their cutting efficiency
tends to decrease dramatically. Their
cutting diamonds tend to wear down
and debris accumulates in the bur
cavities (Fig. 4), reducing efficiency.9
In order to compensate, dentists tend
to press harder on the tooth with the
bur in order to maintain the earlier
cutting efficiency. Inadvertently, this
actually decreases the efficiency of the
procedure and increases the potential
for heat formation.
Diamond burs tend to grind tooth
structures while carbide burs CUT
these same materials. This leads to
the conclusion that crown and bridge
preparation, where rapid and effective
gross tooth reduction is required and
desirable, is best accomplished with
carbide instruments.
Recent research has indicated that
when a crown or onlay restoration is
to be bonded to the tooth surface, carbide bur preparation can improve the
bond to the dentin.10 A more effectively
bonded crown increases the longevity
of the restoration by decreasing leakage, and thereby the possible adhesive
failure of the restoration. Carbide burs
typically generate a smoother surface
and the partially visible smear layer.11
This smear layer may be more
easily dissolved and incorporated by

Fig. 1

Fig. 3a

Fig. 2
Fig. 3b

Fig. 5

self-etching primers, thus providing
a stronger hybrid layer. This results
in higher bond strengths.12 Cross-cut
carbide burs improve the retention of
crowns cemented with zinc phosphate
by approximately 50 percent. Thus,
the use of finishing burs on axial walls
is discouraged.13
Current concepts of conservative
dentistry dictate that a minimum of
healthy tooth structure be removed
during the preparation prior to the
restorative process. Natural enamel
and dentin are very likely the best
dental materials in existence. Tooth
structure conservation is thus inherently a desirable dental objective.
Consequently, minimally invasive
procedures that allow a greater part
of the healthy tooth structure to be
preserved are preferable (Fig. 5).14
The patient also benefits greatly from
minimally invasive dentistry. There is
typically less discomfort during treatment, and a greater likelihood that the
repaired tooth will last a lifetime.
The dental profession tends to take
burs for granted. They are frequently
used for patient treatment every day,
and their effectiveness and efficiency can have dramatic impact on the
practice. It is interesting to note that
if the practitioner uses burs that are
just 10 percent more efficient, the
savings in operative time can easily
increase practice billing significantly
without any corresponding increase
in overhead. Thus, the entire revenue
increase goes directly to the bottom
line.

Fig. 4
Generally, burs are one of the least
expensive components of the dental
armamentarium, at least relatively. A
small difference in bur cost can often
make a major clinical impact. The
most important parameter to consider
is to select the best bur for the job,
keeping in mind that a small added
expense of opting for a premium
instrument can pay off handsomely.
Some burs are designed for single
use. They can be sterilized and reused, but often exhibit a significantly
decreased cutting efficiency. Other
burs are designed to be sterilized and
re-used.
Recent research at the University
of Rochester, Eastman Dental Center,
jointly undertaken by the prosthodontic and the mechanical engineering
departments, examined the efficiency
of various dental burs with respect
to cutting rate and load needed to
complete standardized preparations
in Macor samples. Both air-driven and
electric handpieces were tested.
The cutting rate represents the
speed at which the bur (reflecting its
material composition and design) cuts
through a standardized material. The
faster the speed, the more efficient
the preparation. The load measures
the operator pressure needed to cut
effectively. A higher required load will
cause more operator fatigue at the end
of a long working day.
In the air-driven high-speed handpiece, the SS White Great White Ultra
(SS White Burs, Lakewood, N.J.) had

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DTME template_DTME 3/8/2010 11:18 AM Page 7

DENTAL TRIBUNE Middle East & Africa Edition

Media CME

Fig. 11

Fig. 10

Fig. 9

Fig. 14
Fig. 15

Fig. 13
Fig. 12

a significantly greater cutting rate
than the other burs tested (Fig. 6).
In addition, the Great White Ultra
bur required the least load, or operator pressure, for effective preparation
(Fig. 7).
Similar results were observed for
electric high-speed handpieces. The
SS White Great White Ultra had a cutting rate significantly greater than the
other burs tested (Fig. 8) and required
the least load, or operator pressure, for
effective preparation (Fig. 9).
In practical terms, the Great White
Ultra burs cut between 11–35 percent faster than the other burs tested.
This can save the practitioner between
one to three minutes on a 10-minute
preparation procedure. The decreased
load translates into greater operator
comfort.
Dental bur design has developed
varying flute angle and cutting characteristics that are specific to the intended task. Operative, cavity and crown
preparation carbide burs have flutes
(dentates) that are designed deep and
wide, creating a more aggressive cutting of enamel with increased speed
and efficiency (Fig. 10).
Operative burs are either straight
bladed or crosscut. Straight-bladed
burs cut more smoothly but are slower, particularly with harder substrates.
Crosscut burs tend to cut faster, but
may create more vibration. Finishing
burs have more flutes, closer together
and shallower, than operative instruments (Fig. 11). This design allows for
fine finishing and polishing of dental
materials or tooth surfaces.
The Great White Ultra bur is an
innovative technological development that represents a new category
of crown preparation burs; it is more
sharply dentated than earlier crosscut
burs. The unique geometry in the
blades’ design creates a bur that cuts
faster with less vibration in both tooth
structures and other dental materials
(Fig. 12).
The bur cuts faster and smoother

because it does not “grab” or “catch”
the substrate, and thus does not stall
in harder materials. The novel design
creates less stress on the remaining
tooth structure and less frictional heat
that may irritate the pulp and damage
the supporting periodontal structures.
The aggressive cutting angle (Fig.
13) of the Great White Ultra allows
the operator to use less pressure on
the tooth during preparation (resulting in decreased tooth heating and
dentist fatigue). The tightly controlled
parameters of manufacturing quality
control develop a high degree of concentricity in the Ultra burs that offers
less vibration and chatter during use,
and decreased maintenance costs for
handpieces (Fig. 14).
The goals of conservative tooth
preparation include:15
1) Re-contouring the remaining
tooth and restored structures to a specified shape and size to accommodate
a crown.
2) Providing a depth guide on all
surfaces, including the occlusal, to
allow the crown to have sufficient bulk
and strength to withstand occlusal and
other intraoral forces.
3) Completing the preparation process with a single pass by one bur on
the buccal, lingual, mesial and distal.
4) Creating the intended marginal
finish, whether shoulder or chamfer,
at the same time as accomplishing
the gross preparation of the other surfaces.
5) Developing a surface that is suitable for bonding the indirect restoration.
6) Remaining conservative of tooth
structure.
7) Preparing the tooth quickly and
efficiently for both patient and dentist
comfort.
For most dentists, the cutting speed
tops the list of features that are important in selecting dental burs. Carbide
manufacturers have produced a variety of designs and shapes that are
intended to reduce the time that it

Fig. 16

takes a practitioner to prepare the
tooth for a crown.
The Great White Ultra bur cuts
quickly and smoothly through enamel. It negotiates amalgam and other
restorative materials with minimal
clogging and no drag or stalling in
these harder materials. The bulk
reduction in the crown preparation
phase can be accomplished with a
single instrument (Fig. 15).
The highly dentated body of the
Great White Ultra cuts efficiently and quickly, and combined with
the smooth tip, helps to provide two
reduction actions in one single pass
with a single bur (Fig. 16). The rounded, non-crosscut tip provides smooth,
precise and controlled margins with
the same cutting motions as the gross
reduction preparation. Thus, the Great
White Ultra is more efficient; there is
less chair time.
There are two preferred marginal
anatomies for crown preparation, the
chamfer and the shoulder. Accordingly, two margin-specific clinical
series of burs have been crafted. The
Great White Ultra 856 Series develops
a rounded axial-gingival margin providing a chamfer finish for the preparation (Fig. 17). The Great White Ultra
847 Series creates a 90 degree axialgingival wall and provides a shoulder
margin for crown restoration (Fig. 18).
The Great White Ultras are available
in a variety of diameters and cutting
lengths.
The Great White Ultra bur kits
organize a variety of shapes and sizes
that are typically used in routine crown
preparation. The bonus is that once
the correct bur is selected, the entire
preparation can often be completed
without changing to another instrument. Bulk reduction AND a smooth
margin are created with the same

Fig. 17

reduction instrument.

Clinical case No. 1
The preparation of the bicuspid crown
is very rapid and straightforward. A
single pass of the Great White Ultra
bur reduces the bulk of the tooth at the
height of curvature and finishes the
chamfer margin simultaneously (Fig.
19). The inter-proximal preparation
must be accomplished without marring the surface of the adjacent tooth.
One of the thinner GWU burs may be
used (Fig. 20).
The buccal surface is not smoothed
out with a disc or diamond; the striations created by the bur increase
the surface area available for adhesion (Fig. 21). The occlusal reduction is completed to provide 1.5–2.0
mm clearance for the crown (Fig. 22).
The completed preparation, ready for
impressions, is viewed from the occlusal (Fig. 23). The entire circumferential preparation was completed with
a single Great White Ultra bur in a
single pass.

Clinical case No. 2
The molar crown preparation is begun
on the buccal surface (Fig. 24) and
continued circumferentially as in the
case above. The bulk and marginal preparations are completed at the
same time. The completed preparation, ready for impressions, is viewed
from the occlusal (Fig. 25).
The stone model is verified against
the intra-oral preparation, and the
crown is tried on extra-orally (Fig.
26). If the fit on the model is correct,
then the crown is tried intra-orally and
cemented on to the prepared abutment
(Fig. 27).
J DT DTpage 22A

page 8

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DENTAL TRIBUNE Middle East & Africa Edition

Media CME

IDTDTPage
page
7 20A

Surg 1965; 19: 515–30.
6.

A circumferential preparation that
has even depth throughout and adequate space for the restoration, as well
as a well-defined margin (whether
chamfer or shoulder), results in a wellfitting and long-lasting crown.

Clinical case No. 3
Some practitioners prefer to use depth
grooves to guide crown preparation.
The Great White Ultra bur is well
suited to this task. The depth grooves
are placed quickly and evenly to the
desired preparation depth (Figs. 28a–
d) at the same time that the location of
the margin is determined.
The depth grooves are joined,
maintaining the selected depth of the
preparation and the location of the
restorative margin (Fig. 29a, b). The
occlusal surface is reduced to an ideal
depth and shape (Figs. 29a–c) and
the preparation, completed within a
matter of minutes, is viewed from the
occlusal (Fig. 29d).
It is reasonable to expect that Great
White Ultra burs can be used for multiple tooth preparations, and that they
can be cleansed effectively between
patients. There are two important
steps to follow for the proper sterilization of multiple-use tungsten carbide
burs.
Step 1: Burs should be cycled
through an automated washer such
as the Hydrim (SciCan, Toronto, Canada), that provides rapid and effective
washing, rinsing and drying with a
single push of a button.
(The instruments may be cleaned
manually, but they should be presoaked to loosen debris and handled
with extreme care to avoid skin punc-

Fig. 19

Fig. 18

tures. Avoid cold sterilizing solutions
that contain oxidizing agents that can
weaken carbide burs. Ultrasonic systems can be used as well. The re-use
of solutions in these systems is less
than ideal, however.
Separate the burs from each other
in a bur block during ultrasonic
immersion to prevent damage to the
cutting surfaces. Brush any remaining
debris away with a stainless steel wire
brush. Rinse and dry the burs.)
Step 2: It is only at this point that
sterilization can be initiated. The
importance of this step cannot be overstated. Only the effective sterilization
of burs eliminates the threat of cross
contamination to patients and staff.
Steam autoclaves will effectively sterilize carbide burs, but some units may
allow surface corrosion to develop.
Metal bur blocks may promote galvanic corrosion and should be avoided.
Both dry-heat sterilizers and chemiclaves can be used without corroding
or dulling carbide burs.

Conclusion
Great White Ultra burs are an innovative solution for the crown and bridge
tooth preparation process.
The differential reduction provided
by the varied cross cutting of the bur’s

active surface allows intraoral multitasking.
Great White Ultras simplify the clinical procedure by reducing the circumferential bulk of the tooth and preparing the final margin at the same time.
Rapid cutting, less structural stress
and a more adhesive surface are additional advantages. DT

References
1.

von Fraunhofer JA, Siegel SC.
Using
chemo-mechanically
assisted diamond bur cutting for
improved efficiency. JADA 2003;
134:53–58.
2. Siegel SC, von Fraunhofer JA.
Cutting efficiency of three diamond bur grit sizes. JADA 2000;
131:1706–10.
3. Stanley HR, Swerdlow H. Reaction
of the human pulp to cavity preparation: results produced by eight
different operative grinding techniques. JADA 1959;(5) 58:49–59.
4. Stanley HR. Traumatic capacity
of high-speed and ultrasonic dental instrumentation. JADA 1961;
63:749–66.
5. Zach L, Cohen G. Pulpal response
to externally applied heat. Oral

Headline

von Fraunhofer JA, Siegel SC,
Feldman S. Handpiece coolant
flow rates and dental cutting.
Oper Dent 2000; 25:544–8.
7. Siegel SC, von Fraunhofer JA.
Dental burs: what bur for which
application? A survey of dental schools. J Prosthodont 1999;
8:258–63.
8. Kimmel K. Optimal selection and
use of rotary instruments for cavity and crown preparations. Dent
Echo 1993; 63(2):63–9.
9. Siegel SC, von Fraunhofer JA.
Effect of handpiece load on the
cutting efficiency of dental burs.
Machining Sci Technol J 1997;
1:1–13.
10. Castro AKB, Hara AT, Pimenta
LA. Influence of collagen removal
on shear bond strength of onebottle adhesive systems in dentin.
J Adhes Dent 2000; 2:271–77.
11. Dias WRL, Pereira PNR, Swift Jr.
EJ. Effect of bur type on Microtensile Bond Strengths of Self-etching
Systems to Human Dentin. The
Journal of Adhesive Dentistry
2004; 195–203.
12. Nakabayashi N. Bonding mechanism of resins and the tooth (in
Japanese) Kokubyo Gakkai Zashi.
J Stomat Society, Japan 1982;
49:410.
13. Ayad MF et al. J. Prosthet Dent
1997; 116–21.
14. UCR. Freedman G, Goldstep F,
Seif T. “Watch and wait” is not
acceptable treatment. Ultraconservative Resin Restorations 1999;
1–14.
15. Freedman G, Goldstep F, Seif T,
Pakroo J. Ultraconservative Resin
Restorations. J Can Dent Assoc
1999; 65:579–81.

MEDIA CME
Self-Instruction Program

Deck
By line

tk Fig. 20
Fig. 24
Fig. 27

Fig. 21

Fig. 28a

Fig. 25

Fig. 22
b

Fig. 29a

Fig. 23
Fig. 26

Dental Tribune Middle East & Africa in collaboration with CAPP introduce to the market the
new project mCME - Self Instruction Program.
mCME gives you the opportunity to have a
quick and easy way to meet your continuing education needs.
mCME offers you the flexibility to work at your
own pace through the material from any location at any time. The content is international,
drawn from the upper echelon of dental medicine, but also presents a regional outlook in
terms of perspective and subject matter.
How can professionals enroll?
They can either sign up for a one-year (10 exercises) by subscription for the magazine for
one year ($65) or pay ($20) per article. After the
payment, participants will receive their membership number and will be able to attend to the
program.
How to earn CME credits?
Once the reader attends the distance-learning
program, he/she can earn credits in three easy
steps:
1. Read the articles.
2. Take the exercises
3. Fill in the Questionnaire and Submit the
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Email :info@cappmea.com
After submission of the answers, (name and
membership number must be included for
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with unique ID Number within 48 to 72hours.
Articles and Questionnaires will be available in
the website after the publication.
www.cappmea.com

[9] => DTME

DTME template_DTME 3/8/2010 11:20 AM Page 9

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[10] => DTME

DTME template_DTME 3/8/2010 11:20 AM Page 10

DENTAL TRIBUNE Middle East & Africa Edition

10 Clinical Matters

Cantilevered Premolar: The Implant Supported Molar
Although the implant supported mandibular molar is
very predictable the restoration of the single posterior implant presents its own unique
set of problems. The most obvious problem is that the
mesiodistal width of a molar is
significantly greater than that
of the standard 3.75mm diameter implant. A wider diameter
implant would reduce this discrepancy but is reliant on available bone which due to resorption is often insufficient. (Figure 1)
Ideally the implant should be
positioned in the centre of the
edentulous space but if a standard diameter implant is used as

Figure 7

a result of limited buccolingual
bone width the crown will be
grossly over contoured.(Figure
2) Another option would be to
place two standard diameter implants but this requires a minimum mesiodistal space of

Figure 8

Figure 9

14mm. Apart from the difficulty
of sufficient space to accommodate two implants there is also an
associated cost implication.
An alternative restorative option in this region of the mouth is
the cantilever premolar which
requires only a single implant for
support. (Figure 3) The implant
is positioned distally and used to
provide support for a mesial cantilever premolar pontic. This
type of restoration is indicated
where the remaining dentition is
sound, the occlusion stable and
the mesial distal space is between 11-14mm.

Implant Site Preparation
Figure 1

figure 3

Figure 2

figure 4

Following a mid-crestal incision and exposure of the residual
alveolar ridge a 2mm pilot bur is
used to cut the osteotomy site to
the predetermined depth. (Figure 4) As the tapered implant is
self drilling as well as self taping
it is not necessary to use any additional burs to enlarge the site
prior to implant insertion. (Figure 5) This preserves bone and
improves primary stability as
well as speeding up the insertion
procedure cutting back on surgical stages. As the implant is
screwed down into position the
bone is expanded improving
ridge contour and the emergence profile of the definitive
restoration.

Implant Positioning
Figure 5

Figure 6

It is important for the stability
of the bone margin that there is

Figure 10

2mm bone on the buccal aspect of
the implant. There should be
1.5mm bone between the circumference of the implant and
root of the adjacent tooth. If the
implant is placed closer to the
root than 1.5mm the biologic
width is violated and periodontal
health of the tooth jeopardised. If
the distance is greater than
1.5mm the definitive restoration
will be over contoured predisposing to hygiene and maintenance problems. The implant
should also submerged by 1mm
beneath the bone crest in order to
provide sufficient space to develop the emergence profile.

AEEDC and DUPHAT are two
prestigious events hosted by the
emirate of Dubai every year and
highly supported by the Dubai
Health Authority as they are held
under the patronage of H.H
Sheikh Hamdan Bin Rashid Al
Maktoum, Deputy Ruler of

Dubai, Minister of Finance and
President of the Dubai Health Authority.
The announcement came at a
press conference held today at
the Dubai Health Authority
Headquarter and was presided
by H.E Qhadi Saeed Al
Murooshid, Director General –
Dubai Health Authority, Dr. Tariq
Khoory, the Director of the Dental Department at the Dubai
Health Authority and the Honorary Chairman of AEEDC
Dubai, Dr. Nasser Malik, the
Conference Chairman, Dr. Ali
Sayed, the Director of Pharmaceutical Services Department at
Dubai Health Authority and
Chairman of DUPHAT Conference and Mr. Abdul Salam Al
Madani Executive Chairman of
AEEDC and DUPHAT Conference and Exhibition and President of Index Holding.

Dr. Tariq Khoory praised the
significant increase at AEEDC
Dubai every year, in terms of the
number of companies and dentists participating in the conference and exhibition. Dr. Tariq
also mentioned that this large

Author Info

Transmuosal Healing
Tissue closure is not required
as the placement protocol ensures that primary stability is sufficient to permit the placement of
a healing abutment after implant
insertion. Instead the flaps are
lightly sutured around the healing abutment. Once soft tissue
healing is complete after three
months impressions can be
taken for the definitive restoration.(Figures 6,7 and 8)

Cantilevered Premolar
Providing the long axis of the
implant is parallel to the occlusal
plane a friction fit abutment may
be used. A friction fit abutment
does not require a screw thus
eliminating micro leakage associated with the micro gap. The
crown is made from a composite
restorative material (gradia) that

Dubai Health Authority Supports AEEDC
and DUPHAT Conferences and Exhibitions
More than 30.000 Visitors Expected to Attend AEEDC and
DUPHAT form 120 Countries
Dubai –Index Conferences
and Exhibitions Organisation
Est. – member of Index Holding
announced today the launch of
two major events during March;
the UAE International Dental
Conference and Arab Dental Exhibition (AEEDC Dubai) and the
Dubai International Pharmaceuticals and Technologies Conference and Exhibition (DUPHAT)
at the Dubai International Convention and Exhibition Centre.

is bonded directly to the friction
abutment. This type of restoration delivers a premolarised posterior occlusion with a narrow
occlusal table with low cusp angles reducing lateral load. (Figures 9 and 10) The cantilevered
premolar pontic is amenable to
routine oral hygiene procedures
and is very well tolerated by patients.

turnout is due to the global status
enjoyed by Dubai as a regional
hub for all international companies looking to market and promotes their products to all the region through Dubai.

Dr Stewart Harding is the Associate
Director Postgraduate Dental Education Unit, Institute of Clinical Education University of Warwick and
has extensive teaching experience
helping many dentists towards
their ultimate goal of placing implants for the benefit of their patients. He is also the inventor of the
Osteo-Ti implant system and practices implant dentistry in the UK
(London, Harley Street), Sudan and
The Dental Center, Dubai Health
Care City.

Dr. Tariq also mentioned that
AEEDC Dubai strives to raise the
high standard of medical services in general and dentistry in
specific, especially after the
World Dental Federation FDI announced last year that AEEDC
Dubai is the fifth largest conference and exhibition of its kind in
the world, where key oral health
professionals from the Middle
East and Eastern Asia meet.
Dr. Nasser Malik, the Conference Chairman said that “This
year, we have brought the radiography to the scientific program, this subject has been a
controversial one for all dentists,
and this year we are hosting the
world’s key specialists to talk intensively about it. The courses
will raise the dentists’ efficiency
and will display the latest technology used in the medical field.”
AEEDC Dubai introduces for
the first time the International
Orthodontic Meeting and the
GCC meeting, in addition to the
annual Dubai World Dental
Gathering which will be held before the event.

[11] => DTME

DTME template_DTME 3/8/2010 11:20 AM Page 11

DENTAL TRIBUNE Middle East & Africa Edition

Camel burger on menu in Dubai
A traditional Emirati restaurant in Dubai has added a new
entree to its menu billed as a fatfree choice for carnivores but
health-conscious diners: the
camel burger.

'Dead'
woman
comes back
to life

A woman pronounced dead
by doctors in Colombia has been
rushed back to the hospital after
a funeral home worker saw her
move while preparing her body.
Noelia Serna was admitted to
a Cali hospital on Monday after
suffering a heart attack and was
on life support before doctors declared her dead.
Speaking from the hospital,
Dr Miguel Angel Saavedra said
the 45-year-old showed no vital
signs: "The electronic devices
that she was connected to
showed that there was neither
heartbeat nor arterial tension.
Because of that, the respiratory
therapist performed a test when
she removed the respirator and
the patient could not breathe on
her own. Sadly she was declared
deceased."
Funeral home worker Jaime
Aullon told reporters: "I stopped
the process. And as soon as I
stopped I started looking at her
whole body and I noticed her
midsection moving. I placed my
hand here (pointing to his nose
and mouth) and I felt her breathing. I told my partner that she
should go back to hospital because she is alive."
It is being speculated that it
could be a case of what is known
as Lazarus Syndrome, a rare condition where heart rate and
breathing drop below measurable levels before returning.

For 20 UAE dirhams ($5.45),
the Local House restaurant offers
a quarter-pound camel burger,
loaded with cheese and smothered in burger sauce, the Xpress
weekly newspaper reported yesterday.
Ali Ahmad Esmail, Local
House assistant manager, told
the paper that the burger patties
were fat- and cholesterol-free.
But he declined to say how the
AD

outlet tenderized the tough
camel meat.
"It's a trade secret," he said.
Camel meat is widely eaten in
some Arab countries, but is not
typically sold in supermarkets or
served in restaurants.
The paper reported that Local
House said it was the first to introduce the burger in the United
Arab Emirates. A fast-food outlet
in neighboring Saudi Arabia put

Dental Cafe 11
baby camel burgers on its menu
last year.
The camel burger, a hit with
residents and tourists, could
soon also be on offer in the Burj
Khalifa, the world's tallest tower
formerly known as Burj Dubai,
where Local House may open an
outlet, the paper said.
The burger is served with
fries or potato wedges, and the
paper suggested it could be
washed down with a soft drink or
a camel milkshake, also available in Dubai.

[12] => DTME

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[13] => DTME

DTME template_DTME 3/8/2010 11:22 AM Page 13

DENTAL TRIBUNE Middle East & Africa Edition

News & Opinions 13

What you didn't learn in dental school: space maintenance
Rob Veis,
When I was in dental school,
we were taught virtually nothing
of orthodontics. We were certainly not taught how to integrate
appliance therapy into our practices. We were taught the basics,
but never to the extent that we
could actually hope to perform
the procedures ourselves. We
were taught how to make referrals instead of solve problems.

The unfortunate truth is that
nothing has really changed.
The average dentist today
feels ill–equipped to take care of
basic orthodontic problems. As a
result, they lose professional
ground, are denied the economic
opportunity to advance their
practices, and end up costing
their patients more money for
care and treatments.
The goal of appliance therapy
is to provide the best, most eco-

nomical care possible over the
lifetime of the patient —while
providing the dentist the opportunity to offer needed therapy
and make a good living. These
are not mutually exclusive concepts. In this article (and articles
to follow), we'll examine how
this works and how it can build
your practice.
Growth, development, and
early orthodontic treatment
problems don't get better on their

own. Unfortunately, when you
can't recognize the problems —
or feel that you can't address the
problems — you certainly can't
treat or refer these cases early on.
For example, if a patient has
lost teeth early, it is important to
either maintain the existing
space or regain any lost space.
Failure to intervene will cause
crowding in the adult dentition.
Space management ... what
you need to know

See us at AEEDC Dubai 2010, Hall 4, Booth 802

•
Space management is
often the simple key to preventing a serious malocclusion in the
permanent dentition.
•
Maintaining and regaining space are relatively easy
procedures.
•
Ignoring these procedures makes things worse. Supervised neglect — the default
position for all too many dentists
because they haven't been
trained but they have been taught
to fear orthodontics — is not an
option.
•
Follow–up
appointments are generally needed only
to monitor patient growth.
•
The average fee for
these procedures ranges from
$400 to $800 — and may eliminate the need for further orthodontic care later (a potential savings to the patient of $3,500 to
$8,000). Even if you place only
one appliance a month, you can
add an average of $7,200 to your
bottom line. Why wouldn't you do
it?
What you need to learn
What teeth need to be replaced? Children must be evaluated for missing primary teeth in
order to determine if any space
maintenance is necessary. As a
general rule, it is recommended
that all space created by missing
primary teeth be maintained.
The transition period. The
adult cuspid and two premolars
will erupt during the transition
period from the deciduous to the
permanent dentition. The space
available for their eruption and
final position is limited by the position of the first permanent molar and the lateral incisor. If, for
example, a child is brought to you
six months after a tooth has already drifted forward, a mixed
dentition analysis should be performed to determine if the dental
arch still contains enough room
to accommodate the yet
unerupted permanent teeth.
How to do a mixed dentition
analysis. You will need a set of
study casts, a Boley gauge, and a
mixed dentition analysis worksheet. Advantages:
1. User–friendly (beginner or
expert)
2. Time efficient
3. No special equipment or radiographic projections required
4. Easily done in the mouth or
on dental casts
5. Applicable for both dental
arches
What appliance(s) to use and
when. Use of a simple space
maintainer or space retainer after the early loss of primary teeth
is one of the more common clinical procedures in interceptive
orthodontics. Although these
procedures can be done with either fixed or removable appliances, fixed appliances are preferred in most situations because
they eliminate the question of patient cooperation.
Early space management is
the most economical for the patient long term, and the dentist
gets to make a good living while
doing it. It doesn't make any
sense not to do it.

[14] => DTME

DTME template_DTME 3/8/2010 11:22 AM Page 14

DENTAL TRIBUNE Middle East & Africa Edition

14 Events

MIDDLE EAST EVENTS 2010
MARCH

APRIL

Mar 30, 2010 - Apr 2, 2010 - Amman, Jordan
The 22nd Jordanian Dental
Congress 2010
Jordan Dental Association
Tel.: + 962 5 666 161//665 520
Fax: + 962 5 696 479
Website: jda-congress.com

Apr 7, 2010 - Apr 10, 2010 - Istanbul, Turkey
IDEX International Dental
Show
CNR Ekspo Trade Fairs
Istanbul, Turkey
Tel: +90 212 4657475
Fax: +90 212 465 74 76/77
E-mail: info@cnr-idex.com
Website: www.cnr-idex.com

TURKISH DENTAL BUSINESSMEN ASSOCIATION
Tel: +90 212 5881553
Fax: +90 212 5881554
E-mail: dissiad@dissiad.org.tr
Website: www.dissiad.org.tr
Venue: CNR EXPO Istanbul –
Turkey
Apr 15, 2010 - Apr 18, 2010 Damascus, Syria

Healthcare & Dental Damascus
Arabian Group for Exhibitions &
Conferences
Tel: +963 11 4475801
Fax: +963 11 4475070
E-mail: arabiangroup@net.sy
Website:
www.arabiangroup.com
www.healthcare.com.sy

AD

THE 1st SESSION
OF THE 4th GROUP
BEGINS ON MAY 13, 2010
7+(16*5((&(

Venue: Damascus International
Fairground

MAY
May 4, 2010 - May 6, 2010 Doha, Qatar
Qmedic 2010
CONEX
Tel: +974 4442270/71
Fax: +974 4422838
Mobile: +974 3595623
Email: qmedic@conexqatar.com
www.conexqatar.com
www.qmedic.net
Venue: Doha Exhibition Center,
Doha.
May 9, 2010 - May 12, 2010 Riyadh, Saudi Arabia
Saudi Dentistry 2010
Riyadh Exhibitions Co.
Tel: +966 1 2295604
Fax: +966 1 2295612
E-mail: esales@recexpo.com
Website: www.recexpo.com
Contact Person: Habib Alphonse
E-mail:
halphonse@recexpo.com
Venue: Riyadh International Exhibition Center
May 13, 2010 - May 15, 2010 Colombo, Sri Lanka
APDC Asia Pacific Dental
Congress
C/o Sri Lanka Dental Association
Tel/Fax: +94 11 2595147
E-mail: slda@sltnet.lk
Website: www.apdc2010.com //
www.slda.lk
Congress and Exhibition Venue:
Bandaranaike Memorial Convention & Exhibition Centre

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FACULTY:
Dr. Peter Ehrl, Dr.med.dent., Dentist, Oral surgeon, Specialist
Implantology
Dr. Detlef Hildebrand, Dr.med.dent., Dentist, Dental Technician
Dr. Klaus U. Benner, Prof.Dr.med., Anatomy demostration on
human codavers
'U&KULVWLDQ%HUJHUDentist, Oral Surgeon, President BdiZ EDI
'U)UHG%HUJPDQQMaxillofacial Surgeon
Dr. Ronald Younes, DDS, MS, Ph.D., Oral Surgeon
Dr. Nabih Nader, DDS, CES, DU, Oral Surgeon
Dr. Katja Nelson, DDS, PhD, Clinic for Oral- and Maxillofacial
Surgery and Navigation and Robotics
'U*HRUJH*RXPHQRVDDS, MS, DrOdont, Periodontist
Dr. Spyros Karatzas, DDS, MS, DMD, Periodontist

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'U1LNRV.URPSDVDDS, General Dentist
'U&RQVWDQWLQRV/DJKLRVDDS, MS, Endodontist
'U6WUDWLV3DSD]RJORXDDS, MS, PhD, Assistant Professor
University of Athens, Greece
Dr. Stavros Pelekanos Dr.Med. Dent, Assistant Professor
of Prosthodontics, University of Athens, Greece

Fee

8.100€

Dr. Nikos Raptis DDS, Prosthodontist
Dr. Ioannis Fakitsas DDS, DrOdont, Maxillofacial Surgeon

LIMITED NUMBER
OF PARTICIPANTS

SPONSORS:

PERIOD 2010
Location:
$WKHQV%HUOLQ
Total duration
of the lessons:
16 days of clinical
education.
The implants from A to Z:
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Workshops

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For Registration & More Info: Contact Person in Athens:0UV/LWR&KULVWRSKLORSRXORX
¨HO +30 210 21 32 084 | +30 210 22 22 637 Fax.: +30 210 22 22 785 E-mail: lito@omnipress.gr website: www.omnipress.gr

May 13, 2010 - May 14, 2010 Dubai, UAE
4th CAD/CAM & Computerized Dentistry International
Conference
CAPP FZ L.L.C
Tel: +971 4 3616174
Fax: +971 4 3686883
Mob: +971 50 2793711
Email: info@cappmea.com
Website: www.cappmea.com
Venue: Dubai Marina

JUNE
Jun 13, 2010 - Jun 16, 2010 Tehran, Iran
IranMed 2010
Iranian International Exhibitions Company (IIEC)
Tel: +98 21 88206720-1 //
22662801-4
Fax: +98 21 88206720-1
E-mail: info@iranfair.com
Web: www.iranfair.com //
www.iranmedonline.com
Jun 16, 2010 - Jun 20, 2010 Damascus , Syria
SYRIAN DENTECH 2010
United for Int'l Exhibitions &
Conferences
General Manager: Ayman
Shamma'a
Tel: +963 11 3312123
Fax: +963 11 3312423
Mobile: +963 94 213131
E-mail: united.exh@mail.sy //
info@syrianmedicare.com
Web: www.syrianmedicare.com
Venue: Fairground- Airport
Road - Damascus - Syria

[15] => DTME

DTME template_DTME 3/8/2010 11:22 AM Page 15

Time to talk about dry mouth?
Dry mouth is an increasingly common condition, primarily
related to disease and medication use.
In fact more than 400 medicines can cause dry mouth1 and
the prevalence is directly related to the total number of
drugs taken.2

Ask your patient
Some patients develop advanced coping strategies for dealing with
dry mouth, unaware that there are products available that can help
to alleviate the symptoms, like the biotène system.
Diagnosis may also be complicated by the fact physical symptoms
of dry mouth may not occur until salivary flow has been reduced by
50%.3

Diagnosing dry mouth
Four key questions have been validated to help determine the
subjective evaluation of a patient’s dry mouth:4
1
2
3
4

Do you have any difficulty swallowing?
Does your mouth feel dry when eating a meal?
Do you sip liquids to aid in swallowing dry food?
Does the amount of saliva in your mouth seem to be too little, too
much or you do not notice?

Clinical evaluations can also help to pick up on the condition, in
particular:
s USE OF THE MIRROR @STICK TEST PLACE THE MIRROR AGAINST THE BUCCAL
mucosa and tongue. If it adheres to the tissues, then salivary
secretion may be reduced
s CHECKING FOR SALIVA POOLING IS THERE SALIVA POOLING IN THE FLOOR OF
the mouth? If no, salivary rates may be abnormal
s DETERMINING CHANGES IN CARIES RATES AND PRESENTATION LOOKING FOR
unusual sites, e.g. incisal, cuspal and cervical caries.

Consequences of unmanaged dry mouth include caries,
halitosis and oral infections.

Saliva’s natural defences
Saliva’s natural defences contain a mixture of proteins and enzymes,
each of which plays a specific role:5

Protein:
s LACTOFERRIN n CHELATES IRON $EPRIVES BACTERIA OF IRON WHICH IS
essential for bacterial growth.

Enzymes:
s LYSOZYME n DISRUPTS CELL WALLS OF BACTERIA RESULTING IN CELL DEATH
s LACTOPEROXIDASE n SYNTHESIS OF HYPOTHIOCYANITE A POTENT
antimicrobial agent.

The biotène patented salivary LP3 enzyme
system
The biotène formulation supplements natural saliva, providing
some of the missing salivary enzymes and proteins in patients
with xerostomia and hyposalivation to replenish dry mouths.
The biotène system allows patients to choose the right product
to fit in with their lifestyles:
s RELIEF PRODUCTS /RAL "ALANCE GEL
s HYGIENE PRODUCTS TOOTHPASTE AND MOUTHWASH
The range is specifically formulated for the sensitive mucosa of
the dry mouth patient:
s ALCOHOL FREE

s 3,3 FREE

s MILD FLAVOUR

The biotène formulation:
s HELPS MAINTAIN THE ORAL ENVIRONMENT AND PROVIDE PROTECTION
against dry mouth
s HELPS SUPPLEMENT SALIVAS NATURAL DEFENCES
s HELPS SUPPLEMENT SALIVAS NATURAL ANTIBACTERIAL SYSTEM
weakened in a dry mouth.

GSK welcomes
biotène to its oral
care family

leaders in dry mouth treatment
1. %VESON *7 @8EROSTOMIA 0ERIODONTOLOGY 2. 3REEBNY ,- 3CHWARTZ 33 @! REFERENCE GUIDE TO DRUGS AND DRY MOUTH n ND EDITION 'ERODONTOLOGY 3. $AWES # @(OW MUCH
3ALIVA )S %NOUGH FOR !VOIDANCE OF 8EROSTOMIA #ARIES 2ES 4. &OX 0# "USCH +! "AUM "* @3UBJECTIVE REPORTS OF XEROSTOMIA AND OBJECTIVE MEASURES OF SALIVARY GLAND PERFORMANCE *!$!
5. 4ENUVUO * @#LINICAL APPLICATIONS OF ANTIMICROBIAL HOST PROTEINS LACTOPEROXIDASE LYSOZYME AND LACTOFERRIN IN XEROSTOMIA EFFICACY AND SAFETY /RAL $ISEASE

[16] => DTME

DTME template_DTME 3/8/2010 11:23 AM Page 16

Visit A-dec at
AEEDC

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Hall 6
Stand 230

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A-dec Inc.
2601 Crestview Drive, Newberg, Oregon 97132 USA
Tel: +44 2476 322089 Fax: +44 2476 345106 Web: www.a-dec.com

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