News / Industry / Composite artistry in everyday clinical practice… with BioSmart restoratives / News / Matching of CBCT and virtual wax-up for single-tooth replacement of a central incisor / New materials for a classic indication / News
News
01 - 02 viewIndustry
06 - 10 viewComposite artistry in everyday clinical practice… with BioSmart restoratives
12 - 12 viewNews
14 - 14 viewMatching of CBCT and virtual wax-up for single-tooth replacement of a central incisor
16 - 22 viewNew materials for a classic indication
22 - 24 viewNews
26 - 34 viewArray
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[1] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
NL
Y
O
LS
NA
IO
SS
FE
O
PR
NT
AL
DE
www.dental-tribune.me
PUBLISHED IN DUBAI
May-June 2019 | No. 3, Vol. 9
ENDO TRIBUNE
LAB TRIBUNE
IMPLANT TRIBUNE
ORTHO TRIBUNE
HYGIENE TRIBUNE
Endodontics white paper
callsfor treatment to consider
patient health
Metal-free aesthetics in
everyday lab work
Prevention 0:
The best way to prevent
peri-implant disease?
Tooth whitening and
orthodontics:
The icing on the cake
Plaque bacteria prove no match
for guided biofilm therapy
ÿA1-4
ÿB1-4
ÿC1-4
ÿD1-4
ÿE1-8
14th CAD/CAM & Digital Dentistry Conference
& Exhibition Highlights
DENTAL TRIBUNE
© CAPP
The World’s Dental Newspaper Middle East & Africa Edition
[2] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
2
NEWS
IMPRINT
PUBLISHER/
CHIEF EXECUTIVE OFFICER
Torsten R. OEMUS
Dentsply Sirona at IDS 2019
Innovative and efficient: Dentsply Sirona presented itself
as a new, dynamic and agile company and impressed
at the IDS 2019 with substantial products
By Dentsply Sirona
Spread over two booths with a total
of more than 2,000 square meters,
Dentsply Sirona made a spectacular
impression at the IDS 2019. Bringing
to life the motto "Inspired by your
needs," the world's largest manufacturer of dental products and technologies presented innovations that
are set to have a sustained impact on
dentistry. The products presented,
such as Primescan, play a key role
in helping dentists and dental technicians provide their patients with
optimal treatment. The Dentsply
Sirona team, wearing matching blue
and orange sneakers, demonstrated
a unified spirit in presenting Dentsply Sirona as a customer-centric
company.
“At IDS 2019, we demonstrated that
'Inspired by your needs' is much
more than just a motto for us," said
Don Casey, CEO of Dentsply Sirona.
"Our mission is to translate the
needs of dentists into products. We
have shown over these five days that
we can make a difference for dental
professionals with our investment
in R&D, education and training.
Dentsply Sirona has presented itself
as a new, dynamic and agile company that focuses on one thing above
all else: the customer. More than
14,000 live demonstrations at the
IDS booth and 300 product courses
in one week underline this impressively. It is this interaction with our
customers that drives us forward as
a company and complements our
$150 million annual investment in
R&D.”
Innovations that will have a
major impact on dentistry
Of the numerous innovations that
Dentsply Sirona presented at its two
booths, Primescan, the new intraoral
scanner for CEREC and digital impressions, stood out by far. In the
more than 100 live treatment pro-
“cheese” and received their personalized copy of the magazine.
Over 14,000 demonstrations were
held to explain the new products and
how they function to visitors to the
booths. In addition, more than 3,000
dentists and dental technicians took
the opportunity to participate in
training events. The focus here was
on treatment plans for endodontics
as well as issues relating to digital imaging and dental technology.
The Dentsply Sirona team at IDS 2019
cedures on two stages directly at the
booths, visitors could see for themselves just how quickly, easily, and
precisely impressions can be produced with Primescan. A whole-arch
scan of previously unseen accuracy
can be produced with Primescan in
less than one minute, making this
product a versatile partner for all areas of dentistry from restorative treatments and orthodontics to implant
dentistry. One example of this is the
fully digital production of SureSmile
Aligners for straightening teeth. For
this, the scan is combined with a
2D X-ray and a photo of the patient.
Seamless, validated interfaces simplify the process noticeably, giving
dentists the flexibility they desire.
Surefil one, an innovative filling concept for the posterior tooth region,
also attracted a high level of interest.
The self-adhesive restoration material combines the simplicity of a glass
ionomer with the stability of a conventional composite and also has
good esthetic properties. This allows
a cavity to be treated in just one layer
without retentive preparation. This
makes the entire treatment process
four steps shorter, cutting the treatment time by about seven minutes.
Visitors to the booth were able to experience the innovations first hand
in live demonstrations and even try
them out themselves on the model.
More interaction,
more training
Dentsply Sirona used the IDS 2019 to
engage in in-depth discussions with
customers and partners. The survey
"1 profession. 1000 jobs." provided a
great starting point for this – numerous visitors to the booth took part at
www.1profession1000jobs.com, and
the results confirmed beyond doubt
that, in addition to treating patients,
dentists and dental technicians perform a whole range of other tasks.
The company received a wealth of
feedback from the countless discussions held at the booths. As a token of
appreciation, visitors were presented
with a Dentsply Sirona rubber duck:
"Resto Rebecca", "Preventive Preston", "Lab Lara" and their brightly
colored colleagues soon became the
stars of the tradeshow. The cheerful
ducks, featuring a dental design, almost became collector's items and,
at the end of the five-day tradeshow,
more than 12,000 ducks had found a
new home.
The popular photo opportunity at
the Treatment Centers booth was
once again a real crowd pleaser. Visitors were able to pose for their personalized cover of the new trenDS
magazine containing details of the
four new international design trends
for practices in 2019/2020. More
than 2,500 tradeshow visitors said
At the Implants booth, visitors were
able to find out more about Azento,
the latest workflow solution for single tooth replacement that enables
practices to provide consistently
excellent customized implant treatment. And in the spirit of customization, over 2,500 visitors received a
personalized Azento milkshake with
their selfie printed on top.
The very best support for
day-to-day work with
patients
"The feedback from our customers
has confirmed that our dedicated
team has worked on the 'right' product solutions that make a real difference in everyday practice,” Casey
reflected. "It was also impressive to
see how much the Dentsply Sirona
team has grown together – visually
expressed by our IDS sneakers."
Note – due to different approval and
registration times, not all technologies and products are immediately
available in all countries.
Dentsply Sirona
21st Floor, The Bay Gate Tower
Business Bay, Al Sa’ada Street
Dubai, United Arab Emirates
Tel.: +971 (0)4 523 0600
Web: www.dentsplysirona.com/MENA
E: MEA-Marketing@dentsplysirona.com
CHIEF FINANCIAL OFFICER
Dan WUNDERLICH
DIRECTOR OF CONTENT
Claudia DUSCHEK
SENIOR EDITORS
Jeremy BOOTH
Michelle HODAS
CLINICAL EDITORS
Nathalie SCHÜLLER
Magda WOJTKIEWICZ
EDITORS
Franziska BEIER
Brendan DAY
Monique MEHLER
Kasper MUSSCHE
COPY EDITOR
Ann-Katrin PAULICK
Sabrina RAAFF
BUSINESS DEVELOPMENT & MARKETING
MANAGER
Alyson BUCHENAU
DIGITAL PRODUCTION MANAGER
Tom CARVALHO
Andreas HORSKY
Hannes KUSCHICK
PROJECT MANAGER ONLINE
Chao TONG
WEBSITE DEVELOPMENT
Serban VERES
E-LEARNING MANAGER
Lars HOFFMANN
SALES & PRODUCTION SUPPORT
Puja DAYA
Hajir SHUBBAR
Madleen ZOCH
EXECUTIVE ASSISTANT
Doreen HAFERKORN
ACCOUNTING
Karen HAMATSCHEK
Anita MAJTENYI
Manuela WACHTEL
EXECUTIVE PRODUCER
Gernot MEYER
ADVERTISING DISPOSITION
Marius MEZGER
DENTAL TRIBUNE INTERNATIONAL
Holbeinstr. 29, 04229 Leipzig, Germany
Tel.: +49 341 48 474 302
Fax: +49 341 48 474 173
www.dental-tribune.com
info@dental-tribune.com
DENTAL TRIBUNE ASIA PACIFIC LTD.
Room A, 20/F
Harvard Commercial Building
105–111 Thomson Road, Wanchai, HK
Tel.: +852 3113 6177
Fax: +852 3113 6199
THE AMERICA, LLC
116 West 23rd Street, Ste. 500, New York
N.Y. 10011, USA
Tel.: +1 212 244 7181
Fax: +1 212 244 7185
DENTAL TRIBUNE MEA EDITION EDITORIAL
BOARD
Dr. Aisha SULTAN ALSUWAIDI, UAE
Prof. Paul TIPTON, UK
Prof. Khaled BALTO, KSA
Dr. Ninette BANDAY, UAE
Dr. Nabeel HUMOOD ALSABEEHA, UAE
Dr. Naif Almosa, KSA
Dr. Mohammad AL-OBAIDA, KSA
Dr. Meshari F. ALOTAIBI, KSA
Dr. Jasim M. AL-SAEEDI, Oman
Dr. Mohammed AL-DARWISH, Qatar
Dr. Dobrina MOLLOVA, UAE
Dr. Ahmed KAZI, UAE
Dr. Munir SILWADI, UAE
Dr. Khaled ABOUSEADA, KSA
Dr. Rabih ABI NADER, UAE
Dr. Ehab RASHED, UAE
Aiham FARRAH, CDT, UAE
Retty M. MATTHEW, UAE
PARTNERS
Saudi Dental Society
Saudi Ortho Society
Lebanese Dental Association
Lebanese Orthodontic Society
Qatar Dental Society
Oman Dental Society
Kuwait Dental Association
American Academy of Implant Dentistry
International Federation of Dental
Hygienist
British Academy of Restorative Dentistry
British Academy of Dental Implantology
AALZ - Aachen Dental Laser Center
Singapore Dental Association
DIRECTOR OF mCME
Dr. Dobrina MOLLOVA
mollova@dental-tribune.me
Tel.: +971 50 42 43072
More than 100 live treatment procedures on the stand.
The Dentsply Sirona stand, spread over two booths with a total of more than 2,000
square meters.
DIRECTOR
Tzvetan DEYANOV
deyanov@dental-tribune.me
Tel.: +971 55 11 28 581
EDITING & DESIGN
Kinga MOLLOV
k.romik@dental-tribune.me
Tel.: +971 56 23 70 721
PRINTING HOUSE & DISTRIBUTION
Al Nisr Printing
P. O. Box 6519, Dubai, UAE
800 4585/04-4067170
©2018, Dental Tribune International GmbH.
The Dentsply Sirona IDS 2019 Press Conference
Over 14,000 demonstrations took place on the Dentsply Sirona stand at IDS 2019
All rights reserved. Dental Tribune International 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.
[3] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
»Usability is my goal.
And Primescan is my answer.«
Florian Sobirey, UX-Designer
Primescan
E
ngineered for superior performance.
Innovation requires commitment to ambition: Primescan sets new standards in dental technology,
making scanning more accurate, faster and easier than ever. It is engineered to enable all kind of
treatments, from single tooth to full arch. An increased field of view and the dynamic depth scanning
technology ensure a high data density right from the first scan. The excellent results are immediately
displayed on the wide format touchscreen of the new Acquisition Center. With Primescan, intraoral
scanning is as easy as never before.
Enjoy the scan.
Learn more at: dentsplysirona.com/primescan
[4] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
Gunnar Reich, Germany
The next generation polyether:
Superfast. Super detailed.
Taking outstandingly precise impressions in an efficient procedure – this
is feasible for everyone using the new 3M™ Impregum™ Penta™ Super Quick
Polyether Impression Material launched by 3M in April 2018. The material
offers a working time of 45 seconds and an intraoral setting time of only
two minutes.
It is thus as fast as or even faster than many quick-setting VPS-based
impression materials and particularly suited for impression taking in the
context of producing single-unit restorations or small bridges. In addition to the
increased speed, it offers all proven polyether benefits that lead to a reliable
clinical performance and highly accurate results. These include a great flow
behavior and an intrinsic hydrophilicity, i.e. high affinity to water, which ensure
that the material flows deeply into the sulcus and captures every detail. In
addition, polyethers maintain their flowability consistently throughout the
Case 1
whole working time, meaning that a user does not need to be afraid of any
premature setting reaction that may have a negative effect on the quality of
the final impression.
The use of the new material developed for the monophase technique –
3M™ Impregum™ Penta™ Super Quick Medium Body Polyether Impression
Material – is demonstrated showing two different patient cases.
The first patient had a fractured composite restoration on her lower first molar
that needed to be replaced. The second patient had previously received an
implant in the region of the upper first premolar. After the healing phase,
the final prosthetic work needed to be produced and placed. A closed tray
impression technique was used in this case.
Case 2
1
2
7
8
3
4
9
10
Fig. 7: Initial situation of case 2: Implant with healing cap six months after
implant placement.
Fig. 8: Syringing of 3M™ Impregum™ Penta™ Super Quick Medium Body Polyether
Impression Material around the impression coping with the 3M™ Penta™
Elastomer Syringe.
5
Fig. 9: Impression coping securely fixed in the impression that was taken using
the monophase technique and a closed tray.
6
Fig. 1: Initial situation of case 1: Fractured old composite restoration on the
lower first molar.
Fig. 10: Final veneered all-ceramic crown cemented on an implant abutment.
Fig. 2: Deep distal preparation with bleeding from inflamed gingival tissue.
Fig. 3: Challenging moisture control and bleeding managed by using a soaked
retraction cord.
Fig. 4: Impression taken with the monophase technique. Syringing of 3M™
Impregum™ Penta™ Super Quick Polyether Impression Material (Medium Body)
around the preparation with the 3M™ Penta™ Elastomer Syringe.
Fig. 5: Final monophase precision impression made of 3M™ Impregum™ Penta™
Super Quick Polyether Impression Material (Medium Body).
Fig. 6: Final situation: 3M™ Lava™ Esthetic Fluorescent Full-Contour Zirconia
restoration cemented with 3M™ RelyX™ Unicem 2 Self-Adhesive Resin Cement.
Dr. med. dent. Gunnar Reich
gunnar.reich@web.de
Dr. Gunnar Reich attended the Universities of Munich and Berlin
and obtained his Dr. med. dent. (DDS) degree in 1986. Ever
since, he has been practicing dentistry in the South of Germany.
Today, he is the owner of a private practice in Munich.
3M, Impregum, Lava, Penta and RelyX are trademarks of 3M Company or 3M Deutschland GmbH. Used under license in Canada. © 3M 2019. All rights reserved.
3M™ Impregum™ Super Quick Polyether Impression Material
Be impressed.
[5] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
3M™ Impregum™ Super Quick
Polyether Impression Material
Capture every
detail in 2 minutes?
Yes, it can.
Ideal for smaller cases with
superfast 2-minute setting.
A brand new chemistry unites
world-class polyether precision with
the speed of a VPS material.
A significantly improved taste
and less time in the mouth make
a better patient experience.
3M.com/Impregum
3M and Impregum are trademarks of 3M Company or 3M Deutschland GmbH. Used under license in Canada. © 3M 2019. All rights reserved.
[6] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
6
INDUSTRY
Dental Tribune Middle East & Africa Edition | 3/2019
3D Printing in Dental:
Ready for Adoption by the Majority
By Rik Jacobs, The Netherlands
Last year I published an article on
LinkedIn: “3D Printing: Sustainable
Additive Innovations Transforming
the Dental Industry.” In this article, I
shared my vision and journey to redefine digital dentistry with innovations in additive technology. It summarizes 10 years of advancements
that have culminated in the NextDent 5100–a plug-and-play system
with a trusted connection, hardware,
firmware, software and biocompatible, certified dental materials.
Beyond biocompatibility, the most
important requirement for a dental
technology or product is quality assurance in terms of accuracy and fit.
In order to improve oral care, predictable quality and the performance of
a medical device is necessary. As a
result, the dental industry has transitioned from cumbersome analog
solutions to digital subtractive technologies. In looking at analog versus
digital techniques, it was obvious to
me that stable quality became more
predictable with the use of the scanning and software solutions that
have been introduced over the last
several years. Yet with all the benefits
these digital subtractive solutions
have brought to the industry, they
have essentially hit their limits. This
is why an additive solution made so
much sense to me after more than
20 years in the dental industry.
Additive manufacturing brings complete freedom of design enabling
complex geometries that are unattainable with subtractive solutions.
The speed at which parts are created
can be up to 4X faster for different
indications often at lower cost than
possible with subtractive. Finally,
with subtractive solutions environmental waste can be many times
larger than the weight of the part
itself; and near zero with additive solutions. These reasons reinforced my
belief that additive manufacturing
was the perfect technology for multiple dental applications: models, surgical guides, try-ins, dentures, longterm temporaries, copings, frames,
trays and orthodontics. In any dental
lab or clinic, the technicians could be
addressing several of these in any
given day. Additive manufacturing
solutions provide the flexibility to
address multiple applications and
just-in-time production. This was
the motivation for producing the
NextDent 5100 solution. I saw the
need for a robust quality dental production printer with rapid printing
speeds, flexibility to change materials, ease-of-use, and biocompatible
certified materials.
In the months after Lab Day 2018,
we were busy optimizing the NextDent 5100 printer and materials
with feedback from our global beta
testers to ensure that once shipped,
the printer would fulfill our promise
and perform in accordance with the
intended use. Through this collaboration with our beta testers, the advancements we’ve been able to make
in the last 12 months are comparable
Rik Jacobs - VP, GM for NextDent 3D Systems
to what the dental industry achieved
in the 10 years that preceded them.
I couldn’t have been prouder when
we shipped our first NextDent 5100s
to our end users, and have been delighted with the reports from labs
and clinics on how it’s transforming
workflows and capabilities. Much of
the feedback was validation of the
benefits and outcomes we anticipated in terms of speed, accuracy and
cost. Even more exciting, however
was all the positive activity in regards
to things we hadn’t even thought of.
For example, we saw the birth of the
“NextDent Users’ Group” on social
media without any intervention
on behalf of 3D Systems. This user
group is comprised of thousands of
bright dental industry professionals who share their experiences and
knowledge with one another. We’ve
seen this group experimenting with
new indications in light of the NextDent 5100’s capabilities resulting
in impressive applications such as
staged printing or new indications
like full arch implant bridges and
dentures on implants.
A successful worldwide distribution
would not have been possible without our highly knowledgeable and
responsive resellers, who are also
qualified as certified medical device
distributors. We made a conscious
decision as part of our strategy to
only work with qualified, certified
dental and medical device distributors. Additionally, we chose resellers
who have proven themselves to be
experienced dental CAD/CAM service providers. We believe the certification, experience and expertise
AD
Dental Tribune International
PRINT
EVENTS
SERVICES
EDUCATION
DIGITAL
The World's
Largest Dental
Marketplace
www.dental-tribune.com
will help ensure our customers will
receive the highest levels of service
and support as they incorporate the
NextDent 5100 to transform their
workflows. I am confident we selected the right resellers by following our
rigorous qualification procedure.
While our 3D Systems NextDent
team has been convinced for several
years that the market was ready for
our solution, we were glad to see
proof of our conviction through a
number of unsolicited external validation points:
• In the top 10 list of new dental products for 2018, the top 4 were all newly
launched 3D printers, which proves
this industry-changing technology has been making a huge impact.
(DentalCompare)
• 3D printers were named the second leading technology (after digital
x-ray sensors) in the category “Running Away in 2018.” This category of
products dominated media coverage and received the most attention
throughout the year. 3D printing
only missed out on being number
one by a handful of hits. Much like
cone beam systems, 3D printers
hold the possibility of shaking up restorative, orthodontic, implant, and
general dentistry in countless ways.
(DentalCompare)
• Traditional lines are being blurred
for dental care providers due to the
consolidation going on by Dental
Service Organizations, as well as
within clinical and lab settings.
• The Dentalcompare “most popular dental article of 2018” focused
on 3D printing. In fact it was a Q&A
with me that occurred shortly after
we announced the NextDent 5100
at Lab Day 2018. This was validation
that people were keenly interested in
the solution we were bringing to the
market.
• Advancements in key areas like
scanning, software, materials - combined with the 3D printing quality
of the NextDent 5100 - enable the
accuracy required for 3D printing to
reach the tipping point in the dental
industry in 2018.
This is all to say that the timing of
the NextDent 5100 printer could
not have been better. We formulated
new biocompatible materials to take
advantage of unparalleled printer
accuracy and speed delivered by
the most experienced 3D Printing
OEM. We implemented a scanning
system with a matrix code on the
bottle to show relevant authorities
that we have secured our certification approval so labs and clinics can
have complete confidence in their
work. We integrated 3D Systems’ 3D
Sprint software, which we optimized
for ease-of-use and with a trusted
connection with dental software
suppliers. Then, in the second half
of 2018 we received the official Class
II certification for our NextDent Micro Filled Hybrid Crown and Bridge
material in six different colors. In
November, we proudly announced
that the NextDent5100 became part
of the Ceramill workflow as a result
of a close cooperation with Amann
Girrbach. For all dental applications,
we ensured the 3D printed output
was specifically designed for the intended use and took cost into consideration - minimizing the cost per job
based on the printer price and waste
savings. All this within our first year,
and we are rolling into 2019 with an
incredible degree of positive momentum and market support.
We take our responsibility very
seriously to deliver long-term performance and safety, and we continuously review clinical events
specific to defined patient populations, as well as within more representative populations of users and
patients. Post-market surveillance is
an integral and ongoing part of delivering a quality system and is a regulatory requirement we uphold with
the highest priority.
Close cooperation with our resellers
and our early adopters/new NextDent key opinion leaders has proven
critical and informative. We also
recently founded a users’ group for
the NextDent community that represents a global pool of experienced
users in the clinical, laboratory and
educational environments.
For more information contact:
3D Middle East, 3D Systems Distributor
3204 Prism Tower, Business Bay
P.O. Box 28820, Dubai, UAE
Tel: +971 4 443 3853
E-mail: info@3d-me.com
Web: www.3d-me.com
[7] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
WhatsApp
Enquiry
+971502793711
08–09 November 2019
InterContinental Hotel
DFC, Dubai, UAE
Dental Hygienist Seminar
Training at the Exhibition
Poster Presentation
Hands-On Courses
ORGANISED BY
www.cappmea.com/aesthetic
[8] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
8
INDUSTRY
Dental Tribune Middle East & Africa Edition | 3/2019
The new eye-catching W&H logo. The design is clearer and more focused.
New corporate design for W&H
W&H has a fresh new look: the renowned medical technology company has a new,
even more modern corporate design to go with its new strategic orientation.
“W&H has developed from a supplier of products into a provider of
solutions, and is offering more and
more digital solutions to support
everyday practice. W&H’s product
range boasts innumerable innovations, with products that are easy to
use, reliable and feature a modern
design. This is exactly what should
be reflected by the corporate design.
The new design strengthens W&H’s
profile in relation to its competitors.
W&H has also defined individual
brand identities for the new business
areas W&H Med and W&H Vet,” says
Anita Thallinger, Director of Marketing, on the subject of the new corporate design.
© W&H
Under the motto, ‘Simple. Clear.
Modern.’, W&H has created an image that shows it’s ready to take on
the future. New logo, new font, more
designs and colours – perfect for all
digital channels. The aim of the relaunch was to achieve a gentle, but
still clearly noticeable change that
would outwardly reflect the rapid
development of the W&H Group
whilst staying close to the W&H core
values.
© W&H
By W&H
The aim of the was a gentle, but still clearly noticeable change that would outwardly
reflect the rapid development of the W&H Group.
New logo, new font, more designs and colours – perfect for all digital channels.
W&H logo remains the
central element
Experience W&H online
The corporate design, which was
produced in collaboration with Gerhard Andraschko-Sorgo and his design and advertising agency “Linie
3”, immediately catches the eye. The
central element of the W&H logo, the
hexagon shape, remains the same.
However, the design is now clearer
and more focused. Together with
the new corporate font “Neue Hel-
vetica World”, W&H’s look has been
given a new burst of energy thanks
to a range of additional colours that
complement the traditional apple
green, as well as a modern image and
design language. In order to create
a clear distinction between the two
new business areas W&H Med (human medicine) and W&H Vet (veterinary medicine), the former features
a dazzling cyan blue, and the latter
an eye-catching turquoise green.
For W&H, usability for customers
is essential. Which is another factor
that influenced the new corporate
design. As part of the relaunch, the
website has also been revised. It is
now fully responsive, looks much
more modern and has more space
for products and digital content.
Large images and a new navigation
tool make browsing much easier and
encourage customers to explore the
world of W&H. “Our international
websites have featured the new corporate design since the middle of
March. By the end of the year, the
new corporate design will be visible
across all channels and countries”,
says Anita Thallinger on the relaunch
of the wh.com website.
For more information, please visit:
wh.com
AD
Temporary crown & bridge material
• Less than 5 min. processing time
• Strong functional load
• Perfect long-term aesthetics
• Excellent biocompatibility
Kaltpolymerisierendes provisorisches Kronenund Brückenmaterial, Paste-Paste-System
Material provisório polimerizável a frio
para coroas e pontes, sistema pasta-pasta
50 ml cartridge / mixing tips
Made in Germany
0482
Glass Ionomer Filling Cement
Light-curing micro-hybrid composite
• Applicable for various indications
• Attributes which ensure aesthetic results
• Excellent physical properties
• High filler content
• Packable consistency (also available
as Composan LCM flow)
• For fillings of classe I, III and IV
• Excellent biocompatibility and low acidity
• High compressive strength
• No temperature rise during setting
• Enamel-like translucency
• Excellent radiopacity
• Stable and abrasion resistant
Visit www.promedica.de to see all our products
Dental Material GmbH
24537 Neumünster / Germany
Tel.
+49 43 21 / 5 41 73
Fax
+49 43 21 / 5 19 08
eMail
info@promedica.de
Internet www.promedica.de
[9] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
Dental Tribune Middle East & Africa Edition | 3/2019
9
INDUSTRY
3Shape wins two Red Dot design awards
By DTI
COPENHAGEN, Denmark: 3Shape,
a global leader in 3-D scanners and
CAD/CAM software solutions, has
received two prestigious Red Dot
awards for high-quality product
design. The two design awards
were presented to the just-released
3Shape TRIOS 4 intra-oral scanner
and the TRIOS MOVE+.
The 3Shape solutions were selected
by the Red Dot global jury from
more than 5,500 entries. The distinction marks the fifth and sixth 3Shape
solution given a Red Dot product design award over the past three years.
Nikolaj Deichmann, 3Shape cofounder and co-CEO, said: “We are
very proud to receive the Red Dot
awards and appreciate the jury’s recognition. The awards not only highlight the value of our solutions, they
also celebrate our company’s design
philosophy. 3Shape creates solutions
to enable dental professionals to bet-
ter care for their patients. But an important part of that is making sure
that the form and function of our
solutions is equally outstanding. The
Red Dot awards acknowledge this.”
3Shape TRIOS 4 is the world’s first
intra-oral scanner that allows for
timely detection of both surface and
interproximal caries with a single
scanner. Now with the release of the
brand-new TRIOS 4, intra-oral scanners will no longer be used only for
restorative and orthodontic applica-
tions. These are diagnostic applications that do not emit radiation. The
wireless TRIOS 4 delivers its caries
innovation without compromise to
ergonomics or an increase in the size
and weight of the scanner.
3Shape TRIOS MOVE+ is one of
three hardware set-up options for
the TRIOS intra-oral scanner. TRIOS
MOVE+ now features a larger 15.6
in. touch screen attached to an arm
and an elegant, easy-to-move stand
with a mounted PC. Dentists can
easily move and position the TRIOS
MOVE+, as well as use its touch
screen as a canvas to design and
discuss treatments with patients.
TRIOS MOVE+ helps to drive patient
involvement and case acceptance in
conjunction with 3Shape patient excitement apps like TRIOS Treatment
Simulator and TRIOS Smile Design.
The new Chiropro & Chiropro PLUS
Bien-Air Dental unveils its new range of implant and oral surgery motors
By BienAir
BIENNE, Switzerland: During the 2018 EAO
congress, Bien-Air Dental presented its two
new implant and oral surgery motors, the
new Chiropro and the Chiropro PLUS.
Designed to simplify the fitting of implants
as well as oral surgery procedures, the new
Chiropro and Chiropro PLUS have been fully
developed around a single philosophy: Simplicity.
A single control knob allows you to control
the entire system. Simply turn the knob to
navigate via the menus and adjust the settings, and press it to confirm the selected
value. Moreover, the control knob – the only
point of contact between dentists and the unit
during procedures – can be easily removed
and sterilised to simplify maintenance.
Thanks to their clear and concise interface,
the new Chiropro and Chiropro PLUS plainly
display all the information required for procedures to go smoothly: type of instrument,
speed, torque, irrigation flow and direction of
rotation. Pre-set operating protocols and the
option to modify settings based on patients'
dental features, also make the new Chiropro
and Chiropro PLUS easier to use.
Although these two systems are both easy
to use, the new Chiropro and Chiropro PLUS
have different fields of application. Whereas
the new Chiropro is mainly dedicated to implantology procedures, the Chiropro PLUS
enables you to perform both implantology
procedures and oral surgery procedures.
Owing to the fact that each clinical discipline
requires a very specific group of instruments,
the new Chiropro and Chiropro PLUS units
can be connected to the relevant micromotor and rotary instrument required for each
procedure.
Implantology
Powered by the Chiropro (Chiropro PLUS
resp.), the new MX-i micromotor (MX-i PLUS
resp.) and CA 20:1 handpiece combine to offer you the very best rotary technology for all
your implantology procedures. Coupled with
the MX-i micromotor (MX-i PLUS resp.), the
CA 20:1 handpiece provides an exceptionally
stable speed, for precise and smooth procedures. As well as offering an unparalleled service life, the CA 20:1 handpiece is fitted with
a brand-new internal irrigation system. The
irrigation line will not inconvenience dentists
when they are using the handpiece.
particular. Thanks to the high power of the PM
1:2, the cutting time is reduced by 70% (just 12
seconds to fully section a tooth) and the force
required is significantly reduced. The risk of
overheating is considerably lowered thanks to
the self-cooling system built into the MX-i PLUS.
Oral surgery &
periodontology
You can also carry out oral surgery and periodontology procedures using the combination
of the Chiropro PLUS, MX-i PLUS micromotor
and the new CA 1:2.5 handpiece. The angular
shape of the handpiece proves better suited to
the target operating area than a straight hand-
piece, and the high torque of the MX-i PLUS and
its built-in self-cooling system guarantee procedures can be performed quickly without the
instrument overheating, even during long and
complex procedures.
For further information, please contact:
Bien-Air Dental
Länggasse 60, 2500 Bienne 6, Switzerland
E-mail: fanny.vongunten@bienair.com
Web: www.bienair.com
AD
Oral surgery (including wisdom
tooth extraction)
Combined with the PM 1:2 straight handpiece
and the MX-i PLUS micromotor, the Chiropro PLUS is the ideal solution for oral surgery
procedures, and wisdom tooth extraction in
ultimate
reliability
60
MONTHS
OF WARRANTY
Bien-Air Chiropro PLUS (right)
YEARS
OF KNOW-HOW
60 years of know-how and passion is the
secret that leads Bien-Air Dental today
to offer exceptionally reliable products.
Discover all our expertise and attention to
detail in the new TORNADO X turbine.
60 MONTHS OF WARRANTY
DENTAL@BIENAIR.COM
Bien-Air new Chiropro (front)
Bien-Air Dental SA Länggasse 60 Case postale CH-2500 Bienne 6 Switzerland Tel +41 (0)32 344 64 64 dental@bienair.com www.bienair.com
190218_DTMEA_TornadoX_122x188_.indd 1
02.04.19 13:33
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10
INDUSTRY
Dental Tribune Middle East & Africa Edition | 3/2019
Dynamic Duos Reign Supreme
for Beverly Hills Formula
By Beverly Hills Formula
ingredients – the brand’s perfect
pairings are vital products for anyone looking to get a ‘Hollywood
Smile’ in the comfort of their own
home.
They say that one is lonely and two
is company – indeed this is definitely
the mantra that oral care brand Beverly Hills Formula have chosen to
live by. Once again, the Irish-based
brand has cited their Perfect White
Range as being one of the top performing at-home teeth whitening
ranges on the market today – and
it is their Perfect Pairings within this
range that have been the driving
force behind its success.
Launched in 2012, the Perfect White
Range has been growing continuously strong ever since, and the
brand has seen huge success across
the Middle East. The range is now
available in UAE, Jordon, Lebanon,
Oman, Qatar, Kuwait, Bahrain, Iran
and Saudi Arabia. A combination
of clever branding, high impact colours, and a vow remain true to their
intrinsic values (safe, affordable and
effective) has ensured that the Perfect White Range continuously remains at the forefront of consumer’s
minds.
The Perfect White Family consists of
the infamous Perfect White Black,
Perfect White Gold, Perfect White,
Perfect White Sensitive, Perfect
White Black Sensitive and Perfect
White Black Mouthwash. Joining
them were their most recent prod-
Perfect White Black and Perfect White Black Mouthwash
Perfect White Black and Perfect
White Black Mouthwash go hand in
hand to give an all-round, highly effective clean, the effects of which can
be felt throughout the day. The brand
were first to market with the secret
weapon of Activated Charcoal, which
has been clinically proven to be one
of the most effective teeth whitening
ingredients available today. Activate
Charcoal is known for its love of tannins and is the ideal ingredient to
add to a whitening product. Perfect
White Black works to whiten teeth,
remove surface and deep stains and
helps to eliminate the bacteria that
causes nasty bad breath.
Perfect White Black and Perfect White Black Mouthwash and Perfect White Gold and
Perfect White Gold Mouthwash
ucts - Perfect White Optic Blue, Perfect White Gold Mouthwash and the
Perfect White Whitening Kit.
Within this range, it is their ‘dynamic
duos’ that have given them the edge
against their competitors, and have
ensured that Beverly Hills Formula
remain the stand-out option for consumers today. The duos work symbiotically and effortlessly complement
each other – as all good partnerships
should! Two very different colours,
two very different and cutting edge
Complimenting this hero product
is Perfect White Black Mouthwash
which has been scientifically formulated to combat bad breath. The
‘shake to activate’ formula also contains Activated Charcoal which helps
eliminate the bacteria that cause bad
breath and neutralises remaining
odours for lasting freshness. In addition, Pyrophosphates help remove
surface and deep stains.
Perfect White Gold and Perfect White Gold Mouthwash
The Golden Duo has quickly caught
up with the success of the Perfect
White Black products, thanks to its
highly innovative ingredients. Containing real gold particles, known for
their anti-inflammatory properties
alongside Beverly Hills Formula’s
non-abrasive stain removal power,
it is not hard to see why this has become one of the most popular products for the brand. It’s partner, the
opulent Perfect White Gold Mouthwash which also contains real gold.
This luxurious mouthwash eliminates bad breath and provides a longlasting freshness. The ‘shake to activate’ formula and Pyrophosphates
help to further remove surface and
deep stains for a brighter and whiter
smile. Scientifically formulated to
combat bad breath, this innovative
mouthwash is made from crueltyfree ingredients and does not contain parabens – the ideal pairing for
those seeking some luxury!
For more information contact:
Beverly Hills Formula
Unit P1/P2 North Ring Business Park
Swords Road, Dublin, 9, Ireland
Web: www.beverlyhillsformula.com
E-mail: info@beverlyhillsformula.com
Tel: + 353 1 842 6611
Fax: + 353 1 842 6647
The new Chiropro & Chiropro PLUS –
Bien-Air Dental unveils its new range of
implant and oral surgery motors
By BienAir
BIENNE, Switzerland: During the
2018 EAO congress, Bien-Air Dental
presented its two new implant and
oral surgery motors, the new Chiropro and the Chiropro PLUS.
Designed to simplify the fitting
of implants as well as oral surgery
procedures, the new Chiropro and
Chiropro PLUS have been fully de-
Chiropro & Chiropro PLUS
veloped around a single philosophy:
Simplicity.
A single control knob allows you
to control the entire system. Simply turn the knob to navigate via
the menus and adjust the settings,
and press it to confirm the selected
value. Moreover, the control knob
– the only point of contact between
dentists and the unit during procedures – can be easily removed and
sterilised to simplify maintenance.
Thanks to their clear and concise
interface, the new Chiropro and Chiropro PLUS plainly display all the
information required for procedures
to go smoothly: type of instrument,
speed, torque, irrigation flow and direction of rotation. Pre-set operating
protocols and the option to modify
settings based on patients' dental
features, also make the new Chiropro
and Chiropro PLUS easier to use.
Although these two systems are
both easy to use, the new Chiropro
and Chiropro PLUS have different
fields of application. Whereas the
new Chiropro is mainly dedicated to
implantology procedures, the Chiropro PLUS enables you to perform
both implantology procedures and
oral surgery procedures.
Owing to the fact that each clinical
discipline requires a very specific
group of instruments, the new Chiropro and Chiropro PLUS units can
be connected to the relevant micromotor and rotary instrument required for each procedure.
Implantology
Powered by the Chiropro (Chiropro
PLUS resp.), the new MX-i micromotor (MX-i PLUS resp.) and CA 20:1
handpiece combine to offer you
the very best rotary technology for
all your implantology procedures.
Coupled with the MX-i micromotor (MX-i PLUS resp.), the CA 20:1
handpiece provides an exceptionally
stable speed, for precise and smooth
procedures. As well as offering an
unparalleled service life, the CA 20:1
handpiece is fitted with a brand-new
internal irrigation system. The irrigation line will not inconvenience
dentists when they are using the
handpiece.
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12
RESTORATIVE
Dental Tribune Middle East & Africa Edition | 3/2019
Composite artistry in everyday clinical
practice… with BioSmart restoratives
By Dr Melvin Sia, Malaysia
We are often faced with aesthetically challenging cases in our everyday practice. Selection of
the right composite material combined with a
comprehensive finishing and polishing protocol is often the key to success to achieving predictable aesthetic restorations.
How often would you attend a hands-on workshop and get to practice what you learnt the
very next day in your dental clinic. I recently
attended a workshop by Dr. Ronnie Yap on Predictable Class IV Restorations with the ‘Naturomimetic “ONE” Layers Protocol’ based on the
MiCD concept introduced by Dr. Sushil Koirala
during a major dental conference in Malaysia.
The next day a dentist friend of mine visited
the clinic with a fractured anterior tooth where
I replicated the layering technique learnt at the
workshop.
The patient case shared below is a common
clinical situation routinely seen in dental prac-
tice where the Shofu range of biosmart composites with its patented S-PRG filler technology was used to showcase composite artistry
(Fig. 1).
Patient Case
A 33 year old female patient visited my clinic
with a fractured restoration on the upper left
central incisor tooth after accidentally biting
too hard on a metal fork. The patient requested
for emergency dental treatment as she was in
the organizing committee of the dental conference and had to work the next day .
Intra oral examination revealed, complete fracture of the old composite restoration and the
tooth responded positive to vitality test. Patient was advised that the most suitable treatment plan would be to restore the tooth with
BioSmart tooth coloured composite using the
layering technique to achieve the desired aesthetics (Fig. 2).
Materials used
Fig 2: Pre-operative fractured upper left central
After careful examination and shade selection
the following materials were identified to complete the restoration
• Composite materials
– Palatal Shell - Beautifil II Enamel shade T
– First Dentin layer - Beautifil II LS opaque
shade A3O
– Second Dentin layer - Beautifil II LS shade A3
– Enamel Layer - Beautifil Injectable shade BW
& Beautifil II LS shade A3
• Adhesive – FL-Bond II
• Finishing & Polishing - One Gloss, Super-Snap
Xtreme Technique kit
Restorative Approach
Fig 3: Build-up of composite to prepare the putty
index
Fig 5: Preparation of labial margins and selective
enamel etching
Fig 4: Putty index created with impression material
Fig 6: Application of FL-Bond II bonding system
Fig 7: Palatal shell with Beautifil II Enamel T
Fig 8: Application of glycerine and final cure
Fig 9: Line angles created with Super-Snap violet disks
Fig 10: Surface texture achieved with OneGloss
silicone polisher
Fig 11: Polishing with Super-Snap Xtreme green disk
Fig 12: final polish achieved with Super-Snap Xtreme
red disk
Fig 1: Before and after restoration with Beautifil II
BioSmart composite
When using the OneGloss polishers it is recommended to use more pressure with intermittent water for surface texturing and light
pressure to smoothen the surface before the
final polishing step (Fig. 10). Final polishing
was done with Super-Snap Xtreme green disk
followed by the red disk to achieve the desired
lustre of the restored surface (Figs. 11, 12).
To achieve better tooth form of the final restoration it is important to take the time to create
the palatal shell. The first step was to build-up
the fractured tooth with composite using a finger followed by preparation of the putty index
using impression material (Figs. 3, 4).
Patient being a dentist herself, was very satisfied with the aesthetics achieved using the
Minimally Invasive Cosmetic Dentistry concept. The shade match and aesthetics of the
restored surface were well maintained at the 2
month review visit (Figs: 13a &13b , 14a & 14b).
Labial enamel margins were prepared with a
long & star burst bevels using Diamond points.
FL-Bond II, a 6th generation 2-step adhesive
was applied in combination with the selective
enamel etching technique. (Figs. 5, 6). Then the
palatal shell was created using the putty index
with Beautifil II Enamel shade T (Fig. 8).
Conclusion
Composite Build-up
Build-up of the dentin layer was done using
Beautifil II Opaque shade A3O followed by
Beautifil II LS shade A3. As the tooth was opaque
with fluorosis, Beautifil Injectable BW was used
to mimic some of the white fluorosis patterns
in combination with Beautifil II LS shade A3 as
the enamel layer. Before the final cure, glycerine was applied on the restored tooth surface to
minimize the formation of the oxygen inhibition layer (Fig. 7).
The above clinical case illustrates the life-like
aesthetics that can be achieved using the naturomimetic “ONE Layers protocol” adopting
the Minimally Invasive Cosmetic Dentistry
(MiCD) concept with BioSmart composite material. Beautifil II range of composites have a
simple shade system with a range of translucent shades that helps to achieve predictable
aesthetics in addition to fluoride release and
prevention of plaque accumulation. These
added benefits of the BioSmart composites
helps to prevent caries in addition to creating
life-like restorations making it an ideal choice
for every dentist.
Finishing and Polishing Protocol
After final light-cure with glycerine, the following finishing and polishing protocol was used
to achieve the final high gloss restoration surface. Finishing and anatomical contouring was
done using Super Fine Diamond points and
line angles created with Super-Snap violet disk
(Fig. 9). Surface texture to mimic the adjacent
tooth was achieved with OneGloss polisher.
Dr. Melvin Sia
BDS(AIMST),FICD(USA)
Clinical Director of M Dental Clinic
Kuala Lumpur, Malaysia
E-mail: drmelvin@mdentalclinic.my
Fig 13a & 13b: Immediate post-op
Fig 14a & 14b: 2 month post-op recall visit
For more information contact:
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14
NEWS
Dental Tribune Middle East & Africa Edition | 3/2019
Cooperation between Dentsply Sirona
and exocad promotes the digital workflow
in the practice and laboratory
By Dentsply Sirona
Dentsply Sirona, the world's largest
manufacturer of dental products
and technologies, and exocad, one
of the leading dental CAD/CAM software manufacturers for the dental
lab, have announced their extensive
cooperation in the field of digital
dental workflows. International customers of both companies will now
benefit from the direct transmission
of digital impressions from Dentsply
Sirona’s intraoral scanners to exocad
labs. Furthermore, both companies
will align elementary interfaces
between the inLab hardware and
exocad software and, among other
aspects, implement Dentsply Sirona
Fig. 1: Thanks to this cooperation, dental practices with Dentsply Sirona intraoral scanners such as Primescan will now, for the first time, be able to work with exocad laboratories in a validated workflow and transmit digital impressions conveniently and directly
for a whole range of indications.
Fig. 2: This cooperation also comprises the alignment of data interfaces between the exocad DentalCAD software and the inLab CAD/CAM components from Dentsply Sirona,
such as the highly accurate scanner inEos X5 and the laboratory production units inLab
MC X5 and inLab MC XL.
AD
tooth lines and material-specific parameters in the DentalCAD software from exocad.
Flexible open systems play an important role in digital
dentistry. At the same time, ensuring the maximum
compatibility of the systems used in practices and labs is
becoming increasingly important to design reliable and
efficient digital workflows. Considering these objectives,
the cooperation between Dentsply Sirona and exocad
offers completely new options in the digital production
chain.
Validated workflow for digital impressions
Thanks to this cooperation, dental practices with Dentsply Sirona intraoral scanners will now, for the first time,
be able to work with exocad laboratories in a validated
workflow and transmit digital impressions conveniently
and directly for a broad range of indications. Using the
new software application, Connect Case Center Inbox
from Dentsply Sirona, exocad labs have direct access to
the complete intraoral scan and order data in the Connect Case Center Portal.
"With the connection of exocad labs to Dentsply Sirona’s
intraoral scanners, the digital production options based
on intraoral impression data for practices and dental labs
around the world are expanded", explained Dr. Alexander Völcker, Group Vice President CAD/CAM & Orthodontics, Dentsply Sirona. "Furthermore, the high level of
scanning accuracy offered by our new intraoral scanner
Primescan is set to inspire digital dentistry among numerous dental practices and labs."
An application-oriented approach to
developing digital dental technology
This cooperation also comprises the alignment of data
interfaces between the exocad DentalCAD software and
the inLab CAD/CAM components from Dentsply Sirona, such as the highly accurate scanner, inEos X5, and
the laboratory production units, inLab MC X5 and inLab
MC XL. Above and beyond this, the material-related design parameters of selected Dentsply Sirona CAD/CAM
materials and dental databases will be integrated in the
exocad software. "The integration of material parameters
and tooth lines in the DentalCAD software offers exocad
users additional advantages as well as enhanced process
safety in terms of indication-tailored designs and reliable
workflows in the lab", explained Tillmann Steinbrecher,
the CEO of exocad.
The cooperation between these two dental companies
not only promotes digital dental technology and dentistry as a whole, but also the position of the individual
user groups – for even safer and more efficient dentistry.
Organiser
Partners
Dentsply Sirona
21st Floor, The Bay Gate Tower
Business Bay, Al Sa’ada Street
Dubai, United Arab Emirates
Tel.: +971 (0)4 523 0600
Web: www.dentsplysirona.com/MENA
E: MEA-Marketing@dentsplysirona.com
[15] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
THE NEW NiTi FILE GENERATION
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BIOACTIVE SEALING AND FILLING
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GuttaFlow bioseal
Double safety level
´ Cost efficient root filling
´ Excellent flow properties even
at room temperature
´ Fast working, fast curing, safe
sealing (about 12-16 minutes)
004595 03.19
dietmar.goldmann@coltene.com | P +41 71 757 54 40
Step 1 (direct protection)
Step 2 (sleeping protection)
Protection already at filling, e.g. with
bioactivity due to possible residual
moisture in the root canal
Regenerative protection against
possible moisture ingress, e.g.
by cracks
[16] =>
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16
CAD/CAM
Dental Tribune Middle East & Africa Edition | 3/2019
Matching of CBCT and virtual
wax-up for single-tooth
replacement of a central incisor
By Dr Jakob Zwaan, The Netherlands and Mr Vito Minutolo, Italy
Though many smile design programmes offer us solutions for
rendering of multiple-tooth replacements, very often in our daily
practice we encounter major challenges when just a single tooth needs
to be substituted. In order to estimate the risk of an unacceptable aesthetic final result of our treatment
and to determine the most effective
and predictable treatment plan, it is
necessary, also in these cases, to perform an analysis of the desired tooth
shape, the soft tissue architecture
and the bone volume necessary to
stabilise an implant in the optimal
position and support the soft tissue. This analysis can be done using
several means. In the traditional
workflows, we asked our dental
technician, after taking impressions
of the dental arches and registering
the occlusion, to perform a wax-up
to obtain information about tissue
volume available and needed. It was
difficult to get from this hard model
information about the lip line and
gingival exposure, and before the era
of 3D scanning, it was impossible to
interface the teeth with the deeper
anatomy. With the arrival of digital
photography, video, intraoral scanners1 and CBCT scanners, our possibilities have grown enormously,
thus raising the accuracy and predictability of our treatments.
In the following case report, the author will try to describe how he and
his team approach cases in which a
single tooth needs to be replaced by
an implant-supported crown. Most
of the procedures can be applied to
more extensive cases, since the basic
rules of implant dentistry are universal. After an anamnestic interview in
which patient expectations play a
fundamental role, we proceed with
the intraoral examination. Hygiene
and periodontal health are checked,
and if required, a session for calculus
debridement, motivation and instruction is scheduled.
Normally, the first radiographic examination performed is an intraoral
radiograph for a single tooth (Fig. 1)
or a dental panoramic tomogram if
the need for a more extensive treatment is suspected. In the same session, both dental arches are scanned
with an intraoral scanner and the
bite is registered. A simple photographic sequence is followed:
1. Full frontal view intraoral photograph (Fig. 2).
2. Detailed photograph of the single
arch, possibly with a black mirror to
contrast the teeth (Fig. 3).
3. Photograph of laterolateral detail
of the tooth and gingival profile (Fig.
4).
4. Full-face photograph with maximum gingival exposure (Fig. 5).
5. Full-face photograph of a spontaneous smile (Fig. 6).
6. Photograph of the full face at rest.
This sequence allows one to view
immediately the presence of orthognathic and periodontal issues (Figs. 1
& 2), to evaluate the biotype (Figs. 2 &
3) and to estimate aesthetic challenges, like tooth colour, tooth texture,
soft tissue/lip exposure and position
of the incisal edge/lip (Figs. 2 & 4–6).
The 3D intraoral scan is extremely
helpful for determining orthodontic alignment of the teeth and in our
protocol replaces an occlusal and/or
12 o’clock photograph in most cases.
“There can be different ways of treating a disease, but there can be only
one correct diagnosis.” Dr Morton
Amsterdam, 1974. When anamnesis,
intraoral examination and preliminary radiographs are sufficient to
conclude that the tooth in question
cannot be preserved, it needs to be
decided what the optimal timing
for extraction and a CBCT scan is
and how to provide for a temporary
tooth replacement. Also, the timing
of implant placement is essential
and the operator must choose between immediate, early or delayed
placement in the fresh extraction
socket. Will there be a (potential)
need for bone augmentation and/or
a soft tissue graft? In short, our policy is the following: in case of acute
inflammation that cannot be effectively treated in a way that an infection of the future implant site will
be prevented, we will proceed with
extraction. A temporary fixed etch
and bond or removable prosthesis
can be used to guarantee acceptable
aesthetic comfort to the patient. In
these cases, a CBCT scan will be taken
after extraction so that the most detailed image of the socket anatomy
can be obtained. Since a provisional
solution has been provided for, there
is no need for very early implant
placement. Timing is now based on
the expected period needed for the
infection to be eliminated and the
risk of loss of volume by the collapse
of tissue. Normally, the implant is
placed four to six weeks after the extraction. Another reason for delayed
implant placement can be the need
for healed soft tissue in order to facilitate proper wound closure to protect, for example, bone substitutes
and membranes when bone augmentation is necessary. Additionally,
if the patient is suffering owing to the
tooth that is to be extracted, it can be
a reason to proceed quickly with the
extraction, thus gaining time for
adequate treatment planning and
preparing for surgery and eventual
immediate temporary crowns. If
the anatomy and biological conditions are favourable, one can decide
to proceed with implant surgery at
an early stage after extraction, such
as one week. Only in those cases in
which there is no acute inflammation or infection, and sufficient bone
and soft tissue quantity and quality
are present is it recommendable to
place the implant in the fresh extraction socket. Obviously, in such a case,
the CBCT scan would be performed
before proceeding. Minor bone augmentation and/or connective tissue
grafting can be performed contemporaneously. The decision to place
an immediate provisional crown on
the implant is strongly related to the
expected primary stability of the
implant, as well as the opportunity
to manage the position of biomaterials in such way that undisturbed and
uncontaminated healing is guaranteed. After healing, good aesthetics
and sufficient protection of the underlying implant and implant–prosthesis connection are requisite if we
Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
CT graft
Fig. 8
wish to treat our patients in the best
possible way and earn their longterm trust.
Risk evaluation
First aesthetic risk evaluation
A very simple tool to start with can
be a render of a 2D photograph. We
use the macro intraoral shot with
the black background behind the
teeth (Fig. 3). With Adobe Photoshop,
GIMP, Microsoft PowerPoint or Keynote, for example, it is possible, with
little time invested and no expense,
to cut out the shape of the contralateral tooth that will not be extracted,
copy it, flip it horizontally and paste
it in the position of the tooth that
needs replacement.
It will be clear immediately whether
this shape, which provides for symmetry, supports the papillae sufficiently or whether there is a lack
of volume that needs to be compensated for (Fig. 7). Another trick
is to use this image with the flipped
contralateral tooth and align it with
the original photograph and then
draw a horizontal line across both
images that coincides with the same
gingival reference points. This will
demonstrate whether there is a vertical component that indicates a
lack or abundance of soft tissue (Fig.
8). This can be easily quantified in a
metric system if an intraoral reference is measured with a calliper. We
can now inform the patient whether
ÿPage 18
[17] =>
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→ THE EVOLUTION OF PROPHYLAXIS
COMBI touch
→ AIR-POLISHING AND ULTRASOUND IN ONE UNIT
→ easy switch from supra to subgingival air-polishing by a simple click
→ subgingival perio air-polishing tip – flexible, soft and anatomically
adjustable to the periodontal pocket
→ more than 40 inserts for scaling, perio, endo and prosthetics
→ soft mode: the ultra-gentle scaling for sensitive patients
→ www.mectron.com
→ www.we-love-prophylaxis.com
[18] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
18
CAD/CAM
Dental Tribune Middle East & Africa Edition | 3/2019
◊Page 16
Fig. 10a
Fig. 9
Fig. 10b
Fig. 10c
Second risk evaluation
The intraoral scan is imported into
CAD software and transformed into
a virtual master model without the
tooth to be extracted and a separate
STL shape of the ideal CAD-designed
tooth (Fig. 9). Now there is the opportunity for 3D evaluation of the dimensional relation between the new
tooth and the soft tissue before extraction. In the current case, the tooth
involved had not been extracted and
a CBCT scan was performed (X-Mind
trium, ACTEON; 110 x 80 mm field of
view; 0.15 mm voxel size) for further
investigation and treatment planning. In the AIS 3D App software that
comes with the CBCT X-Mind trium
device, STL files can be matched and
aligned with the 3D bone volume,
thus giving the opportunity to plan
the future implant position taking
into account the shape and position
of the future crown (Figs. 10a & b). In
an additional procedure like guided
bone regeneration (GBR) or a connective tissue graft will be needed,
which can be helpful for informed
consent and financial planning.
Fig. 11a
Fig. 11b
Fig. 11c
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16
Fig. 17
Fig. 18
Fig. 19
Fig. 20
Fig. 21
accordance with the prosthetic procedure preferred, cemented versus
screw-retained, CAD/CAM-fabricated versus manual layering and the
type of material to be used, all the
information for the final treatment
plan is available, on which decisions
can be made regarding GBR, connective tissue graft and timing of implant loading.
profile. Minor general gingival recession had led to the presence of a tiny
inter-dental space. The marginal gingiva was reddened, and the central
papilla was not symmetrical.
Fig. 22
Fig. 24
Case report
Fig. 23
Fig. 25
Fig. 26
The female patient, aged 47 and a
non-smoker, was in good general
health. She performed regular oral
hygiene and had good periodontal
health. The patient experienced increasing mobility of the maxillary
left central incisor and complained
about compromised aesthetics due
to the extrusion and progressive
migration of the tooth in a buccal direction. The incisor had been treated
with a crown at a preadolescent age
after a violent trauma. The intraoral
radiograph showed incomplete root
development and evidence of a root
canal therapy suggesting a strip perforation though no signs of periapical lesions were present. The shape
of the crown was not symmetrical
in relation to the triangular shape
of the maxillary right central incisor, but had a wider and rectangular
Probing depths were within 2 mm
for both the right and left central
incisors and the radiographic mesial
and distal bone peaks were of a regular height.
The photographic aesthetic evaluation showed that it would be very
difficult to obtain symmetry in tooth
shape and have good-looking and
healthy soft tissue support at the
same time. The patient’s maximum
smile exposed the gingival contours.
In such cases, it may be wise to consider also the possibility of altering
the anatomy of the contralateral
tooth with, for example, a ceramic
veneer and discuss outcomes with
the patient before finalising the
treatment plan. This can be evaluated by performing the cut/copy/
flip/paste sequence in reverse (Fig.
7). Together with the patient, it was
decided to start performing the best
possible replacement of the maxillary left central incisor and evaluate
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at an advanced stage with a temporary crown on the implant and mature, conditioned tissue whether to
add a veneer to the maxillary right
central incisor.
Analysing the CBCT scan
Fig. 27
Fig. 28
Fig. 29
Fig. 30
Fig. 31
Fig. 32
Fig. 34
Fig. 35
Fig. 36
Fig. 37
Surgery
Fig. 38
Fig. 39
Fig. 40
Fig. 41
Fig. 42
Fig. 33
It became evident that the shortrooted tooth could be extracted without compromising the buccal bone,
and that there was sufficient bone
volume and quality to obtain good
primary stability of the implant.
Thanks to the AIS 3D App software,
this information can be visualised
using the bone density tool and linear measures tool (Fig. 10c) and represented in a graphic or according to
a coloured scale. The presence of the
nasopalatine duct prohibited ideal
palatal positioning of the implant,
and if the implant were to be placed
flush with the palatal alveolar bone,
this would have resulted in a 1.5–2.0
mm high exposure of the implant
collar on the buccal aspect (Fig. 11b).
This information, combined with the
aesthetic analysis, led to the decision
to place the implant in that position
and to augment the buccal bone volume with a contemporaneous GBR
procedure, thus also providing for
major soft tissue support. As often
described in the literature, it is to be
expected that in some measure the
implant will deviate buccally2–4 from
the original planning because of
the major mechanical resistance of
the palatal plate. The author’s team
prefers whenever possible screwretained solutions. Several production centres are capable of milling
angulated screw access holes in
cobalt-chromium abutments of up
to 25°,5 which is a range that covers
most cases in daily practice. It can be
easily checked in the implant planning software whether the future
access hole will exit on the palatal
aspect of the tooth, either by angulating the implant extension tool or
by choosing a virtual abutment from
the library. Confirming being in the
safety range from this point of view
allowed for an approach that foresaw
the implant in native bone without
the necessity for major GBR on the
apical aspect of the implant. Knowing that a flap needed to be raised
to facilitate the marginal tissue augmentation, it was decided to use a
surgical guide (Figs. 11c) for only the
first drill to determine with precision
the position and angulation of the
osteotomy that would be performed
freehand thereafter. In order to limit
surgery time and eliminate unpredictable factors inherent in immediate loading, a removable temporary
prosthetic tooth was produced in
advance.
Fig. 43
Local anaesthesia was performed
with 2% mepivacaine with 1:100,000
adrenaline. Preventative antibiotic
therapy with amoxicillin (1 g, b.d.
for five days) was prescribed, aided
by use of a 0.2 % chlorhexidine
mouthrinse three times a day for one
minute. The tooth was extracted and
the sulcular epithelium removed
with diamond burs. The milled surgical template (Figs. 12 & 13) served as
a guide for the first 2 mm diameter
pilot drill (Fig. 14). Thus, the planned
depth, position and angulation of
the osteotomy were obtained. The
drill sequence was completed freehand, using tapered 3.0 and 3.4 mm
drills. A Neoss ProActive Tapered
Implant of 4 mm in diameter and
13 mm in length was inserted flush
with the mesial/palatal/distal bone,
motor driven up to a torque of 50
Ncm and then with a manual wrench
(Fig. 15). The correct position of the
internal hex was verified by checking
the references on the implant driver,
which ideally points in the buccal direction. Resonance frequency analysis with Penguin RFA (Integration
Diagnostics Sweden) determined
an ISQ value of 73/76. At this stage,
a Neoss Esthetic Healing Abutment
with a ScanPeg was connected to
the implant (Fig. 16). A flap was then
raised after a vertical incision of the
frenulum and the expected buccal
exposure of the implant neck was
evident. Autogenous bone harvested
from the drills was positioned directly on the implant surface (Fig. 17),
followed by a bone substitute on top
of it and on the buccal cortical bone
(Fig. 18). This material was covered
with a resorbable membrane (Fig. 19).
The mobilised flap was then repositioned by rotating it coronally and
fixed with single sutures (Fig. 20).
The removable partial denture was
adapted and delivered (Fig. 21). An
immediate postoperative CBCT scan
of 60 x 60 mm was performed, and
it confirmed a perfectly centred implant position (Figs. 22 & 23).
Intraoral scan
Eight days after surgery, the patient
reported that healing was uneventful and the prosthodontist removed
the stitches. It has become the author’s standard protocol to perform
an intraoral scan for implant position in this same session (Figs. 24 &
25). The specific and unique PEEK
healing abutment used has an internal circular channel and on one
side, normally positioned on the
buccal aspect, a vertical rectangular
slot (Fig. 26). After removing the PTFE
tape used to plug this area during
surgery, a ScanPeg can be positioned
inside the healing abutment. This
allows for a unique scanning procedure without removing the healing
abutment, thus avoiding disturbing
healing tissue or dislocating recently
placed biomaterials. The producer
provides libraries for STL files of the
five different anatomical shapes—
wide incisor, narrow incisor, canine,
premolar and molar—that determine the basic profile of the gingival
tunnel during healing.
Temporary crown
The surgeon indicated that the healing abutment may be removed after
four weeks. By then, the temporary
screw-retained crown had already
been fabricated by the technician,
who had prepared a CAD/CAMmilled acrylic tooth glued on to a Neoss NeoLink abutment (Figs. 27–30).
As a result of the decision to place
the implant entirely in native bone,
the angulation was such as to locate
the screw access hole of the provisional on the buccal aspect. This can
be easily camouflaged by a simple
composite filling after plugging the
channel with PTFE tape. The gingival profile copies in this first stage of
loading the central incisor anatomy
of the Neoss Esthetic Healing Abutment (Fig. 31).
Tissue conditioning
As evidenced by the aesthetic analysis before treatment, it was clear that
symmetry with the contralateral
incisor would be impossible. The implant was placed slightly distal because the distal papilla normally has
a narrower mesiodistal basis than
the central papilla. The tissue volume augmentation helped to obtain
the necessary quantity of gingiva to
shape nice papillae, leaving a minimal gap. The soft tissue architecture
was conditioned (Fig. 32) by adding
composite to the temporary crown
and grinding material where necessary until the prosthodontist and
the patient felt an optimal result had
been achieved.
Transfer of the profile
A new intraoral scan sequence was
performed. First was the scan of the
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full arch with the temporary crown
in place. The provisional was then removed from the mouth and screwed
on to an implant replica fixed to a
stable support with wax. The second
scan revealed in 360° the modified
shape of the temporary crown, including the gingival profile (Fig. 33).
These files can be easily matched in
the CAD software when the technician designs the definitive crown
(Figs. 34–36). If a monolithic material
is used, the technician may copy the
entire shape of the temporary. When
a support is needed that will be layered with ceramic afterwards, at least
the gingival profile can be duplicated
in a reliable way.
Definitive crown
The author strongly prefers screwretained devices. Owing to the angulation of the implant, it was necessary to relocate the screw access
hole. In CAD, the design for a cobalt-
chromium support that copied the
gingival profile of the temporary was
prepared, and the screw access was
brought to the palatal aspect (Fig. 37).
The file was sent to the Arc solutions
milling centre in Helsingborg in Sweden. High-quality material and CAM
production guarantee an excellent
outcome in terms of connection
and smooth surfaces (Figs. 38–40).
The technician layered feldspathic
ceramics to obtain the final anatomy
and texture. The patient was totally
satisfied with the result and did not
wish for intervention for the maxillary right central incisor. Minor gingival asymmetries, though evident
at high magnification in photography, are not really disturbing when
viewed at social distance if all other
parameters, like colour, incisal edge,
tooth texture, correct proportion of
the incisal two-thirds of the tooth
and transitions, are respected (Figs.
41–43).
Conclusion
Innovative technologies enable
extremely accurate diagnosis and
treatment planning. Affordable
high-quality CBCT has profoundly
changed our profession. In the current case, the detailed X-Mind trium
3D images allowed for planning and
performing implant placement in
the optimal mesiodistal position.
Correct distances to the lateral incisor and the nasopalatine duct were
obtained. Final choices will always remain related to the experience, skills
and equipment of the performing
team. After collecting all of the necessary information and knowing what
technology can provide, it is possible
that one team will opt for GBR and
monolithic crowns, where another
might try to minimise the invasiveness of surgery and employ innovative milling strategies to deliver a
predictable, beautiful solution. In the
actual challenging buccopalatal di-
mension, the implant was perfectly
planned and guided into to the centre of the native bone. Guided bone
regeneration was limited to the minimum and minor buccal exposure of
the implant was predicted. Reviewing the case described above, the fact
that bone volume could be matched
with the dental preoperative situation and the CAD virtual wax-up
made the whole procedure, from
extraction to final restoration, highly predictable. Bone volume, bone
quality, extent of GBR indicated and
the type of prosthodontic solution
were all known before starting treatment thanks to the implant planning with the AIS 3D App software.
Both the clinician and patient were
well informed and prepared, avoiding surprises, improvisations and
unnecessary stress. New developments like smart, scannable healing
abutments will help to continue cre-
ating treatment outcome and comfort improvements.
Editorial note: A list of references is
available from the author.
Dr Jakob Zwaan, The Netherlands
graduated from Utrecht University in the
Netherlands in 1987. He is a member of
Digital Dentistry Society and Nederlandse
Vereniging voor Parodontologie [Dutch
society of periodontics] and President of
the 3D-Simplement Association. He has
authored numerous scientific publications and spoken widely at international
events. He focuses on implant surgery and
digital dentistry, and runs a private practice in Calusco d’Adda in Italy. He can be
contacted at zwaan@dentz.it or zwaan.
jakob@libero.it.
New materials for a classic indication
Cementation of all-ceramic restorations using Variolink Esthetic
By Drs Eduardo Mahn & Juan Pablo
Sánchez, Chile
Zinc phosphate cements are seen
as classic luting materials for the cementation of metal-ceramic crowns.
Along with all-ceramic materials,
glass ionomer cements (GICs) and
resin-modified glass ionomer cements (RMGICs) were introduced.
Generally, luting cements are expected to meet certain requirements: they should provide an optimum bond to the tooth structure
and restorative material, must not
be soluble in water, should be suitable for application in thin coatings
and should offer long-term stability. This is in contrast to the properties of classic cements, which are
water soluble and do not establish
an adhesive bond to the enamel or
dentine (zinc phosphate cements) or
establish only a minimally adhesive
bond and only to the dentine (GICs
and RMGICs). Nonetheless, these
cements show reasonable survival
rates if used for the appropriate indication even if they have certain
limitations.
Fig. 1: Pre-op situation.
Fig. 2: Situation after composite build-up (Tetric N-Ceram Bulk Fill) and preparation.
Figs. 3a&b: Crown design in the software suite (inLab) and try-in before crystallisation firing (IPS e.max CAD).
Problem 1: Opacity
The opacity of the luting material is
a critical issue for all-ceramic crowns,
as well as ceramic inlays and onlays.
Almost any colour can theoretically
be reproduced with ceramics by exploiting their natural translucent
properties. Using an opaque luting
material appears to be counter-productive in achieving this. Further
critical issues are the limitations
involved in the anterior region and
the location of the cement line in the
visible area for inlays and onlays. For
instance, if a tooth is restored with a
veneer, the basic shade of the tooth
is maintained; only the enamel is
replaced, usually by using a translucent ceramic that covers the natural
dentine. In such a case, it is essential
to use a translucent luting material
to achieve a favourable result.
Problem 2: Adhesion
The comparatively low bond
strength of conventional cements
is also problematic. Classic preparations around the tooth create a high
degree of friction and retention.
However, the retention is signifi-
Fig. 4: Characterised and glazed crown.
Fig. 5: Etching and silanating with Monobond Etch & Prime.
Fig. 7: Applying Variolink Esthetic DC into the crown.
cantly reduced with partial crowns,
veneers or onlays. It is therefore advisable to use a luting material that is
capable of providing a strong adhesive bond. Both problems led to the
widespread use of luting composite
Fig. 6: Enamel etching prior to application of the adhesive.
Fig. 8: Placing the crown.
materials. Perhaps their only disadvantage is the removal of excess material. These luting materials are hard
and solid and not water soluble, and
they have a high adhesive strength,
making removal of excess diffi-
cult. Early luting composites were
equipped with a self-cure mechanism. Users had to wait a few minutes until the composite was almost
fully set before they could remove
the excess material. This period was
risky because of the moisture in the
mouth. Blood or saliva could come
into contact with the non-polymerised composite and cause damage.
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ZirCAD MT Multi
The most esthetic high-strength,
1
multi-translucent zirconia
All ceramic,
all you need.
1
Composed of different material classes
www.ivoclarvivadent.com
Ivoclar Vivadent AG
Bendererstr. 2 | 9494 Schaan | Liechtenstein | Tel. +423 235 35 35 | Fax +423 235 33 60
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NEWS
Dental Tribune Middle East & Africa Edition | 3/2019
◊Page 22
Dual-curing
luting composites
These issues led to the rise of dualcuring composites for the cementation of all-ceramic crowns. Dualcuring luting composites are usually
delivered in double-push syringes
with a mixing tip. During extrusion,
the base and catalyst are automatically mixed. The material can be
applied directly. The main advantage is that the curing process can
be accelerated with light and excess
material can easily be removed. At
the same time, the self-cure mechanism ensures a reliable cure, even
with relatively thick or opaque ceramic layers. Nonetheless, there are
some situations in which excess
material cannot be removed all that
easily because the setting reaction
takes place too quickly or the material does not cure down to the depth
of the composite layer. After one
second of light curing, the surface is
set and excess can be broken off, but
the material is still paste-like at the
interface to the crown or tooth. Excess can be polymerised en bloc and
pulled off as a ring in one go with no
uncured material left in contact with
the tooth or crown. In addition, the
luting composite does not con- tain
amine, which is another advantage,
since amine may be implicated in
discolouration of the cement line
over time.
One material, five shades
Variolink Esthetic (Ivoclar Vivadent)
is based on the value shade concept.
The shades are classified accord-
Fig. 9: Excess removal is easily achieved
owing to the new technology based on
the Ivocerin photoinitiator.
Fig. 10: Final curing. Excess luting material was removed beforehand (quarter
technique).
Fig. 11: Seated crown after excess removal.
Figs. 12a & b: Lateral and occlusal views of the completed restoration.
ing to the effect to be achieved with
the cement. Five shades are available: Light+, Light, Neutral, Warm
and Warm+. In this way, the shade
spectrum ranges from an opaque
white tone (Light+) to an opaque
yellow-brownish shade (Warm+). In
between lie shades such as a coconut water white and a neutral tone
(very translucent) and a warm tone
(comparable to A3). In addition, the
luting composite is available in an LC
(light-curing) and a DC (dual-curing)
version. The LC version is designed
for relatively thin restorations, such
as inlays, onlays and veneers. The
DC version is suitable for more extensive and opaque restorations.
The luting composite is used in conjunction with the light-curing singlecomponent Tetric N-Bond Universal
(Ivoclar Vivadent).
Figs. 13a & b: Radiographic control images before and after the treatment.
AD
Clinical case
A 45-year-old male patient presented
to the practice with a restoration on
tooth #46. The tooth had been endodontically treated and temporised
with a filling (Fig. 1). The temporary
was removed, the tooth built up
with Tetric N-Ceram Bulk Fill (Ivoclar
Vivadent) and then prepared for the
crown restoration (Fig. 2). An impression was taken with a one- step, twophase impression technique using a
putty and light-body silicone. After
scanning the model, the crown was
designed in the software suite (inLab,
Dentsply Sirona) and milled from
an IPS e.max CAD lithium disilicate
block (Ivoclar Vivadent; Figs.3a & b).
After the crystallisation fir- ing, the
crown was stained and glazed (Fig. 4).
The next step was to etch and silanate
the ceramic crown with the new
glass-ceramic primer Monobond
Etch & Prime (Ivoclar Vivadent). This
primer combines a ceramic etching
and silanating component in a single
material and therefore eliminates
the need for the ceramic to undergo
hydrofluoric acid etching (Fig. 5). After the etching and silanating step,
the crown was rinsed with water and
dried. The isolated enamel was then
etched (Fig. 6). The adhesive (Tetric
N-Bond Universal) was applied and
dispersed with a strong stream of air.
The dual-curing version of the Variolink Esthetic luting composite was
used for seating owing to the thickness of the crown and the low translucency of the ceramic material (Fig.
7). The luting composite was applied
into the crown. The restoration was
then seated (Fig. 8) and light-cured
from each side for two seconds. Excess composite was easy to remove
owing to the Ivocerin photoinitiator
(Ivoclar Vivadent), which provides a
fast and thorough cure with a minimum amount of energy (Fig. 9). For
final polymerisation, the restoration
was light-cured from each quarter
for 20 seconds (Fig. 10). Figures 11 and
12a & b show the oral situation after
placement of the crown. Although
the cement line was located above
the gingival margin, it was not visi-
ble owing to the favourable tone and
opacity of the luting composite. Figures 13a & b show radiographic control images of the restoration: the
radiopaque build-up material and
cement can easily be distinguished
from the tooth structure. This aspect
is particularly important in situations where excess cement cannot
be seen with the naked eye.
Conclusion
The cementation methods used in
conjunction with all-ceramic materials have changed for single-crown
restorations. Variolink Esthetic is a
protagonist of the latest generation
of luting composites. Excellent bond
strength values, coupled with userfriendly handling characteristics and
highly aesthetic properties, make
this material an asset in day-to-day
dental restorative care.
Editorial note:
This article was originally published in
cosmeticdentistry beauty & science,
Issue 1/2018.
For more information contact:
Dr Eduardo Mahn is a certified implantologist and the Director of Clinical Research, and the Director of the Program
of Esthetic Dentistry at the Universidad
de los Andes in Santiago in Chile.
He can be contacted at:
emahn@miuandes.cl.
Dr Juan Pablo Sánchez
is a dental surgeon. He holds a postgraduate degree in oral rehabilitation from the
Universidad de los Andes and lectures on
this field at the university.
He can be contacted at:
drjpsanchez@gmail.com.
[25] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
r ietar y tech
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[26] =>
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26
NEWS
Dental Tribune Middle East & Africa Edition | 3/2019
Dentsply Sirona Clinical Affairs 2018
Almost 432,000 dental professionals have benefitted
from clinical education and training
By Dentsply Sirona
Dentsply Sirona Clinical Affairs organises one of the largest clinical
and most comprehensive education programmes in the dental industry to empower dental professionals to provide better, safer and
faster dental care. In 2018 alone,
Dentsply Sirona offered 11,835
courses all over the world, in which
nearly 432,000 dental professionals participated.
of the on-demand format allows
dental professionals to learn at their
convenience and to earn CE credits
where appropriate. “Compared to
2017, the number of on-demand
webinar participants has increased
almost fivefold in 2018.” explains
Dr. Terri Dolan, Chief Clinical Officer of Dentsply Sirona, “We see the
use of educational technologies as
a great way to support our customers, introduce new clinical concepts,
explain procedures and solutions,
and then encourage participants
to attend more extensive courses
and hands-on learning based on
their needs and interests. Providing these educational opportunities, paired with our leading materials and technologies, are key to
empowering dental professionals
and improving dental care and oral
health.”
Clinical Affairs 2018 at a glance
11,835 Courses
99 Countries
431,854
Attendees
© Dentsply Sirona
The global Clinical Affairs team
develops the next generation of
educational content that supports
the implementation of innovative
solutions for dental professionals.
This clinical education program’s
overall objective is to empower
dentists, technicians, and dental
team members to improve dental
care and oral health. Clinical Affairs
cooperates with opinion leaders, academic and research communities,
and practitioners in their respective
local markets.
In 2018, Clinical Affairs offered 11,835 courses, which provided training and education to 431,854 dental professionals in 99 countries.
AD
2018: Over 330,600
dentists attended
Dentsply Sirona’s courses
#YourNextChapter
starts at MBRU
Master of Science in:
Endodontics
Orthodontics
Pediatric Dentistry
Periodontics
Prosthodontics
Specialized learning beyond
the traditional dental degree
Reimagine your future as you further your education through
one of our advanced postgraduate dental programs.
In 2018, more than 432,000 dental
professionals from 99 countries
participated in the program. Over
76 per cent – over 330,600 – of
them were dentists – 11 per cent
more than in 2017. Also, the number of participating students has
grown by 12 per cent to a total of
33,220. Together, they took part in
11,835 courses in total, including
live lectures, product trainings,
Train-the-Trainer sessions, self-instructional courses, Webinars and
hands-on trainings. For the latter
the participants spend at least 33
per cent of the instructional time
practicing skills. Compared to the
2017 statistics, the number of organized courses increase by almost
ten percent. Hands-on seminars or
participation course became more
important with a rise of 31.5 percent
to 3,396 courses in 2018. About half
of them were held in Europe, the
Middle East and Africa region and
about one third in American markets.
Innovative technologies
meet traditional methods
Graduates are recognized as
specialists in the UAE
Extensive clinical training over
the 3-year program
Postgraduate students
practice at the largest dental
clinic in Dubai
Opportunities to participate
in overseas
scientific presentations
Accredited by
Ministry of Education
International
academic faculty
Admissions open
to all nationalities
Eligibility for the Royal College of Surgeons of Edinburgh
and for the Royal College of Surgeons in Ireland Specialty
Membership examinations
The three key course topics include
endodontics, implant dentistry and
restorative dentistry. Furthermore,
the dental professionals were interested in CAD/CAM, preventive
dentistry and ultrasonic instrumentation and imaging. Besides
traditional live lectures and product trainings, the Clinical Affair’s
program comprises innovative
active learning and engagement
methods including simulated and
patient demonstrations of procedures and workflows.
On-demand courses have gained
importance because they allow
the participant to learn when they
want and where they want to learn.
And the use of state of the art webinar technology allows us to extend
our reach and reach dental professionals across country boundaries.
In addition to live webinars, the use
Dentsply Sirona Academy
offers triple excellence
The success of the Dentsply Sirona
Academy’s educational program is
increasing annually. This positive
result can be attributed to our understanding of customer needs and
organizing courses in three important categories: clinical excellence,
technical excellence and practice
excellence.
Clinical excellence offers scientifically sound, evidence-based
education on key clinical topics and
common clinical challenges facing
dental professionals. The program
covers topics such as prevention,
restorations, orthodontics, endodontics, implantology and prosthetics.
Technical excellence introduces
Dentsply Sirona’s new technologies,
innovative materials and workflow
solutions, for example. These courses support dentists, technicians and
team members in adopting and implementing technological innovation and workflows into their own
practices.
Practice excellence as the Academy’s third component focusses
on administrative and management issues including front office
and back office support to improve
practice efficiency and patient outcomes: “A dental practice is only
successful when all members of the
team – dentist, dental hygienist, assistant, office manager, and laboratory technician – work together to
support the needs of the patient,”
says Dr. Dolan, “So, the practice excellence component supports the
team performance of a high-quality
dental treatment.“
For more information about clinical
education from Dentsply Sirona please
contact your local representative or visit
dentsplysirona.com/MENA
Dentsply Sirona
21st Floor, The Bay Gate Tower
Business Bay, Al Sa’ada Street
Dubai, United Arab Emirates
Tel.: +971 (0)4 523 0600
Web: www.dentsplysirona.com/MENA
E-mail: MEA-Marketing@dentsplysirona.com
[27] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
Mastership Programme
Lasers in Dentistry
Certification Course
From Aachen Dental Laser Center &
RWTH International Academy - RWTH Aachen University & CAPP
DUBAI
AACHEN
Group 7
Registration Open
Prof. Dr. med. dent.
Norbert Gutknecht
DDS, MS, PhD
Germany
Dr. Dimitris Strakas
DDS, MSc, PhD
Greece
Dr. Miguel Rodrigues Martins
DDS, MSc, PhD
Portugal
Priv.-Doz. Dr. rer. medic.
Rene Franzen
Germany
Pathway to
German Masters
84 CME
& Daily Hands-on
One-year clinical specialisation course for selected wavelengths
Module 1 | 23-26 October 2019 (4 days) | Laser Safety, Laser Devices and Diode Lasers
Laser Safety Officer course | e-learning | Laser technique (Diode lasers) | High power Diode lasers (clinics) |
Scientific background and clinical indications | Skill training every day of every clinical indication | Patient treatments
(demonstrations)
Hands on: Pigmentation on soft tissue, gingivectomy and gingivoplasty, frenectomy, fibroma removal, crown
lengthening, depigmentation, endodontic procedure- canal irradiation performed on sheep heads | Patient treatments (demonstrations)
Module 2 | 11-14 March 2020 (4 days) | Module Erbium Lasers
Laser Safety Officer course | e-learning | Laser technique (Diode lasers) | High power Diode lasers (clinics) |
Erbium Lasers (clinics) | Laser technique (Erbium lasers) | Er:YAG and Er,Cr:YSGG | Scientific background and clinical
indications | Skill training every day of every clinical indication | Patient treatments (demonstrations)
Hands on: Preparation in enamel and dentine, generation of a retentive surface, canal decontamination, apicectomy,
soft-tissue cut with short pulses, soft-tissue cut with long pulses, open curettage, crown lengthening and bone
preparation performed on sheep heads. | Patient treatments (demonstrations)
Module 3 | 13-16 December 2020 (4 days) | Combined Wavelengths Therapy Concepts & Mastership Exams
Laser therapy concepts with the use of 2 different wavelengths | Written multiple-choice exam |
Oral Exam (presentation of 5 patient treatments cases with diode or Erbium lasers) |
Graduation Ceremony, after successful completion of an examination at RWTH Aachen University |
600 hours total workload | Over the complete course duration: case documentation & discussions
The programme targets dentists who would like to specialise in certain wavelengths. Over the course of one year, participants are taught fundamental physical
and technical knowledge, and how to recognise primary, secondary, and tertiary indications on 12 attendance days split into 3 modules held over 3 educational
blocks. This programme concludes with an official certificate of RWTH Aachen University, and is offered in collaboration with the RWTH Aachen International
Academy, the post graduate education wing of the University..
+971 528423659 | p.mollov@cappmea.com
www.cappmea.com/laser
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NEWS
Dental Tribune Middle East & Africa Edition | 3/2019
© Sergii K./Shutterstock
Researchers develop
microrobots to break up
plaque
A cross-disciplinary team of researchers have recently developed a swarm of microrobots, directed by magnets, that can break apart and remove dental biofilm.
By DTI
PHILADELPHIA,
U.S.: The fight
against plaque has been a longrunning battle. In a discovery that
might give dentists the upper edge,
researchers from the University
of Pennsylvania have developed a
swarm of microrobots, directed by
magnets, that can break apart and
remove dental biofilm from a tooth.
The innovation arose from a crossdisciplinary partnership among dentists, biologists and engineers.
Lead researcher Prof. Hyun Koo,
AD
Are semi-adjustable
articulators (SAA)
really necessary in
restorative dentistry
By João Palmieri
CD MCS Esp.
Brazil
Probably, and unfortunately, most clinicians prescind the use of a SAA. They point they
require a time consumption technic and can work properly without them. Maybe because
they are not trained to use them for diagnosis. In the sequence of photos presented here, we
intent to show how important is to set a Centric Relation (CR) with a pair of models and how
indispensable is the use of SAA before planning any treatment involving the patient's bite.
1A
1B
1C
Figure 1 A, B and C - A pair of casts during a Maximum Intercuspation (MI) assembled in a SAA. Observe at figure 1A, that
extruded right second molar. It doesn't participate of patient's occlusion. In figure 1B, with a frontal view we can see a good
alignment of teeth, but the small amplitude of the overbite and apparent tip destruction of upper incisors can be observed. In
picture 1C, beyond the upper left first molar missing, we can observe how the tendency of a Angle's Class III malocclusion is
more prominent.
Whenever we consider only the teeth position, we can be easily betrayed by a false mandibular position. This will invariably
lead us to an erroneous diagnosis. And any treatment based in a wrong interpretation of reality will lead us to a erroneous
treatment.
2A
2B
Figure 2 A, B and C - The same pair of models at the same SAA, but now in the CR arch o closure. At picture 2A
is clear that the extruded second right second molar is interfering in the ideal mandibular closure. To avoid this
isolated contact, the mandible is protruded and assumes a false Angle's class III malocclusion position. The
compensatory inclination of the lower anterior teeth indicates the orthodontic treatment applied to the patient
probably neglected the CR position of the mandible. At picture 2B, the dental wear of lower incisors and canines
are more evident.
The situation represented by this case is more common in the daily clinic routine than we imagine. The patient is
now looking for an occlusal reconstruction. If we continue to ignore the orthopedic mandibular position,
probably our treatment will not "fit" in the patient's mouth.
The combination of a CR registration with a SAA allow us to start our treatment from the temporomadibular
perspective and avoid be betrayed by the teeth position.
2C
from the University of Pennsylvania School of Dental Medicine (Penn
Dental Medicine), said the development was truly a synergistic and
multidisciplinary interaction. “We’re
leveraging the expertise of microbiologists and clinician-scientists as
well as engineers to design the best
microbial eradication system possible. This is important to other biomedical fields facing drug-resistant
biofilms as we approach a post-antibiotic era,” he explained.
This collaboration came about after
Koo and his colleagues made headway in breaking down the biofilm
matrix by using iron oxide-containing nanoparticles that work catalytically, activating hydrogen peroxide
to release free radicals that can kill
bacteria and destroy biofilms in a targeted fashion. Serendipitously, the
Penn Dental Medicine team found
that groups at Penn Engineering, led
by Dr. Edward Steager, Prof. Vijay Kumar and Prof. Kathleen Stebe, were
working with a robotic platform
that used very similar iron oxide nanoparticles as building blocks for microrobots. The engineers control the
movement of these robots using a
magnetic field, allowing a tether-free
way to steer them.
Together, the cross-school team designed, optimized and tested two
types of robotic systems, which the
group called catalytic antimicrobial
robots, or CARs. One system works
on surfaces and the other operates
inside confined spaces. After testing the robots on biofilms growing
either on a flat glass surface or in
enclosed glass tubes, the researchers tested the removal of biofilm
from hard-to-reach parts of a human
tooth. According to the researchers,
the CARs were able to degrade and
remove bacterial biofilms not just
from a tooth surface but also from
one of the most difficult-to-access
parts of a tooth, the isthmus.
“Existing treatments for biofilms are
ineffective because they are incapable of simultaneously degrading the
protective matrix, killing the embedded bacteria and physically removing the biodegraded products,”
noted Koo. “These robots can do all
three at once very effectively, leaving
no trace of biofilm whatsoever.”
“Treating biofilms that occur on
teeth requires a great deal of manual
labor, both on the part of the consumer and the professional. We hope
to improve treatment options as
well as reduce the difficulty of care,”
said Steager.
The team now hopes to move its
invention into clinical application
and has received support from the
Penn Center for Health, Devices and
Technology, an initiative supported
by the Perelman School of Medicine,
Penn Engineering and the Office of
the Vice Provost for Research at the
University of Pennsylvania.
A research paper, titled “Catalytic antimicrobial robots for biofilm eradication,” was published in the April
2019 issue of Science Robotics.
[29] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
THE COMPACT
MAKES
A BIG
CHANGE
To help any user of air driven handpieces
conver t to electric and enjoy the full
b e n e fi t s o f i t s h i g h f u n c t i o n a l i t y. A b i g
change in treatment environment is
brought with only a minor addition to the
current equipment in your off ice.
ELECTRIC MICROMOTOR UPGRADING SYSTEM
*NLZ E ：with Endo Function
[30] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
30
NEWS
© Andrey_Popove/Shutterstock
Dental Tribune Middle East & Africa Edition | 3/2019
Scientists
find effective
treatment for oral
pain caused by
radiation therapy
A new study has reported that doxepin mouthwash or diphenhydramine-lidocaine-antacid mouthwash may be effective in reducing
radiotherapy-related mucositis pain.
AD
By DTI
JACKSONVILLE, Fla., U.S.: Scientists
have recently discovered that an oral
rinse referred to as magic mouthwash significantly reduces the pain
caused by oral mucositis and mouth
ulcers in patients receiving radiation
therapy for head and neck cancers.
The mouthwash contains diphenhydramine, lidocaine and antacids.
www.celtra-dentsplysirona.com
The study was led by Dr. Robert C.
Miller, Professor of Radiation Oncology at Mayo Clinic. The findings
emerged from a multi-institutional
randomized, double-blind, placebocontrolled Phase III clinical trial.
“Our group published a study in 2012
showing that an oral rinse of doxepin reduced oral mucositis-related
pain, compared to placebo,” said
Miller. “However, there were no large
randomized controlled trials studying the potential benefits of magic
mouthwash.”
In the new study, conducted between November 2014 and May
2016, Miller and his colleagues studied 275 patients who underwent
definitive head and neck radiotherapy and had an oral mucositis
pain score of 4 points or greater. The
participants were followed up for a
maximum of 28 days. The research
team found that pain related to
oral mucositis was reduced by 11.6
points after using doxepin mouthwash and by 11.7 points after using
diphenhydramine-lidocaine-antacid
mouthwash, within 4 hours of administration. There was a reduction
of 8.7 points for placebo mouthwash.
Both experimental rinses were also
well-tolerated by patients.
CEREC® CAD/CAM Solutions
Designed to simply work better together
“Radiation therapy may cause
mouth sores because it is designed
to kill rapidly growing cells, such as
cancer cells,” said co-author Dr. Terence T. Sio, a radiation oncologist at
the clinic. “Unfortunately, healthy
cells in your mouth also divide and
grow rapidly, and may be damaged
during radiation therapy, which can
cause discomfort. We’re glad to have
identified a proven method to help
treat the discomfort of this side effect,” he concluded.
Celtra® Duo (ZLS) blocks, Prime&Bond universal™ Adhesive, and Calibra® Ceram Cement
were designed to enhance and strengthen the individual benefits each of them
provides, resulting in an easy-to-use system that streamlines the restoration process.
Celtra Duo (ZLS) blocks
• Restoration longevity of Celtra Duo (ZLS) is ensured when used with
Prime&Bond universal Adhesive and Calibra Ceram Cement
• Firing is optional: choose either fire and seat or polish and seat
Prime&Bond universal Adhesive
• No need to use a self cure activator when used with Calibra Ceram Cement
• Low film thickness to allow passive seating of the crown
The study, titled “Effect of doxepin
mouthwash or diphenhydraminelidocaine-antacid mouthwash vs
placebo on radiotherapy-related oral
mucositis pain: The Alliance A221304
randomized clinical trial,” was published online on April 16, 2019, in
JAMA.
Calibra Ceram Cement
• One-step curing when used with Prime&Bond universal Adhesive
• 10-second tack cure window and 45-second gel phase ensures an easy, no-stress cleanup
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DTMEA_No.3. Vol.9_DT_FINAL.indd
31
NEWS
Dental Tribune Middle East & Africa Edition | 3/2019
Scientists work on remedy
for painful jaw disease
By DTI
LOS ANGELES, U.S.: University of
Southern California (USC) researchers and collaborators from the
University of California, Los Angeles (UCLA) have reported a breakthrough in preventing the damage
to the jaw that is a side effect suffered by some people undergoing
treatment for cancer or osteoporosis.
The newly published research is an
important step toward a cure for osteonecrosis of the jaw, which is a rare
consequence of drugs commonly
used to combat bone loss.
the skeleton. “Think of it as a way to
fight fire with fire,” McKenna commented.
The scientists involved in the study
used mice to test different BPs attached to fluorescent dyes. One
coded the BP zoledronate, which is
administered systemically to treat
osteoporosis and cancer, while a different dye coded a BP compound
with similar bone affinity, but no
biological activity, referred to as rescue BP. The researchers discovered
that the rescue BP injected into the
jaw removed most of the BP drug
causing the jaw bone tissue damage, clearing the way for the animal’s
natural healing process to repair the
extraction site.
The new technique is not yet ready
for clinical use in humans. McKenna said BioVinc, which provided
The study, titled “Rescue bispho-
The Celtra® Duo (ZLS) 3-Step Restoration
and Cementation System for CEREC® Users
Designed to simply work better together
STEP 1
USC scientist Prof. Charles McKenna
said the research raises hope that
physicians could adapt the new
method to treat the condition in people. “This is a condition that has been
excruciatingly painful and difficult
to treat for more than a decade. We
think our new approach may provide hope for the future.”
Design and mill the restoration
Design the restoration as usual with CEREC, then mill
it out using Celtra Duo (ZLS) material.
Celtra Duo (ZLS) advantages:
• You choose the processing pathway: fire and seat, or
polish and seat—you’re always in control
STEP 2
A
A
Apply Prime&Bond universal™ Adhesive
Apply Prime&Bond universal Adhesive to the tooth.
Prime&Bond universal Adhesive advantages:
• Universal application means you’re in control: self-etch,
total-etch and selective-etch—it’s always your choice
• Low film thickness
• Virtually no post-op sensitivity
B
B
Apply Calibra® Ceram Cement
After etching and silanating the intaglio surface of the
restoration, apply a thin, uniform layer of Calibra Ceram
Cement to the internal surface of the restoration.
Although the condition is very rare
at the lower BP doses used to combat
osteoporosis, many patients avoid
the drugs altogether for fear of the
side effects. The risk is low, as the
National Osteoporosis Foundation
estimates incidence of osteonecrosis of the jaw owing to the BP used
to treat osteoporosis to be between
one in 10,000 and one in 100,000
people annually. The risk has been
estimated to be much higher, about
3 percent of patients, at the BP dose
used to treat cancer, McKenna said.
Nonetheless, more and more osteoporosis patients are willing to take
their chances with the disease rather
than risk the side effects. Surveys
have shown that the recent trend in
reduced hip fractures among postmenopausal women may be reversing owing to BP drug aversion.
“The fear factor of this condition has
led to severe underuse of bisphosphonates for osteoporosis, so much
so that we’re seeing a rise in hip fractures in elderly people, aversion to
bisphosphonates in oncology clinics
and liability concerns in the dental
office,” McKenna said.
sphonate treatment of alveolar
bone improves extraction socket
healing and reduces osteonecrosis
in zoledronate-treated mice,” was
published online ahead of print on
March 26, 2019, and is due to appear
in the June 2019 issue of Bone.
AD
Osteonecrosis of the jaw causes severe and persistent inflammation
leading to loss of bone from the jaw
and has no effective means of prevention or cure. The risk, though
small, deters people from taking
drugs needed to fight bone cancer
or prevent fractures owing to loss of
bone density.
For years, physicians have prescribed
a class of drugs called bisphosphonates (BPs) for metastatic bone cancer patients and for osteoporosis
patients to maintain bone density.
BPs include a range of compounds
that share a remarkable ability to adhere to bone, but when used in high
doses in the cancer clinic, BP drugs
sometimes have the debilitating
side effect of necrosis in the jaw. The
problem often occurs after a tooth is
removed; the extraction socket does
not heal, and the jaw begins to deteriorate.
funding for the study via a National
Institutes of Health small business
research grant, will be responsible
for advancing the treatment to commercial clinical use. Several of the authors of the study disclosed a financial interest in BioVinc, a company
specializing in bone-targeted therapeutics and diagnostics. McKenna is
the company’s academic founder.
Calibra Ceram Cement advantages:
• High bond strength for long-term restoration success
• Easy excess cement cleanup:
- wide tack cure window of up to 10 seconds means no worry
of over-curing
- 45-second extended gel phase gives you the time you need
for a thorough and effective cleanup
STEP 3
Seat restoration
Seat the restoration; the cement will set permanently
after final light curing of all areas of the restoration.
Developed to Make a Difference.
To place an order, contact your Dentsply
Sirona Representative.
For more information visit www.dentsplysirona.com
Find us on
www.facebook.com/dentsplysirona.mena
© Dentsply Sirona 2017
The research team used a different
BP compound, an inactive compound that could be used locally in
the mouth to push the BP drug from
the jawbone while leaving undisturbed the useful drug in the rest of
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32
NEWS
Dental Tribune Middle East & Africa Edition | 3/2019
Quality Beyond Reliability –
How Dentsply Sirona
defines design for treatment centers
By Dentsply Sirona
There is never a second chance for
the first impression. This phrase is
particularly true for a patient’s perception of a dental practice where a
treatment center is the centerpiece.
To convey the high quality and comfort of its treatment centers Dentsply Sirona places high value on
premium design – a central pillar of
the quality commitment “Quality
Beyond Reliability”.
What turns a plain dentist’s appointment into a first-class treatment?
Dentsply Sirona’s answer to this
question is the premium design concept for its treatment centers Teneo,
Sinius and Intego. In a concept where
“form follows function”, each treatment center visualises high-quality
functions by its ergonomic design
with elegantly clean lines. This ensures comfort for the patient as well
as an optimal working position and
workflow for the dentist.
Award-winning design with
three colour schemes
“Our treatment centers’ design
evokes trust and spreads an atmosphere of safety and reliability. The
patient experiences this in a fraction of a second”, explains Susanne
Schmidinger, Vice President Global
Brand Marketing and Clincial Affairs,
Equipment and Instruments. Dentsply Sirona’s treatment centers combine harmonious color design with a
distinctively streamlined shape. The
design concept provides three color
worlds grouping together shades
that harmonise particularly well
with each other. This convincing design received renowned awards such
as the iF Design Gold Award and the
nomination for the German Design
Award.
Premium design visualises
hand-made high quality
The essential basics for premium
design are high-value materials and
high-quality production processes.
Therefore, Dentsply Sirona’s treatment centers rely on three indispensable principles:
– Collaborating with specialized
designers guarantees that thetreatment centers show a state-of-the-art
ingenuity that fulfill andexceed the
customers’ high expectations.
– The research and development
(R&D) work hand in hand with theprocurement department to carefully select the best possible materialsfor the treatment centers.
– According to Dentsply Sirona’s demanding test procedures theupholstery needs to pass 250,000 stresses
and strains without loss of quality –
150,000 times more than officially
required.
The upholstery is available in two
versions: As a premium option that
is processed by thermoforming for
ultra-firm cushioning or as a handsewn lounge version with a smooth
and seamless surface for a flat design.
Latest design trenDS within
the dental sector
The latest trends in design will be
published in Dentsply Sirona’s exclusive trenDS magazine at this
year’s IDS. In this issue Dentsply
Sirona has discovered four exciting
new directions among dental practice designs all over the world: Mind-
Fig. 1: Award-winning product design
for a lasting impression. The treatment
center Teneo combines innovation and
design in perfect harmony.
ful Clarity, Striking Energy, Sensitive
Luminance and Refined Luxury. The
magazine includes personal interviews with dentists around the world
and some interesting background
articles on dental solutions and lighting, a look at the patient experience
in general and a myriad of stunning
and inspiring photos.
Tangible benefits
for patients and dentists
The well well-thought-out design of
Dentsply Sirona treatment centers
benefits both, patients and dentists.
Thanks to the compact but soft upholstery, patients enjoy a stable and
comfortable positioning including support of their shoulder and
back area. The cooling effect of the
thermo upholstery reduces accumulated heat in the seat and back
area to contribute to the patient’s
relaxation, whereas the lounge version offers extra comfort through
additional softness. Moreover, the
spacious legroom enables easy ac-
Fig. 2: How Dentsply Sirona defines design for treatment centres
cess to the treatment center. At the
same time, the dentist can work in
an ergonomic position throughout
the treatment. In addition, the treatment centers’ flat surfaces are easy to
clean and disinfect.
Dentsply Sirona
21st Floor, The Bay Gate Tower
Business Bay, Al Sa’ada Street
Dubai, United Arab Emirates
Tel.: +971 (0)4 523 0600
Web: www.dentsplysirona.com/MENA
E: MEA-Marketing@dentsplysirona.com
Stress—Friend or enemy?
By Michèle Reners
“Stress” is a term that is often misused and applied inappropriately. In
today’s world, being stressed is often
associated with a busy, active work
life. In reality, what we call “stress”
is actually a complex phenomenon
that weakens our organism and
whose main purpose is to maintain
internal balance. Stress is blamed for
many illnesses and, more than just a
risk factor, it is a real affliction.
But it was not always like this. Primitive humans lived under much
more stressful conditions than we
do today, since their survival was
constantly at stake. They had to
hunt to survive and were required
to either fight or flee. The reactions
generated by stress were a source of
energy that allowed them to survive
in the aggressive world they lived in.
They immediately channelled their
energy into action. In today’s world,
aggression is evidently more often
verbal and it is impossible to fight or
flee from a board of examiners, the
boss or a traffic jam. Stress often lasts
longer and is more intense (bullying
in the workplace, for example) and it
is here that the pathology becomes
ingrained.
But what is stress?
It is an adaptive response. In 1920,
Cannon proposed a scientific description of stress: “the body of any
complex animal manifests a stereotyped response pattern to any
environmental threat disturbing
its balance”, the well-known fight or
flight response. It was Selye who in
1936 named it the “general adaptation syndrome”. He described three
stages of physiological responses.
The first is the alarm stage, when
faced with a difficult situation. This
stage aims to mobilise resources:
breathing accelerates, fat is burned
and glucose released. The heart rate
increases and the five senses become
sharper. Digestion is interrupted and
saliva production decreases. Priority
is given to the muscles and the brain.
All of these reactions, or adaption efforts, are normal and useful and they
allow our body to adapt to a continually moving environment. If no action is possible and no solution conceivable for adapting to the threat,
the resistance stage begins. This
stage corresponds to a state of heterostasis, and it is at this stage that
psychological and/or psychosomatic
problems may begin. The stage of exhaustion marks the end of the stage
of resistance with the exhaustion of
resources and the abandoning of effort. This is burn-out.
Of course, everyone reacts differently to stressors, because everyone
sees things differently and has his
or her own capacity for adaptation
(or ability to cope). We talk about
successful coping behaviour when
the individual has a feeling of confronting and staying in control. It
would be a failure if he or she were
overwhelmed by events (stressors).
Selye also made a distinction between negative stress (distress) and
positive stress (eustress). The latter
is beneficial to everyone, as it allows
one to push one’s boundaries with-
out losing one’s internal balance and
reach a fixed objective (for example,
the stress of a sportsperson before a
competition).
What is the link between
stress and periodontal
disease?
Periodontal disease is an inflammatory multifactorial bacterial disease.
In necrotic periodontitis, stress has
long been recognised as a major risk
factor. Alexander the Great’s soldiers
were already suffering from this pathology, and later, it affected soldiers
in World War I, when it was known
as “trench disease”. Stages of activity
have been described in the development of periodontal disease. Stress is
considered to be an aggravating factor owing to two phenomena: stress
generates a change in behaviour on
the one hand and a reduction in immune defences on the other. Many
studies, some very old, have shown
that patients with depression have
a tendency to eat poorly, take less
care of themselves and increase their
consumption of tobacco, alcohol and
medication. We know that periodontal disease is stabilised if patients
carry out daily meticulous cleaning
of their teeth and interdental spaces.
Internal motivation is reduced in depressed patients and so negligence of
dental hygiene increases the amount
of biofilm and changes its composition. Nutritional deficiencies are also
responsible for decreased immunity.
Tobacco use is a recognised risk factor for periodontal disease. The accumulation of all these changes in
behaviour increases the risk of developing periodontitis or of relapsing.
The way in which stress acts on the
immune system is summarised
according to the hypothalamic–pituitary–adrenal axis. Psychosocial
stress is capable of activating the
hypothalamus, which will secrete
adrenocorticotropic
hormone,
which will in turn stimulate the
adrenocortical gland to produce glucocorticoids, of which cortisol has an
ÿPage 37
[33] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
33
NEWS
Dental Tribune Middle East & Africa Edition | 3/2019
Plant-based diet could help
reduce gingivitis
FREIBURG, Germany: A recent study
has shown that a plant-based wholefood diet enriched with omega-3
fatty acid and vitamin D is able to
reduce gingival inflammation naturally. Based on the findings of this
trial, the researchers recommended
that dental professionals ought to
assess dietary behaviour in patients
with gingivitis and provide dietary
recommendations in addition to
periodontal therapy.
For the trial, 30 patients with gingivitis were randomised to an experimental and a control group stratified
carbohydrates
and animal proteins, and rich
in omega-3 fatty
acid, vitamin C,
vitamin D, antioxidants, plant
nitrates and fibre
for four weeks,
whereas
the
control group
remained
on
A new study has suggested that gingivitis is profoundly affected
their
western
by diet.
diet. All particiby their plaque values, which were pants stopped using dental floss and
taken at baseline and the end of other interdental cleaners during the
the study. The experimental group trial period. Periodontal parameters,
changed to a diet low in processed such as subgingival plaque values
© 9dream studio/Shutterstock
By DTI
and gingival bleeding, after the procedure were assessed by a blinded
dentist.
The findings indicated that, although
there were no differences regarding
the participants’ plaque values, the
experimental group experienced
a significant reduction in gingival
bleeding. Apart from the potential
benefit for oral health, a substantial
increase in vitamin D values and
weight loss was also evident.
“Study results clearly demonstrate
the possibility to naturally reduce
gingivitis by an optimised diet that
also promotes general health. According to this, dental teams should
address dietary habits and give adequate recommendations in the
treatment of gingivitis, since it might
be a side effect of a pro-inflammatory western diet,” said lead author Dr
Johan Wölber, a dentist and research
assistant in the Department of Operative Dentistry and Periodontology
of the Centre for Dental Medicine at
the University of Freiburg Medical
Centre.
The study, titled “The influence of an
anti-inflammatory diet on gingivitis.
A randomized controlled trial”, was
published online on 2 April 2019 in
the Journal of Clinical Periodontology ahead of inclusion in an issue.
AD
◊Page 36
immunosuppressive action. The adrenal cortex will produce catecholamines because it is stimulated by the
autonomic nervous system.
It is interesting to note that coping
behaviour is a determining factor
in the outcome of periodontal treatment: results are better in patients
who are good at coping. The latest
research highlights emotional intelligence; the higher it is, the better patients respond to periodontal
treatment.
How should we deal with
stress?
We must diagnose stress in our patients and direct them to specialised
therapists. However, patients are
not the only ones who suffer from
stress; dentistry is a highly stressful
profession. It is therefore important
to detect stress early and manage it
effectively. We know more now than
ever about the causes of stress, how
it works, its consequences and antidotes. To start with, we can adopt
a healthy lifestyle and follow some
recommendations. Sport is the ideal
way of reducing stress, since physical
activity frees the energy accumulated by stressful situations. Whatever sport one chooses, one should
enjoy it and set reachable goals at the
beginning. Some prefer relaxation
with yoga or meditation, including
Meditation-Based Stress Reduction.
It has also been shown that these
techniques directly stimulate the
regions of the brain associated with
well-being, relax muscles and have
an analgesic effect. Having pleasant
social interactions and avoiding isolation reduces the secretion of cortisol. Similarly, relaxation techniques
reduce the concentration of catecholamines.
Stress is our body’s alarm signal,
and it is important to detect it. It can
remain our friend if we listen to it.
However, if we ignore the warning
signs and fail to recover the internal
balance, it can quickly become our
worst enemy.
More shades.
More indications.
More success.
SDR Plus
®
At Dentsply Sirona, we’re always asking how we can make our industry-first
products even better. We started with our proven SDR formula, then added
increased wear resistance, greater radiopacity, more clinical indications, and
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Editorial note: A list of references can
be obtained from the publisher.
dsp_915_2017_SDR_plus_Revised_Print_Ad_v4_FINAL.indd 1
7/21/17 10:33 AM
[34] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
Dental Tribune Middle East & Africa Edition | 3/2019
34
NEWS
Unilever to acquire
Fluocaril and Parogencyl brands
from Procter & Gamble
By DTI
LONDON, UK/ROTTERDAM, Netherlands: Unilever has announced
that it has signed an agreement to
acquire the Fluocaril and Parogencyl oral care brands from Procter &
Gamble.
Fluocaril and Parogencyl are wellknown therapeutic brands sold in
the pharmaceutical industry, pri-
marily in France and Spain. They
have a product portfolio that is widely endorsed by health professionals.
Fluocaril offers oral care solutions
specialising in protection against
dental caries. Parogencyl tackles gingival issues.
The acquisition will give Unilever a
leading role in oral care in the pharmaceutical industry in France, as
well as a strong position in Spain.
Research finds
presence of dental
phobia not a barrier
to treatment
With their powerful brand heritage,
high visibility and sound reputation with dentists, these brands are
a great complement to the existing
oral care portfolio of Unilever.
By DTI
LONDON, UK: It has been estab-
The terms of the deal were not disclosed. The acquisition is expected to
close in the second quarter of 2019.
lished that patients with a phobia of
dentistry may often delay visiting
the dentist or avoid it altogether. It
comes as welcome news, then, that
a recent study has found that treat-
AD
The fast way to esthetic perfection.
ment plans offered by dentists are
overwhelmingly influenced by the
complexity of the patient’s oral situation and are not impeded by the
presence of a phobia.
Though over 50 per cent of the British public say that they are anxious
about visiting the dentist, 12 per cent
have such high anxiety levels that it
can be classified as a phobia. These
patients frequently have poorer oral
health and higher rates of dental
caries, outcomes that are partially
driven by an avoidance of clinical
treatment.
A new study conducted by researchers from King’s College London set
out to test whether the presence of
a dental phobia modifies the proposed treatment plan for such a patient compared with the plan for a
non-phobic patient. The researchers
invited 79 UK-based dental practitioners to create a treatment plan for
an imagined patient that had either
simple or complex treatment needs
based on a number of dependent
variables, such as periodontal treatment, extractions and provision of
crowns.
The natural fine-structure feldspar veneering ceramic for zirconia frameworks.
The results of the study showed that
dentists offered a more complex
treatment plan for complex conditions and that treatment decisions
were primarily influenced by the
oral needs of the patients, and not
whether or not a dental phobia existed.
3519E
Dr Ellie Heidari, lead author of the
study and a senior specialist clinical
teacher at King’s College London,
said in a release regarding the study:
“In order to deliver dental care for
people with dental phobia, it is important to adapt an approach, where
prevention of oral diseases and preservation of teeth, when possible,
is provided as part of dental care
plans.”
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“Another important component in
their care would be to address dental
phobia by providing them with an
opportunity to access cognitive behavioural therapy. This is a therapy
that has been proven to be very successful,” she added.
Dr Tim Newton, Professor of Psychology as Applied to Dentistry at King’s
College London, commented: “Those
with dental phobia are experiencing
both the enormous challenges of
living with their fear, and of having
poorer oral health. It is gratifying to
see that for the dental team the presence of a phobia is not perceived to
be a barrier to complex restorative
or preventive approaches. We hope
to be able to ensure that not only do
people with dental phobia derive the
benefits of good oral health but also
overcome their fear through the
most effective treatment—cognitive
behaviour therapy.”
The study, titled “The impact of
dental phobia on care planning: A
vignette study”, was published in the
April 2019 issue of the British Dental
Journal.
[35] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
From British Academy of Restorative Dentistry
DUBAI
2019-2021
Prof. Paul Tipton,UK
Specialist in Prosthodontics
President, British Academy
of Restorative Dentistry
Prof. Edward Lynch, UK
The University of Warick, Coventry
PhD, Lond, MA, BDentSc, TCD, FDSRCSEd,
FIADFE, FDSRCSLond, FASDA, FACD
Prof. Göran Urde, Sweden
Director Futurum Clinic
Program Director P.G Education
Dept. of Materials Sci. & Tech.
Prof. James Prichard, UK
BDS (ULond), MSc(ULond),
LDSRCS (Eng), MFGDP (UK)
FIADFE (USA)
Dr. Malcolm Riley, UK
BDS (Lon), LDS RCS(Lon),
FDS RCS(Lon), MRD(Ed),
FDS RCS(Ed)
Dr. Matthew Holyoak, UK,
BDS, Dip Rest Dent
(RCS Eng), MSc (Rest Dent)
Dr. Timothy Eldridge, UK
BDS Birm
Clinical Director myFACE
Dr. Adam Toft, UK
BSc (Hons), BDS (Hons), MFGDP (UK),
MMedSci (Rest Dent), Dip Aesth (BARD)
FBARD PGCertEd (Sheffield)
Dr. Ash Rayeral, UK
BDS MFGDP(UK) MSc
(Aesthetic and Restorative
Dentistry)
Dr. Adam Nulty, UK
BChD MJDF RCS Eng
PGCert MSc (Dist.)
MAcadMEd
Group 5
Registration Open
Pathway to UK
Masters
210 CME & Daily
Hands-on
Certificate | 4 Modules | 15 Days
Module 1 | 19-21 September 2019 | Prof. Paul Tipton & Dr. Adam Toft & Dr. Ashish Rayarel
Treatment Planning in Advanced Restorative Dentistry | The Principles of Occlusion in Advanced Restorative Dentistry | Tooth
Preparation in Advanced Restorative Dentistry
Module 2 | 20-23 November 2019 | Prof. Paul Tipton & Dr. Matthew Holyoak & Dr. Adam Toft & Dr. Ashish Rayarel
Minimally Invasive Veneer Preparations | Master the Art of Composites Part 1 - Adhesion Composites & Anterior Composite
Restorations | Master the Art of Composites Part 2 - Composite Veneers | Master the Art Composites Part 3 - Posterior Composites
Module 3 | 19-22 February 2020 | Prof. Paul Tipton & Prof. James Prichard & Dr. Adam Toft & Dr. Ashish Rayarel
Enhance Your Expertise in Endo Part 1 | Enhance Your Expertise in Endo Part 2 | Occlusal Examination | Emax & Zirconia Anterior
& Posterior Restorations
Module 4 | 08-11 April 2020 | Prof. Paul Tipton & Dr. Malcolm Riley & Dr. Adam Toft & Dr. Ashish Rayarel
Bridge Design | Aesthetic Perio Connective Tissue Grafting | Aesthetic Perio Crown Lengthening | Modern Post and
Core Techniques
Diploma | 4 Modules | 15 Days
Module 5 | September 2020 | Prof. Paul Tipton & Dr. Adam Toft & Dr. Ashish Rayeral
Bridge Preparation Techniques | Articulator selection in Restorative Dentistry | Porcelain Inlays & Onlays | Veneer Cementation
Techniques Practical
Module 6 | November 2020 | Prof. Paul Tipton & Mr. Gary Jenkinson & Dr. Adam Toft
The Art & Science of Aesthetic Dentistry Part 1 & Anterior Diagnostic Waxing | The Art & Science of Aesthetic Dentistry Part 2
& Posterior Diagnostic Waxing | TMD, It's Diagnosis and Treatment | Adhesive Bridge Preparation Techniques
Module 7 | February 2021 | Prof. Paul Tipton & Prof. Edward Lynch & Dr. Adam Nulty & Dr. Adam Toft & Dr. Ashish Rayeral
Minimally Invasive Dentistry | Digital Dentistry Workflow & Photography Principles, Hardware and Storage Part 1 & 2
Module 8 | May 2021 | Prof. Göran Urde & Dr. Timothy Eldridge & Dr. Adam Toft & Dr. Ashish Rayeral
Implant Prosthodontics Part 1 & 2 | Botox & Dermal Fillers – A Dental Facial Aesthetics Part 1 & 2
[36] =>
DTMEA_No.3. Vol.9_DT_FINAL.indd
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)
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