DT Middle East and Africa No. 5, 2013

NEW: 5th Dental Facial Cosmetic International Conference Hosts Inman Aligner Accreditation Course / Emirates Dental Society Attends Annual World Dental Congress On Dental Technology And Oral Health To Bring Back Key Learnings To The UAE / Snoring And Sleep Apnoea – A Role For The Dentist / Esthetic Long-Span Bridge Using BruxZir / Oral Health Benefits Of Chewing Gum / Applying CBCT To Endodontics Can Reveal Deficiencies That Otherwise Might Go Undiagnosed / New Treatment Center - SINIUS TS - Offers Maximum Flexibility / Dental Technician Forum 2014 in Singapore / BIDM 2013 Show Edition / 3Shape Releases CAD Solution For Post And Core Restorations / Oral Management Of Oncology Patients Requiring Radiotherapy / Dubai School Of Dental Medicine Welcomes Second Batch Of Students / The Up-To-Date Series Of Educational Events Start In The Middle-East / Qualident I Snore Device / Growing Old…Healthily

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1
20
BIDM
OW
H
S

EDITION

DENTAL TRIBUNE
The World’s Dental Newspaper · Middle East & Africa Edition
www.dental-tribune.com

Printed in Dubai

september - october 2013 | No. 5, Vol. 2

ORAL HYGIENE
The Up-To-Date Series
Of Educational Events
Start In The Middle-East

MEDIA CME
Esthetic Long-Span
Bridge Using BruxZir

PRODUCT LAUNCH
New: Sensodyne
Complete Protection

SHOW EDITION
BIDM 2013 Beirut
Lebanon

> Page 22

> Page 6-7

> Page 14-15

> Insertion

NEW: 5th Dental Facial Cosmetic International
Conference Hosts Inman Aligner Accreditation Course
Inman Aligner M.E. is a division of Middle East Dental Laboratory

NOW IN THE UAE
Since 1995 Middle East Dental Laboratory has been a vanguard of the latest advancements in the field of

The Inman
is a revolutionary
By technology
Inman Aligner
dental
in the UAE; and gained a reputation for expertise
in the Aligner
fields of orthodontics
implants

and________________________
cosmetic dentistry.

appliance described as the “missinglink” between cosmetic dentistry and
orthodontics. It can move teeth in the
Now with the support of a state‐of‐the‐art full service laboratory, dental suites and skilled technicians our
anterior region quickly, safely and
expanded facility is able to offer Inman Aligners ‐ an innovation in front teeth alignment. The Inman Aligner
he 5th Dental Facial Cospredictably using a single appliance.
is a simple removable
used to align front
teeth quickly and safely. It's ideal as a stand alone
meticappliance
International
ConWhether it’s a standalone treatment
treatment or to ference
pre‐align teeth
prior to
further with
cosmetic options such as bonding or minimal veneers.
joint
event
or prior to further cosmetic dentistry,
2nd Global Conference of
patients and dentists love the speed
the
Academy
How
doesAmerican
it work? The Inman
Aligner of
has Implant
Nickel Titanium of
coil springs
that power
aligner
bows that
treatment.
At two
last,
conservative,
Dentistry
onother,
08-09
November
at their
the newno-compromise
gently
oppose each
guiding
the teeth into
position. These gentle forces
are active
over a
cosmetic
dentistry
Beach
Hotel
in isDubai
has works
become
a great
andshows
is now
veryJumeirah
large range of
movement,
which
why the will
Inman Aligner
so quickly.
Theoption
image below
host
the
newest
product
in
aesthetic
available
in
the
UAE.
the squeeze effect of the two aligner bows on the front teeth. The inner bow pushes forwards, while the
orthodontic treatment provided by
outer bow pulls back on the front teeth.
Inman Aligner.
Inman Aligner will be launching

the highly recommended handson course “The New Concept of
Alignment, Bleaching and Bonding
(ABB) (Inman Aligner Accreditation
Course). Taking place on November
10 between 9am – 6pm attendees will
be able to get started right away. Certified providers can access free online
support, revision courses, marketing
materials, downloads and the ‘Spacewize’ crowding calculator.

> see filling page 21
Fig. 1 The sgeeze effect of the two aligner bows on the front teeth.

As the leading dental laboratory in the Middle East, we work within international guidelines to
deliver this latest advancement in the field of dental technology. Our experienced staff offer a
bespoke service for optimal results.
The first course in Dubai to become an accredited Inman Aligner doctor is being held on
November 10th and 11th 2013. Check the web site for more course information and other
upcoming training dates & events.

UAE clients call 800-INMAN. www.inmanaligners.com
Overseas clients call 009714 3329201
1901 White Crown Building PO Box 12135 Dubai UAE Tel: 009714 3329201 800INMAN Email: inman@mdentlab.com

[2] =>

NEWS

Dental Tribune Middle East & Africa Edition | September - October 2013

Emirates Dental Society Attends Annual World Dental
Congress On Dental Technology And Oral Health To
Bring Back Key Learnings To The UAE
The Emirates Dental Society urges UAE residents to adopt a complete oral health regimen, of brushing flossing, dental visits and even
chewing sugar-free gum, and announce intention to host a mega dental congress in Dubai next year
than 80 percent of the population. In
an effort to combat these staggering
statistics and further advance oral
care in the UAE, a delegation from
the Emirates Medical Association’s
Dental Society (EDS) headed by its
President, Dr Aisha Sultan Alsuwaidi, attended the 2013 Annual World
Dental Congress (FDI) in Istanbul,
Turkey on 28th-31stAugust.

Dr. Aisha Sultan
President of EDS

By Emirates Dental Society

________________________

ubai, UAE. According to
recent research conducted by SEHA, (Abu Dhabi
Health Services Company), 64% of school children in the
Emirates show signs of tooth decay,
largely due to poor dental hygiene.
Furthermore, data shows tooth decay
a largely preventable condition to be
the most prevalent chronic health
condition in the UAE affecting more

According to Dr Aisha Sultan and
based on Emirates Dental Society
surveys and data resources; “Four out
of five people residing in UAE exhibit
signs of tooth decay” commented Dr
Aisha Sultan. This is particularly alarming given the fact that tooth decay
is largely preventable through good
oral hygiene habits such as brushing
at least twice daily, flossing, chewing
sugar-free gum and regular visits to
dentists.
Dr Aisha Sultan continued, “Each year
at FDI, we are able to bring back key
advances to the Emirates that might
help improve the oral health practices
of our residents. For example, scientific evidence shows that something
as simple as chewing sugar-free gum
following meals has significant oral
health benefits. It stimulates saliva,

which washes away food debris, and
ultimately leads to healthier teeth and
gums. This is one simple and perhaps
underutilized and undervalued option that helps prevent tooth decay and
begin to establish a good oral healthcare routine.”
In an effort to promote oral health
awareness and good oral hygiene
practices in the UAE, the EDS is
collaborating with the Asia Pacific
Dental Federation, the UAE Ministry
of Health and the Emirates Medical
Association to host an international
dental event in Dubai next year. The
Asia Pacific Dental Congress (APDC)
will be held at the Dubai World Trade
Center from the 17th to the 19th of
June 2014. The congress is expected
to attract more than 3,000 dental industry experts from approximately
45 countries. As such, APDC Dubai
2014 is set to become the largest industry event in the region.
Dr Aisha Sultan, President of the
Emirates Dental Society and Chairperson of APDC, commented, “Our
aim is for the APDC to feature a
broad scientific program that truly
underlines pioneering research and
technological developments which

region, but will also showcase our
commitment to improving the general health and the overall wellbeing of
the natives and residents of the UAE
and beyond.”

have the potential to change the landscape of oral healthcare and hygiene.
The global dental community recognizes the positive impact of good
oral hygiene on the general wellbeing
of the society. The theme for APDC
2014 is Improving Quality of Life
through better Dental Care. APDC
will not only provide an opportunity
to uplift the dental profession in the

To learn more about APDC Dubai
2014, please visit http://apdentalcongress.org.

International Imprint
Licensing by Dental Tribune International Group
Editor

Daniel Zimmermann

newsroom@dental-tribune.com

+49 341 48 474 107
Clinical Editor

Magda Wojtkiewicz

Online Editors

Yvonne Bachmann
Claudia Duschek

Copy Editors

Sabrina Raaff
Hans Motschmann

Publisher/President/CEO

Torsten Oemus

Director of Finance & Controlling Dan Wunderlich
Business Development Manager

Claudia Salwiczek

Media Sales Managers

Matthias Diessner (Key Accounts)
Melissa Brown (International)
Peter Witteczek (Asia Pacific)
Maria Kaiser (USA)
Weridiana Mageswki (Latin America)
Hélène Carpentier (Europe)

Marketing & Sales Services

Esther Wodarski

Accounting

Karen Hamatschek

Executive Producer

Gernot Meyer

Dental Tribune International
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Tel: +49 341 4 84 74 302 |
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info@dental-tribune.com
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Dental Tribune Middle East & Africa
Edition Editorial Board
Dr. Aisha Sultan Alsuwaidi, President Emirates Dental Society, UAE
Dr. Nabeel Humood Alsabeeha, Consultant Prosthodontist,
Ministry of Health, UAE
Dr. Dobrina Mollova, MDS, UAE
Dr. Munir Silwadi, BDS, MRCDSO, DUSS, FADI, FICD, UAE
Dr. Khaled Abouseada, BDS, MS, orthod. cert.
Consultant Orthodontist , KSA
Dr. Rabih Abi Nader, B.D.S, D.E.S, D.E.S.S, Oral Surgeon and
Implantologist, UAE
Rodny Abdallah, Dental Technician, CDT, Lebanon
Director of mCME

Dr. Dobrina Mollova
info@cappmea.com
+971 50 42 43072

Business Development Manager

Tzvetan Deyanov
deyanov@dental-tribune.com
+971 55 11 28 581

[3] =>

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[4] =>

ev en ts

Dental Tribune Middle East & Africa Edition | September - October 2013

Snoring And Sleep Apnoea – A Role For The Dentist
By Dr. Danielle Stephenson

________________________

leep apnoea has been known,
and reasonably well understood, by the medical profession for a considerable time.
Indeed, there are accurate descriptions of sufferers in some of Charles
Dickens’ work. However, the disease
process was not understood during
the Victorian period and it wasn’t
until the 1980s that technology was
developed to help treat the problem.
The last decade in particular has seen
far greater understanding of the disorder and the introduction of simple,
cost-effective solutions that deliver
real benefits for patients.
Sleep-related breathing disorders are
caused by varying degrees of collapsibility of the pharyngeal airway and
range from simple palatal snoring
to obstructive sleep apnoea. Simple
snoring (affecting up to 45% of the
adult population) is itself a health
hazard. It has been shown to lead
to poor memory, excessive daytime
sleepiness, inability to concentrate,
and reduction in overall performance
due to the resultant sleep disturbances.
With Obstructive Sleep Apnoea
(OSA) there is a much greater degree

of collapse of the pharyngeal airway,
causing obstruction, which leads to
pauses in breathing (‘apnoea’) or episodes of abnormally shallow breathing (‘hypopnoea’). The hypoxia and
hypercapnia resulting from these apnoeic and hypopnoeic events wakes
the sufferer in order to re-establish
patency and normal ventilation.
Snoring is present in nearly all OSA
patients and is classically very loud
and intermittent. The snoring may
be accompanied by gasping and some
patients may wake with the feeling
they are choking or gagging. Most
problematic of all for sufferers is excessive daytime sleepiness as a result
of the hypoxia and poor quality sleep
arising from the multiple arousals
from sleep. Left untreated, OSA is also
thought to place patients at increased
risk of hypertension, coronary artery
disease, heart failure, cerebrovascular
disease and sudden death.
Dr. Ama Johal, Consultant and Senior Lecturer at Barts and the London
Queen Mary’s School of Medicine
and Dentistry and a leading expert
in the field of sleep-related breathing
disorders, said: “There is ever increasing awareness of sleep-related breathing disorders and the role mandibular
advancement splints play in treating
them. CPAP – continuous positive
airway pressure – remains the gold
standard treatment for severe cases of

OSA. However, mandibular advancement splints, provided by a patient’s
dentist, can offer a much simpler and
more comfortable solution which can
effectively treat many cases of mild
and moderate OSA and eliminate
snoring. There are a number of appliance designs on the market but not all
have the same evidence base behind
them.”
With an increasing awareness of the
problem there has been an increase
in demand for the provision of mandibular advancement splints to treat
these conditions, the demand coming
both directly from patients attending
dental practices and also on referral
from medical colleagues.
Nicolas Bell, Managing Director
of training company CPD Dubai
agrees. “We are aware of the increasing demand from dentists to be able
to provide mandibular advancement
splints to treat a range of sleep-related
breathing disorders. These disorders
can have a profound effect on sufferers, their partners and those around
them and we think this can be both
a professionally and commercially
satisfying area for dentists to get involved with. We have invited Dr. Ama
Johal to come and speak on the topic
to increase understanding amongst
dentists in the regions and improve
their ability to safely assess and treat

Fig.3, 4, 5: The ‘Sleepwell’ mandibular advancement splint.
Fig.1: CPAP machine

patients using mandibular advancement splints.”
The treatment of snoring and sleep
apnoea using mandibular advancement splints is a rapidly expanding
market both in Europe and North
America, but despite large numbers
of sufferers in the region, there are
relatively few dental practitioners in
the Middle East who can provide effective appliances. Samer Sabbagh,
Managing Director of Qualident
Dental Laboratory, said: “We view
mandibular advancement splints as
a core product we need to be able to
provide to practices across the UAE
and beyond. We have been working
with a UK company called S4S to undertake the required training to fab-

ricate the Sleepwell appliance which
is by far the most clinically proven
and effective design. The Sleepwell is
a soft, slim-line, two-piece appliance
that unlike many similar appliances
allows full lateral movement with the
degree of advancement being fully
adjustable. We are also looking to
support local dentists with marketing
and education materials for patients”.

Contact Information
Information on CPD Dubai,
licence renewal requirements and
upcoming courses can be found
at: www.cpd-dubai.com

‘Snoring and Sleep Apnoea – A Role for the Dentist’
will take place on October 12th at The Address Hotel,
Dubai Marina.
Please visit www.cpd-dubai.com for more information and
to make your booking.
Fig.2: With appliance

[5] =>

W

NO
Y
L
P
P
A

CURRICULUM RECOGNIZED BY ROYAL COLLEGE OF EDINBURGH

2014

[6] =>

M edi a CME

Dental Tribune Middle East & Africa Edition | September - October 2013

Esthetic Long-Span Bridge
Using BruxZir

Centre for Advanced Professional Practices (CAPP) is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental Association to assist dental professionals
in identifying quality providers of continuing dental education. ADA CERP does not
approve or endorse individual courses or instructors, nor does it imply acceptance of
credit hours by boards of dentistry.

mCME articles in Dental Tribune have been approved by HAAD as having
educational content for CME credit hours. This article has been approved for
2 CME credit hours.
By Mark McOmie, DMD
________________________

ne of the challenges that
we face in dentistry today
is how to build a longspan bridge with maximum esthetics in mind. In the age
of implants, we can usually shorten
the span by adding in a few implants
or eliminate the need for a bridge all
together by using implants to replace
those missing teeth.
However, what about those cases
where we don’t have the quality or
quantity of bone that we need, a medical history that won’t allow implant
surgery such as free bleeding, a highrisk host such as a poorly controlled
diabetic, smoker, etc.? Often times a
patient doesn’t desire to go through
the complex surgery of a sinus lift or
bone graft to make an acceptable site
for implants.
Patients should be given the options
and risks associated with each approach and allowed to make an informed decision with the dentist’s
guidance. For a missing tooth there
could be five or more options presented to the patient as ways to restore
the space.

of tooth #8 and fractured the porcelain in an incisal gingival direction.
About 2 mm of porcelain came off
toward the distal contact.
The metal substructure of the bridge
was showing. The piece of porcelain
was intact. She was on her way to a
meeting she could not get out of and
desired a temporary fix.
I tried the piece of porcelain in and
found it to be adequate but not an
exact match for fit. Some of the porcelain had chipped away and was lost.
I rough-ened the surface of the bridge
in her mouth in the area that needed
the repair then placed K-etchant Gel
by Kuraray to clean the area. I used
Alloy Primer from Kuraray on the
metal substructure.
On the porcelain, I placed Clearfil
Ceramic Primer. Clearfil Majesty flowable composite was placed on the
metal and on the piece of chipped
porcelain. I refit the porcelain and
light cured. All of these materials to
do the repair are readily available in
the Clearfil Repair Multi-Purpose kit
from Kuraray.
It makes life simple to have eve-

rything you need in one place. The
patient was able to get on with her day
and made it on time to her meeting
(Fig. 5). You can see the repair on the
distal of #8.
Material selection
In the pre-op photo (Figs. 1,3, 5) you
can see there is the telltale sign of a
metal allergy to the metal that is in
the bridge. The dreaded “black gum”
look. In addition, there is a difference
in height of the gingiva on teeth #8
and #9. The patient had already made
the choice of a bridge, now we had to
decide which material to use.
The patient reported that she has
metal allergies to jewelry unless it is
gold. So odds are high that any metal
we use that is not 80 percent gold or
more is going to cause a metal allergy and the dark gingiva. However, a
metal that high in gold will bend on
this long of a span, so we ruled out the
use of metal. By eliminating the metal, the “black gum” look will go away
(Figs. 5, 6).
BruxZir was the material of choice for

A case history
In 1998, a 39-year-old female presented with an abnormally loose tooth
#12. Upon radiographic and clinical
examination, it was noted there was
little to no root left on teeth #10–13.
Teeth #8 and #9 appeared normal as
did tooth #14. Her gingival health was
optimal and her medical history was
unremarkable, and she was taking no
medications at the time.
The patient recalled that when she
was 14 years old she was hit in the
face right above these teeth with a
golf club during a friend’s backswing,
which probably lead to the resorption
of the roots of the teeth in question.
All options and risks were explained
to the patient.
The sinus floor was 3 to 4 mm from
the crestal bone. Implants with a sinus
lift to allow room for placement were
discussed. The patient did not like the
idea of surgery and the healing time
that would be required for a permanent restoration.
A partial was discussed; however, the
young patient did not want to have a
partial and was worried her esthetic
demands would not be met. More
options for less permanent treatment
were offered, but the patient did not
desire them.
The patient choose to do a long-span
bridge, double abuting on teeth #8
and #9 with pontics to replace teeth
#10–13 and using tooth #14 as a distal abutment. This would meet the
patient’s demands for esthetics and
be a non-removable restoration. She
would have the permanent restoration in less time than it would take to
undergo implant therapy.
Porcelain-fused-to-metal was used
on the original bridge work done in
1998. The highest noble metal content available that could span a fourpontic length was used. The porcelain
work was done with a layered porcelain technique to provide a life-like
appearance.
In January 2012, the patient, who
was now 52 years old, presented
with a broken tooth. She was eating a
peppermint, incised it with the distal

Fig.1: Full face with the old bridge.
(Photos/Provided by Dr. Mark McOmie)

Fig.2: Full face with the new BruxZir
bridge and IPS e.max veneer on tooth #7.

CAPP designates this activity for 2
continuing education credits.

this case. BruxZir is a solid zirconia
material that is sold to laboratories in
a pre-sintered disk. CAD/CAM technology is then used to design and mill
the restoration.
BruxZir Zirconia exceeds the flexural strength of typical zirconia (up to
1,465 MPa versus 1,200+ MPa for typical zirconia). BruxZir exhibits three
to six times the fracture toughness
(also known as the K1C value) of typical zirconia.
To better understand this concept,
consider that a piece of steel or lead
has high fracture toughness, whereas
glass or brittle materials have a low
K1C value. This property gives it high
impact resistance. It also has excellent
resistance to thermal shock. This low
thermal expansion means the restorations will remain very stable in the
mouth.
BruxZir is available in all the Vita
Classic shades. Due to the esthetic demands of the patient, a mono- lithic
colored restoration would not be acceptable. By performing a “cut back”
on the facial of the bridge, we could
achieve the desired esthetics and have
the necessary strength. The advantage
of BruxZir zirconia over other zirconia frameworks with overlay porcelain is that the lingual and occlusal
surfaces do not have the opportunity
to de-bond or chip.
The old bridge had metal lingual on
#8 and #9 (Fig. 3) and a metal occlusal surface on tooth #14. This allowed minimal tooth reduction. Using
BruxZir allows us to use the same
minimal reduction, as low as 0.5 mm,
thus conserving tooth structure. In
addition, BruxZir allows us to have
the esthetics desired with no additional reduction (Figs. 3, 4).
If using a zirconia framework system
that required full-contour porcelain,
we would need to reduce tooth #14
substantially. This theoretical reduction would give a clinical height on

the prep of around 1 mm.
This would be an insufficient abutment for a bridge of this length.
Minimal preparation of the tooth
structure, especially on #14, makes
BruxZir an ideal material.
Additional considerations were given
to try to balance this smile. The patient wanted to change the anatomy of
#7 and add a little more length. A veneer was added to this case on tooth
#7. IPS e.max lithium disilicate by
Ivoclar Vivadent was chosen for the
veneer material. IPS e.max lithium
disillicate is an all-ceramic material
that is available in a millable block
or pressable ingot using the lost wax
technique. IPS e.max CAD blocks
have a flexural strength of 360 MPa
versus 400 MPa for the IPS e.max
press ingot.
Blocks and ingots are available in various shades and levels of opacity to
achieve a final shade match. A stump
shade is recommended for IPS e.max
due to the level of translucency. IPS
e.max press was used for the veneer
and is indicated for anterior crowns
and bridges with one pontic as well
as posterior single units. A gingival
recontouring procedure to match
gingival heights was performed on
teeth #8 and #9 using radiosurge electrocautery.
Lab portion
This case was sent to Oral Arts Dental
Laboratories, a full-service lab located
in Hunstville, Ala. I took a stick bite
to establish the horizontal place along
with full upper and lower impressions and bite. Once the model work
was completed, the models and dies
required digital scanning. BruxZir is
a CAD/CAM-fabricated material and
thus must be digitally designed by a
technician using a digital scanner and
design software.
Once the final contours and design

Fig.3: Lingual of old bridge with metal lingual and occlussal surfaces on the abutments.

Fig.4: Lingual of new bridge; the BruxZir material allows us to have full contour with the
desired esthetics without having to reduce any more than would be required with metal.

Fig.5: Notice the porcelain repairs on the distal of tooth #8 on this old bridge.

Fig.6: Black at the gingiva is gone on this new bridge, and the gingival collar is more uniform.

[7] =>

Dental Tribune Middle East & Africa Edition | September - October 2013

M edi a CME

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Membership:
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Fig.7: The screen shot of the design from Oral Arts Dental Lab in Huntsville, Ala.

The answers and critiques published herein have been checked carefully and
represent authoritative opinions about the questions concerned.
Articles are available in www.cappmea.com after the publication.For more
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DETAIL AT THE END OF EACH ARTICLE.

Fig.8: Full-contour zirconia cut-back to allow porcelain on the facial to increase esthetics.

Fig.9: Porcelain facial applied to the BruxZir.

Fig.10: Layout of crowns on a design computer to be milled in BruxZir.

are complete, the file is “nested” or
positioned in the zirconia disk (Figs.
10, 11) and milled to a full contour
approximately 30 percent larger than
the final restoration. Once the restoration is milled and removed from
the disk, it is dipped in the appropriate coloring solution and sintered in
an oven for 6.5 hours at 1,530 degrees
Celsius where it shrinks to its final
size.
I requested that Oral Arts e-mail me
the initial design for my approval
before milling (Fig. 7). The case met
my expectations on design and we
proceeded with fabrication. On large complex cases, I enjoy the option
of approving digital case design via
e-mail before case completion. After
the bridge framework was sintered
and checked for accuracy of fit and
margins (Fig. 8), IPS e.max Ceram
was stacked and baked onto the facial
surfaces for enhanced esthetics. IPS
e.max Ceram is a stackable ceramic
powder within the IPS e.max system.
The veneering ceramic is the key to
highly esthetic results, both on lithium disilicate and on zirconium oxide
(Fig. 9).
The veneer was then waxed to a cutback shape with mamelons, invested,
burned out using the lost wax technique and pressed using IPS e.max
Press lithium disilicate. Once the veneer was divested, it was layered using
IPS e.max Ceram to further improve
esthetics.
Final delivery and cementation

Fig.11: BruxZir disc with the crowns “nested” and fully milled.

One of the challenges of cementing a
case like this is the fact there are two
dental materials side by side. Tooth #7

has an IPS e.max veneer and teeth #8
and #9 will be BruxZir with porcelain
facials. IPS e.max is more translucent
than the BruxZir, thus allowing more
visibility of the cement and tooth that
is prepped.
The cement chosen for the bridge was
Panavia SA Cement, a self-adhesive
resin. I choose a self- adhesive resin
cement for the bridge because it has
ease of use in that it can be light cured, but if the light doesn’t penetrate
the zirconia completely it will auto
cure. This gives strength but also
keeps the cementing process simple;
it also would work on a full crown
made of IPS e.max.
The cement for the veneer was Clearfil Esthetic Cement EX, a resin cement. Veneer preps do not have a retentive and resistant form. The veneer
needs to have the maximum strength
that resin bonding can give. I can get
light though the veneer to fully cure
the cement so an auto-cure option
is unnecessary. Clearfil Esthetic Cement EX is one of the strongest bonds
available and will work excellently on
this veneer or a full crown made from
IPS e.max.
Both restorations, the veneer and
bridge, were tried in and contacts
and occlusion checked. The colors
were very close to exact between the
two restorations. Clearfil Esthetic Cement EX comes with try-in paste, so
we used the try-in paste and found
that Universal colored try-in paste
on both the bridge and veneer made
a perfect match.
K-etchant gel was used to clean both
restorations; the abutments were
cleaned using a prophy cup and simple flour pumice with no fluoride.
Panavia SA Cement was placed in
the bridge abutments and the bridge
was placed on the teeth. There is no
need for a silinating agent on BruxZir because Panavia SA Cement will
bond to the zirconia. Then it was light
cured in place and the excess cement
cleaned off.
An advantage to this type of cement
is that it gives the benefits of resin
bonding, and if you can’t get the curing light to the cement through the
material it will auto cure in five minutes on its own, thus giving the benefit
of a resin cement but the ease of use
of a glass ionomer. The veneer was
treated with ceramic primer before
resin bonding using Clearfil Esthetic
cement in the Universal shade and
light cured, then the excess cement
was cleaned up.

The bottom line
In 2011, many labs reported the
number of metal-free restorations
surpassed the number of porcelain
-fused-to-metal restorations for the
first time. Most of these metal-free
restorations are full-contour zirconia and lithium disilicate. Porcelain
-fused-to-metal restorations have
reigned as the predominant toothcolored, indirect restorations for 50
years, so they have a long, successful
history.
On the other hand, BruxZir has a
much shorter history and most labs
have only had it available for less
than four years. The demand on the
dentist to place esthetic restorations
that are strong and will last has lead
to BruxZir’s large market share. Learning new ways to employ this material is a must, and new innovative
techniques can evolve to meet our
patients’ demands.
References is available from the
author.

Contact Information

Mark McOmie, DMD, attended the
University of Utah. While attending the university he worked as a lab
technician for several years. He then
furthered his education at the University of Louisville School Of Dentistry, graduating and entering private practice in 1998. McOmie has
presented research at the Kentucky
Dental Association, International
Association of Dental Research and
American Association of Dental Research. He is a member of the Tennessee Valley Dental Study Group,
Chattanooga Area Dental Society,
Tennessee Dental Association, and
the American Dental Association.
McOmie also has hospital privileges
at Memorial Hospital, where he routinely presents lectures on dentistry.
You may contact him at
markmcomie@gmail.com.

[8] =>

8

Or a l H ygien e

Dental Tribune Middle East & Africa Edition | September - October 2013

Oral Health Benefits Of Chewing Gum
By Michael WJ Dodds, BDS, PhD,
Wm. Wrigley Jr. Company
Excerpt from paper originally
published in the Journal of the Irish
Dental Association.

________________________

T

he use of sugar-free gum
provides a proven anticaries benefit, but other
oral health effects are less
clearly elucidated. Oral health, particularly caries-reducing, benefits of
sugar-free chewing gums have been
well documented in many studies
and reviews.1-6 In addition, chewing
gum is increasingly being viewed as
a delivery system for active agents
that could potentially provide direct
oral care benefits. Chewing sugar-free

chewing gum promotes a strong flow
of stimulated saliva, which helps provide a number of dental benefits;
• the higher flow rate promotes more
rapid oral clearance of sugars;
• the high pH and buffering capacity
of the stimulated saliva help neutralise plaque pH after a sugar challenge;
• studies have shown enhanced remineralisation of early caries-like lesions and ultimately prospective
clinical trials have shown reduced
caries incidence in children chewing
sugar-free gum.
Scientific evidence shows that chewing gum has a place as an additional
mode of dental disease prevention to
be used in conjunction with the more
traditional preventive methods.

Benefits of chewing sugar-free gum
Oral clearance and saliva stimulation, plaque pH neutralisation
The major benefits of sugar-free
chewing gum are mediated through
oral physiology: stimulation of the
salivary glands to produce a strong
flow of saliva (a 10-12 fold increase
over unstimulated saliva) is elicited
by a combination of masticatory and
gustatory stimuli.7 Although saliva
flow rates are highest during the first
five to seven minutes of chewing,
when the sweeteners and flavour release is maximal, a two-fold increase
in flow rate (over unstimulated flow)
is maintained for as long as the gum
continues to be chewed.8
One of the immediate short-term ef-

Michael WJ Dodds, BDS, PhD, Wm. Wrigley Jr. Company

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Remineralisation and clinical caries
reductions
In addition to the pH neutralising
effect, the increased rate of delivery
of soluble calcium and phosphate
ions from the stimulated saliva helps
to remineralise surface enamel lesions, as shown in a number of in situ
remineralisation studies.16-19 Clinical
studies conducted in children who
chewed gum at least three times daily
for two or three years show that they
have significantly lower rates of decay than children who do not chew
gum.20-22 Furthermore, these cariesreducing effects have been confirmed
by systematic reviews.2, 5, 23 Indeed, the
American Dental Association has recently provided clinical guidelines for
the use of sucrose-free polyol chewing gums in high caries-risk children
and adults.23
Extrinsic stain reduction
Chewing gum can reduce extrinsic
tooth stain, either by removing existing stain or inhibiting its formation,24
whilst the addition of specific active
agents (typically polyphosphates)
may provide additional efficacy.25, 26
However, it should be noted that these
types of claims are cosmetic and do
not directly affect oral health, and the
magnitude of the effect is small compared to bleaching therapies. On the
other hand, accelerated oral clearance
of staining agents such as tea or coffee, by chewing gum stimulated saliva
could conceivably reduce the formation of extrinsic stain over time and
help prolong the benefits of a dental
prophylaxis. Interestingly, chewing
gum has been found to counteract
the short-term sensitivity associated
with professionally-applied bleaching
treatments,27 although the mechanism of this effect is not clear.

VITA shade, VITA made.
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fects of this enhanced saliva flow is
the increased clearance of sugars and
food debris from the oral cavity.9 The
higher flow rate, pH and buffer capacity of stimulated saliva further help
neutralise acids found in the mouth,
and in particular help raise the plaque
pH.10,11 The short-term neutralisation
of plaque pH out of the demineralisation danger zone can also be supplemented by medium-term benefits, as
it has been shown that frequent chewing increases baseline (unstimulated)
saliva flow rate and increases the resting plaque pH and subsequent ability
of the plaque to form acid from sugar.12, 13 Some studies have suggested
that chewing gum is better tolerated
than artificial saliva for symptomatic
relief of xerostomia.14, 15

Effects on plaque and gingivitis
There is evidence that regular use of
chewing gum, in conjunction with
normal oral hygiene procedures, provides a slight, but significant, reduction in plaque scores,28-30 although
one other study did not show this effect.31 In addition, two of these stud-

facebook.com/vita.zahnfabrik

11.07.13 10:57

[9] =>

Dental Tribune Middle East & Africa Edition | September - October 2013

Or a l H ygien e

ies showed effects on inflammatory
parameters, such as bleeding score or
gingival index.29, 30 A recent systematic review concluded that chewing
sugar-free gum provides a small but
significant reduction in plaque scores
when used as an adjunct to normal
plaque control measures.32 Therefore,
any claims regarding effects of sugarfree gum without actives on plaque
should be interpreted only as a potential adjunctive effect, not intended to
substitute chewing gum as an alternative to regular brushing and flossing.
Active agents for remineralisation/
caries
There have been many attempts to
improve the inherent remineralising
effect of chewing gum-stimulated saliva through the addition of specific
active ingredients. See an overview of
some of these actives below.
Specific polyol effects
Sugar-free gums are usually sweetened with polyol (sugar alcohol)
sweeteners, such as sorbitol, mannitol, xylitol, or maltitol. These polyols have all been certified as safe for
teeth by appropriate plaque pH testing; thus, while their inherent sweetness helps stimulate saliva, their rate
of metabolism and acid production
by the oral (plaque) bacteria is slow
and does not cause an effective drop
in the plaque pH, so the net effect is
an increase in the plaque pH. There
has been considerable research to test
whether certain polyols show superior efficacy, but a recent systematic
review23 stated it was not possible to
distinguish between benefits derived
from chewing versus those associated
with specific polyol effects.
Calcium and Phosphate salts
Other approaches to improving the
inherent anti-caries effect of sugar
free gums have focused on the use
of suitable calcium or calcium phosphate salts to supplement the natural calcium and phosphate levels of
saliva, raising the level of saturation
of the immediate tooth environment with respect to these ions to aid
remineralisation.33, 34 Calcium lactate
added to chewing gum has also been
shown to provide an enhanced remineralisation benefit.35, 36
Potential negative effects of chewing gum
It is worth acknowledging that there
are some concerns over chewing gum
use, including its potential to be a
choking hazard in young children,
be subject to littering, and exert a
laxative effect. Consumers should be
reminded not to give gum to children younger than school age and to
dispose of chewed gum responsibly.
The laxative threshold of most polyol
sweeteners used in gum is typically
more than 15 g/day, which would
require consumption of 10 or more
sticks of chewing gum per day to
achieve.
Conclusion
The scientific evidence supporting
the non-specific benefits of chewing
sugar-free gum has been reviewed
and endorsed by key dental organizations across the globe including
FDI (World Dental Federation), the
ADA (American Dental Association)
and the EFSA (European Food Safety
Authority). Traditionally, preventive dentistry has focused on sugar
restriction, plaque removal/oral hygiene, fluoride usage, fissure sealants
and education. More recently, these
approaches have been modified by
improved diagnostic methods to allow early identification of disease,
together with an accurate assessment of disease activity. There is an
opportunity for chewing gum to be
considered as another preventive modality to provide an additional layer
of prevention by helping maintain the
oral ecology in high and lower risk
individuals and populations. Whilst it
is not the intention of this article to

provide clinical guidelines for the use
of sugar-free chewing gum, the aim
is to inform practitioners so they can
accurately answer his or her patients’
questions regarding this topic and be
able to provide appropriate guidance
about chewing sugar-free gum and
it’s oral health benefits when used
as a complement to usual oral care
regimens. While chewing gum may
not be a treatment for oral diseases,
by helping generate a healthy flow of
saliva, it may help offset the perturbations in the oral ecology that lead to
clinical disease states.
References
1. Burt BA. The use of sorbitol- and
xylitol-sweetened chewing gum in
caries control. J Am Dent Assoc. 2006
Feb;137(2):190-6.
2. Deshpande A, Jadad AR. The impact
of polyol-containing chewing gums on
dental caries: a systematic review of
original randomized controlled trials
and observational studies. J Am Dent
Assoc. 2008 Dec;139(12):1602-14.

3. Edgar WM. Sugar substitutes, chewing gum and dental caries--a review.
Br Dent J. 1998 Jan 10;184(1):29-32.
4. Imfeld T. Chewing gum--facts and
fiction: a review of gum-chewing and
oral health. Crit Rev Oral Biol Med.
1999;10(3):405-19.
5. Mickenautsch S, Leal SC, Yengopal
V, Bezerra AC, Cruvinel V. Sugar-free
chewing gum and dental caries: a systematic review. J Appl Oral Sci. 2007
Apr;15(2):83-8.
6. Twetman S. Consistent evidence to
support the use of xylitol- and sorbitol-containing chewing gum to prevent dental caries. Evid Based Dent.
2009;10(1):10-1.
7. Dawes C, Macpherson LM. Effects
of nine different chewing-gums and
lozenges on salivary flow rate and pH.
Caries Res. 1992;26(3):176-82.
8. Dawes C, Kubieniec K. The effects
of prolonged gum chewing on salivary
flow rate and composition. Arch Oral
Biol. 2004 Aug;49(8):665-9.
9. Fu Y, Li X, Ma H, Yin W, Que K,
Hu D, Dodds MWJ, Tian M. Assess-

ment of chewing sugar-free gums for
oral debris reduction: a randomized
controlled crossover clinical trial. Am J
Dent. 2012;25(2):118-22.
10. Manning RH, Edgar WM. pH
changes in plaque after eating snacks
and meals, and their modification by
chewing sugared- or sugar-free gum.
Br Dent J. 1993 Apr 10;174(7):241-4.
11. Park KK, Schemehorn BR, Bolton
JW, Stookey GK. Effect of sorbitol gum
chewing on plaque pH response after
ingesting snacks containing predominantly sucrose or starch. Am J Dent.
1990 Oct;3(5):185-91.
12. Dodds MWJ, Hsieh SC, Johnson
DA. The effect of increased mastication by daily gum-chewing on salivary gland output and dental plaque
acidogenicity. J Dent Res. 1991
Dec;70(12):1474-8.
13. Jenkins GN, Edgar WM. The effect of daily gum-chewing on salivary
flow rates in man. J Dent Res. 1989
May;68(5):786-90.
14. Bots CP, Brand HS, Veerman EC,
Valentijn-Benz M, Van Amerongen

BM, Nieuw Amerongen AV, Valentijn RM, Vos PF, Bijlsma JA, Bezemer
PD, ter Wee PM. The management of
xerostomia in patients on haemodialysis: comparison of artificial saliva
and chewing gum. Palliat Med. 2005
Apr;19(3):202-7.
15. Davies AN. A comparison of artificial saliva and chewing gum in the
management of xerostomia in patients
with advanced cancer. Palliat Med.
2000 May;14(3):197-203.
16. Creanor SL, Strang R, Gilmour
WH, Foye RH, Brown J, Geddes
DA, Hall AF. The effect of chewing gum use on in situ enamel lesion
remineralization. J Dent Res. 1992
Dec;71(12):1895-900.
Full list of references is available
from the author.
www.wrigleyoralcare.com

[10] =>

10 En do Tr ibu n e

Dental Tribune Middle East & Africa Edition | September - October 2013

Applying CBCT To Endodontics Can Reveal Deficiencies

That Otherwise Might Go Undiagnosed
By Ernesto Jaconelli

________________________

hen on site CBCT
technology systems
first became affordable the early adopters
were Implantologists. The significant
improvement that a 3D view brought
to the accuracy and success of Implant preparation was immediately
apparent encouraging investment
in the new technology. However a
CBCT, 3D scan can bring the same
benefits to other dental procedures
and in particular to Endodontics.
Dr. Alan Holland is the founder of
the highly successful Bristol Specialist Dental Clinic which incorporates Bristol Endodontic Clinic
and Bristol Oral Surgery Clinic.
He is the principal Endodontist
and has developed his Clinic to offer state of the art excellence. For
the past twenty years the Endodontic Clinic has offered solutions
to complex endodontic problems.
Alan became one of the early Endodontist Adopters of CBCT when he
decided to invest in his own CS 9000
3D System (was originally Kodak
now Carestream Dental) in January
2012. An important consideration
when choosing the CS 9000 3D was
its ability to produces high definition
76 micron images focused on a 3.5 x 5
mm quadrant view with no distortion

procedures but surprisingly about
80% of the use has been dedicated to
Endodontic diagnosis. “The CS 9000
3D offers an unprecedented vision
into the heart of the root canal anatomy which using the 3D rendering
is a veritable revelation to patients
to whom regular radiographs often
remain a black and white mystery.
With the rendered image we can easily explain what needs to be done
and why, Complex surgical problems
are easily understood and treatment plans more readily accepted”.

in length and angulation. This ensures truly accurate images with no magnification or distortion. The effective
patient dose is similar to a conventional panoramic scan and so justifies
its use for a wider range of cases.
Alan explains, “The in-house 3D imaging service attracts those patients for
whom diagnosis of complex endodontic
failures and atypical anatomical anomalies is rendered transparent using
the new technology. With the introduction of 3D scanning, Endodontists now
have the ability to critic their work in
much greater detail. Often a shocking
realization is that what appears to be
an excellent result in a 2D parallel radiograph, when viewed in a 3D format
reveals an aspect of anatomy which
highlights deficiencies that would
otherwise go undiagnosed when retreating failed endodontic cases or diagnosing complex Oral Surgery problems”.
This is best illustrated by the following case: A referred case of an
upper first molar previously root
treated some 2 years earlier showed a
well adapted root filling with perhaps
a slight indication of an area which
may have healed or still be in the process of resolving. Intermittent mild
symptoms had prompted the patient
to return having had no sensation
from other root fillings completed
within our clinic. As a precaution a
3D scan was taken which shockingly
revealed the extensive unresolved
apical infection. The cosy appea-

rance of a 2D radiograph disguising
extensive lesions is perhaps a much
more common occurrence and the
dedicated Endodontic journals are
now littered with articles on the nature of complex endodontic lesions,
resorption and anomalies which
quickly establish that a procedure is
either likely to succeed or fail before

the patient is subjected to an expensive and perhaps fruitless procedure.
(Three captioned clinical images supplied to support this case)
“3D CBCT allows us to offer better,
more accurate diagnosis and enhances
the patient’s perception and confidence
in the knowledge that their endodontic needs are being met in a safe and
thoroughly professional environment”.
When Alan originally invested in the
CS 9000 3D System he fully expected it to be monopolized by the Oral
Surgeon. It proved to be an important adjunct to many Oral Surgery

Alan chose Hulbert Dental as the
supplier of his CS 9000 3D and this
he believes was just as important a
consideration as choosing the equipment itself. Training and support is
essential when introducing any new
technology to your clinic. This was
very competently supplied by Tony
Hulbert himself. But the relationship
did not end there! Tony and Alan
have formed a partnership supported
by Carestream Dental to provided
CBCT Application and Compliance
training to all those who are now
incorporating 3D imaging in their
practice. The courses are essential
for those dentists either considering
investing in their own systems or
referring patients to clinics such as
Bristol Specialist Dental Clinic. These
CPD courses contribute significantly
to the education and knowledge sharing process aimed at delivering best
practice within the profession.
For more information on Carestream
Dental products please visit www.
carestreamdental.com or contact
ernesto.jaconelli@carestream.com

The apical infection is obvious when viewed on a CT scan as opposed to a
2D image.

[11] =>

Every dentists best friend

Improving the standard
of care for every dentist
CS 9000 3D: Appreciated already by dentists all over the world,
the essential CS 9000 3D imaging system enhances the standard of
care in the general practice. It enables you to do more, see more and
offer more – all in your practice, and all at an affordable price.
• 3D, panoramic and optimal cephalometric imaging
• High resolution imaging (76 μm) at a very low dose
• Focused fields of view from all angles and slices
• CAD/CAM ready for enhanced capabilities and procedures
Call 1-800-944-6365 or explore it here carestreamdental.com/cs90003d
© Carestream Health, Inc. 2013. *Limited time offer.

3D

PANORAMIC

CAD/CAM

[12] =>

12 INDUSTRY

Dental Tribune Middle East & Africa Edition | September - October 2013

New Treatment Center, SINIUS
TS, Offers Maximum Flexibility
By Sirona

________________________

S

alzburg, Austria: starting in
October, Sirona will be rolling out the OTP version of
SINIUS, which was previewed
at the IDS. Its mobile support arm
system means that dentists can adjust
the center ideally to their individual
working positions, allowing practitioners to work ergonomically at all
times.
The SINIUS TS treatment center from
Sirona sets standards when it comes

Unique to the market: The flexible positioning and adjustability of the SINIUS TS tray
element.

The new treatment center, SINIUS TS, impresses with maximum flexibility and ergonomics




to flexibility and the technical support of the most ergonomic working
position possible: With the OTP unit,
the tray can be moved in all directions
independently, thus allowing it to be
flexibly positioned near the patient
without having to readjust the dentist
element. This solution not only offers practitioners unique freedom of
movement ‒ it is also easier than ever
to work in an ergonomic position in
every situation. “With SINIUS TS, we
have once again expanded the central
theme of efficiency and flexibility,
features that all SINIUS centers have.
The capabilities of the OTP system
help dentists to position all elements
of the center optimally and ergonomically,” says Susanne Schmidinger,
Head of Product Management at Sirona.
Flexibility is also the keyword for the
additional design of the dentist element and tray: The dentist element is
particularly suitable for treatments in
the 12 o’clock position and can be easily moved in any other position. The
420 mm vertical range of movement
allows the dentist to optimally adjust
the element for sitting and standing
treatments. Thanks to the practical
clip system, the tray can be easily removed and cleaned. In addition, the
large placement area on the dentist
element and tray provide more than
enough space. SINIUS TS has particularly compact dimensions thanks to
its functional and space-saving support arm system. The unit can also
be easily positioned in smaller rooms.
Expanding the efficiency class
To date, SINIUS, Sirona’s efficiency
class, has been available in the sliding
track and swivel arm versions (SINIUS CS). Like its siblings, SINIUS TS
is equipped with the intuitive EasyTouch touchscreen interface, which
also allows the dentist to control
the optional integrated endodontics
function with a stored file library
and ApexLocator. To save time while
complying with hygiene regulations,
sanitation adapters have been integrated into the SINIUS centers, which
makes sanitation bowls superfluous.
In addition to the three versions (sliding track, swivel arm, OPT), with
SINIUS dentists can also choose between six application packages and
many individual options, and can
configure their center to their exact
requirements.

More Information



 
    

    

Sirona Dental GmbH
Sirona Straße 1
A-5071 Wals bei Salzburg
Austria
P +43 (0) 662 / 2450-0
F +43 662 2450-109590
contact@sirona.com
www.sirona.com

[13] =>

L a b Tr ibu n e

Dental Tribune Middle East & Africa Edition | September - October 2013

13

Dental Technician
Forum 2014 in
Singapore
By By Centre for Advanced Professional Practices

________________________

I

t is without a doubt that Dental
Technicians are a very important part of the dental team for
the success of the dental treatment – from the small prosthetic cases to the complicated implantology
clinical cases, almost in all fields of
dentistry. The industry changes and
advances with rapid speed innovation
and new developments in dental technology. Working hard daily and spending long hours in the laboratories,
how will the dental technician access,
understand and apply these fast-moving state-of-the-art technologies?
The first Dental Technician Forum

„Dental Technicians are a
very important part of the
dental team for the success of
the dental treatment“
will take place at IDEM Singapore
2014 as an innovative extension to
IDEM to include programs for the
entire dental team. This two day dedicated scientific program will include groundbreaking lectures from the
industry key opinion leaders, workshops and an extensive trade show
focused entirely on the dental laboratory profession. The two informative
and enjoyable days will see international speakers share and discuss cutting edge knowledge and innovations
in the dental technician industry to
the dental technicians from Asia Pacific, Europe and the Middle East.
The event will provide twelve hours
CPD over two pleasant days out of
the laboratory filled with networking,
knowledge and fun.

The Dental Technician Forum at
IDEM Singapore will provide excellent networking opportunities, creating an environment for discussions,
questions and the exchange of valuable feedback, while viewing the latest
trends and developments, systems
and technologies at the product display area.
Topics to be discussed:
• Everything from Smile Design to
CAD CAM
• An Aesthetic Approach to Material
• Shade Selection
• CAD/CAM options for scanning,
milling and 3D building of models
and restorations
• Ceramic systems, materials and
their applications today
• Implant Prosthodontics - Incorporating the latest implant products and
techniques
Session and Speaker details will be
released later. Dental Technicians
who register for this forum are also
entitled to attend the sessions in the
IDEM Singapore Scientiﬁc Conference.

More Information
Dental Technician Forum
05-06 April 2014
Singapore
Co-organized by:
Centre of Advanced Professional
Practices & Koelnmesse
For more information contact
Dr. Dobrina Mollova at:
info@cappmea.com

[14] =>

new

1 COMPLETE
SENSITIVITY TOOTHPASTE

SPECIALLY DESIGNED WITH

7 BENEFITS

*

All-round care for dentine
hypersensitivity patients*1-6
We are constantly evolving our specialist range to meet the differing needs of dentine
hypersensitivity patients. That’s why we developed Sensodyne® Complete Protection.

SENSITIVITY

ENAMEL

CLEAN

GUMS

FRESH

PLAQUE

WHITENING

*With twice daily brushing

References: 1. Du MQ et al. Am J Dent 2008; 21(4): 210−214. 2. Pradeep AR et al. J Periodontol 2010; 81(8): 1167−1113. 3. Salian S et al. J Clin Dent 2010; 21(3): 82–87. 4. Tai BJ et al. J
Clin Periodontol 2006; 33: 86–91. 5. Devi MA et al. Int J Clin Dent Sci 2011; 2: 46-49. 6. GSK data on file (study 23690684). Prepared July 2013, Code: CHSAU/CHSENO/0007/13

[15] =>

42nd Conference of the Arab Dental Federation
23rd BIDM . Beirut Lebanon . 26-28 September 2013

BIDM 2013
show edition

meet and bring together inspired
professionals from all over the world
and ensuring that the Lebanese Dental Association remains at the cutting
edge.
We would like to take this opportunity to give you an idea of what
you can expect and what we hope to
achieve over these four days. The Scientific Committee has put together
an unprecedented group of over 130
speakers, 45 of whom travelled from
abroad especially for this conference, to deliver lectures and to lead
workshops and problem-based panel
discussions (PBLD). Presenters will
share comprehensive cases on nearly
every aspect of dental practice to
Share Solutions.

Professor Elie Maalouf, President of the
Lebanese Dental Association

We, at the LDA, are transforming
the way we operate to continuously
improve our ability to build relationships among academics, practitioners
and the dental industry in a quest for

Dear friends and colleagues,
On behalf of the Board and the Scientific Committee of the Lebanese Dental Association (LDA) we would like
to welcome you to the 2013 Beirut International Dental Meeting (BIDM).

www.bidm-lda.com
better and safer patient care. Our organization and partners have continued to meet the challenges of our field
and to excel despite the many challenges. We should all be very proud of
where we are today and excited about
where we are headed.
Finally, we would like to thank you for
attending the BIDM2013 and bringing your expertise to our gathering.
You have the vision, the knowledge
and the experience to help us pave
the way into the future. You are truly
our greatest asset, and we could not
accomplish what we do without your
support. Throughout this congress,I
urge you to stay engaged, keep us
proactive and help us shape the future
of the LDA.
Prof. Elie Azar Maalouf
President
Lebanese Dental Association
Dr. Nabih Nader
Chairperson
LDA Scientific Committee

Show Edition | BIDM 2013
INTERVIEW
Interview:
“We should All Be Very Proud Of Where
We Are Today And Excited About Where
We Are Heading.”
> Page 2

SCIENTIFIC PROGRAMME
Nearly 100 speakers participate in the
congress which will focus on treatment
planning as a means of addressing the
challenge commonly faced by dental
clinicians – how to reach the goal between
“a patient’s wish” and “the perfect result”.
Pre-congress courses and workshops will
take place on Wednesday September 25th
at the same venue. There will also be a
wide range of other attractions including
multiple parallel Oral sessions, live video
transmissions, research sessions in Clinical
and Basic Research, a poster presentation,
and a series of pre-congress ‘step-by-step’
> Page 2-3

These are stimulating times for the
LDA as we continue to grow and
adapt, always remaining open and
responsive to new ideas. Our organization is confronting many challenges
and we are meeting these challenges
in a time of nation-wide and global
change. The BIIDM2013 is an exciting forum in which we continue to

EXHIBITION
BIDM 2013 is opening its conference
environment to welcome a range of
industry exhibitors who will have direct
access to all Middle East Congress
participants, thanks to the integrated
layout of the exhibition area a with the
main conference hall and LDA Desk.
With its best-in-class infrastructure and
extensive facilities, the Congress Palace is
an excellent choice for the event. It offers
great conditions for loading and unloading
of stand material and the event schedule
includes plenty of time to assemble and
take down booths.

EXPECTED
3.000 VISITORS
2.000 DELIGATES
130 SPEAKERS
Previous LDA Event

> Page 4

VISIT OUR
BOOTH:

A103

Lebanese University RAFIC HARIRI Campus, Hadath

[16] =>

2

42nd Conference of the Arab Dental Federation
23rd BIDM . Beirut Lebanon . 26-28 September 2013

Scien tific progr a m

Scientific Program Time Table

Friday
27th2
BIDM
2013 Friday

Thursday
of September
BIDM 201326th
Thursday
26 Sep.
8:45-9:00
9:00-9:15
9:15-9:30
9:30-9:45
9:45-10:00

10:00-10:15

10:15-10:30
10:30-10:45
10:45-11:00
11:00-11:15

Hall A
“Soft and hard tissue changes in single implants placed in
delayed bone or placed in extraction sockets”
Hugo De Bruyn

“A defined algorithm for implant success in the esthetic zone”
Maurice Salama

“Guided Bone Regeneration: factors affecting healing”
Nikolaos Donos

Hall B / Oral-B

Hall C / Listerine

Hall D / Sensodyne

“Provisionals as a blueprint for definitive restorations: A clinical
guide”
Wael Att

“Use of laser in oral surgery, state of the art.”
Samir Nammour

“The inman Aligner and an Ethical Revolution for Cosmetic
Dentistry”
Rami Chayah
“The use of removable appliance in Orthodontics and Pediatric
Dentistry : Clinical cases and assessment of results”
Philip Souhaid
“Orthodontic/Orthognathic Surgery Symbiosis”
Elie Amm
“Cleidocranial Dysplasia: Interdisciplinary Management of a
Unique Case”
Chimene Chalala

“ProTaper Next: another way for shaping root canals or a
convergence of improvements in design and dynamic motion”
Edmond Koyess

“From delayed to early loading of dental implants”
Hugo De Bruyn

"Er,Cr:YSGG in oral surgery”
Joseph Arnabat

“Laser applications in dental implants”
Joseph Arnabat

“Dental plaque associated with self-ligating brackets during
orthodontic treatment” Saud A. Al-Anezi

11:15-11:30

Opening Ceremony and Exhibition

Lunch & Exhibition Visit

Lunch & Exhibition Visit

1:45-2:00

3:45-4:00
4:00-4:15

“ER,CR:YSGG and 940NM Diode Laser supported periodontal
treatment concept”
Norbert Gutknecht

“Implants placed in fresh extraction sockets: from the single
tooth to the full arch - Part I”
Ugo Covani

“Current concepts of implant retained overdenture of the
mandible”
John Beumer

“Alveolar ridge preservation”
Nikolaos Donos

Preventing implant removable prosthodontics complications.
Some practical pearls”
Tony Daher

4:15-4:30
4:30-4:45
4:45-5:00
5:00-5:15

Break & Exhibition Visit
“Treatment of pulpaly compromised teeth”
Simone Grandini

5:15-5:30
5:30-5:45
5:45-6:00
“Advanced Restorations of endodontically treated teeth”
Walter Dias
6:00-6:15

6:15-6:30

9:00-9:15
9:15-9:30
9:30-9:45
9:45-10:00
10:00-10:15
10:15-10:30
10:30-10:45
10:45-11:00
11:00-11:15
11:15-11:30
11:30-11:45

11:30-11:45
11:45-12:00
12:00-12:15
12:15-12:30
12:30-12:45
12:45-1:00
1:00-1:15
1:15-1:30
1:30-1:45

2:00-2:15
2:15-2:30
2:30-2:45
2:45-3:00
3:00-3:15
3:15-3:30
3:30-3:45

“Traitement ortho-chirurgical en technique linguale chez les
adultes"
Sami Bou Saba

8:45-9:00

Break & Exhibition Visit

“Peri-implant soft tissue management:is it a must?”
Ronald Younes
“How to avoid and treat buccal recession of implant in the
esthetic zone?” Alain Romanos
“Synergy of reconstructive hard and soft tissue surgery: the role
of bioengineering in clinical practice”
Maurice Salama

Panel Discussion:“Peri-implant hard and soft tissue
enhancement in the esthetic zone”
Georges Tawil, Ugo Covani, Nikolaos Donos, Maurice Salama,
Ronald Younes, Alain Romanos

11:45-12:00

“Blanchiment des dents décolorées dévitalisées: Un survol
sur les causes, matériaux et techniques.”
Nicole Harrak Jabbour
“Re-treatment of Anterior Composite Restorations"
Mireille Feghali
What you know, what you don't know and what you should
know about Veneers”
Mohamad Hassib El Bizri
Lunch & Exhibition Visit

Invisible restorations with resin composites: A possible
challenge
Simone Grandini
“Composite Restorations as the ultimate direct solution”
Walter Dias

12:00-12:15
12:15-12:30
12:30-12:45
12:45-1:00

Lunch & Exhibition Visit

“Régénération et revascularisation pulpaire: Mythe ou réalité ?
Une revue de la littérature”
Hitaf Nasrallah Nasseh
“Genetics and Paediatric Dentistry”
Isabelle Bailleul-Forestier
“Minimal Invasive Dentistry: The Smart Prep Bur”
Roula Sinno
Break & Exhibition Visit

“Smile analysis and treatment options for gummy smile
patients”
Ahmed Korayem Abderhaman

“Child periodontum specificity”
Isabelle Bailleul-Forestier

Break & Exhibition Visit

Cone beam computed tomography (CBCT) in pediatric dentistry”
Riad Bacho

“The mandibular microradiographical anatomy : A CBCT
review”
Alexandre Khairallah
“Evaluation of Sleep Apnea on CBCT”
Sayde Sokhn
“La désinfection conventionnelle assistée avec le LASER
diode”
Salwa Yammine
“Do the new nickel-titanium methods of root canal
preparation guarantee the success in root canal therapy?”
Ali Yaghi

Exhibition Visit

Exhibition Visit

Centre for Advanced Professional Practices (CAPP) is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental Association to assist dental professionals
in identifying quality providers of continuing dental education. ADA CERP does not
approve or endorse individual courses or instructors, nor does it imply acceptance of
credit hours by boards of dentistry.

2:45-3:00

“A combined endodontical LASER supported treatment
concept”
Norbert Gutknecht

MISIP: Minimally Invasive Sub-Sinus Implant Procedure”
Gilles Chaumanet

“Current perspectives on prefabricated glass fiber post in
endodontically treated teeth: cementation strategies and
clinical evaluation”
Antonio Signore
Accidents and complications in endodontics - how to solve
them?”
Danilo Shimabuko

“ Minimizing errors in implantology: 4 cases report”
Georges Hage
“Short and ultra short dental Implants: a long term followup Up”
Jihad Abdallah

Break & Exhibition Visit
“Atrophic posterior maxilla rehabilitation, is lateral sinus lift
the only option?”
Shadi Daher
“Eureka R2 - Next paradigm of implant dentistry “ One day
implant “”
Kuang Bum Park
Panel Discussion: “Management of the Posterior atrophic
Break & Exhibition Visit

“Implants placed in fresh extraction sockets: from the single
tooth to the full arch - Part II”
Ugo Covani

maxilla”
Panel Discussion: Nabil Barakat, Gilles Chaumanet,
Shadi Daher, Georges Hage, Jihad Abdallah

Lunch & Exhibition Visit
Lunch & Exhibition Visit
“Trying to solve the puzzle - caries risk and prevention in
orthodontic patients”
Anas El Mulla
“Is there an alternative to autogenous bone grafts in the
dental implantology? status quo and future perspectives
Ralf Smeets

3:00-3:15
3:15-3:30

“Bone preservation and immediate post-extractive implant”
Gilles Chaumanet

3:30-3:45

4:00-4:15
4:15-4:30

“Crestal bone gain in short and ultra-short single tooth
locking taper implants”
Shadi Daher

“Implants and orthodontics; a symbiotic relationship”
Roy Sabri

“Piezocision: rapid orthodontic tooth movement”
Rima Abdallah
“The dentists role in early orthopaedic treatment of
developing Class II and Class III malocclusions”
William Wiltshire
Break & Exhibition Visit
“Orthognathic surgery: conventional surgery is not always
the answer”
Samer Abou Zeid

4:30-4:45

Break & Exhibition Visit

4:45-5:00
5:00-5:15

I won´t leave your office without teeth! - Possibilities and
limitations of immediate placement and immediate loading
of dental implants”
Oliver Hugo

Othognathic surgery, beauty and attractiveness”
Nasser Al-Manthery

“Precision and esthetics. From preparation design to final
cementation”
Carlos Sabroza

“Evidence-based” interceptive orthodontics - the team
approach”
William Wiltshire

Esthetic strategy for the preparation of ceramic restorations
with minimally invasive prepares.”
Manoel Martin Jr

Exhibition Visit

5:30-5:45
5:45-6:00
6:00-6:15
6:15-6:30
6:30-6:45
6:45-7:00

Exhibition Visit

6:30-6:45
6:45-7:00

1:15-1:30
1:30-1:45
1:45-2:00
2:00-2:15
2:15-2:30
2:30-2:45

5:15-5:30
Exhibition Visit

Hall B / Oral-B

1:00-1:15

3:45-4:00

“New outcomes for vitamin D and caries prevention”
Isabelle Bailleul-Forestier

Hall A

CAPP designates this activity for
20.25 continuing education credits.

Interview: “We should All Be Very Proud Of Where We
Are Today And Excited About Where We Are Heading.”

By Mr. Rodny Abdallah
Dental Tribune Middle East

________________________

F

ounded in 1949, the Lebanese
Dental Association (LDA)
represents the dentists in
Lebanon. A professional association devoted to the development of dentistry and the benefit of
its members, the industry and wider
community as a whole, it is acknowledged by government, public and private sectors both nationally and internationally. Every year, the LDA hosts
the Beirut International Dental Meeting (BIDM), presenting a large scale
of products and services available for
the dental community in Lebanon.
President Professor Maalouf Biography
A Periodontist and Implantologist
by profession and was the Head of

the Periodontology Department at
the Lebanese University School of
Dentistry (2006-2012). Has a DMD
from St. Joseph University (USJ) Beirut Lebanon 1985, CES A AnatomoPhysiology Paris V Mont Rouge 1986,
CES B Periodontology Paris VII Garancière 1987 FRANCE, CES B Prosthodontics Paris VII Garancière 1987
France, Doctorate in Periodontology
2010 Lebanese University Lebanon,
Lecturer at the Lebanese University
from 1988, Director of Post graduate
program in Periodontology 20022005 and has accomplished more
than 100 lectures in Periodontolgy
and Implantology locally and Internationally.

“Sharing your knowledge is
always a noble task.“
Comparing with your beginnings,
how can you define the evolution of
dentistry in Lebanon?
It is amazing to witness the huge transition of traditional dentistry into the
digital era. I have had the chance to
live the two worlds. Lebanon takes
pride in sharing state of the art dental techniques and technology. Today
radiography for example has changed
the face of imaging by providing for
colleagues and patients a clearer view
of the dentition for a better disease
diagnosis and treatment plans. We
are now able to make an x ray with
a small sensor and show the patient

the tooth on the computer in just a
few seconds. Lebanese dentists were
the pioneers in adopting this new
technology. Many other aspects have
changed in dentistry, for example filling materials: Amalgam is no more
the material of choice for many dentists with Composite replacing it by
all means. I also would like to mention other dental gadgets that have
caused a huge impact in our daily
practice such as lasers, CAD CAM
systems, digital photography, and
computer assisted Implantology as
well as more.
How important is the involvement
of digital dentistry?
Digital dentistry has gone very far in
our careers. The future of dentistry is
here where we are now. Technology
has made our lives as dentists easier.
It has helped us to serve our patients
in a better way and on a higher level.
We have experienced that the digital equipment has saved us a lot of
time and money. I will give you one
example about the importance of the
involvement of the digital dentistry.
Today any dentist placing implants in
his office should have access to Cone
Beam imaging because it allows for
accurate and precise treatment planning. With 3D, you place the implant
in the software and virtually go all
around it seeing every single angle
and how close it is to neighbouring
teeth and major structures such as

the sinus or the mandible nerve. We
could have never done that in the previous years before the digital technology entered our dental industry.

“Dentistry today is living a
new age of metal free restorations.“
How important is the role of the
dental Lab technician in the dental
team?
In today’s complex arena of dentistry, a Lab technician has to have a
broad understanding of artistry, light,
color and anatomy. They really need
to upgrade their skills in order to be
at the same level with their dentists.
Continuing educational courses are
as much important to dentists as to
dental technicians. In Lebanon we
have a high number of qualified dental technicians. Dentists working in
teams need a skilled dental lab technician to join. His role is major in all
aspects because he can achieve a good
case through communication and
knowledge.
How big is the influence of the dental industry in LEBANON?
The dental industry plays a major
role in Lebanon. It has grown fast in
the recent years. Overall dentistry
is experiencing steady and healthy
growth. Dental companies are providing many services for general and

cosmetic dentists. Demand for dental
services is driven largely by population growth and awareness. Today
most people recognize the advantage
of preventive care. They also understand the importance of doing minimal invasive work when they decide
to replace missing teeth. Implants are
playing a major role in this regard.
This matter is giving a huge boost to
the dental companies to provide more
innovative products and always invest
in technology to find better solutions
for the dentists and patients. Some of
the dental companies in Lebanon are
studying the market and they fill any
gap whenever found. We have almost
all major dental materials.
Do you have any goals for the Lebanese Dental Association to achieve
in the next three years?
One of our major targets is to transform the Lebanese Dental Association into a professional enterprise
where LDA members could find several facilities from our new website
that will allow them the advantage of
having a private email, forum to exchange ideas and cases, communicate
and also interrelate with each other
on a professional level as well as providing them with a special page dedicated for different dental branches
with multiple articles. Another target
is to provide all Lebanese dentists the
chance to upgrade their skills and gain
additional knowledge by continuing
education at our center in Sodeco and

[17] =>

42nd Conference of the Arab Dental Federation
.
.
Lebanon 26-28
September 2013
23rd BIDM Beirut

3

show edition

BIDM, 26-28 September 2013
Saturday
28th of September
BIDM 2013 Saturday 28 Sep.

7 of
Sep.September
Hall C / Listerine

“Kystes et tumeurs odontogènes des maxillaires”
Hervé Reychler

“Clinical evaluation of immediate loading of implants
among Yemeni khat chewers”
Abdulwahab Ismail AlKholani
“TMJ office arthrocentesis with reference to arthroscopy”
Reha Kisnisci
Break & Exhibition Visit
“Clinical treatment of teeth hypersensitivity”
Samir Namour
“When and how LASERs can be used?”
Jihad Habli
Risque hémorragique post-extractionnel chez un patient
sans antécédent médico-chirugicau."
Nicole Aoun El-Hajj
“Le Laser en Pathologie Orale: Diode Versus Er, Cr:
YSGG”
Antoine Cassia

Lunch & Exhibition Visit

Hall A

Hall D / Sensodyne
“Obstructive Sleep Apnea: Overview of Lebanese study and
recent advances”
Osama Ababaker Alsaddik

8:45-9:00
9:00-9:15

“Oral appliances for the treatment of snoring and sleep
apnea”
Patirick Arkach

9:15-9:30
9:30-9:45
9:45-10:00

“Side effects and complications of oral repositioning splints for
sleep apnea “
Patirick Arkach

10:00-10:15

Break & Exhibition Visit
“Scientific and clinical state of the art of the use of the
different Bone Substitutes in Dental and maxillofacial
surgery”
Guy Daculsi
“Trends in oral diseases among schoolchildren in Gaza Strip”
Lamis Abulhaloob

10:15-10:30

10:30-10:45

Lunch & Exhibition Visit

Hall B / Oral-B

Hall C / Listerine

“Chirurgie orthognathique : state of the art.”
Hervé Reychler

10:45-11:00

“Complete Protection, a new daily desensitising toothpaste
containing NovaMin®”
Jonathan Earl
“Mega trend: E-learning in a scientific environment”
Joachim Tabler
“The importance of dental group practice in restructuring the
Lebanese dental health care system”
Mohamad Medawar

11:00-11:15
11:15-11:30
11:30-11:45
11:45-12:00

Break & Exhibition Visit

“Pre-prosthetic Bone Reconstruction”
Reha Kisnisci

“Get up your nerve to deal with the mandibular nerve”
Charbel Allam

“Implants and esthetic results with a global
approach of bone augmentation”
Hadi Antoun

Break & Exhibition Visit
Use of CBCT in endodontics
Francesco Mannocci

Break & Exhibition Visit

Break & Exhibition Visit
“Minimally invasive oral surgery- MIOS : An efficient “Update on host modulatory treatment for the management
method for sharing solutions in contemporary dentistry
of periodontal diseases”
Ziad Noujeim
Nayer Aboelsaad
“Contemporary bone and soft tissue regeneration
protocols, techniques and materials”
Naji Abboud

12:00-12:15

12:15-12:30

“New trend for biotechnology in bone regeneration: the
combination of osteogenic cells and bioactive ceramics”
Guy Daculsi

“Novel techniques to repair defective labial plate
of bone and deficient alveolar ridge”
Abdelsalam Elaskary

“Referral criteria of CBCT in dentistry”
Ibrahim Nasseh
“Effet des parodontopathies sur la sante generale I”
Mohamad Rifai

12:30-12:45
12:45-1:00

“Eureka R2 - Next paradigm of implant dentistry “ Bone
regeneration””
Kuang Bum Park

“Build-up of endodontically treated teeth using resin-based
materials”
Hani Ounsi
“One file system (reciproc, wave one, one shape) biologic
and techniques concepts”
Danilo Shimabuko

1:00-1:15
1:15-1:30
1:30-1:45
1:45-2:00
2:00-2:15
2:15-2:30
2:30-2:45

Break & Exhibition Visit
“Idealizing esthetic and functional integration while
preserving the reliability of the prosthetic outcome.”
Giacomo Fabbri
“Optimizing aesthetic results after immediate implant
placement”
Oliver Hugo
Exhibition Visit

Concept generation in Endodontics. Where does it come
from?”
Didier Lakomski

2:45-3:00

“New product development fundamentals: application to
Endodontics”
Didier Lakomski
Exhibition Visit

in all other provinces. We are working
to fulfill a dental insurance and bank
loan program for patients as well.
One of our latest achievements is a
custom exclusive partnership agreement with a dental online college in
Germany from which all Lebanese
dentists can benefit from a free access
to visualize scientific online videos
for the next two years.

“The Delegates registered for
the congress are eligible to receive ADA CERP continuing
education.“
As president of the Dental Arab
Federation, can you brief us on its
role and importance in the dental
field?
Dental Arab Federation was established to create a forum of support,
education and cooperation. In our
region, there are tens of thousands
of highly skilled Arab dentists, physicians and other professionals, who
could do much better through introducing each other.
Please identify your goals and ambitions for the next 2 years as part
of your mandate as President of the
Arab Dental Federation? How do
you plan to achieve them?
This is another important issue, my
vision is to create a Committee from
the entire Arab world where we can
exchange our experiences in the dental fields, organise series of continuing education with many levels from
basic to advanced in all dental fields.
Finally organise a congress where all
Arab countries participate and this
congress will give us an idea about the
level of dentistry in the Arab world.
What is the main focus of BIDM
2013? What can you tell us about
this event this year?
The BIDM2013 is an exciting forum
in which we continue to meet and
bring together inspired professionals
from all over the world and ensure
that the Lebanese Dental Association
remains at the cutting edge. I would
like to take this opportunity to give

Hall D / Sensodyne

Hall E

“Diagnosis and treatment of peri-implantitis due to
“Assessment of determinants affecting the utilization of dental
“Le collage de la zircone sur différents matériaux de
microbial factors”
“Cosmetic and functional stability of implants in
services: a cross-sectional study on elementary school
reconstitutions coronaires est-il encore un mythe?
Zoubeida El Yahfoufi
the esthetic zone”
children in Beirut”
Maria Atallah Naba
Bassam Rabie
Ingrid Karam
“Periimplantitis - Etiology - Diagnostics - Therapy - What
“Selecting the all-ceramic material for your patient:
“Failure of a free gingival graft: A case report”
next?
Zirconia Vs. Lithium-Disillicate”
Hilal Chehade
Ralf Smeets
Faysal Succaria
“Implant placement in a smoker, diabetic and periodontally
“The challenge of the hybrid prostheses in the maxilla.
compromised patient”
(a clinical case report)”
Nazem
Mayyas Joudi
“The Importance of the Maxillary Sinus in
Assaad
“Innovative all-ceramics approaches in implant“Ridge Splitting in the Esthetic Zone: A Case Report”
Oral Surgery, Pathology and Implantology” “Implants and esthetic results with a global approach of
supported restorations”
Giacomo Fabbri
Hicham Oday Nuaimi
Nabil Barakat
bone augmentation”
“Bonding to Zirconia, Is it a myth?”
Ghassan Masri
Maisoun Latrash
Peri-implantitis : what is the best treatment ?”
“Smaller scale for bigger results: Nanotechnology big
Carlos Khoury
promises”
“How critical is implant macrogeometry in the stability of
Rami Al-Saidi
peri-implant hard and soft tissue?”
“3D
SMART
Restorations”
Peter Tawil
Break & Exhibition Visit
Reda Mohiddin Dimashkieh
“Computer Guided Surgery: Perspectives,
“10 Ans de rehabilitation implantaire
“La prescription d’antibiotiques en endodontie : De
Complications and Limitations”
“Gestion des Kystes sinusiens en vue de
immediate et fixe des edentements totaux.
l’empirisme à l’évidence fondée sur les preuves”
Hasan Dbouk
comblements : un ou deux temps operatoires.”
Les realites cliniques chirurgicales et
Maria Moukarzel
Georges Khoury
prothetiques.”
Hani Khoury
Break & Exhibition Visit
“Patient selection and treatment planning
when restoring posterior quadrant with
oseointegrated implants”
John Beumer

“Controversies in occlusion and practical and
clinical applications”
Tony Daher

“Post or no post, crown or no crown for
endodontically treated teeth”
André Assaf

Break & Exhibition Visit

“Management of severely damaged teeth. Part Functional dentures: The quest for success Treatment planning and bone grafting modalities in front
of complex implant rehabilitations”
1”
Paul Boulos
Charles Khoury
Miguel Roig
“The Hydrodynamic Ultrasonic Cavitational Sinus Lift
(INTRALIFT): a total replacement of conventional sinus
lift procedures”
Samir Khoury
“Perforation de la membrane sinusienne : Conduite à
tenir”
Rita Bou Assaf
“Management of severely damaged teeth. Part
Etiology of endodontic infection, new
“Can I place implants and make bone graft without
2”
techniques for bacterial detection.
oedema, without pain…? Clinical application of
Miguel Roig
Francesco Mannocci
different types of steroids in oral surgery”
Rima Bou Tayeh
“Prevention and Treatment of Postoperative Infections
after Sinus Elevation Surgery”
Wasfi Kanj

3:00-3:15
3:15-3:30

you an idea of what you can expect
and what we hope to achieve over
these four days. The Scientific Committee has put together an unprecedented group of over 130 speakers,
45 of whom travelled from abroad
especially for this conference, to deliver lectures and to lead workshops
and problem-based learning discussions (PBLD). Presenters will share
comprehensive cases on nearly every
aspect of the dental practice. For the
first time this year, the delegates registered for the congress are eligible
to receive ADA CERP continuing
education points by attending accredited scientific sessions throughout the
congress. This has been made possible through our partnership with the
esteemed Continual Medical Education provider Center for Advanced
Professional Practices. Throughout
this congress, I urge all dentists to
stay engaged, remain proactive and
help us shape the future of LDA. I
believe there are more than 70 dental companies exhibiting and sharing
their latest products and news of the
trade they represent.

“L’Avantage Biomécanique des Matériaux Amortisseurs dans
l’Implantologie Dentaire”
Ali Merdji
“Du PRF vers les Matrices plasmatiques Minéralisées (MPM)
en implantologie”
Cherine Farhat
“Immediate Placement of Dental Implants into Infected
Dento-alveolar Sockets”
Wahid Terro
“Is immediate implant placement possible in "Any case"?
Overcoming the challenges”
Souheil Bechara
“Immediate implantation Vs delate implantation”
Ghassan Bassit
Break & Exhibition Visit

“Immediate implant placement in fresh extraction sockets”
Mohamad Al Bazzal
“Success criteria for immediate loading”
Youssef Khalifeh
“Temporization of critical Implant Cases”
Abdallah Al Tassi
“Implant supported overdenture for the atrophic mandible”
Elie Abdo
“Influence of microgap on
bone resorption around dental implants”
Maissa Aboul Hosn

“Management of Deep Mandibular Impactions”
Chantal Abou Jaoudeh
“Management of Condylar Hyperplasia”
Eliane Gharios ZIADE
“Bonded retainers in orthodontics: expected or unexpected
outcomes?”
Evita Nader
“Mandibular protraction devices in non-compliant Class II
patients”
Joe Feghali
“Accelerated osteogenic
orthodontics: Overview and clinical applications”
Wassim El Sayed
“Mandibular retention:is it always conventional?”
Lama Matar
“Facial beauty, new standard?”
Liliane Bachir
“What is behind midline deviation?”
Marc Bakalian
Break & Exhibition Visit
“Safe zones for enhancing miniscrews stability”
Marilyn Eddo
“Lower incisor extraction: Problems and solutions”
Mohamad Ladki
“Mandibular protraction devices in non-compliant Class II
patients”
Mohannad Nawaf Khandakji
Parry-Romberg
syndrome:surgical and dental manegement.
Katy Bitar
“Pediatric and orthodontic
treatment of Schwachman-Diamond syndrome”
Roula Tarabay
Streptococcus Viridans: a possible etiology of pneumonia
Sandra Andari
“Root position inspected on CBCT vs Panoramic: a
comparative analysis
Sarah Wazneh”
Improvement of orthodontic diagnosis with CBCTs”
Shana Harb
“Auxiliary means to bite opening””
Suzanna ALMAALI

Closing Ceremony

What can you say about the dental
education in LEBANON?
I hope that the Education offered in
Lebanon would be available to doctors in every continent. Lebanon is
an international hub for education
in general and dentistry is no exception. Our experience in education has
been positive over the past decades.
Each dental university or educational
center has highly qualified instructors
to support the dental curriculum or
program they offer. The LDA continuing education courses were created
to enable dentists to develop confidence and skills required to achieve
optimal aesthetic results. Dentistry
today is living a new age of metal
free restorations. This has brought
the demand of conducting continuing educational courses for dentists
and lab technicians to accompany the
state of the art new techniques and
materials. It is important to mention
that in Lebanon the universities support our dentist pursuit for advanced
learning and one of the advantages we
have in Lebanon is that educational

programs are offered in English and
French speaking universities and are
approached from Anglo-Saxon and
European points of view.

“BIDM2013 is an exciting
forum.“
How will your rich knowledge and
experience help you handle the responsibilities as President of the
Lebanese Dental Association?
As you know the experience and
knowledge in the dental field can help
to understand the need of dentists
and their requests and to improve
their situation by finding solutions to
their problems. I have always enjoyed
my role as an academic. Sharing your
knowledge is always a noble task, I
have always been committed to help
and assist people. We should all be
very proud of where we are today and
excited about where we are heading.
What are your recommendations to
the dentists and fresh dental graduates?

My modest experience permits me to
say to all freshly graduated dentists
that the diploma is just the beginning
of your career. It is like a drop of water
in a glass, only knowledge, experience
and continuing educational conferences can improve our skills. My advice is that they should not be satisfied with just being a General Dentist.
One must aim high, obtain additional
knowledge and training, and go for a
speciality in the dentistry.
Prof Maalouf, it has been an honour to interview, is there anything
else you would like to share with the
readers?
I am thankful to Dental Tribune Middle East and I hope that we can collaborate more and more with CAPP
and Dental Tribune Middle East in
the future. I will be expecting your
full support and cooperation to make
our partnership as fruitful and successful as possible.

[18] =>

4

tr a de e xhibition m a p

3
3.T Technology		

A77

A
AMG
Ass.

A18
A37

B
Bicon ME
Biodiamond ME s.a.l
Bq BBAC
Bq BLC
Bq Byblos
Bq. Inter
Bq. SGBL
Bq.BOB

A98
A55
A88
A85
A79
A34
A21
A19

C
Carus
Croix Rouge

A26
A99

D
Dental Design Studio
A31
Dental Lab & Clinics
A1.2.3
Dental Shares s.a.r.l
A42.47.51
Dental Tribune Middle East
A103

42nd Conference of the Arab Dental Federation
23rd BIDM . Beirut Lebanon . 26-28 September 2013

Dental World
A104
Dentaltech s.a.r.l
A75.76
Dentycare Group
A54.54
Diab Med.
A83
DMS
A6.7.8.9
Doct. Ort.
A38
Doctor Smile / Comeco
A71
Droguerie Tamer A52.53.56.57.10.11

Implamedica Est
Interbio
Ivory Dental Lab

E

L

Eric
Eypress Nashawy

A55
A32.33

F
Fidelity
Flashmed
Fouad Khalil
FPM

A20
A81
A111
A42.46

G
GSK / FDC

A59.63

H
Hachem Dental Care
Hage Medical s.a.l

A66.67
A50

I
Imaging Center
Impco

J
JPM
Julphar

LDA
Liba Teknika
Listerine

A106
A100

A39.40.41
A94
A82

M
Medek s.a.r.l
A27.28.29
Medic Devices
A96
Medicals International
A17
Mersaco
A101
Mitri Matar & Co s.a.r.l
A30

N
Nepco
Novartis

A80
A90

O
Oral B

A93
A4

A84
A70
A95

P

Pharmaceutique
Pharmacol s.a.l
Picodente s.a.r.l
Prodent
Provis

A107
A60.61.65.72
A91.92
A44.45.48.49
A102

R
Rest.
Richa Dental Store

A23-25
A12-16

S
Services Rapides
Smart Dental
Saad Medical Trading
Societe Georges &
Antoine Ganage s.a.l
Sol-T

A73.74
A97
A64
A58.62
A110

T
Technological Crown Innovation
A109
Teledenta s.a.l
A108
Toff Dental
A68.69
Trident s.a.r.l
A54

V
A5

Visa
Well Care Group

A35
A78

[19] =>

SENSITIVE TO THE NEEDS OF YOUR

DENTINE HYPERSENSITIVITY PATIENTS

Sensodyne® understands that dentine
hypersensitivity patients have differing needs

Sensodyne® Complete Protection helps
maintain good gingival health4-6

Sensodyne® Complete Protection, powered by NovaMin®,
offers all-round care with specially designed benefits to meet
your patients’ different needs and preferences. With twice-daily
brushing, Sensodyne Complete Protection:

Good brushing technnique can be enhanced with the use of a
specially designed dentifrice to help maintain good gingival health.18,19

Clinically proven to provide dentine hypersensitivity relief1-3

In clinical studies, NovaMin® containing dentifrices have shown up
to 16.4% improvement in plaque control as well as significant reduction
in gingival bleeding index, compared to control toothpastes.4-6

Contains fluoride to strengthen enamel
Significant reduction in gingival bleeding index (GBI)
over 6 weeks with a NovaMin® containing dentifrice4

Helps to maintain good gingival health4-6

Sensodyne® Complete Protection, powered
by NovaMin® – an advanced approach to
dentine hypersensitivity relief

In vitro studies have shown that the hydroxyapatite-like layer starts
building from the first use7-9* and is up to 50% harder than dentine.9,14
The hydroxyapatite-like layer binds firmly to collagen within
exposed dentine10,15 and has shown in in vitro studies to be
resistant to daily physical and chemical oral challenges,9,14-17
such as toothbrush abrasion16 and acidic food and drink.14-17

with a NovaMin® containing dentrifrice4

1.4
1.2
Mean GBI*

NovaMin®, a calcium and phosphate delivery technology,
initiates a cascade of events on contact with saliva7-12 which
leads to formation of a hydroxyapatite-like restorative layer
over exposed dentine and within dentine tubules.7, 9-13

58.8% reduction from baseline in 6 weeks
p<0.001

p=ns

Baseline
6 weeks
NovaMin® containing
dentifrice

Baseline
6 weeks
Placebo control

1.0
0.8
0.6
0.4
0.2
0

Adapted from Tai et al, 2006.4 Randomised, double-blind, controlled clinical study of 95
volunteers given NovaMin® containing dentifrice or placebo control (non-aqueous dentifrice
containing no NovaMin®) for 6 weeks. All subjects received supragingival prophylaxis
and polishing and were instructed in brushing technique.4 *GBI scale ranges from 0–3.

In vitro studies show that a hydroxyapatite-like layer forms
over exposed dentine and within the dentine tubules:7,9,10,12,13
Hydroxyapatite-like
layer over exposed
dentine

Hydroxyapatite-like
layer within the
tubules at the surface

5 µm

Adapted from Earl et al, 2011 (A).13 In vitro cross-section SEM image of hydroxyapatite-like layer
formed by supersaturated NovaMin® solution in artificial saliva after 5 days (no brushing)13

All-round care for dentine hypersensitivity patients1-6

References:
1. Du MQ et al. Am J Dent 2008; 21(4): 210−214. 2. Pradeep AR et al. J Periodontol 2010; 81(8): 1167−1113. 3. Salian S et al. J Clin Dent 2010; 21(3): 82-87. Prepared November 2011, Z-11-496. 4. Tai BJ
et al. J Clin Periodontol 2006; 33: 86-91. 5. Devi MA et al. Int J Clin Dent Sci 2011; 2: 46-49. 6. GSK data on file (study 23690684) 7. LaTorre G, Greenspan DC. J Clin Dent 2010; 21(3): 72-76. 8. Edgar WM.
Br Dent J 1992; 172(8): 305-312. 9. Burwell A et al. J Clin Dent 2010; 21(Spec Iss): 66–71. 10. Efflandt SE et al. J Mater Sci Mater Med 2002; 26(6): 557-565. 11. de Aza DN et al. J Mat Sci: Mat in Med 1996;
399–402. 12. Arcos D et al. A J Biomed Mater Res 2003; 65: 344–351. 13. Earl J et al. J Clin Dent 2011; 22[Spec Iss]: 62-67. (A) 14. Parkinson C et al. J Clin Dent 2011; 22(Spec Issue): 74-81. 15. West
NX et al. J Clin Dent 2011; 22(Spec Iss): 82-89. 16. Earl J et al. J Clin Dent 2011; 22(Spec Iss): 68-73. (B) 17. Wang Z et al. J Dent 2010; 38: 400−410. 18. “Dentifrices” Encyclopedia of Chemical Technology
4th ed. vol 7, pp. 1023-1030, by Morton Poder Consumer Products Development Resources Inc. 19. van der Weijen GA and Hioe KPK. J Ciul Periodontal 2005; 32 (Supp 1.6): 214-228. Date of Preparation:
July 2013, Code: CHSAU/CHSENO/0008/13

Arenco Tower, Media City, Dubai, U.A.E.
Tel: +971 4 3769555, Fax: +971 3928549 P.O.Box 23816.
For full information about the product, please refer to the product pack.
For reporting any Adverse Event/Side Effect related to GSK product please contact us on contactus-me@gsk.com.

Evolving expertise in
dentine hypersensitivity

[20] =>

16 I n dustry

Dental Tribune Middle East & Africa Edition | September - October 2013

3Shape Releases CAD Solution For Post And
Core Restorations
By Bruce Frederic Mendel

_______________________

Shape, the provider of 3D
scanners and CAD/CAM
software solutions for the
dental industry, announces
the launch of its CAD solution for
Post and Core restorations – which
includes dedicated Post and Core intraoral scanning with 3Shape TRIOS®
and unique CAD design workflows in
Dental System™ 2013. 3Shape’s Post
and Core solution utilizes special
scanning capabilities, 3Shape Scan
Posts™, and sophisticated software

tools for reliable capture and optimally shaped and functional Post and
Core designs. The solution saves time
by allowing lab technicians to design
all layers in a single digital workflow.

to support drill systems from major
suppliers. Patent Pending.
Flexible input – takes scans from
TRIOS® and from dental lab scanners

3Shape Scan Posts™ – for use in clinics and labs

3Shape’s Post and Core solution can
be used with 3Shape TRIOS® digital
impressions and 3D scans of gypsum
models. Dentists with 3Shape TRIOS®
can kick start Post and Core cases in
the clinic by capturing and sending
highly reliable input to the lab for
direct designing. A special dual-scan
workflow using 3Shape Scan Posts™
ensures accurate capture of true

3Shape has developed special Scan
Posts™ to facilitate accurate capture
of the Post and Core restorations’
positions and depths. Scan Posts™ are
approved for both intraoral use in the
clinic and for model scanning in the
lab. Scan Posts™ are autoclavable, and
they come in various shapes and sizes

3Shape TRIOS

Impression-taking has never been easier

depths and positions of the root canal. If gypsum models are the input
source, lab technicians simply insert
Scan Posts™ in the model before scanning.
Sophisticated design tools

3Shape TRIOS is the next-generation intraoral digital impression solution. Easily
create accurate digital impressions and send cases directly to the lab with a single
click.
®

3Shape TRIOS

• Spray- and powder-free for optimal accuracy and patient comfort
• Optimized Ultrafast Optical Sectioning software - now 40% faster
•

Wide range of indications, including implant abutment cases

•

Instant impression and occlusion validation and smart edit scan tool

•

Autoclaveable tip with anti-mist heater

•

Choose TRIOS Color or TRIOS Standard

TRIOS® Pod solution
Use TRIOS® with your iPad, laptops, PC’s in your treatment rooms, or
with the PCs integrated in your chair units.

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announcements, special offers, articles, and more
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Scan the QR code to register.

In the lab, technicians align the captured Scan Posts™ and let the software calculate positions and depths
automatically. By first designing the
anatomy layer and applying dedicated
Post and Core modeling tools, technicians can create optimally shaped
and functional Post and Core designs
that are matched to the clinical case
and ready for manufacturing through
wax print & cast, milling, or laser sintering.
Frederic Rapp, Director of Crown
Ceram dental laboratory in France
says: “In combination with TRIOS®,
3Shape’s Post & Core design software
gives us a fast and easy way to model optimally shaped and robust Post
and Core restorations. The full digital
workflow makes it very easy to design
parallel post and cores, or work with
cases involving multiple posts.”
All types of Post and Core cases
Labs can design Post and Core cases
for standard crowns, single-piece retained crowns, and anatomical single-piece retained crowns that are cut
back for veneering.
3Shape’s Post and Core design solution is fully functional in the released
Dental System™ 2013 software, and
with 3Shape TRIOS®. 3Shape Scan
Posts™ are available for both dental
clinics and labs through 3Shape distributors. Please contact your local
3Shape representative for details and
purchase information.

Contact Information
Bruce Frederic Mendel
3Shape Communications
E-mail: Bruce.mendel@3shape.com
Web: www.3shape.com

[21] =>

INTERNATIONAL SYMPOSIUM SERIES 2014

Madinat Jumeirah Resort
Dubai, UAE • May 7-9, 2014
REGISTRATION
Ralph Rmeily
dubai2014@biohorizons.com
Tel #: +1 205-986-1235
SPMP13175 REV A JUNE 2013

[22] =>

18 R e se a rch

Dental Tribune Middle East & Africa Edition | September - October 2013

Oral Management Of Oncology Patients Requiring
Radiotherapy
1.1. Pretreatment oral evaluation
Ideally, a comprehensive oral evaluation should take place 1 month before cancer treatment starts to allow
adequate time for recovery from any
required invasive dental procedures.
The pretreatment evaluation includes
a thorough examination of hard and
soft tissues, as well as appropriate radiographs (panoramic and CBCT) to
detect possible sources of infection
and pathology.1,5

By Professor Ibrahim NASSEH,
Dr. Saydé SOKHN

________________________

ntroduction
Surgery, chemotherapy and radiotherapy are the options for
treatment of head and neck cancers. Each modality is associated with
a number of considerations related to
treatment of the cancer and quality of
life of the patient.
Radiation therapy plays an important
role in the treatment of patients with
head and neck cancer. Depending on
the location of the malignancy (primary tumor, lymph node metastases),
the salivary glands, oral mucosa, and
jaws have to be inevitably included
in the radiation treatment portals.
The complications must be considered thoroughly so that every effort
is undertaken to minimize the oral
morbidity for these patients before,
during and after cancer treatment and
throughout the patient’s lifetime.
With over 1.4 million new cases of
cancer diagnosed each year and a shift
to outpatient management, dentists
are more likely to see some of these
patients in their practice; so they need
to know about potential oral side effects. Preexisting or untreated oral
disease can also complicate cancer
treatment. Such complications can be
prevented or at least better managed
if dental and medical health care providers work together.1,2

Also take the following steps before
cancer treatment begins:

Fig.1: Axial view.

• Identify and treat existing infections, carious and other compromised
teeth, and tissue injury or trauma.

1.2. Pre-radiotherapy extraction
The majority of patients who develop osteoradionecrosis (ORN) are
those who were dentate just prior to
the commencement of radiotherapy.
Tooth removal accounts for the vast
majority of trauma-related ORN, so
all teeth located within the primary
beam of the radiation portal should
be closely scrutinized. Early consultation with the radiation oncologists
and therapists is essential. 7,8

Fig.2: Right side

This paper offers the dental team an
overview of the consequences associated with radiotherapy to facilitate
collaboration with the patient’s medical team.

A number of factors influence the
clinician’s decision as to which teeth
need to be removed prior to the commencement of radiotherapy. There is
still much controversy surrounding
the extraction criteria for radiotherapy patients, but the following need to
be considered:6,9,10,11

1.The role of pre-treatment oral care
A thorough oral evaluation by a
knowledgeable dentist before cancer
treatment begins is important to the
success of the regimen. Pretreatment
oral care achieves the following:
• Reduces the risk and severity of oral
complications.
• Allows for prompt identification
and treatment of existing infections
or other problems.
• Improves the likelihood that the
patient will successfully complete
planned cancer treatment.
• Prevents, eliminates, or reduces oral
pain.
• Minimizes oral infections that could
lead to potentially serious systemic
infections.
• Prevents or minimizes complications that compromise nutrition.
• Prevents or reduces later incidence
of bone necrosis.
• Preserves or improves oral health.
• Provides an opportunity for patient
education about oral hygiene during
cancer therapy.
• Improves the quality of life.
• Decreases the cost of care. 3,4
With a pretreatment oral evaluation,
the dental team can identify and treat
problems such as infection, fractured
teeth or restorations, or periodontal
disease that could contribute to oral
complications when cancer therapy
begins. The evaluation also establishes baseline data for comparing the
patient’s status in subsequent examinations.
Open communication with the patient’s oncologist is essential to ensure
that each provider has the information necessary to deliver the best possible care.

Oral surgery should be performed at
least 7 to 10 days before the patient
receives myelosuppressive chemotherapy. Medical consultation is indicated before invasive procedures.
• Remove orthodontic bands and
brackets if highly stomatotoxic chemotherapy is planned or if the appliances will be in the radiation field.
• Consider extracting highly mobile
primary teeth in children, and teeth
that are expected to exfoliate during
treatment.
• Prescribe an individualized oral hygiene regimen to minimize oral complications. Patients undergoing head
and neck radiation therapy should be
instructed on the use of supplemental
fluoride.
Radiographic examination is essential in assessing the presence of
abscesses, evaluation of periodontal
status and determination of the existence of metastatic disease. Previous
dental experience and exposure may
also serve as a useful prognostic indicator.4,5,6

Fig.3: Left side

Fig.4: Lateral view

Fig.5: Cross sectional views

• Stabilize or eliminate potential sites
of infection.
• Extract teeth in the radiation field
that are nonrestorable or may pose
a future problem to prevent later extraction-induced osteonecrosis.
• Conduct a prosthodontic evaluation
if indicated. If a removable prosthesis
is worn, make sure that it is clean and
well adapted to the tissue. Instruct
the patient not to wear the prosthesis
during treatment, if possible; or at the
least, not to wear it at night.
• Perform oral prophylaxis if indicated.
• Time oral surgery to allow at least
2 weeks for healing before radiation
therapy begins. For patients receiving
radiation treatment, this is the best
time to consider surgical procedures.

1.2.1. Non-dental factors
a. Radiation dose
If the radiation dose to the bone of
the mandible and maxilla is less than
5000cGy, then according to the literature, there should be minimal risk of
osteonecrosis after radiotherapy. The
radiation oncologist must give this
information to the dentist prior to the
initiation of head and neck radiation.
b. Location of radiation ports
At some oral oncology clinics, recommendations for dental extractions
prior to radiotherapy are limited to
those areas of the mandible and maxilla that are going to receive greater
than 5000cGy. If there are teeth outside the potential high dose field
of radiation, that are symptomatic
or have a hopeless prognosis, they
should be extracted prior to radiation, if time permits.
c. Patient prognosis
If the prognosis of the patient is extremely poor or if the tumor is growing rapidly, the radiation oncologist
may decide that radiation needs to
proceed without delay. After extraction, 2-3 weeks healing time is recommended before head and neck radiation therapy begins.
d. Patient age
The younger the patient, the longer
the teeth must be maintained disease
free. If dental extractions are required
(due to tooth decay or periodontal
disease) in areas that will receive high
dose radiation, the patient will be at
significant risk for osteonecrosis. The
risk of osteonecrosis in irradiated areas is present for the duration of the
patient’s life. There is no “safe” time
limit to wait for extractions or surgery

[23] =>

R e se a rch

Dental Tribune Middle East & Africa Edition | September - October 2013
A mandibular CBCT showed Ill defined, low density areas in the right
and left mandibular molar regions
(fig.1). On the right side, the area is
extending from tooth #43 to distal of
tooth #47 and occupying the superior
half of the mandible (fig.2). On the
left side, the area is extending from
tooth #36 to tooth #34 and is also
occupying the superior half of the
mandible; some granular opacities
are noted within the region of interest (fig.3). Both areas are associated
with interruptions of the lingual and
superior cortices. No root resorption
could be detected on any of the involved teeth.
5. Clinical Case 2
Post radiation spontaneous mandibular fracture.

Fig.6: 3D representation

in these areas. Therefore, the patient
needs to be informed of the potential
life-long risk before radiation therapy
is initiated, even if the teeth are very
healthy.
e. Patient finances
If the patient cannot afford dental
care that is required after radiation
therapy, serious consideration needs
to be given as to whether any teeth
should remain in the proposed high
dose field of radiation.
f. Patient compliance
If the patient has demonstrated lack
of motivation in previous dental
care and oral hygiene, or has a severe
dental phobia, serious consideration
needs to be given whether any teeth
should remain in the proposed high
dose field of radiation.
1.2.2. Dental Factors
a. Radiographs
A panoramic radiograph should be
taken prior to radiotherapy to assess
health of the teeth and jaws. Patients
without teeth should also have a
panoramic film. Other intraoral radiographs may be necessary, and even
imaging techniques when justified.
b. Periodontal disease
Teeth in the proposed high dose field
of radiation should be considered for
pre-radiation therapy extraction if
periodontal sulcular depths are equal
to or greater than 5mm, if there is furcation involvement, if they have a history of refractory periodontitis, tooth
mobility, bleeding, or inflammation
of the gums.
c. Caries (tooth decay)
Teeth in the proposed high dose field
of radiation should be considered
for pre-radiation therapy extraction
if they have deep decay, especially in
a patient that has numerous areas of
tooth decay throughout the oral cavity.
d. Root canals
Teeth having root canals in the proposed high dose field of radiation
should be considered for pre-radiation therapy extraction if they have
silver points and/or evidence of root
canal failure, i.e. pain, swelling or apical radiolucencies.
e. Impactions
Impacted teeth, especially third molars, that will be located in the proposed high dose field of radiation
should be extracted prior to radiation, if there is pathology associated
with the teeth or if the teeth have a
communication with the oral cavity.
f. Large fillings, fractures, occlusal wear
Teeth with large fillings, fractures or
significant occlusal wear should be
considered for extraction prior to receiving high dose radiotherapy.
g. Pain, apical radiolucency
Teeth that are painful, have a history
of pain, sensitivity to percussion or
apical radiolucency should be considered for extraction prior to receiving
high dose radiotherapy.
h. Unopposed teeth
Teeth that do not have contact with

a tooth in the opposing arch should
be considered for extraction prior to
receiving high dose radiotherapy, if
they are in the proposed high dose
radiation field.
2. Management during treatment
It is extremely important to keep the
mouth clean and healthy during head
and neck radiation, to help reduce the
risk of oral infection. A professional
dental cleaning prior to radiation is
highly recommended. Following are
some suggestions for reducing oral
complications during head and neck
radiation.7,9
Monitor the patient’s oral hygiene.
Tooth brushing should be performed
at least twice daily. Supersoft toothbrushes* are available that will not
cause irritation, Flossing is recommended as well as the use of a waterirrigating device, on a low setting, to
eliminate food between teeth.
Watch for mucositis and infection.
Treating infections as soon as they are
detected will help to reduce pain, as
well as the spread of infection. A fungal, bacterial or viral culture is recommended if infection is suspected.
Maintaining a self-care regimen may
decrease the incidence of mucositis.1,4,9 Advise against wearing removable appliances during treatment or
left out at night.1,9
3. Management after treatment
• Recall the patient for prophylaxis
and home care evaluation every 4 to
8 weeks or as needed for the first 6
months after cancer treatment.
• Reinforce the importance of optimal
oral hygiene.
• Monitor the patient for trismus:
check for pain or weakness in masticating muscles in the radiation field.
Instruct the patient to exercise three
times a day, opening and closing the
mouth as far as possible without pain;
repeat 20 times.
• Consult with the oncology team
about use of dentures and other appliances after mucositis subsides. Patients with friable tissues and xerostomia may not be able to wear them
again.
• Watch for demineralization and
caries. Lifelong, daily applications of
fluoride gel are needed for patients
with xerostomia.
• Advise against elective oral surgery
on irradiated bone because of the risk
of osteonecrosis. Tooth extraction, if
unavoidable, should be conservative,
using antibiotic coverage and possibly
hyperbaric oxygen therapy.7,9
4. Clinical Case 1
Post radiation osteoradionecrosis of
the mandible (courtesy Pr. Marcel
Noujeim).
The patient has a history of radiotherapy for the treatment of tonsilar
carcinoma; he is currently undergoing hyperbaric-oxygen therapy.

The patient complains from pain after extraction and curettage of the
wound.
The CBCT of the angle of the mandible shows an incomplete healing in
the site of extraction, with ill-defined
borders, discontinuity of the mandibular borders and bone sequestration
(fig.4-6).
Conclusion
The clinical management of carcinomas of the head and neck region causes oral sequelae that can compromise
patients’ quality of life and necessitate
abandonment or reduction of optimal

therapeutic regimens, which in turn
reduces the odds of long-term survival. Such sequelae can be prevented
or at least better managed if dental
and medical health care providers
work together. It is therefore essential
that dentists have an understanding
of cancer therapy and a sound working knowledge of the prevention and
management options for the oral sequelae of cancer treatment.
The careful, thorough consideration
of the complications of radiotherapy
and chemotherapy must be considered so measures can be undertaken
in every phase of treatment to alleviate undue patient discomfort and suffering. It is the responsibility of the
general dental practitioner to help
the patient navigate the minefield of
the potentially devastating legacies of
cancer therapy. So your oral health
needs to be as good as possible before
the start of treatment to avoid problems later.3.11
References
1. Hancock JP., Epstein BJ. and Sadler
R.G. Oral and Dental Management
Related to Radiation Therapy for Head
and Neck Cancer. J Can Dent Assoc
2003; 69(9): 585-90.
Rest of references is available from
the author.

Contact Information

Professor Ibrahim NASSEH,
DDS, PhD (Paris),
Fellow of the International College
of Dentists
Director, Oral and Maxillofacial Radiology postgraduate program
Department of DentoMaxilloFacial
Imaging, Lebanese University,
School of Dentistry
Consultant at Lumiray®, 3D Dental
Imaging Center, Beirut, LEBANON
ibrahim.nasseh@gmail.com
tel: +9613302232

Dr. Saydé SOKHN
BDS, DUA, DUB
Head of Service, Department of
DentoMaxilloFacial Imaging,
Lebanese University, School of Dentistry, Beirut, LEBANON
ssokhn@corpocare.com
tel: +9613255442

[24] =>

20 Aca de mia Tr ibu n e

Dental Tribune Middle East & Africa Edition | September - October 2013

Dubai School Of Dental Medicine Welcomes Second
Batch Of Students

By Dubai School of Dental
Medicine
________________________

D

ubai School of Dental
Medicine (DSDM), a
home-grown specialist
dental school located in
Dubai Healthcare City (DHCC), has
welcomed its second intake of postgraduates.
The batch of students includes 26
dentists, enrolled into the five accredited postgraduate MSc programmes,
testament to the school’s established
position as a recognised leader in
dental education, research and clinical practice.
The three year Master of Science programmes on offer incorporate clinical
training at the level of Specialist Trainee. The courses provide appropriate
preparation for external specialist
clinical examinations including the
Membership Examination of the
Royal College of Surgeons of Edinburgh, and therefore have a higher
credit than that typically required for
Master’s degree.
Welcoming the students at this week’s
orientation, Marwan Abedin, CEO of
DHCC said, ‘DHCC is an internationally recognised centre of healthcare excellence and is committed to
education and furthering its medical
research offering through its specialised centres of excellence, including
DSDM. Our institutions represent
global standards in healthcare education, and to the continual development of specialist healthcare in the
UAE. DSDM is home to some of the
world’s top specialists in the field, and
we are delighted to see the arrival of
the second batch of students’.
The new academic term has also seen
the school welcome Dr Khawla Humaid Belhoul as Director of Clinical
Operations. Dr Belhoul will manage
the clinical operations and patient
care at the clinic to support the academic programmes.
Inauguration of the new students took
place at the Mohammed Bin Rashid
Academic Medical Center (MBRAMC), DHCC’s dedicated complex
housing a number of facilities which
collectively promote their healthcare
education and research mission.
Dr. Amer Sharif, Managing Director
of Education at DHCC said ‘I am
delighted to be welcoming our second batch of postgraduate students.
DHCC has prioritized education in
2013, and by offering a dental school
of such esteemed academic excellence
we are truly establishing a globally recognised medical education hub and
supporting our ultimate ambition of
building a specialised medical talent
pool in the region’.

Continuing Education

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Networking

[25] =>

INDUSTRY

Dental Tribune Middle East & Africa Edition | September - October 2013

> see filling page 1
The reasons for choosing the Inman
Aligner as an alternative orthodontic
system to provide to the patients are
as following:
• It achieves great results using just
one appliance.
• It has considerably lower lab costs
than other orthodontic alignment
systems.
• Patients love the speed of treatment.
Most cases are completed in 6-18
weeks.

• It is safe due to the gentle and consistent pressures exerted by the appliance.
• There are no reported cases of root
resorption or de-vitalization.
• The comprehensive and affordable
hands-on training course provides all
the knowledge and skills required for
dentists to start their first cases.
Why You Should Choose the Inman
Aligner:
The Inmam Aligner can be used to

quickly align teeth before veneer
preparations to de-radicalize preparations and avoid elective endodontics. It can be removed and inserted
as easily as a retainer. There are no
minimum annual case number requirements and it has an ongoing
and reliable case mentoring via web
forums. Additionally there is an access to active web forums to discuss
cases with other Inman Aligner providers through the clever ‘Spacewize’
crowding calculation system. The sys-

Biological &
Conservative

FKG Dentaire SA
www.fkg.ch

tem facilitates rapid chair-side Inman
Aligner case assessment and occlusal
planning.
Is It Safe?
Tried and tested The Inman Aligner
has over 1500 successful cases which
have been completed by the official
trainers of the Inman Aligner Certification Course. With over 90,000 successful cases completed worldwide,
The Inman Aligner has a 12 year
proven track record with over 1500

US and 3000 EU dentists and orthodontists having used the product. The
key of the system is the continuous
low peak orthodontic forces which
have been proven to move teeth both
quickly and safely. The patient will
need to remove the appliance just for
4 hours a day, whilst eating and cleaning and has been proven to reduce
the resorption risk. Lastly, there are
no recorded cases of devitalization or
root resorption meaning The Inman
Aligner is fast and safe.

[26] =>

22 Or a l H ygien e

Dental Tribune Middle East & Africa Edition | September - October 2013

The Up-To-Date Series Of Educational Events Start
In The Middle-East

By Dental Tribune Middle
East
________________________

bu Dhabi, UAE: The
event was held at the
Millennium Hotel in
Abu Dhabi and was
sponsored by Crest and Oral-B and
organized by CAPP. The two lecture event received accreditation by
Health Authority Abu Dhabi and
the American Dental Association
for 2 CE credit points.
Friday 30th of August 2013 saw the
official launch in the Middle East of
the very popular series of Up-ToDate educational events supported
by Crest and Oral-B. Nearly 200 people attended the program and those
included were dental practitioners,
dental hygienists and dental assistants
all of whom play an important role towards the oral health of our community. Two excellent speakers namely
Ms. Victoria Wilson from UK and Dr.
Carine Tabarani from Lebanon updated the audience on the importance of
oral health and prevention.
The program included a welcoming
reception, two lectures on oral hygiene prevention, a lucky draw and a
delegate dinner. The evening began
with an introduction by the Chair of
the Scientific Committee Dr. Ninette
Banday, Head of Dental Services at
SEHA–Ambulatory Healthcare Services Co. Dr. Ninette provided an
inspiring speech on the importance
of oral hygiene prevention. She reminded the audience that cavities or
dental caries is a ”Silent killer disease

and to a large extent is preventable
with good oral hygiene and regular
dental checks and care. The health
of our teeth and mouth are linked to
our overall health and well-being. The
ability to chew and swallow our food
is essential for obtaining the nutrients
we need for good health”.
Dr. Ashhad Kazi, Consultant for Professional & Academic Relations in
the Arabian Peninsula for Crest and
Oral-B explained the vision behind
the Up-To-Date scientific exchange
events, which are very well established courses in Europe. Quoting Dr.
Kazi, “Crest and Oral-B have a long
history of high quality research and
we want to make you aware of the significant impact that a dental professionals’ recommendation can have in
a patients’ long term oral health. Oral
hygiene is a topic that quite often is
overlooked and not given its due importance in our daily lives and clinics,
with newer oral care technologies
now at our disposal, it can be a game
changer in the fight for maintaining
good oral health”.
Kicking off the scientific session, first
to speak was Ms. Victoria Wilson,
Dental Hygiene Therapist from the
United Kingdom. A lively, enthusiastic and engaging speaker, Ms. Wilson
titled her lecture “Dental Hygiene
Prevention, are we actually doing all
we can?Recapping on the Dental Hygiene Definition and informing about
the need to view the patients and their
needs as a whole by also dealing with
silent obstacles affecting the patients
overall oral health. Further in the
lecture Ms. Wilson provided tools to
enhance communication and explore
the expansion of clinical competence
and further professional development avenues. Most importantly, Ms.
Wilson elaborated on the usage of
manual brushes versus electric toothbrushes. Highlighting her main point

Crest & Oral B Middle East Team at the first Up To Date Scientific Exchange Seminar in Abu Dhabi, UAE

Dr. Carine Tabarani, Oral Surgeon, French Dental Clinic, Abu Dhabi, UAE

by using the quote: “Understanding
your patients’ goals and desires is the
gateway to practice success in today’s
dental market. Electric brushes with
an oscillating/rotating action remove
plaque more effectively and studies
show they reduce gingivitis when
used for over 3 months. Rotation/os-

Ms. Victoria Wilson, Dental Hygiene Therapist, UK

cillation brushes are also more effective at reducing plaque and gingivitis
compared to manual brushing.”

The Scientific Exchange Session

The lucky draw with Dr. Ninette Banday (SEHA), Mr. Tzvetan Deyanov (Dental Tribune Middle East) and Dr. Ashhad Kazi (Crest & Oral-B)

Ms. Wilson also remarked that reports from literature have suggested
a link between periodontal (gum)
disease and cardiovascular disease.
Recent studies suggest evidence that
periodontal disease in pregnant women may be a significant risk factor
for preterm low birth weight with
some indicating that 18% of all low
birth weight cases may be attributable
to periodontal disease (gum disease).
The second speaker Dr. Carine Tabarani from Lebanon, Oral Surgeon
at the French Dental Clinic in Abu
Dhabi presented the audience with
a lecture on “New era of oral health
management: opportunities for an
optimized, evidence based management”. In her lecture, Dr. Tabarani
focused on the different formulations
of toothpastes that are available in the
Middle Eastern market specifically
detailing the benefits of the stabilized
stannous and fluoride complex. She
underlined: “The stannous fluoride
will enhance the resistance of hydroxy appatite to acid attack and make it
less soluble”. Furthermore, “Sodium
hexametaphosphade will help remove
stains by high binding to the calcium

ions of the hydroxy appatite” “Power
tooth brushing is the most efficient
in removing proximal marginal and
lingual plaque”.
All in all, the event summarized the
importance of oral health maintenance for the whole dental team and
can be seen as the start of numerous
similar events to hit the region soon
through the Up-To-Date course series.
The event came to a conclusion with
six lucky draws sponsored by Crest
and Oral-B and CAPP. Dr. Ashhad
Kazi awarded six lucky winners
through the ticket raffle. The first
three receiving the Oral-B Triumph
5000 electric toothbrush and the remaining three received VIP tickets to
attend the 5th Dental Facial Cosmetic
International Conference joint event
with 2nd Global Conference, American Academy of Implant Dentistry
on 8-9th of November 2013 at the Jumeirah Beach Hotel in Dubai, UAE.
After a discussion regarding what the
next series of lectures should be about
and what in the delegates’ opinion
was needed to make them a permanent success, the evening ended with
a delegate dinner giving the audience
an opportunity for networking in an
educational and friendly atmosphere.

[27] =>

[28] =>

24 L a b Tr ibu n e

Qualident
I Snore
Device
By Qualident Dental Laboratory

________________________

ualident I Snore Device
is a patented prosthesis
of splint type designed as
solution for snoring and
obstructive sleep apnea
and moderate sleep syndrome and increased resistance of the upper airway
and for patients with severe apnea,
who can not tolerate Constant Positive Airway Pressure. It is also effective in the treatment of bruxism and
forward jaw, which to some extent
limits lateral movements that appear
in this disorder.

„It allows limited natural
movements. It is possible to
talk, drink, and cough etc.
while using the device.“
The main feature of the mandibular
advancement prosthesis is its milimetric controlled advancement, allowing in the case of degradation the
ability to retract the jaw. The merger
of laterality, progress and openness
had never been joined into one device, making this an advantage, in effect the rest of the existing apparatus.
It is the only mechanism that can be
used in any type of dentition on patients with removable prosthesis and
dummy implants.
Other advantages are:
• It is Comfortable and easy to use.
• It is tailor made for each individual.
• It is manufactured with biocompatible materials (titanium thermoplastic)

• It can be easily adapted.
• It allows limited natural movements.
• It is possible to talk, drink, and
cough etc. while using the device.
• It facilitate easy breathing, eliminating snoring forever.

Dental Tribune Middle East & Africa Edition | September - October 2013

• It is recommended for people suffering from Sleep Apnea and treatment
of snoring.
• It allows lateral movements.
• As it also helps in the treatment of
anxiety, tiredness, high blood pressure, muscular pain, and irritability.

Contact Information
Dubai, U.A.E
Century Plaza 101
Jumeirah 1 Beach Road
Tel: +971 4 3427576
Fax:+971 4 3427016

Contact Information

Sharjah, U.A.E
Al Ettihad Road Opposite Safeer Mall
Wasl Bldg, 101 P.O.Box: 24476
Tel: 06-5255199 / Fax: 06-5302900
qualident@emirates.net.ae
www.qualident-online.com

[29] =>

or a l hygien e

Dental Tribune Middle East & Africa Edition | September - October 2013

Growing Old…Healthily
By Beverly Hills Formula
________________________

the dental team understand what products are available to help provide a
long-term solution.
Treating dry mouth
Saliva replacement gels, which contain natural enzymes found in normal saliva, can help moisturise dry
mouth, whilst effectively supporting
the saliva’s natural defences, and
nourishing and strengthening gums.
However, for these gels to successfully
do this, they must contain the following ingredients:

hanks to improvements
in healthcare and lifestyle,
society is living for longer.
In fact, research from the
Office for National Statistics published late last year suggested that most
people in the UK are living six years
longer1. As a result, the elderly are an
expanding group the entire healthcare profession will need to provide
care for.
Although not limited to the elderly,
xerostomia (dry mouth) is a common
condition amongst this age group,
due to age and prescription drug
use. Saliva cleanses and moistens
the mouth; aids food digestion; and
contains an antibody that prevents
harmful bacteria forming inside the
mouth. Therefore, a lack of saliva can
have a negative impact on a patient’s
personal and social life, affecting
speech and mastication. It also leaves sufferers more vulnerable to oral
infection, which can lead to halitosis,
and, if not treated, the harmful bacteria can cause gum disease, eventually resulting in tooth loss, in extreme
cases.
There are many causes of this uncomfortable, and sometimes painful,
condition. It can be the result of a
lifestyle or a side-effect of essential
medications or an illness, making it
more difficult to treat. In the latter
case, dental professionals will need
to help patients manage dry mouth.
To successfully do this, it is vital that

•
Carbomer
Carbomer produces a transparent,
lubricating and moistening film that
coats the soft tissue mucosal surface
to hold in moisture and provide relief
to dry mouth. Carbomers are white,
fluffy powders frequently used in gels,
cosmetics, personal and oral care
products and are used to optimise
the rheological properties of aqueous solutions. These polymers have
the ability to absorb and retain water
and expand many times their original
size, thus increasing the flow of saliva.
•
Glucose Oxidase
Glucose Oxidase is an enzyme that
converts glucose to hydrogen and
is added to oral care products to reduce the frequency of dry mouth
conditions and increase saliva production. An essential element within
the balanced enzyme system, Glucose
Oxidase is designed to boost and replenish saliva’s own natural defenses
whilst decrease oral bacteria. As a saliva substitute, Glucose Oxidase offers
potential antimicrobial and moisturising benefits and may be particularly
useful before eating, speaking, and
sleeping.
•
Lactoferrin
This compound is from milk (lacto)
and is able to bind iron (ferrin). It is
effective in mimicking the role of saliva by lubricating the oral cavity and
controlling the existing normal oral
microbiota. Lactoferrin is an essential
human salivary defense protein and
regularly used in oral care products,
restoring the saliva’s own antimicrobial capacity in patients with dry
mouth. Its antiviral and antibacterial
agent helps iron absorption and immunomodulation (changing immune
system) and is also known to help kill
bacteria, fungi and viruses.

•
Lactoperoxidase
Lactoperoxidase is a peroxidase, milk
enzyme from mammary, salivary, and
other mucosal gland that has natural
bacterial defense systems, and proves
to be a useful ingredient for symptomatic therapy for those suffering
from dry mouth syndrome (xerostomia). Its use in oral care products is to
reduce oral bacteria and the acid produced by that bacteria and treat dry
mouth. Lactoperoxidase can reduce
plaque and treat gingivitis.
Mouth conditioners such as Beverly Hills Formula’s moisturising
Mouth Conditioner contains such
ingredients to recreate and boost
the natural defence system found in
the mouth, providing antibacterial
protection, healing properties and a
healthier salivary flow.
A healthy mouth means a healthy
smile and, when used as part of a
daily oral care regime, Beverly Hills

Formula moisturising Mouth Conditioner provides long-lasting relief of
dry mouth, effectively soothing and
protecting the mouth against minor
irritations and burning sensations.
Treating an aging population
The elderly have some very specific and, sometimes, complex dental
needs. Recent research2 has highlighted this, after discovering that oral
health among homebound senior residents is poor and their quality of life
is ‚significantly affected‘ by the lack of
basic dental care. Almost 76% had at
least one tooth with severe gum disease and nearly six in 10 said they
“often or always” had limitations and
problems with the type of foods they
could eat, speaking clearly and their
general appearance.
In light of this, it’s also important for
dental professionals to become familiar with what products are available
to recommend to sufferers of dry

Visit us at
www.promedica.de

high quality glass ionomer cements
first class composites

Glass ionomer luting cement
• highly biocompatible, low acidity
• micro-fine film thickness
• excellent adhesion
• no temperature rise during setting

innovative compomers
modern bonding systems
materials for long-term prophylaxis
temporary solutions
bleaching products …

Light-curing nano-ceram composite
• highly esthetic and biocompatible
• universal for all cavity classes
• comfortable handling, easy modellation
• also available as flowable version

All our products convince by
excellent physical properties
perfect aesthetical results

PROMEDICA Dental Material GmbH

phone: +49 43 21/5 41 73 · fax +49 43 21/5 19 08 · Internet: www.promedica.de · eMail: info@promedica.de

Dental desensitising varnish
• treatment of hypersensitive dentine
• fast desensitisation
• fluoride release
• easy and fast application

mouth, which will not only help
maintain optimum oral care and prevent problems, but also improve and
enhance their quality of life.
References
1. Britons living longer than previously
thought: http://www.telegraph.co.uk/
health/elderhealth/9751444/Britonsliving-longer-than-previously-thought.
html
2. Neglected oral health of elderly a
„concern“: http://www.dentalhealth.
org/news/details/667

Contact Information
For more information please contact:
Tel: +353 1842 6611
Email: info@beverlyhillsformula.com
or visit
www.beverlyhillsformula.com

[30] =>

6 Months Clinical Masters Program

in Implant Dentistry
12 days of intensive live training with the Masters
in Como (IT), Maspalomas (ES), Heidelberg (DE)

Live surgery and hands-on with the masters
in their own institutes plus online mentoring and
on-demand learning at your own pace and location.
Learn from the Masters of Implant Dentistry:

Registration information:
12 days of live training with the Masters
in Como, Heidelberg, Maspalomas + self study

Curriculum fee: € 11,900

contact us at tel.: +49-341-48474-302 / email: request@tribunecme

(€ 900 when registering, € 3,500 prior to the first session, € 3,500 prior to the second session, € 4,000 prior to the last session)

Collaborate
on your cases

University
of the Pacific

Latest iPad
with courses

and access hours of
premium video training
and live webinars

you will receive a
certificate from the
University of the Pacific

all early birds receive
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100

ADA CERP
C.E. CREDITS

Tribune America LLC is the ADA CERP provider. ADA CERP is a service of the American Dental Association to assist dental professionals
in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors,
nor does it imply acceptance of credit hours by boards of dentistry.

[31] =>

This is where

fits in

[32] =>

) [page_count] => 32 [pdf_ping_data] => Array ( [page_count] => 32 [format] => PDF [width] => 723 [height] => 1077 [colorspace] => COLORSPACE_UNDEFINED ) [linked_companies] => Array ( [ids] => Array ( ) ) [cover_url] => [cover_three] =>

[cover] => DT Middle East and Africa No. 5, 2013

[toc] => Array ( [0] => Array ( [title] => NEW: 5th Dental Facial Cosmetic International Conference Hosts Inman Aligner Accreditation Course [page] => 01 ) [1] => Array ( [title] => Emirates Dental Society Attends Annual World Dental Congress On Dental Technology And Oral Health To Bring Back Key Learnings To The UAE [page] => 02 ) [2] => Array ( [title] => Snoring And Sleep Apnoea – A Role For The Dentist [page] => 04 ) [3] => Array ( [title] => Esthetic Long-Span Bridge Using BruxZir [page] => 06 ) [4] => Array ( [title] => Oral Health Benefits Of Chewing Gum [page] => 08 ) [5] => Array ( [title] => Applying CBCT To Endodontics Can Reveal Deficiencies That Otherwise Might Go Undiagnosed [page] => 10 ) [6] => Array ( [title] => New Treatment Center - SINIUS TS - Offers Maximum Flexibility [page] => 12 ) [7] => Array ( [title] => Dental Technician Forum 2014 in Singapore [page] => 13 ) [8] => Array ( [title] => BIDM 2013 Show Edition [page] => 15 ) [9] => Array ( [title] => 3Shape Releases CAD Solution For Post And Core Restorations [page] => 20 ) [10] => Array ( [title] => Oral Management Of Oncology Patients Requiring Radiotherapy [page] => 22 ) [11] => Array ( [title] => Dubai School Of Dental Medicine Welcomes Second Batch Of Students [page] => 24 ) [12] => Array ( [title] => The Up-To-Date Series Of Educational Events Start In The Middle-East [page] => 26 ) [13] => Array ( [title] => Qualident I Snore Device [page] => 28 ) [14] => Array ( [title] => Growing Old…Healthily [page] => 29 ) ) [toc_html] =>

Table of contents

[toc_titles] =>

[cached] => true )