DT U.S. No. 9, 2010

‘We could not support the health care reform legislation’ / News / Video marketing ‘do’ or ‘die’ / Changes and opportunities for health-care practitioners’ finances / The endo-implant algorithm / International congress on cone-beam 3-D technology / OSAP launches new Web site / Industry News / Cosmetic Tribune

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DENTAL TRIBUNE
The World’s Dental Newspaper · U.S. Edition

April 2010

www.dental-tribune.com

Vol. 5, No. 9

CHosmetiC
RiBUNe
YGIENE TtRIBUNE
the
Dentistry
Newspaper
· U.s.
edition
TheWorld’s
World’sCosmetic
Dental Hygiene
Newspaper
· U.S.
Edition

Cool stuff for the practice

Take a peek at some interesting products we
spotted at events and elsewhere.
u page 4A

Nearly empty waiting room?

Find your patients online with video marketing
that isn’t as expensive as you think.
u page 5A

Improving communication

How do you choose a lab? Did you know technicians choose you, too?
upage 1B

‘We could not support the health
care reform legislation’
By Daniel Zimmermann, Dental Tribune
International Group Editor

and how it will affect dentistry in
the United States.

The health care reform bill
recently approved by the U.S. Congress aims to improve access to
health care for more than 30 million Americans. However, dental
groups say that the legislation is
significantly neglecting oral health.
Daniel Zimmerman, group editor at Dental Tribune International
(DTI) headquarters, recently spoke
with Dr. Ronald Tankersley, president of the American Dental Association, about the historical decision

The ADA did not support the
health-care reform bill recently
approved by Congress. Could you
explain the rationale behind this
decision?
As America’s leading advocate for
oral health, our decision was primarily based on the oral health
provisions of the bill.
We could not support the healthcare reform legislation because it
did not include provisions to meaningfully improve access to dental

The endo-implant algorithm
An endodontist is
in a unique
position to
evaluate the
critical factors involved
in determining if a precedure will
result in a
successful
outcome.

care for millions of American children, adults and elderly by properly
funding Medicaid dental services.
You say that the reform does
not do enough to assure that
low-income families receive adequate oral health care. On the
other hand, millions of people
will finally be able to buy health
insurance regardless of their
social status or pre-medical condition.
While countless other groups can
weigh in on the health care reform’s
overall merits and flaws, people

ADA President Dr. Ronald Tankersley

look to the ADA for a determination
of how it could impact oral health.
And when the government is
willing to spend close to a trillion
g DT page 2A, ‘Health care …’

Breakthrough in
tissue engineering
By Fred Michmershuizen, Online Editor

Researchers at the University of
Illinois might have discovered the
key to re-growing tooth enamel. In
a comparative study on animals,
they found that repeated simple
amino acids, or prolines (see photo
on next page), are responsible for

making teeth stronger and more
resistant.
Their findings could help in
r eplacing lost parts of teeth in
p atients suffering from dental
decay. Proline is a major component of the protein collagen, the
g DT page 2A, ‘Breakthrough …’
AD

g See page
10A

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[2] =>

News

Dental Tribune | April 2010

‘certain surgical procedures must be
performed only by licensed dentists’
f DT page 1A, ‘Health care …’
dollars during the next 10 years,
but not spend a dime on improving
access to Medicaid dental services
for those most in need, somebody
has to raise an objection.
If we didn’t do that now, how
could we expect lawmakers to
take our concerns seriously in the
future? That was the basis for our
decision.
You have also rejected the idea of
workforce pilot programs; can
you tell us why?
The ADA’s opposition to the alternative dental models pilot program
was limited and based upon our
long-held belief that certain surgical procedures must be performed
only by licensed dentists.
What effects do you think the
reform will have on the dental
profession itself?
Although the ADA could not support the final legislation, we did
recognize that it contained many
worthwhile provisions pertaining to
oral health.
These included increased funding for public health infrastructure including Centers for Disease
Control and prevention programs,
additional funding for school-based
health center facilities and federally qualified health centers.
We also recognized increased
Title VII grant program opportunities for general, pediatric or public health dentists and funding for
the National Health Services Corps.
loan repayment programs.
These provisions, which the ADA
supported and lobbied for, will have
a measurable beneficial effect on

dentistry and dental patients.
In your opinion, what should be
changed in the reform bill to
make it feasible for dentists and
move patient care forward?
When it comes to improving access
to oral health care, our message
remains: Fund Medicaid, the Children’s Health Insurance Program
and other dental public health programs properly.
These programs are only capable of fulfilling their roles if they
receive adequate funding. Many
states spend less than 0.5 percent
of their Medicaid dollars on dental
care — an astonishingly low rate,
considering the importance of oral
health to overall health.
Further, poor dental reimbursement rates paid to dentists mean
that many of them can’t participate
in Medicaid, which is one of the
reasons many states fail to provide
oral health care for even half of
their eligible children.
The federal government can and
must do more to ensure states are
able to come up with their share of
these benefits.
Republicans and other interest groups have announced to
further oppose the reform bill.
Where will you position yourself
once the law has become effective?
The ADA will continue to lobby for
improvements to Medicaid dental
benefits and will be watching closely as federal agencies implement
provisions of the law.
We want to ensure that the provisions we support are carried out
correctly and will work to change
the provisions we oppose. DT

Tell us what you think!
Do you have general comments or criticism you would like to share? Is
there a particular topic you would like to see more articles about? Let us
know by e-mailing us at feedback@dental-tribune.com. If you would like
to make any change to your subscription (name, address or to opt out)
please send us an e-mail at database@dental-tribune.com and be sure
to include which publication you are referring to. Also, please note that
subscription changes can take up to 6 weeks to process.

Dental
infomatics?
Dental informatics is about
acquiring, managing and displaying information in order
to support dental practice,
research and education.
Informatics attempts to
answer the question of how
we can use information in
order to deliver better patient
care; be more successful in
understanding health and
disease through research;
and educate students, practitioners and patients more
effectively and efficiently.
Through the end of April,
the Center for Dental Informatics, School of Dental
Medicine at the University
of Pittsburgh is currently
recruiting for their training
program in dental infomatics (MS, PhD, postdoc). Find
more details at di.dental.pitt.
edu/cdipr102309.php.
Interested in dental infomatics? Join the worldwide
dental infomatics community
at www.dentalinformatics.
org for free! DT

DENTAL TRIBUNE
The World’s Dental Newspaper · US Edition

Publisher & Chairman
Torsten Oemus
t.oemus@dental-tribune.com
Vice President Global Sales
Peter Witteczek
p.witteczek@dental-tribune.com
Chief Operating Officer
Eric Seid
e.seid@dental-tribune.com
Group Editor & Designer
Robin Goodman
r.goodman@dental-tribune.com
Editor in Chief Dental Tribune
Dr. David L. Hoexter
d.hoexter@dental-tribune.com
Managing Editor/Designer
Implant Tribune & Endo Tribune
Sierra Rendon
s.rendon@dental-tribune.com
Managing Editor/Designer
Ortho Tribune & Show Dailies
Kristine Colker
k.colker@dental-tribune.com
Online Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.com
Product & Account Manager
Mark Eisen
m.eisen@dental-tribune.com
Marketing Manager
Anna Wlodarczyk
a.wlodarczyk@dental-tribune.com
Sales & Marketing Assistant
Lorrie Young
l.young@dental-tribune.com
C.E. Manager
Julia E. Wehkamp
j.wehkamp@dental-tribune.com

f DT page 1A, ‘Breakthrough …’

(Photo/Florida State
University)

Repeated simple amino
acids, or prolines (shown
above), are responsible for
making teeth stronger and
more resistant.

connective tissue structure that
binds and supports all other tissues.
It can be also found in protein
bubbles that help to form enamel.
In the study, the researchers
comp ared the number of proline
r epeats in amphibian and mammal models, such as mice, cows
and frogs, and discovered that
when the repeats are short, teeth
lack the ena mel prisms that are
responsible for the strength of
human enamel.
In contrast, when the proline
repeats are long, they contract
groups of molecules that help
enamel c rystals grow.
According to the researchers,
the findings could aid other important areas of scientific research
in addition to dentistry, including
the treatment of neurodegenerative dise ases, such as Alzheimer’s
disease or Creutzf eldt-Jakob disease. DT

Dental Tribune America, LLC
213 West 35th Street, Suite 801
New York, NY 10001
Tel.: (212) 244-7181
Fax: (212) 244-7185
Published by Dental Tribune America
© 2010 Dental Tribune America, LLC
All rights reserved.
Dental Tribune strives to maintain the
utmost accuracy in its news and clinical reports. If you find a factual error or
content that requires clarification, please
contact Group Editor Robin Goodman at
r.goodman@dental-tribune.com.
Dental Tribune cannot assume responsibility for the validity of product claims
or for typographical errors. The publisher also does not assume responsibility
for product names or statements made
by advertisers. Opinions expressed by
authors are their own and may not reflect
those of Dental Tribune America.

Editorial Board
Dr. Joel Berg
Dr. L. Stephen Buchanan
Dr. Arnaldo Castellucci
Dr. Gorden Christensen
Dr. Rella Christensen
Dr. William Dickerson
Hugh Doherty
Dr. James Doundoulakis
Dr. David Garber
Dr. Fay Goldstep
Dr. Howard Glazer
Dr. Harold Heymann
Dr. Karl Leinfelder
Dr. Roger Levin
Dr. Carl E. Misch
Dr. Dan Nathanson
Dr. Chester Redhead
Dr. Irwin Smigel
Dr. Jon Suzuki
Dr. Dennis Tartakow
Dr. Dan Ward

[3] =>

[4] =>

News

Dental Tribune | April 2010

Cool stuff for your practice
By Fred Michmershuizen, Online Editor

Buzzy device makes injections easier for kids
For children, getting an injection can be quite traumatic. That’s
why most dentists would probably
agree that just about anything
that can be done to make “getting a shot” easier is certainly
welcome. With that in mind, meet
Buzzy — a reusable FDA class I
pain relief device.
It’s the brainchild of Amy Baxter, MD, a pediatrician who developed it to ease the pain that children feel when getting shots at
doctors offices. But it works just
as well for dental injections.
“The physiology is pretty
basic,” Baxter told Dental Tribune
during an interview at the recent
Dr. Amy Baxter, a pediatrician, shows
Thomas P. Hinman Meeting in
off the Bee-stractor cards and Buzzy
Atlanta. “The combination of a
pain relief device at the recent Hinman
frozen cold pack and vibration
Meeting in Atlanta. (Photo/Fred Michblock the sharp pain nerves when
mershuizen, DTA)
pressed proximal to the pain.”
There’s scientific evidence to
back that up. Baxter and four other doctors conducted a randomized clinical
trial, the results of which were published in the September/October 2009 issue
of Clinical Journal of Pain. The study found that the combined cold and vibration sensations decreased injection pain “significantly.”
“The ‘wiggling the cheek’ thing dentists have always done is called ‘gate
theory nerve blockade,’” Baxter explained. “Buzzy does the same thing but
with added cold.” For palatal injections administered in a dental office, she

ADS

said, simply press Buzzy to the maxilla or zygomatic arch. “It’s effective
in about 15 seconds,” she said.
The reusable device looks like a bumblebee and has freezable gel
pack “wings.” It’s available from MMJ Labs, an Atlanta-based company
that also makes Bee-stractor cards, which allow parents to get involved
in pain distraction by asking their kids questions that are written on the
back of the cards about pictures on the front.
More information on these products is available online, at www.
buzzy4shots.com.

Versatilt: wheelchair patients recline in comfort
Dentists might find it awkward to treat patients who
are in wheelchairs. For those
who can’t be transferred into
a dental chair, it might be difficult to perform work if the
patients can’t be reclined. REDpoint International, a Vancouver, Wash.-based company that
designs, develops and markets
innovative medical devices, has
come up with a solution.
The Versatilt allows wheelchair patients to be tilted, Thanks to the Versatilt, a patient in
a wheelchair can be treated right
while in their wheelchairs, to a
where he or she sits. (Photo/ REDdegree that is optimal for pro- point International)
viding professional patient care
in the best ergonomic positions
possible.
Chuck Nokes, president and CEO of REDpoint International, told Dental Tribune during a telephone interview that the idea behind the device
is to allow dental practices to provide specialized care for those who are
handicapped.
“The Versatilt can help improve the working environment for care
providers in their diligent treatment of the wheelchair-bound,” he said.
What’s more, Nokes said, patients who are treated while being
reclined with the device, which accommodates most manual and motorized wheelchairs, find it comfortable. The patient can be reclined up to
65 degrees. It requires floor space of 36 by 60 inches, and it can be folded
into an 18-inch deep space for storage.
The Versatilt received the Attendee’s Choice Award for Best New
Product at the National Ergonomics Conference and Exposition (NECE),
held in 2009 in Las Vegas.
More information — including a video of the Versatilt in action — is
available at www.versatilt.com.

Unique works celebrate the art of dentistry
Do you ever use a phrase like
“the art of dentistry” or perhaps
“the art of endodontics” or even
“the art of smile design”? If you
consider yourself an artist in addition to a dentist, you might want
to check out some of the threedimensional works available from
Art 4 Your Practice.
The Walnut-Creek, Fla.-based
supplier offers a wide array of
unique shadowboxes, showcases,
sculptures and paintings that are
dedicated to the fine art of the
dental practice. For example, a
three-dimensional, glass-enclosed Attendees at a recent dental meettooth is surrounded by scaffolding, ing check out the shadowboxes
with a miniature construction crew available from Art 4 Your Practice. (Photo/Fred Michmershuigoing to work. There are also jaws
zen, DTA)
or entire smiles being worked on
in a similar manner.
The works, which are handcrafted by artists in Europe, can be a great
way to give your patients something to contemplate while waiting for
their turn in your chair.
More information about the company is available online, at www.
art4yourpractice.com. DT

[5] =>

Dental Tribune | April 2010

Practice Matters

Video marketing ‘do’ or ‘die’
f DT page 2A

By Mary Kay Miller

I know this subject is scary and
most of you don’t even want to think
about producing video as part of your
Internet marketing program. “It’s too
expensive. It takes too much time. I
don’t know where to start!”
If you don’t, though, you are missing out on a huge opportunity that will
affect the bottom line of your practice
today and its future in the years to
come.
Online video viewership set a new
record in December 2008 with a 13
percent increase over the previous
month, according to a report released
from the comScore.com Video Metrix
Service. For the first time, U.S. Internet
users watched more than 14.3 billion
videos in December.
As you might expect, Google Sites
(which includes YouTube) led the
growth charge, accounting for 49 percent of the incremental gain in overall videos viewed versus the previous
month. In December, almost 100 million viewers watched almost 6 billion
videos on YouTube alone.
Having your video rank on page one
of Google is equivalent to reaching the
“dental marketing Mecca.” Viewers

can’t resist clicking on a video when
searching for products or services
online. Once your video link reaches
page one, you are golden.
Viewers click and your video keeps
playing and playing, just like the Energizer® battery bunny, 24/7, whether
you are working, sleeping, eating,
playing golf or spending time with
your family. There is no better return
on investment today than video marketing.

Are you waiting around for
patients to find you?

Why is video so powerful?
Video is the No. 1 marketing tool available to deliver your personalized marketing message, exactly the way you
want it, at precisely the moment a
prospective new patient is looking for
your services on the Internet.
It engages the senses and creates
emotion. Viewers can hear and see
who you are and what you are all
about. This is difficult to accomplish
with the written word on a Web site.
Statistics show that video marketing on a Web site increases consumer
interest by more than 100 percent,
resulting in a call to action for products
or services (such as, actually contacting your office for an exam).
It is less expensive to produce video

(Photo/Qwasyx, Dreamstime.com)
than TV and radio commercials. In
addition, once your video is created
and uploaded to the Internet, it is
“evergreen:” visible for everyone to
see until you take it down, or not.
Video is the No. 1 preferred form of
communication in today’s tech-savvy
society. What would you prefer to do:
watch a video on a subject of interest

or read Web site copy? There is no
contest.

Speed to market
Speed to market wins the race. The
window of opportunity to be the first
in your area to add video to your Web
g DT page 6A
AD

[6] =>

Practice Matters

f DT page 5A
site is a small one. Don’t be a “me too”
practice. Lead the way in an economy
that cries out for something different
to allow a practice to stand out in the
crowd.
If your marketing budget doesn’t
allow for custom video right now, an
inexpensive but powerful alternative
is www.marketingwithlivevideo.com.
Here, you can hire an Internet actor
to deliver your marketing message for
you.
One way or another, video is the
key to a successful Internet marketing
campaign. Venture outside your comfort zone and deliver your own public
relations message to consumers in
your demographic.
Do it today to improve the health of
your practice, or die. DT

Dental Tribune | April 2010

Earn C.E. credits online with Miller’s focused Webinar series
Mary Kay Miller offers a six-part series of Internet marketing Webinars. Each archived module allows you to watch the
videos at a time that is convenient for you. Take advantage of this opportunity to improve your Internet presence with your
current Web site and Web 2.0 marketing strategies, while earning ADA-CERP credits. You can find Miller’s Webinar series
at www.DTStudyClub.com.

About the author
Mary Kay Miller is founder and CEO of Orthopreneur™ Marketing Solutions. After 30-plus years as a business and marketing coordinator for
professional practices, Mary Kay has narrowed her marketing expertise
to Internet Web 2.0 marketing, SEO (search engine optimization) and the
creation of marketing systems to save teams valuable time and effort.
Her book, “Marketing Your Practice Through Different Eyes,” was
released in May 2008 and is a free 100-page eBook available on her Web
site www.orthopreneur.com. It is the first multi-media eBook of its kind
in dentistry and the first book ever written on marketing for both dentists
and team members. It enables dentists and staff members to understand
and experience for themselves how the Internet and Web 2.0 marketing
engages and grabs the attention of today’s consumer.

Fight oral
cancer!
D

id you know that dentists are one of the most
trusted professionals to give
advice? Thus, no other medical professionals are in a better position to show patients
that they are committed to
detecting and treating oral
cancer.
Prove to your patients just
how committed you are to
fighting this disease by signing up to be listed at www.
oralcancerselfexam.com. This
new Web site was developed
for consumers in order to
show them how to do selfexaminations for oral cancer.
Self-examination can help
your patients to detect abnormalities or incipient oral
cancer lesions early. Early
detection in the fight against
cancer is crucial and a primary benefit in encouraging
your patients to engage in
self-examinations. Secondly,
as dental patients become
more familiar with their oral
cavity, it will stimulate them
to receive treatment much
faster.
Conducting your own
inspection of patients’ oral
cavities provides the perfect
opportunity to mention that
this is something they can easily do themselves as well. You
can explain the procedure in
brief and then let them know
about the Web site, www.
oralcancerselfexam.com, that
can provide them with all the
details they need.
If dental professionals
do not take the lead in the
fight against oral cancer, who
will? And in the eyes of our
patients, they likely would not
expect anyone else to do so —
would you?

[7] =>

[8] =>

Financial Matters

Dental Tribune | April 2010

By Keith Drayer

There are many areas that can
bring small and large changes to a
practice’s income as well as the individual health-care practitioner. Outlined below are a few of the changes
and opportunities.

The practice’s finances
An area to take advantage of is the
2010 IRS Section 179 Tax Code that
ADS

allows business owners to lower their
taxable income by acquiring eligible
property (such as dental equipment,
technology and off-the-shelf software). What makes the 2010 Section
179 benefit important is that in the
year 2011, this generous allowance
will come down to $25,000.
As more and more dentists
embrace equipment and technology,
such as all-tissue lasers, comprehensive scanning, designing and milling

(Photo/ Denisenko,
Dreamstime.com)

Changes and opportunities for
health-care practitioners’ finances

CAD/CAM systems and cone-beam
dentistry, this benefit can be applied
to lower the buyer’s taxable income.
These investments make a practice
more efficient, productive and profitable.
One of the key areas we suggest
dentists to focus on each year is their
current fee schedule. Too many dentists leave thousands of dollars in the
hands of insurance companies every
month because of an unbalanced fee
schedule.
We recommend that dentists set/
balance their fees into the proper
percentiles for their particular zip
code. This will not only help to maximize the coverage of insurance the
employer has purchased for the
employee, but it will also be the best
way to increase profitability.
While this is not tax advice, as individual circumstances apply, dentists
should find out more about Section
199, a benefit for domestic manufacturing. A dentist could qualify for a
deduction of 9 percent of the lesser
of “Qualified Production Activities
Income (QPI),” or taxable income
from milling activities.
Dentists may significantly reduce
their tax bill on domestic production
activities as a result of the previous American Jobs Creation Act. This
deduction is permanent and should
be explored.

Personal finances
Most people have multiple credit
cards. The odds of unused credit
cards being cancelled should not be
discounted.
Many of us keep extra, unused
credit cards for a “rainy day” (often in
a fireproof box, hidden in our home
or off-site at a bank-rented vault).
Additionally, many people have
taken a retailer’s credit card, as they
were making a purchase, for the
instant 10 percent one-time rebate,
which was the incentive for taking
that credit card. What has changed in
the new era is two-fold.
Financial institutions incur a marginal cost for providing credit. Thus,
many lenders are still reducing assets
and/or being selective about whom
they are renewing.
Canceling unused cards has been
happening over the last year and a
half and is not ending.
The credit-card consumers holding
onto credit cards for a rainy day could
mean “the flu” for lenders. Lenders

are worried that the person who has
not used a card in more than a year
is taking out their card because of
worst-case scenarios (recent unemployment, need to raise funds for a
called in home equity line, etc.).
To protect your credit card lines,
you may want to use your cards in
intervals (every six to nine months).

Finances and partnerships
A change in today’s lending environment affects partnerships. Before
the financial crisis hit, many lenders
needed one partner or 50 percent of
ownership to have decent credit.
Decent is defined differently
among different lenders, but a FICO
score of 675 could have helped a
health-care practitioner on an application-only loan (which means providing your name, address, social
security, license number) to obtain
approximately $250,000.
In today’s lending environment, all
owners are scrutinized. Thus, if one
partner or an owner with more than
a 20 percent stake has weak credit
(FICO below 675), then that could be
a detriment for the practice obtaining
financing.
It’s prudent to be pro-active in
finding out your partner’s credit
before you obtain financing. This is a
surprise you want to avoid. DT

About the author

Keith Drayer is vice president of Henry Schein Financial Services (HSFS).
Henry Schein Financial
Services provides equipment,
technology, and practice startup and acquisition financing
services nationwide. HSFS can
be reached at (800) 853-9493
or hsfs@henryschein.com.
Please consult your tax
advisor regarding your individual circumstances.

[9] =>

[10] =>

10A Clinical

Dental Tribune | April 2010

The endo-implant algorithm
A clinical case demonstrates the surprising importance of endodontists in dental implant treatment planning
ADS

By Jose M. Hoyo, DMD

There’s a new vision
in dentistry that is
gradually being recognized and is referred
to as the endo-implant
algorithm.
This new approach
considers the role of the
endodontist as critical
in considering whether
a tooth can be saved or
whether extraction and

Fig. 1: Pre-op radiograph prior to
extraction.

replacement with a dental implant
is the c orrect treatment protocol.
An endodontist is in the unique
position to evaluate critical factors
leading to endodontic failures in
order to determine whether another endodontic procedure will lead
to a predictable and successful
outcome. Should the outcome not
be favorable, then extraction and
replacement with a dental implant
would be the protocol to follow.
In considering the ideal treatment plan, it is imperative to provide the patient with all treatment
options, as well as the financial
cost and procedures associated
with each treatment option. The
patient is thus given the opportunity to make an educated decision
as to the best treatment protocol
for him or her.
The information presented to
the patient should include the
e ndodontist’s opinion regarding
which treatment option is more
practical and predictable.
For example, a patient with a
non-contributory medical history
was referred to my office for evaluation of the maxillary left first
molar. The patient was asymptomatic, and the tooth had been
endodontically treated by a general dentist approximately seven
months prior to the consultation
and had never been restored.
Clinically, it presented extensive decay, probing depths of 3
mm all around, exposure of the
obturation material to the oral
cavity and no temporary restoration. Radiographically, no periapical lesions were detected, and
the bone levels around the tooth
were adequate (Fig. 1).
In order to determine the integrity of the tooth structure, some
excavation was performed using
4.5x magnification and supplementary illumination, provided
by a fibre-optic headlight, with a
dental rubber dam for isolation.
After the removal of some decay, a
bitewing X-ray was taken (Fig. 2)
and the following was determined:
a) the floor of the pulp chamber

[11] =>

Clinical 11A

Dental Tribune | April 2010

Fig. 2: Bitewing X-ray after decay
has been removed.

Fig. 3: Grafted socket following
extraction.

Fig. 4: Peri-apical film showing healing of grafting material after four
months.

Fig. 5: Pre-op film on the day of surgery.

f DT page 2A

On the day of surgery, the patient’s
blood pressure was 119/73 with a
heart rate of 76.
Under local anaesthetic (Lidocaine 2 percent HCl with epinephrine 1/50,000 x 2 cpl) and using a
dental rubber dam, magnification
loupes and supplementary illumination, the tooth was sectioned
into three pieces.
The rubber dam was removed,
and using PDL-Evator e levators
(Salvin) all three roots were
extracted without any complications.
Spoons were used to curette
the socket in order to clean any
granulation tissue and engage the
cancellous bone.
This crucial step results in some
bleeding and thus promotes angiogenesis. The crest of the interradicular bone was engaged with
the socket cupped part of a XiVE
osteotome (DENTSPLY Friadent),
and a sinus lift was performed
using the S ummer’s technique.
There were no signs of a sinus
perforation based on the Valsalva
test. The sockets and sinus-lift
area were then grafted with a
m ixture of DBX and MCP using
a marshmallow technique. This
grafting mixture helps the site
produce its own bone in terms
of mineral and collagen from the
DBX, and it provides a better scaffold effect from the MCP. The area
was covered with a PTFE membrane, slightly tucked under the
periosteum (not more than 2 mm).
Sutures were done with polyglycolic acid using a criss-cross fourx corner technique (Fig. 3).

(Lidocaine 2 percent HCl with epi
nephrine 1/50,000 x 2 cpl), a tissue
punch access was done using a 3.8
tissue punch XiVE drill (DENTSPLY Friadent).
The pilot drill from the ANKYLOS implant system (DENTSPLY
Friadent) was then used to drill 6
mm, just short of the sinus floor
(Fig. 6). A series of XiVE osteotomes, from size 2.0 up to 3.4,
were used to perform a sinus lift
using the Summer’s technique.
The osteotomy was prepared to a
depth of 11 mm (Fig. 7).
A Valsalva test was performed to
ensure that the sinus had not been
perforated. An ANKYLOS implant
A11 (3.5 mm x 11 mm) was placed
and primary stability was obtained.
The density of the bone perceived

as D-3 during the drilling stage,
likely changed to D-2 with the use
of the osteotomes.
The implant-transfer mount
was removed, as was the cover
screw that came pre-mounted
inside the implant, and a 1.5 mm
sulcus former (healing abutment)
was placed into the implant (Figs.
8, 9).

was too shallow;
b) it was too close to perforation and
c) the peri-radicular dentine
was insufficiently strong to support a permanent restoration.
These critical factors, in my
opinion, rendered the tooth nonrestorable.
A cotton pellet and Cavit were
placed in the access cavity and a
follow-up call with the referring
dentist was conducted in order
to update him on the condition of
his patient and to determine what
recommendations should be given
regarding the tooth.
It was recommended to the
patient that the tooth be extracted
and the socket preserved through
a minor grafting procedure. This
would allow for an ideal amount
of bone to receive a dental implant
approximately four to six months
later.
It was also recommended that
he receive some orthodontic treatment prior to the placement of the
implant so that all the diastemas
would be closed and the dentition
properly aligned for this procedure.
The patient clearly understood
the concept and the logistics of
the orthodontic treatment recommended but expressed no interest
in this approach.

The bigger picture
It is very important in evaluating
treatment using implants to consider the entire dentition and not
just the space or tooth in question.
It should be borne in mind that
implants, unlike teeth, do not
move, so if there are any misalignments in the dentition, orthodontic treatment prior to implant
therapy is imperative should the
patient proceed with the dental
implant at a later stage.
If the treatment plan is not in
this sequence, the dental implant
could become a challenging obstacle during the orthodontic treatment.
The patient was prescribed
500 mg Amoxicillin (one every
six hours, beginning two days
before the next appointment) and
Chlorhexidine rinses (three times
a day, also beginning two days
before the next appointment).
The use of tartar-control toothpaste was also recommended in
order to avoid staining of teeth.

Removing the sutures
The sutures were removed two
weeks later. Two weeks after
suture removal, the patient was
seen again for the removal of the
membrane. This was done by gently picking at the membrane with
cotton pliers and exerting pull
on it — there is often no need for
anaesthesia.
The benefit of using this
allograft cocktail is that the
waiting period for re-entry was
approximately four to six months
versus six to nine had a xenograft
been used. The quantity and the
quality of the bone appeared to be
much better with the use of this
allograft cocktail.
At the time of re-entry, the
patient’s blood pressure was
113/69 with a heart rate of 64
(Figs. 4, 5). Under local anesthetic

Conclusion
This case clearly demonstrates
one of the reasons that endodontists are becoming increasingly
i nvolved in implant dentistry.
They are able to provide a com
prehensive evaluation of the tooth
in question, and they are able to
g DT page 12A
AD

[12] =>

12A Clinical

Fig. 6
AD

Dental Tribune | April 2010

Fig. 7

Fig. 8

Fig. 6: Guide pin in osteotomy following use of 2 mm pilot drill.
Fig. 7: Radiograph showing XiVE
osteotome in place during the osteotomy.
Fig. 8: Radiograph of implant with
sulcus former (healing abutment);
the apical portion of the implant is
under the Schneiderian membrane.

Fig. 9: Bitewing X-ray showing subcrestal placement of implant with
sulcus former in place.

present the patient with the best
options based on clinical assessment. DT

About the author

Dr. Jose M. Hoyo works in private practice in Stoughton and
Taunton, Mass. He can be contacted at drjhoyo@aol.com.

[13] =>

Events 13A

Dental Tribune | April 2010

International congress on
cone-beam 3-D technology
Imaging Sciences International
and Gendex Dental Systems proudly announce the fourth International Congress on 3-D Dental Imaging, which will be held in La Jolla,
Calif., on June 25 and 26.
Experienced dental clinicians
and professionals will share their
vast knowledge of the third-dimension’s past, where it is today and
where it’s going in the future.
These leaders in education
will also offer their expertise on
the practical applications of this
dynamic technology: how it actually
works in the clinical environment.
Three-dimensional technology is
already redefining dental outcomes
across a broad spectrum of treatment options, including implants,
bone grafting, oral surgery, orthodontics and endodontics.
As it continues to build a reputation for facilitating efficiency,
accuracy and detail in diagnosis
and treatment, new applications are
allowing dentists to expand their
treatment horizons and practices.
To meet the demand for education, the congress’ curriculum has
been expanded yet again this year
to include topics ranging from basic
information to detailed clinical use
and hands-on training with 3-D
planning software programs.
During the two-day symposium,
attendees will also gain insight into
the different field-of-view options
for various specialties, detailed
clinical application and hands-on
training with 3-D planning software
programs, powerful advice on legal
issues and marketing opportunities, plus a tantalizing peek into the
amazing future possibilities of cone
beam.
In addition to the seminars, a
variety of vendors will display supporting 3-D products, such as imaging, implant and restorative systems
as well as 3-D treatment planning
software.
Dr. John Flucke, leading dental technology expert and congress
speaker said, “Three-dimensional
radiography allows clinicians a
view into their patient’s anatomy
that is more complete than any
other traditional dental imaging
modality.
With all of the information captured by 3-D, it is extremely beneficial to learn all of the facts behind
the technology and how it can be
used to assist in treatment planning
from start to finish.”
The congress is honored to host
attendees who seek in-depth knowledge on this innovative technology
that can place them at the forefront
of their profession.
“I think we are quickly moving
toward ‘the’ standard of care being

CBCT scans in the dental office,”
said Dr. John Graham, speaker at
this year’s congress.
“The dentists that attend the congress are looking to learn more
about a technology that can help
them advance patient care and that
can set their practices apart. This
program is where they will gain the
information they need.”
This leading industry event

promises to expand the knowledge of this imaging advancement
and propel the dental profession’s
implementation for planning and
treatment.
“We’ve learned from owners of
3-D radiography that they greatly benefit from integrating this
groundbreaking technology,” says
Henrik Roos, president of Imaging
Sciences International and Gendex

Dental Systems.
“We are proud to be able to sponsor this comprehensive educational
event that offers dentists the opportunity to treat their patients more
safely and grow their practices.”
For more information or to register for the fourth International
Congress on 3-D Dental Imaging,
please visit www.i-CAT3D.com or
call (800) 205-3570. DT

AD

[14] =>

14A Online
AD

Dental Tribune | April 2010

OSAP launches
new Web site

(Photo/OSAP)
The Organization for Safety
& Asepsis Procedures (OSAP)
has launched a new Web site
at www.osap.org. The OSAP
Web site is the gateway for
accessing up-to-the-minute
research-based information on
infection control and safety in
dentistry.
The site features charts,
checklists, training tools, continuing education programs,
news summaries and more.
Much of the content is available to the public, but OSAP
members are able to access
special content and features.
A new social networking
capability allows OSAP members to connect with each
other, as well as follow the
organization on Facebook and
Twitter, view photos and videos on Flickr and YouTube,
and subscribe to the RSS feed.

A Safety Mall offers products and services relating to
infection control and includes
downloadable materials for
those with an immediate need.
The new site features a fresh
look and many new features.
Special content is available for speakers, consultants,
dental professionals and others concerned about infection
control and safety in dentistry.
Visitors can also get information and register for events,
such as the 2010 Infection
Prevention Symposium, which
will be held June 10–13 at the
Hyatt Regency in Tampa, Fla.
The OSAP Web site is updated on at least a daily basis,
but when pandemics, natural disasters or other breaking developments that impact
infection control occur, the
site is updated multiple times

a day.
Visit www.osap.org frequently to stay current on fastchanging safety and infection
control challenges.

About OSAP
OSAP is the Organization for
Safety and Asepsis Procedures.
Founded in 1984, the nonprofit association is dentistry’s
premier resource for infection
control and safety information.
Through its publications,
courses, Web site and worldwide collaborations, OSAP and
the tax-exempt OSAP Foundation support education,
research, service and policy
development to promote safety
and the control of infectious
diseases in dental health-care
settings worldwide.
(Source: OSAP)

www.dental-tribune.com
Missed the last edition of Dental Tribune?
You can now read some of its content
online!
ADA says panels need working dentists and
more should receive care
www.dental-tribune.com/articles/content/
scope/politics/region/usa/id/1699

Levin shares his views on challenges facing
dentists
www.dental-tribune.com/articles/content/
scope/specialities/section/practice_management/id/1686

Here’s some other online content that may
also be of interest to you …

D. Walter Cohen: An iconic icon
www.dental-tribune.com/articles/content/
scope/specialities/section/general_dentistry/
id/1656

Hinman Meeting draws 23,000 attendees to
Atlanta
www.dental-tribune.com/articles/content/
scope/news/region/usa/id/1792

Dentist offers free exams and cleanings, raises
money for environment
www.dental-tribune.com/articles/content/
scope/news/region/usa/id/1732

Immediate single-tooth replacement, provisionalization
www.dental-tribune.com/articles/content/
scope/specialities/section/implantology/id/1774

[15] =>

Dental Tribune | April 2010

Industry News 15A

Using risk identification and credit
granting to build your practice
By Paul Zuelke

In 1980, when we took our first
dentist as a client, almost all dental offices were routinely granting
credit to their patients. If a patient/
parent needed a few months to pay
for his/her clinical treatment, a
payment plan was usually allowed.
Thirty years later, things have
clearly changed. Dentists today
rarely grant credit because they
don’t want to assume the risk.
Patients are pushed to pay in full or
to use third-party financing.
In fact, many of the practice
management consultants who are
active today are recommending
their dental clients be “cash only”
and only provide third-party financing (finance company, bank, credit
card) for their patients.
The result is simply horrible
rates of case acceptance, postponed/phased treatment, more
single-tooth treatment than ever
in the past, significant increases in
failed appointments, a reduction in
the number of new patient referrals
and a net reduction in production
per dentist hour worked in many
practices.
This defensive behavior is
unnecessary because credit granting, internal credit granting, is
safer and more productive today
than it has ever been in the past!
While choosing not to grant credit, to be a cash-only practice, solves
some delinquency and cash flow
problems, that policy often makes
other problems worse. Failed
appointments do not improve, and
often become worse, because when
money is tied to appointments,
patients often find good reasons
to postpone or cancel the appointments and, in more serious cases
they simply become a “no show.”
Although collection rates are
good, actual cash flow does not
improve because of the single biggest problem with being a cashonly practice, weak case acceptance.
If your patients are not having
you perform the work you have
diagnosed, or if they only accept
work covered by insurance, your
production will be down and cash
flow will be down as well. Ultimately, being a cash-only practice
contributes to the biggest problem
of all: poor referrals and weak new
patient flow.
Let me note that there is no
legal, ethical or moral reason why
any dentist needs to grant credit.
The only reason to grant credit is
the obvious and practical one: You
will have more patients who will
accept more of your diagnoses.
It is not a coincidence that during the last three years, while our
economy has been less than stellar,

practices that routinely allow their
patients monthly payments for
their treatment have experienced
significantly less of an impact from
the economy than have the cashonly practices.
Appropriate credit granting is
often the answer to building a
consistently growing, productive
and profitable practice. Of course,
“appropriate” is the operative word.
While you cannot afford to have
your great patients postpone their

treatment because of your financial
policies, neither can you afford the
financial loss and other problems
associated with granting credit to
the wrong patients.
Obtaining credit reports on
patients was the answer to this
dilemma in 1980, and it is still the
answer today. The difference today
is that learning a patient’s potential
risk to the practice is much less
expensive, less intrusive, less time
consuming and much more accu-

rate than it has even been.
The Zuelke Automated Credit
Coach (ZACC) is a Web-based tool
available from DentalBanc that has
been specifically designed for the
dental profession. ZACC evaluates
stability, maturity and credit integrity in exactly the same fashion as a
bank loan officer, but ZACC does it
in a few seconds.
Once ZACC has evaluated your
patient/responsible party, ZACC
g DT page 16A
AD

[16] =>

16A Industry News
f DT page 15A
assigns a credit grade and even
makes a recommendation regarding the most liberal financial
arrangement that you can safely
ADS

offer the patient.
Although ZACC reads and interprets every line and every column
on a credit report, a ZACC inquiry
does not affect a patient’s credit
score nor does a ZACC inquiry

Dental Tribune | April 2010
show up as an inquiry to your
patient’s other creditors.
You can grow your practice with

safe and appropriate credit granting. Take a look at ZACC at www.
getzacc.com. DT

About the author
Paul Zuelke is president and
founder of Zuelke & Associates,
Inc., a management consulting firm
specializing exclusively in teaching
credit management and accounts
receivable control techniques to
health-care practices.
Zuelke’s extensive professional
background in lending and corporate finance, combined with
30 years of experience with more
than 1000 client practices located
throughout the United States, Canada and Australia, position him as

the leading authority in using effective credit management to build a
quality health-care practice.

‘The Fender
Way: fast
and safe’

(Photo/Directa)
Directa AB — a leading Scandinavian dental manufacturing company
located in Stockholm — dedicates
itself to introducing innovative,
high-quality and cost-effective products into the dental market, is probably best-known for its Luxator®
extraction instruments and polycarbonate crowns.
However, a new Directa product
is now creating quite a buzz in the
dental world.
Many dental practitioners are
already familiar with Directa’s FenderWedge®, which separates and protects adjacent teeth during preparation for a Class II restoration.
This product is a combined wedge
and protective stainless steel plate,
or “fender.” FenderWedge pre-separates teeth and protects the adjacent
tooth during preparation.
Research has shown that damage
to the adjacent tooth occurs in more
than 60 percent of cases during
preparation unless it is adequately
protected.
Now, FenderWedge has a complimentary product: FenderMate®.
A one-piece sectional matrix and
wedge specifically designed to allow
dentists to complete a composite
restoration quickly and efficiently
with a tight contact and cervical
margin. FenderMate may be utilized
either from the buccal or lingual
aspect.
g Continued, ‘The Fender …’

[17] =>

Industry News 17A

Dental Tribune | April 2010

Velopex’s air abrasion
unit fits many occasions
There are many uses of the
Velopex Aquacut Quattro Fluid
Air Abrasion Unit. Here are
some of them:
• minimally invasive and cosmetic dentistry,
• patient-friendly stain removal
and cavity preparation,
• fast, efficient cutting and
cleaning,
• ideal for repair of composites.
The Aquacut Quattro will
give you greater control and
flexibility than any other piece
of equipment you own. Some of

its other benefits include:
• no vibration, turbine noise,
heat generation or smell,
• greatly reduced need for local
anesthesia,
• a handpiece that creates a
fluid curtain around the powder medium,
• a triple-action foot control that
speeds treatment by allowing
cut, wash and dry operations
through the same handpiece,
• no chipping or stress fracturing,
• minimal loss of sound tooth
material. DT

The Aquacut Quattro and stand.
(Photo/Velopex)

Kank-A launches soothing beads
Mouth pain can occur at anytime throughout the day, and
treating the problem while away
from home isn’t always convenient. The best products provide
a tailored solution to localized
pain, but can be difficult to use
on the go.
Kank-A® Soothing Beads™
provide two benefits: effective,
comfortable relief for all-overmouth pain and a form that is
easy to carry and discreet to use.
Kank-A Soothing Beads are
comfortable, smooth balls that
melt in the mouth to deliver
maximum strength medication
(15 mg benzocaine per five-bead
dose). Kank-A Soothing Beads
can be rolled around the mouth
for all over relief or held in one
spot for concentrated treatment.
Each five-bead dose is individually packaged on a perforated card (like many over-thecounter caplets), making it easy
to leave some at home, work
or in any other location that’s
handy throughout the day.
They beads are designed to
deliver effective relief without
excessive numbing and are ideal
for use on gum irritations, mouth
burns, canker sores, orthodontic
appliances and dentures.
With a suggested retail price
of $5.49–$7.99 for each 15-dose
pack, Kank-A Soothing Beads

f Continued, ‘The Fender …’
The combined wedge and
matrix design of FenderMate
means that it may be applied
quickly without the fumbling of
tradition multiple-piece matrixing. A flexible “wing” on the
wedge ensures a sealed cervical margin, thus avoiding the
possibility of overhang occur-

(Photo/Zeno Group)

will be available in May 2010 at
food and drug stores nationwide.
Kank-A offers a full line of
products designed to provide
solutions tailored to specific oral
pain needs. Each product offers
maximum strength benzocaine
to ease pain, other beneficial
ingredients and unique application systems that deliver relief to
sore spots.
Kank-A SoftBrush® is a supereffective treatment for toothaches and gum pain. It offers
a dual-relief formula combining the maximum level of ben-

ring. The matrix is pre-curved
to adapt to the tooth and has a
pre-shaped contact point. No
retaining ring is required.
FenderMate has already
made a tremendous impact
worldwide and was rated as one
of the best new products in the
dental field in 2009.
The product is available in
four sizes: left/right and nar-

zocaine (20 percent) with an
active oral astringent, zinc chloride, for fast, deep pain relief. Its
unique, pen-shaped applicator
and soft brush tip make it easy
to apply gently and comfortably
anywhere in the mouth, especially between teeth and around
braces. Kank-A Softbrush retails
for $5.49–$7.99.
Professional Strength Kank-A
Mouth Pain Liquid has received
the ADA seal of acceptance for
its effectiveness in the relief
of canker sores and has long
been the ideal treatment for
pain caused by canker sores and
other mouth sores. Kank-A Liquid provides maximum strength
medication for a liquid or gel
(20 percent benzocaine), while
forming a long-lasting film that
protects sores from further irritation.
The protective coating holds
the anesthetic in contact with the
sore and acts as a barrier against
further irritation. Designed for
precise, convenient dispensing,
Kank-A Mouth Pain Liquid has
a built-in applicator, allowing
consumers to easily place the
medication where it’s needed.
Kank-A Liquid retails for $5.49–
$7.99.
For additional information
about Kank-A products, visit
www.Blistex.com. DT

row/regular, and is color-coded
for ease of identification. It is
available as an assorted kit of
four boxes, each box containing
18 pieces, or as separate boxes.
Information about all Directa
products and distributors may
be found at www.directadental.
com or by calling (203) 7884224. DT

[18] =>

[19] =>

Cosmetic TRIBUNE
The World’s Cosmetic Dentistry Newspaper · U.S. Edition

April 2010

www.dental-tribune.com

Vol. 3, No. 4

You can’t always get what you
want (unless you clearly ask!)
By Laura Kelly, AAACD

Let’s be honest: There are times
when your laboratory technician simply doesn’t deliver what you envisioned so clearly in your mind. A bit
more translucency or a specific gingival color; a minor mesial rotation on
that bicuspid or an occlusal table that’s
just a little too wide.
Twenty years ago, when I began
my career as a laboratory technician,
we had only a few tools at our disposal.
Hastily made sketches on the back
of prescription pads, a few colored
pencils to indicate body shade, incisal
level or some other specific instruction; and sometimes pre-op models
were sent.
Looking back, I’m amazed at what
we pieced together given such limited
communication tools. Yet that was the
best the dentists could provide to the
technician, and we had to work from
what we had. It was challenging to create the specific results for, say, a single
unit anterior crown.
Often there were trips between the

laboratory and the practice or extra
meetings — not to mention costly
remakes for everyone. As we got better, we pulled it off, but it wasn’t easy.
Fast forward two decades to the
era of digital camera, e-mail and
Skype and the way we work together
is instantly and forever transformed.
No longer must we guess, imagine
or try to convey with facsimiles or
mere words. These tools have totally
changed the way the dentist and laboratory technician collaborate on their
work, and everyone — the patient
included — has been the beneficiary
of this technology.
Imagine if you had to work without
a digital camera today: Film. Developing. Printing. Waiting. Time. Out of
focus. Do it again. Wait some more.
With today’s digital technology,
the clinician can instantly determine
whether the information in the photograph will adequately convey everything necessary to the technician.
Many cases require more than a
shade tab number written in the shade
box on the prescription, and taking full

CASE

Communicating shade
face, retracted and lateral views make
all the difference to the technician
working on your cases.
Once the image is captured, e-mail
can transfer the information virtually
instantaneously, permitting the dentist
to choose a technician anywhere in
the country. This allows the dentist

FILE

Shade tab
placed in the
same plane
as teeth,
ensuring the
tab and corresponding
shade number is in the
photo.
(Photo/
Provided by
Laura Kelly
and Dr. Jeff
Morley)

to work with a technician with whom
he or she can work best, regardless of
geography. The technician, in return,
can send preliminary images of his
or her wax up and bisque bake along
with the final stage images for the deng CT page 2B

‘Would you like a massage while you wait?’
Florida cosmetic dentist wants to rub the stress away for his patients
By Fred Michmershuizen, Online Editor

Let’s face it: For many patients,
going to the dentist can be — shall
we say — a bit stressful. Even if they
are coming in for a cosmetic procedure, such as veneers or teeth whitening, many are apprehensive about
looming pain, real or imagined.
With that in mind, Dr. Hamid
Nassery, a cosmetic dentist with a
thriving practice in Miami called the
Miami Beach Dental Institute, offers
massages to his patients. He says the
massages are a great way to relax his
patients, improve dental procedures
and even treat temporomandibular
disorders.
“Going to the dentist should be
a relaxing experience that makes
people feel good about their teeth,
their body and their overall health,”
says Nassery, who is able to offer the
massages to his patients through an
arrangement with Love Life Massage, a local spa. “Not only can massage improve the dental experience

as a whole, but it also treats conditions such as TMD, which causes
pain in the jaw and face.”
Nassery says the idea behind the
added benefit to patients is to make
people comfortable. The benefits of
dental massage include stress relief,
reduced pain, quicker recovery and
an improved sense of well-being and
body awareness, he says.
“With these new massage services, we’re moving toward stress-free
dentistry that works to put patients
at ease in the dentist’s chair as well
as improve their dental health,” he
says.
Patients can receive a massage
at the Miami Beach Dental Institute
before and after their dental procedure. A therapist tailors each massage based on the patient’s specific
needs and concerns.
The massage therapists at Nassery’s office also specialize in temporomandibular joint (TMJ) massage, which focuses on eliminating
pain to the jaw by treating the chew-

ing muscles and releasing tension
in the jaw, neck and face. Patients
who suffer from temporomandibular
joint disorder (TMD) benefit from

therapeutic massage, especially
when scheduled with regular deng CT page 3B
AD

[20] =>

Clinical

Cosmetic Tribune | April 2010

COSMETIC TRIBUNE

When looking for a new lab …

The World’s Dental Newspaper · US Edition

• Call and introduce yourself, communicate what it is you
are looking for and what is missing from your current lab
relationship. (We need to know what you don’t like so it’s not
repeated!)
• Ask to see photos of their work, and find out who receives
the e-mail photos that you will be attaching to your cases.
• Ask how the lab assigns your cases to a technician(s) and
request to speak directly with the technician you will be working with.
• Visit the lab if possible, or use Skype for instant communications online.
• Ask for a bisque bake photo to be e-mailed to you for
approval before sending the case out. This saves time and the
dentist can give useful feedback at a time when modifications
are easily made.
• Schedule quarterly phone or in-person meetings to discuss
how everything is progressing; so engage in regular meetings.
• Ask other dentists what their experience has been with the
laboratory you are considering.
• Outsourcing cases overseas has increased in the laboratory
profession. If this is important to you, you may want to inquire
as to where your restorations are being made.

What to include
• Clear, full arch impressions
• Bite
• Photos
• Face bow or stick bite
• Pre-op models
• Model of temps or diagnostic wax-up to follow
• Concise instructions

f CT page 1B

tist’s approval. Both parties can then
have confidence that the case has been
fabricated exactly as envisioned by the
dentist and the patient.
This process of instruction, feedback and adjustment has allowed
more dentists to deliver an increasingly sophisticated product created
by more clinically astute and in-tune
technicians — usually in less time and
with greater precision from the beginning.
A laboratory technician would
always prefer to work with a photograph and would prefer this level of
information than not, thus, these tools
have become the new standard of care.
It must be said that in addition
to increasing the predictable results,
using these communication tools
increases profitability for both the laboratory technician and the dentist.
When you consider the cost of
remakes and adjustments as well as
sending cases back and forth multiple times — not to mention patient
dissatisfaction with these frustrations
— the savings are real and the profits
are equally real. When professionals
spend more time at the beginning and
avoid costly mistakes, the benefits are
tangible.
Even with these improved technologies, the most important tool we have
is the time the dentist and laboratory
technician invest in one another.
By taking the time meet and discuss
cases, being clear about mutual expectations and giving immediate feed-

back to one another, the dentist and
technician can build a strong working
relationship that can last for years and
even decades.

Labs evaluate you too
We all know that dentists are constantly evaluating their laboratory technicians and relationships, but the same
is true for the technicians.
When we receive a case from a client who communicates well, makes
expectations clear, works in a collaborative partnership and gives candid
and timely feedback, we know we
have to be on our toes and it challenges us to do our very best.
When we work with a dentist who
sends clear impressions, focused photographs and who alerts us to the
arrival of the case, we know that dentist is serious and that his or her expectations are high.
However, when impressions are
distorted, margins are unreadable or
prescriptions are incomplete, it sends
a very different message indeed. Perhaps it doesn’t matter much to some
dentists? Perhaps, just about anything
will do? Perhaps your case can wait?
In many larger laboratory environments, the most highly trained technicians are assigned the cases of the
first dentist — the one who sent clear
impressions that is — because their
time is too valuable to work with poor
material and information.
Here’s a little secret: technicians
are naturally pleasers and we want to
impress you, make you happy and rise
to meet your needs.
If you want the best technicians
working on your cases, make it your
business to send them the best, communicate with them until you work
like a well-oiled machine and demand
excellence in return. The way you
communicate will affect all of this.
In modern dentistry, it is easy to do
the right thing. We have the tools. We
have the standards. We have the
desire. We can work better together.
Just tell us what you want and we can
deliver. CT
g CT page 4B

Publisher & Chairman
Torsten Oemus
t.oemus@dental-tribune.com
Vice President Global Sales
Peter Witteczek
p.witteczek@dental-tribune.com
Chief Operating Officer
Eric Seid
e.seid@dental-tribune.com
Group Editor & Designer
Robin Goodman
r.goodman@dental-tribune.com
Editor in Chief Cosmetic Tribune
Dr. Lorin Berland
d.berland@dental-tribune.com
Managing Editor/Designer
Implant & Endo Tribune
Sierra Rendon
s.rendon@dental-tribune.com
Managing Editor/Designer
Ortho Tribune & Show Dailies
Kristine Colker
k.colker@dental-tribune.com
Online Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.com
Product & Account Manager
Mark Eisen
m.eisen@dental-tribune.com
Marketing Manager
Anna Wlodarczyk
a.wlodarczyk@dental-tribune.com
Sales & Marketing Assistant
Lorrie Young
l.young@dental-tribune.com
C.E. Manager
Julia E. Wehkamp
j.wehkamp@dental-tribune.com

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213 West 35th Street, Suite 801
New York, NY 10001
Tel.: (212) 244-7181
Fax: (212) 244-7185

Published by Dental Tribune America
© 2010 Dental Tribune America, LLC
All rights reserved.
Cosmetic Tribune strives to maintain
utmost accuracy in its news and clinical reports. If you find a factual error or
content that requires clarification, please
contact Group Editor Robin Goodman at
r.goodman@dental-tribune.com.

Cosmetic Tribune cannot assume responsibility for the validity of product claims
or for typographical errors. The publisher also does not assume responsibility
for product names or statements made
by advertisers. Opinions expressed by
authors are their own and may not reflect
those of Dental Tribune America.

Tell us what
you think!
Do you have general comments or criticism you would like to share? Is there
a particular topic you would like to see
articles about in Cosmetic Tribune?
Let us know by e-mailing feedback@
dental-tribune.com. We look forward to
hearing from you!

[21] =>

Interview

Cosmetic Tribune | April 2010

Three decades of healthier teeth and beautiful smiles
After 30 years in practice, Dr. Brett Magnuson of Kalamazoo, Mich., is smiling, too
By Fred Michmershuizen, Online Editor

Dr. Brett Magnuson, a cosmetic
dentist, is celebrating 30 years in
practice this year. His office, Magnuson Dental Design, offers cosmetic dentistry services to residents
in Kalamazoo, Mich., and surrounding communities.
Magnuson says he’s honoring the
occasion by continuing to do what
he does best: making people smile.
He says part of the mission of his
practice is helping patients improve
the look and health of their teeth
by offering the latest procedures
in a friendly, relaxed atmosphere,
and to truly help them understand
the importance and advantages of
maintaining their oral health.
Magnuson, began his dental
career in 1978, which is when he
opened his Kalamazoo practice.
“I just fell in love with the town,
the community, and the people,”
he says. Magnuson specializes in
correcting common esthetic and
functional issues for his patients
and also performs teeth whitening, composite fillings and dental
implants.
“We foster teamwork through
innovation, personal responsibility,
trust and communication between
our doctors, dental team and
patients,” he said.
Magnuson prides himself in staying on top of the latest technology
and giving people effective, beautiful results in the most comfortable
way possible. He says his experience has been a rewarding one,
largely because of his patient-centered approach toward dentistry.
“Our staff strives to create open,
friendly relationships with each of
our patients to ensure that they
receive the most dedicated and
highest quality customer service
and care,” he says. “Our personalized service and warm, relaxing
atmosphere set us apart.”

f CT page 1B

tal visits and used in addition to
treatments such as night guards or
splints.
Patients can also receive reflexology massage, which stimulates
reflex areas and improves blood
flow, as they are seated in the dental
chair. Massage chairs in the office
allow for full body massage and
relaxation.
“The body is a complex system,
and when one part of the body is in
pain, the entire body reacts,” Nassery says. “With the use of massage in
the dentist’s office, patients can
experience a sense of overall balance, making the dental procedure
that much more effective and painless.” CT

Magnuson is accredited by the
American Academy of Cosmetic Dentistry (AACD), and he has
served as an accreditation examiner for that organization. He is also
a member of the American Board of
Cosmetic Dentistry. The Consumer’s Research Council has named
him one of America’s Top Dentists.
In addition to offering porcelain
dental veneers in Kalamazoo and
other methods of improving smiles
and general oral health, Magnuson
says he makes it a point to reach
out to his own community as well

as those around the world.
He is a contributor to the Give
Back a Smile Foundation — an
organization dedicated to helping
victims of domestic violence —
and the AACD Foundation Disaster
Relief Fund. The latter organization has helped many people in the
United States and around the globe
who have been affected by the 2007
California wildfires, the 2004 tsunami that hit countries along the
Indian Ocean and the 2005 hurricanes that impacted the U.S. Gulf
Coast.

Magnuson says his 30-year milestone as a cosmetic, implant and
sedation dentist have only made
him more excited about the future
ahead. He says that as dental technology and techniques continue to
evolve, the coming years should
hold even better ways to give his
patients bright, breathtaking smiles
in a comfortable, pain-free experience.
“We strive to give every patient
who walks in our doors star-quality,
individualized attention and treatment,” he says. CT

[22] =>

4B Clinical

Cosmetic Tribune | April 2010

CASE FILE: comparing techniques

(Photos/Provided by Laura Kelly and Dr. Jeff Morley)

pressed &
stained

pressed/
cut-back

feldspathic/
layered

The most simplified technique,
yet all surface staining creates an
unnatural appearance, and surface stain can be removed leaving
‘bald spots’ if adjustments are
necessary.

Maintains excellent marginal adaptation due to the lost wax technique,
and also provides a more natural
appearance due to the internal
placement of color.

Very natural appearance due to
complete layering of porcelains.
Can be technique and labor intensive, requiring technical expertise to provide excellent, life-like
results.

Labs evaluate you by …
• Quality of impression, free of pulls, distortions or voids on the margins.
• Photographs sent with shade tab desired, as well as prep or “stump” shade for all ceramic
restorations.
• Detailed prescriptions and “call to discuss” written on cases that require more communication.
• Your willingness to be open to feedback. Ask your technician what you can do to make his/her
job easier and he/she will be happily surprised.
• Your direct and honest feedback. Technicians need to know what you like and what you don’t
in order to improve and meet your expectations.
AD

About the author
Laura
Kelly is
a dental
ceramist
and began
her dental
laboratory
career in
1985. An
accredited
member
of
the
American Academy of Cosmetic
Dentistry (AACD), she is also
the first dental technician to
have been elected to serve as
president of the AACD (2007–
2008).
Recently, Kelly was elected to
serve as secretary for the International Federation of Esthetic Dentistry (IFED), currently serves on
the editorial board of Spectrum,
and is also the editor in chief
for Lab Tribune. She lectures
nationally and internationally on
dentist/technician communications, new laboratory materials
and how to incorporate effective
marketing concepts into dental
practices and laboratories.
Kelly can be contacted at
laura@lkdentalstudio.com.

[23] =>

[24] =>

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[cover] => DT U.S. No. 9, 2010

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