DT UK 2109

Dentists still ‘poor relation’ to GPs / News / The Steele behind the Steele Review / News & Opinions / Dedicated dental solutions / Concentrate on quality / IMPLANT TRIBUNE (part1) / IMPLANT TRIBUNE (part2) / The importance of structure / How to give feedback / Ed Bonner considers The case for… and against Returnment / Industry News / BSDHT Oral Health Conference and Exhibition 2009

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DENTAL TRIBUNE
The World’s Dental Newspaper · United Kingdom Edition
PUBLISHED IN LONDON
News in brief

SEPTEMBER 7–13, 2009
News

Money Matters

VOL. 3 NO. 21
Implant Tribune

DCPs

£7.6m centre
Scotland’s public health minister carried out the official
sod cutting ceremony for a
£7.6m dental treatment and
training centre in Perth. The
site will feature 20 surgeries,
a clinical skills training room,
laboratory and decontamination unit. It will open towards
the end of next year and it is
expected that 7,000 patients
will be registered.
Shona Robison said: ‘This facility, which the Scottish government has provided £4.5m
for, is just one example of the
work going on across Scotland to provide healthcare facilities that are fit for the 21st
Century and I'm sure it will be
warmly welcomed by the people of Perth.

Oral Health Month

Quality control

Growth factors

Handling feedback

Oral health initiative signs up
more than 85 per cent of practices - are you taking part?

You need to keep your eye on the
ball if you're to get things right in
business, and dentistry is no different, argues Frank Pons.

Prof. Liviu Steier and Gabriela
Steier discuss how growth factors are a valuable addition to regenerative dentistry.

Nikki Berryman discusses the issue of giving feedback to team
members and why it is important.

page2

page10

page11–13

page23

Dentists still ‘poor relation’ to GPs
contractual system
and reveals the average earnings of
NHS dentists varies
greatly depending on
whether they personally held a contract with their Primary Care organisation.”

Chewing paan
Bangladeshi people in the UK
could be at a higher risk of getting oral cancer due to their
liking for chewing paan, a
mixture of tobacco and areca
nut, according to research.
The habit of chewing paan
may have led to an ‘alarming’
rise in the number of cases of
oral cancer in East London,
according to researchers at
Barts and The London School
of Medicine and Dentistry.
A team from the Centre for
Clinical and Diagnostic Oral
Sciences used a mobile dental
unit to tour areas of East London, targeting the Bangladeshi
community, especially those
who rarely visited a dentist.

Oral cancer
Oral cancer rates for both
men and women of all ages,
have increased by more than
45 per cent since records began in 1975, according to Cancer Research UK. The charity
revealed that oral cancer
rates in the UK for men in
their 40s have gone up by 28
per cent since the mid 1990s,
and rates for women in their
40s have increased by 24 per
cent in the same period.

Hypnotist hired
A dentist in Scotland has
hired a hypnotist to help patients overcome their fear of
dentists.
Patients at the Edinburghbased Lubiju can now opt to
have treatment under hypnotherapy instead of having
the traditional needle.
Dentist Dr Biju Krishnan said:
‘What the hypnotherapy offers is that it puts the person
back in control of those fears,
it lets them feel that they are
in a safe place and in control.’

www.dental-tribune.co.uk

he average income for a
dentist in England and
Wales is just over £89,000,
according to recent figures from
the NHS Information Centre.
This is still considerably below the £107,000 that the average GP earns. However the figures revealed that for some
dentists, earnings can be much
higher with one in 20 dentists
earning more than £200,000
between 2007 and 2008 and
nearly 400 earning more than
£300,000.

The NHS Information Centre
statistics revealed that 382 dentists - nearly two per cent of the
total - earned more than £300,000
in the year.
The figures cover earnings in
the second year of dentists working under the new NHS contract
introduced in 2006. The earnings
cover both their NHS and private
work.
Dentists running their own
practices, who had a contract
with the local primary care organisation, to provide NHS services earned on average £126,807.
But dentists working in a
practice without such a contract
earned on average £65,697.
The NHS Information Centre’s chief executive Tim
Straughan said: “The England
and Wales report looks at earnings in the second year of the new

John Milne, chair
of the British Dental
Association’s (BDA’s) General
Dental Practice Committee, said:
‘These statistics reflect the second year of operation of the 2006
dental contract in England and
Wales, a time when dentists were
working hard to overcome problems with the new arrangements
and make them work for their patients.
“Many practitioners were
contending with the uncertainty
of potential clawback of their
contract values. Dentists, almost
uniquely in the NHS, carry the
business risk of their surgeries
and are responsible for providing
premises, equipment and staff.”
“The picture the statistics
paint is one of earnings settling
and the expenses of NHS practitioners rising slightly.”
He added: “What’s important
now is that we look forward to
what we hope will be a better future for NHS dentistry in which
the reforms recommended by
Professor Steele’s report are
properly consulted on, meaningfully piloted and implemented
for the good of patients and dentists alike.”
Health Minister Ann Keen
claimed the report confirmed
‘that NHS dentists have good levels of earnings’.
She said: “Access to NHS dentistry is continuing to improve,
following record investment, an
expanding workforce and a con-

tinuing increase in the amount of
services being bought by the
NHS.”
One of the reasons it is
thought that dentists are seeing
their earnings grow is that they
are taking on more private work
and diversifying into cosmetic
dentistry. This is a growth industry with the number of people seeking cosmetic treatments for their teeth increasing
up by to 40 per cent year, according to the British Academy of
Cosmetic Dentistry (BACD).
The richest dentist in Britain
is thought to be James Hull, who
opened his first surgery in 1987
in Newport, Wales and now has
48 dental practices in the UK,

most of which specialise in cosmetic dentistry. The chain has
become a leader in cosmetic
dentistry, which includes teeth
whitening, veneers and implants. It has also expanded into
osteopathy, chiropody and
Botox treatments
Earlier this year, the dental
chain was valued at £230m, when
it looked at selling a 30 per cent
stake in the business to a private
equity firm, in order to expand
into continental Europe and the
Middle East.
The Sunday Times Rich List
claims Dr Hull is personally
worth about £54m and said he
has a £6m collection of vintage
Jaguars. DT

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[2] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

News

2

Dental Protection takes Horizons programme to Scotland

T

he indemnity organisation, Dental Protection, is
set to take its Horizons programme, on how to manage difficult people, to Scotland.
Dental Protection has run its
Horizons series of events in England and Northern Ireland and
will now be running it in Scotland.
The programme will be held
in four cities in Scotland this year,
and two more next year, to allow
more dental professionals the
opportunity to attend.
The team-focused, evening
events will see renowned speak-

ers talk on relevant and practical
subjects that will be useful for all
members of the practice team.
During October, Horizons
will visit Inverness, Aberdeen,
Stirling and Dumfries, with
events in Glasgow and Edinburgh following in April 2010.
Speakers, including Hugh
Harvie, Kevin Lewis (Inverness
and Aberdeen) and John Tiernan
(Stirling and Dumfries), will be
talking at the sessions, entitled
The Good, The Bad and The Ugly,
which will explore the management of difficult people and difficult situations that arise through-

out the practice - from chairside
to reception.
Kevin Lewis, director of Dental Protection, said: “We were
overwhelmed by the response to
last year’s Horizons event, and
are pleased to be running another series.”
“Our aim is to bring quality
programmes closer to home for
more of our members, and in
that spirit this same programme

has recently been taken to our
members in 17 cities all over Australia.”
The evening includes 2.5
hours of verifiable Continuing
Professional Development (CPD)
(pending) for all members of the
dental team who are GDC-registered.
Tickets cost £60 for members
and £75 for non-members. Tickets for DPL Xtra Practices and

their staff are priced at £50 per
person.
Further information and tickets
can be obtained by contacting
Sarah Garry on 020 7399 1339 or
email sarah.garry@mps.org.uk.
Further information is available on the Dental Protection
website, http://www.dentalprotection.org/uk/newsnevents/events/horizonsscotland DT

Over 85 per cent of dental practices
take part in Colgate Oral Health Month
tice waiting room poster, to be included in the Colgate Oral Health
Month 2010 practice pack.

KaVo – Dental Excellence

This CPD programme offers
everyone in the dental team the
opportunity to participate and provides four hours of verifiable CPD.
The CPD programme can be
downloaded from www.colgateohm.co.uk

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M

ore than 85 per cent of
dental practices in the
UK are taking part in this
year’s Colgate Oral Health Month,
an oral health initiative run by
Colgate in partnership with the
British Dental Association.
The aim of the campaign is to
educate the general public about
the importance of oral health and
promote communication between dental professionals and
their patients.
This year it is focusing on the
theme of delivering prevention
in practice.
Colgate is offering dental professionals the chance to take part
in its 2009 Colgate Oral Health
Month CPD (continuing professional
development)
programme, which utilises ‘Delivering Better Oral Health’– a toolkit
for prevention published by the
Department of Health.
“A spokeswoman for the campaign said: ‘This toolkit provides

the dental team with simple, evidence-based advice to promote
oral health to their patients.”
“In order to bring its advice
to life, and to engage patients,
the CPD programme will show
some practical examples of
how to deliver prevention in
clinical practice.”
“We want dentists to speak to
patients in a manner that patients
will understand readily, so that
they are better able to follow a route
to improved oral health care.”
“Focusing on one key preventive theme and working together
as a team, practices are asked to
develop accessible, easy to understand oral health messages
they can communicate to their
patients to help them implement
a good oral hygiene routine.”

A road show is also travelling
around the UK this month visiting major retailers at selected
venues and dental professionals
will be in attendance at mobile
toothbrushing units giving advice on oral health and demonstrating appropriate toothbrushing techniques.
More than 85 per cent of UK
dental practices have registered
to take part in this year’s event.
They have each received a
practice pack containing educational materials, patient samples, motivational stickers and
materials to enable dental teams
to create their own display to
drive awareness of oral health
within their practices. DT

Practices are invited to submit
the messages they’ve conveyed
and these will be reviewed by a
panel of judges. The winning entry will be developed into a prac-

International Imprint
Executive Vice President
Marketing & Sales

Peter Witteczek
p.witteczek@dental-tribune.com

DENTAL TRIBUNE

For further information contact
KaVo on 0800 281 020
or your preferred Gendex supplier

The World’s Dental Newspaper · United Kingdom Edition

Published by Dental Tribune UK Ltd
© 2009, Dental Tribune UK Ltd. All rights reserved.

KaVo Dental Limited
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mail: sales@kavo.com · www.kavo.com

Dental Tribune UK Ltd makes every effort to report clinical
information and manufacturer’s product news accurately, but
cannot assume responsibility for the validity of product claims,
or for typographical errors. The publishers also do not assume
responsibility for product names or claims, or statements made
by advertisers. Opinions expressed by authors are their own and
may not reflect those of Dental Tribune International.

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Director
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Mash Seriki
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Joe@dentaltribuneuk.com

Editor
Lisa Townshend
Tel.: 020 7400 8979
Lisa@dentaltribuneuk.com
Clinical Editor
Prof Dr Liviu Steier
lsteier@gmail.com

Marketing Manager
Laura McKenzie
Laura@dentaltribuneuk.com

Dental Tribune UK Ltd
4th Floor, Treasure House
19–21 Hatton Garden
London, EC1N 8BA

[3] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

News

Editorial comment
Please allow me to introduce myself

‘

“Hi, I’m Troy McClure.
You may remember me
from such films as...”

For those who aren’t
fans of The Simpsons, that was just
a cheeky little way to get you into
the introductory mood. I’m actually Lisa Townshend, previously
Editor of a well known monthly
publication in the dental press and
now Editor of Dental Tribune UK.
First of all, thanks to the many
people who have wished me well
in my new role. I’m looking forward to continuing the good work
of previous Editor Penny Palmer,
and ensuring that Dental Tribune

BDA calls
for action
on Steele
Report

remains the must read newspaper in the dental profession.

life beyond the Review as the new
head of Newcastle Dental School.

With this in mind, in this issue
I have spoken with Prof Jimmy
Steele, who discussed with me
the Review, its implications and

Of course, although I am not new
to the dental profession, I am still
new to the Dental Tribune family.
This is where you come in. Please get

in touch and let me know what you
think about the newspaper; what
you like, what you don’t and
anything in between!
E-mail me at lisa@
dentaltribuneuk.com DT

’

A thumbs up to your oral health.
That’s our partnership goal!

he British Dental Association (BDA) is urging the Department of Health to take
action and start consulting on the
proposals put forward by Prof
Jimmy Steele in his report on NHS
dentistry.

The BDA’s call comes after the
NHS Information Centre revealed there has been a small increase in the number of patients
accessing NHS dentistry in the six
months up to 30 June 2009 and a
fall in the number of complex
dental treatments carried out between 2003/04 and 2008/09.
John Milne, chair of the BDA's
General Dental Practice Committee, called the continued increase
in the number of patients able to
access NHS dental care ‘good
news for those who are benefiting
from it’.
He added: “These reports also
highlight a change in the treatment
patterns of care provided by NHS
dentists, with decreases in the
amount of many more complicated
treatments compared to 20032004. This change is in line with the
aim of the reforms to reduce the
amount of complex treatments being provided.”
“What’s important now is that
the conclusions of the review of
dentistry led by Professor Steele
are properly consulted on. For the
good of dentists and patients alike,
the reforms arising from them
must be piloted to deliver an NHS
dental service that assesses dentistry in terms of the health outcomes it delivers and provides a
quality service to all who use it.”
Shadow health minister, Mike
Penning, called the fall in the number of complex treatments ‘a failure for the profession, for patients,
and for the wider NHS’. DT

The entire dental team can get involved in the 2009 campaign focusing on
Delivering Prevention in Practice.
Practice packs contain educational materials, motivational stickers, patient samples and
materials to enable dental teams to create their own display to drive awareness of oral
health within their practices.
The 2009 interactive CPD programme Delivering Prevention in Practice, providing
4 hours verifiable CPD is available to download by visiting www.colgateohm.co.uk
If your practice has not previously been involved in Colgate Oral Health Month,
please call 0845 257 3468 to register.

www.colgateohm.co.uk

[4] => DTUK2109_01_Title

News & Opinions

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

The Steele behind the Steele Review
Interview: Lisa Townshend speaks to Prof Steele

or the last nine months, the
name on the lips of anyone interested in NHS dentistry has
been Professor James Steele. Since
the announcement of the independent Review into NHS dentistry
in December 2008, Prof Steele has
been at the forefront of the dental
agenda as the lead in the Review
process.
Prof Steele graduated in dentistry from the University of
Dundee in 1985 and was awarded
his PhD in 1994. His research is
around oral health in populations
and oral health services research.
He has been awarded the International Association for Dental Research Distinguished Scientists
Award for geriatric oral research.
He is also a clinician, working as a
consultant in Restorative Dentistry
for the Newcastle Hospitals NHS
Trusts. Formerly chair in Oral
Health Services Research at Newcastle University, he has recently
taken up his new post of head of
Newcastle Dental School.
Speaking with Prof Steele, he
looked back to the beginning of the
Review and explained how he had
become involved: “I was contacted
in November of last year to ask if I
might be interested in the Review,
and I think there was a shortlist of
people at that time. I’m really not
sure how I ended up on that shortlist to be honest. I like to think it was
a combination of things – I hadn’t
been involved in everything that
had gone before, so I think that
made it a bit easier as I was coming
from a neutral position and I had no
‘baggage’ attached. I had made various comments and observations
over the initial reform period,
which had been reasonably balanced. In addition, I think an academic background helps when
producing documents, writing and
analysing etc - so I probably had the
right sort of skills. But as to how I
was selected is actually a mystery.”
He was keen to praise the support the University of Newcastle
had given him during the Review
process: “It’s not really something
you can turn down – it was a really
big task and a really difficult task. It
was a quite important thing to do in

a sense I was less concerned about
the dental school more concerned
to make sure that the university understood what it was I had been
asked to do and they were broadly
supportive.
“Sometimes your natural modesty takes over and you think ‘can I
really do this?’ and I looked at it and
thought ‘well yes I think I probably
can do this’. There are a lot of things
I can’t do but this was one I could.”
One of the first tasks for Prof
Steele was appointing the Review
team. “I had a lot of input into the
rest of the Review team. There were
some really difficult decisions to
make because this had to be done
quite quickly – this was my decision. There was a certain amount of
momentum coming off the back of
the Health Select Committee report
and I wanted to maintain that. I
wanted to keep the momentum; I
wanted to do it relatively quickly.
And I wanted to engage widely, but
I didn’t want a huge team with
dozens of people because we would
never have gotten the job done. I
was keen to keep the team quite
small and compact and have on
board people that I knew could deliver.”
Deciding on a team of him and
three others, Prof Steele then felt he
had all the bases covered. The Review team finally consisted of himself, Janet Clarke (clinical director,
Salaried Dental services, Birmingham; and deputy director, Provider
services, Heart of Birmingham
teaching PCT), Eric Rooney (consultant, Dental Public Health, Cumbria and Lancashire PCTs) and
Tom Wilson (director of Contracting and Performance, NHS Tameside and Glossop).
He added: “One of the areas
where there had been a bit of an issue was whether I should have a
practising dentist on the team, and
I had to give that a lot of thought. Initially I was quite keen to do that, but
then the more I considered it and
thought through the implications,
for the team and the individual concerned, I thought that it was not in
the best interest of the Review,
largely because it would put in-

credible pressure on the one who
was doing it. And then the accusation would be that I had only gotten
one view and there was such diversity of views about the way forward
that in order to do the process fairly
I would have had to have about ten
or 20 practitioners on the team and
that would have made the whole
thing difficult. However, the engagement events were focussed towards practitioners and I think in
retrospect that they actually gave
us a much better opportunity for
people to have an input, which we
could then take control of and implement in the writing of the Review.”
Prof Steele has admitted that he
did have a couple of fixed ideas
about how the Review was going to
pan out – and he says that he was
proved almost completely wrong.
“I did have a few preconceived
ideas and whatever I had they were
all wrong. Well not all wrong – I
knew I’d find quite a lot of anger
amongst the profession. Amongst
patients we weren’t really sure
what we would find to be honest,
because quite a lot you see comes
through the media and that tends to
have its own agenda. So I wasn’t really sure what we would find there
and I wasn’t really sure what I
would find in the commissioning
world and people’s responses. I didn’t find exactly what I expected
from the profession - I think there
was a fantastic willingness to engage with the process, a real interest in getting it right and a lot of dentists who were really interested in
doing good dentistry. That didn’t
surprise me but what perhaps did
was the real willingness to engage
with the process and to really want
to try to improve the system for
everybody – not just for dentists but
for patients and everybody else as
well. And that was good - because if
I had got to the end and finished the
job in a way I had been expecting to
finish it back in December it wouldn’t have been much of a Review!”
Discussing the biggest issues
which came out of the Review Prof
Steele did state that UDAs weren’t
the actual problem. “The UDA ends
up as a focus of all evil. But it’s not
the concept of being paid for a unit

of treatment, we always had that.
It’s just that in the past we had different sizes of units. The biggest issue is actually the variability of the
UDA and one that does concern me.
And the way it is grouped togetherthe banding across the system –
came up as a bit of a problem.
“Clearly some dentists have
done much better than others and
some have benefitted because of
the reforms and others not. However, some of the cases that concern
me are the really honest guys who
are trying to do a thoroughly good
job and who it hasn’t really worked
for - because of the way their UDAs
ended up or their patients or whatever it was and I have a lot of sympathy there. So the UDA was one
thing, but actually there was much
more.
“There was an awful lot about
the relationship between the dentists and the commissioners and
how good or bad that relationship
was. In some areas the relationship
was absolutely fantastic - there was
really good commissioning and it
was imaginatively well done. We
heard a lot about that; naturally
people were very keen to tell us
how well it was working in their
area. This included dentists who
didn’t like the contract but who
thought that commissioners were
doing a really good job and who
were working with them. Equally,
there were lots of complaints about
the commissioning process. This
included that they [commissioners]
didn’t know what they were doing
and were junior so couldn’t be expected to get their head round dentistry because they had so many
other things to do at the same time.
And so dentists felt short-changed
by not getting the quality of commissioning they felt they should deserve. And I think a lot of commissioners felt the same way!
Of course cynicism about the
Review was something Prof Steele
was expecting – and got! “I did come
across a lot of cynicism about what
we were doing and I still come
across it. And I think to some extent
that’s understandable. We have
been through a number of Reviews
before and nothing has come of it.

But I think we are in a different
place now we are running out of
chances to get it right; so I can understand the cynicism and we really have to get it right now.
“The circumstances in which
we have to do this - we are in the
middle of a recession, there’s not
much money and there is a cut in
public spending, so it is all well understood that now is not the easiest
time to be doing it. In a sense
though, if you understand that nobody is going to get a lot of money
then it makes it a bit easier – not to
deliver but it does make it easier to
say ‘right, this is the situation we are
in’. We are in a battle now to maintain our position to be appropriately
resourced. We have to use what we
have maybe a little bit better. From
the point of view of the profession it
must make sure that it does maintain what we’ve got because eroding it further could cost dear. And I
think we can do a lot with the resource we have if we use it better
than we do.”
Prof Steele added: “The feedback we’ve had has been pretty positive, but there has been the kind of
cynicism that you might expect. I’ve
had the accusation that the Department of Health (DH) was all over
this, that it was a DH document - I
can assure you they weren’t. What I
negotiated with DH at the beginning was for total editorial control
of the Review and that was respected. It’s the words of the Review
team and I stand by everything
that’s in the document – nothing has
been altered.
“There have been a lot of questions about implementation; I think
there is perhaps some frustration
that there isn’t more detail of implementation in the Review. I thought
it was more important to get the
principles clearly set out then the
principles clearly agreed by all parties - then the details can be worked
on the back of that. In addition, our
terms of reference didn’t include
implementation; they were to
make suggestions about how we
were going to do various things. For
these things to work they have to be
on firm foundations; sensible, clinical and theoretical foundations for
what might work and what might
not. Let’s Review theoretically what
patients want and what dentists can
deliver and it was done on that sort

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[5] => DTUK2109_01_Title

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DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

News & Opinions

DT page 4

of basis. For that there will be all
sorts of detail and the devil is in the
detail - detail about set up about the
contracts and how they operate and
that’s fine detail that frankly I don’t
want to be involved in! But it has to
be done and there are people who
will do that.”
Discussing the recommendations the Review has made, Prof
Steele detailed what he thought

would be the hardest to implement. “The most difficult for DH is
always going to be the thing that
implies most resource, so I think
the most difficult for them will be
the IT; actually I think it could be
one of the most important recommendations in the whole thing so
that we get our data collection systems and IT properly set up. The
one that I think has been most controversial amongst practitioners is
the idea of warranties. The point I
was trying to make is that this is a
principle because it is something

that patients say ‘well, why not?’
and we have to ask the question ‘if
we can’t do that, then why can’t we
do that?’ - there would have to be a
very good answer to that. There are
situations where you can’t guarantee it and there are many situations
where we already do because there
is a free replacement for some
treatment within 12 months. That
one will be the hardest to get agreement on, and the hardest to implement will be the one that costs
money, so I think that will probably
be the IT.

Looking to the future, Prof
Steele was clearly excited about
his recent appointment to head of
Newcastle Dental School, a position that he took over at the beginning of August. “It’s been a revelation. The Review now seems years
away. I feel like I finished it months
and months ago when in reality I
only finished six weeks ago. So
much happened during the period
of the Review and it was so intense
that it really occupied every
minute of my life just about for six
months. Then it tailed down a little

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“As head of the dental school I
have to make the decisions about
how we are run. I have to make big
strategic decisions about research
direction, our teaching ‘manifesto’
and our role in the NHS. There’s
some quite big decisions I’ve got –
I have to manage our budget properly which is quite substantial I’ve
got dealings with the local trusts
which we are part of. Many millions of pounds come into the system every year and I’ve got to try to
make sure that is used fairly. I
think we’ve got a fantastic school
here and a fantastic workforce and
I’ve got to make sure that we use
everybody to the best of their ability. It’s a reasonably big school and
it is obviously very expensive to
train dentists so I have to think
pretty carefully about how we do
that.”
Training and retaining students and young dentists within
the NHS is a matter that has been
coming up more often as the issue
of access is raised. Prof Steele acknowledged that dental schools
have an important role to play in
this and commented that it had
been raised within the Review. “It’s
come up in independent thinktanks and one of the consumer associations raise their concerns
about dentists being committed
for a certain time. There is an issue
as the taxpayer puts an awful lot in
to training dentists and they quite
rightly expect something back. I
think that for the most part we do
get something back which is good.
But I’m very keen to ensure our
students recognise that actually
they are working for the NHS, that
they have got a role within the NHS
they do – a really important role in
the NHS. They provide care within
the NHS and in return they have an
awful lot invested in their training.

and Digital Imaging Systems

R4 Version III
Practice
Management
Software

bit with the presentations and
that’s all done now. So I’ve been
trying to clear an awful lot of backlog and the new role has already
been really challenging!

“It’s interesting that the students pay fees now - £3000 a year and I think there’s a misconception that the fees cover the training. It doesn’t come close and I’m
not sure they get that. So I’m very
keen to make sure they know that
they have a huge responsibility to
the NHS, that they have a real role
to play. But it’s been a real challenge and I’ve enjoyed it so far.
Looking back on the last nine
months, Prof Steele wanted to
show his appreciation to the people who participated in the Review
process. “I would like to put on
record my thanks for the people
who contributed out of their own
time, and there were many people
who emailed in (I tried to reply to
all of them but sometimes I was
unable to do so because of the volume), people who came along to
the engagement events, people
who telephoned me or stopped me
at meetings or gave me stuff that
was important and I didn’t have a
chance to thank all of them so if
they are reading Dental Tribune –
Thanks! I tried to make sure that I
read everything that I got and that
it was a vast amount but I really did
try to do that so I would like to
thank the whole of the profession
for that.” DT

[7] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

News & Opinions

GDPUK round-up
Tony Jacobs shares the most recent snippets of conversation
from his ever-growing GDPUK online community

lthough there hasn’t been
a lot of attention-grabbing
news in the world of
dentistry through the last few
weeks, GDPUKers have still
found time to air topics they feel
strongly about.

One colleague was able to
share a letter he had received
from his dental contracts team at
the PCT reminding dental colleagues that during the summer
months, when the weather is
warmer, they may be off work
more, but reminding the colleagues that they must still provide cover for patients in pain
even if not at the practice. The
letter had four signatories, all
dental nurses working in the
dental contracting department of
that PCT. This letter raised ire on
the GDPUK forum, but no one
ever thinks that this item is the
last straw to start any revolt
against the unscientific, unreasonable levels of contracting demands placed upon general dental practitioners by the Government, which claims the high
moral ground yet bullies the profession.
Some other topics briefly covered at this time were questions
about spontaneous pulpal haemorrhage, NTI TSS appliances,
the recording of telephone calls
and there was longer set of messages when a colleague reported
his problems following illness
and the wording of his BDA associate contract.

About the author

Tony Jacobs,
52, is a GDP in the suburbs of Manchester, in practice with partner
Steve Lazarus at 406Dental (www.
406dental.com). He has had roles
in his LDC, local BDA and with the
annual conference of LDCs, and is
a local dental adviser for Dental
Protection. Nowadays, he concentrates on GDPUK, the web group
for UK dentists to discuss their profession online, www.gdpuk.com.
Tony founded this group in 1997
which now has around 7,000
unique visitors per month, who
make 35,000 visits and generate
more than a million pages on the
site per month. Tony is sure
GDPUK.com is the liveliest and
most topical UK dental website.

The arrangements should the
swine flu pandemic become
more serious or widespread
were discussed, and there has
been guidance given by the GDC

as well as other bodies. Colleagues on GDPUK are also
knowledgeable about the bird flu
and other pandemic arrangements too.

A question was asked about
saliva substitutes. Some patients
have situations whereby there
is no saliva being produced, and
as sometimes happens when ex-

perts are asked, there are several varying answers, but the
overall consensus was that this
is a major problem, there is no
real substitute, and patients
clearly suffer if they have this
condition.
There was some discussion
about a future course, and perhaps there will be a report in due
course on GDPUK, on the role of
the state in dentistry. Perhaps this
could be the subject of a future
textbook, or PhD paper. DT

[8] => DTUK2109_01_Title

News & Opinions

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

Call for boys to have HPV vaccine

he British Dental Health
Foundation has backed
calls by leading cancer researchers for boys to be given the
HPV vaccine to prevent them getting mouth cancer.
Leading academics have
pointed to the links between the
cancer causing human papilloma virus (HPV) in mouth can-

cer cases, particularly amongst
young men contracting the virus
via oral sex.
Currently the gardasil vaccine preventing HPV is only given
to girls to combat cervical cancer
cases.
The British Dental Health
Foundation is backing these calls.

Foundation chief executive
Dr Nigel Carter said: “Mouth cancer hits some 5,000 people each
year in the UK, killing one person
every five hours.
“It is time we took action to
prevent this hidden killer, which
is beginning to affect more and
more young people. Expert studies suggest HPV could become a

leading cause of mouth cancer so
let us be proactive and plan
against this threat.”
The government sensibly rose
above controversy to give young
girls anti-HPV jabs to young girls to
curb cervical cancer. Mouth cancer affects far more people than
cervical cancer, so surely it is time
to widen the programme to boys.”

‘Routine check-ups save lives’
Can you see the
cancer in this mouth?

Speaking at a cancer conference in Melbourne in Australia,
British expert Prof. Margaret
Stanley of Cambridge University
said: “These HPVs don't just
cause cancer in women. They
cause it in men as well. Cancer in
the mouth, cancer in the anus
and those cancers are very hard
to treat.”
“As an anti-cancer prevention strategy, I would have
thought immunising boys was a
sensible way to go.” DT

Lemonchase
now sole UK
distributor

K distributor Lemonchase is now the sole UK
distributor for EC Dental Solutions products.
The company, established
in April 2005, aims to offer surgeons and dentists expert advice and the finest in magnification, lighting and ancillary
equipment. It is headed up by
two faces well known to the
surgical and dental communities, Nick Lemon and Mark
Chase, who have long specialised in magnification and
lighting. They offer a one-stop
shop for surgeons needing
magnifying loupes and for
dentists interested in dental
loupes and dental microscopes.
Commenting on the news,
Nick said, “We've been on the
lookout for high quality, sensibly priced consumable products to create a repeat business
division of the company. EC
Dental Solution's products fit
that brief perfectly and are
proving very popular with existing customers and dentists
nationwide.”

Now you can with ViziLite Plus

™

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Approved by
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NEXT GENERATION

The range currently consists of premium diamond and
carbide burs, high-speed
handpieces both fibre and non
fibre optic and hygienist prophy paste in disposable cups.
The diamond burs are individually packed, pre-sterilised
and can be treated as single
use. The high-speeds are compatible with the big handpiece
brands such as KAVO, W&H,
Bien Air, NSK, Star etc., and due
to the move to dental dishwashers and central sterilisation are proving an economic
alternative.
Over the next six months the
range will be extended to include the following products: 1. Fiber post
2. Dental instruments
3. Fluoride varnish
4. Nano-composite
5. Hygiene scalers and composite instruments
For information on how you
can purchase these, go to the
industry news pages 26-29. DT

[9] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

Money Matters

9

Dedicated dental solutions
If you join the ASPD, you’ll find no shortage of trustworthy advice on
running your practice. Here, some members share their experiences

T

he success of any dental
practice ultimately depends on the decisions
taken by the principal, but the
everyday dilemmas facing a
small business often need more
than clinical expertise. Of course,
there is no shortage of ‘expert’
guidance on offer, but how can
you tell whose advice can be
trusted and who has genuine experience of the dental industry?

Maintaining high standards
Professions engaged in services such as accountancy, banking,
financial advice, insurance, equipment leasing and vehicle rental,
legal and litigation advice, valuations and estate agency have their
own professional associations.
The multi-discipline Association
of Specialist Providers to Dentists
(ASPD) moves a step further by offering the highest standards of
service across the whole spectrum
of business activity. Membership
to the ASPD is open only to individuals within companies that have
been vetted, can demonstrate substantial experience of the dental
environment and are familiar with
the latest developments within the
dental sector.
Mike Hughes of Dental Practice Consultancy Service (DPCS)
and current chairman of the ASPD
finds it difficult to over-emphasise
the benefits of membership. ‘The
ability to communicate regularly
with other professionals whose
interest in serving the dental profession is paramount, is of enormous benefit,’ he says, ‘whether
those individuals are involved in
the provision of similar advice or
in a complimentary field. One
objective is to ensure that advice is
as broadly consistent as possible
and secondly, I have total confidence in recommending clients to
seek advice from fellow members
as appropriate.’
‘Accreditation to the ASPD
demonstrates that we are a professional firm specialising in the
provision of services for dentists,’

says Beverly Mills of Smart &
Cook, an insurance broker, which
also provides risk management
and financial advice. ‘The dental
sector is continually evolving and
to maintain our specialist status
we must keep up to date with all
areas affecting the profession.’

An ideal solution
Another advantage to the
client of engaging an ASPD member is co-operation – member
firms are happy to recommend
each other or will work together
to provide the dentist with the
ideal solution. Members are familiar with colleague companies’ expertise; as George
Manolescue of Dental Business
Solutions remarks, ‘We know
each others’ strengths and specialties, and so can recommend
other professionals with suitable
experience and commitment.’

Financial services
and advice
A hot topic for dentists today is
identifying a safe haven for investment, particularly for those with
pensions in view, as well as advice
on surviving the credit crunch.
This is the stamping ground of the
dentist’s independent financial
adviser (IFA), who has access to
the latest global information as
well as an understanding of the
specifics of the UK dental market.
‘Being an ASPD member allows us
to keep up to date with changes in
dentistry,’ says Essential Money’s
Sarah Gwilt. ‘It also offers good
networking opportunities and
helps us better understand the
needs of clients.’
Richard
Lishman
of
money4dentists agrees. ‘Our
clients can be confident they are
receiving reliable advice from
the best service providers in the
market.’
The value of the ASPD to both
its members and their clients is acknowledged by high-street banks,
some of who are members them-

selves. ‘When I meet a prospective
client,’ says Alan Springett of
Lloyds TSB, ‘I explain I am a member and recommend a visit to the
association’s website. Clients often find a member offering exactly
the skills they are seeking.’
Member David Brewer,
healthcare manager at RBS,
confirms that his dentist clients
have instant access to a ‘one stop
shop’ of the best financial service
providers.

Legal services and advice
At intervals throughout their
careers, all dentists need legal
support – when forming a limited
company, for example, or a partnership, or when transferring
practice ownership – and to avoid
industry specific pitfalls it is vital
to engage a solicitor with detailed knowledge of modern dentistry. The ASPD encourages its
members to network their experience to benefit their clients.
‘We meet three or four times a
year to share knowledge and discuss problems,’ says Mark SantaOlla of Gordon’s Solicitors. Andrew Lockhart, of Lockhart’s Solicitors says: ‘I enjoy talking to
fellow professionals working in
the dental sector and find the
meetings and contacts to be very
valuable.’
‘It’s extremely useful being
able to discuss problems and developments with other members,’ says Edwin Ross of Edwin
Ross & Co solicitors, a benefit
also acknowledged by Chris
Pomfret of solicitors HowellJones LLP.
A recent recruit to the ASPD
(September 2008), Sinton’s Solicitors enjoyed almost instantaneous benefit. ‘We have already
received instructions on two
matters through the ASPD,’ reports Amanda Maskery, ‘and I
would recommend membership
to colleagues working in the
same area.’

David Griffiths of Maxwell
Hodge Solicitors believes that
ASPD membership helps persuade potential dentist clients to
choose his company rather than
a non-member, while Graeme
Burn of Burn & Co acknowledges
the benefits of extra mural discussions and appreciates being
part of a multi-disciplinary organisation. ‘We can confidently
refer clients to members from
other disciplines.’

An accountancy package
A good accountant offers much
more than a tax and auditing service and will also provide valuations, cashflow forecasts and commercial asset value management
advice. As dental equipment becomes more sophisticated and expensive, an industry-aware accountant can compare the merits
of leasing against those of outright
purchase as well as offering informed advice on debt/capital ratios. Specialist knowledge of how
the health sector operates is vital.
‘ASPD membership has
broadened our network of professional contacts around the country,’ says Greg Penfold of
Humphrey & Co accountants, referring to introductions effected
at the quarterly meetings, which
help members keep up with legislation. Andrew Chuen of FKST
Accountants, a member of the
ASPD for five years, is impressed
by how useful these meetings
have been. ‘I have found the quarterly meeting extremely useful as
this gives me the opportunity to
talk to the other accountants and
professionals, and keep up to date
with new developments and legislation affecting dentistry.’
‘In my everyday professional
life, I refer to people all around the
country from a wide range of professions,’ says Cathy Tew of Cathy
Tew Associates. ‘Each ASPD
member contributes their own
experience and knowledge to the
group, which helps to keep every
member up to date with legisla-

tive and other changes affecting
the dental arena.’ Longden and
Cook’s Henry Brownson and John
Minford of Minford’s agree; ‘We
can keep our fingers on the pulse.’

Only the best
Lyndsey Lococq of Libran
Management, which offers practice management and consultancy solutions, was pleased to
feel instantly welcome when she
joined. ‘I have gained general information about the NHS and
specific information about the
dental market which it would be
hard to find elsewhere,’ she says.
‘I feel my clients benefit as I now
have access to other professionals I know I can trust.’
‘I have a large referral base of
dental experts,’ adds Robert
Miller of dental practice business
sales experts Henry Perlow
Group. ‘I can call fellow members for advice, and my clients
are comforted that I am a member of a known trade body.’
Having been a member since
2000, ASPD Chairman Mike
Hughes is delighted with how the
Association has developed. ‘I have
seen the organisation grow and
strengthen enormously and become more defined in its role,’ he
concludes. ‘While the core values
have remained unchanged, the
membership is now more diverse
covering a wider range of professional disciplines. It has been a
privilege over the last 12 months
to have served as Chairman of an
organisation so committed to ensuring that members of the dental
profession receive the highest
quality of help and advice.’
The ASPD is the leading association of dental service
providers, and is always keen to
attract new members with a
proven track record of exceptional service to the industry.
For more information on the
ASPD, call 0800 458 6773 or visit
www.aspd.co.uk. DT

[10] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

10 Money Matters

Concentrate on quality
You need to keep your eye on the ball if you’re to get things right
in business, and dentistry is no different, insists Frank Pons

he English physicist
Michael Faraday identified concentration as one
of the skills essential for success.
In every profession, taking care
to get things right is vital, and
dentistry of course is no diffe-

very competitive for several
years, but the credit crunch has
raised this almost to fever pitch.
Dentists are under the greatest
pressure to deliver high quality
treatment at a reasonable price,
but not only that – they must also

rent. However, when you are enduring a protracted tax investigation, the costs can prey on your
mind.
Presence of mind is key, particularly now. Dentistry has been

do so with a smile. Patients are
feeling the financial pinch too,
and will not put up with anything
less than the best possible standard of service.
This has led to many dentists
investing in new equipment, new
training and possibly extensive
refurbishments. One thing that
must remain constant is the dental professional’s unerring focus
on great results during every single procedure, for every clinical
hour.

Think all
toothpastes work
the same?
Take a deeper look.

Concentration all round
Concentration is not confined
to moments when you have an instrument in your hand. It also applies to your business planning
and management. When your
mind is elsewhere, it can be hard
to see things as they really are; effective business decisions become harder to make. Opportunities are missed, particularly
galling when opportunities are
few and far between.
Looking beyond the practice,
dentists need to be making the
most of their free time. Indulging
in their hobbies, spending time
with their loved ones, even planning for the future. Even this becomes difficult to do when facing
a potentially crippling bill from
an accountant or investigation
specialist.
Tax investigations have been
known to last several years.
Imagine how many hours of assistance you will have to pay for
during this time, and you will see
how the prospect can drive dentists to distraction. The media is
full of doom and gloom at the moment, and people are looking to
the future with uncertainty.
Those dentists in the midst of tax
investigations know only one
thing for certain: eventually, the
investigation specialist will want
paying. Even if the tax inspector
decides that no extra tax is required.

Protect yourself

Gingivitis, if left unchecked, may lead to periodontitis. Emerging scientific research is
associating periodontitis with other diseases, such as cardiovascular disease, diabetes
and stroke1,2
"Over the last decade, mounting evidence from epidemiologic studies suggests that
periodontitis… may be an independent risk factor for atherosclerosis and CVD."
Dye BA et al. J Clin Periodontol. 2005; 32: 1189–1199.

Colgate Total has been proven to significantly reduce gingivitis
Colgate To
T tal contains a unique formulation comprising a copolymer to help ensure
delivery and retention of the active ingredient, triclosan, for up to 12 hours of

Peace of mind is hard to come
by in Britain, 2009. However,
when it comes to protecting yourself from the expensive fees incurred during a tax investigation, leading providers are offering insurance of up to £75,000 – so
when the bill from the investigation specialist arrives, you won’t
be terrified to open it. With the
right policy of Tax Investigation
Cost Protection in your corner,
you can work, manage and live
with a clear head, making the
most of your time professionally
and personally, and concentrating on the good things in life: clinical excellence, job satisfaction
and personal fulfilment. DT

antibacterial protection,3 plus anti-inflammatory action4
z

Its sustained antibacterial action significantly reduces dental plaque5*

Significantly reduces the number of sites with gingival bleeding5*

About the author

Colgate Total: Clinically Proven 12-Hour Antibacterial Protection, plus Anti-Inflammatory Action

Better Oral Health as part of Better Overall Health
References: 1. Scannapieco FA. Compendium. 2004; 7(Suppl 1): 16–25. 2. Dave S et al. Compend Contin Educ Dent. 2004; 25(7 Suppl 1): 26–37. 3. Amornchat C et al. Dent J. 2004; 24: 103–111.
4. Lindhe J et al. J Clin Periodontol. 1993; 20: 327–334, supplemental report on file. 5. Garcia-Godoy F et al. Am J Dent. 1990; 3 Spec No: S15–26. Erratum in: Am J Dent. 1991; 4: 102.
*vs ordinary fluoride toothpaste.

The therapeutic indications set out in the Summary of Product Characteristics for Colgate Total include the reduction of dental caries, improvement of gingival
health and reduction of periodontitis – it does not include the treatment or prevention of other diseases, such as cardiovascular disease, diabetes or stroke
For further information please call us on 01483 401901 or visit www.colgateprofessional.co.uk
PRODUCT INFORMATION. Product Summary. Trade Name of the Medicinal Product: Colgate Total
Toothpaste. Active Ingredients: Triclosan 0.3% w/w, Sodium Fluoride 0.32% w/w (1450ppm F).
Indications: To reduce dental caries, improve gingival health and reduce the progression of
periodontitis. Dosage and administration: Brush the teeth for one minute twice daily. Children under
7, use a pea-sized amount. If using fluoride supplements, consult your dentist. Contraindications:
None known. Individuals with known sensitivities should consult with their dentist before using.
Special Warnings and Special Precautions for Use: Children under 7, use a pea-sized amount.

If using fluoride supplements, consult your dentist. Interactions with Other Medicines: None known.
It is important to note that as for any fluoride containing toothpaste in children under systemic fluoride
therapy, it is important to evaluate the total exposure to fluoride (fluorosis). Undesirable Effects: None
known. Legal Class: GSL. Product Licence Number: PL 0049/0036. Product Licence Holder:
Colgate-Palmolive (UK) Ltd., Guildford Business Park, Middleton Road, Guildford, Surrey GU2 8JZ.
Recommended Retail Price: £1.29 (50ml tube), £2.29 (100ml tube). Date of Revision of Text: September
2008.

Frank Pons
A qualified chartered accountant
and tax expert, Frank Pons
founded PFP in 1984, the first company to recognise the need for and
provide dentists with tax investigation insurance. For more information, contact PFP on 0845 307 1177,
email info@pfp.uk.com or visit
www.pfponline.com. PFP also offers unlimited human resources
and employment advice with the
HR Plus service.

[11] => DTUK2109_01_Title

IMPLANT TRIBUNE
Regeneration

Concept

Treatment

Growth factors

Platform Switching

Immediate loading

Prof. Liviu Steier and
Gabriela Steier discuss
how growth factors are
a valuable addition to
regenerative dentistry.

Prof. Liviu Steier and
Gabriela Steier look at
the benefits of this
concept, how best to
carry it out and which
manufacturers offer
the equipment.

Dr Devorah SchwartzArad discusses a preferred solution in the
esthetic zone

pages 11–13

pages14–16

pages 17–21

A patient’s growth factors
Prof. Liviu Steier and Gabriela Steier discuss how growth factors are a
valuable addition to regenerative dentistry
TGF- ␤
• Activates intracellular proteins
• Promotes extracellular matrix
production for example in periodontal ligament fibroblasts
• Stimulates the proliferative activity of periodontal ligament fibroblasts
• Stimulates biosynthesis of type
I collagen and fibronectin.
IGF-I
• In combination with PDGF will
stimulate cementogenesis
• Bone formation; and many more.
Pre-operative x-ray showing upper and lower jaw.

lood clots are extremely
valuable for initiating
healing and regeneration
for both soft and hard tissue.
Platelet rich plasma (PRP) is becoming more accepted as a way
of accelerating and enhancing
natural wound healing, and has
been successfully used for
decades in orthopaedic surgery
as well as in dermatology.

release adenosine diphosphate,
serotonin and thromboxane,
contributing to the clotting cascade and hemostatic process, as
well as to the platelet plug formation. The platelet plug is reinforced by an insoluble protein fibre meshwork as a product of the
clotting cascade.

Under research
4. Transforming growth factoralpha = TGF-␤, etc
5. Epidermal growth factor = EGF
6. Vascular endothelial growths
factor = VEGF
7. Hepatocyte growth factor =
HGF.

It’s important to note the fact
that platelets actively extrude
growth factors, such as:

Here I will attempt to explain
a bit about some of the benefits of
these well-researched growth
factors:

Well-researched growth factors
1. Platelet-derived growth factor
= PDGF
2. Transforming growth factor-‚
= TGF-␤
3. Insulin like growth factor =
IGF-I.

PDGF
• Proliferative activity on periodontal ligament fibroblast
• Promotes collagen and protein
synthesis
• Enhances proliferation of bone
cells.

Growth factors
A variety of proteins and
growth factors interact with each
other to induce wound repair.
In a once-injured vessel, the
platelets will start to stick to exposed collagen proteins and will

Venous blood, which has been collected in
office and drawn into four sterile tubes containing an anticoagulant (here 3.8 per cent
sodium citrate) before centrifugation and
further manipulation.

Non-activated PRGF used to coat the implants before insertion (Biohorizons implant).

It was Marx who in 1998 published a paper on the significance
of increased bone formation and
bone density after using thrombocyte growth factor. Rutherford
et al. (1992) and Anitua (1999)
published a paper on platelet
concentrates for coating dental
implants.

Commercial systems
available for PRP
• Smart Prep autologous platelet
concentrate system (Harvest Autologous Hemobiologics, Norwell, Massachusetts)
• Tisseel system (Baxter Heath
corp., Deerfield, Illionois)
• Curasan PRP kit (Curasan,
Kleinostheim, Germany)
• Friadent-Schuetze PRP (Friadent-Schuetze, Vienna, Austria

BioOss (Geistlich) soaked in PRGF.

• PRGF by Anitua ( G.A.C. Medicale
San Antonio, Vitorio Espana).
How the systems differ:
1. Cycles of centrifugation
2. Speed of centrifuge
3. Amount of blood to be collected
4. Addition yes/no of bovine
thrombine.
I have used the Curasan approach for many years and
switched to the PRGF technique almost three years ago. For the purpose of exemplification the latter
technique will be briefly described.
As such, based on the technique used, the platelet count as
well as the growth-factor content
may differ. Differentiation of the
above number may occur as well
as a consequence of the donor.
The Anitua technique:
• Venous blood (between 10-30 mL)
has to be collected in office and
drawn into two to six sterile tubes
containing an anticoagulant (here
3.8 per cent sodium citrate).
• Centrifugation: Eight minutes
at 1800 rpm.
• Three different blood fractions
will be identified and isolated
by pipetting:
Fraction 1 = platelet poor
plasma (the above 0.5ml)
IT page 12

The PRGF membrane ready to be placed.

[12] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

12 Implant Tribune

PRGF membrane sutured in place.

Post-operative x-ray showing the implants in place as well as the fully augmented upper jaw.

X-ray taken at 12 months recall.

IT page 11

aesthetics

enhanced by

technology

Fraction 2 = plasma containing a
number of platelets (next 0.5ml)
Fraction 3 = platelet rich growth
factor (remaining plasma above
the buffy coat) this is the most
important fraction.
The platelet then needs activation using 10 per cent calcium
chloride (0.05ml per 1ml PRGF).
The coagulation will occur in
five to eight minutes (best at 37
degrees Celsius – incubator).
Weibrich et al (2002) measured 46+/- 7.45 per cent PRGF
collection efficiency.
The same study confirmed
the absence of leucocytes in all
three fractions.
One can use the gained material as follows:
a. Not activated for coating implants before seating
b. Activated:
1. To be mixed with graft materials
2. To make membranes.

Laser-Lok® dental implant at 8 years
post-restoration showing superior
crestal bone & tissue maintenance.

Laser-Lok

Case courtesy of Cary A. Shapoff, DDS (Surgical); Jeffrey A. Babushkin, DDS (Restorative)

microchannels
BioHorizons is known for using science and innovation to create unique implants with proven surgical and aesthetic
results. Laser-Lok microchannels exemplify our dedication to evidence-based research and development.
The effectiveness of Laser-Lok has been proven with over 15 years of in vitro, animal, and human studies at leading
universities.† This patented precision laser surface treatment is unique within the industry as the only surface treatment
shown to inhibit epithelial downgrowth, attract a true, physical connective tissue attachment to a predetermined zone
on the implant and preserve the coronal level of bone; long term.‡
Laser-Lok is currently available on Tapered Internal, Single-stage, and Internal Implants.

For more information, contact BioHorizons
Customer Care: 01344 752560
Email: infouk@biohorizons.com
visit us online at www.biohorizons.com

†

Clinical References available. ‡Human Histologic Evidence of a Connective Tissue
Attachment to a Dental Implant. M Nevins, ML Nevins, M Camelo, JL Boyesen, DM Kim.
The International Journal of Periodontics & Restorative Dentistry. Vol. 28, No. 2, 2008.

Strengths of the technique
1. Needle-free approach which
drops infection risk for practitioner
2. Duration for the preparation is
about 20-25 min
3. Reduced centrifugation time
4. No need of additional bovine
throbine.

Weakness of the
described technique
1. Lack of leukocyte might lead
to a reduced anti-infective
protection
2. High number of pipetting procedures (up to 30)
3. The use of a so-called “open
system” implicates high sterilisation criterion.

Conclusion
PRP is a new tissue-engineering application suitable for the clinician. Among the different procedures available, I am describing the approach which in my
hands currently works best. The
use of the PRP here PRGF technique significantly changed the
treatment outcomes in my practice: less complications, better
healing and higher predictability
of regeneration procedures.

SPMP09074 REV A MAR 2009

Disclaimer
The author has no financial
interests in any of the presented
products or systems.

[13] => DTUK2109_01_Title

Implant Tribune
Aesthetic Risk Factors

Low (score 1)

Medical status

Healthy patient and intact immune system

Smoking habit

Non-smoker

Medium (score 2)

High (score 3)

Patient’s esthetic
expectation

Medium

Smile line

Medium

Biotype

Medium-scalloped.
medium-thick

Biotype

Normal

Shape of tooth crowns

Square

Rectangular Oval

Infection at implant site

None

Chronic

Bone level at adjacent teeth

< 5mm to contact point

... Why compromise
Triangular

Restorative status of
neighboring teeth

Crowns

Width of edentulous span

2 teeth or more

Soft-tissue anatomy

Soft-tissue defects and
recession >1

Height of existing papilla and
evenness of FGM (GAL)

Long or absent papillae
and GAL class 4

Bone anatomy

Vertical bone deficiency

Bone contour
Tooth position (immediate
placement)

Excellent Quality
Excellent Value

Heavy smoker (>10 cigfd)

A-Silicone Fast Set Putty

Minimal buccal dip
Regular tooth alignment

Socket integrity and
anatomy

Multi-rooted, sever bone
deficiency

Aesthetic risk score

> 36

Clinical case study
A 54-year-old female patient
presented to our practice requesting rehabilitation of the upper jaw with implant-supported
fixed restorations.
The patient had not received
dental assistance for the last 12
years and had no medical problems. The patient’s chief complaint was non-satisfactory
chewing efficacy. She requested
rehabilitation of the upper jaw
with implant supported fixed
restorations.
Her oral hygiene was adequate so she underwent a rigorous oral hygiene programme for
three months. The soft tissue examination revealed no problems; TMJ and muscles showed
no acute problems; occlusal assessment revealed a lack of occlusal support; implant assessment showed suspect teeth: 16,
13, 12, 22, 25, 26; available bone is
moderate to poor; treatment plan
includes planned extractions of
teeth 16, 13, 12, 22, 25, 26 and a total of seven implants.

Consent was obtained and
the treatment started. The first
treatment step comprised extractions and the fitting of a temporary restoration. Ten weeks
later, impressions were taken,
castes were mounted in a semiadjustable articulator and sent
to the lab for manufacturing of a
surgical guide. PRGF, implant
insertion and bone graft (a mixture of Grafton, (Biohorizons)
and BioOss, (Geistlich) soaked
in PRGF) were performed concomitant in local anesthesia.
Antibiotic coverage was assured for seven days.
The patient was asked not to
wear temporary prosthesis for
10 days and an antibiotic regimen was prescribed.
The second-stage surgery
was performed six months
later. After a gingival healing/maturation time of 14 days,
definitive impressions were
taken, bite registered and a
face bow made.
After two try-in sessions the
definitive restorations were fitted.

dures seem to have gained more
predictability. IT
References are available on request.

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Dr. med. dent. Liviu Steier
is a visiting professor at the School
of Dental Medicine in Florence;
visiting professor at Tufts School of
Dental Medicine on its endodontic
postgraduate programme; and an
honorary clinical associate professor at Warwick Medical School. He
is a registered specialist in endodontics (GDC) and Spezialist
fuer Prothetik (www.dgzpw.de).

Flouride-releasing Light-cure
Universal Microhybrid Composite

only £12.50 per 4g syringe

He can be reached at
l.steier@msdentistry.co.uk

Esthetic risk analysis
We explained to the patient
the high risks of smoking and it
was agreed that the patient
would attend a stop-smoking
programme. Three months after
this, the patient did stop smoking
and treatment began.

The 12-month X-ray proved
a stable outcome and it is expected that the patient will
come back for rehabilitation of
the lower jaw.

About the author

Conclusion
The following treatment plan
was agreed and discussed with
the patient:
• Planned extractions: 16, 13, 12,
22, 25, 26.
• Number of implants: seven
• Position of implants: 15, 14, 13,
12, 22, 26, 27.
• Bone graft using: BioOss
(Geistlich) and PRGF (Anitua
technique).
• Type of prosthetic restoration:
single crowns.
• Surgical template: conventional lab-made surgical guide.

Wound-healing deficiencies
do not often impose an obstacle
in guided bone regeneration
(GBR) procedures when associated with implant placement.
The use of PRP techniques in
medicine go a long way back
and its application into dentistry
represented a change of paradigm. The author can only anecdotally affirm, based on his own
experience, that since using
PRP (latest PRGF) techniques,
wound-healing problems don’t
occurred again and GBR proce-

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Gabriela Steier
is a BA from Tufts University
Boston. She has conducted extensive research in the field of ozone
in endodontics and has co-authored several articles, and textbooks chapters.

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Tel: 020 8236 0606 5 020 8236 0070
All trade marks acknowledged. Offers subject to availability. Not valid with any other offers, price
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[14] => DTUK2109_01_Title

14 Implant Tribune

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

Platform switching in dental implants
Prof. Liviu Steier and Gabriela Steier look at the benefits of this concept, how best to
carry it out and which manufacturers offer the equipment
Introduction
The crestal area is the region
to suffer initial breakdown when
it comes to the implant tissue interface. Adell et all. (1981) first

communicated 1.2mm of marginal bone loss from the first
thread during healing time, with
a continuation of 0.1 mm annually.

As a consequence, Smith and
Zarb (1989) established the following as criteria for implant success: vertical bone loss of <0.2mm
annually following the first year.

This of course is a major issue
in the anterior esthetic zone.
Since then, clinicians and manufacturers have worked hard to try
to improve this condition.

Factors affecting loss
The following factors are
among the most discussed to
cause crestal bone loss:
1. Surgical trauma
2. Biologic width/seal
3. Microgap
4. Occlusal overload
5. Crest module.
Causes of trauma
Overheating the bone during the drill procedure; extended full-flap raise, Screw-in
forces higher than 35 N/cm2 are
optional causes for crestal
breakdown. As such, these factors may only be responsible for
bone loss prior to prosthetic
load.

‘These factors
may only be
responsible for
bone loss prior
to prosthetic
load.’

Biologic width/seal
This seal starts the day the
abutment is mounted and continues for the next six weeks into
treatment. Today’s surgical protocols control this fact by adequate three-dimensional implant positioning.
Microgap development
Two-stage implants seem to
be prone to microgap development. Even with implant engineering work, it’s hard to control
via different improved connections, glue, etc.

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Occlusal overload
Crestal bone is mostly cortical bone. Forces occurring at the
crestal level are described as
shear forces. Cortical bone is
highly susceptible to shear
forces. Occlusal concepts have
been developed specially for implant-supported restorations to
address this issue.
Crest module
Implant professionals as
well as implant manufacturers
have introduced different
remedies to address this issue:
polished collar, Connective
Contour (Astra), Laser-Lok
Technology (Biohorizons), for
example.

The peri-implant histology

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Ericsson et al (1995) reported
the following findings:
a. Plaque associated inflammatory cell infiltrate;
b. Implant associated inflammatory cell infiltrate.
As such implantologists addressed more attention to the
area.

[15] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009
Serendipity
• In the late 1980s, NobelPharma
introduced a Branemark 5mmdiameter implant. The prosthetic components used a
“standard” diameter.
• In 1991, Implant Innovations
introduced wide diameter implants. Of course not all prosthetic abutments were available. As a result, prosthetic
parts from a regular platform
have been used.
Long-term observations of
this demonstrated a reduced loss
vertical change in crestal bone
height compared to the available
standards.

The platform switching
treatment concept
The platform is the crestal
area of an implant. Let us say as
an example that the crestal diameter of the implant is 3.8mm and
the abutment used measures
3.2mm. The difference of the diameter between the implant and
the abutment is the so called
“platform switching”.
Manufacturers offering the
concept
The concept of platform
switching is only offered exclusively by a restricted number of
implant manufacturers.
1. Wieland
2. BTI
3. 3I
4. Astra
5. Dentsply ¬– Ankylos
6. Zimmer
7. NobelBiocare.

Scientific evidence
1. A random prospective multicentre trial evaluating the platform-switching technique for
the prevention of postrestorative crestal bone loss. Int J Oral
Maxillofac Implants. 2009
Mar-Apr; 24(2): 299-308.
Conclusion: The findings of
the current trial indicate that
the use of implants with an enlarged platform can result in
better preservation of crestal
bone as compared with conventional cylindric implants
when a reduced abutment is
mounted.
2. Double-blind
randomised
controlled trial study on postextraction immediately restored implants using the
switching platform concept:
soft tissue response. Preliminary report., Canullo L, Iurlaro
G, Iannello G., Clin Oral Implants Res. 2009 Apr;20(4):
414-20.
Conclusion: This study suggests that, in a limited time period of two years, immediately
placed implants with subsequent platform switching can
provide peri-implant tissue stability.
3. Effect of microthreads and
platform switching on crestal
bone stress levels: a finite element analysis. Schrotenboer
J., Tsao YP., Kinariwala V.,
Wang HL. J Periodontol. 2008
Nov; 79(11): 2166-72.
Conclusion: Results from this
study showed the reduction of
abutment diameter (for exam-

ple, platform switching) resulted in a measurable, but minimal effect on Von-Mises stress
in the crestal region of cortical
bone.
4. Peri-implant bone level
around implants with platform-switched abutments:
preliminary data from a
prospective study.,Hürzeler
M, Fickl S, Zuhr O, Wachtel
HC. Department of Operative Dentistry and Periodontology, J Oral Maxillofac

Implant Tribune 15

‘The concept of platform switching
is only offered exclusively by a
restricted number of implant
manufacturers.’
Surg. 2007 Jul; 65(7 Suppl 1):
33-9
Conclusion: The concept of platform switching appears to limit
crestal resorption and seems to
preserve peri-implant bone lev-

els. A certain amount of bone remodelling, one year after final
reconstruction occurs, but significant differences concerning
the peri-implant bone height
compared with the nonplatform-

switched abutments are still evident 1 year after final restoration.
The reduction of the abutment of
0.45mm on each side (5mm implant/4.1mm abutment) seems
sufficient to avoid peri-implant
bone loss.
5. Evaluation of peri-implant
bone loss around platformswitched implants. Cappiello
M, Luongo R, Di Iorio D, Bugea
C, Cocchetto R, Celletti R., Int J
IT page 15

[16] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

16 Implant Tribune

Squareshaped
Tulip

A Nobel Speedy Replace Implant with
adapter and abutment. (Picture by
NobelBiocare)

IT page 15

Periodontics Restorative Dent.
2008 Aug; 28(4): 347-55.
Conclusion: Platform switching
seems to reduce peri-implant
crestal bone resorption and increase the long-term predictability of implant therapy.
6. Preservation of peri-implant
soft and hard tissues using
platform switching of implants
placed in immediate extraction sockets: a proof-of-concept study with 12 to 36-month
follow-up.,
Canullo
L,
Rasperini G., Int J Oral Maxillofac Implants. 2007 NovDec; 22(6): 995-1000.
Conclusion: This proof-of-concept study suggests that imme-

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The abutment screwed in demonstrating platform switching. (Picture
by NobelBiocare)

diate loading with platform
switching can provide peri-implant hard tissue stability with
soft tissue and papilla preservation.
7. Biomechanical analysis on
platform switching: is there
any biomechanical rationale?
Maeda Y, Miura J, Taki I, Sogo
M., Clin Oral Implants Res.
2007 Oct;18(5):581-4. Epub
2007 Jun 30.
Conclusion: Within the limits of
the present study, it was concluded that both CAM and CPS
implants revealed crestal bonelevel changes after 28 days of
healing.
The ITI Consensus Statements and recommended clini-

cal procedures regarding esthetics in implant dentistry (ITI
Treatment Guide Volume 1 –
Quintessence) have to be mentioned here as the authors wish to
avoid raising false expectations
that only platform switching (a
group of prosthodontic and
restorative procedures) can lead
to predictable results. The author’s statements in the articles
are based on:
1. Long-term results (from evidence to newer surgical approaches)
2. Surgical considerations (from
extraction planning to soft tissue stability)
3. Prosthodontic and restorative
procedures (from standards for
esthetic fixed-implant restora-

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Nobel Active implant with abutment screwed in place
demonstrating platform switching. (Picture by NobelBiocare)

tions to location of the implant
shoulder)
4. Well-executed esthetic risk
analysis performed prior to
any treatment planning.

• Can implants be placed at or below the osseous crest and avoid
bone loss to the first thread after
abutment connection?
• Can implant esthetics be improved through “platform
switching?”

Conclusion
The authors would like to end
with questions raised by DM
Gardner in an article in NYSDJ,
from APRIL 2005:
• Can implants be placed closer
than 3mm from an adjacent implant, while still maintaining
interproximal height of bone?
• Can implants be placed less
than 1.5mm from an adjacent
tooth and still maintain interproximal bone?

The authors’ personal experience is of course limited to one manufacturer, but over time the results
are encouraging and many more
long-term multicentre studies are
needed to obtain evidence. IT

About the author

Dr. med. dent. Liviu Steier

Gabriela Steier

Crestal level animation showing the
hard/soft tissue Relations. (Picture by
NobelBiocare)

is a BA from Tufts University
Boston. She has conducted extensive research in the field of ozone
in endodontics and has co-authored several articles, and textbooks chapters.

is a visiting professor at the School
of Dental Medicine in Florence;
visiting professor at Tufts School of
Dental Medicine on its endodontic
postgraduate programme; and an
honorary clinical associate professor at Warwick Medical School. He
is a registered specialist in endodontics (GDC) and Spezialist
fuer Prothetik (www.dgzpw.de).
He can be reached at
l.steier@msdentistry.co.uk

[17] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

Implant Tribune 17

Immediate loading of
immediate implants
Dr Devorah Schwartz-Arad discusses a
preferred solution in the esthetic zone

I

n the past two decades, immediate implant placement into
fresh extraction sites has
gained in popularity and is considered a predictable and acceptable procedure.1-6 However, the
dimensional changes and esthetic results are controversial.7-10
The rationale behind immediate
implant placement is, in part,
based on observations that it may
contribute to bone preservation.8,9 Early extraction and immediate placement could lead to a
favourable crown-implant ratio,
better esthetics, and a favourable
interarch relationship.1,11

1a

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1b
Fig 1b: A pre-operative CT scan revealed thin buccal plate in the area of
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1c
Fig 1c: The canine was atraumatically extracted, taking care not to
damage the buccal plate and the adjacent papillae.

1d
Fig 1d: An implant was immediately
placed into the fresh extraction
socket without raising a flap.

1e
Fig 1e: An acrylic resin provisional
crown without any occlusal contacts
was fabricated and placed.

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1f
Fig 1f: Healthy soft tissue around the
provisional crown is evident at six
months.
 IT page 18

Fig 1a: In this case, the
right maxillary canine
was scheduled for extraction due to root
fracture. Single-tooth
replacement through
immediate provisionalisation was chosen
as the treatment
method.

T h e

D e n t a l

C o m p a n y

[18] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

18 Implant Tribune

2a

2b

Figs 2a and 2b: Immediate provisionalisation of multiple adjacent implants in a partially edentulous arch. The patient was referred for extractions and immediate implant placement in the sites of all six anterior
maxillary teeth.

2c

2d

2e

Fig 2c: Teeth were extracted atraumatically and a surgical guide
was used for implant placement.

Fig 2d: Four dental implants were
placed into the fresh extraction
sockets of the two central incisors
and canines.

Fig 2e: A prefabricated provisional
fixed partial denture was inserted,
taking care to avoid occlusal loading.

 IT page 17

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In 2001, Garber et al.12 introduced immediate provisionalisation of immediate implants and described the next
generation of the immediate
implantation technique, which
included atraumatic tooth removal with simultaneous rootform implant placement and
temporisation in one session.
This technique of “Immediate
Total Tooth Replacement” allows for the maintenance of the
bony housing and soft-tissue
form that existed before extraction, while simultaneously
establishing a root-form anchor in the bone for an esthetic
restoration.

Diagnosis and
treatment planning
These are key factors in
achieving successful outcomes
after placement and restoration of implants inserted immediately after tooth extraction.13
A socket often presents dimensions that may be considerably
greater than the diameter of
most implants after extraction.
In a histological report, Wilson
et al.14 stated that the horizontal
component of the peri-implant
defect was apparently the most
critical factor relating to the final amount of bone-implant
contact.
Botticelli7 states that small
defects (1-1.25 mm) may heal
with new bone and a high degree of osseointegration and
that the placement of a barrier
membrane after implant installation does not improve the
outcome of healing. Jung et
al.15 concluded that the remaining defect, small enough
to be clinically neglected, irrespective of gap size within two
mm, does not need any kind of
regenerating procedures.
In 1998, this author16 examined the hypothesis that immediate implants can succeed
without primary flap closure. A
technique was described that
does not require any incisions
during immediate implant
placement. No barrier membranes were used and the sole
grafting material was autogenous bone chips. Clinical osseointegration was achieved
with minimal gingival recession and papillae preservation.
It was concluded that immediate implant placement in the
anterior maxilla can be successful in replacing a single
tooth even without primary
closure.

[19] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009
The esthetic zone
Preservation of the buccal
bone crest after tooth extraction is of major importance in
achieving esthetic results and
long-term implant survival.
However, controversy exists in
the literature regarding immediate implantation benefits for
preserving the morphological
ridge contour.16 A marked reduction of the buccal bone following implant placement in
fresh extraction sockets has
been shown in animal studies.7,17,18 For example, Araújo et
al.17 concluded that the boneto-implant contact established
during the early phase of socket
healing following implant installation was partly lost when
the buccal bone wall continued
to resorb, and that implant
placement failed to preserve
the hard tissue dimension of
the ridge after tooth extraction.
The buccal and lingual
bone walls were both resorbed.
The surgical procedure included mucoperiostal fullthickness flaps that were elevated to disclose the buccal and
lingual hard tissue wall of the
ridge. The same surgical procedure conducted by Botticelli
et al.7 also concluded that the
height of the approximal
socket walls may be retained
and the reduction of the crestal
bone will be limited to the buccal walls of the recipient site.

Immediate loading of
immediate implants

Immediate loading of immediate implants does not impair osseointegration of an immediate post-extraction implant compared to an unloaded
post-extraction implant. The
key difference between success and failure of osseointegration of the immediately
loaded implants is controlling
the micromotion, which is reduced through broad anteroposterior distribution of the
immediately loaded implants.
Anchorage of the cortical bone,

The objective of immediate
provisionalisation or loading of
dental implants is to combine tissue preservation with bone
preservation (Total Volume
Preservation) that follows immediate placement. This will preserve proper volume and shape
of the hard and soft tissues. Immediate provisionalisation also
results in fewer surgical interventions and a simpler solution
for the patient.

Implant Tribune 19
especially in the maxilla, may
be necessary to increase implant stability. Recently, this
author found that after a mean
follow-up of 15.6 months, provisionalisation of immediately
placed implants proved a predictable procedure with a high
implant survival rate (97.6 per
cent).20
Histologic
observations
from different animal and human studies have shown that
immediately loaded implants

IT page 20

To motivate behavioural change, it helps if patients understand the beneﬁts
of brushing for at least 2 minutes twice a day with ﬂuoride toothpaste,
compared to an average brushing time of around 46 seconds.1
New research results from Aquafresh show that increasing brushing time:

Bone preservation

A pilot study in which buccal bone remodeling after immediate implantation, using a
flap or flapless approach in
mongrel dogs was evaluated,
has shown that the flapless approach reduces the buccal
bone height loss for immediate
post-extraction implants.19 A
reasonable explanation could
be the preservation of the periosteal vascular network. Immediate post-extraction implants also have a high percentage of bone-to-implant
contact.

Therefore, this treatment
concept can be applied to
everyday clinical practice in
properly selected patients who

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for 120 seconds compared
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The controversy regarding
bone preservation has been
discussed in several studies.
Fickl et al.8,9 have shown that
the resorption rate of the extraction socket decreases
when the periosteum remains
in place. A significant lower resorption rate was found in the
“flapless groups” with and
without the socket-preservation techniques. Furthermore,
the flapless technique implementing bone augmentation
materials preserves the socket
volume better. In their study on
dimensional changes of the
alveolar ridge contour after
different socket preservation
techniques, Fickl et al.8 were
not entirely able to compensate for the alterations after
tooth extraction. Yet, incorporation of BioOss collagen
seems to have the potential to
limit but not avoid post-operative contour shrinkage. Treatment of the extraction socket
with BioOss collagen and a free
gingival graft is beneficial in
limiting the resorption process
after tooth extraction.

can have a direct bone-to-implant interface without any fibrous tissue formation.21 Success in immediate placement
and loading of implants is
based on several clinical parameters.

Surface microhardness
(SMH) increased in a linear
fashion over the period
30–180 seconds*3

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1. Beals D, Ngo T, Feng Y, et al. Development and laboratory evaluation of a new toothbrush with a novel brush head design. Am J Dent 2000; 13: SpIss 5A–13A.
2. Gallagher A, Sowinski J et al. The effect of brushing time and dentifrice on dental plaque removal in vivo. [Accepted for publication in J Dent Hyg]
3. Zero DT, Creeth JE et al. The effect of brushing time and dentifrice dose on ﬂuoride delivery in vivo and enamel surface microhardness in situ. [Manuscript submitted]
AQUAFRESH is a registered trade mark of the GlaxoSmithKline group of companies.

[20] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

20 Implant Tribune

IT page 19

have good primary stability
and sites with a fully preserved

extraction socket with no bone
dehiscence. Immediate provisionalization should be proposed only if an appropriate

Figs 2f to 2h: Healing of
the soft tissue was remarkable with preservation of the interimplant papillae at 6
months. (Restoration
by Dr Nitzan Bichacho,
Tel-Aviv, Israel).

initial insertion torque has
been applied to the implant.22
Implant placement in extraction sockets combined with im-

mediate function has been
widely reported.20,23–25
The esthetic success10,26,27 is
related to Total Tissue Preservation and to several other parameters, including maintenance or re-establishment of
harmoniously scalloped soft
tissue lines and natural contours, number of missing teeth,
location of missing teeth and
the relation to the midline,
whether missing teeth are adjacent, etc.

OsteoCare

™

Implant System

www.osteocare.uk.com

5 - Day
Implant Course

Single -tooth replacement
A single tooth replaced by a
single-implant restoration is
an increasingly popular treatment option, especially among
young patients (Figs. 1a to 1f).
A high level of surgical and
prosthetic success is achieved
with the single-implant restoration.26,28 A significant reduction in the number of surgical procedures required, and
elimination of the need for a
provisional prosthesis between the surgical and prosthetic phases of treatment are
among the advantages of the
immediate-loading protocol.
This procedure has shown predictable clinical success and
possible preservation of the
existing osseous and gingival morphology. Immediate
restoration of implants placed
immediately in fresh extraction sites can provide a safe
treatment option, with success
rates of 94 per cent to 98 per
cent.20,25
Atraumatic tooth extraction
is essential for successful immediate implant placement
and the maintenance of the
buccal plate (see Fig. 1c). The
most important factors and
main prerequisites for immediate loading are sufficient initial implant stability and insertion torque of about 40 N/cm.
When a single-tooth implant is
immediately loaded, the implant-abutment connection
should also be stable; primary
stability is fundamental.

Cairo, Egypt
The 5-day intensive course is designed to
introduce the basic as well as the advanced
concepts and principles related to Dental
Implantology, with the emphasis on using
the transmucosal technique.

Single-tooth replacement
does not actually represent immediate functional loading,
since clinicians normally prevent any occlusal function of
the provisional restoration.
Therefore, these types of
restorations are classified as
immediate provisionalisation
only.

This CPD accredited course is held in the impressive
& professional surroundings of the OsteoCare™
Training Centre, Cairo, Egypt and hosted by Professor
Amr Zahran BDS, MDS, PhD, Cairo University.

A strong advantage of this
treatment protocol is immediate placement of the restoration. This eliminates the need
for a provisional removable
prosthesis and leads to satisfactory esthetic results. Second-stage surgery is unnecessary, and excellent soft tissue
healing occurs predictably,
with a stable mucogingival
junction in relation to adjacent
teeth and with preserved interproximal papillae. These clinical outcomes reduce the necessity of further surgical procedures to improve the gingival architecture.

Each delegate will place implants under supervision,
using a wide range of OsteoCare™ implants.

Multiple adjacent implants

For more information or a Full Course Programme,
please contact Barbara Baker: 01753 770006 or
E-mail: barbara@osteocare.uk.com

Replacement of multiple
adjacent teeth with fixed implant restorations in the anterior maxilla is poorly documented. The esthetic results
are not always predictable because the mechanism of tissue
behaviour in the context of the
esthetic outcome is still not
fully understood.29 The distance of the bone crest from the
restoration’s contact point is
related to the presence of the
interimplant papillae.6,30 This
may imply that preservation of
this bone crest is imperative for

[21] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009
interimplant papilla regeneration.6,16
The effect of immediate implants on non-compromised
bone shape and quality (for example, in the maxillary premolar and anterior mandibular
regions) is less important.
However, it becomes a major
contributing success factor
when bone shape and quality
are compromised (for example, in the anterior maxillary
region and posterior regions of
both arches). The preservation
of alveolar ridge dimensions
immediately after tooth extraction has been documented.11
Immediate loading of multiple adjacent implants in a partially edentulous arch could result in success rates even higher
than those for single-tooth replacement20 (Figs. 2a to 2j). This
might be due to the distribution
of forces among the adjacent
implants and the absence of rotational forces that act on a single implant.

‘Immediate
restoration of
implants placed
immediately in
fresh extraction
sites can provide
a safe treatment
option’
As with single-tooth implants, the clinician is advised
to eliminate any function of the
provisional restoration for the
first three to six months, which
is the waiting period prior to final restoration.

Tips for success
Several important parameters should be considered for
successful implant placement
with immediate loading:
• Primary stability is crucial
(40 N/cm is recommended). An
implant with stability less than
30 N/cm should not be loaded.
• Flapless surgery is preferable
in the esthetic zone.
• Gap filling is recommended at
the esthetic zone.
• The use of membrane is not
necessary.
• Implant placement should be
slightly palatal for better esthetics and volume maintenance in the anterior maxilla
(with augmentation at the buccal area).
• Rigid fixation is used when
more than one implant is involved.
• The provisional crown or fixed
partial denture should not be in
occlusal contact.
• Strategic extraction should be
considered when it allows
placement of longer implants,
which leads to better prognosis
and prosthetic positioning, especially in the esthetic zone. IT
References are available on request.

Implant Tribune 21

About the author
Dr Devorah Schwartz-Arad
received her DMD and PhD degrees from the Faculty of Medicine,
Hebrew
University,
Jerusalem, Israel. She is a specialist in oral and maxillofacial
surgery. She is a member of the
Specialty Examination Board for
Oral and Maxillofacial Surgery in
Israel, has published numerous
scientific articles and abstracts
and presented more than 100 papers at scientific meetings in Is-

rael, Europe and the United
States. She has been awarded
several academic and professional awards, including the Israeli Academy of Sciences and
the Israel Cancer Association.
She has been a lecturer and a senior lecturer for more then 20
years at the Department of Oral
and
Maxillofacial
Surgery,
School of Dental Medicine, Tel
Aviv University and is a wellknown lecturer internationally.

Dr Schwartz-Arad is the owner
and senior surgeon of an active
Day Care Surgery Center specialising in oral and maxillofacial
surgery, qualified by the Israeli
Ministry of Health for Surgery
and General Anesthesia with
special expertise in orthognatic
surgery, bone grafting and dental
implantation.
To contact her, email dubi@dsa.
co.il, visit www.dsa.co.il or call
+ 972 3549 7368.

[22] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

22 Education

The importance of structure
If you decide to add orthodontics to your treatment list, it’s essential you
choose a system that will aide accuracy of treatment, says Andrew McCance

rthodontic treatment is becoming more accessible,
which can only be a good
thing for patients. Innovative new
systems have enabled general
dental practitioners to offer treat-

ment for mild to severe malocclusions, with the close support of experts in the orthodontic field.
Thanks to the media, people in
the UK are becoming more inter-

ested in achieving straight, white
smiles. One of the benefits of orthodontic treatment is that it achieves
this naturally, using the patient’s
own dentition, and the results can
be truly life changing. However, or-

thodontic treatment requires considerable expertise to perform, and
can seem daunting to dentists who
already spend a great deal of time
on continuous study to improve
their skills and knowledge.

Straightforward options
Fortunately, the leading system has been designed so that it is
organised into a clear structure.
This provides GDPs with the most
straightforward set of options,
and experts are on hand to discuss
cases and offer support. When a
dentist decides to add orthodontic
treatment to his or her treatment
list, it is imperative to look at the
way the system is organised, since
this will impact greatly on the
speed and accuracy of treatment.
The leading system is organised into five key elements, with
each one addressing a specific area
of treatment. Not only does this
make the system more intuitive for
GDPs, it also promotes appropriate
implementation and treatment. It
is highly unlikely, with a clear system of processes, for the GDP to
miss a crucial stage of the process,
and excellent results are facilitated
by the step-by-step approach.

Five key elements
The first step is pre-alignment,
and in the leading system this part of
the process involves the use of the
CODA expansion device. This affects expansion in both arches using
very light elgiloy wire and soft esther
acrylic. Pre-activated and pre-adjusted in the laboratory, the CODA is
easy to utilise for the dentist.

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The second key element is
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a number of options. Fixed wire and
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a positioning tray in the anterior
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The third element is alignment, which uses a set of clear,
medical-grade polymer positioners to move teeth incrementally in the desired direction.
The fourth step involves finishing and detailing, with a variety
of devices including extrusion
elastics, buccal segment settling,
the final occlusion refinement and
detailing appliance and more.

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The fifth element includes the
extras, a range of applications for
bite opening and anchorage, as
well as attachments for gaining a
greater purchase on the tooth.
With these five elements, the
leading system helps GDPs not
only offer orthodontic treatment to
patients, but also work confidently,
without feeling over-awed by the
wealth of options available. DT

About the author

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patients treated annually in his specialist practices. Call 01342 337910
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[23] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

DCPs 23

How to give feedback
As a practice manager, you must regularly inform your staff about their
performance. Nikki Berryman explains why this is beneficial and how it
can be done successfully

eedback is a powerful motivator. It is an indicator that
the job we are doing is important, it is crucial for learning
and development and it is one of
the main tools in monitoring performance in ourselves and staff
members. Feedback is essentially a way of conveying appropriate, significant information to
others and to some degree is a
trust-building exercise. It can
also be a way of learning more
about ourselves and others.
As a practice manager, you
must regularly inform your staff
about
their
performance.
Whether they are performing
well or need to do something better, giving feedback means acknowledging what was done.

A good manager will deliver
both positive and negative feedback by:
• Being genuine, honest and
open
• Being specific and direct
• By giving encouragement for
improvement when feedback is
negative
• Genuinely listening to the response
• Giving time for reflection/discussion
• Being consistent.

Start with the positive
Always start with positive
feedback, it makes people feel
warm, motivated and encouraged and therefore more open to
receive negative feedback (if
necessary). Show and advise
how to turn negative feedback
into a positive result, this will
give your team member a goal
and something to work on rather
than focusing too much on what
they actually got wrong.
It is important to be very specific and to avoid generalisations, there needs to be as much
detail as possible in order for the
recipient to use this as a learning
process. Make it clear that the
feedback has come from you, for
example, ‘I thought that…’ This
is especially important where
negative feedback is concerned
as it removes any thought of ‘being ganged up on’. We need to remember that the person to whom

you are giving feedback must always be encouraged and given
the opportunity to respond.
Negative feedback, if treated
appropriately, can be a positive
experience. Robert Heller (1998)
stated: If you only get positive
feedback, it may well not be the
whole truth.

‘If you only get
positive feedback, it may well
not be the whole
truth.’
When to give feedback
Meetings can be used to give
or receive generalised feedback
as to how a system/technique
may be working within the practice. Meetings should never be
used to offer personal negative
feedback. Daily management
meetings – 20 to 30 minute sessions at the beginning of each
day, to discuss the day ahead and
give or receive feedback from the
day before.
Team meetings (for example,
weekly) – individual teams can
organise and run these between
themselves. Excellent for improving communication levels
between staff members. Sometimes allow people to become
more expressive and confident
where they wouldn’t normally
due to ‘managerial’ presence.
Appraisal – these can used to
give feedback as a whole, i.e. how
someone is developing within
the practice. This is the most
commonly used way of giving
feedback; but practice managers
must ensure that the yearly appraisal is not the only time that
feedback is given.
One–to–one – private one-toone sessions should always be
used for negative feedback. Positive feedback is also better given
in this kind of situation, there are
no distractions and people will
be able to take in what is being
said to use as a learning tool.

End of day – for example,
‘Thanks for coping well with a
difficult day’ – simple feedback
for a job well done.
Coaching and mentoring - the
coach/mentor will be expected
to give feedback. Assign each
staff member a mentor. This does
not necessarily need to be someone who is ‘above’ them in the
practice hierarchy. It is about
having someone to communicate with, to discuss ideas with, to
get feedback from.
Coaching sessions – in a business where innovation is built
into the culture, coaching is an
ongoing process. Coaching sessions with a peer (from inside or
outside the business) can provide improved communication
and positive feedback.
Feedback is better given on a one-to-one basis

Points to note
• Feedback must be acceptable
and useable
• Focus on the ‘here and now’

‘How can you
expect your
team members
change, develop
or improve their
performance
if you, as their
manager, are not
giving regular
feedback?’

between assertiveness and aggressiveness. It is generally
recognised that most people fluctuate between these two areas.

change, develop or improve their
performance if you, as their manager, are not giving regular feedback?

Assertiveness
• Being able to say what you
mean clearly and confidently
• Ability to stand up for your
rights
• Being open
• Being objective
• Not using undue emotion

This article is an extract from
one to be published in the Autumn 2009 issue of Dental Management, which is sent free to
all members of the British Dental Practice Managers' Association. The BDPMA is the essential forum for dental practice
managers and organises seminars on all aspects of practice
management. For more information telephone the BDPMA
at 01452 886364 or visit
www.bdpma.org.uk DT

Aggressiveness
• Harsh tone of voice
• Body language – wagging finger, rolling eyes, shaking head
• Not listening
• Over forceful communication
of beliefs
• Causing offence

About the author
• Share ideas – do not lecture
with advice
• Learn to listen
• Both positive and negative
feedback should be delivered in
a positive way
• Be specific
• Feedback sessions should be
held in an atmosphere of sensitivity and support

Where to start

How to feed back

If as a practice manager you
do not feel confident giving feedback; the easiest place to start is
of course with positive feedback. It doesn’t have to be over
the top, a simple thank you for a
job well done will suffice. As you
learn to be more confident and
as you begin to give more regular feedback it will become easier to give negative feedback
where necessary.

Assertiveness is also an important part of feedback. However, there are clear distinctions

The golden rule is: how can
you expect your team members

What are you doing now?
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mmm$_dl[djehoY_hYb[$Yec

Nikki Berryman
is BDPMA membership co-ordinator and practice manager for past
10 years of Pure Dental Health and
Wellbeing Centre in Truro, Cornwall. She is also a qualified dental
nurse, has a diploma in dental
practice management (DipDPM)
and a diploma in management
(DipMngmnt). She has been married to Paul for 14 years and she enjoys running, hiking, cricket
(watching, not playing), cooking
and spending time with friends on
the beach.

[24] => DTUK2109_01_Title

Together, guiding the way to long-term oral health
Recommending Oral-B® Power toothbrushes can help your patients reach their long-term oral health goals.
That’s because the unique small round brush-head design and the oscillating-rotating cleaning action ensure
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[25] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009
Ed Bonner considers

dom after you have completed
your 1.000th crossword.

The case for… and against

Keep on achieving

Returnment
W

It is now an established fact that
our minds if left unemployed
wither as quickly as our bodies as
we age; yet if put to use, can achieve
extra-ordinary things. The author
of these thoughts has often wondered why great pianists and other
musicians, composers, artists and
authors live to a grand old age, no
matter how dissolute their lives,

hat is ‘returnment’? Very
simply, it is the act of returning to work after one
has retired. Now, I know many
people whose entire working lives
have been devoted to arriving at
that magical moment when they
clear their desks or instrument
drawers or whatever, attend the
farewell drinks celebration of
their years of diligence and hard
work, and wave goodbye for the
last time to those they have worked
with for so long. With the first installment of their hard-earned
pensions about to grace their bank
account, they are all set to head for
the golf course or bowling green be
it in Merton, Margate or Majorca.
Just think, never having to worry
ever again whether that crown will
fit, never having to listen ever
again to some ancient biddy complaining about her lower denture
rubbing on her gums.

The perfect scenario?
Lot to be said for that – having
time for the garden, the grandchildren and the geographical locations you have always wanted
to visit; having heaps of quality
time to spend with your spouse
with whom you have spent so
many years not spending time.
Or even to settle down and write
that novel that has been tossing
around in the back of your mind
for so long. Or learn to play the
guitar, easier because your fingers are still supple and loose, or
sculpt (dentistry is a form of minisculpting) What could be nicer?
But halt awhile! All may not be
rosy in the garden of retirement.
In the first instance, your
spouse will have had about 40
years of being used to not having
you under his/her feet, of not having you chattering away at breakfast, lunch AND dinner, of not having to ask if you want tea every
three hours, and, perish the
thought, of not being asked if they
fancied a roll in the hay twice a day.
Then, think about all that
knowledge you have accumulated. What to do with it? Let it
wither, or put it to some really useful use: teach? You always got on
well with young people and would
certainly find telling what really
works (compared to what the theorists though really worked) quite
rewarding. Write your memoirs?
Bet you could spin some amazing
stories that you have accumulated
over the years! Write articles such
as ‘The case for… and against’ for
a dental magazine?
Go back to your practice a couple of mornings a week just to keep
your hand in on those few patients
who truly believed that you walked
on water? Take on locums where
you can work for a couple of weeks
at a stretch in between your trips to
golf on the Algarve or ski in Tignes?
That would definitely keep you in

petty cash and your hand in and
you off the street. Whatever you
decide to do, do something, unless
you literally want to die of bore-

Practice Management 25
and has come to the conclusion
that it is due to the following factors: (i) they can continue do what
they do, and do it well, even if in a
modified form; (ii) they have more
things to do than time to do them;
(iii) they retain their sense of selfworth; (iv) they enjoy the challenge
of re-inventing themselves concentrating on using their retained
strengths rather than dwelling on
their fading faculties; and (v) they
become revered role-models providing they retain their sense of humour (Katherine Hepburn said

that if you survived long enough,
you would be revered – rather like
an old building).
Can’t remember who it was
who said old age is not for sissies,
but it was definitely Norman Vincent Peale who said: ‘Live your life
and forget your age!’ The immortal Mae West said something similar: ‘You’re never to old to become
younger!’ and there’s nothing that
keeps you younger than going
back to work when you don’t have
to. That’s returnment. DT

[26] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

26 Implants

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NobelReplace™ Tapered is
the most widely used implant in
the world and offers high initial
stability for all indications, including cases of immediate extraction & implant placement.
Completely colour coded and
excellent for narrow spaces between remaining roots, NobelReplace™ offers:

The Swing Mini Armrest has
the same features as Swing but
is smaller. Designed for use
specifically with Support Stool,
its smaller size suits their beautiful and stylish design to perfection.
For further information contact your regular Dental
Dealer or Support Chairs on
01296 581764, fax 01296
586583, email sales@supportstool.co.uk or visit www.supportstool.co.uk.

BioHorizons are pleased to
introduce Biologic Solutions,
their new comprehensive Biologic product portfolio, offering
a wide range of evidence-based
regeneration options to ensure
ideal site development. This
proven hard and soft tissue
range is successful in delivering
optimal aesthetics and successful implant placement.
Biologic Solutions follows
the BioHorizons history of introducing market leading products based on science and evidence based research. The
range comprises Laddec (dental bone graft), MinerOss mineralised allograft (cortical &
cancellous bone chips), Grafton
(Demineralized Bone Matrix),
Alloderm (Regenerative tissue
matrix) and the most recently
introduced Mem-Lok (Type 1
Collagen resorbable barrier
membrane of bovine origin).

move freely are essential. The
seat and back of the Support
Stool is designed to take the
weight off the incumbent’s back
and provide maximum comfort.
The fully adjustable back support and bowl-shaped seat ensuring a proper posture.

Nobel Biocare are the world
leader in innovative restorative
and esthetic dental solutions
and offer professionals an outstanding range of effective, easy
to use implants that are scientifically proven to be safe and effective.
For further information please
call: +44 01895 452 912, or visit
www.nobelbiocare.com

SaniSwiss –
Cost saving
surgical
essentials!
Are your surgical consumables costs creeping up? The
new range of Swiss quality
Drape kits and disposable giving sets from Swallow Dental
may be the answer for you. The
sterile giving sets are compatible with all major manufacturers including W&H and Nouvag
and can save you up to 9% on
your current costs. The SaniKit

Support Chairs

Ergonomically
designed for
optimum
comfort!
It is universally accepted
that maintaining a correct posture whilst at the chairside is essential for operator efficiency,
comfort and health. This is particularly important during procedures, where the clinician
spends long periods bent over a
patient, staying relatively still in
order to perform intricate procedures. Poor posture can easily result in back pain, a problem that haunts most Dentists
causing discomfort, reduced
working hours and possible
forced early retirement.
Support Chairs’ Support
Stools have been developed for
professionals
working
in
sedentary positions, where both
body support and the ability to

pre-packed drape kits provide a
time and cost saving solution for
your surgical needs. They contain a comprehensive range of
drapes and gowns and feature a
detachable traceability label for
your records and are currently
on offer from £20 per pack.
To place an order or for further information contact
Swallow Dental on 01535
656312.
Email: rebecca.jacques@
swallowdental.co.uk
www.swallowdental.co.uk

lished, scientific references
supporting our products. Due to
the consistency of our implant
design, the results from those
references are in fact applicable
for the implants that we are selling and marketing today.
The system has been documented for a range of clinical
indications, surgical applications and prosthetic solutions.
High implant success and survival rates
• Maintained marginal bone
level i.e. no or limited marginal bone resorption
• The same optimal clinical outcome with one-stage and twostage surgical protocols
• Predictable results for early
loading and immediate loading protocols
The results from our research
and documentation are published in scientific journals
and summarised in our Scientific Reviews and Documentation Summaries. For more information
please
e-mail
info.uk@astratechuk.com or
call 0845 450 0586.

Looking at
Cone Beam
Technology!
Digital Dental
have the range
to suit every
requirement
and budget.
Digital Dental offers a complete range of cone beam digital
imaging systems.

For further information call
Digital Dental on 0800 027
8393, email sales@digitaldental.co.uk or visit www.digitaldental.co.uk.

GC UK Ltd
GC Gradia is a high strength
micro-hybrid composite system with the brightness,
translucency and warmth in
the oral environment, making
it remarkably life-like in appearance providing fantastic
aesthetics combined with superb physical properties. Gradia is the material of choice for
inlays, veneers and crowns
and bridges.

As an adjunct to the Gradia
system, GC developed a light
cured composite for the highly
aesthetic reproduction of
missing gingival tissue. GC
Gradia Gum is particularly indicated for implant superstructures and for other fixed
or removable prosthesis.
GC Gradia Gum allows you
to reproduce unlimited natural
gingival shades, as the layering technique combined with a
variety of modifiers provides
endless possibilities.

The Astra Tech
Implant
SystemTM
It’s all in the
documentation

A comprehensive study programme that began in 1986 now
includes more than 300 pub-

All of the systems automatically switch between the
panoramic and CT sensor and
can replace your existing OPG
– enabling you to scan every
type of image without the need
to purchase more than one device.

Digital Dental

Scottish Dentist July/August
edition 09

You can count on Astra Tech
for solid documentation and reliable clinical results. In fact,
our implant system is exceptionally well documented. At
Astra Tech, documentation is an
integrated and essential part of
the quality assurance process.

Top-of-the-range, the Reve
3D is the first system to offer
Free FOV ranging from 5cm x
5cm to 15cm x 15cm. This further extends the range of diagnostic capabilities and includes various default values
for greater operator convenience.

The entry-level Uni-3D is a
combined panoramic and small
FOV cone beam CT system
which can be upgraded with a
one shot Ceph for orthodontic
applications. It has been designed for the multi-disciplinary practice which carries out
implant dentistry. The midrange Duo 3D offers a wider selection of fields of view, with
four options between 5cm x 5cm
and 12cm x 8cm.

GC FitChecker II is the perfect material to check the fit of
your crowns and bridges, as
well as dentures. This A-silicone has excellent flow characteristics enabling minute
surface detail to be recorded.
You can easily identify even
subtle misfittings according to
the tone and translucency of
the set FitChecker II, which
has a film thickness of just 15
microns.

For further information please
contact GC UK on 01908 218999
or visit www.gceurope.com

DT page 27

[27] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009
DT page 26

All-on-4

Predictable
Treatment
Results

The rehabilitation of the
edentulous maxilla and the
mandible always presents a
challenge for professionals.
The All-on-4 evidence based
procedure enables implantologists predictable results in even
the most difficult of cases.

The procedure is based on
placing two straight anterior
implants and two angulated
posterior implants to avoid the
sinus/nerve but at the same
time reduce the cantilever.
Dental professionals will benefit greatly from the All-on-4
treatment outstanding features
including:
• No complicated bone grafting
procedures required
• No sinus lifts required
• No nerve repositioning required
• Limited/Shorter cantilevers
on posterior implants
• Faster treatment time
• Compatibility with NobelGuide ™
Complete rehabilitation of
the upper and lower jaw can be
costly and time consuming.
Practices that offer less expensive, immediate loading techniques will be able to create a
better service patients and offer
faster, less traumatic procedures and a speedy recovery.

flexible configuration, quality,
cutting edge technological innovation, modern design and
value for money.
Convenience
A relaxed practice team is
the ideal basis for an efficient
workflow. You can now actively
shape your working environment. Thanks to their compact
dimensions, our C+ products
deliver clear ergonomic benefits, even in compact treatment
rooms.
Optimal Workflow
The user-friendly features
of the C3+, C4+ and C5+ not only
eliminate unhealthy fatigue
symptoms, but also promote an
optimum
workflow.
Each
model is based on a proven ergonomic concept.
Enhanced comfort for patients
Make sure that your patients
feel as comfortable as possible.
Thanks to the ErgoMotion system, the thermo upholstery and
the anatomically designed
headrests, you’ll be uniquely
placed to enhance the well-being of your patients – and to
achieve optimum treatment
outcomes.

When slotted under fixed
work surfaces, Highline offers a
very economical alternative to
traditional fixed cabinetry. Implantologists who have already
opted for this concept have been
delighted by its efficiency and
considerable savings on capital
outlay.
For further information telephone Support Chairs on 01296
581764, fax 01296 586583, email
sales@supportstool.co.uk or visit
www.supportstool.co.uk.

Innovative
Ultrasonic
Surgery

For further information please
contact: Sirona Dental Systems
0845 071 5040
Info@sironadental.co.uk

Support Chairs Highline

Bespoke
Implantology
Storage
Solutions

NSK’s powerful VarioSurg is
the first choice for ultrasonic surgery as it is packed with features
to help control exacting surgical
procedures. Strong, precise cutting power is enhanced with TiN
(Titanium Nitride) coated bone
cutting tips that are available in a
wide variety of shapes and sizes,
increasing cutting efficiency,
and leaving a surface that aids
bone formation.
NSK’s VarioSurg employs ultrasonic cavitation of the irrigation solution reducing heat generation,
minimising
osteonecrosis and avoiding damage to any surrounding soft
tissue.

A plus for any
practice
Highline bespoke healthcare storage solutions, from
Support Chairs, are the ultimate
answer in mobile storage systems. Their Implantology Trolleys incorporate a variety of features designed to make Implantology even easier and more efficient.
Available in a choice of nine
formats they are extremely versatile and meet the exact storage requirements for each and
every individual. Probably the
reason why Highline cabinets
are becoming so widely used in
clinics, surgeries, laboratories
and treatment rooms.

BioHorizons
announce First
Ever European
Congress

The VarioSurg is fast becoming recognised as an effective
tool for implant dentists, among
them Dr. Joe Bhat BDS FDS RCS
MClinDent MRD RCSEd, Specialist in Prosthodontics and
Oral Surgery, Director of Moor
Park Specialist Dental Centre
and Fellow of the International
Team for Implantology. “I have
found NSK’s ultrasonic surgical
unit VarioSurg is multifunctional yet very easy to use and it
has certainly revolutionised my
way of performing implant surgery”.
NSK’s VarioSurg is versatile
enough to be useful in numerous areas of implant surgery including bone surgery and sinus
lifts and periodontal surgery.
For more information call
Jane White at NSK on 0800
6341909.

NEW CEREC
AC Bluecam ~
Seen in a new
light
Sirona UK is a specialist division of Sirona Dental Systems,
which for the last 5 years has
supplied and supported CEREC
3
CAD/CAM
all-ceramic
restoration system in the UK

Following the success of their
5th Annual Global Symposium in
June, BioHorizons are now delighted to announce the details of
their first ever European Congress on 8th – 10th October 2009.
Cascais, near Lisbon, Portugal, is the exciting location for the
BioHorizons European Congress
and features an impressive lineup of renowned international
speakers addressing current
trends in implant dentistry and
tissue regeneration with a special focus on satisfying and exceeding patient expectations.
BioHorizons is one of the
fastest growing oral reconstructive device companies in
the world as a result of their
commitment to providing the
most comprehensive line of evidence-based, scientificallyproven dental implants and tissue regeneration solutions.

Equipment options
Discover the various equipment options for the C3+, C4+
and C5+ treatment centers.

For more information about a
world class All-on-4 course
date in your area or to find a
Nobel Biocare mentor please
call: +44 01895 452 912, or visit
www.nobelbiocare.com

You are your practice’s most
important asset and maintaining your health is vital – Sirona’s
aim is to design our treatment
centers for your ergonomic
needs and to promote sustained
well-being. Devoting their attention to user-friendliness,

Composed of modules,
which contain sets of 4 different
drawer sizes, they can be combined in one of nine models to
create units of the required
height, width and mixture of
drawer sizes to suit the individual.

Implants 27

Speakers include internationally renowned Maurice
Salama, David Garber, HomLay Wang and Marius Steigman.
Please register now to reserve
your place at this outstanding
educational event.
For further details and to register please contact BioHorizons on 01344 752560, email:
infouk@biohorizons.com or
visit our website at www.biohorizons.com

Vital –
Still using a
membrane?
If you, like most implantologists and periodontologists find
membranes difficult to handle,
then VITAL may be the answer
for you. It is a great British product that reliably and quickly
turns into bone. Vital is simple
to use and sets to become cell
oclusive so no additional membrane is required. It is 100%
synthetic and allows implants to
be placed after 4-6 months.
For NEW clinical and research
information please contact
Swallow Dental Supplies on
01535 656312 or visit www.
swallowdental.co.uk.

With product simplicity key
to the success of any dental
practice, Sirona are now proud
to launch their new CEREC AC
Bluecam imagining unit making the CEREC even easier to
use for the dentist.

Sirona has helped to successfully integrate CEREC into
dental practices for over 22
years, with more than 24,000
systems now in place worldwide. It offers convincing longterm aesthetic restorations in a
single visit.
Sirona UK`s mission is to deliver satisfaction to the dentist
using tried and tested in-surgery training methods supported by CEREC Specialists
who are dedicated to your success.
To find out how the Sirona
team can directly support your
practice and for a no obligation
demonstration please telephone 0845 071 5040 or email:
info@sironadental.co.uk or
visit www.sironacadcamsolutions.co.uk

DIO’s
Advanced
Biotite-H
Implants

DIO’s advanced infusion technique, combining specialist
RBM surface treatment with a
special Brushite coating, has
solved the exfoliation issues
experienced by other implant
manufacturers.
Brushite is transformed into
a very stable calcium phosphate
compound – hydroxyapatite
(HA), Ca5 (PO4)3OH, which is
also found in the external periosteal callus of repaired

DT page 28

[28] => DTUK2109_01_Title

28 Industry News
DT page 27

introduction of endodontic instruments.

femoral fractures in children.
Significant improvements in
stability have been achieved by
providing an increased amount
of calcium ions (Ca2+ and
PO42-) to the transforming media due to compound solubility,
accelerating osteogenesis and
mineralization. The advanced
Brushite coating increases the
blood osteoblast count on the
implant surface and accelerates
and enhances osseointegration
between implant and bone. The
implants effectively speed up
osseointegration by dissolution
and promote recovery by promoting bone formation around
the implant.

R&S Cat Files have been
shown to be stronger and more
flexible than regular K files due
to the square cross-section of
the instrument. These stainless
steel files reliably move
smoothly through the canal establishing a glide path in the
canal for successive shaping.

DIO is so confident about
their technological advances
that they are offering coated
surface options for their most
successful dental implants. The
hybrid implants (BioTite-H) receive a dual surface treatment
consisting of a biocompatible
Brushite coating (Cap) and advanced RBM surface roughness.

The 21mm R&S Nerve
Broaches are available in a
range of sizes from 15-60 in
pack of 12 instruments; all
colour co-ordinated to allow for
easy identification.
To see the full range of R&S
Endodontic Instruments or
further information please
contact Dental Sky on 0800
294 4700.

Quiet &
Compact

For more information, visit the
website at www.DIOUK.com.
Alternatively, email sales@
DIOUK.com or call 0845 123
3996 to speak with a qualified
representative.

Industry News

Simplify
Your RCT
with R&S from
Dental Sky
The R&S range of endodontic instruments are market
leaders in Europe and with
Dental Sky as the exclusive UK
distributors they are sure to be a
success in this country.
Being high quality, R&S endodontic instruments bring reliability to all of your endodontic
work. The useful R&S EndoAccess Nickel-titanium instruments provide easy access by
widening the coronal third.
With a non-cutting tip to avoid
damage to the canal R&S EndoAccess Nickel-titanium instruments help to simplify the

It almost goes without saying that compressed air and
suction are key requirements
for any practice. Therefore securing their provision in an efficient and economic manner is
one of the most important decisions for the business can take.

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

Eschmann, the first name in
infection control, is proud to introduce the powerful SeptProtector, the complete surgery
disinfection
solution.
Microparticles and bacteria, particularly those distributed by
dental turbines can contaminate exposed surfaces and remain active for many hours
within the surgery.
The SeptProtector is specifically designed to safeguard
against cross-infection risks.
• Reliable, automated, handsfree disinfection of all patient
areas
• Protects against microbial, viral and sporicidal contagions
• Disinfects all exposed surfaces more effectively than
manual methods
• Proven broad spectrum Hydrogen Peroxide/Silver Nitrate disinfectant
• Silver Nitrate technology enhances the level and longevity
of protection
The SeptProtector utilises
the specially formulated SeptProtectol, which is automatically dispensed at the correct
volume for the size of the room.
Treatment takes no more than
90 minutes and will not interfere with the usual daily routine.
Full
protection
is
achieved after only two treatments, providing protection in
areas of normal traffic for several days.

The unit offers the versatility of a ‘wet’ suction system (the
Durr VS type) or a ‘dry’ option
(the Durr V type) where the
functionality separates air and
water.
Perhaps the most remarkable features are the sound and
size, or rather the lack of them.
The new PTS120 is no louder
than a standard dishwasher and
in size no larger than a fridge,
meaning you can get state of the
art technology and maximum
efficiency all from a device you
could fit in your kitchen! What’s
more the PTS120 is easy to install and operate, it doesn’t require miles of cabling and this
helps to keep installation and
on-going maintenance costs
down.

nity to take part in hands-on
workshops with Dr. Jackson
where they will be able to use
the new Empress Direct system
now available from Ivoclar Vivadent. This new system is a dynamic, state-of-the-art, naturally shaded composite system
that has recently been introduced by the company.

Introducing
SeptProtector
for complete
surgery
disinfection

For complete confidence in
effective infection control, dentists choose Eschmann.
For more information on the
latest solutions to sterilisation, contact Eschmann on
01903
875787
or
email
ic.sales@eschmann.co.uk,
www.eschmann.co.uk

A great solution, and although we want to shout about
it, you’ll agree it’s definitely one
that’s on the quiet.

NEW Velopex
Extra-X

For more information call
01536 526740.

The new x-ray processor for
all sizes of intra-oral x-ray film,

panoramic and cephalometric
film sizes – up to 24x30cm will
be arriving over the Summer.
Simple Technology delivering proven archival quality film.
The new Velopex Extra-X is
a high quality intra and extraoral x-ray film processor that
has been designed to make the
processing of film simple.
• Simple to use and operate in
daylight - making the darkroom a thing of the past.
• Simple to position – its compact design means that it can
be sighted almost anywhere in
the surgery, sterilisation room
or office.
• Simple to maintain - making it
very user friendly.

Additionally a practical
overview will be given on opacity and translucency as well as
achieving finishing and polishing both quickly and predictably.
As places are limited those
wishing to attend are advised
to register quickly. Please
contact Ivoclar Vivadent directly on 0116 284 7880 for further information or to make
your booking for either the
19th or 20th November.

Adec

The unique film transport
system has been designed by
our engineers to make ‘lost’
films a thing of the past.
The new Extra-x has a ‘interupt’ facility for rapid processing of endodontic films.
This means that a ‘wet’ film is
available for viewing in just 2
minutes!
For more information please
call Mark Chapman on 07734
044877, or your normal
Dealer

Ivoclar Vivadent
and Dr. Ron
Jackson To
Demonstrate
The Art of
Direct Resin
Leading industry expert Dr.
Ron Jackson of the American
Academy of Aesthetic Dentistry
has teamed up with Ivoclar Vivadent to present two one day
courses on the Art of Direct Resin.
The two seminars which include
7 hours verifiable CPD will be
held on 19th and 20th November
2009 at LonDEC the world class
facility for continuing education
in the centre of London.
Those attending the day programmes will have the opportu-

A-dec is delighted to announce the results of the BDTA
Certificate: ‘Introduction to
Dentistry’ exam taken by 15 Adec employees during May,
June and July this year. All candidates passed the exam with
flying colours; 9 receiving distinctions!
Every year over 170 individuals from different dental companies study for the BDTA Certificate: Introduction to Dentistry examination to enhance
their understanding of the industry in which they work.
Under the BDTA’s Code of
Practice, members are responsible for ensuring that their staff
has the ongoing experience,
product knowledge and ability
necessary to perform their duties properly and effectively.
This includes effective and
timely response to customers’
queries.
Successful A-dec candidates
look forward to receiving their
individual certificates during
the forthcoming Dental Showcase at the NEC. The results received are a reflection of the
dedication by the A-dec team to
the company, the profession
and their customers.
For more information about
A-dec and its products and
services, please call 024 7635
0901.

DT page 29

[29] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009
DT page 28

Ledermix:
Effective Pain
Relief for
Endodontic
Treatment

Blackwell Supplies is proud
to offer Ledermix, the established solution to the pain and
inflammation patients experience in cases of pulpitis. Ledermix combines the antibiotic action of Demeclocycline with the
anti-inflammatory action of Triamcinolone and is particularly
useful as an emergency measure in endodontic therapy,
where it can be used to fill in the
root canals between appointments.
Ledermix is available in
Combination Kits comprising
the Dental Paste and Dental Cement, with Hardeners for fast or
slow setting. The Dental Paste
contains one third more steroid
than the Cement, and is preferred in the treatment of exposed pulp. In the case of irreversible pulpitis, the Paste reliably relieves pain until definitive root canal therapy can be
carried out.
In small pulp exposure
cases, the Cement is excellent
as a pulp-capping agent and if
the dentine is hypersensitive, it
can be used as a temporary sublining for deep cavities where
no exposure has occurred.
For a copy of the Summary of
Product Characteristics (SPC)
please call John Jesshop of
Blackwell Supplies on 07971
128077 or email john.jesshop@
blackwellsupplies.co. uk

A Six Hit
It’s becoming increasingly
commonplace for dental practices to contain multiple surgeries. The advantages of this strategy are many; it allows dentists
and hygienists to work concurrently, it minimises waiting
times and allows more flexible

from the Genus team, and access
to cost-effective and high quality
equipment, furniture, fixtures
and fittings, the end result will
match your vision and suit your
needs down to the ground.

opening times for patients (for
example early morning or later
evening to fit in with their working days).
This trend has led to a different and more exacting set of requirements for many of the
tools and systems within a surgery, and Dürr Dental’s VS1200
S suction system is the perfect
response.
Dürr Dental already provide
a range of units (the VS 300 S, VS
600 and Vs 900) to suit practices
of varying sizes and the VS
1200S is the latest in this range.
Like the others, installation and
ongoing maintenance are trouble free and low cost. Furthermore, the VS 1200S is made from
corrosive free materials and is
therefore
very
extremely
durable.
For further information contact your dental supplier or
call 01536 526740.

How to score in
Endodontics.
Old Trafford, Manchester
United (5 Nov) & Stamford
Bridge, Chelsea (6 Nov) football
stadia are the exciting venues
for this amazing learning opportunity. This multi media
course is designed for the general practitioner to improve
their daily endodontic skills.

Areas covered will include diagnosis, case selection, the latest
endodontic instrumentation
and the cleansing, shaping and
packing of the root canal system
in three dimensions with warm
obturation techniques and
bonded obturation. Dr Rich
Mounce, DDS, the widely published US endodontist, will conduct the day which includes refreshments, lunch & complimentary tour of stadium & museum. There will be an
opportunity to use TF Twisted
Files at the end of the presentation; kindly bring accessed extracted teeth. Please send your
cheque for £150 made payable
to Ormco BV (SybronEndo Division) to Keith Morgan c/o Kavo
Dental Ltd., Raans Road, Amersham, HP6 6JL.
Contact keith.morgan@sybrondental.com for full key learning
objectives.

Griptab by
Triodent
Griptab changes the way indirect restorations are handled.
Placing crowns, veneers, inlays and onlays can be frustrating because of their size and
slippery surfaces. That has all
changed thanks to the Griptab
by Triodent.

Industry News 29

For more information please
call Genus on 01582 840484 or
email info@genusgroup.co.uk,
www.genusinteriors.co.uk

The Griptab, which comes in
three sizes, is effectively a small
handle that is adhered to a
restoration. The light-cured,
flexible adhesive is strong and
resistant to Silane and moisture, but at the same time is easily and cleanly detached from
the restoration at the end of the
procedure.
By having a handle on the
restoration, the dentist has a reliable grip using Triodent PinTweezers or a small hemostat,
for total mastery of the placement process.

Excellent
Oral Health On
the Go
Curaprox knows that maintaining an excellent level of oral
health is sometimes difficult
away from home or when short
of time. The Curaprox Travel
Sets feature everything you
need for healthy teeth and gums
when you’re on the move, be it
on holiday, business travel or
just for your handbag.

Griptab ensures precise
control during try-ins, and during hydrofluoric acid-etching,
silanation and even ultrasonic
cleaning. The restoration can
be picked up and released multiple times in a passive, controlled way with no risk of dropping it.
For more information, go to
www.triodent.com or ph
0800-311-2097.

Nothing
Compares To
Genus Design
and Build
Nothing compares to seeing
your dreams realised. Genus
takes great pride in helping dentists achieve their ambition of
providing cutting edge treatment
in a stylish and fully compliant
environment, with its celebrated
Design and Build service.

The Handy Travel Sets are
available in translucent yellow,
green, red and blue and include:
• Mini Tube of Curasept Gel
Chlorohexidine Toothpaste –
Non staining, contains fluoride and is antibacterial for effective, gentle cleaning
• Tartar Stick – Anatomically
shaped with a mineral based
surface specifically designed
for ease of use
• Toothbrush – Modified CS3960
super soft head with detachable handle for folding away
Curaprox offers a broad range
of innovative products developed
for optimal oral health and hygiene including soft bristle toothbrushes, interdental brushes,
toothpastes and mouthwash.
For free samples please email
clare@curaprox.co.uk
For more information please
call 01480 862084, email
info@curaprox.co.uk or visit
www.curaprox.co.uk

When you work with Genus,
your expectations are exceeded.
At the design stage, the Genus experts use the latest software and
technology to set out your vision,
taking into account all new and
existing industry requirements.
Then you see your vision take
shape during the construction
phase, with a dedicated specialist ensuring that everything runs
smoothly and that time and
budget limits are respected.
Genus understands that this
is your dream, and with an accountable point of contact
throughout the project, you stay
in control. With reliable advice

Dentomycin
for Effective
Periodontal
Management
With periodontal health a major element in the success of many
dental treatments, Blackwell Supplies’ Dentomycin is an essential
adjunctive treatment in the fight
against periodontal disease.
Containing 2% minocycline,
an antibiotic well known for its
ability to eliminate key periodontal pathogens, Dento-

mycin’s gel formulation binds to
the root surface and is slowly released over time.
Dentomycin’s anti-bacterial
action helps to maintain the reduction in bacteria levels
achieved through scaling and
root planning, preventing levels returning to baseline within
the typical period of 8 weeks.
Blackwell Supplies is committed to providing high quality,
high performance products like
Dentomycin to the dental profession and has additionally produced a patient information
leaflet ‘How healthy are my
gums? – Help and advice on your
oral care’. This important publication is available free to practices and patients and is designed
to help promote better oral
health and combat periodontitis.
For more information please
call John Jesshop of Blackwell
Supplies on 020 7224 1457, fax
020 7224 1694 or email
john.jesshop@blackwellsupplies.co.uk

Lemonchase
Denatl
Lemonchase, the renowned
loupes and lighting specialist,
have launched a dental consumables division. Their new range
includes low-cost, high quality
USA made Wolf Fibre-Optic
Handpieces that are compatible
with all other brands, including
Bien Air, Kavo, W&H, NSK, Midwest & Star. Uniquely designed to
be self-maintaining, the handpieces are priced at only £369 +
VAT - and with the move to dental
dishwashers and central sterilisation, they’re proving a very popular and cost-efficient alternative.
Lemonchase are also supplying a full range of KUT presterilised and individually
packaged Diamond Burs at extremely competitive prices.
The company will continue
to supply its world leading
loupes & LED Lights from Designs for Vision – as used by over
half of all USA Dentists.
Lemonchase can be reached
on 01892 752305 and Lemonchase.com (or lemonchaseconsumables.com for extra online savings).

[30] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

30 Events

BSDHT Oral Health Conference and Exhibition 2009
Don’t miss a galaxy of learned speakers and the largest ever trade exhibition hosted
by the society with more than 50 stands

T

he UK’s major event for
dental hygienists and
dental hygienist-therapists takes place on 16 and 17
October at Bournemouth International Conference Centre,
and offers something of interest

to all members of the dental
team.

Diamond Jubilee
In 1949, 12 dental hygienists
established the British Dental

complemented by a Diamonds
are Forever themed Diamond
Jubilee Dinner on Friday 16 October, taking place in the Victorian splendour of the Royal Bath
Hotel on the Bournemouth
seafront.

Hygienists’ Association, which
evolved into the British Society of
Dental Hygiene & Therapy. With
the society celebrating its 60th
anniversary in 2009, this year’s
Oral Health Conference & Exhibition will be a special event,

Eminent speakers
Marina Harris, President of
the BSDHT, will open the conference itself on the Friday morning.
Martijn Rosema, a widely respected researcher and co-author of many books, is the first
speaker of the conference and
will discuss Prevention of gingivitis: fact, future or fantasy?
Edwina Kidd follows, with an
important session on caries –
what it is and how it can be
treated. Entitled: The role of the
dental hygienist/therapist in the
treatment of caries, this one-hour
session is not to be missed.

Annual award
At midday the AGAM takes
place – an event all BSDHT members are encouraged to attend. After lunch, the Dr Gerald Leatherman Award will be presented.
Friday afternoon belongs to
Phil Ower as he runs two sessions
in which he asks: Periodontal
therapy at the crossroads – infection or inflammation? This session has been named The Graham Smart Memorial Lecture in
honour of a great man who died
recently, an ardent supporter of
the dental team, and who was
scheduled to co-present with Phil.

    
   
   
  

    

 
Day two



Saturday’s lectures commence with Martin Fulford and:
Infection control - an update.

 

   
   
  

The provocatively titled session, Evidence based dentistry –
do we care?, comes next with Dr
Keith Milsom speaking.

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Professor Stephen Flint takes
delegates to the lunch break as he
discusses drugs and osteonecrosis
of the jaw in: Bisphosphonates and
dentistry – what you need to know.

 
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Saturday afternoon begins
with Making sense of dentine sensitivity by David Gillam with
Joanne Rodriguez talking after
refreshments on: What is soft tissue management? Why do we
need it in dental practices?
The final session has Ewan
Macleod presenting: Current developments at the GDC – moving
towards revalidation of dental
professionals.
Two workshops sessions will
take place on the Friday and be repeated on the Saturday. Restorative Materials – are they ready for
the 21st Century? is being hosted
by Bob McLelland and Hot Topics
– what’s hot & what’s not! is a Core
CPD workshop to be facilitated by
Andrew Collier.
More information and a booking form can be found at www.
bsdht.org.uk. Reduced rate registration fees are available for booking made by 25 September. DT

[31] => DTUK2109_01_Title

DENTAL TRIBUNE United Kingdom Edition · September 7–13, 2009

Classified 31

Postgraduate DCP Tutors
Salary commencing at £38,666 pa (pro rata) including London Weighting
Up to six positions based across London
The London Deanery is currently recruiting for Postgraduate Dental
Care Professionals (DCP) Tutors.

The post is for either one or two sessions per week. If you are in hospital
employment you may be appointed by secondment to the post.

You will be responsible and accountable to the Postgraduate
Dental Dean for the delivery, monitoring and assessment of
postgraduate education and the continuing training for the dental
team at a local level, as well as needs assessment, mentoring
and appraisal of the dental workforce when required. You will be
based at one of the postgraduate centres funded by the Deanery
and will work in collaboration with other Deanery tutors.

Informal enquiries should be made to Raj Raja Rayan OBE
(07739303490)/raj.rayan@londondeanery.ac.uk)
or Corinne Tapsell (020 7866 3218 or 020 7866 3177/
corinne.tapsell@londondeanery.ac.uk)

A tutorial background is not an essential requirement for this post,
you must however, be fully registered as a DCP with the General
Dental Council. You will be enthusiastic with a commitment
to continuing professional development, both of yourself and
the Dental Team of Nurses, Hygienists, Therapists and Dental
Technicians. In return, we offer a bespoke training programme to
enhance your personal development in this role.

Alternatively for general enquiries email ldnrecruit@
londondeanery.ac.uk or call 020 7866 3176
during business hours (09.00 - 17.00).

To apply online, visit our website

http://www.londondeanery.ac.uk/var/recruitment/
internal-recruitment

Closing date for receipt of applications and detailed
curriculum vitae: 14th September 2009.
Interviews will be held week commencing
21st September 2009.

www.londondeanery.ac.uk

Something to
Smile about!...
SmileGuard is part of the OPRO Group, internationally renowned for revolutionising the
world of custom-fitting mouthguards. Our task is to support the dental professional with
the very latest and best oral protection and thermoformed products available today.

7BMVBUJPOT PURCHASE SALE BUYING IN RETIREMENT
1VSDIBTFT PRACTICES AVAILABLE COUNTRYWIDE
4BMFT
TOTALLY CONFIDENTIAL SERVICE FOR VENDORS

Custom-fitting Mouthguards* – the best protection for teeth
against sporting oro-facial injuries and concussion.
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BSSBOHFEGPSBOZ
QVSQPTFGSPN
BCPWF CBTFSBUF

OPROshield – a self-fit guard enabling patients
to play sport whilst awaiting their custom–fit guard.

NightGuards – the most comfortable and effective way
to protect teeth from bruxism.

 "RADMORE "UILDING "RADMORE 'REEN
"ROOKMANS 0ARK (ERTS !, 12

2EXMSR[MHI
TFSWJDF

We are pleased to announce the following pan-London core courses for

Infection Control
1st or 2nd October 2009 at the Royal College of Obstetricians & Gynaecologists,
Regents Park, London

Snoreguards – snugly fitting appliances to
reduce or eradicate snoring.

All full days course open to the whole dental team
The course will cover
t 3JTL.BOBHFNFOUBOEUIFFTTFOUJBMTPGJOGFDUJPODPOUSPM
t 5IFSFHVMBUPSZGSBNFXPSLBOEQSBDUJDBMBTQFDUTPGJOTUSVNFOU
decontamination, and the use of sterilizers
t 5IFQSFWFOUJPOPGCJPmMNGPSNBUJPOBOENBOBHFNFOUPGDPOUBNJOBUFE
dental unit waterlines
t *NQBDUPGFNFSHJOHQBUIPHFOTPOJOGFDUJPODPOUSPMJOUIFEFOUBMTVSHFSZ

OPROrefresh – mouthguard and tray
cleaning tablets.

In 2007, OPRO was granted the UK's most prestigious business award,
the Queen's Award in recognition of outstanding innovation.

“Very good organised course”
“reinforced my knowledge”
“All parts of the course were extremely useful and well presented”

Dental Law & Ethics

CONTACT US NOW!

14th October 2009 at the Royal College of Physicians, Regents Park, London

OPRO Ltd, A1(M) Business Centre, 151 Dixons Hill Road,
Welham Green, Hatfield, Herts. AL9 7JE

* SmileGuard - the first to provide independent certification relating to
EC Directive 89/686/EEC and CE marking for mouthguards.

5 
' 

LondonDeanery2009/10

Bleaching Trays – the simplest and best method for
whitening teeth.

www.smileguard.co.uk
email info@smileguard.co.uk or call 01707 251252

UFBN!GUBTTPDJBUFTDPN
XXXGUBTTPDJBUFTDPN

“All lectures were relevant to every day practice”
“very useful to have lawyers presenting”
“vey well laid out course, lots of information”
“good mix of speakers”
“well structured programme with good handouts”

Radiology, Core of Knowledge
UI.BSDIBUUIF3PZBM$PMMFHFPG4VSHFPOTPG&OHMBOE
A full days course open to the whole dental team
The aims of this course are to provide dental practitioners with an update
course in dental radiography and radiation protection, a Core CPD
TVCKFDUBTSFDPNNFOEFECZUIF(%$JOBOEDPWFSJOHUIF*3 .& 3UPQJDT
TQFDJmFEJOUIF%FQBSUNFOUPG)FBMUIT(VJEBODF/PUFTCPPLMFU
“a well run course that was interesting and full of lots of easy to
understand information”
“very dynamic speakers”
“information applicable to everyday use of radiography”

A full days course open to the whole dental team

part of the oprogroup
7320_09_3

The course will cover
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For a booking form or further details please
contact Simon Best, sbest@londondeanery.ac.uk
or call on 020 7866 3111

[32] => DTUK2109_01_Title

C

SODY

L

OR

O

PE

RTISE

YEARS

F

GU

MCARE

EX

Dual care for
gums and teeth

Corsodyl Daily Gum & Tooth Paste is different from regular dentifrices
The only formulation to contain sodium bicarbonate,
1400 ppm ﬂuoride and six natural plant extracts

Over 67% of the ingredients are for the care of gingiva and
teeth – compared to 25% in many other regular dentifrices

Backed with 30 years of dedicated
gum health expertise

Free from sodium lauryl sulfate – suitable for patients using
0.2% chlorhexidine digluconate mouthwash

Corsodyl Daily Gum & Tooth Paste is a clinically proven dentifrice,
which can kill bacteria that can cause gum disease1.
With regular brushing, it helps maintain ﬁrm and tight gums and a low gingival index2.

Recommend Corsodyl Daily Gum & Tooth Paste – because teeth need gum care too
References: 1. Arweiler N, Auschill T, Reich E , Netuschil L. Substantivity of toothpaste slurries and their effect on re-establishment of the dental bioﬁlm.
J Clin Perio 2002, 29, 615-621. 2. Yankell SL, Emling RC. Two month evaluation of Parodontax dentifrice. J Clin Dent 1988 Suppl A, A41-3.
CORSODYL is a registered trade mark of the GlaxoSmithKline group of companies.

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[cover] => DT UK 2109

[toc] => Array ( [0] => Array ( [title] => Dentists still ‘poor relation’ to GPs [page] => 01 ) [1] => Array ( [title] => News [page] => 02 ) [2] => Array ( [title] => The Steele behind the Steele Review [page] => 04 ) [3] => Array ( [title] => News & Opinions [page] => 07 ) [4] => Array ( [title] => Dedicated dental solutions [page] => 09 ) [5] => Array ( [title] => Concentrate on quality [page] => 10 ) [6] => Array ( [title] => IMPLANT TRIBUNE (part1) [page] => 11 ) [7] => Array ( [title] => IMPLANT TRIBUNE (part2) [page] => 16 ) [8] => Array ( [title] => The importance of structure [page] => 22 ) [9] => Array ( [title] => How to give feedback [page] => 23 ) [10] => Array ( [title] => Ed Bonner considers The case for… and against Returnment [page] => 25 ) [11] => Array ( [title] => Industry News [page] => 26 ) [12] => Array ( [title] => BSDHT Oral Health Conference and Exhibition 2009 [page] => 30 ) ) [toc_html] =>

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