DT UK No. 5, 2014

News / Book Review / Event Review: Top Tips For Aesthetic Brilliance Part 1 / Stress in the dental profession / Implant Tribune: Flapless MIMI® implantation using the two-piece implant shuttle preventing physiological bone loss / Implant Tribune: Fabrication of a customised implant abutment using CAD/CAM: A solution specific to each clinical case / Implant Tribune: Treatment options for peri-implantitis / The University Hospital in Copenhagen is offering its 4th Trauma Symposium in Copenhagen / Industry News

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May 2014

PUBLISHED IN LONDON
News in Brief

Neel Kothari on stress in the
profession

page 10

page 2

Peri-implantits

What are the treatment
options?

University Hospital
Copenhagen

Fourth Trauma Symposium

pages 19-20

page 21

Changes in dentistry
deterring future generations
Rising costs of training and education is off-putting says dentists
changes to the NHS pension
scheme (55 per cent).
The survey further found
that 45 per cent of dentists

DFT year.
The British Dental Association has called this an ‘attack on the youngest and most

‘31 per cent of dentists would not recommend their profession to someone at the
start of their career’

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In response, the BDA has
launched a petition to oppose
the proposals. At time of writing, the e-petition had 2,220
signatures. It can be viewed
at http://epetitions.direct.gov.
uk/petitions/64208 DT

Sixty four per cent of dentists said they were worried
about rising costs and reduced
profits, followed by the new
dental contract for England
and Wales (63 per cent) and

This comes after NHS England announced proposals to
reduce the salary paid to Dental Foundation Trainees in
England. It is proposing a cut
of nearly eight per cent to the
salary which would see those
beginning DFT in September
2014 being paid £28,076; more
than £2,000 less than those
currently completing their

M A

The survey, carried out
by Wesleyan, found that 31
per cent of dentists would

not recommend their profession to someone at the start of
their career, and 40 per cent
wouldn’t choose the same career again given the chance.

vulnerable members of the
profession’, and argues that
dental students are graduating with increasing levels of
debt. This means that they
are already facing challenges
to manage their finances and
launch their careers.

he increasing cost of
training and education,
together with the falling financial incentives, will
deter future generations from
joining the profession, said 74
per cent of dentists in a recent
survey.

were concerned about NHS reforms, while 37 per cent worried about the growth of corporate dentistry.

3D mouthpiece may help
treat sleep apnoea
A new device to treat sleep
apnoea has been developed
by Australian researchers.
A 3D technology is used to
make a customised mouthpiece which changes the
airflow through the mouth
to the back of the throat,
avoiding obstructions from
the nose, the back of the
mouth and the tongue.
The developers say that
the mouthpiece, which is
expected to be available
next year, can be tailored
to every individual’s mouth
using a 3D scan. In the UK,
it is estimated that around
four per cent of middleaged men and two per cent
of middle-aged women suffer from sleep apnoea, although the condition often
goes undiagnosed. Studies
have also shown that 60 per
cent of people over 65 years
old have sleep apnoea.

Stress

Men prosecuted for
YouTube claim

O T

Norwich-based
illegal
tooth whitener prosecuted
The General Dental Council (GDC) has prosecuted
a woman for unlawfully
carrying out teeth whitening. Catherine Davies, who
carried out the treatment
at Oasis Sport and Leisure
Complex in Norwich on 6
January 2014, has never
been registered with the
GDC. On 30 April 2014 she
pleaded guilty at Norwich
Magistrates’ Court to unlawfully practising dentistry, and was sentenced
to a 12 month conditional
discharge. She was ordered
to pay costs of £300 to the
GDC, compensation of £99
to the complainant, and a
£15 victim surcharge.

YouTube

Advertorial
Clinical

Implant Tribune

Feature

Michael Buble knocks out
tooth with microphone
Canadian singer Michael
Buble had to undergo emergency dental surgery after
he knocked out his tooth
during a Sydney concert.
Buble posted a picture of
himself wearing a mask in
a dental surgery on social
media site Instagram, with
the caption: ‘Thankfully no
one knew but I knocked
my tooth out with my microphone last night during
the second song!!’ He carried on the rest of the show,
with fans none the wiser
that he was missing a tooth.
He later visited a local dental surgery in Sydney to get
it fixed.

News

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2 News

United Kingdom Edition

May 2014

Ban sugary drinks from schools, says poll

new poll has found that
two thirds of people
would support a ban on
sugary drinks in all UK schools
and academies.
Current government policy
bans the sale of fizzy drinks,
crisps and sweets in local authority-run schools, but leaves
the decision of whether children can bring them to school
up to head teachers. These
rules do not apply to acade-

mies, free schools and private
schools.
The poll, carried out for
BBC 5Live’s Richard Bacon programme, found that more than
four out of ten people would
support a tax on sugary drinks,
while 59 per cent said health
warnings on packaging would
encourage them to eat more
healthily.
However according to the

BBC, some representatives
from the sugar industry say it
is being ‘demonised’. Head of
food science at AB Sugar Dr Julian Cooper said: “It’s quite simplistic just to demonise one ingredient to the exclusion of all
others. We would say that we’re
probably consuming too many
calories and probably doing
too little exercise and activity. There is probably an over
consumption of all calories; not
sugar per se.” DT

Food needs tobacco-like regulation, say health experts

he food industry should
be regulated like the tobacco industry, international groups have said.

with global deaths attributable
to obesity having risen from
2.6 million in 2005 to 3.4 million in 2010.

Consumers
International
and World Obesity Federation
have called on the international community to develop a
global convention to fight dietrelated ill health, similar to the
legal framework for tobacco
control.

The groups are asking governments to introduce policy
measures designed to help
consumers make healthier
choices. These could include
pictures on food packaging of
damage caused by obesity, similar to those on cigarette packages, as well as placing stricter
controls on food marketing and
requiring reformulation of unhealthy food products.

They say that obesity currently poses a greater global
health risk than cigarettes,

Call to ban microbeads in
toothpaste in New York

ew York’s Attorney
General
Eric
Schneiderman is making
calls to ban the sale of products
containing
microbeads, such as face washes and
toothpastes.
Schneiderman

said

that

Published by Dental Tribune UK Ltd
© 2014, Dental Tribune UK Ltd.
All rights reserved.

Dental Tribune UK Ltd makes every
effort to report clinical information and
manufacturer’s product news accurately,
but cannot assume responsibility for

the beads end up in New
York’s waters and can stay
there for decades, absorbing
cancer-causing toxins. He has
received support from doctors, educators, activists and
legislators from across the
state, who all demand that the
state Senate pass the Microbeads-Free Water Act.
If adopted, products containing microbeads would
be banned by 2016. It would
make New York the first state
to ban the sale of these products. DT

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 UK.

Editor
Lisa Townshend
Tel: 020 7400 8979
Lisa@healthcare-learning.
com

Sales Executive
Joe Ackah
Tel: 020 7400 8964
Joe.ackah@
healthcare-learning.com

Advertising Director
Joe Aspis
Tel: 020 7400 8969
Joe@healthcare-learning.
com

Editorial Assistant
Angharad Jones
Angharad.jones@healthcarelearning.com

Design & Production
Ellen Sawle
Tel: 020 7400 8970
ellen@healthcare-learning.
com

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

Consumers
International
Director General, Amanda
Long, says: “The scale of the
impact of unhealthy food on
consumer health is comparable
to the impact of cigarettes. The
food and beverage industry has
dragged its feet on meaningful
change and governments have
felt unable or unwilling to act.
“The only answer remaining for the global community
is a framework convention
and we urge governments to
seriously consider our recommendations for achieving that.

If they do not, we risk decades
of obstruction from industry and a repeat of the catastrophic health crisis caused by
smoking.”

take on the corporate interests
who promote these foods. Governments need to take collective action and a Framework
Convention offers them the
chance to do this.” DT

World Obesity Federation
Director of Policy, Dr Tim Lobstein, says: “If obesity was an
infectious disease we would
have seen billions of dollars
being invested in bringing it
under control. But because
obesity is largely caused by the
overconsumption of fatty and
sugary foods, we have seen
policy-makers unwilling to

Halving levels of smoking could
prevent 43 million deaths

eaching globally-agreed
targets for health risks
such as smoking and alcohol could prevent more than
37 million deaths by 2025, a new
study has found.
The study, led by Imperial College London and published in The Lancet, found that
the large majority of the extra
deaths will be in low-to-middle-income nations. Targets for
reducing smoking and blood
pressure will lead to the largest
health benefits.
In 2011, the UN General Assembly agrees to reduce deaths
from the big-four chronic diseases: cancers, diabetes, lung
disease and cardiovascular disease. The World Health Organi-

sation (WHO) created targets
for both premature deaths from
these chronic diseases and their
key risk factors like smoking, alcohol use, high blood pressure
and blood glucose, obesity and
salt consumption.
The study shows that the
big-four chronic diseases killed
more than 28 million people in
2010; a number that is projected to increase to 39 million in
2025 is no new action is taken.
If the six risk factor targets are
achieved, more than 37 million deaths will be prevented by
2025.
Currently, global targets include a 30 per cent reduction in
smoking levels, a 10 per cent reduction in alcohol consumption

and a 30 per cent reduction in
salt in food. However this new
research found that if a more
ambitious level of halving the
levels of smoking is achieved,
alongside the other targets,
the risk of dying prematurely
from the big-four would prevent nearly 43 million deaths by
2025.
Lead author of the study,
Dr Vasilis Kontis from Imperial College London, said: “Our
study demonstrates that the tobacco use target should be more
ambitious. Reducing the prevalence of smoking by 50 per cent
by 2025 is feasible based on
proven policy measures, and
should become a global target
to avoid millions of premature
deaths.” DT

Man prosecuted for YouTube
‘dental technician’ claim

he General Dental Council (GDC) has prosecuted
a man for unlawfully
calling himself a ‘Dental Technician’ on YouTube.
Luis Fairman, who has never
been registered with the GDC,
unlawfully used the title ‘dental

technician’ on a video entitles
“NHS Dentistry – Ed’s Story”.
On Thursday 8 May, he appeared at Bodmin Magistrates’
Court and pleaded guilty to the
charge. He has been fined £500
and ordered to pay a £50 victim
surcharge. He must also pay

£500 in costs to the GDC. DT

[3] =>

United Kingdom Edition

News 3

May 2014

Tesco removes checkout sweets
es and ready meal ranges by
changing the recipes to reduce
their sugar, salt and fat content.
And we will continue to look for
opportunities to take out more.

esco has announced that
sweets and chocolates
will be removed from
checkouts across all of their
stores.
This follows research that
found 65 per cent of customers said removing confectionery from checkouts would help
them make healthier choices
when shopping. Larger Tesco
stores stopped selling sweets at
checkouts 20 years ago, but for
the first time they will be removed from all stores, including
Tesco Metro and Express.

removed billions of calories
from our soft drinks, sandwich-

“We’re doing this now because our customers have told
us that removing sweets and
chocolates
from
checkouts
will help them make healthier
choices.”

Tesco will be trialling a
variety of healthier products
at checkouts before implementing the full change
across all stores at the end of
the year.
Earlier this year, Lidl also
announced that it was banning sweets and chocolate
from checkouts in all of its UK
stores. DT

Do you have an opinion or something to say on any Dental Tribune
UK article? Or would you like to
write your own opinion for our
guest comment page?
If so don’t hesitate to write to:
The Editor,
Dental Tribune UK Ltd,
4th Floor, Treasure House,
19-21 Hatton Garden,
London, EC1 8BA
Or email:
lisa@healthcare-learning.com

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Tesco Chief Executive Philip
Clarke said: “We all know how
easy it is to be tempted by sugary
snacks at the checkout, and we
want to help our customers lead
healthier lives. We’ve already

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James Hull puts
classic car collection
up for sale

THREE
CLASSES
ECONOMY
ONE CLAIM
WE ONLY PUT THE
BEST INTO YOUR HANDS.

r James Hull, 53, who
founded dental practice
chain James Hull Associates, has put his classic car
collection up for sale, with a reserve price of £100m.
Britain’s largest privately
owned classic car collection,
which has been 35 years in the
making, will be sold to the highest bidder.

SIROINSPECT

According to the Financial
Times, Dr Hull is selling his collection because of health problems. It is made up of 457 cars,
and includes Winston Churchill’s Austin and Lord Mountbatten’s Mini Traveller, as well as
365 replica miniature pedal cars
and industry memorabilia.
The collection will be sold
intact through a private bidding
process. Dr Hull said: “Whether it’s to a national exhibition
venue in the UK, or to a foreign
bidder, I will insist upon it being
kept together. Hopefully, it will
end up staying here.”

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4 News

United Kingdom Edition

May 2014

New photoactive molecule hardens
dental fillings faster
R
esearchers at the Vienna
University of Technology
have developed a new
dental filling material which is
easier to harden.

The researchers, in collaboration with dental manufacturer Ivoclar Vivadent, have developed photoactive materials
based on germanium, which
they say reduces the duration
of the hardening process for
fillings.
Modern dental composites

contain photoactive organic
resins which react to light
of a particular wavelength
and readily solidify. Professor
Robert Liska from the University said: “Usually, light in
the violet and ultraviolet region is used.” Light with longer wavelengths can also be
used, which penetrates deeper
into the material, but the polymerisation process is less
efficient. If the filling cannot be hardened in one step,
the procedure is repeated several times.

The newly developed composite contains 0.04 per cent of
germanium. The researchers
say that the molecule is split
into two parts by blue light,
creating radicals, which initiate a chain reaction: molecular
compounds (which are already
present in the filling) assemble
into polymers, and the material
hardens.
Tests showed that the penetration depth could be increased from two mm to four
mm with the new compound. DT

Prosecuted man vows to carry on denture business

A

Liverpool man who was
prosecuted for unlawfully practising dentistry
has said he will carry on his
denture business.
Frank Mulholland, 74, was
prosecuted for working as an
un-registered Clinical Dental Technician from his dental
laboratory located opposite the
Royal Liverpool Dental Hospital, providing dentures and

denture repairs.
Mr Mulholland later told the
Liverpool Echo that he believes
the prosecution was unfair and
that he was appropriately qualified to carry out the work he was
doing. He said he will no longer
do dentures but will continue to
carry out dental repairs, which
he says the GDC allows.
He said: “Most people come

to me to have old dentures,
I mix up the dental materials, put it in the denture and
they press them back into their
mouths themselves. I’ve never
been registered with the GDC
because I’m 74 and there’s
a grandfather clause to say
I didn’t have to join it.
The judge was horrible, she
told me to plead guilty or the
fine would be £12,000 rather
than £4,000.” DT

C

M

Y

CM

MY

CY

CMY

Saliva used to run
power generators

S

aliva can power microsized
microbial
fuel
cells which produce tiny
amounts of energy sufficient
to run on-chip applications, a
team of engineers from Penn
State University has found.
“By producing nearly one
microwatt in power, this saliva-powered, micro-sized MFC
already generates enough
power to be directly used as
an energy harvester in microelectronic applications,” the
researchers wrote in the report, published in the journal
NPG Asia Materials.
The researchers believe
that the emergence of ultra-

One in five adults vitamin D deficient

T

wenty three per cent of
adults have a vitamin D
deficiency, new figures
show. This comes after new guidance from the National Institute
for Health and Care Excellence
(NICE) Centre for Public Health
confirmed that 1 in 5 adults are
vitamin D deficient.
In light of these figures, the
National Osteoporosis Society is
urging people to get safe sun exposure every day between May
and September to boost bone
health, as part of their annual
Sunlight Campaign.

low-power chip-level biomedical electronics – devices able
to operate at sub-microwatt
power outputs – is becoming a reality. One possible
application, the researchers
say, would be a tiny ovulation predictor based on the
conductivity of a woman’s saliva, which changes five days
before ovulation. The device
would measure the conductivity of the saliva and then use
the saliva for power to send
the reading to a nearby mobile
phone. DT

Claire Severgnini, Chief Executive of the National Osteopo-

rosis Society, said: “The Sunlight
Campaign is all about raising
awareness of vitamin D and its
importance for bone health. We
want to give clear advice about
how to achieve this natural
health boost safely so that people can be confident about going
outdoors and getting the sun exposure they need without burning and damaging their skin.”
The charity advises that ten
minutes once or twice a day in the
sun with bare arms and legs is
enough for us to top up our vitamin
D levels to last through winter.
Dr Alison Tedstone, Chief Nutritionist and Director of Diet and

Scientists find mechanism
behind red wine’s health benefits

R

eservatrol, found in red
wine, blueberries, cranberries and peanuts, is
associated with beneficial effects in ageing, reducing heart
disease and some types of cancer, and inflammation.
Scientists from The Scripps
Research Institute (TSRI) have
now identified one of the molecular pathways that reservatrol uses to achieve its ben-

eficial action. They found that
reservatrol controls the body’s
inflammatory response as a
binding partner with the oestrogen receptor without stimulating oestrogenic cell proliferation, which is good news for
its possible use as a model for
drug design.
Study lead Kendall Nettles
said: “Oestrogen has beneficial
effects on conditions like dia-

Obesity at Public Health England
(PHE) said: “I am delighted to
see the launch of this campaign
which highlights the importance
of getting enough vitamin D they
need by exposing their skin to
summer sunlight for short periods, taking care to cover up or
protect their skin before it burns.
“In line with government
advice, PHE recommends that
people who are unable to get
enough sun, as well as infants
and young children aged six
months to five years, pregnant
and breastfeeding women, and
people over 65 years, take a daily
vitamin D supplement to prevent
deficiency.” DT
betes and obesity but may increase cancer risk. What hasn’t
been well understood until now
is that you can achieve those
same beneficial effects with
something like reservatrol.”
According to Nettles, reservatrol doesn’t work very efficiently in the body. However, he
said: “Now that we understand
that we can do this through
the oestrogen receptor, there
might be compounds other
than reservatrol out there that
can do the same thing – only
better.” DT

K

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6 News

United Kingdom Edition

May 2014

E-cigarettes increase drug-resistant bacteria

E

-cigarettes
can
increase drug-resistant
and potentially lifethreatening bacteria, while
decreasing the ability of human cells to kill these bacteria, researchers have found.
Researchers at the VA San
Diego Healthcare System and
the University of California,
San Diego, tested the effects
of e-cigarette vapour on live
MRSA and human epithelial
cells.
Lead investigator Laura
Crotty Alexander said that ex-

posure to e-cigarette vapour
increased the virulence of the
bacteria, helping MRSA escape killing by antimicrobial
peptides and macrophages.
However, they found that
when MRSA is exposed to
regular cigarette smoke, their
virulence is even greater. In
a mouse model of pneumonia, cigarette smoke exposed
MRSA had four-times greater survival in the lungs, and
killed 30 per cent more mice
than control MRSA. E-cigarette vapour-exposed MRSA
were also more virulent in

mice, with a three-fold higher
survival.
Crotty Alexander said: “As
health care professionals, we
are always being asked by patients, ‘Would this be better
for me?’ In the case of smoking e-cigarettes, I hated not
having an answer. While the
answer isn’t black and white,
our study suggests a response:
even if e-cigarettes may not
be as bad as tobacco, they still
have measurable detrimental
effects on health.” DT

Apex Dental Care bought by Oasis Healthcare

O

asis Healthcare has
acquired Apex Dental
Care for an ‘undisclosed sum’.
Oasis also took over Smiles
Dental in April 2014. The additions of Apex and Smiles
to the Oasis portfolio will increase the company’s turnover by 40 per cent from £160
million to more than £225
million. Its practice network
will have grown by more than

50 per cent from 204 to more
than 310 in six weeks.
Justin Ash, CEO at Oasis
Healthcare Group, said: “We
are delighted to welcome the
Apex team to Oasis. Both companies share the same commitment to providing high
quality, easily accessible dental care and have developed a
patient-led culture.
“Adding

both

Apex

and

Smiles to the Oasis portfolio
rapidly transforms the size
and scope of Oasis and underlines the rapid progress we are
making in building a strong,
trusted and customer focused
dental brand in a fragmented
market. Our ambitions for
growth do not stop here and
we have a strong pipeline of
acquisitions and new builds.”
Ben Chaing, CEO at Apex
Dental said: “We are pleased

that Oasis will be taking forward the Apex practices and
teams. Following initial discussions with the Oasis team
it soon became apparent that
we shared the same vision for
how the dental market should
evolve. By combining Apex’s
dental practices with Oasis
the group will be well placed
to continue improving the
breadth and quality of our service to patients with the benefit of an expanded network

and even stronger
support team.” DT

clinical

Antibiotic resistance is ‘serious worldwide threat’
in all WHO regions in those
that cause both community and
healthcare-associated
infections; this includes E.coli, MRSA
and TB among others.

A

new report from the
World Health Organisation (WHO) reveals the
serious global threat of antibiotic resistance.

The report reviewed the
levels of antimicrobial resistance in many types of bacteria,
viruses, fungi and parasites,
in 114 member states. It notes
very high levels of resistance

Dr Keiji Fukuda, WHO’s Assistant Director-General for
Health Security, said: “Without
urgent, coordinated action by
many stakeholders, the world is
headed for a post-antibiotic era,
in which common infections
and minor injuries which have
been treatable for decades can
once again kill.”
Some WHO regions were
found to have very high levels of antibiotic resistance in

many different bacteria, but
this wasn’t the case in the UK;
resistance to carbapenems, the
antibiotics of ‘last resort’ for
multi resistant ‘klebsiella’ has
increased over the years but the
number of isolates is still relatively low in the UK.
There is an area of concern
in the treatment for gonorrhoea,
however, as the bacteria shows
high levels of resistance across
a range of antibiotics. This is
coupled with sustained transmission and repeat infections.
Dr Paul Cosford, Director for
Health Protection and Medical
Director at PHE, said: “Whilst

Teeth are new sign of social status

T

eeth are becoming the
new indicator of social
status, according to social scientists Malcolm Gladwell.
The writer of David and
Goliath said that obesity and
bad teeth will now define status and hamper upward mobility, rather than race and
gender.
He told The Times:

“That’s kind of the way we’re
moving, as the gap between
the fit and unfit grows. The
teeth thing and the obesity
problem are the same: they
are symptoms of the same set
of inferences that are being
drawn.”
He also added that having bad teeth will mean that
you are denied certain entrylevel jobs, leading to a lower
chance of success.

This follows a poll conducted by Vision Critical last
year that found people with
whiter teeth were thought to
earn £10,000 more on average
than they actually did. Those
surveyed thought their teeth
made them look up to five
years younger and improved
their employment potential by
10 per cent. DT

the UK does not have the levels
of antibiotic resistance seen in
some parts of the world we do
see patients with infections resistant to antibiotics. This is a
trend that is increasing and we
take this very seriously.
“Combatting the development and spread of antibiotic
resistance requires a multifaceted approach and PHE is
working very closely with its
stakeholders to address this.
Our work is contributing to the
new cross-government national
strategy that aims to tackle one
of the biggest healthcare issues
of our time.” . DT

[7] =>

United Kingdom Edition

Book Review 7

May 2014

Dental Foundation Training

A review of Amit Rai’s book by James Bannister

B

lind spots tend to go unnoticed until it’s rather too
late. Take choosing a career – most people would agree
that to enter into a profession, one
has to take a relevant course at
university. Which is true, for the
most part (apprenticeships are
an oft overlooked alternative),
but then comes the big question:
what happens between university
and that first job? Like a movie
with a missing scene, people often just assume there’s a jump
cut from graduation to the start of
your chosen career. In truth, it’s
a lot more complicated than that;
no less so in Dentistry.

dental profession (including a
substantial portion on potential
career paths following training).
However, while comparatively
easy to read, the scientific journal
writing style may not appeal to all
readers. Abbreviations are ubiquitous, for example, and it can
prove challenging to memorise

every single one. While there is an
abbreviations section to help with
this, it merely adds a secondary
problem of having to constantly
flick back-and-forth in order to
make sense of some sentences.
Overall, the type of reader
that would benefit from this most

After detailing the purpose
of foundation training, the book
goes on to describe general dental practice with particular respect to NHS dentistry, complete
with a checklist of things to do in
preparation for your first day of
practice. Chapters 3, 4 and 5 are
dedicated to describing the teaching process, curriculum and assessment involved in foundation
training, and the latter half of the
book discuss the future following
foundation training – potential
career paths, dento-legal considerations (with a particular focus
on how to avoid being sued) and
a general survival guide for your
years as a foundation dentist. Indeed, the advice given in these
last few chapters has universal
application, such as how to respond to a complaint not just in
terms of formal proceedings, but
in terms of personal development
and growth.
Equal parts textbook and syllabus, Dental Foundation Training
acts as a catch-all guide to a year
of functional dental training, providing advice on every step of your
journey from university into the

short of calling it “essential,” but
it’s nothing less than invaluable. DT

Book info
Dental Foundation Training: the essential handbook for foundation dentists by Amit Rai. ISBN: 9781846199974
Available from Radcliffe Health at
£29.99. Go to http://www.radcliffehealth.com/ to order a copy

of

Dental Foundation Training:
The essential handbook for foundation dentists is precisely that:
an essential handbook detailing
quite literally everything you will
need to know during your transition from undergraduate study to
unsupervised performance.
The book employs a very thorough, concise writing style not
dissimilar to a journal article, and
wastes no time in bringing the
reader up to speed on the details
of foundation training – one is
quickly informed of what it is, its
purpose and how to secure a place
on the scheme. Substantial detail
is also provided on its technicalities, such as the role of your supervisor and what to do if you miss
asession.Thissurvivalguideaspect
tothebook’snatureshinesthroughout – one tip later on to set up
a code word with your nurse to
alert a supervisor mid-procedure
particularly struck me as invaluable advice.

would be a graduate dental student keen to make the most of
their career. The book is filled with
good advice, and acts as a
consolidated library of information
regarding
training,
development,
and
the subsequent career possibilities for dentists. I would stop just

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06.02.2014 14:20:03

[8] =>

8 Event Review

United Kingdom Edition

May 2014

Top Tips For Aesthetic Brilliance Part 1
Lloyd Pope BDS describes Galip Gurel’s use of APTs for veneers, one of the
cornerstones of Galip Gurel’s presentation at the 10th Annual BACD Conference

T

he keynote presentation
at this year’s BACD Conference was delivered by
Galip Gurel, arguably one of the
world’s leading exponents of minimally invasive aesthetic dentistry.

Nowadays, just a small amount
of treatment to one or two teeth
can have a dramatic effect on
the overall aesthetic result. We
need to be able to visualise the
final result ourselves and then

introduce our ideas to the patient.
One of the most important tools
for achieving this is the use of
Aesthetic Provisional Temporary
(APT) mock-ups, one of Galip’s
outstanding areas of expertise.

Galip highlighted the evolution of veneer preps as follows:
1) Solely using depth guide diamond burs

2) Silicone indexes, which were
an improvement but still had
some faults
3) APT mock-ups
With simple cases, you can
virtually guarantee that every
dentist will do the same veneer
preparations because all the teeth
are perfectly aligned. What is
more they can easily be prepped
using depth cutting burs following a standard protocol. There are
various depth cutting burs available, some with single sections
and some with multiple sections.
These burs are also available
with different depths so that there
is something available for every
circumstance. The preparations
should be supra-gingival. Once
prepped you can provide provisionals for the patient to wear
whilst the final restorations are
prepared. Simple preps, with reductions within the enamel only
offer good long-term success because there is optimal bonding
and minimised flexing of the residual tooth.
However, if the case involves
space management, either because of overcrowding or overspacing, this creates different
problems. If space management
is involved this requires a degree of visual illusion in order
to achieve an aesthetic result.
Essentially you can change the
alignment and appearance of the
smile by altering line angles etc.

fo r
1
.
o
N
es*
The
& bridg
s
y crown
r
a
r
o
p
tem

Everyone has a favourite.
Luxatemp.
For more than 20 years, Luxatemp has been setting new
benchmarks as the ultimate material for perfectly fitting and
aesthetic provisionals. DMG has continuously expanded its
range of products for temporaries – with bespoke variants
to meet all the everyday requirements of the practice.
Whether Luxatemp-Plus, the reliable tried-and-trusted

Rule 1 – if the teeth are crooked
don’t do veneers straight away,
use orthodontics first to move
them into a reasonable position
first.
The Aesthetic Provisional Temporary Protocol

classic, Luxatemp-Fluorescence, for superior natural
aesthetics, or Luxatemp Star, the high-tech material with
new record values in flexural strength and fracture
resistance – each member of the Luxatemp family offers
the quality and unique clinical results for which Luxatemp
has been known worldwide for years.
www.dmg-dental.com

Step 1 – The mock-up and
silicone key
Do a mock-up in composite to
create the final outcome, though
not necessarily in every detail.
This is designed to assess the
length of the teeth etc and to
share the information with the
patient. At this stage you can add
composite to the teeth and even
onto the soft tissue to see the effect of any proposed soft tissue
adjustment within an appropriate
frame, the lips. Both you and the
patient can assess the effect. Will
orthodontics be required or not?
This depends upon the patient’s
opinion, so sometimes yes and
sometimes no.

Awards for Luxatemp Star. Luxatemp Star is sold in the USA under
the name Luxatemp Ultra. *Market share USA 2012 according to
the dental research company Strategic Data Marketing.

AZ_Lx3_DeEn+GB_2014-01.indd 1

Sometimes not every prep is
perfect, no matter who does it,
therefore you need a protocol to
make it more reliable and predictable.

10.01.14 11:08

[9] =>

United Kingdom Edition

After creating an acceptable
mock-up you take two impressions; one impression of the
mock-up and one impression of
the existing teeth. By comparing
the two the laboratory can do a
wax-up to mimic the results. The
resultant wax-up will have the
perfect outline. This then enables
you to create a silicone key either
within the laboratory or chairside.

easier GG uses a pencil to highlight the grooves on the tooth.
Then, once the APT is removed,
it is simply a case of reducing the
enamel in the appropriate areas

Event Review 9

May 2014

until all the pencil lines have been
eliminated.
Research proves that if veneer
preparations are entirely within

enamel there is a 99 per cent success rate, but that if the dentine
is involved in any way the success rate drops to just 68 per cent.
Typical failures are fractures,
discolouration, marginal leakage etc. This research includes a
retrospective study by GG himself
in which he followed his own veneer retention results. It was published in two articles in the JPPD
in November 2012 and February
2013. It showed that in enamel
you only get failures due to frac-

tures, you don’t get microleakage
or debonding. These fractures are
mainly due to occlusal problems
relating to new crowns, changes
in chewing patterns etc.
You then do a simple butt joint
across the incisal edge to a depth
of 1.5 mm. This is the strongest
type of joint. DT
Look out for part II of this article series in the next issue of Dental Tribune.

Step 2 – The old way!
Use the silicone key to create the
perfect APT (Aesthetic Provisional Temporary) mock-up using an
appropriate temporary crown and
bridge material. GG uses DMG’s
Luxatemp because it is simply
the best. This is then used to assess everything before you start
to prep the teeth. At this stage you
can evaluate the aesthetics, occlusion, phonetics, etc.
Because the patient is not yet
anaesthetised you can still assess
the smile-line etc too.
How much space is required for
the veneer?
The minimum must be 0.5mm,
but the actual thickness entirely
depends on the amount of shade
change required.
As a rule of thumb, on average you require 0.15mm per
shade change with a minimum of
0.5mm, though this does depend
upon the lab and the materials
they will be using. Therefore a
shade change of four requires a
minimum reduction of 0.7mm.
Consequently, after removing the APT use the silicone key
to assess which parts of the teeth
to prep and which to leave alone.
Prep if <0.5mm gap between silicone template and tooth and leave
if >0.5mm gap between silicone
template and tooth. However it
is very difficult to perform this by
simply looking at the two things
and attempting to judge the size
of the gaps. Normally results in
over-prepping as a precaution,
with all the complications this entails.

Are you prepared for a medical
emergency in your dental practice?
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→ Midazolam 10 mg (buccal)

Features of the complete drugs kit
→ Supplied in a bespoke bag for easy storage
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→ Items can be bought individually or as part
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Step 3 – Galip’s way!
GG realised that you actually
don’t need to be able to see the
teeth to prep them.

We also supply medical oxygen with prices from
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He realised that when you
have an APT to demonstrate the
aesthetics to the patient, and
they like it, you can simply leave
the APT over the teeth and prep
through it using an appropriate
0.5mm depth drill. If the gap is
<0.5mm the drill will penetrate
the enamel. If the gap is >0.5mm
it won’t and the teeth don’t need
prepping. To make this even

BOC: Living healthcare

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www.bochealthcare.co.uk

506970-Healthcare Drugs Kit Advert-Full Page 07.indd 1

10/02/2014 17:12

[10] =>

10 Comment

United Kingdom Edition

May 2014

Stress in the dental profession
Neel Kothari discusses the stress that comes with practising dentistry

espite the many rewards of being a dentist I have always felt
that, overall, ours is a lonely
profession. The stress of day to
day decision making, potential
litigation and the practice of
defensive dentistry is enough
to keep anyone busy, but add
on the stress of complying with
non clinical organisations such
as the CQC and having to nod
politely with the sheer mass
of risk assessments, practice
policies and legislation, this is
simply enough to suck the soul
out of any person.

Fellow
editorial
board
member
Stephen
Hudson
once told me that all you really need with your patients
is rapport, “no one sues you if
you have rapport with them”.
At the time I politely nodded and pretended to agree,

however as time went on I
found myself strangely drawn
to that statement and have
tried to improve my rapport
with patients ever since. I don’t
know if this will reduce the
future risk of complaints or
litigation, but I can certainly
say it has made day to day
working a slightly happier environment.
Since entering dental school
I was always told that dentists
have the highest suicide rates
amongst all professions. I’m
not completely sure whether
this is in fact true, however a
number of authors have raised
the issue of suicide and have
highlighted its prevalence. A
literature review published in
the International Dental Journal by Sancho and Ruiz (2010)
looking at whether the risk
of suicide amongst dentists

is a myth or a reality came to
the conclusion: ‘In the literature we find systematically a
suicide rate among dentists
higher than those of other occupations. These studies lack
the correct scientific weight
and new studies are required
that introduce the demographic variables, the psiquiatric
morbidity previous to the development of the profession,
the opportunity factor, the
stressors not related to work
and the relative emphasis to
these are necessary to for the
profession to decrease the risk
of suicide.’
Last December dentist Dr
Kamath committed suicide
after feeling “harassed and
bullied” by health chiefs over
standards of record keeping
at his practice in Leeds. Dr
Kamath was under investiga-

4 copenhagen
th

trauma
symposium

September 19th - 20th 2014

Copenhagen, Denmark

The University Hospital in Copenhagen offers a 2 days course in:

RESTORATIVE TREATMENT AFTER
SEVERE DENTAL TRAUMA
AN EVIDENCE BASED APPROACH
It is a fact that approximately half of all traumas affecting the permanent dentition requires
a restorative treatment, including various crown restorations or tooth replacement
procedures. It is also known that many of these treatments have a very doubtful longterm prognosis. During this symposium 6 different restorative treatments, such as
composite restorations, porcelain laminates, crowns and conventional bridges, implants and
autotransplanted premolars used in the treatment after tooth loss, will be analyzed in detail
and the most reliable treatments will be presented by 9 experts.

J. ANDREASEN

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L. BAKLAND

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T. KOFOD

Registration fee: DKK 2850,- (€ 380)
www.dentaltraumaguide.org/registration.aspx

U. PALLESEN

O. MALMGREN

tion by NHS, Airedale, Bradford
and Leeds over the keeping
of his records and his suicide
prompted calls for an immediate inquest. The inquest at
Wakefield heard father-ofthree Dr Kamath feared for
his career and that the trust
had threatened to refer the
practice to regulatory body the
General Dental Council. The
inquest also heard how following two minor complaints
about the dental practice, the
primary care trust decided to
conduct an audit of 30 of the
practice’s patients and how Dr
Kamath committed suicide just
five days after a meeting with
PCT officials.
In a statement read to the
court, wife Dr Rajni Prasad described how the couple felt after their last meeting with the
trust: “My husband and I were
both very stressed by this and
both felt very vulnerable and
harassed and bullied with no
support offered.”
The need for support is
an absolutely essential part
of our profession and I for
one am sick and tired of government officials telling us
how intelligent dentists are
every time they want to enforce a new change. Our dental school training doesn’t
teach us why or how to do a
legionella risk assessment or
why I find it easier to access
my bank account online rather
than the NHSBSA website to
update and verify my pension
contributions! It teaches us the
foundations of clinical dentistry instead.
It really bugs me when
dentists are asked to put their
professional integrity above
all other incentives but are not
supported in doing so. For instance, in 2011 the House of
Commons Health Select Committee suggested that whistleblowing should be a statutory
duty for all NHS employees.
The proposal was to make it a
‘professional obligation’ upon
all healthcare workers to report colleagues they suspect
of poor practice or misconduct - and if they failed to do
so, they would themselves face
disciplinary action. However at
the same time the Committee
said they were well aware that
some doctors and nurses who
have blown the whistle have
‘sometimes been subject to
suspension, dismissal or other
sanctions’.
Over the course of our
professional careers we will
all encounter situations out-

side of our control that must
make us question whether
or not we should raise our concerns to higher powers. Whilst
on face value it may seem
that this decision should be
an easy one, in reality very
few people actually do whistle
blow and those who do are not
always met with welcoming
arms.
At the risk of stating the
obvious it is clear that the
business of dentistry is a very
stressful one and it probably

‘It really bugs me
when dentists are
asked to put their
professional integrity above all other
incentives but are
not supported in
doing so’

always has been. It’s difficult to point the finger at one
specific part of the job that
brings rise to such stress, but
in my opinion dealing with
the non clinical business
side of things brings rise to
many more problems than
the healthcare side we were
taught at dental school.
For most of us, creating
happiness within a workplace
clearly involves more than just
a monetary reward and unfortunately having to comply with
the raft of legislation imposed
upon the profession such
as HTM01-05 and CQC inspections simply claws away
just that little bit more happiness from our day to day working lives.

About the author
Neel Kothari qualified as a dentist
from Bristol University
Dental
School in 2005, and
currently
works
in Sawston, Cambridge as a principal dentist at High
Street Dental Practice. He has completed a year-long
postgraduate certificate in implantology and is currently undertaking the
Diploma in Implantology at UCL’s
Eastman Dental Institute.

[11] =>

Implant Tribune
Implant Tribune

Implant Tribune

Flapless MIMI® Implementation

Perio-implantitis

Customised implant abutment

Using the two-piece implant shuttle

What are the treatment options?

By Theirry Lachkar

pages 11-16

pages 19-20

pages 17-18

Flapless MIMI® implantation using the two-piece
implant shuttle preventing physiological bone loss
Armin Nedjay discusses Flapless implants
Fig 1

Fig 2

Fig 3

Sulcus 0,2 - 0,5 mm
Epithelial attachment
about 1 mm

Dentogingival
Connective tissue attachment complex

Biological
width

about 1 mm

Fig. 1: Implant on the right: Physiologically speaking, bone loss has been considered as
inevitable, and some traditional implants are frequently associated with bone loss.
Fig. 2: The epithelial attachment in natural teeth and the one in osseous implants have
many features in common, but there are also differences between them. The connective
tissue fibers adjacent to the implant are in parallel with the longitudinal axis of the
implant, which is different from the biological structures around natural teeth5-8. There
are no nerve and vessel structures adjacent to the implant surface; the tissue is similar to
scar-like tissue and differs from periodontal tissue, which is connected to the tooth and
alveolar bone.
Fig 3: Soft tissue consists of the sulcus, the gingival epithelium, and the connective tissue
attachment. Their vertical height of 3 mm is called the biological width. A biological
cuff-like barrier protects healthy implant surfaces/sites from apical migration of bacteria. Hard and soft tissue, mineralized connective tissue (alveolar bone), soft connective tissue and junctional epithelium serve as a protective barrier. Bacterial migration
into the periodontal and periimplant soft tissue in the sulcus area causes an apical
migration and destruction of soft and hard tissue, which can lead to an attachment
loss9-11. Poor dental hygiene or the iatrogenic detachment of the periosteum with a flap
reflection and/or an implant exposure can cause injury to soft tissue, which can lead to
periimplantitis.

ccording to valid scientific criteria for a successful implant treatment, bone loss after one-year
loading is considered as inevitable1. Thus, the implantation is defined as successful when crestal
bone loss does not exceed 2mm
after one-year loading time and
0.2mm annually thereafter.
With more than 22,000 successful implantations with immediately restored and loaded
implant systems, the author describes solutions that have been
successful in preventing physiological bone loss. With respect
to Tarnow’s findings concerning

bone loss2-4, the author has suggested that the periosteum preserving MIMI® procedure with
implants that have an integrated
Platform-Switching design and
that can achieve primary stability
has a proper potential to prevent
physiological bone loss. Since
bone loss can be evidenced if animplant is uncovered, it is also
recommended to avoid implant
exposure.
Implant Design & Physiological Bone Loss
Most traditional implant systems
have a conventional platformmatched implant-abutment connection. External and internal

connections can have an impact
on the hard and soft tissue interface. Long-term studies have
shown that the peri-implant bone
level is established apically from
this platform-matched implantabutment connection (Bullon
1999). If the implant, surrounded by bone, heals with its cap
screw in bone until its exposure
and if the cap screw is removed
by means of ostectomy and replaced with a healing cap, a bone
remodeling process starts after
exposure. This can lead to a periimplant bone defect (Fig. 1, implant on the right).
Micro-gap
The micro-gap is located between the implant body and abutment. It has been considered as
a disadvantage of two-piece implants. If the micro-gap is too big,
as is the case with many conventional two-piece implant systems
and due to loading of the implantabutment connection, there is a
high risk of bacterial contamination of the micro-gap and implant
body. This can lead to bone loss.
X-ray images of some twopiece implant systems (eg ITI),
which are connected to the
oral cavity, have shown that the

biological vertical distance between the micro-gap and the
implant-bone contact area is
2mm, regardless of how deeply
the implant is inserted in bone
(Hermann 1997, 2000 and 2001).
Tarnow2-4 has demonstrated in
his studies 2000 and 2003 that the
micro-gap expands horizontally
by about 1.4mm, which is similar
to the effect in case of a periodontal defect. Tarnow recommends
that the minimum distance between two implants should be
3mm to protect bone and interimplant papillae.
Platform Switching
Implants with a Platform-Switching concept have a proper potential to prevent bone loss15,16. The
diameter of the healing abutment
is narrower than the diameter of
the implant platform/shoulder.
In this way, the implant-abutment connection is not platformmatched. Dental implant systems
such as the Champions (R)Evolution® (Fig. 17 & 18), Ankylos®
and Astra Tech® have an integrated Platform-Switching design
and an internal cone that is long
enough and that has an optimal
angle. In addition, the geometry
of the implant-abutment connection is the same for all implant

diameters, so there is a prosthetic line for all implant diameters. With the Platform Switching function, the central position
of the micro-gap is moved to the
implant axis. Through the separation of the micro-gap, which
might risk being contaminated
with bacteria, from the peri-implant bone tissue in the implant
shoulder area, the biological
width is shifted away from bone.
As a rule, an exposure of the
Champions (R)Evolution® implant and a reopening/ injury of
the sensitive biological width are
not necessary. In this way, biological bone loss can be avoided, and
the issue according to Tarnow remains to be discussed, also with
respect to one-piece implants.
Conclusion
Conventional implantation methods have been increasingly questioned13,14. MIMI® is the abbreviation for the Minimally Invasive
Method of Dental Implantation.
One-piece implants and also twopiece implant systems will be ideal for MIMI® if they can remain
bacteria-resistant even if they are
loaded with strong forces.
à DT page 12

[12] =>

12 Implant Tribune

United Kingdom Edition

May 2014

ß DT page 11

Fig 4

Fig 5

Fig 6

Fig. 4-6: For the implant site preparation, the conical triangular drills (not twist drills!) are used, which allow for bone condensation. You prepare the bone cavity depth that corresponds to the endosseous implant length, except
if you perform an indirect sinus lift. To ensure periimplant nourishment through the intact periosteum, the 3.0 mm and 3.5 mm-diameter reduced implants are used. The 2.5 mm-diameter implants are only used in individual
cases.

Fig 7

Fig 11

Fig 14

Fig 8

Fig 9

Fig 12

Fig 15

Fig 10

Fig 13

Fig. 7 -13: With conical triangular drills, you prepare the bone
cavity depth that corresponds to the implant length, except if
you perform an indirect sinus lift. For the D1 bone, the twist
drills can also be used. Contrary to what critics might think,
MIMI® surgery is not a “blind procedure”. After each drilling
and preparation with condensers, it is an absolute must to
palpate and check thoroughly in all dimensions by means of a
thin probe. Autologous blood for humidifying the bone cavities
is recommended. Only if primary stability is not achieved with
condensers or diameter-reduced implants, can you insert an
implant with a larger diameter (for example, a 4.5 mm or 5.5
mm-diameter implant).

Fig 16

Fig. 14 - 16: Due to a lack of a Platform-Switching function or a too short or too large cone of many implant systems, for example with diameters of 3.8 mm or 4.1 mm, there is a risk of bacterial migration into the micro-gap. In
studies, a relatively wide gap was observed when certain implant systems were loaded with forces of only 100 N. In such a case, there is a risk of bacterial penetration into the inner thread and outer part of the implant, which
can induce periimplantitis.

Fig 17

ty without deforming or breaking
the outer part and inner thread
and without loosening the abutment during the prosthodontic
phase.

Fig 18

Fig. 17 - 18: By comparison, two-piece implant systems with an optimized cone-implant-abutment connection can be loaded with
strong forces, causing just an extremely small micro-gap or none at all. For instance, this picture shows a 3.5 mm-diameter Champions- (R)Evolution® implant that was loaded with a force of 200 N in a study led by engineer Holger Zipprich. No micro-gap was
observed12.

1) The Shuttle: The two-piece
Champions (R)Evolution® implant system consists of an integrated bacteria-proof “Shuttle”/
Insert, which remains in the
implant for at least eight weeks
post surgery until the final prosthodontic restoration is fit. Dur-

ing the healing phase in the
first weeks, the implant internal
thread will not be contaminated
with bacteria. During implantation, the Shuttle and micro-close
connection protects the internal
thread from contamination with
bacteria, blood or saliva. With
these two-piece implant systems

and also one-piece implants,
there is very little risk of bone
loss. Sufficient primary stability at a torque of at least 35Ncm
is a prerequisite for a successful
implantation17. The implant with
the Shuttle can be inserted at a
torque of up to 70/80Ncm and
achieve sufficient primary stabili-

2) Platform Switching & Optimised Cone Connection: It has
been found that crestal bone loss
can be prevented with implants
with an integrated PlatformSwitching design15,16. In addition,
internal cone connections should
have an angle of 5° to 10°, and
the cone should be long enough
in order to prevent bacterial migration even if, for example, a
3.5mm-diameter two-piece implant is loaded with a force of
200 N12. Since one-piece implant
systems have no micro-gap at all,
they are bacteria-proof as well.
The one-piece implant system

is particularly indicated for the
rehabilitation of four or more
implants/teeth. In order to compensate insertion divergences,
Prep-Caps (zircon or titanium)
can be cemented. The impression can be cast with super hard
plaster (no Laboratory Analogs!)
in the dental laboratory. If done
correctly, the cement will not
be pressed subgingivally so that
there is no risk of periimplantitis because of cement remains
in these one-piece implant PrepCaps (“abutments”).
3) Due to the flapless MIMI® procedure and the fact that a second
or third session is not necessary
(implant exposure, subgingival impression), the biological
width can be formed and is not
disturbed because of a second

[13] =>

United Kingdom Edition

intervention (exposure). During
surgery, the periosteum, which
nourishes peri-implant bone on
the long-term, can be preserved.
Peri-implant bone nourishment
shall be ensured. The minimally
invasive implantation method
has proven beneficial to the periosteum18-23. In this way, the supracrestal bone/bone’s sensitive
outer membrane connection can
be protected. The peri-implant
bone is almost completely nourished by the histological, doublelayered bone membrane, which
is richly supplied with blood
vessels and nerve fibres: the inner cambium layer (Stratum
osteogenicum) is rich in cells.
It is composed of stem cells (osteoblasts!!), ensuring bone regeneration, as well as of nerves and
blood vessels. The outer fibrous
layer (Stratum fibrosum) is connective tissue, which is not cellrich but rich in collagen fibers.
The Sharpey’s fibers, which pass
from the outer layer through the
inner layer, are embedded in the
Substantia compacta of the bone
and secure the periosteum to

Apical deviations of 500 μm have
been observed24. Implants for at
least four implants/teeth that will
be splinted (including fixed, prepared teeth that are positioned
mesially from the implants) can
be immediately loaded with a
final implant-supported restoration within the first 14 days post
surgery. Current studies have
demonstrated good treatment
outcome with regard to stable
soft and hard tissue conditions after immediate restoration – also
in conjunction with immediate

Implant Tribune 13

May 2014

implantation. This success rate is
comparable to the one obtained
in conventionally loaded implants three to six months after
implantation25-31. In addition, immediately restored/loaded and
delayed loaded implants showed
similar bone-implant interface
contact rates28. In addition, a
biologically optimised surface
enhances bone cell regeneration19,32.
With these techniques, the
risk of physiological bone loss

can be reduced or even eliminated. Currently, Tarnows theory
that there should be a distance
between the implants of at least
3mm is controversial. DT
Bibliography
1) Zarb GA, Albrektsson T.: Towards optimized treatment
outcomes for dental implants. J
Prosthet Dent. 1998 Dec;80(6):63941.
2) Tarnow, D. P. and R. N. Eskow
. Preservation of implant esthetics: soft tissue and restorative con-

siderations. J Esthet Dent 1996.
8:12–19.
3) Tarnow DP, Cho SC , Wallace
SS: The effect of inter-implant
distance on the height of interimplant bone crest. J Periodontol
2000; 71:546-549
4) Tarnow, D. , N. Elian , and P.
Fletcher . et al. Vertical distance
from the crest of bone to the height
of the interproximal papilla between adjacent implants. J Periodontol 2003.
à DT page 14

‘The peri-implant
bone is almost completely nourished
by the histological, double-layered
bone membrane’

the bone. The iatrogenic detachment of the periosteum can lead
to poorly nourished bone after
weeks, months or years. Consequently, an iatrogenic mucoperiosteal flap is not recommended.
However, if the gingival thickness
is 4 mm or more, crestal incisions
(also flapless) can be performed.
The peri-implant, gingival
structures and the periosteum,
which nourishes bone, remain
intact. Physiological bone loss is
very unlikely to occur. Current
studies and clinical findings over
16 years have shown that the
periosteum preserving flapless
MIMI® method is very beneficial18-23.
Drilling templates have not
always shown to be particularly
accurate to perform MIMI®. On
the one hand, the diameter of the
Champions® implant is not congruent with the diameter of the
conical triangular drills.
On the other hand, studies
have compared virtually planned
implant positions using current
DVT-based
navigation-guided
templates with achieved implant
positions, also involving the use
of drills with diameters congruent with the implant diameters.

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Birmingham

Manchester

London 2 Devonshire Place, London W1G 6HJ
Manchester Mansion House, 3 Bridgewater Embankment, WA14 4RW
Birmingham 2nd Floor, Varsity Medical Centre, 1a Alton Road, B29 7DU

London

[14] =>

14 Implant Tribune

United Kingdom Edition

May 2014

ß DT page 13

Fig 19

Fig 21
Fig 20

Fig 23

Fig 22

Fig 25

Fig 30

Fig 35

Fig 26

Fig 27

Fig 31

Fig 28

Fig 32

Fig 36

Fig. 19 - 24: When inserting the implants using the flapless and
periosteum preserving MIMI® method, we drill the bone cavity
transgingivally at a rotation speed ranging from 50 – 250 rpm
with the conical triangular drills, depending on the bone density.
In most cases, this is done without water cooling. The cylindrical
drills are additionally used to prepare the D1 and D2 bone. For
preparing the soft D3/D4 bone, it is sufficient to use the conical triangular yellow drill and special bone condensers. After each step,
the bone cavity must be checked with the thin BCC (Bone Cavity
Check) probe. While avoiding bone overheating, a two-piece Champions (R)Evolution®, which is equipped with an Insert/Shuttle, can
be inserted at a torque ranging from 40-60 Ncm without deforming or breaking the inner thread and the thin titanium part (for
instance, a 3.5 mm-diameter implant has an approx. 0.4 mm-thick
outer part). Sufficient primary stability can be achieved.

Fig 24

Fig 37

Fig 33

Fig 38

Fig 29

Fig 34

Fig. 25 - 29: The bacteria-proof platform-switched Shuttle (see Fig. 11 and
„2“), which is set in the implant cone,
is restored with a Gingiva-Clix. The
Gingiva-Clix is made from white biocompatible WIN!, and it is available in 6
combinations of heights and dimensions.
During the bone remodeling phase within
8 weeks following surgery, the GingivaClix stays on the Shuttle. After 8 weeks,
the Gingiva-Clix is removed, and with
this particular Clix type, the gingiva is
shaped irritation-free. An impression post
is transgingivally set in the Shuttle and
manually screwed…

Fig. 30 - 34: The Impression Coping is
set. After making the impression and the
supraconstruction, the Shuttle, which
is connected to the implant, is removed
with the Shuttle Extractor. The Shuttle is
removed for the first time, while the screw
remains uncontaminated. After removing the Shuttle, the Abutment (ICA zircon
abutment) is screwed seal-tight, preventing
bacterial migration. Finally, the crown is
cemented and fit.

Fig. 37: View of the implant in Tooth site 14: when the Shuttle was
removed from the implant, the inner thread and the exterior wall of the
Champions -(R)Evolution® remained intact and was not contaminated
with bleeding, saliva and bacteria.
Fig: 38: After removing the Shuttles, the Abutments for Ball-Head are
screwed with the Insertion Aid that is also used for one-piece Champions®.
Fig. 39 - 40: The Shuttles are removed from the implants (without local
anesthesia because the treatment, including the impression, is performed
supragingivally).

Fig 39

Fig. 35 - 36: After removing the small implant/Shuttle connecting screw, you can easily
remove the Shuttle from the Champions-(R)Evolution® with the Shuttle-Extractor. This
procedure is performed either about 8 weeks after implantation (transition between
Primary Osseointegration Stability and Secondary Osseointegration Stability) in many
cases or immediately after the insertion of the implants like in this case.

Fig 40

[15] =>

United Kingdom Edition

74:1785–1788.
5) Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg
B, Thomsen P. : The soft tissue
barrier at implants and teeth.
Clin Oral Implants Res. 1991 AprJun;2(2):81-90.
6) Buser, D., Weber, H.P., Donath,
K., Fiorellini, J.P., Paquette, D.W.,
Williams, R.C.: Soft tissue reactions to non-submerged unloaded
titanium implants in beagle dogs.
J Periodontol 1992;63:225-235
7) Abrahamsson, I., Berglundh,
T., Wennstrom, J. , Lindhe, J.: The
peri-implant hard and soft tissues
at different implant systems. A
comparative study in the dog. Clin
Oral Implants Res 1996;7:212-219
8) Abrahamsson, I., Berglundh, T.,
Moon, I.S. , Lindhe, J.:Periimplant
tissues at submerged and non-submerged titanium implants. J Clin
Periodontol 1999;26: 600- 607
9) James RA, Kelln EE.: A histopathological report on the nature
of the epithelium and underlying
connective tissue which surrounds
oral implants. J Biomed Mater
Res. 1974;8(4 Pt 2):373-83.
10) Ericsson, I., Persson, L.G.,
Berglundh, T., Marinello, C.P.,
Lindhe, J, Klinge, B. : Different
types of inflammatory reactions
in peri-implant soft tissues. J Clin
Periodontol 1995;22:255-261
11) Tillmanns HW, Hermann JS,
Cagna DR, Burgess AV, Meffert
RM: Evaluation of three different dental implants in ligatureinduced peri-implantitis in the
beagle dog. Part I. Clinical evaluation. Int J Oral Maxillofac Implants 1997;12:611-620
12) Zipprich H (Universität
Frankfurt am Main): Überprüfung der konischen Implantat/
Abutmentverbindung des Champion (R)Evolution® Systems mit
3,5mm, 4,0 und 4,5mm Durchmessern auf Bakteriendichtigkeit auf
Belastung mit 0N, 175N und 200
N auch im Vergleich mit anderen
Implantat- Systemen, Mai-November 2012, noch nicht veröffentlicht
13) Chen ST, Beagle J, Jensen SS,
Chiapasco M, Darby I. Consensus statements and recommended
clinical procedures regarding surgical techniques. Int J Oral Maxillofac Implants 2009; 24 Suppl:
272-278.
14) Crespi R, Capparè P, Gherlone
E, Romanos GE: Immediate occlusal loading of implants placed
in fresh sockets after tooth extraction. Int J Oral Maxillofac Implants. 2007 Nov-Dec;22(6):955-62
15) Telleman G, Raghoebar GM,
Vissink A, Meijer HJ.: Impact of
platform switching on inter-proximal bone levels around short
implants in the posterior region;
1-year results from a randomized
clinical trial. J Clin Periodontol.
2012 Mar 29. doi: 10.1111/j.1600051X.2012.01887.x.
16) Romanos GE, Nentwig GH:
Immediate functional loading
in the maxilla using implants
with platform switching: fiveyear results. Int J Oral Maxillofac Implants. 2009 NovDec;24(6):1106-12
17) Esposito M, Cannizzaro G,
Soardi E, Pistilli R, Piattelli M,

Implant Tribune 15

May 2014

Ramakrishnan T, Ambalavanan
Corvino V, Felice P.: Posterior
N: The efficicacy of flapless imatrophic jaws rehabilitated with
plant surgery on soft-tissue proprostheses supported by 6 mmfile comparing immediate loadlong, 4 mm-wide implants or by
ing implants to delayed loading
longer implants in augmented
implants: A comparative clinical
bone. Preliminary results from
study. J Indian Soc Periodontol,
a pilot randomised controlled
2010 Oct;14(4):245-51
trial. Eur J Oral Implantol. 2012
20) Al-Juboori MJ, bin AbdulrahaSpring;5(1):19-33.
man S, Subramaniam R, Tawfiq
18) Chen ST, Darby IB, Reynolds
OF: Less morbidity with flapless
EC, Clement JG. Immediate imimplant. Dent Implantol Update,
plant placement postextraction
2012 Apr;23(4):25-30
without flap elevation. J Periodon21) Müller CK, Thorwarth M,
tol 2009; 80:163-172.
The membrane you can trust_Layout 1 15/10/2013 13:10 Page 1
Chen J, Schultze-Mosgau S: A lab19) Ravindran DM, Sudhakar U,

Aug;26(4):760-7.
23) Tsoukaki M, Kalpidis CD,
Sakellari D, L Tsalikis, Mikrogiorgis G, A. Konstantinidis: Klinische,
radiologische, mikrobiologische
und immunologische ImplantatErgebnisse nach chirurgischem
Zugang mit oder ohne Lappenbildung: eine prospektive randomisierte kontrollierte klinische
Studie, Clin Oral Implants Res.
18. Juni 2012. doi: 10.1111/j.16000501.2012.02503.x.
24) Dreiseidler T, Tandon D,

oratory study comparing the effect of ridge exposure using tissue
punch versus mucoperiosteal flap
on the formation of the implantepithelial junction. Oral Surg Oral
Med Oral Pathol Oral Radiol Endod. 2012 Jan 25
22) Mueller CK, Thorwarth M,
Schultze-Mosgau S.: Histomorphometric and whole-genome expression analysis of peri-implant
soft tissue healing: a comparison
of flapless
and open surgery. Int J Oral Maxillofac Implants. 2011 Jul-

à DT page 16

Unique, original
& clinically proven
The membrane
you can trust

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s
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• THE WORLD’S NUMBER MEMBRANE
• years of successful clinical history
• More than 200 studies
• Early membrane vascularisation supports
bone regeneration1
www.bio-gide.com
1

Schwarz F et al. Clin. Oral Implants Res.

;

[16] =>

16 Implant Tribune

United Kingdom Edition

May 2014

ß DT page 15

Kreppel M, Neugebauer J, Mischkowski RA, Zinser MJ, Zöller
JE.: CBCT device dependency
on the transfer accuracy from
computer-aided
implantology
procedures. Clin Oral Implants
Res. 2012 Sep;23(9):1089-97. doi:
10.1111/j.1600-0501.2011.02272.x.
Epub 2012 Jun 11.
25) Zafiropoulos GG, Deli G, Bartee BK, Hoffmann O. a case series
using two different implant designs. J Periodontol 2010; 81:604615.Single-tooth implant place-

Fig 41

Fig 44

tions. J Oral Maxillofac Surg
2009; 67:89-107.
28) Linares A, Mardas N, Dard M,
Donos N.: Effect of immediate or
delayed loading following immediate placement of implants with
a modified surface. Clin Oral Implants Res 2011; 22:38-46.
29) Atieh MA, Payne AG, Duncan
WJ, Cullinan MP.: Immediate restoration/loading of immediately
placed single implants: is it an
effective bimodal approach? Clin
Oral Implants Res 2009; 20:645-

ment and loading in fresh and
regenerated extraction sockets.
Five-year results:
26) Mura P. Immediate loading
of tapered implants placed in postextraction sockets: Retrospective
analysis of the 5-year clinical outcome. Clin Implant Dent Relat Res
2010.
27) Block MS, Mercante DE,
Lirette D, Mohamed W, Ryser M,
Castellon P.: Prospective evaluation of immediate and delayed
provisional single tooth restora-

Fig 42

Fig 45

Fig 46

Fig 51

Fig 47

Fig 48

Fig 49

Fig. 47 - 49: After eight weeks, when – independent of bone type – the transition of all Champions® from Primary Osseointegration
Stability to Secondary Osseointegration Stability can be assured, we remove the Gingiva-Clix and the small screw from the Insert/
Shuttle and screw the metal impression posts in the Insert/Shuttle. In this case, we prepared Tooth 45, which was then provided
with a crown. The impression can be made without removing the Insert/Shuttle from the implant and without contaminating the
implant with saliva. The impression of this two-piece implant system is made transgingivally or supragingivally. Implant exposure and anesthesia are usually not necessary.

Fig 52

Fig. 50 - 52: After taking X-rays, we fixed the white impression copings on the metal impression posts and made a
closed impression.

Fig 56

J Periodontics Restorative Dent.
2012 Feb;32(1):29-37
32) Glauser R, Ruhstaller P, Windisch S, Zembic A, Lundgren A,
Gottlow J, et al.: Immediate occlusal loading of Branemark
System TiUnite implants placed
predominantly in soft bone: 4-year
results of a prospective clinical
study. Clin Implant Dent Relat Res
2005;7 Suppl 1:52-59.

Fig. 41-43: The initial situation in the 4th quadrant
shows concave parts and alveolar structures that were
not completely ossified. Tooth 23 could not be preserved,
so the model cast prosthesis was widened by Tooth 23 in
the maxilla. After the patient had received a periodontal
treatment and had been informed about possible therapy
solutions, the patient opted for a fixed implant-supported
restoration in the sites 46 and 47. We provided the patient with a passive-fitting restoration. Tooth 45 was also
provided with a crown. In this way, the patient was able
to “feel” his implants.

Fig 43

Fig. 44 - 46: The patient was treated under anesthesia (UDS forte). He was given 600 mg
Ibuprofen. With the yellow, black, white and blue drills, we drilled in the D1/D2 bone at a
maximum rotation speed of 250 rpm. Then, we checked the bone cavity quality with the BCC
(Bone Cavity Check) probe. Then, we inserted the Champions (R)Evolution® implant with
the Insert/Shuttle, which had been fixed on the implant at a torque of only 10 Ncm Ex Works,
at torques ranging from 40 to 60 Ncm. In most cases, the Shuttles remain aleo loco. Then, we
set Gingiva-Clix on the Champions®-Insert/Shuttle immediately after an X-ray check. The
Gingiva-Clix, which are made from biocompatible WIN! serve as transgingival healing caps.
They are available in a combination of six widths and heights.

Fig 50

659.
30) Crespi R, Capparé P, Gherlone
E, Romanos GE : Immediate versus delayed loading of dental implants placed in fresh extraction
sockets in the maxillary esthetic
zone: a clinical comparative study.
Int J Oral Maxillofac Implants.
2008 Jul-Aug;23(4):753-8
31) Crespi R, Capparè P, Gherlone
E, Romanos G.: Immediate provisionalization of dental implants
placed in fresh extraction sockets using a flapless technique. Int

Fig 53

Fig 54

Fig 55

Fig. 53 - 55: The abutments are chosen. Then, the final prosthodontic restoration is fabricated. When fitting
the prosthodontic restoration, the Gingiva-Clix are removed, and the Inserts/Shuttles are removed from the
implant for the first time. With a Pattern Resin key, you can set the abutments in the 9.5° Champions inner
cone and screw them at a torque of 30 Ncm.

Fig 58

Fig 57

Fig. 56 - 58: After closing the abutment screws with Cavit, the crowns can be fixed with ImplantLink semi (company Detax, Champions- Liga).

Fig 59

Fig 60

Fig. 59: This figure shows 8 placed 3.5 mm-diameter and 10 mm-diameter Champions
(R)Evolution® implants, which were inserted transgingivally using the flapless MIMI®
method. The bone cavity depth corresponded to the implant length. After each drilling
and step, the bone cavity was checked in all dimensions. After taking X-rays, the Insert/
Shuttle was removed, and the implants were immediately restored with Ball-Head
Abutments to fix the prosthesis in the maxilla. Because of the gentle, patient-friendly and
periosteum preserving keyhole and flapless MIMI® method, which is indicated in at
least 80% of the cases, you hardly see any bleeding and open wounds. With this method,
swelling, pain, and hematomas following an implantation are now a thing of the past in
many cases. However, even if this technique might be quite easy to learn, it is not always
suitable for beginners in Implantology. In order to apply the MIMI® method successfully,
it is necessary that the dentist has enough experience in Implantology and that he/she has
considerable manual dexterity.
Fig. 60: This 99 year-old patient from Munich (patient at risk) was the oldest patient
worldwide who was treated with implants using the flapless MIMI® method. In June
2011, this lady was provided with four implants to support a full prosthesis in the mandible. Under local anesthesia, surgery lasted about 20 minutes, and the preparation of the
restoration and matrices in the dental laboratory took about 2 hours. Two hours following surgery, she was able to eat an apple strudel. Two years later, she was still satisfied
with her implants and did not experience any pain.

[17] =>

United Kingdom Edition

May 2014

Implant Tribune 17

Fabrication of a customised implant abutment using
CAD/CAM: A solution specific to each clinical case
Dr Thierry Lachker describes an implant case

he multiplicity and sophistication of the offering in the field of prosthetic elements in implantology
allow the practitioner to make a
choice appropriate to the clinical particularities of each case. If
the practitioner chooses a standard implant abutment, the dental technician will have to make
adjustments, which implies considerable losses in precision and
time. Moreover, with such abutments it is difficult to create an
anatomical emergence profile
because it cannot be modified
and the base of the abutment
cannot be changed. This observation is equally applicable
to the angulation, which might
even be selected by default.
A customised abutment created with CAD/CAM is the most
accurate and simplest solution
for an optimal result. The abutment is individually designed in
order to ensure the homothety of
the thickness of the materials and
therefore the overall strength of

‘A customised abutment created with
CAD/CAM is the
most accurate
and simplest solution for an optimal
result’
C

CMY

the prosthesis. The dental technician has in this case maximum
freedom in terms of design in order to create an abutment with
the optimum emergence profile
and angulation. In this manner,
the abutment is specifically designed and fabricated for each
patient.
Titanium has been established in dental implantology as
the reference material owing to
its biomechanical properties and
its biocompatibility. Today, we
are able to benefit from over 40
years of clinical and experimental experience in implantology.
Customised abutments can be
fabricated from titanium, zirconia or hybrid materials, such as
a combination of titanium and
zirconia, which in certain clinical circumstances improves the
aesthetics of the visible areas
while respecting the requirements of biocompatibility and
biomechanics.

sented for treatment. He had no
Seating a four-unit bridge
particular medical conditions or
on three anatomical implant
any contra-indications concernabutments
ing the placement of implants. In
Clinical DentalTribune_CO_A4_June13.pdf
case
1 17/06/2013 20:03:40
2009, the patient had undergone
A 40-year-old male patient pre-

a sinus lift (an increase of the
maxillary bone volume and the
displacement of the sinus membrane to ensure implant success
by increasing the height of the

available bone) at a hospital prior to the placement of implants
to replace teeth 15–17. The postoperative sequelae (pain, oedeà DT page 18

[18] =>

18 Implant Tribune

United Kingdom Edition

May 2014

ß DT page 17

mas, etc.) resulted in the patient
being entirely opposed to another intervention of this kind on
the opposite side of the mouth.
During an appointment in
October 2011, I was able to persuade the patient to accept implant treatment. I suggested first
removing the three-unit bridge
on teeth 23–25 and then extracting the roots of teeth 23 and 25,
as well as seating of a denture
on the day of the extraction, followed by placement of three implants in regions 23–25, the extraction of tooth 26, and seating
of a four-unit bridge as the final
prosthetic solution.
As the height of the available bone around tooth 26 was
insufficient, I would not place an
implant in that area but a tooth
extension (a sinus lift would otherwise have been essential). The
treatment plan was accepted by
the patient two weeks later, and
teeth 23 and 25 were extracted at
the end of the month.
The patient was seen on
10 January 2012 for implant
placement: two implants (NobelReplace RP, Nobel Biocare)
with a diameter of 4.3mm and
a length of 13mm for regions 23
and 24, and one implant (Nobel-

‘Customised CAD/
CAM prosthetic
elements and abutments respect the
dental anatomy
and allow extremely precise seating
of a bridge on implants’

allow extremely precise seating
of a bridge on implants. Periodontal maintenance is therefore
easier owing to easy access with
a toothbrush because of the predetermined interdental spaces.
The simplicity of the process
saves a considerable amount of
time: no adjustments are necessary, the bridge is seated immediately, the occlusion is usually
ideal, and greater accuracy can
be achieved. In addition, only
two appointments are necessary:
one for impression taking and
another for seating of the bridge.

Replace WP) with a diameter
of 5mm and a length of 10mm
for region 25. Tooth 26 was extracted on the same day without
placement of an implant as already mentioned.
In May 2012, implant-level
impressions were taken (opentray impression technique), and
the patient’s occlusion was recorded using silicone and a bite
tray. Owing to the constraints
related to the angulation of the
implants in regions 24 and 25,
I opted for titanium abutments.
The angle of the implant in region 23 allowed for the insertion
of a titanium–zirconia abutment
for good gingival grip and a better aesthetic result.
Ten days later, two titanium
abutments (ANA. T, Laboratoire
Dentaire Crown Ceram) and
one titanium–zirconia abutment
(ANA. TZ, Laboratoire Dentaire
Crown Ceram) were screwed
onto the implants at a torque of
35N, and sealed with compos-

ite. An adjustment check of the
contact points and of the occlusion was performed, followed by
cementation of a ceramic bridge
with a zirconia framework. A
follow-up visit took place three
days later.
Technique
For this case, it was possible to
use abutments made from different materials according to
the angulation of the implant:
titanium for the pronounced
angulations, and a combination

of titanium and zirconia for the
angulation with no particular
constraints. It would have been
equally possible to use a titanium abutment for the implant
in region 23 but I opted for the
titanium– zirconia abutment to
obtain a better aesthetic result
in the anterior region: brightness, translucency and no visible
metal margin.
Customised CAD/CAM prosthetic elements and abutments
respect the dental anatomy and

Dental technician’s perspective
When the laboratory (Laboratoire Dentaire Crown Ceram) received this case, we were asked
to create three customised anatomical abutments with a titanium interface for an individual
and more precise fit, respecting
the requirements of biocompatibility and biomechanics, and a
coronary part in zirconia for a
better aesthetic result.
Once the moulds had been
cast, we determined that the
considerable angulation of the
implants in regions 24 and 25
and their shallow position in the
tissue posed difficulties regarding the design of titanium–zirconia abutments. However, Dr
Lachkar explained to us that in

this case (ie the patient’s reluctance to undergo pre-implant
surgery) he was forced to place
the implants in the bone available and not necessarily in the
ideal situation according to a
prosthetic plan.
In this case, the titanium interface would have considerably
exceeded the buccal surface and
it would therefore have been
necessary to reduce it. The bonding surface would therefore have
been limited, which would have
resulted in a great loss of mechanical resistance. We thus decided to use a titanium abutment
manufactured from a single
block and specially made to allow
for such substantial angulations
for teeth 24 and 25. For tooth 23,
the implant angle allowed for
a titanium–zirconia abutment,
which was preferred to a titanium abutment for a better aesthetic result. DT

About the author
Dr Thierry Lachkar is a dental
surgeon (Paris Diderot University)
and has been a
practitioner for 15
years. He is a general practitioner
and he works at a dental surgery in
Paris. He has specialist postgraduate
training in conservative dentistry and
in endodontics. He can be contacted
at drlachkar@yahoo.fr.

[19] =>

United Kingdom Edition

Implant Tribune 19

May 2014

Treatment options for peri-implantitis
A look at options for peri-implantitis therapy

T

he idea of creating
a
prosthetic
dental
implant to replace a
missing tooth is certainly not
a new one – in fact, there is
evidence of early civilisations
using dental implants as far
back as 4,000 years ago, when
the Chinese made bamboo
into dental pegs – and 2,000
years ago when the Egyptians
fashioned pegs out of precious
metals. Millions of dental
implants are placed every
year on partially and fully
edentulous patients – most of
which achieve long-term success and do not develop complications.

plants – opting for the invasive
treatment because the patient
requests it, or simply expects
it and is unaware that there
are other non-invasive solutions available that don’t run
the risk of infection.

Awareness among dentists about peri-implantitis is
growing and most are aware
that it is no longer rare – although knowledge of the aetiology of peri-implant diseases

number in coming years, as
studies have shown that occurrence of peri-implantitis
increases with the number
of years that the implant has
been in place .

à DT page 20

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prevalence is hard to define
as studies quote varying figures. However, peri-implantitis is thought to affect approximately one out of every
10 implants placed. The oral
disease is therefore shaping
up to become a major concern
for both patients and dentists
involved in implant treatment
in the future. New implants
that promise better osseointegration may have an effect
on whether peri-implant diseases develop, but the results
would need to be studied in
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Booming business
The number of dental implant
purchases is on the increase,
with
approximately
five
million being sold annually.
It is a very popular treatment
option for people in Asia,
as well as the Middle East,
in particular, Israel – and
has been rising in popularity the world over since the
modern implant was introduced in the 1970s. Some
dentists now believe that
we are placing too many im-

Cases demonstrating biologic
complications
such
as peri-implantitis and the
less
serious
peri-implant
mucositis, which is often
the precursor to peri-implantitis, look set to increase in

[20] =>

20 Implant Tribune
ß DT page 19

is still work in progress. This
has meant that there is currently no consensus or gold
standard as to how to treat
peri-implantitis, as there is
limited scientific evidence
available to back up either
surgical or non-surgical treatment, or explantation of the
dental implant.
Peri-implant diseases
If peri-implant mucositis is

allowed to develop, it turns
into peri-implantitis, which
can lead to progressive loss of
the supporting bone, and implant failure – and is therefore
much more complex to treat.
Peri-implant diseases are
caused by bacterial infection
and/or biomechanical overload, which cause the inflammation. Patients with existing periodontal disease and
poor oral hygiene habits – and
smokers in particular – are
very susceptible to developing

United Kingdom Edition
a peri-implant disease.
Poor oral health and plaque
control are a big cause of
peri-implant diseases, and often occur due to the patient’s
reticence to clean the area
due to fear of pain or bleeding.
Additionally, the patient may
be unable to brush and floss
properly due to the implant’s
positioning or design increasing bacterial prevalence.
Diagnosis and treatment
It’s important to ensure that

the dental team works together to spot the warning signs
of peri-implant diseases – as
these are often not noticed
until they become more severe – and that each member of staff is knowledgeable about the risk factors,
signs and symptoms in order
to achieve early diagnosis
and intervention. It is also a
good idea to partner with a
periodontist as soon as possible
following
diagnosis.
Evidence suggests that periimplant mucositis can be

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treated effectively if detected
early, and is easily treated
non-surgically. Prevention is
possible with regular monitoring of dental implants, comprehensive periodontal evaluation and proper periodontal
maintenance.
Peri-implantitis can be
treated with mechanical debridement with antiseptics
such as chlorhexidine, or
surgery – or when all other

‘It’s important to
ensure that the
dental team works
together to spot
the warning signs
of peri-implant
diseases’

therapies fail explanation. It
is preferable to try a nonsurgical
treatment
first,
where possible. In terms of
the merit of using antibiotics,
Stefan Renvert et al in 2012
found that the use of antibiotics makes no difference.
Many bacteria are now also
resistant to most antibiotics –
we’re in the era of widespread
antibiotic
and
multi-drug
resistance.
In cases where just an
implant is affected by periimplantitis, a non-surgical
approach can have its merits. For example, scaling and
root planing combined with an
antiseptic such as chlorhexidine digluconate. This has
been clinically proven as an
effective adjunctive treatment
for peri-implantitis and an effective first-line treatment for
periodontal pocketing.
In conclusion, as with all
inflammatory diseases, early
detection and intervention of
peri-implant mucositis and
peri-implantitis is the best
solution – however in cases
that do develop, judge the
merits of a non-surgical approach on a case by case basis
and choose this option where
possible to avoid invasive surgery. More study is needed on
peri-implant diseases; we still
do not know enough about
them and require further research to substantiate emerging claims. DT
Prescribing
for PerioChip
request.

See demonstrations at www.pearldentalsoftware.com
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BHA-A4-ad-Mince pie (Dentistry).indd 1

14/02/2014 16:52

May 2014

information
available on

About the author
For more information or to contact
the team behind PerioChip®, email
team@periochip.co.uk or call 0800
013 2333

[21] =>

United Kingdom Edition

Advertorial 21

May 2014

The University Hospital in
Copenhagen is offering its 4th
Trauma Symposium in Copenhagen
structions is therefore often
seen. Especially sufficient and
stable vertical dimension of
the reconstructions are difficult to obtain. A variety of
different surgical techniques,
including vertical alveolar
distraction and interpositional
osteotomies is a part of the arsenal used,depending on the
individual case.The results
of such different treatment
methods will be presented.
A large consensus group
representing implantologists,
oral surgeons and prosthodontics was recently assembled in
Scandinavia to answer some
critical questions about the
use of implants: are implants

raumatic dental injuries may lead to serious healing complications such as infection related
resorption, ankylosis or loss
of marginal bone support.
The Resource Center for Rare
Oral Diseases at the University Hospital in Copenhagen is
offering its 4th Trauma Symposium in Copenhagen. The
overall theme this year is diagnosis and treatment of these
complications and the long
term consequences of early
tooth loss.

teeth. A number of treatment
options are available, each
presenting advantages and
disadvantages.
Information
about indications, technical
procedures in treatment, and
outcome expectations of both
traditional as well as current
approaches will be shown.
In recent years new knowledge has been accumulated
about the long-term fate of
composite restorations. In this
symposium critical aspects
of composite restorations of

Sealing of Hollow Spaces in Implants
implant gaps and hollow spaces
 Seals
stops infiltration of germs into
 Durably
the hollow spaces and the reinfection
of periimplantal tissue

‘In recent years new knowledge has been
accumulated about the long-term fate of
composite restorations’

The participant in the symposium can expect to be updated with an evidence based
approach on various topics,
for example the treatment of
pulp necrosis in immature

crown fractured teeth will be
presented. Furthermore various types of crowns will be
compared based on their biomechanical properties, and
the long-term fate of porcelain
laminates will be discussed.
In case of premature loss
of anterior permanent teeth,
orthodontic space closure often becomes an actual treatment option. In the past, large
experience has been gained
using such a treatment and it
appears that what seems to be
simple treatment often result
in a less aesthetic solution.
The critical aspects of space
closure will be presented.
Dental trauma may result
in significant loss of alveolar
bone and soft tissue. A poor
aesthetic outcome of recon-

Examples of how the technical problems with implants
can be reduced and furthermore the results of the
treatment of periimplantitis
will be presented. For more
information about the 4th Copenhagen Trauma Symposium
and trauma treatment guidelines visit www.dentaltraumaguide.org DT

GapSeal®
sed
Sorry, clo !
ay
from tod

The
understanding
of
healing
after
trauma
is
of
vital
importance
for
the oral health specialist.
Tooth loss or unaesthetic treatment results can
have a serious psychological effect on the patient.
Therefore it is necessary
that the specialist knows
the log-term consequences
of the different treatments
available,
says
Dr.
Jens
Ove Andreasen, author of 11
textbooks and 360 scientific
articles, who is the main researcher behind the organisation of the symposium.

long term reliable especially
in relation to gingival health,
functional stability and actual
loss. The same analyses were
made for conventional bridges
and resin bonded bridges. The
results of this consensus conference will be presented.

avoids a main reason for
 Effectively
periimplantitis

www.hagerwerken.de
Tel. +49 (203) 99269-0  Fax +49 (203) 299283

Video

[22] =>

22 Industry News

United Kingdom Edition

Castellini – Swift and comprehensive
care, always available
Castellini’s
wide-ranging
and
comprehensive
support
and
maintenance service is a highly valued
feature by its customers. With an
attitude of providing imagination and
excellence in its products, it follows that
Castellini’s support service is also of the
highest standards. Globally recognised for providing quality equipment in the
dental industry, Castellini ensures that the customer is put firmly first. Teams
of specialist engineers are at your disposal should any technical support be
required at any stage after installation. Castellini pledges a swift conclusion
in these circumstances, because it knows that peace of mind is invaluable to
you. With service centres across the UK, guidance and information can always
be obtained. All repairs are performed with the use of genuine manufacturer
parts, ensuring that achieving the ideal result is certain. Superior design and
exceptional support are the fundamental qualities that Castellini operates on.
You can be assured that a prompt and complete service is readily available to
you to help protect your long-term equipment investments.

Difficult diagnosis? Refer to
EndoCare
At EndoCare we excel at
diagnosing and treating dental
pain in all its forms. Our team
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are all experts in their field and
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pain and saving teeth. In fact in
the last 10 years, we’ve saved over 10,000 teeth from extraction!

Castellini UK Ltd

To find out more, contact EndoCare today.

Please call 08000 933975 for details of your local Castellini dealer: Castellini has
service centres through out UK

For further information please call EndoCare on 020 7224 0999
Or visit www.endocare.co.uk

Our philosophy is simple: we aim to provide high quality Endodontic treatments
in a warm and caring environment where patients’ needs are always our number
one concern.
So if you have a difficult diagnosis, or need help with any aspect of root canal
treatment, give our expert team a call today. We welcome contact from all
referring practices and are ready and willing to assist you in any way we can. We
particularly excel at treating anxious patients and other challenging issues such
as hot pulps, microsurgery and re-treatments.

You will be kept informed
every step of the way so that you’ll know which technician is looking after your
order and when your product is ready for dispatch and free delivery. We will
also send all new restorations with patient statement certificates both for your
peace of mind and to ensure compliance with GDC regulations.

Simple, aesthetic, stable: Structur 3
Composite material for the
fabrication of provisional crowns
and bridges
Structur 3 is the new, self-curing crown
and bridge material from VOCO. It is
used for the quick fabrication of highquality provisional crowns and bridges,
as well as inlays, onlays, partial crowns, veneers and temporary posts. Long-term
temporaries can also be constructed using Structur 3. An additional indication is
the lining of pre-fabricated provisional crowns made from composite material,
polycarbonate or metal. Structur 3 possesses extraordinary stability and highly
aesthetic properties and is as quick as it is easy to process.

Serving as an extension to your professional team, we work hard to create the
products you need, when you need them.

Manufacturer: VOCO GmbH, P.O. Box 767, 27457 Cuxhaven, Germany, www.
voco.com

Now working with more and more practices, we have recently welcomed two
new members of staff within our customer services team. We are also soon
to be joined by ten new dental technicians, ensuring that we can meet the
growing demand for our expert craftsmanship and quality service.

For more information please contact: info-uk@voco.com

A service you can trust
At Sparkle Dental Labs, we
understand how important
quality customer service is for
your practice, and so we are
dedicated to providing a quick
and reliable service every time.

May 2014

DMG UK
Luxatemp
The market leading temporary
C&B material celebrates its
20th Anniversary
To be successful internationally
for 20 years is quite a remarkable
achievement for a temporary
crown and bridge material,
but DMG’s Luxatemp can lay
claim to that. The Luxatemp range of bisacryl composite temporary crown
and bridge materials, market leader in the USA since 1997, can look back on
a long history of the highest accolades. Multi-award-winning Luxatemp was
acclaimed Top Provisional Material and Best of the Best*; whilst Luxatemp Star,
the new faster setting version, has already been awarded the highest possible
rating of 5 stars by REALITY, an independent testing lab in the USA**. During
its assessment Luxatemp Star received top marks for fracture resistance and
flexural strength, which help ensure its reputation for dependable stability and
durability. Long-term shade stability has also been optimized. What’s more,
Luxatemp Star attains its final hardness in just 5 minutes, making it even faster
than conventional Luxatemp.
For further information contact your local dental dealer or DMG Dental
Products (UK) Ltd on 01656 789401, fax 01656 360100,
email info@dmg-dental.co.uk or visit www.dmg-dental.com

Mix and match
3M ESPE is dedicated to developing
practical and affordable solutions
for dentists. The Pentamix
Lite automatic mixing unit is
lightweight, simple to use and can
be stored upright when on standby.
It also has an integrated handgrip,
allowing it to be easily moved
around the practice as required.
The Pentamix Lite automatic mixing unit is suitable for all viscosities and works
beautifully with all 3M ESPE impression materials, dispensing a void-free mix for
accurate and precise restorations.
The Pentamix Lite automatic mixing unit can be used almost immediately after
delivery – just plug it in, turn it on and start mixing.
For more information, call 0845 602 5094 or visit www.3Mespe.co.uk
3M ESPE and Pentamix are trademarks of the 3M Company.

So if you are looking for a British dental laboratory that you can trust, contact
Sparkle dental Labs today.
For any additional information please call 0800 138 6255 or email
customerservice@sparkledentallabs.com or visit: www.sparkledentallabs.com

Providing Effective Aftercare
Tandex provide quality Orthodontic Kits to help aid
your patients’ aftercare following treatment.
An effective way to ensure that patients maintain
efficient oral health care after a dental procedure
is complete is to offer a fully prepared kit that
contains all of the necessary tools.
The Tandex Orthodontic Kit has a selection of
adjuncts ranging from an Advance Medium
toothbrush to eliminate bacteria from around the oral cavity, to the SOLO
Medium brush for precise interdental cleaning. It also comes with 4 FLEXI
Lime interdental brushes with non-slip flexible grip for pleasant and versatile
maintenance.
The kit includes a detailed user guide that comprehensively instructs patients
on optimum cleaning protocols. Produced in cooperation with dentists and
hygienists the in-depth information allows patients to use the products as they
were intended, for easily achievable and excellent results.
Tandex Orthodontic Kits offer your patients the highest quality tools and
direction for effective aftercare. Contact the team at Tandex today to find out
more.
For more information on Tandex’s range of products,
visit www.tandex.dk or email: martin@tandex.dk

Tavom: Quality cabinetry with the customer
service you deserve
For over 35 years now, Tavom has distinguished
itself as one of the leading providers of bespoke
dental and medical cabinetry in the industry.
The team at Tavom understand that every room
within a dental practice has a well-defined
purpose, and it is important that each of these
areas function with optimal efficacy. They also
have all the experience and skills to ensure your
new practice meets all your specifications, and a range of colours and finishes
are available to help you create a design totally unique to you.
Supplied by Tavom UK, all cabinetry is crafted of the most durable materials for
maximum longevity, and styles incorporate ergonomics for optimal comfort
and aesthetics for both staff and patient alike.
With absolute dedication to first-class customer service, open communication
and flexible working times, you can also rely on the team at Tavom UK to make
the whole process as easy and stress-free as possible.
For a full catalogue of products, or to find out more,
please visit www.tavomuk.com

Improve Implant Success with Water Flossers from
Waterpik International, Inc.
To ensure the success and longevity of dental
implants, good oral hygiene is essential. Indeed,
studies have shown that bacterial plaque build up
can lead to mucositis and peri-implantitis which are
similar to gingivitis and periodontitis around natural
teeth.
To combat plaque and other such oral health issues Waterpik International, Inc.
produce a range of innovative and highly effective Water Flossers including the
Waterpik® Nano™, Cordless Plus, and Ultra models – all of which are supported
by a weight of scientific evidence to support their use.
When compared with dental floss Waterpik® Water Flossers are proven to be up
to 50% more effective than string floss for reducing gingivitis. Water Flossers
also are up to 29% more effective at removing plaque from the interproximal
tooth surfaces.
With such strong scientific backing for Waterpik® Water Flossers, there are now
more options than ever for clinicians to recommend to their implant patients
to maintain and indeed improve the standard of their oral health.
For more information on Waterpik® Water Flossers please speak to your
wholesaler or visit www.waterpik.co.uk. Waterpik® products are widely
available in Boots stores and selected Lloyds Pharmacies.

Excavating caries: check-ups are good,
SIROInspect is better
In May Sirona, technology leader in the
dental industry, is bringing a detection
system onto the market that enables
dentists to identify reliably, quickly and
simply where caries does or does not exist:
SIROInspect.

Visualisation solutions for all situations
Delegates at the BDA Conference and Exhibition
2014 were given the opportunity to test for
themselves the Carl Zeiss visualisation systems
provided exclusively in the UK by Nuview. They
were particularly impressed by the incredible
image quality and ergonomic sophistication on
display.

Give your business the MyRay
Boost
Whether you are looking to enhance
the quality of dental care you provide,
increase your patients’ trust in you
or generate more business through
patient referrals, you need first-class
dental equipment.

SIROInspect is based on Fluorescence-Aided Caries Excavation technology,
known as FACE®, which exploits the fluorescence characteristics of teeth. If
teeth are illuminated with violet light in the spectrum of around 405 nm, it
doesn’t only stimulate degradation products of caries bacteria but also healthy
dentine to fluoresce. Healthy dental tissue lights up green whereas carious
areas are visibly red. The attending dentist can therefore see at first glance –
and very clearly - which areas are carious and which ones are not.

With a selection of loupes and dental microscopes ranging from the
fantastic TTL Teleloupe and the GTX, to the top-of-the-range OPMI Pico
dental microscope, the team from Nuview were happy to explain the many
advantages of these fantastic dental tools.

Offering a wide variety of leading digital imaging systems and dental
radiography equipment, MyRay provides a solution. From cutting-edge
intraoral cameras to top-of-the-range Hyperion X7 OPG machines and the
advanced Hyperion X9 CBCT equipment, all products are designed to produce
the very best image quality, while encouraging an efficient and streamlined
workflow.

Whether delegates were endodontic specialists looking for the perfect
microscope to see deep down into the root of a problem, or GDPs looking for
a set of loupes to accompany their everyday dentistry, Nuview exhibited an
effective solution for every scenario.
Discover the benefits that employing a Carl Zeiss visualisation system can
bring to your daily practise by contacting the team at Nuview today.
For more information please call Nuview on 01453 872266,
email info@nuview-ltd.com or visit www.nuview.co

Unique features and styling, free software and more importantly free upgrades
as developments take place have convinced many UK MyRay users, that they
made the right choice when it came to going digital. Two Year warranty on
all equipment and a comprehensive network of Service Technicians, gives the
confidence practitioners require. MyRay have raised the bar in quality whilst
striving to reduce costs.
Discover how MyRay could help you improve your practice and boost your
patient service today. Call 0870 752 1121for MyRay in the UK
or visit www.my-ray.co.uk

[23] =>

United Kingdom Edition

There’s Value, and then there’s
VALUE PLUS!
The Dental Directory’s VALUE PLUS
brochure is out now.
This latest issue of Value Plus
features special offers and
impressive savings on a wide range
of products from many of dentistry’s leading brands.
Everyday materials and consumables, whitening products and innovative
equipment and imaging systems all feature in this issue. There is even a very special
offer on the Belmont Compass treatment centre that could save you an astonishing
£6,100! Also featured is the Mikrozid disinfection range with savings of up to 27%,
PLUS you can get your hands on FuturaBond U – the latest universal adhesive from
VOCO.
PLUS, don’t forget all this is backed up by The Dental Directory’s commitment to
outstanding customer service, massive stock holdings and free delivery with no
minimum order value and same day dispatch on orders received before 5pm.
You always get a PLUS from The Dental Directory - the company independently
verified as the Best Priced Dental Dealer in both 2012 and 2013.
The Independently Verified Best Priced Dealer!
For more information, contact The Dental Directory on
0800 585 585, or visit www.dental-directory.co.uk.

CB12® – effective relief from the
effects of halitosis
Patients who suffer from chronic
bad breath have to contend with
both the physical and psychological
effects of their condition.
In a seven-year Swiss study, halitosis has been found to bring about inhibition,
insecurity, withdrawal and reduced social contact to chronic sufferers.
You can greatly help by recommending CB12, which has been proven to
effectively neutralise all three odour-causing Volatile Sulphur Compounds
better than 18 other leading mouthwash brands.
For all-day freshness and confidence, patients can also use CB12 boost. This
new product is a scientifically formulated two-layer, sugar-free gum that
contains zinc, fluoride and xylitol – three ingredients that prevent bad breath,
strengthen teeth and prevent caries, and reduce plaque.
For effective relief from halitosis that can help set your patients’ minds at ease,
you can confidently recommend these two products from CB12.
For more information about CB12 and how it could benefit your patients,
please visit www.cb12.co.uk

May 2014

Let The Dental Directory help
you take a BIG BITE out of your
spending
The Dental Directory’s latest edition
of Big Bite is out now, with offers on a
wide range of oral hygiene products.
Save over 30% on Colgate MaxWhite
One Professional Kit, 25% on
SofGrip Scalers, and 30% on Wisdom
Micropower battery toothbrush, plus savings on many other products too.
For many dentists, supplying oral hygiene products to patients has proved to
be a valuable revenue builder for their practice. Big Bite is an ideal source of
inspiration and supplies, ranging from toothbrushes to xylitol chewing gum,
waterflossers to Tooth Fairy envelopes.
Our sales teams are ready to help and with no minimum order value, no
delivery charge and same day dispatch for orders received before 5pm,
we are at your service. Make The Dental Directory your first choice for your
oral hygiene needs. Order by telephone, fax or through our comprehensive
website, where you can view more of the 27,000 products we offer.
The Independently Verified Best Priced Dealer!
For more information, contact The Dental Directory on
0800 585 586, or visit www.dental-directory.co.uk

Spoilt for Choice
Carestream Dental at BDA Conference and
Exhibition
Delegates visiting Carestream Dental at
this year’s BDA Conference and Exhibition
had access to a huge range of cutting-edge
technologies on display. From the innovative
CS Solutions system that enables dentists
to scan, design, mill and place restorations
in a single appointment, to the eSignatures
module enhancing patient consent and the time-saving AutoPost service,
delegates were truly spoilt for choice. The award-winning CS 8100 OPG Unit
was particularly popular feature on the stand, having recently been voted ‘Top
Panoramic Imaging System of 2014’ by The Dental Advisor. Delegates were also
keen to find out more about the innovative CS 9300 CBCT impression scanner
and CS 3500 intraoral scanner available.
In addition, the team from Carestream Dental introduced the brand new CS 8100
3D from within the Innovation Zone, demonstrating the many benefits of easyto use technology and high quality 3D images in everyday practice.
For further information on any of the award-winning technologies from
Carestream Dental, contact the experts today.
For more information, contact Carestream Dental on 0800 169 9692
or visit www.carestreamdental.co.uk

Available exclusively in the UK from Nuview, Carl Zeiss loupes offer comfort,
sophisticated technology and unparalleled visualisation.

High performance LED technology
from Clark Dental
New from Clark Dental, the Zenium
ZYO is the latest high performance
operating light featuring ‘shadowless’
technology for perfect clarity of vision.
Designed with the modern practice
in mind, the ZYO is the perfect blend
of style and sophistication. The unit consists of six powerful LED lights that
can be adjusted to produce between 5,000 and 32,000 Lux, while innovative
new materials improve heat dissipation while ensuring the unit remains light
and compact. With ergonomics such an important consideration, users will
appreciate the excellent freedom of movement offered by the articulating
ZYO arm, which has been designed to offer maximum fluidity and variety
so you can illuminate your procedures from any angle. The Zenium ZYO can
be purchased as an LED light only as above and also offers clinicians the
additional option of a fully integrated digital HD camera, complete with zoom
function. This provides a high quality display via a monitor, with the ability
to save dental procedures to a hard disk for review as still images and also as
video clips. Combining style, sophistication and cutting-edge technology, the
Zenium ZYO is the perfect addition to any dental practice.
For more information call Clark Dental Sales on 01270 766167, email
info@clarkdentalsales.co.uk or visit www.clarkdentalsurgerydesign.co.uk

With a Little Magic…
Known for their sound knowledge and extensive
expertise in business, the team at 7connections
are bringing a little more magic into dentistry.
Providing an array of both digital and hard copy
marketing resources, the innovative MagicBox
delivers all the tools you need to market your
practice effectively for the next year. Posters,
personalised referral cards and social media
banners are all featured to name but a few, as well as a 12-month marketing
plan and a return on investment tracker enabling you to monitor your progress
throughout. And more information is available on the fresh new website,
www.7connections.com, where you can find out more about other business
services available, the team’s backgrounds or upcoming events, while also
keeping up-to-date with the industry by reading the team’s blogs.
Marketing – it’s amazing what you can achieve with a little Magic….
Book your free marketing review with 7connections today, and quote discount
code MB004 to receive a 25% on your first three months of MagicBox*!
For more information about 7connections and the MagicBox,
please call 01647 478145, email phillippa.goodwin@7connections.com. or
visit the brand new website www.7connections.com
*Discount code valid until the end of May 2014

The Best of British
Delegates visiting the award-winning
Sparkle Dental Labs at this year’s BDA
Conference and Exhibition were eager to
find out what the company can offer their
business.

Carl Zeiss Loupes from Nuview – “The field of
vision is brilliant.”
Many dentists are discovering the numerous
advantages that a set of loupes can bring to their
clinical work. The name Carl Zeiss is recognised
for creating visualisation systems of the very
highest standard and Carl Zeiss’ range of loupes
is no exception.
However, using a set of Carl Zeiss loupes doesn’t
just guarantee enhanced visualisation, it also
ensures comfort. Carl Zeiss loupes allow the user
to sit in an upright position, this improved posture
makes developing back and neck problems a lot
less likely. Dr Uns Moutiz, Dental Associate at All Saints Green Dental Practice
says: “With the loupes I can see minor details, which can otherwise be missed
and helps in diagnostics. I can add finesse to a greater degree, which was not
achievable with naked eye, especially when I am doing cosmetic work and a
higher level of finesse is expected. I don’t have to adjust the light if I want to
see in odd corners of the mouth as the light follows my direction of the head. I
would absolutely recommend these to every dentist.”

Industry News 23

The power of information from Christie + Co
Whatever questions you may have about selling of buying a practice, Christie
+ Co can help provide you with the right answers.
From the best strategy to sell your practice to the best specialist dental finance
to suit your needs, Christie + Co can draw upon its years of experience and
expertise to provide you with the right information and the best guidance.
Whether you’re buying or selling a dental practice, Christie + Co knows how
the right information presented in the right way can lead to the most desirable
result – your business or retirement goals, met with ease.

Visitors were keen to find out more about
Sparkle Dental Labs’ courier service to and
from dental practices. The first of its kind when it was introduced by the company, the
service offers free pick up and delivery with fast lab-work turnaround times.
The team were on hand to pass on information about the full certification provided
for each restoration, which complies fully with GDC regulations, and spoke about the
benefits of buying British hand-crafted dental products.
All in all the exhibition was a great success for the company, which looks set to
continue leading the way in product excellence.
For any additional information please call 0800 138 6255 or email
customerservice@sparkledentallabs.com or visit:
www.sparkledentallabs.com

To discuss how Christie + Co might help you achieve your future plans please
contact Simon Hughes on 0207 227 0749

For more information please call Nuview on 01453 872266.

Aligned with the British Dental
Health Foundation
Align Technology is supporting the
British Dental Health Foundation’s
2014 National Smile Month campaign.
Orthodontic treatment has the
potential to help some patients
overcome their dental phobia. The
most recent Adult Dental Health
Survey1 showed that 12% of people surveyed in the UK experience extreme
dental anxiety. However orthodontic treatment is viewed as a positive aspect
of dentistry – where people are motivated to actually seek out treatment from
their dental professional to improve their smiles. To back up the campaign,
Align Technology is developing a number of promotions with the BDHF
to educate the public and drive potential patients to enquire about tooth
straightening.

The Carl Zeiss OMPI Pico microscope – “I
remain as impressed now as I was when I
purchased it
“I’ve been using the OMPI Pico microscope
for about 18 months now and I remain as
impressed now as I was when purchased it,”
says Dr Devin Vaghela of The Morgan Clinic in
Maidenhead. “The unit is very well designed.
Its arms and Mora interface allow it to be
positioned at a wide range of angles over a
two-metre span. Its locking screws hold very
well even when gently tightened, allowing
minor degrees of movement, especially
important when under high magnification. A DSLR or Camcorder specific
adaptor can be mounted on the unit. It’s great for presentations to colleagues
and patients. Assistants like it too!”

Invisalign providers are also being encouraged to hold open days to capitalise
in the interest being generated during National Smile Month and to support
this initiative; Align is offering them 50% discounts on their lab fees between
19 May and 19 June. The company is also branding the famous National Smile
Month ‘smile on a stick’ providing participating practices with something to
promote Smile Month events.

The Carl Zeiss OMPI Pico microscope is available exclusively from Nuview
in the UK. “John and his team at Nuview recognise this purchase as a large
investment,” continues Dr Vaghela. “I have dealt with the team for a few years
now and have no hesitation in recommending them. They offer good technical
support, advice and a prompt service.”

The expert team includes implantologist Dr Zaki Kanaan and Specialist
Orthodontist Dr Preet Bhogal, two highly experienced and qualified
professionals dedicated to ensuring the success of your patient’s treatment.
As the referring dentist, you will be involved in the treatment planning, have
regular progress updates, and be required to approve each stage of the
treatment. Every case is documented with before and after photographs,
while orthodontic referrals receive treatment-planning models to send to their
ceramist. Offer your patients more – contact the London Smile Clinic and see
how they can work with you to provide optimum treatment and patient care.

For more information please call Nuview on 01453 872266,
email info@nuview-ltd.com or visit www.nuview.co

For more information, please contact 020 7255 2559
or visit www.londonsmile.co.uk/refer - your patients will be glad you did!

For more information visit www.nationalsmilemonth.org or
www.invisalign.co.uk

Enhance Your Patient Service With The
Experts At The London Smile Clinic
Regardless of your dedication to training and education, at some point you will
come across a patient that requires treatment outside of your skill set.
In those cases, offer patients the widest range of treatment options by referring
to the award-winning London Smile Clinic. The practice is open for referrals for
orthodontic treatment, implant work and complex multi-disciplinary cases.

[24] =>

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[cover] => DT UK No. 5, 2014

[toc] => Array ( [0] => Array ( [title] => News [page] => 01 ) [1] => Array ( [title] => Book Review [page] => 07 ) [2] => Array ( [title] => Event Review: Top Tips For Aesthetic Brilliance Part 1 [page] => 08 ) [3] => Array ( [title] => Stress in the dental profession [page] => 10 ) [4] => Array ( [title] => Implant Tribune: Flapless MIMI® implantation using the two-piece implant shuttle preventing physiological bone loss [page] => 11 ) [5] => Array ( [title] => Implant Tribune: Fabrication of a customised implant abutment using CAD/CAM: A solution specific to each clinical case [page] => 17 ) [6] => Array ( [title] => Implant Tribune: Treatment options for peri-implantitis [page] => 19 ) [7] => Array ( [title] => The University Hospital in Copenhagen is offering its 4th Trauma Symposium in Copenhagen [page] => 21 ) [8] => Array ( [title] => Industry News [page] => 22 ) ) [toc_html] =>

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