FI March 19

A par tnered publication with Dental Sales Pro • www.dentalsalespro.com

For Dental Sales Professionals

March 2019

Faster, easier, better Cone beam technology and 3D printing continue to be game-changers for dentists and patients alike.

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Editorial Staff Editor Laura Thill lthill@sharemovingmedia.com Managing Editor Graham Garrison ggarrison@sharemovingmedia.com Founder Brian Taylor btaylor@sharemovingmedia.com Senior Director of Business Development Diana Partin dpartin@sharemovingmedia.com Director of Business Development Jamie Falasz, RDH jfalasz@sharemovingmedia.com Art Director Brent Cashman bcashman@sharemovingmedia.com

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MARCH 2019

Faster, easier, better

Cone beam technology and 3D printing continue to be game-changers for dentists and patients alike.

Dental implants

Newer technology has made implants simpler and more accurate.

A Successful NDC Dental Forum in Sunny Florida Healthy Reps

Health news and notes

Quick Bytes

Technology News

News

Circulation Wai Bun Cheung wcheung@sharemovingmedia.com Associate Editor Alan Cherry acherry@sharemovingmedia.com

First Impressions Digital Edition is published monthly by Share Moving Media 1735 N. Brown Rd. Ste. 140 Lawrenceville, GA 30043-8153 Phone: 770/263-5257 Fax: 770/236-8023 www.firstimpressionsmag.com First Impressions (ISSN 1548-4165) is published monthly by Share Moving Media, 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Copyright 2019 by Share Moving Media. All rights reserved.

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First Impressions

March 2019

3

SURGICAL ADVANCES

BY LAURA THILL

Faster, easier, better Cone beam technology and 3D printing continue to be game-changers for dentists and patients alike.

In nearly the time it takes to make a pot of coffee and retrieve the morn-

ing paper from the driveway, some dentists can place an implant. While there’s no way to guarantee a perfect cup of coffee, that implant’s going to be close to perfect, if not spot-on.

Cosmetic and reconstructive specialist Michael Fulbright, DDS, owner of Fulbright Cosmetic and Reconstructive Dentistry, Redondo Beach, California, spends much of his day in surgery. His services range from implants and fullmouth rehabilitation to porcelain veneers, periodontal care and treatment for TMJ disorders and sleep apnea. “If there’s one thing that has made my patients’ life better – and my life easier – it has been cone beam technology, or 3D cat scans,” he says. “That combined with my CEREC CAD/CAM technology, procedures have

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March 2019

First Impressions

Michael Fullbright, DDS

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gotten easier and less expensive, with better results.”

Fulbright, in fact, had just completed an implant procedure shortly before taking time to discuss surgical advances that have changed the dental industry for the better. “With my Gallileos cone beam and CEREC, I was able to plan this morning’s surgery ahead of time and place the implant exactly where it needed to be using a surgical guide fabricated right in my office.” Not long ago, it would have been impossible to get an unobstructed view to determine whether the patient had enough bone height to avoid the mandibular nerve, he points out. Not so today.

“In the old days, using 2D X-ray technology, I would have to place implants freehand. Although I have placed

many freehand implants successfully the predictability and precision of guided implants has given us more confidence and has made the procedure more efficient. The patient experience and case acceptance have increased dramatically with the patient being able to visualize and be a part of the planning process.

With regard to our digital scanning technology (CEREC) to take impressions versus the old putty impressions, there really is no comparison. Patients love the fact that they don’t have to have a goopy, gaggy impression made, and the accuracy of the impression and fit of the subsequent crown is superior.”

“Today, I approach the procedure using reverse engineering, first planning the ideal crown and then planning the implant. Next, using a surgical guide sleeve over the missing tooth, I position the drill in the sleeve and can get within microns of the mandibular nerve or sinus, confident I won’t hit it.” Surgical times have been reduced from an hour to about 10 or 15 minutes, he adds. His practice runs more efficiently and his patients and dental team are happier.

Furthermore, even smaller dental offices are able to accommodate cone beam equipment.

“The cone beam foot print is small enough that it should fit in most dental offices,” he says.

“3D printers have come down in price tremendously. And, because he is able to work more accurately and efficiently, his printer has practically paid for itself, he notes. “So, I don’t need to raise my fees to reflect the cost of the equipment. I don’t pass that cost on to my patients.”

A window to the future

If cone beam has changed the face of dental surgery, 3D printing has opened a window to the future. “3D printing definitely has changed – and will continue to improve – the way I work,” says Fulbright. “My CEREC digital scanner ensures I get the most accurate impression possible, which I can send to a lab or print a model in-office with my 3D – Michael Fulbright, DDS printer. I believe this is where every dental practice is headed. I use my printer to print models for Invisalign-type aligners, sleep apnea appliances and nightguards.

“3D printers have come down in price tremendously,” he continues. And, because he is able to work more accurately and efficiently, his printer has practically paid for itself, he notes. “So, I don’t need to raise my fees to reflect the cost of the equipment. I don’t pass that cost on to my patients.”

3D printing is still relatively new, according to Fulbright. “It’s really just getting started,” he says. “Today, we only basically print plastic. As the materials catch up to the technology, I expect we’ll eventually move away from milling and start printing porcelain crowns and implant abutments. The sky is the limit”

Expanding roles Advances in surgical technology have led to new and expanding roles for dental assistants. Indeed, as more and more can be accomplished in the dental office, dental assistants no longer take a back-seat to the rest of the team.

“Dental assistants’ jobs have changed tremendously,” says Michael Fulbright, DDS, owner of Fulbright Cosmetic and Reconstructive Dentistry, Redondo Beach, California. “The dental assistants are the ones who are learning the software involved in milling, planning and 3D printing. I always complete the training with my team, but it’s my dental assistants who are using these machines day in and day out!”

And this is a good thing, he adds.

“Patients know and trust their dental assistants – often more so than their dentist. For patients, this technology means shorter chair times and less re-dos.”

Editor’s note: Michael Fulbright, DDS, owner of Fulbright Cosmetic and Reconstructive Dentistry (Redondo Beach, CA), offers restorative options such as dental implants and full-mouth rehabilitation, as well as a full range of general and cosmetic dentistry procedures. In addition, he is dedicated to helping individuals who suffer from obstructive sleep apnea. Dr. Fulbright is also very involved in giving back to his community. He has helped restore the lives of domestically abused men and women through the Give Back a Smile Foundation, as well as volunteered through Remote Area Medical (RAM), the Beacon House and various community causes.

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First Impressions

March 2019

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SURGICAL ADVANCES

Dental implants Newer technology has made implants simpler and more accurate.

Dental implants date back to 2500 BC, when the ancient Egyptians tried to sta-

bilize teeth with gold ligature wire. Today, researchers are exploring ways to grow a new tooth in a human adult – something that could take root, so to speak, in the next 10 years or so.

BY THOMAS HIRSCH, DDS Owner of a Malibu, Californiabased dental practice and founder of Isolite Systems, currently Zyris 6

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Recently, a Tufts University team constructed a cellular matrix that allows successful implantation of a tooth bud into a pig’s jaw. Under their design, early adultstage teeth develop within five months. Researchers project that humans won’t profit from these developments for another ten years. The exciting progress hints at options once believed to be impossible.

For now, dental implants are the closest alternative to growing new teeth. Research has

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brought major benefits to implant technology as well.

A higher standard of care It was debated several years back that if dentists had a CT scanner in their office, they would be held to a higher standard of care.

And, in fact, they were.

“Medical professionals who are liable for non-diagnosis of any abnormality on the CBCT scan include the dentist who orders the CBCT

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scan and likely any other professional who uses the CBCT for diagnosis or treatment planning. Dentists must possess the requisite standard of care when diagnosing and treating patients. This standard is normally stated as the level of knowledge, skill and care of a reasonable dentist. To meet this standard when using CBCT, dentists should use CBCT’s full capabilities to obtain maximum diagnostic accuracy. The standard of care must be met whether or not the dentist received specialized training on CBCT imaging because dentists are required to stay current in the areas in which they actively practice by enrolling in continuing education courses. There is even argument that dentists who use CBCT should be held to the higher standard of a board-certified oral and maxillofacial radiologist.”1 So how do dentists integrate a CBCT into their treatment planning and execution of dental implant procedures? Plan, plan, plan. It’s actually quite simple. First, patients should be medically evaluated before any implant surgery is scheduled. Patients either must have enough bone to support the implant, or be good candidates for surgery to build up the bone where the implant will be placed. Chronic illnesses, such as diabetes or leukemia, may interfere with healing after surgery. Patients that have taken bisphosphonates can have osteonecrosis of the surgical site.

Using tobacco can also slow healing.

Another great advance, although it’s no longer considered new, is CAD/CAM technology. CAD/CAM, combined with CBCT technology, allows dentists to virtually plan the final result.

So, the next step in this journey is to take physical or digital impressions of the patient’s maxillary and mandibular arches.

Once the arches are scanned and the vital structures are identified (in this example, that includes the adjacent teeth and the mandibular nerve, as well as the mental foramen) a virtual final restoration can be designed.

With the proper size and shape of the final virtual restoration, the implant of choice can be positioned.

It’s vitally important to determine the path of insertion of the implant relative to the occlusal surface of the crown, lest the screw access hole exits out of the buccal or lingual! Now it’s clear where the implant should be placed, but how does the dentist ensure it gets there? Neophytes in implant placement would do well to take beginning and advanced surgical dental implant courses. But even the best laid plans can fall short when using steady hands to place implants in the genesis, which is why the surgical guide has become so important.

Dentists can construct and print their own guide, mill it and have their laboratory fabricate one, or they can work with a third party. Whether the procedure involves a single implant or

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First Impressions

March 2019

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SURGICAL ADVANCES

Dentists can construct and print their own guide, mill it and have their laboratory fabricate one, or they can work with a third party.

multiple implants, the surgical guide ensures it runs smoother, with fewer complications.

The surgery Now comes the fun part: the surgery. For this, dentists must trust in their planning and clinical abilities, since they cannot actually see under the patient’s bone, and proceed as follows: • Review patient’s medical history.

• R eview treatment, options, risks, complications, alternatives and fees.

• Verify surgical guide fit.

• Treat in accordance to surgical protocol.

• Lay a flap or go flapless (tissue punch).

• Place the implant.

• Place the cover screw or healing abutment.

• Close the surgical site.

At my dental office, the surgical time to place a simple implant, a healing abutment and to close the surgical site can be as short as 10 minutes. Much depends on the implant method selected. In the end, when the implant is placed with a high degree of precision and accuracy, it makes the final crown restoration a simple one.

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March 2019

Thanks to directly visible surgical conditions, implantation is not only safer, it’s also minimally invasive. What’s more, dentists can save time during patient consultations since their patients understand the 3D visualization more easily.

Maximum efficiency All of this great CAD/CAM and CBCT technology has allowed me to design my operatories for maximum efficiency. We have placed treatment centers in all of our rooms. Our chairs are integrated with surgical motors built into the dental unit, and there is a pump for sterile saline. We always have a surgical handpiece ready to go. It has become very convenient to remove a cover screw, healing cap, abutment or implant crown. Sure, this has involved an investment in technology, but the returns have been fantastic. My front desk assistant has been crossed-trained to determine how long the procedures will take and to schedule a shorter amount of time to accommodate them.

My hygienist can recommend treatment with a great deal of confidence, knowing that guided dental implant procedures are much easier for the patient and entire team, and my dental assistant essentially has an extra pair of hands during surgery. And as for me: dental surgery has become more like a hobby than work. I do it for the love of it.

Stuart J. Oberman, Esq. Dental Tribune U.S. Edition, Vol. 6 No. 18, December 2011.

First Impressions

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DISTRIBUTION

A Successful NDC Dental Forum in Sunny Florida The NDC Dental Forum 2019: Power of Partnership brought 230 peo-

ple together from 38 dealer and 72 vendor companies. The annual event delivered powerful networking opportunities, face-to-face strategic meetings, educational sessions, a product fair and awards ceremony. Held in January at the Loews Royal Pacific Resort in Orlando, the Forum provided a setting for vendors and dealers to develop strong sales strategies for the coming year.

A Rapt Audience at the Opening General Session

Keynote Speaker, Perrin DesPortes

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First Impressions

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NDC President & CEO, Mark Seitz, shared with Forum attendees the investments the company is making to elevate support for customers, including: an improved contract processing platform, a renewed focus on operational efficiencies, access to pharmaceutical products and price-saving programs through NDC’s proprietary GPO, NuEdge Alliance, LLC. “Independent dealers continue to gain market share,” remarked Lori Paulson, NDC’s Chief Commercial Officer, Dental & Specialty Markets, during the opening session. She continued, “In 2018, NDC dental members’ collective business grew slightly more than industry reports for the overall dental market. Additionally, merchandise consumables grew versus prior year, despite flat equipment sales.”

The keynote presentation, “Group Practice Fundamentals & Selling Tactics to Compete in the Space,” was delivered by Perrin DesPortes of TUSK Partners. DesPortes discussed why doctor-founded and debt-funded group practices are the fastest-growing segment in the entire dental industry. He took the audience for a deep dive into consolidation of practices, mid-tier group formation and the roles played by private equity groups and enterprise-level dental service organizations (DSOs). Both dealers and vendors walked away with insights to build a better value proposition when engaging with special markets.

The Forum also featured a product fair, allowing vendors to showcase products and give hands-on demonstrations of new products. This event gave vendors a chance to discuss the unique products and services they can offer dealers.

Manufacturer of the Year: Medicom

Dental Member of the Year (Full Service): Midway Dental

Dental Member of the Year (Merchandise): Top Quality Manufacturing

Attendees at the Awards Reception

Face-to-Face Strategy Sessions

Vendor Product Fair

Additionally, a fun challenge was posed to the dealer group this year for a Floss Dance Video Contest. The winner of the contest was awarded $500 and a 1-year supply of floss. A group from IQ Dental Supply won the contest, and the President of IQ Dental Supply, Sergey Kunin, announced that the prize will be donated to America’s ToothFairy, an organization that provides dental care to underserved children.

At the annual awards event, NDC recognized new members, including: • AMAX Health (St. Catharines, Ontario, Canada) • Best Buy Dental Supply (Harrison, Ohio) • Newark Dental-Pemco (Springfield, New Jersey) • Preferred MedSurg (Columbia, South Carolina) The awards ceremony was an exciting celebration of top-performers from the previous year. The 2018 award winners are as follows: DENTAL MEMBERS OF THE YEAR: • Full Service: Midway Dental • Merchandise: Top Quality Manufacturing MANUFACTURER OF THE YEAR: • Medicom

NDC BRAND PERFORMANCE AWARD: • DDS Dental Supplies QUALA TRENDSETTER AWARD: • J&L Dental WAREHOUSE PERFORMANCE AWARD: • Midway Dental WAREHOUSE VENDOR OF THE YEAR: • Southern Dental Industries (SDI) MULTI-MILLION DOLLAR CLUB: • AM-Touch Dental • Burkhart Dental • Dental City • Dental Health Products, Inc. • IQ Dental • Midwest Dental Equipment & Supply • Top Quality Manufacturing MILLION DOLLAR CLUB: • DDS Dental Supplies • Parkway Dental • Scott’s Dental Supply

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• Atlanta Dental • DC Dental • Dental Distributors, Inc. • Goetze Dental • Midway Dental • Nashville Dental • Safco Dental Supply • Ultimate Dental

• Healthcare Supply Service • PureLife Dental

First Impressions

March 2019

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HEALTHY REPS

Health news and notes

12

Get happy

Pay attention

Being active can help you improve your health and feel better, says the Department of Health and Human Services. It can lower your blood pressure and reduce your risk of chronic diseases, like type 2 diabetes and certain cancers. Physical activity can also boost your mood and help sharpen your focus. In its new Physical Activity Guidelines for Americans, HHS says that adults need at least 150 minutes of moderate-intensity physical activity per week. You can start with just 5 minutes at a time. Swim, garden, walk the dog, dance, or bike your way to feeling better.

Strengthening your muscles is important too. At least two days each week, do some push-ups or lift weights. Children ages three to five should be physically active for at least three hours throughout the day. Kids six through 17 need at least one hour per day. All of your physical activity adds up. Moving more often throughout the day can help you get enough activity.

Adults with obesity who attended group sessions teaching mindfulness-based eating techniques lost an average of 2.85 kg more than similar adults who attended group classes without mindful eating strategies, according to findings published in The Journal of Clinical Endocrinology & Metabolism and reported by Helio.com. “Our study has shown that mindfulness techniques can improve eating behavior and facilitate weight loss in patients with obesity attending specialist weight management service,” said Petra Hanson, MBChB, MRCP, AFHEA, a clinical research fellow at Clinical Sciences Research Laboratories, University Hospitals Coventry and Warwickshire, U.K. “Mindfulness taught in such a setting can also improve patients’ confidence and ability to manage weight in the long term. It is a very scalable intervention that can be applied to everyone.”

March 2019

First Impressions

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Housework for brainiacs

Unhappy meal

Now there’s no excuse for not doing more housework. Even simple housework, like cooking and cleaning, may make a difference in brain health, according to researchers at Rush University Medical Center in Chicago. In the last years of research before death, each participant in the Rush study wore an activity monitor called an accelerometer, similar to a Fitbit, which measured physical activity around the clock – everything from small movements, such as walking around the house, to more vigorous movements, like exercise routines.

Researchers collected and evaluated 10 days of movement data for each participant and calculated an average daily activity score. The findings showed that higher levels of daily movement were linked to better thinking and memory skills, as measured by the yearly cognitive tests. And when researchers analyzed brain tissue under a microscope, this finding turned out to be the case even for individuals with at least three signs of Alzheimer’s disease, such as amyloid plaques and neurofibrillary tangles. Even though these individuals might have been diagnosed with Alzheimer’s, 30 percent of them had “normal” cognition at death.

A hamburger a week, but no more – that’s about as much red meat people should eat to do what’s best for their health and the planet, according to a report by EAT, a Stockholm-based nonprofit, and published in the medical journal Lancet, reports the New York Times. Eggs should be limited to fewer than about four a week, and dairy foods should be about a serving a day, or less. The report from a panel of nutrition, agriculture and environmental experts recommends a plant-based diet, and encourages whole grains, beans, fruits and most vegetables.

Added sugars should be limited, as should refined grains, such

In November, vaping giant Juul voluntarily shut down its Facebook and Instagram accounts and pulled several flavors out of retail stores. But there’s been little discussion of how to treat nicotine addiction in children as young as 11 years old.

What to do about vaping?

Health authorities agree: Teen vaping is an epidemic that affects some 3.6 million underage users of Juul and other e-cigarettes, reports the New York Times. But no one seems to know the best way to help teenagers who may be addicted to nicotine. E-cigarettes heat a liquid solution that usually contains nicotine into an inhalable vapor. Federal law prohibits sales to those under 18, though many high schoolers report getting them from older students or online. In recent months, government officials have rolled out a series of proposals aimed at keeping the products away from youngsters, including tightening sales in convenience stores and online. In November, vaping giant Juul voluntarily shut down its Facebook and Instagram accounts and pulled several flavors out of retail stores. But there’s been little discussion of how to treat nicotine addiction in children as young as 11 years old. Physicians who treat young people now face a series of dilemmas: The anti-smoking therapies on the market – such as nicotine patches and gums – are not approved for children, due to lack of testing or ineffective results. And young people view the habit as far less risky than smoking, which poses another hurdle to quitting.

as white rice, and starches, like potatoes and cassava. It says red meat consumption on average needs to be slashed by half globally, though reductions would need to be more dramatic in richer countries like the United States.

Older adults: Mind your protein Older adults need to eat more protein-rich foods when losing weight, dealing with a chronic or acute illness, or facing a hospitalization, according to a growing consensus among scientists, reports Kaiser Health News. During these stressful periods, aging bodies process protein less efficiently and need more of it to maintain muscle mass and strength, bone health and other essential physiological functions. Even healthy seniors need more protein than when they were younger to help preserve muscle mass, experts suggest.

Yet up to one-third of older adults don’t eat an adequate amount due to reduced appetite, dental issues, impaired taste, swallowing problems and limited financial resources.

Combined with a tendency to become more sedentary, this puts them at risk of deteriorating muscles, compromised mobility, slower recovery from bouts of illness and the loss of independence.

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March 2019

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Editor’s Note: Technology is playing an increasing role in the day-to-day business of sales reps. In this department,

QUICK BYTES

First Impressions will profile the latest developments in software and gadgets that reps can use for work and play.

Technology News 5G is coming. Fast.

Wireless turntable

5G is a set of technical ground rules that define the workings of a cellular network, including the radio frequencies used and how various components like computer chips and antennas handle radio signals and exchange data, explains the New York Times.

But lay people need to know just one thing – it’s fast. We’ll be able to download movies in seconds. Streaming video will be a breeze. The virtual reality experience will be much less cumbersome than it is today. The faster networks could help spread the use of artificial intelligence and other technologies.

Sony Electronics Inc. announced the Sony PS-LX310BT wireless turntable, said to “fuse the much-loved vinyl sound quality with the convenience of connecting wirelessly to enjoy clear, natural sound.” The turntable – which costs about $200 – has a builtin Bluetooth® transmitter. Featuring one-step auto playback, it automatically lowers the tone arm, finds the groove and plays the music. When the record ends, the tone arm automatically returns to its resting position.

Speed drying

The kids are alright Expectant mothers, start your day confident in the wellness of your unborn child, with the Owlet Band. Specialized sensors housed in a fabric band that sits around the mother’s abdomen track fetal heart rate and kick count in the second and third trimesters, sending real-time data to a smartphone. It offers fetal heart rate tracking, fetal heartbeat recording, wellness notifications, automated kick counting, contraction tracking, and maternal sleep position indicators. The sensors are said to be extremely thin and are bonded to a stretchable knit fabric band, providing a form-fitting and comfortable feel.

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March 2019

First Impressions

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The Zero vacuum clothes dryer from MORUS is said to achieve low-temperature, low-energy-consumption and high-speed clothes-drying. The company says you’ll like the Zero for three reasons: 1) The drying process is faster, because the Zero allows the water in the clothes to boil at a lower temperature, so the water will evaporate more easily; 2) vacuum drying can significantly reduce energy use, because it does not need to heat the drum to a high temperature because the boiling point of water is lowered; and 3) low-temperature drying protects clothes. Overheated tumble drying reduces the strength of textiles, and it is a main cause of fabric wear damage.

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NEWS

Industry News

16

Christian Brutzer named President of Ivoclar Vivadent North America

Darby to host 18th Annual SmartScramble Charity Golf Outing to benefit Give Kids a Smile

Ivoclar Vivadent announced that Christian Brutzer has been appointed President of Ivoclar Vivadent North America, effective July 1, 2019. Currently a Vice President of Ivoclar Vivadent N.A., Brutzer will be responsible for leading the North American subsidiaries (US and Canada).

Christian Brutzer Brutzer joined Ivoclar Vivadent AG in 2006 as Director of Sales for the Asia/Pacific Global Region, and Vice President of Alloy Sales for North America. He was appointed to the Ivoclar Vivadent AG Corporate Management Board in 2011.Until July 1st, Mr. Brutzer will continue in his current role in North American operations and work with current Ivoclar Vivadent President and CEO, Robert Ganley, toward an effective and seamless transition. He will also maintain his position on the Corporate Management Board responsible for the Asia/Pacific Global Region.

"Mr. Ganley has enjoyed a storied career with Ivoclar Vivadent," said Brutzer. "Under his leadership, the company has experienced tremendous growth. He was responsible for jumpstarting the Esthetic Revolution and many of his accomplishments still serve as industry benchmarks. In this position, I look forward to continuing his legacy."

Darby Dental Supply, LLC, one of the largest dental distributers in the United States, is gearing up to host the 18th Annual SmartScramble Charity Golf Outing to support the Arizona Dental Association’s Give Kids a Smile. The outing will take place April 12, 2019 in Paradise Valley, Arizona, located at the CW Marriot Camelback Golf Club. Founded in 2002 by Phoenix-based SmartPractice, the annual SmartScramble golf tournament supports charitable organizations in Phoenix and surrounding communities. Re-named the Darby SmartScramble in 2018 after Darby acquired the dental supply division of SmartPractice, this year’s event marks Darby’s first time hosting this event. Last year’s event was the most successful to date, raising $85,000 for Give Kids a Smile. Darby, along with their generous list of sponsors and participants are set to surpass that number this year. For more information on how to participate or donate, please visit darbysmartscramble.com

March 2019

First Impressions

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Henry Schein completes spin-off of global animal health business Henry Schein Inc (Melville, NY) completed the spin-off of its animal health business February 8, 2019. As part of the spin-off, Henry Schein received approximately $1.1 billion in what is expected to be tax-free proceeds that will be used to pay down debt. The debt repayment will generate additional debt capacity for Henry Schein, which could be used for general corporate purposes, including share repurchases and mergers and acquisitions.

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