www.dta-uk.org
March 2018 | volume 5 | issue 2
articulate the bi-monthly e-newsletter of the dental technologists association
This issue contains 30 minutes of CPD for DTA members
F13a Kestrel Court, Waterwells Drive Waterwells Business Park Gloucester GL2 2AT Telephone: 01452 886366 Email: sueadams@dta-uk.org Web: http://www.dta-uk.org
DTA Nominated Charity of the Year 2018 DTA members have selected Den-Tech as DTA’s nominated Charity of the Year for 2018. If you’d like to find out more about their work, go to www.den-tech.org
Enhancing your Orthodontic Build up Technique Knowledge Standards for Dental Professionals: ● Standard 7.3 Update and develop your professional knowledge and skills.
Aim: ● To highlight three different techniques of enhancing the appearance of orthodontic base plates.
CPD Outcome(s): ● To gain an understanding of how to fabricate a split colour and a marble effect orthodontic base plate; ● To learn how to incorporate a logo or an identification marker within a baseplate; ● To enhance knowledge within different types of fabrication techniques.
Introduced by Tony Griffin With grateful thanks to Steve Szara we present a link to this piano playing American dental technician. As indicated in the previous TT, we would encourage those with such skills to share with their colleagues. Steve has allowed the DTA to have links to his interesting video demonstrations and to create some Multiple Choice Questions to provide an opportunity for you to gain verifiable CPD.
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n this demonstration Steve shares his way of creating the build-up of a split colour orthodontic base. Although this is just around 5 minutes long it is obvious that much personal practice is required to create this with confidence and reproducible quality. ■ https://www.youtube.com/ watch?v=S0U-7cb-ZJY This demonstration provides techniques for creating a marble effect within a build-up technique. Steve reflects on how in previous attempts to perfect this effect he has learnt and is still learning how best to develop this effect. ■ https://www.youtube.com/ watch?v=H77KwMDFOTA
In this final link Steve explains how to introduce a Decal/Logo to a retainer. He also explains that to be able to share this technique he has moved away from the extraction hood. We cannot support putting yourself at risk to share knowledge with colleagues. But you will see the detail of the technique and an excellent result. ■ https://www.youtube.com/ watch?v=52sjD2aFj5k Finally, we provide the link to Steve’s passion for his own produced music as he mentions in the above ■ https://www.youtube.com/ channel/UCjVMs1zDL6MRx6E7162ZU7A
Dental Technologists Association, F13a Kestrel Court, Waterwells Drive, Waterwells Business Park, Gloucester GL2 2AT. call: 01452 886 366 email: sueadams@dta-uk.org web: www.dta-uk.org
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March 2018 | volume 5 | issue 2
Enhancing your Orthodontic Build up Technique Knowledge... continued... CPD Questions Q1 What does the presenter say is the key to success in the two colour spray build up?
Q2 What does the presenter say regarding how the two colour build up skill was developed?
Q3 For the marble effect what does the presenter use in this case?
a) To take time to allow residual polymerisation b) To start on the right and build up fast c) To be fast and efficient d) To be quick and overbuild the centre line
a) Using specialised liquids to enhance the colours b) Years of personal practice c) Using a clear base layer when finished d) Making separate halves in hard acrylic then moving onto spray systems
a) Blue, red, purple and clear monomer, & b) b) Blue, white, dark red, purple and black polymer and clear monomer, c) Clear and white monomer, & b) d) Black, pink, purple and blue polymer and only clear monomer
Q4 What tip does the presenter suggest for marble effect build up?
Q5 In adding a logo or decal why does the presenter suggest care is required in placement?
a) b) c) d)
a) b) c) d)
Keep tilting the modules and to encourage holding the pattern in place When you find the right marble pattern freeze it with clear polymer Add less black and b) Follow a predetermined pattern
Not too close to the fit surface Not creating a thick palate Creating sufficient coverage of the placed item All the above
CPD Reflection There are no right or wrong answers for these questions – tick only one answer for each question. A. What did you learn from this CPD activity I. Updated my own knowledge on the subject II. Gave me a basic understanding of this area of activity III. Made me consider possibly sharing this information with others IV. Was of no use to me whatsoever
B. How might this CPD help improve your professional working I. It will not, but it has made me aware of potential business opportunities II. Made me aware of other areas of work activity III. Gave me the opportunity to consider other potential learning IV. No help whatsoever.
Feedback Box:
Disclaimer Notice: This publicly available information is provided to members for educational purposes only and DTA accepts no responsibility for any inaccuracies contained therein. Clinical aspects are shown in order to (a) assist members’ understanding (b) promote team working with clinical colleagues and (c) support continuing professional development.
Find out more at: https://www.gdc-uk. org/professionals/ cpd/enhanced-cpd Dental Technologists Association, F13a Kestrel Court, Waterwells Drive, Waterwells Business Park, Gloucester GL2 2AT. call: 01452 886 366 email: sueadams@dta-uk.org web: www.dta-uk.org
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March 2018 | volume 5 | issue 2
E-NEWS SHOTS BRACON DIGITAL COURSES WITH VERIFIABLE CPD The Bracon International Training and Education Centre, otherwise known as BITE, is our exciting new state of the art training facility. This will provide a hub in the South of England for all Dental Professionals and is part of Bracon’s continued commitment to the Dental Team. Through this centre we offer fully compliant in-house CPD courses; to aid you in your development and to give you an opportunity to get hands-on with some of the products and equipment that we can supply. Bracon has always strived to stay up-to-date with the ever-changing world of dentistry and is constantly reviewing and improving its product range and service. In line with this policy is the ability to provide training courses and demonstrations of new products and techniques. Together with its suppliers, Bracon is able to bring innovation and new technology
directly to its customers, all based at its comfortable new laboratory, seminar and conference facility. AN INTRODUCTION TO DIGITAL DENTISTRY, SCANNING, AND PRINTING A comprehensive one-day course, for those that want to know more, includes hands on practical sessions in scanning and printing. DIGITAL DENTISTRY, SCANNING AND PRINTING OVERVIEW Delegates will have a great opportunity to learn more about Digital Dentistry processes and the procedures involved in scanning and 3D printing. Delegates will gain an understanding of what can be fabricated using current materials and how this technology is already changing the Dental landscape.
Breaking Down Barriers The 22nd Conference for Dental Care Professionals Saturday 10th March 2018 ● For full details and to book your place go to: https://www.rcsed.ac.uk/events -courses/event-entry?diaryId=2098
● For full details and to book your place go to: http://www.bracon.co.uk/cpd
The time is right to come together Past delegates to the Dental Technology Showcase have praised how the event seamlessly integrates a high-quality educational platform with what’s new and exciting in the dental technology and products market. With thought-provoking lectures and workshops running alongside a diverse and vibrant trade exhibition, this helps to ensure that all the equipment, materials and software on display are compatible with what a modern dental lab actually needs.
The conference programme has been tailored to teach, inspire, challenge and breathe life into all areas of the laboratory. The exhibition is there for the team to discuss, source and compare products and turn any new ideas into reality. This holistic approach reflects what it takes to be a successful lab owner and great technician in the modern climate. Clinical knowledge, the ability to think creatively as well as analytically, passion and a dedication to give every patient a beautiful, stable and functional result using the best materials and techniques – these are the
threads that the Dental Technology Showcase ties together. It’s not just about creating something that looks good, but something that actually works, too. Stefan Picha will discuss the importance of function as well form in his presentation at the DTS Lecture Theatre. Stefan, a member of the Oral Design Foundation, will be sharing his knowledge and experiences of full-arch restorations that he has seen in the laboratory he runs in Fürth, Germany. Underpinning the work of his lab is a philosophy that a smile has to be functional as well as beautiful. After all, we constantly use our teeth. They have important practical duties – chewing and speaking – that they must be capable of fulfilling for a very long time. Stefan says: “A lot of technicians focus on the aesthetic as the most important thing. But if the function of the restoration is wrong, then our work has failed. I will be looking at the problems that we can encounter if we don’t give equal
Dental Technologists Association, F13a Kestrel Court, Waterwells Drive, Waterwells Business Park, Gloucester GL2 2AT. call: 01452 886 366 email: sueadams@dta-uk.org web: www.dta-uk.org
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March 2018 | volume 5 | issue 2
E-NEWS SHOTS (CONTINUED...) priority to the function in a lecture called, ‘Function is the guarantee for a long-term success. What do we have to consider in a full-arch restoration?’ “I am going to cover what we need to know before we start and the main reasons for any slipping in such a restoration. I am also going to look at why people do monolithic restorations and the relationship between red and white. “I really believe this in an area in which technicians can grow their skills. I hope that delegates will take away from my lecture the information they need to get a better aesthetic and more importantly a better function when they do this type of restoration. This will mean less slipping and fewer problems in the mouth overall. I also hope that they will understand what they can do to avoid failure in the future.” The Dental Technology Showcase aims to help you do things better. That’s why its educational content reflects the diverse range of knowledge and skills you need to keep raising the bar. As well as the DTS Lecture Theatre programme, delegates will be able to listen to presentations in the Digital & Innovations Theatre and attend valuable Business Skills Workshops too. There will also be a Clinical Dental Technicians (CDT) conference stream as well as the Orthodontic Technician Association (OTA) seminars. The ADI Implant Theatre and BACD Aesthetic & Digital Speakers rounds-up the impressive line-up. The CDT
It’s why, year on year, entire laboratory teams have found it well worth taking time out to attend the Dental Technology Showcase. Performing exacting tasks, day after day, it is easy to become disconnected to what is going on in the profession and forget how all the various threads must knit together if you are going to keep standards high and your patients happy. Networking is so important; hearing new points of view, comparing difficult cases and forcing yourself to think outside the box is what will keep you motivated and inspired. With the British Dental Conference and Dentistry Show running alongside the event, and with attendees getting free access to both, the opportunities for learning, product sourcing and making new contacts are unparalleled. The flagship event of the Dental Laboratories Association, the Dental Technology Showcase is the biggest and best example of how attending professional events is still very important in our ever-more virtual, technologybased online world. It brings together theory and practice, the clinical and the creative and will inspire you to find the technology and materials you need to do things better. Grow your skills, get informed and updated and aspire to successful outcomes every time – secure your free pass today.
FGDP(UK) rejects amalgamation of regulators
The Faculty of General Dental Practice UK (FGDP(UK)) has responded sceptically to proposals to cut costs by amalgamating the UK’s health regulators. In response to a consultation by the Department of Health, it says it is not
convinced that combining dental regulation with that of other professions could save money while retaining the required understanding of the dental professions, and that in the absence of evidence to the contrary, the interests of patients and the profession will best be served by the continued existence of a regulator dedicated solely to dentistry. ● Read more at: https://www.fgdp.org.uk/ news/fgdpuk-rejects-amalgamation -regulators
Stephan Picha
● DTS 2018 will be held on Friday 18th and Saturday 19th May at the NEC in Birmingham, co-located with the British Dental Conference and Dentistry Show. ● For further details, visit: www.the-dts.co.uk , call 020 7348 5270 or email dts@closerstillmedia.com
ELECTION OF MEMBERS TO THE DENTAL TECHNOLOGISTS ASSOCIATION (DTA) 1. Notice is hereby given that an election of five Council Members of the Dental Technologists Association is about to be held. 2. Any Member of the Company is entitled to be nominated as a candidate. 3. Any person entitled to vote may take part in the nomination of any number of candidates not exceeding the number to be elected. 4. Each candidate must be nominated separately by the signatures of not fewer than three Members of the Company on not more than two nomination papers to be obtained from the Returning Officer; and every nomination paper shall contain the name, registered address and title to registration both of the candidate and of the nominated and will accept office if duly elected. 5. The nomination paper or papers for each candidate must be delivered by hand or by registered post to the Returning Officer on or before the 1st day of May 2018. 6. A nomination in respect of which any of these rules has not been complied with will be invalid. James Green, Returning Officer The Dental Technologists Association F13A Kestrel Court, Waterwells Drive Waterwells Business Park Gloucester GL2 2AT
Dental Technologists Association, F13a Kestrel Court, Waterwells Drive, Waterwells Business Park, Gloucester GL2 2AT. call: 01452 886 366 email: sueadams@dta-uk.org web: www.dta-uk.org
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March 2018 | volume 5 | issue 2
TT IS GETTING BIGGER & BETTER TT was launched in the spring of 2008 to coincide with the GDC’s introduction of mandatory CPD for newly registered dental professionals – dental technicians.
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roducing a 28-page publication, originally quarterly and then bimonthly – was a challenge. We had never done anything like this big before! But the introduction of professional registration was a big thing for you – our members – and we wanted to do what we could to support you. The purpose of TT was primarily to ensure that your verifiable CPD needs were covered. If you weren’t able to do any other training, you (and we) could rest assured that you would still fulfil the GDC’s CPD requirements. We think together we all did OK; our strategy of support was successful.
New quarterly schedule Your next edition of TT will be at the start of May (rather than April) and will be a massive 40 pages+. That’s what we like to call a bumper issue. But it isn’t a one-off. TT is moving back to a quarterly cycle from May with two further editions in 2018: August and November.
New bigger issue Future editions of TT will be 40 pages long, so you will still benefit from the breadth of CPD provided in the past in our bi-monthly schedule. Each bumper, quarterly edition will feature several technical CPD articles; we are aiming for something for everyone with orthodontic, C&B and prosthodontics features. In addition, there will be sections focusing on business and compliance, interviews with DTs, and articles focusing on what’s happening in our industry.
New editorial assistant And now, in light of the changes being introduced this August relating to CPD and the compulsory introduction of the Personal Development Plan (PDP), we will be introducing a new approach to TT, to ensure that we once again, adequately support you.
It is all very exciting!
As part of the development of TT we have recruited an editorial assistant with dental technology pedigree, to peer review our articles and ensure that DTA members receive the very best quality education we can possibly provide.
Move to online CPD The last change to announce is that all CPD from the August edition will be done directly online so we will cease to provide answer sheets within each edition of TT from this edition. If you are not familiar with how to complete your CPD online or you have concerns, please contact Sue at DTA to discuss. Of course, we will do everything to support you. We are already working on our bumper May edition with great excitement and we hope you will be just as excited to receive it.
2018 Membership Publications Below is a revised summary of when each DTA publication will be sent to members this year:
Month
Articulate
January February March April May June July August September October November December
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Dental Technologists Association, F13a Kestrel Court, Waterwells Drive, Waterwells Business Park, Gloucester GL2 2AT. call: 01452 886 366 email: sueadams@dta-uk.org web: www.dta-uk.org
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March 2018 | volume 5 | issue 2
CONTOURING, FINISHING AND POLISHING IS MORE THAN JUST “THE ICING ON THE CAKE” Abrasives: The Surface Quality of Ceramic Dental Restorations Is Best Improved Using a Systematic Approach Dr Markus Th. Firla The final, intraoral use of abrasives to anatomically and functionally improve the surface quality of all-ceramic dental workpieces is not easy for dentists, especially in the case of CAD/CAM restorations milled from “industrially prefabricated” zirconia or lithium disilicate blocks. Efficient extraoral finishing of such restorations in dental laboratories should not be underestimated either.
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he objective of both steps is to give ceramic restorations occlusal surfaces which are as smooth as possible, in harmony with natural occlusion, and anatomically and functionally correct. Today, experts agree that all-ceramic CAD/CAM restorations, particularly single and partial crowns, veneers, and bridges, are best finished with diamond rotary instruments, even though – depending on the CAM system used – laboratories frequently rely on carbide instruments in the basic fabrication process. In contrast to the milling of all-ceramic dental workpieces from prefabricated blocks, the subsequent finishing procedures performed
Fig. 2: A maxillary molar (tooth 26) had to be restored with a monolithic all-zirconia crown.
in laboratories and, mostly intraorally, in dental practices are designed to reduce material in the submillimetre or micrometre range. For this minimal treatment, diamond finishers and polishers are the tools of choice; they remove material gently, but efficiently, because instruments coated or impregnated with coarse, medium or fine diamond particles ensure uniform material reduction with continuous and accurate control. Diamonds are the only instrument type allowing users to achieve surface roughness values comparable to those of glaze-fired ceramics, from the contouring step, which creates the final shape of the workpiece, to the finishing step, which determines the surface texture, and the pre-polishing and high-gloss polishing steps, which complete the process.
Fig. 3: Since the tooth structure defects were relatively large and the patient wished to have all the amalgam removed before crown placement, extensive preparation was necessary.
on the ceramic material caused by the antagonist. Likewise, a smooth ceramic surface minimises the abrasive loss of natural enamel of the tooth opposing the restoration. These phenomena need to be considered when working with all-ceramic restorations, especially if they are made of zirconia or lithium disilicate, because the desired hardness of these materials, and also their brittleness, should not be neglected. The dental manufacturer Shofu has recently launched the ZiLMaster system, comprising two kits of instruments specially designed for contouring, finishing and polishing all-ceramic
In addition, the use of diamond rotary instruments to contour, finish and polish dental ceramics substantially reduces the risk of causing microscopic or macroscopic cracking, or even chipping. Fig. 1: The ZiLMaster Adjustment Kit CA, designed for use in dental practices: The Dura-Green DIA diamond stones, the diamond-impregnated ZiLMaster silicone polishers, and the metal shanks can easily be disinfected (with wipes) and sterilised. Photo: Shofu Dental GmbH
The smoothness of a ceramic surface is not only crucial to its gloss, and therefore to the aesthetic result; it also has a second effect, which is equally important. The smoother the ceramic surface, the less likely the occurrence of negative mechanical influences
Fig. 4: The all-zirconia crown, prepared for final shade individualisation and intraoral functional improvement of the occlusal surface (contouring, finishing, polishing) with Dura-Green DIA stones and coarse, medium and fine ZiLMaster silicone polishers.
Dental Technologists Association, F13a Kestrel Court, Waterwells Drive, Waterwells Business Park, Gloucester GL2 2AT. call: 01452 886 366 email: sueadams@dta-uk.org web: www.dta-uk.org
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March 2018 | volume 5 | issue 2
Contouring, Finishing and Polishing Is More than Just “the Icing on the Cake”... continued... References
Fig. 5: The finalised all-zirconia crown (BruxZir, Glidewell Europe GmbH) was stained, glaze-fired, and then adhesively bonded using a resin cement system (ResiCem, Shofu Dental GmbH). Photos 2 to 5: Dr Markus Firla/WeCoMed GmbH
restorations made of zirconia or lithium disilicate. The kits are coded CA (contraangle) for intraoral use by dentists and HP (handpiece) for extraoral use by dental technicians. For both kits, selected shapes of Shofu’s comprehensive and time-tested range of Dura-Green DIA diamond stones have been combined with various shapes of newly designed diamond-impregnated silicone polishers. The different – directly and specifically matched – diamond grits of the Dura-Green DIA instruments and the coarse, medium and fine ZiLMaster polishers excellently complement each other in the contouring, finishing and high-gloss polishing procedures, ensuring a very quick and easy workflow.
1. Dierkes, S. et al.: Einfluss der Oberflächenaktivierung auf den Haftverbund von Verblendkeramik auf Zirkonoxid. Quintessenz Zahntech 2014; 40 (8): 966-978. 2. Janyavula, S. et al.: The wear of polished and glazed zirconia against enamel. J Prosthet Dent 2013; 109 (1): 22-29. 3. Kimmel, K.: Rauhtiefen – ein unterschätztes Qualitätskriterium. Zahnärztl Mitt 1998; 88 (14): 1796-1798. 4. Komet / Gebr. Brasseler GmbH: Rotierende Werkzeuge in der Zahntechnik. – Fachvorträge zum Thema. Jahrestagung der Arbeitsgemeinschaft der Lehrer an Zahntechniker-Fachklassen. 21.-23. Mai 1992, Lemgo. 5. Lang, Ch.: Spezifische Oberflächenbearbeitung keramischer Restaurationen. Quintessenz Zahntech 2014; 40 (10): 1268-1279. 6. Miller, M. B., Castellanos I. R.: Reality –The information source for esthetic dentistry. Volume 22. Reality Publishing Co., Houston, USA, 2012. 7. Preis, V.: Pin-on-Block Verschleißverhalten von Dentalkeramiken. 25. DGZMK/BZÄK/DENTSPLY Förderpreis. Frankfurt, 2011 8. Pröbster, L., Kern, M.: ZrO2-Monolithen – ein Faszinosum ? Der Trend zu vollanatomischen Oxidkeramik-Kronen. DZZ 2012; 67 (12): 777-782. 9. Shofu Dental GmbH: Abrasives – Schleifkörper, Polierer und Poliersysteme. Ratingen, Deutschland, 2010. 10. Shofu Inc.: ZiLMaster Product Information. PowerPoint Präsentation. Kyoto, Japan, 2015. 11. Wehnert, L. et al.: Einfluss von mechanischen Oberflächenbearbeitungsverfahren auf den Verbund von Y-TZP zu vier Verblendkeramiken. Quintessenz Zahntech 2011; 37 (3): 342-356.
Author Dr Markus Th. Firla Hauptstrasse 55, D-49205 Hasbergen-Gaste, Germany E-Mail: Dr.Firla@t-online.de
Fig. 6
Fig. 7
Fig. 8
Figs. 6-9: Systematic improvement of an all-ceramic, lithium disilicate restoration surface in a dental laboratory, shown step by step. Thanks to gentle and efficient contouring, pre-polishing and high-gloss polishing with the ZiLMaster kit, final glaze-firing of the workpiece was not necessary. Photos 6 to 9: Dental-Labor Kock, Wallenhorst Fig. 9
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Dental Technologists Association, F13a Kestrel Court, Waterwells Drive, Waterwells Business Park, Gloucester GL2 2AT. call: 01452 886 366 email: sueadams@dta-uk.org web: www.dta-uk.org