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Editorial: Taking The Journey Smile Makeover for Elley On the cover
2014 Digital Dentistry Roundtable pt II
Dentistry, Dr. Peter Rival laboratory dentalstudios Photography, Trevor Laingchild, RDT, AAACD
Practical Dental Laboratory Photography A Touch of Life
a business information group publication ORAL HEALTH LABS is a supplement to Oral health
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editorial EDITORIAL: TAKING THE JOURNEY Looking back in time, how many of us are able to recollect the specific time and location that we received the inspiration and motivation to commence our dental journey? When was the exact time and place where the inspiration of an individual, or an event, gave us the motivation to enter into a profession helping so many people to live a more fulfilling life, whether that be aesthetically, or functionally? What was the spark? Perhaps it was a chance meeting with a complete stranger. This person was possibly a stranger to you, but not necessary a stranger to the world of dentistry. Maybe it was an educator, a high school teacher, or a professor at a college or university. An individual, with the wisdom to foresee the demographics of future population growths, combined with the potential growth of a profession with ever-increasing aesthetic demands and professional standards. Many of our peers discover our rewarding profession by following family and friends that have already commenced the journey. Currently, numerous family laboratory businesses exist, which foster several generations of expertise that continue to evolve as technology advances. Does dentistry get in the blood amongst family members? Interestingly, the evidence suggests that it does. Over the years as a dental laboratory owner, I have been amazed by the numerous number of dental restorative patients I have encountered that were not aware of the existence of dental technicians. That look of amazement when informed about the role the dental technician has within their treatment plan. Unfortunately, some patients have a total lack of knowledge and awareness of our role and involvement. For example, I have heard these sentences spoken numerous times: “I did not know about you” or “ What do you do here?” The next most popular question often asked is: “Where can I get information about this profession?” and “Where is dental technology education offered?” With some of these experiences over the years, I have often wondered how anybody, looking to undertake the journey with an inspirational career, has found our profession. Given that many people are unaware of dental technology as a career, it is not surprising that they are also unaware of the dental technician’s role within the dental restorative process. Within the general public at large, I feel our professional visibility requires an immediate upgrade. Patients need to be aware of our contribution to restorative dentistry, and also understand the level of professional commitment given to the fabrication process. Unfortunately, the future may well hold a somewhat diminished role for us, as selected established technical protocols are relocated into the clinical realm and away from the dental laboratory. However, as my dental technician grandfather and father once told me with vision many years ago, the want and need for our profession would endure. Can you guess where my journey started? During a lecture I gave many years ago, I illustrated the relevance and power of an advertisement campaign, which had been used by Porsche motorcars, that I feel can be utilized in any profession or business, when applied correctly. The advertisement showcased a stationary Porsche automobile with a group of people staring at the car. The caption read, ‘Nobody needs a Porsche, but most people want one’. I believe
Trevor Laingchild’s sense of adventure has taken him on an international road in his profession. After formal Dental Education in London, England, he managed a Dental Laboratory in Germany and served as Chief Dental Technician for an American Hospital in Saudi
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Arabia. Further experiences included, expanding his technical horizons whilst working in Norway, Scandinavia. He currently owns and operates dentalstudios in Burlington and in Yorkville, Toronto. Trevor is an Accredited member and an Examiner within the American
Academy of Cosmetic Dentistry, in addition is a Certified LVI Master Aesthetic Technician. Trevor is very active lecturing and teaching whilst conducting numerous hands on courses in all aspects of restorative aesthetics, of which, he has had numerous articles published.
the underlying philosophical message, regardless of what object, or service is being advertised, is the ‘Want is more powerful than the Need’. This powerful message relates to a business having the ability to develop clients and patients that desire and want their services. So, combined with an increased visibility and quality products, laboratories should be capable of evolving and continuing to be successful on their journey, even though the landscape may be changing, as it always will. Naturally, maintenance is required whilst journeying and that comes in the form of education and inspiration from fellow peers and educators. Each of us can fondly recall our own personal mentors that have assisted and cultivated us in our development. This is especially important when challenging times have arisen, times and events that require special inspiration. Let us collectively thank those people. We are all unaware of the length and duration of our journey, therefore, let us all be inspirational mentors to our peers and especially assist those who are starting or contemplating their own personal journey. Recently the passing of Paul Rotsaert was announced. I would like to take this opportunity to pass on my condolences to his family and friends and to thank him and his family for their contribution and commitment to our profession. Our journeys crossed paths many times and his passion for his profession and family business was visible to myself and to all those who met him. My own personal journey continued when this summer I had the privilege of travelling to Bucharest, Romania, where I attended and lectured at The International Congress of Esthetic Dentistry. What I found inspirational was the amazing dental talent gathered from all over the world who shared their expertise and visions of dental excellence. The proud people of Bucharest and the organization of the Congress deserve my heartfelt thanks for an amazing experience. Many enduring friends were made who will be cherished for many years to come. Let me thank Bassam Haddad for showcasing his excellent ceramic techniques, which he has kindly shared with us. His different aspects of ceramic creativity, which can be found on page 22, add to the overall knowledge and perspective, benefiting us all. The continuation of the ever-important discussion of digital dentistry within the clinical and technical environments of dentistry can be found on page 10. This discussion is especially important, given the decisions that need to be made on a daily basis, with regard to the equipment, material purchases and the education that is required to facilitate both. Page 16 discusses and illustrates the importance of utilizing a digital camera set-up within the dental laboratory, the use of which will maximize the communicative process and maintain photographic evidence of work completed. This provides a constant reference of personal and educational growth within a career and each of our journeys’ undertaken. Enjoy the journey,
Editor
Trevor Laingchild, RDT, AAACD
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Smile Makeover for Elley by Trevor Laingchild RDT, AAACD
Laboratory Perspective
lley is a dental hygienist working in the Hamilton area and over time had increasingly felt the need for an improvement in the aesthetics of her smile. With a wedding on the horizon, Elley had decided that the time was appropriate for her treatment to begin. Fortunately for her she was working in the same practice with Dr. Peter Rival, who had considerable experience in aesthetic dentistry and he had agreed to undertake her treatment. Dr. Peter Rival commenced the preliminary and customary dental examinations and took pre-operative photographs of Elley, so that Aesthetic Checklist: the discussions on the treatment plan could start. The discussions on the aesthetic ar- > Midline — Should be vertical-perpendicular to the interpupillary line. chitecture required included Dr. Rival, Elley > Incisal plane — cuspid to cuspid — should be parallel to and myself.
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Using the following aesthetic checklist as a guide, the discussion focused on where the changes would be made in order to maximize Elley’s aesthetic desires and ensure longevity of the prosthesis.
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the interpupillary line. > Long axis of incisors to have a vertical or slight mesial angulations. > Length to width ratio should be approximately 75 percent. > Visible width of teeth should be close to Golden
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Proportion when viewed from midline. > Central (1.6) Lateral (1) Cuspid (0.6) All Maxillary Incisors. > Distal of cuspids often not visible when viewed from the midline. > Distal transitional line angles should be in harmony with each other. > Contacts extend to tissue/papilla with no black triangles and have natural interproximal embrasures as to allow natural papilla support. > Distinct definition between reflective and deflective surfaces, showing distinct mesial and distal line angles. > A natural torsion, between the mesial and distal line angles. Following the torsion found between the root and the crown on a natural anterior tooth. > Incisal embrasures require discussion for placement and size, as to reflect and be in harmony with the lower lip curvature. > Anterior arch architecture should blend with the curvature of the posteriors when viewed from the anterior incisal edge. > Emergence profiles and facial contours/ silhouettes should be symmetrical when viewed from different lateral profiles.
When utilizing the above checklist, it can be seen from the pre-operative photographs (Figs. 1-3) that several changes could and should be made in the dental architecture, in order to satisfy Elley`s aesthetic demands. Dr. Rival diagnosed the functional and occlusal issues required and the proposed changes were decided on.
Proposed Changes Maxillary Centrals:
Too wide, add slight length, correct asymmetry in long axis between teeth. Maxillary Laterals:
Correct long axis to the mesial, close, open incisal embrasures, add slight length, remove diamond. Maxillary Cuspids
Lengthen, as to establish lost cuspid guidance, straighten. Maxillary First Bi-Cuspids
Fill out into buccal corridors. Harmonize with second bi-cuspids. General Changes
The above criteria require:
> Lateral excursions be cuspid guided. > Anterior disclussion should be smooth and shared between maxillary incisors.
Lighten shade. Add soft incisal translucency. Minimal incisal adjustment on mandibular incisors required. Gingival
No gingival or peridontal changes were required. FALL 2014
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A diagnostic wax up, illustrating the proposed changes, was fabricated based on detailed discussions. On approval, this diagnostic wax-up allowed for both the provisional and the reduction matrixes to be fabricated. Dr. Rival prepared the teeth using the reduction guide. It is important to note that idealized preparations are required within the final contours of the restorations, to maximize support of the restorations. Uneven thickness of the ceramic material will affect the strength of the ceramic and likely affect the chroma and value of the completed restorations (Fig. 4). Provisional restorations were fabricated and Elley proceeded to evaluate the changes made before the final restorations would be fabricated. Once all considerations of function and aesthetics were satisfactory with Dr. Rival and Elley, the final restorations were fabricated to the approved dimensions, using the provisional restorations as the guide (Fig. 5). IPS e-max was chosen for the restorative material. Due to the open incisal embrasures and spacing between the preparations, a slightly opaque material was chosen for the restorative material in order to maintain an even value of brightness and chroma throughout. A translucent material would have been inappropriate, allowing show through of the tooth structure and the greyness of the spaces in between. Using the correct fabrication protocol from Ivoclar-
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Vivadent, the restorations were pressed and finished according to the treatment plan. The restorations were delivered and subsequently fitted for Elley with minor final adjustments made. After a period of tissue healing, final post-op photographs were taken (Figs. 6-7). I would like to thank Dr. Rival for his excellent clinical expertise for this restorative process and to the staff of dentalstudios for their professional commitment towards teamwork, whilst fabricating the restorations.
Clinical Perspective Dr. Peter Rival: In 2013 Elley approached me wishing to improve her smile, with a view to potentially having porcelain veneers fabricated on her maxillary anteriors. With an initial discussion and a preliminary proposed treatment plan in place, I proceeded with a comprehensive dental examination. In addition pre-operative records were taken. With a clear medical history, it was found that there was a history of pericoronitis with her lower wisdom teeth, however they have currently erupted into the right location and there is no evidence of pathology. On the TMJ examination, Elley exhibited slight tension in her masseter muscles but no pain. Her temporalis, medial and lateral pterygoids, digastrics and suprahyoids were normal with palpation. Interferences were discovered on second molars, both left and right, this included the balancing and working sides in function. Elley had wear on her maxillary anteriors and very slight wear on her mandibular anteriors. Additionally, both notching and wear, was visible on her maxillary cuspids. The central incisors were noticeably badly worn, with a length to width measurements of 7.5 mm and 7.5 mm respectively. The maxillary lateral incisors were also worn, but less than the centrals. Diagnosed from a full series of radiographs, interproximal decay between 11 and 21 and decay on the mesial of 12 and 22 was found and treated. Sixteen pre-operative digital photographs were taken, along with a centric occlusion record. Using a Lucia Jig, centric relationship and a centric occlusion were established. Face bow records were taken, for the maxillary positioning on the SAM III articulator. Once the models were mounted on the SAM III articulator and with the photographs, it was possible to discuss the treatment plan, following Trevor’s checklist. We decided to do a diagnostic wax up of all eight anteriors. Both the buccal corridors needed to be built out and by lengthening the anteriors, including the cuspids, we were able to
lengthen the central incisors to 10mm with a width of 8mm. Elley wished to whiten her teeth and we suggested tray whitening. Significant recession caused sensitivity during this process and because of this, it took a longer time to achieve Elley’s desired results. Discussions with Elley and Trevor continued, until the diagnostic wax up had achieved the desired aesthetic and functional results. This diagnostic wax-up was utilized for several matrixes, which were used for both the tooth reduction guide and for the provisional fabrication. On the day of treatment, the teeth were prepped utilizing the reduction guide and the provisionals fabricated. After adjustment, the incisal lengths were verified using several phonetic exercises and additional photographs were taken. Finally, impressions were taken of the provisionals. We made some minor corrections in the temps and when we were satisfied, Trevor and his staff proceeded to process the IPS e.max veneers for teeth 14 to 24. On insertion of the finished veneers, a few minor adjustments were required, before an impression was taken for a thermoplastic night guard. Elley is really happy and satisfied with her smile now. Trevor took post-operative photographs in his photographic studio, show casing her new smile. Elley’s new smile has created awareness within our practice, for both staff and patients, of the various aesthetic treatment plans available. Elley will be getting married next year, so she has a lot to smile about. We are thrilled and delighted that we were able to give her the smile she deserves. We all wish her much happiness and success for the future.
Dr. Peter Rival graduated from the University of Toronto and started his career at the New Mount Sinai Hospital and the Etobicoke General Hospital. Dr. Rival has completed extensive post-graduate studies including Bone
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7 Elley’s Perspective Deciding to go ahead with eight porcelain veneers was very nerve wrecking for me. I was nervous and apprehensive. Once Trevor showed me the wax-up of what my smile would look like and explained the process, it eased my mind. Now I have a beautiful smile that not only looks great, but feels great as well. My special thanks to Dr. Peter Rival and to dentalstudios for their great work and openness throughout the entire process. L
and Sinus Grafts, Treatment Planning for single tooth replacement and Maxillary Implant Surgery. Additionally Dr. Rival has completed post graduation courses in Perio- Surgery, Intravenous Sedation, Implant Prosth-
odontics, Advanced Surgical Techniques; as well as advanced Prosthodontic treatment planning. Currently Dr. Rival practices at the Eastgate Dental Center in Hamilton, Ontario.
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2014 Digital Dentistry
Roundtable pt.II
rom diagnostics to treatment planning, from documentation to advanced treatment modalities, digital technologies have transformed the dental landscape. Oral Health Labs set out to gain perspective on how the introduction of digital technologies have impacted the relationship between dentists and labs across Canada. The conversation continues with input from dental manufacturers in this issue of Oral Health Labs.
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Sara Anders has over 20 years of experience in the dental industry holding positions in Sales, Marketing and Continuing Education with major dental materials manufacturers. She has lectured and presented training programs internationally for the past 15 years. Sarah joined Ivoclar Vivadent in 2003 as a Marketing Manager and was promoted to Director of Technical Marketing and Director of Canadian Operations. She is currently the Senior Vice President of North American Sales for Ivoclar Vivadent and General Manager of Ivoclar Vivadent Canada.
Joe Andrasko is US Product Line Management – Digital Imaging/CS Solutions, Carestream Dental. Joe Andrasko is the senior product line manager for Carestream Dental’s CAD/CAM restoration solutions portfolio (CS Solutions) and Dental Imaging Software. In managing Carestream Dental’s newest product, Andrasko monitors quality assurance processes, regulatory concerns, as well as internal and external documentation and training. Andrasko attended the Georgia Institute of Technology. Eric Clolus is the Business Development Manager with the Digital Oral Care Business and has been with 3M ESPE for the past five years. Prior to joining 3M ESPE, Eric worked as a partner and manager in a dental lab. Eric learned dentistry with den-
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tal technicians on the bench and assisting dental practitioners. Eric has extensive knowledge of the lab industry and Milling Centres and understands the digital workflows in the laboratory. He actively helps dental practices and laboratories to integrate digital technologies into their businesses. Giorgio Cremaschi Starting as a Marketing Trainee at Bensheim, Germany in 2005, Giorgio Cremaschi is now working for Sirona Dental in Salzburg since 2008, showing responsibility as CAD/CAM Director Sales for Europe and Canada. Previously he completed his degree in telecommunications and engineering in Milano, Italy. Besides his managing position at Sirona he is currently finishing his postgraduate studies (MBA) at the university of Mittelhessen. Neal Russell received his dental technician license in 1981 after graduating from Dental Technology at Vancouver Community College. He is President and General Manager of Protec Dental Laboratories and is in charge of administration, human resources, and marketing. Established in 1973, Protec Laboratories has grown to become one of Canada’s premier full-service dental labs. Through extensive R&D, and the integration of new CAD/CAM technologies, they have become an international leader in digital dentistry manufacturing solutions.
Q A
How has the introduction of “Digital Dentistry/ Technology” affected your business and relationships with dental labs? Sara Anders Ivoclar Vivadent is committed to delivering
innovative materials and processes for quality esthetic dentistry. We believe strongly that the materials are linked to the production process and digital dentistry can play a significant role in this. Each laboratory should have the ability to optimize their productivity and quality by selecting the material and production process that best meets their needs. All ceramic all options from Ivoclar Vivadent affords laboratories the opportunity to choose either IPS e.max or Zenostar Translucent Zirconia to deliver highly beautiful esthetic and high strength restorations to their clients. Further, they can choose from multiple production options including digital technologies to optimize the result for their lab. Ivoclar Vivadent has always had a strong commitment to supporting our laboratory and dentist customers through strong education programs, resource materials and technical support. As we expand further into digital technology, we feel that an even greater level of service and support is needed. Our network of International Centers of Dental Education (ICDE) has expanded to offer digital training and support. This includes our ICDE located in Mississauga that offers a wide variety of courses including the latest in digital options for restorative dentistry. Through our Customer Care line, laboratories and dentists can seamlessly reach experts who can answer questions related to digital technology, fabrication techniques and even clinical placement options. As laboratories face challenging decisions on new technologies, our relationships with our dental laboratory customers have been enhanced. We feel strongly that our laboratory partners can rely on Ivoclar Vivadent as a strong long term partner that supports their objectives for growth as they expand into digital dentistry.
Joe Andrasko For a dentist to commit to a new piece of technology like a digital impression system, seeing really is believing. We offer to work with both the doctor and their lab to demonstrate the digital process and ensure that the workflow is seamless. We do this by holding events in dental labs across North America, showing the ease and workflow integration from scanning to lab within minutes. All files transferred using a secure web portal called CS Connect. This portal allows both dentists and labs to keep track of sent cases, send attachments and fill in lab prescription forms. Preferred Dental labs who have completed the CS Connect validation process are placed on our Carestream Dental Preferred Labs site. This event showcases the labs ability to accept digital scans, design and complete a digital case.
Giorgio Cremaschi Sirona is a pioneer in the world of digital dentistry. The invention of CEREC technology almost 30 years ago sparked a revolution in the field of dentistry in dental practices and laboratories alike and is a revolution that is still ongoing. These new technologies indeed are already established today in the market but are by no means at the end of their development. Sirona has been paying attention to both sides: that of the technician as well as the dentist. We provide what our users need for efficient and fast cooperation: products for digital impression taking (for example, Apollo DI) and a platform where they can connect with one another, namely the Sirona connect portal, the largest digital network for dentists and technicians. We also listened to the needs of technicians to support them in their daily work with improved workflows for faster and more efficient outcomes. An excellent example is the new milling and grinding unit, Sirona’s inLab MC X5. This new unit offers dental technicians the greatest flexibility for the entire production process of aesthetically pleasing restorations and the largest selection of materials available on the market.
Eric Clolus Dentistry begins with the relationship that dentists have with their patients, their laboratories and their suppliers. Without a doubt, digital technology is changing all those relationships, and changing them for the better. First and foremost, the technology is changing the chair side interaction between dentist and patient. Compared to the traditional process, digital technology provides a better patient experience. The patient is more engaged in the process and the result will be better oral care. The ability to exchange files with laboratories and other trusted partners will certainly enhance dental practice workflow and productivity. Digital technology will give dentists the flexibility to work the way they want. FALL 2014
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Digital technology is a trend that will only gain momentum as patients, dentists and laboratories experience the benefits. 3M wants to be a leader in a field that offers significant growth potential. And so, as we bring the technology to market, we consider every patient, every dentist and every lab technician an ambassador for the 3M True Definition Scanner.
Neal Russell Protec has integrated digital workflow solutions to accept digital impression scans and directly produce CAD/CAM restorations, appliances, and models. Dentists and patients appreciate the consistent quality and precision of the
Q A
What has been the most significant product development so far and why? What has its impact been?
Sara Anders Digital technology provides incredible opportunities to enhance patient care. In product development for all of our portfolios, we work to balance the materials with the fabrication processes — creating advanced technologies for both. Revolutionary materials like IPS e.max CAD (millable lithium disilicate) available for CAD/CAM technologies are shifting the paradigm in today’s indirect and implant restorative treatments. In fact, with clinically proven materials like IPS e.max, CAD/CAM technologies have seen expanded applications in dentistry as benefits like consistency, quickness, efficiency and ease of use have been realized. Further development on the processing of IPS e.max CAD will bring new opportunities to maximize the benefits to the laboratory and the clinician. With the acquisition of Wieland, we are able to expand options from processing IPS e.max to include the Zenotec select hybrid machine with wet capabilities for milling IPS e.max. Joe Andrasko The open architecture of our system is the biggest differentiator and most popular feature for our digital impression technology. “Open architecture” means that the doctor owns their data and can use the open format files with no
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inLab MC X5
digital restorations, as well as the wide range of innovative new materials and treatment options. Advances in internet communication allow them to consult with clients, and transfer information and files around the globe in seconds.
cost whatsoever, allowing them to submit cases to labs without worrying about extra fees. It also means that our USB scanner can be used with hardware that the doctor purchases. We don’t require a trolley or specific laptop be purchased from us.
Eric Clolus As far as we are concerned, the most significant product development is actually a system. The 3M™ Connection Center is the secure, cloud-based digital hub where dentists upload, store and share prescriptions and digital impressions from the 3M True Definition Scanner. The 3M™ True Definition Scanner features 3D-in-motion video technology that generates digital impressions in extraordinary detail and accuracy. The 3M™ Connection Center uses Cloud Computing to connect dentist and lab to each other and this creates a new, accelerated business model that enhances accuracy and flexibility while being affordable. Giorgio Cremaschi Speaking for dental technicians, the most recent and also most significant product development is the new inLab MC X5. For the first time, it offers an independent choice of production processes and materials and complete control of the work process. According to our research and what we have heard from the market these are the primary demands dental technicians require of in-house production with modern CAD/CAM systems. Sirona listens to its users so naturally we incorporated these demands. We developed this new five-axis laboratory unit to fulfil these demands and give our users new freedom with wet and dry processing, a wide range of indications and the free choice of materials. Another significant step is the Sirona CEREC Connect platform. It is not a single product but an umbrella of different individual products. The Connect platform not only represents
the ideal working partnership for labs and dental practices but also takes the productivity and performance of the former to a whole new level. It is especially important in today’s world where dental laboratories are facing strong competition from outsourcing to emerging markets, as well as declining productivity and profitability owing to high personnel costs.
3M™ True Definition Scanner
Neal Russell The most exciting new development in dental restorative materials is solid zirconia, as it lends itself very well to 3D computerized milling. The new milled and sintered zirconia is stronger and less expensive, and the restorations fit better as a result of controlled variables and tolerances. In just 8 short years, zirconia based restorations have replaced much of the traditional crowns and bridges and now represent 55% of our production!
Q A
What are the most significant challenges facing you as a manufacturer?
Sara Anders As both a material and CAD/CAM machine provider, we are evolving as an organization and expanding our service and support network, ensuring that all digital dental solutions we provide come with an unprecedented level of support. With the integration of Wieland CAD/CAM systems into the Ivoclar Vivadent group of companies and our expanded ICDE facilities, we have also added Wieland Precision Technology as a digital center of excellence. This center provides over the phone and online support to our Wieland CAD/CAM customers through our customer care line. Most importantly, to ensure our laboratory partners are always able to produce high quality restorations, WPT also offers no charge outsourced milling to any laboratory that has Wieland CAD/CAM equipment that is under warranty should their system need repair or maintenance. Digital Dentistry opens up a wealth of new possibilities in the areas of material development, workflow optimization, treatment planning and clinical efficiency. As a leading manufacturer of clinical materials, we are cognizant of the fact that the efficacy of materials is impacted by how they
are processed and fabricated into the final restoration. It is critical that due diligence is done before new material and processing options are released to market. As speed to market pressures increase we work hard to maintain the high level of quality control and research and development before releasing new products into the market.
Joe Andrasko The digital impression business is beginning to grow significantly, and that means that there are more and more applications for these files in the industry. Having quality, high-resolution technology is only the first step in providing a comprehensive digital impression solution. The workflow for using and submitting these files can vary, so helping both our doctor and lab customers navigate these different options is important. Eric Clolus Perhaps the most significant challenge we face in bringing digital technology to the marketplace is change management. Generally speaking, dentists are understandably cautious when evaluating any new technology or product that affects their patients and their practices. As a supplier, it is our responsibility to fully explain and demonstrate the significant benefits of digital technology to the profession. We are quite certain that dentists and laboratories will readily move to the new digital platform once they are convinced the technology is accurate, flexible and reliable.
Giorgio Cremaschi Shaping technological progress and meeting the needs of our customers! At Sirona, we are conFALL 2014
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stantly trying to overcome these barriers by pushing ourselves harder to offer not only the best possible solutions but also the most affordable. The inLab MC X5 as a great example: We implemented all of our know-how as a pioneer and innovation leader of dental CAD/CAM technology to develop a CAD/CAM laboratory machine tailored specifically to meet both current and future demands. This ensures that inLab MC X5 will be a good investment in the long-term. Following the same motivation of long-term reliability we decided to develop the inLab MC X5 as Sirona’s first open production unit that is suitable for use with various existing CAD/CAM equipment in dental labo-
Q
How do you work with labs and dentists to introduce them to these new products and how do you deal with the challenge of getting them to commit to purchasing/using these new technologies?
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Sara Anders Digital cameras can take photos and movies which are then exchanged electronically between dentist and ceramist. The dentist now has the means to digitally scan a restoration and send the file to the ceramist for fabrication of restorations without having to take an impression and ship a model to the lab. The possibilities are endless and they all point to better communication, faster communication, and ultimately the patient benefits.
Eric Clolus It may sound like a contradiction, but we are taking a relatively traditional approach to introduce an exciting new technology. We are conducting demonstrations at major shows and have offered information sessions at
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ratories. This means that users with a Sirona scanner and inLab software or laboratories with scanners and CAD components from other manufacturers are all supported.
Neal Russell Rising costs and the implementation of new technologies are some of the largest obstacles that we encounter. The big business of financing equipment and return-oninvestment is a relatively new concept and difficult for most labs to manage. Many dentists see the need to grow and invest to effectively partner with their lab, but are reluctant as technology is changing so rapidly and prone to becoming obsolete.
which dentists and laboratory operators and technicians can see the technology in action. In our experience, dentists value peer-to-peer endorsement in their evaluation of new products or technology. The endorsement of key opinion leaders in the profession and the positive experiences of dentists and laboratories using the technology will open the door to future sales. The feedback we have received has all been very positive, and we will be growing our business on this very solid foundation.
Joe Andrasko We offer a very simple “all in” price for the digital scanner. There are no additional fees for updates or file transfers. Giorgio Cremaschi Nothing beats a first-hand experience, that’s for sure! At Sirona, we are continuously organizing events that give customers the opportunity to experience our products first hand. Once they have experienced CAD/CAM on their own at any of our events, and learned how easy it is to learn CAD software or have an in-house CAM system, it all boils down to integrating it into their own dental office or dental lab. Usually in partnership with our distribution partners we are further able to offer on-site visits and we organize best practice sessions at our referral labs all over the country.
Neal Russell Protec sponsors courses and study clubs that promote educational opportunities for dentists to see and learn about their new products and technologies. We use the latest new technology to connect our business with their business and ultimately create better customer communication and satisfaction. Our website is very detailed and attempts to inform and educate our clients and patients about all of the latest science that we apply and the advantages of our business relationships.
IPS e.max® Lithium Disilicate
Where do you see “Digital Dentistry” going? What will be the new areas of development and how will they continue to impact on dentists and dental labs?
Eric Clolus Digital dentistry has advanced and improved very rapidly in the past few years and today, the flexibility of an open, secure, cloud-based platform sets the stage for the future by making it possible for dentists to store unlimited files and share them with the partners they choose. I think we can look forward to more software applications in the near future, with features that improve workflows and capabilities. There will be more opportunity for patient engagement and, at the same time, improvements in productivity and profitability.
Sara Anders Integrating new materials and new fabrica-
Giorgio Cremaschi The dental restorations produced with
tion processes into a laboratory is always difficult and intimidating. This is amplified with digital dentistry as there are so many options and new options are presented daily. With the large capital investment required and the necessary change in the laboratory’s workflow, this makes choosing the right digital solution a daunting task. We believe that the digital workflow is the laboratory workflow of the future. As Ivoclar Vivadent expands its offerings we believe an integrated CAD/CAM solution with multiple materials and multiple processing options from a company you can trust is essential for the future success of any laboratory. I look at this as a digital landscape where there exists a continuum of digital technology. Over time a lab will move back and forth across this digital landscape. Our commitment is that with Ivoclar Vivadent, laboratories can move across that landscape with full confidence and reliability - choosing from the most innovative material and processing options available.
CAD/CAM have become a huge success story in recent years and will remain so in the future. At present, two-thirds of all CAD/CAM restorations produced worldwide are milled on Sirona systems. The future lies with an even stronger integration of the different components of the whole system, from impression taking to treatment planning and patient treatment. The software which links all of the components together plays an important role in that integration. Another fascinating aspect will be how the offers and services of a dental lab will develop, what business models will be implemented and how technology can support these demands. At Sirona we are not only prepared for whatever the future might bring but each and every day are following our approach of changing dentistry as we know it.
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Joe Andrasko Digital dentistry provides a simplified workflow that is cost effective and has many benefits from increased accuracy to faster turnaround times. The applications for digital files will continue to grow as digital impressions become more common and replace more traditional
impressions. Perhaps one of the biggest areas of improvement will be in collaboration and communication between doctors and referrals as well as doctors and their labs. Digital dentistry has the potential to streamline these time intensive processes, and provide visibility to help doctors and labs improve their workflow.
Neal Russell Dentistry is progressing into the digital age faster than most had projected. During just the last few years, digital manufacturing in the dental laboratory has grown explosively. From full digital restorations and appliances, to 3D model production, and digital records archiving and storage, we at Protec believe that the age of digital dentistry is upon us and is here to stay. We expect to see the continued development of 3D digitization, CADCAM software and hardware, and biocompatible intra-oral materials for 3D printing. L FALL 2014
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Practical Dental Laboratory Photography
by Trevor Laingchild RDT, AAACD
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ith the development and evolution of digital photography from film photography within recent years, it has become easier and more spontaneous to obtain that special photograph. In today’s environment of patient’s high expectations with regard to restorative cosmetic dentistry, photography in the dental laboratory has become a very important and sometimes necessary tool, especially in aesthetic and cosmetic cases.
The ability to capture multiple shots of a subject and to decide on a successful image can be achieved almost instantly. Not having to wait for developing processes, with the possibility of disappointment, are a thing of the past. Along with the possibilities of post manipulation with an editing program, good photographs are within reach for everyone. With practice, the artistic composure of the image will improve, allowing for more creative results especially with post-operative images. I consider the advancement of digital photography, to be one of the most singular important tools available in the field of dentistry. It should be said that all aspects of the dental treatment, both clinical and technical should be documented photographically. This documentation is important to maintain a portfolio of restorative cases and to develop a personal library of our abilities – a library, which will allow us to visually collect a history of our growth of capabilities. Having the evidence allows a process of self-awareness of past achievements with an improvement of future endeavors. Without this personal library, how are we able to look back and be self-critical? In addition, this library of images can be used for the publication of scientific articles, slide presentations, marketing and even legal protection. Today, there are numerous experienced Dentists and Laboratory Technicians that teach dental photography, either with a documentative or artistic emphasis. Or sometimes both. Modern cameras, lenses and various lighting sources allow the inexperience photographer to capture great images. For documentation purposes, I would advocate a systematic approach,
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which will ensure images are taken with a similar magnification and exposure. A library of similar images with differing magnification and lighting can look inconsistent and unprofessional. Dental organizations often have easy to follow protocols for this systematic approach, which are easy to follow and implement. As a long time member of the American Academy Of Cosmetic Dentistry, I can highly recommend the teaching protocols they advocate, both for the photography and for the storage of the taken images. Photographic equipment often becomes a personal choice, dependent on an early introduction to a particular brand and often with a strong loyalty thereafter. It is very difficult to keep up with the latest technology, as it is evolving daily. As equipment is constantly being upgraded, that new purchased camera can be yesterday’s camera fast. However, a good camera can be utilized for an extended period, and lenses even longer. It is not necessary to be changing equipment routinely. A good quality SLR digital camera can be available for approximately $1500 and sometimes even less expensive. An appropriate lens, preferably a macro/micro lens is available for approximately $800/$1000, also with price variances. Light sources for the camera vary greatly, with varying costs. It is important to realize that with close-up photography, the light source needs to illuminate the subject with little or no reflection back into the lens. Therefore, the light source needs to be directed from an angle not directly in line with the lens. Many different lights with various mounting capabilities can be purchased with prices ranging from $500 to $1000.
My personal choice is as follows: Camera: Nikon D600 full frame Lens: Nikkor Micro 105 mm 1:2.8 Flash: Nikon Speedlight SB-R200 Lens used in portraits: Nikkor 24-70 mm 1:2.8 However, these are my own personal choices and there are many competent alternatives readily available.
The following is a breakdown of important protocols that should be followed when developing a library of photographs. These photographs will greatly assist in the communication with the clinician, the patient and also with the laboratory team. These images are very important visual tools, which will assist in a comprehensive approach to ensuring a successful outcome of the dental treatment plan and its documentation.
Pre-operative Images Ideally depending on the treatment plan, a full set of pre-operative pictures are recommended. However, a series, which includes both the full face, (smiling) at a magnification of 1:10 and a series of smile pictures (Both un-retracted and retracted) at a magnification of 1:2, and 1:1 depending on the image required, can be utilized in most cases. Often these images are taken by the clinician, especially retracted images and accompany the laboratory case. Laboratory technicians should also be encouraged to understand the protocols and techniques in achieving these images. Viewing the maxillary orientation to the horizontal, the incisal edge orientation to the intra-pupillary line and also the horizontal are critical for treatment planning. Lip support, with maxillary orientation to the lower lip, can also be diagnosed at this point.
Smile view
Full Face Image (Capturing Inter-Pupillary line)
Smile view Open and Retracted
Full Face Image (Capturing Inter-Pupillary line) FALL 2014
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Design Pre-operative
Often these photographs are taken at the laboratory, but not exclusively. These can be smile photographs taken at a magnification of 1:2 and 1:1. They are specific to certain diagnostic requirements i.e. gingival architecture, orthodontic tooth movement requirements, anterior smile design, shade analysis, gingival spacing, negative incisal spacing and numerous other images for diagnostic and communicative requirements.
Shade Analysis (With Shade Tab) (Perpendicular to Facial Surface)
Shade Analysis (Picture showing distinction of dentin to enamel)
Shade Analysis (With Shade Tab) (Perpendicular to Facial Surface)
Shade Analysis (Picture showing distinction of dentin to enamel)
Laboratory Diagnostics These images should be encouraged within the laboratory, as in many situations they are the confirmation of the design pre-operative requests. An example would be an image taken within the laboratory of a diagnostic wax up, showing the required dimensions and contours, often with a magnification of 1:2.
Diagnostic Wax–up Anterior Smile Design
Diagnostic Wax-up and Conversion Into Resin For Edentulous Patient
Provisionals and Temporization Extremely important images illustrating clinical and patient acceptance/ non-acceptance, especially in the anterior smile zone. These images are critical for use in a communicative situation, with either the patient, or the clinician. Fabricating the final prosthesis with approval in the dimensions and contours and possible shade requirements are totally vital to the successful outcome of the restorative case.
Smile View Of Provisionals (Examples of shape, contour and possible patient approval)
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Laboratory Techniques Various technique images should be taken and filed for future reference allowing for documentation and personal growth revision. Visual evidence is paramount for the advancement of education within a group and individual environment. Publication and marketing are available with these images. They can be taken at multiple magnifications and with varying light sources. Creativity can be explored with these images. Laboratory Images of Techniques
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Clinical Inserts Clinical cases often are photographed intra-orally on insertion, in order to establish a visual confirmation of success, or not. A picture says a thousand words. Mostly these images are taken by the clinician, but not always. Many technicians work in a clinical environment that gives access to these images. These images are a valuable tool in the professional development of both the technician and clinician and should be encouraged. Unfortunately many technicians fail to see many of their completed restorations after clinical delivery, which in my opinion stifles their educational and personal growth. We all need to be self critical in our professional dental pursuits. Images are usually taken with magnifications of 1:1 and 1:2.
Clinical Insert Crown 26 (day of insertion)
Clinical Insert Crowns 14 –24 (day of insertion)
Clinical Insert Crown 16 (day of insertion)
Clinical Insert Crown 46 (day of insertion)
Clinical Insert Crown 11 (Check-up appointment after insertion)
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Before and After These images are very useful with patient orientation and education. Having the ability to showcase patients treatment plan, with the final restorative results is very rewarding. As a laboratory technician, assistance may be required from the clinician, to obtain these images. Sharing of these images is in everybody`s interest as it promotes personal professional growth and aids in the communication, for the best interest of the patient. Depending on the image they are mostly photographed with 1.1 or 1.2 magnification.
Before
After
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Post-Operative It is always rewarding on completing a clinical restorative case to capture the emotion shown by the patient. These images can utilize a complex light set-up, but not always. A compact area within the business location can be utilized for this purpose. External light sources which can aid creativity for lighting and shadowing, can be purchased for approximately $2000. Backdrops can be purchased and are available in paper rolls with differing colors and designs. With a stand they allow the ability of mobility and expansion of width and length depending on the size required in the composition of the pose and subsequent image. Alternatively a permanent drape, or an uncluttered wall or curtains can be viable alternatives. Depending on the subject illumination, additional external lights can be used with varying degrees of creativity. Differing backdrops are available depending on personal choice and taste.
Conclusion Documentation, inspiration and the ability to share experiences both scientific and emotional, are in my opinion, the reason digital photography and its versatility are so important in the advancement of comprehensive dentistry. Every time we read and study the illustrations in a dental journal, and visit a dental slide presentation, we witness our peer`s
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abilities within the art of photography. We should all take time to learn from these people. I would like to personally thank the staff at dentalstudios, for the excellent contributions to the prosthetic work in this article and to the numerous incredible people with whom I have been privileged to learn and be inspired from. L
A Touch ofLife
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by Bassam Haddad
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hroughout dentistry, dentists and technicians display their aesthetic skills predominately on anterior restoration cases. The following is a perfect example of a non-ideal aesthetic case for presentation. The restorative case in question does not have enough room for the ideal number of pontics within the dimensions of the restorative case. The following steps will illustrate how a dental technician can create a highly aesthetic restorative case even when the aesthetic circumstances are not ideal and sometimes challenging. To begin, we must choose the material for the infrastructure of the case. A quick cost benefit analysis of the materials available to maximize the successes of aesthetics and strengths in this situation leads us to the option of choosing zirconium oxide for the 6-unit restorative bridge. It has the required strength for the bridge span with good optical properties. While creating a natural aesthetic look, one must follow Bassam Haddad has acquired a comprehensive knowledge in various systems of dental technology. He is the author of several local and international articles on aesthetics and restorative
dentistry. Additionally he is a member of the prestigious Oral Design international Group, Bassam is member of the American Academy of Cosmetic Dentistry, the European Academy of Cos-
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4 metic Dentistry and an honorary member of the Society of Esthetic dentistry in Romania. Bassam owns and operates Vivaclair Canada Dental Laboratory in Montreal. FALL 2014
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certain guidelines in order to create the best possible result. Design of the infrastructure, awareness of inter-proximal areas as well as using the cutback method, will create a natural esthetic smile. The outcomes of using these guidelines will be the correct diffusion of light, better adaptation/degradation and fluorescence of the light within the smile. The key fact is the technician must master the transition and diffusion of light to be able to create natural esthetics in conjunction with the data given by the clinician. These may include pictures and age of the patient. The younger the patient, often more translucency is needed (Fig. 1). I was looking to find a ceramic system which would allow me to achieve high esthetic results with predictability and consistency. I made the decision to utilize the Ceramotion ceramic system manufactured by Dentaurum. In this documented case I have used Ceramotion Zr, which has the benefit and versatility to be layered and baked on both zirconium oxide and lithium disilicate. The first step is to make a connection layer with the zirconium framework. For this a thin layer of dentin is applied and baked at 35 degrees Celsius, a higher temperature than the dentin bake. This is the foundation bake. When the foundation
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bake is applied, it will aid with the stability and support of the subsequent porcelain shoulder firing (Fig. 2). My philosophy is to always build up the dentin bake initially in an irregular way. By respecting the contour and shape of each tooth and by looking at both the occlusal and labial views, we notice asymmetrical mamelons. There are many advantages to layering the ceramic material in this manner. Most importantly, by controlling the shrinkage of ceramic and by positioning the dentin correctly inside the incisal edge area, we have better control of the shade and chroma. This will allow us to avoid the unnatural straight greyish line between the dentin and the enamel of the incisal edge. Now we have the ability to control the degradation of color within the restoration. From this point on we can start feeling life in the bridge (Figs. 3-4). The second bake consists of applying small amounts of dentin material in areas which would require more incisal and completing the contour with incisal materials and also by creating irregularities in respect to the final shape. The fitting surfaces (under the pontics) are covered with gingival dentin (G3 dark) which was previously covered by dentin (Figs. 5-6). The results can be verified after each bake, with special at-
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tention given, to not obtaining a visual straight line between dentin and enamel (Figs. 7-8). After the second bake, I apply the appropriate internal stains and fix internally at a lower firing temperature program. I complete the shape by layering additional translucent enamels and lighter gingival materials. (G1) By texturing the final shape, horizontally in some areas and vertical lobes with the brush, we can obtain the abraded incisal edge, which can mimic the existing dentition, eventually bringing natural life to the bridge (Figs. 9-10). To give a more natural look, it is possible to layer small amounts of opalescence materials such as opal honey, blue, white and gray under the translucent materials. Light shades of gingival porcelains can also be layered into the gingival embrasure areas, in order to achieve a softer transition between the ceramic and the tissue (Figs. 11-13). Always finalize the shape, contact points and the occlusion on a solid uncut model. Since the adaptation of pontics, margins and the profile emergences have been finished on the previous die model, we can eliminate the tissue on this model. Now it is possible to adjust the overlapping by adding where appropriate and also by adding the final touches to the incisal
area, by using various translucent enamel porcelains (Fig. 14). The glazing is completed in two stages. After the glaze, it is important to rubber wheel all areas where it is necessary to have an increase in the reflection of light. By using pumice and polishing paste, manually polishing, will assist in giving a natural light reflection and improved aesthetics to the restoration (Fig. 15). By looking at different angles we can appreciate the final results, especially when we combine proven ceramic techniques with an aesthetic and consistent ceramic material. Notice the opalescence (amber) and the translucency, combined with the surface texture (Fig. 16). In the next picture we notice the results of the manual polishing. This will result in variations in the reflection of light both in intensity and with a scattering effect (Fig. 21). In the next three pictures, overlapping can be appreciated, the degradation of color in the gingival area with the internal crack lines. It is important to note that the ceramic was extremely stable after each progressive bake and maintained its shape and color. This was very important, especially after the glazing bake. In conclusion, I found the Ceramotion ceramic very forgiving and very user friendly (Figs. 17-22). L FALL 2014
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Dental Marketplace
Contact: Karen Shaw • tel: 416-510-6770 • fax: 416-510-5140 • e-mail: kshaw@oralhealthgroup.com Toll free: CDA 1-800-268-7742 ext 6770 • Toll free: USA 1-800-387-0273 ext. 6770
Associateships
Practices & Offices
GREATER VANCOUVER, BC
Large and very well established general practice for sale in South Surrey, Panorama Ridge — a desirable and growing neighbourhood. Beautiful new hi tech facility in new building, completely digital and paperless, solid lease, 5 modern ops, loyal staff, >2300 ACTIVE patients. High Gross, high net — enough for two FT dentists. Reply to Oral Health Labs Box 25 — e-mail: kshaw@oralhealthgroup.com
TORONTO, ON
Professional space for sale at 600 Sherbourne Street. Asking $148.000.00 reasonable maintenance and taxes runs like rent. Around 540 sq. ft. Overlooking the ravine at the subway. Available Dec 1st. Tel: 416-966-0300.
CALGARY, AB
Calgary practice for sale. Located on top floor of professional building. The clinic is long established with a wonderful team of experienced staff. Valuation report prepared by highly reputable Calgary appraiser is available. Please call 403-836-5088 or e-mail: dentrixfielding@yahoo.ca
OTTAWA, ON
Office space for lease in a beautiful commercial plaza in Ottawa,on major highway, ~2000 sq ft, ample parking, perfect for dental GP or specialist. Tel: 613-799-5683, or email: c4ottawa@gmail.com
NORTHERN LAKE SUPERIOR, ON Three family practices available in Marathon, Terrace Bay, White River. Extremely low overhead, unlimited work, above average net revenues. Call in confidence 807-228-1234.
Associateships GUELPH, ON Looking for an energetic and enthusiastic associate for a PT/FT position in our growing and busy office in the south end of Guelph. Please send us your resume to associateinguelph@gmail.com
NORTHERN ONTARIO FULL TIME ASSOCIATE WANTED
Well established busy practice 30 years, poised for growth!!! Remuneration package $20K-$25K per month range. Long standing, cheerful, professional, staff. Experience northern hospitality and nature at her best. Graduates and Experienced Dentists welcome. To book your interview please e-mail resumes to: nor_dent@hotmail.com
HALIFAX, NS
Located in Halifax, Nova Scotia. An experienced Dentist is needed to join a great team of a high volume clinic. As a bonus we offer a profit sharing formula based on overall clinic performance. Be busy the moment you start! Contact info@finetouchatlantic.com or call (902) 835-4222 ext. 223
ASSOCIATES FOR HAMILTON & WATERLOO, ON
Associates required, for TWO VERY busy and modern practices with VERY strong new patient flow. E-mail: associatedentist@ymail.com Fax CV: 888-880-4024
TORONTO, ON
Full time associate dentist needed for busy, modern established practice in Toronto. Complete range of services provided including orthodontics, periodontics, implants, laser dentistry, digital impressions, oral surgery and conscious sedation. An excellent opportunity for professional development concurrent with competitive income. Call: 416-748-3353 or 1-866-866-8437.
AJAX, ON
PART TIME ASSOCIATE FOR A FAMILY PRACTICE We are looking for a personable, compassionate associate who can provide high quality dentistry to our modern, high-tech office. Must have a minimum of 3 years experience in a private dental office setting. Candidate should be available Tuesday evenings, Thursdays and 2 Saturdays a month. Please send resumes in confidence to: Theresa.dentinajax@gmail.com
ST. MARY’S, ON
We are looking for a part time or full time associate for a growing practice in St. Mary’s, Ontario. The candidate must have excellent communication skills with staff and patients. Experience is preferred, but new grads are welcome to apply. Please submit your C.V. to sandie@dentalofficeconsulting.com or sandiedocs@gmail.com
TORONTO, ON
HTL Dental seeking a motivated, personable team player as an associate to join our current three modern and progressive practices in Scarborough, Markham and Richmond Hill. New practice soon to open up in North York. Part time leading to Full time position. Candidate must have excellent clinical and communication skills with a friendly personality. If interested in exploring further, please send cover letter and CV to: jobsteeth@gmail.com
EXCELLENT ASSOCIATE OPPORTUNITY ONE HOUR NORTH EAST OF TORONTO Busy dental office looking for full or part time associate. One evening weekly and no weekends. New graduates welcome. For info please call 705-324-7150 E-mail: lindsayfamilydentistry@gmail.com
GRANDE PRAIRIE, AB
Three full time associates needed for our well established family practices, with travel to our satellite clinic in High Prairie, AB. Present associates will be leaving end of July 2014. Very busy practice with above average remuneration. Please email drroy04@telus.net if interested.
LONDON, ON (and surrounding area) Dove Dental Centres is looking for full time associates for their progressive, modern, multi-location group of dental practices in London, Ontario and surrounding area. Interested candidates should forward resume and cover letter to: dovedental@ody.ca
VANCOUVER ISLAND, BC
We are looking for an Associate for our Cumberland Practice. Cumberland is located on Vancouver Island in the Comox Valley. Dr. Lathangue owns several practices on the Island and is looking for exceptional people to join his team. You must be knowledgeable in all aspects of dentistry and be dedicated to patient care. Email resumes to: joan@dogwooddental.com
MUSKOKA, ON
Are you professionally fulfilled? Are you practicing dentistry in fertile soil and at the level you desire? Fantastic career and lifestyle opportunity! Don’t hope any longer. Come share your passion and enthusiasm for dentistry with a connected like-minded highly trained team! We are looking for an associate who enjoys people and loves dentistry Our thriving modern high tech family practice requires a GP who is confident with a strong clinical skills-set. We are in Ontario’s playground where you can exceed your professional goals while enjoying a lifestyle desired by many. If you are growth minded come interview us and help us move to the next level. Future buy-in opportunity. Please leave a detailed message about yourself, your experience & desires @ (705) 789-6070.
TRENTON, ON
We are looking for a motivated dentist who enjoys all aspects of dentistry. Come work in a busy, state of the art facility with new technologies. We have an excellent and very friendly team and looking for the right fit to join our practice . Please email us at ryounes@sympatico.ca WWW.LAURIERDENTALCLINIC.CA 20 minutes east of Ottawa. Very busy recently expanded dental clinic seeking dentist for long term, full-time position. Multidisciplinary practice with the latest high tech equipment (2D & 3D x-ray). Mentoring available. Above average remuneration. Tel: (613) 446-3368 Fax: (613) 446-5006 laurierdental@videotron.ca
BURLINGTON, ON
Part-time associate required for evenings and some weekends. Please e-mail resume to office@bertabacic.ca
OTTAWA, ON
ASSOCIATE NEEDED We have a thriving practice in Ottawa and we need an associate’s help. We are creating a great opportunity for someone who wants to treat people in a fun and caring environment. Please send your resume to dynamic.dentist.2014@gmail.com
BELLEVILLE, ON Full time Associate needed in Belleville Small well established practice, looking for a full time associate dentist to take over owners schedule. Candidate should have strong communication skills and be proficient in all aspects of dentistry. Please contact Trish at clinicaldirector157@gmail.com
NORTH OF SASKATOON, SK
EAR FALLS, ON
Locum dentist needed from January 23/15 to March 5/15. Prefer dentist who would consider associate opportunity in the future. Accomodations provided at no charge next to the dental office in Ear Falls, plaza and three restaurants nearby, 400km from Winnipeg, 45% of gross billings. Send resume to Dr. Matthew Walkiewicz at e-mail: mattjw@kmts.ca
BARRIE, ON
FT, PT or Locum Dentist Needed North of Saskatoon First Nation Reserves. Travel Expenses covered. Long term commitment required. If interested please send resume to: northerndentalcentre@gmail.com
Looking for an orthodontist in Barrie. Busy neighborhood. Please forward your résumé to dental_manager@ hotmail.com
ASSOCIATE OPPORTUNITY
Part-time associate for downtown practice. Must be interested in all disciplines of dentistry and have comprehensive continuing education. E-mail resume to: tooth_fixer@yahoo.com
Tillsonburg (35 min SE of London) and Stratford (30 min W of Kitchener), Ontario Full time (Tilllsonburg) and Part time (Stratford) available. Busy and established offices. Modern, fully paperless/ digital, new equipment and leading edge technologies (cerec, lasers, implants...). Interested candidates please mail: dentalgroupswo@gmail.com
TORONTO, ON
MISSISSAUGA, SCARBOROUGH, BARRIE, BRANTFORD, ON
TORONTO, ON
Exciting associate positions available for full and part time opportunities. E-mail: yourdentaldream@gmail.com
OAKVILLE, ON
Full time associate required for large group practice in well established office in new building. Modern, digital, paperless office in growing part of beautiful Kingston. Please contact: lorrie@cataraquidental.com
Archer Dental is seeking a dynamic P/T associate with minimum 2 years clinical experience and a passion for geriatric dentistry. Excellent communication skills, energy and a flair for patient care! Experience in hospital dentistry an asset. Email in confidence to: narcher@drarcher.ca
E xpe r ie nc e d de ntal a s so ciate required for a well-established & prestigious family practice. We offer the latest technology and all aspects of dentistry. This position is for Saturdays from 9-5. Seeking a positive, energetic individual with 2-3 years experience, excellent clinical and communication skills who is eager to join our progressively growing team. Email: oakvillesmiles@hotmail.com
EAST OF TORONTO, ON
Experienced friendly oral surgeon and endodontist required for busy dental practice in east of Toronto. Please forward resume to: glenannadental@rogers.com Fax: 905-831-5975
EDMONTON, AB Looking for an associate (part/full time) to join our group of multidisciplinary practices which are focused on the highest quality of patient care and using the latest technology available. We are looking for a self-motivated, high-energy, clinically strong candidate who is interested in learning and continuing education. This is a great opportunity for the right candidate to grow with our expanding group and to work in a great environment. Buy-in opportunities are also available for the long-term associates. If you are interested, please email your CV in confidence to edmontondentalcareer@gmail.com
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THOMPSON, MANITOBA
Full-time, energetic, detail oriented associate needed immediately for established, busy family practice with income potential up to $30,000 per month. Enjoy a fully booked schedule and ability to reach your goals as a dental professional. Experience preferred. Excellent opportunity. New grads welcome. Living and Travel Accommodations provided. E-mail cv: thompsondent@gmail.com Fax (204) 677-4072, Ph: (204) 939-0083.
KINGSTON, ON
PETERBOROUGH AND OAKVILLE, ON
There is an immediate opening for the right associate in the Peterborough and Oakville areas. The candidate must have excellent communication skills with staff and patients. Experience is preferred, but new grads are welcome to apply. Please submit your C.V. to sandie@dentalofficeconsulting.com
DRYDEN, ON
Looking for a motivated full time associate for January 2015. Earn 50% in a friendly efficient environment with fully trained staff and a well established patient base. Will help associate with accommodation and getting settled in Dryden. Experience desirable but not a must. Associate must be dedicated to patient care and clinical quality. Please email your resume to Dr. Ghada Ibrahim at vivadental@hotmail.com
Equipment WATERLOO, ON Dental Equipment For Sale 5 operatories of equipment including chair with accessories, intraoral xray units, custom built operatory cabinetry, instruments and Computer, as well as a Panoramic Xray Unit. Also Server, office computer, printer, fax, etc. Interested parties please contact me at wkamouni@hotmail.com
2014
AWA R D S
Distinction OF
Gala
Thank you, Alumni & Friends! Our Sponsors GOLD SPONSORS
SILVER SPONSORS
BRONZE SPONSORS BMO Bank of Montreal
Patterson Dental
Canadian Dental Protective Association
ROI Corporation
DCY Professional Corporation Chartered Accountants
Sunstar Americas, Inc.
DENTSPLY Tulsa Dental Specialties Nobel Biocare
Sinclair Dental Co Ltd. TD Canada Trust Toronto Crown & Bridge Study Club
TABLE SPONSORS
Proudly Honouring ~ Dr. James W. Brown ~ Dr. Shimon Friedman ~ Dr. Timothy Milligan
DENTSPLY Tulsa Dental Specialties Endodontic Specialists HANSAmed Limited Henry Schein Hiossen Implant Canada Inc. KaVo Kerr Group LHM Dental Studios Ltd. McNulty Group
Modular and Custom Cabinets Oral Health Professional Practice Sales Ltd. RNG Financial Insurance Agency Septodont North America Tier Three Brokerage Ltd. Toronto Academy of Dentistry Transitions Group North America
SUPPORTERS Air Techniques • Alpha Omega Dental Fraternity ITEK Business Solutions Inc. • Ivoclar Vivadent PWM Professional Corporation • West Toronto Dental Society
Be sure to mark your calendar for Access to Care Fund… next year’s Gala! Saturday, March 28, 2015. together, we change lives.
See how at www.dentistry.utoronto.ca/accesstocare