E7 Dental E-publishing, volume 1, 2015 by E7 by EViDENT Academia

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class I occlusal cavity preparation by P&W | EViDENT

dental epub.

About P&W | EViDENT is a group of young dentists that focus on lecturing ideas and innovation to others In order for a better communication, we use digital works to explain the concepts. Most importantly we not only target the dentists as audience, but also the patients too. We are also proceeding the philosophy of evidence-based dentistry, especially in fields of periodontics, prosthodontics and dental implantology. The team was planned over a year (2014-2015) and collected data of needs from undergraduate dental school students and dentists with clinical experience. We share our ideas, our studies, great articles, information of all kinds of dental courses for every dentists and students to get the latest news and discuss for our own protocols. E7 dental e-publishing is one of the online/ paperwork of P&W | EViDENT. The publication contains 7 topics per volume in different aspects of dentistry. It is more like a magazine with both dental research and the enjoyment of living. Including topics of lecturing, practical sessions, photos galleries, lifestyle sharing and etc. It is designed for dentists to have a brand new thinking in the academic field. Authors could be anywhere! E7 and we are happy to have more We are more than welcome to encourage you to share with no help us improve

epub. is an open sharing work which everyone could subscribe and more dentists, professors, students and etc. to join us work. have hear your work experiences, knowledge and ideas, and limitation. Lastly, we welcome and kind of suggestions that will

Team P&W | EViDENT 1 3 Aesthetic Dental Workshop

From Chairman

From Editors

In our constantly changing world, our team

It is a very exciting moment and a brand

P&W | EViDENT stands to the future of

new achievement that P&W | EViDENT has

being the milestone of dentistry information

finally presented its first dental e-publishing,

sharing. It’s our pleasure to gather

E7, sharing the experiences, ideas, and the

information and knowledge to enhance our

innovations of dentistry. Although this is our

development of the publication; without

No.1 volume, we have been discussing and

changing, there will not be any innovation,

modifying over and over again, adjusting to

creativity, or incentive for improvement.

the best for young dentists and experts.

Those who initiate change will have a better opportunity to manage the change which is

E7 contains dental articles, also some interesting reading of lifestyle, travelling,

inevitable.

gourmet, music and etc.. These articles are Development and change is not a simple

written by our members, dentists too!! It is

act. There is no single development in

also another way to share our vision to the

either technology or management.

other. How could one dentist be not just a

Everything in life is related. Our idea of

dentist, a scientist, or an artist, that is the

improvement and development is through

goal.

sharing experiences and knowledge unselfishly. We think everything in life is a

The publishing is an open sharing

chain. In order to become better you need

resources which you could subscribe for free

to help others.

and reference the article anytime you want. Chairman

And of course, if you want to share your ideas, we invite you to contact us and share on the publication too. After all, as the passage says “And do not forget to do good

Contents • • • • •

sacrifices God is pleased.” (Hebrews 13:16)

About..................................................................................1 Calendar (dental events)................................................... 3 Brief Concepts & Evidence of Osseointegration............... 4

Hope you enjoy our work!

Size Matters! - ratio selection for presentation slides.........7 In the Beginning… - keystone routine in periodontal surgery.............................................................................10

• Vision from A Dental Assistant - the cabin crew in dental clinic.................................................................................13

• Hands-on: Single Sling suturing Technique - lingual approach..........................................................................15

• Gallery: P&W | EViDENT 1st Session of Dental Presentation Courses.......................................................18

• Road Trip to Black Forest - to travel is to take a journey into yourself......................................................................19 2

and to share with others, for with such

Editor-in-Chief

Calendar SEPTEMBER 2015 SUN

MON

December

2015

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1. SENAME 2015, Estoril, Portugal 2. 22-25 Sep. FDI Annual World Dental Congress, Bangkok, Thailand. 3. 24-26 Sep. EAO Congress 2015, Stockholm, Sweden.

October

* Calendar events are mainly courses and conferences related to well-known international dental association. Regional events are not included. Further information is advised.

2015

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Aesthetic Dental Workshop

Contact

1. 3-4 Oct. MPI Hands-on Course with STAID, Tainan, Taiwan. 2. 9-11 Oct. SEPES Congress 2015, Sevilla, Spain. 3. 21-24 Oct. ACP 45th Annual Session, Orlando, U.S. 4. 30 - 1 Nov. DDS World Dental Shows, Istanbul, Turkey.

November

Email: evident.academic@gmail.com Issuu: https://issuu.com/perio.prostho.cc Facebook: P&W / EViDENT Associated Blog: https://perioprosthocc.wordpress.com

E7 Dental E-publishing Volume 1, September, 2015 Publisher/ Editor-in-Chief: Chen-Che Hung Senior Editor: Wei-Hua Chen

2015

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P&W | EViDENT Dental Education Chairman: Ya-Hui Chuang Secretary-General: Chen-Che Hung Copyright ÂŠ 2015 P&W | EViDENT Dental Education.

1. 10 - 13 Nov. WIOC 2015, Dubai, UAE. 2. 13 - 14 Nov.Competence in Esthetics by Ivoclar Vivadent, Vienna, Austria.

Articles may be quoted and referenced with the description from the reference data. Permission requests that exceed the above guidelines and instructions must be directed to and approved in writing by P&W | EViDENT Dental Education. Articles from perio.prostho.cc.wordpress.com are permitted to publish or modify under the agreement for the educational use only. For any further information and related questions, please visit the website or contact perio.prostho.cc@icloud.com

Brief Concepts & Evidence of Osseointegration Chen-Che Hung, DDS. keywords: biomechanics, dental implants, osseointegration, titanium *the article is also available on perio.prostho.cc wordpress.com

Introduction The term “Osseointegration” has been established widely when describing the concept of how does the dental implants “seal/ implantation” to the bone. And of course, we could never forget the great work Swedish Dr. Per-Ingvar Brånemark (1929-2014) achieved for us.1

acceptance of osseointegration as a viable treatment. In Sweden he was even openly ridiculed at scientific conferences. Eventually an emerging breed of young academics started to notice the work being performed in Sweden and at a Toronto Conference in 1983 the worldwide scientific community finally began accepting Brånemark's work.1 One of well-known, and excited work from Dr. Brånemark was hanging the mandible of dogs, (Biomechanical Characterization of Osseointegration: An Experimental in-vivo Investigation in the Beagle Dog) proofing the osseointegration of titanium implants and the mandible, which the forces/ loading contains one mature dog’s weight.2, 3

Fig.1 Great mentor Dr. Per-Ingvar Brånemark

In early 1950’s, he first began conducting experimenting with titanium implant chambers to study blood flow in rabbit bone, discovering that the bone had integrated so completely with the implant that the chamber could not be removed. Brånemark called the discovery “Osseointegration.” 1 In the mid 1960’s, he began his first successful experiments on humans. Indeed, his first patient went on to live another 40 years with the original implants still in place and functioning well.1 At first very few fellow scientists took Brånemark very seriously and there was little 4

The original definition of “osseointegration” by Brånemark (1969), provided by Albrektsson et al. (1981) suggested that this was “a direct functional and structural connection between living bone and the surface of a load carrying implant.” 4 The description then was applied by N e w a n e t a l . i n C a r r a n z a ’s C l i n i c a l Periodontology. (Elsevier) Another, clinical definition was provided by Zarb and Albrektsson (1991) who proposed that osseointegration was “a process whereby clinically asymptomatic rigid fixation of alloplastic materials is achieved and maintained in bone during functional loading,” 4 which the discussion including the bone analysis from the work of Lekholm & Zarb Classification.(1985) 5 These days, The concept of osseointegration has opened a new new emerging field of science, the biological surface science and E7 dent., 2015;1:4-6

stresses its importance in the field of alloplastic materials and dental implants.6 which biomechanical forces are one of the scientific research topic to traced down the response and the maintenance of the osseointegrated forces between the dental implants and the bone.

difficult since the fragments of the screw was blocking the pathway of the remaining thread, piezo-surgical remove is proceeded. As the dental implants is removed, the bone on the titanium surface was magnificent. The density of the bone/ bone grafts was intact, and the bone was difficult to separate even using the curettes. Nevertheless, we could not identify the force amount between the 2 different materials, the bonding is compact accurately. Fixation was achieved and indirectly proofed the phrases “a direct functional and structural connection between living bone and the surface of a load carrying implant.”

Fig.2 Scheme of biomechanics forces application.6

Fig.4 Bone/ bone grafts binding on titanium surface. [1] Fig.3 Osseointegration results under microscopic view.6

Evident-based Results Although the concept and the clinical trail/ reviews of osseointegration reveals highly efficient, the real result of the biomechanics of new bone is still a consideration. Whether the bone is closely bonded to the surface or just a simple “stuck” on the titanium surface. The following clinical photos has shown some evident of the osseointegration. 50yrs more, a male patient came for the surgical removal of dental implants (posterior more, more or less 3yrs) due to the fracture of the screw inside the abutment. (occlusal loading fracture) Saving the implant was E7 dent., 2015;1:4-6

Fig.5 Bone/ bone grafts binding on titanium surface. [2]

Acknowledgement Surgical treatment and clinical photos are provided by Dr. Chi-Chou Huang DDS, MS at Nan-An Periodontics Dental Clinic. 5

Reference 1. 2.

History of Osseointegration, European Association for Osseointegration. (EAO) Brånemark R., A Biomechanical Study of Osseointegration. -In-vivo Measurements in Rat, Rabbit, Dog and Man, Dissertation Research, Gothenburg, Sweden, 1996. Brånemark R., Ohrnell L., Skalak R., Carlsson L., Brånemark PI., Biomechanical Characterization of Osseointegration: An Experimental in-vivo Investigation in the Beagle Dog., J Orthop Res, 1998;Jan;16(1): 61-9. Lindhe J., Berglundh T. et al, Osseointegration, Clinical Periodontology and Implant Dentistry 5th Ed., Blackwell Munksgaard, 2008;99-107. Lekholm U., Zarb G.A., Albrektsson T., Patient Selection and Preparation. Tissue Integrated Prostheses, Quintessence Publishing Co. Inc., 1985;199-209. Kinga T., Surface Aspects of Titanium Dental Implants, Biotechnology - Molecular Studies and Novel Applications for Improved Quality of Human Life, 2012.

E7 dent., 2015;1:4-6

Size Matters! - ratio selection for presentation slides Chen-Che Hung, DDS. keywords: aspect ratio, keynote, presentation Keynote design is now a very popular and useful for dentists to present clinical cases to the audiences, for lecturing or even for the patients to have a perfect treatment plan in digital era. Including the well-known dental group DSD (Digital Smile Design), more and more reviews and experience have shown the benefits and convenient using simple presentation software (e.g. Keynote from Apple, PowerPoint from Microsoft and etc.) could be able to detect the possibilities of the treatment outcomes, communicate better not

only with the patients, but also with the dental technicians to have the best results in all processes. Choosing the framework, or say, the template could affect the symmetry of this presentation. Before 4:3 size of the screen was the only choice, due to the projectors and the monitors that time. Now, we are able to design, and control the size. The following is going to suggest the ideal ratio for each kind of project.

4:3 16:9

24:10

16:10

Size of the Slides Fig.1 Comparison of different size of the template. designed using Keynote from Apple.

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4:3 Aspect Ratio - the traditional, the original As the same size of our photos, it is easy to use, and simple for the presentation. Most of the projectors are able to present with terrific colors and portions. Disadvantage will be the lack of space for wide-size photos like panoramic radiographs, and the design is boring due to the limited site.

templates and etc., considering the most optimal option for the presentation nowadays. 16:10 Aspect Ratio - close to the golden ratio The most existing place of 16:10 ratio screen would be the computer displays, tablet and etc. A slice of larger than 16:9, but with more space to process. The ratio is close to the golden ratio which is approximately 1.618. It is a choice for photography portfolio. 24:10 Aspect Ratio - It is like watching a movie

Fig.2 A CRTs (cathode ray tube tube) Sony television with the monitor in 4:3 aspect ratio.

16:9 Aspect Ratio - the era of panoramic view There is one saying that the artist Vincent van Gogh opened the gate to the panoramic view, with his fantastic “widescreen” painting such as his last artwork Wheatfield with Crows. The aspects included the scene of landscape, extending the eyesights. In dentistry, the pictures and the words could be appropriated situated in a harmony size. Panoramic radiograph or a decision tree (horizontal) could be easily placed to have the accurate proportion. It is now available in kinds of television programs (standard broadcast format in Europe digital channels), computer

24:10 ratio screen, is also called CinemaScope, which had been used in film making in the 60’s. Like the movie we saw today, the screen is wide, and useful for the information which contains a timeline, or a chart with long term results . (from left to right or etc.) It is also an excellent choice for showing the smile design, or one arch of anterior teeth to the audience, which is better than 16:9 ratio with wider space. Although the ratio is powerful for the esthetic purpose, it is not common since this kind of presentation should project in a conference hall with the exact size of screen and projector to have the perfect presenting. Using the normal ratio type of hardware will cause the presentation looks very small and difficult to read. Stage of Wound Healing

5 Days

Months Watson T, Electrotherapy and Tissue Repair: The Current State of the Art, Sport Ex-Medicine.28:7-13.2006 Schultze-Mosgau S,Blatz MB et al., Principles and Mechanisms of Peri-implant Soft Tissue Healing, Quintessence int. 2005

Fig.4 An example of 24:10 aspect ratio of timeline chart.

Fig.3 Wheatfield with Crows, 1890. 50.2 cm x 103

Since there are varieties of choices for the slides design, the main key would still be what would you do to construct your own story, and what is the message you want to share to the audiences. Like Steve Jobs said, “Pictures speak louder than words.”

cm, Van Gogh Museum, Amsterdam 8

E7 dent., 2015;1:7-8

Jean-François Millet, L’Angelus, Canvas, 1857-1859 Musée d’Orsay, Paris

Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. (Philippians 4:6)

Christian Love Art Project Classic Art with Passages from Bible

⓪ public domain

In the Beginning… - keystone routine in periodontal surgery Wei-Ching Sun keywords: curette, dental scaling, periodontal surgery, root planning Introduction Since the risen of healthcare and oral education, people have started to seek the dental treatments that are “non-visible.” Unlike placing a prosthesis or having tooth whitening, periodontal surgery is considered as a type of therapy designed to preserve and regenerate the hard tissue and the soft tissue. Esthetics point of view would be covering the exposure of the teeth, and establishing the outcomes of the harmony between the teeth and the gingiva. In the other hand, correction of the morphologic defects is an another goal to achieve the functional purpose for further following dental treatment.1 However, without a standard protocols, the success of the the procedures is doubted. Mostly, periodontal therapies should start from the basis, which is the nonsurgical treatment - scaling and root planning (Sc/Rp) therapy. Importance of Scaling & Root Planning   One of the most essential etiological factor causing gingivitis and periodontitis would be the presence of microbiological bacteria causing plaques and calculus. Accumulation of plaque leads to gingival inflammation and pocket deepening, which in turn increases the area of plaque accumulation.1 Therapies should be processed to in able to control the circulation of the causing factors. (Figure 1) Scaling is the removal of plaque, calculus, and stain from the crown and root surfaces. This is as opposed to root planing, which is the definitive removal of cementum or dentin from the root surface in an attempt to smooth rough surfaces and dislodge calculus.2 10

Fig.1 Cycle of the presence of a periodontal pocket.¹

The purpose of scaling especially amongst patients afflicted with periodontal disease typically targets the area below the gum line. This procedure removes calculus and plaque that attach to the teeth.   In situations where the periodontal disease is more severe, root planing and curettage are more often used. Typically in situations where the periodontal pocket is greater than 5mm.3 (The presence of proximal attachment loss of ≥ 5 mm in ≥ 30% of teeth.) For the reason that plaque is more likely to stick to rough surfaces, the root surface is made smooth to eliminate plaque and calculus.this procedure is called root planing. If a patient have several deep periodontal pockets and with resorption of the gingival tissues which creates pockets that eventually lead up to erosion of the alveolar bones. Therefore, curettage or flap technique is needed to remove granulation tissues and epithelium lining to allow better adhesion between the connective tissues around the teeth. E7 dent., 2015;1:10-12

Clinical Review During the regenerative periodontal surgery, especially in tissue harvesting, it is important to ensure the recipient site is uninfected and able to receive bone materials and the soft tissue graft. Before the first incision, the deepness of periodontal pocket should be detected using the periodontal probe. Probing should perform at all orientation of teeth including buccal, lingual, palatal and the other interproximal aspects.

Afterwards, using the scalpel to trace along the apical region of the teeth in order cutting away the connective tissue. Apply the periosteal elevator to separate the tissue from the bony ridges of the teeth in order to create a flap-like opening. The granulated tissue and soft bony tissue are advised to remove with the ultrasonic scaler and curette, which allows the reveal of the new crestal bone to provide the nutrient to the tissue grafting. Bone grafting material is applied within the eroded pockets and the collagen if deemed

Fig.2 Connective tissue graft was harvested from the donor

Fig.3 Bone recession was measured after the tooth scaling and

region.

root planning.

TG BG

A. Bone grafting materials are applied

B. Connective tissue graft is placed and

C. Expected healing result. Control the

to the root, achieving Guided Bone

the suture is advised to enclose the

relapse of the soft tissue contraction.

Regeneration. (GBR)

wound without any retraction.

Fig.4 Ideal periodontal surgery result. A. adding the bone graft to regenerate more hard tissue according to the anatomic defects of the dental alveolar bone, B. soft tissue graft is applied as the tissue augmentation and the barrier for the bone grafts materials. Sling suturing is one of the recommended procedure, C. Ideal periodontal surgery with the success of the regeneration site.

E7 dent., 2015;1:10-12

necessary for proper recovery of the gingival tissues. Connective tissue graft from the diner site covers the bone materials to prevent the resorption of the bony tissue. In final, the suturing is applied to uphold the flap in the adequate position. Tension release is proceeded to prevent any relapse during the wound healing stage. Periodontal dressing (COE PAK) is put to cover the wound from food, saliva and any contamination. Conclusion The inflammatory components of plaque in both gingivitis and periodontitis can be managed effectively for the majority of patients with a plaque control program and the nonsurgical coupled with continued periodontal maintenance procedures. 4 Importance of dental scaling and root planning should be applied to all the patients with similar symptoms and needs. The last, but the most essential, oral hygiene care should be monitored in able to have the best treatment outcomes for the patients and the clinicians. Acknowledgement Surgical treatment and clinical photos are provided by Dr. Chiou at Jian-En Dental Clinic in Taipei City, Taiwan.. Reference 1. Newman, Takei, et al., Carranza's Clinical Periodonyology, 11th, Elselvier 2. C o h e n E . , A t l a s o f C o s m e t i c a n d Reconstructive Periodontal Surgery, 3rd, BC Decker 3. Leroy R. et al., Methodological Issues in Epidemiological Studies of Periodontitis How can it be improved?, BMC Oral Health,2010;10:8 4. American Academy of periodontology Research, Science, and Therapy Committee, Treatment of Plaque-induced Gingivitis, Chronic Periodontitis, and Other Clinical Conditions, J Periodontol, 2001;72:1790-1800. 12

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Vision from A Dental Assistant - the cabin crew in dental clinic Shan-Yu Tien, BSHA keywords: dental assistant, oral hygiene, working experience *the article was received in Chinese, translated by P&W | EViDENT

As a dental assistant for more or less 3 years, it really was a very unforgettable working experience. Not until training for the techniques and applications did I know how precise and expensive the dental instruments are. In Taiwan, oral hygienists and dental assistants are not certificated to do oral scaling or any intra-oral treatment. However, it is very important and rigorous to educate the patients of tooth brushing, dental flossing and routine visit to the dental clinic.

support during each phases of the treatment. That is why the dentists really should communicate with us and give us the clear order. To me, every surgery I have to assist is a big challenge with pressure, but I eager to do my best. Starting from taking the CT scan, how to adjust the correct position, make the appointment for the surgery, explain to the patients every stage before and after the treatment, ensure the isolation of the operating room, instruments and biomaterials sterilisation, manipulating dental impression,

As a matter of fact, people may wondering what they need to scale the teeth if they already brush them daily. According to NHI *, the ministry suggests to have the oral checkup with tooth scaling every 6 months and to ensure the oral hygiene care (visibility of caries, pain swelling, oral cancer diagnosis) of the patients and prevent the causes of periodontitis by subgingival tooth scaling. Thanks to these recall system, lots of Taiwanese are able to find their problems and treat their disease as soon as possible. (a group amount of Taiwanese citizens suffer in oral cancer due to the abuse of smoking and chewing betel nuts.) Not only we (dental assistants) should learn from the basis of dental materials and manipulation, we also need to know the dental instruments clearly, especially with lots of equipments within a treatment. For example, dental implant surgery. Nowadays, more and more dentists do dental implants in their private clinic. Nevertheless, there is still no such a course or a program to train dental assistants how to manage and E7 dent., 2015;1:13-14

Fig. 1 Dental educational practice for knowing the aspects of the oral cavity.

About Author

Shan-Yu Tien Fig.2 Isolation and sterilization are both essential during the dental implant surgery.

till the continuous of case following and revisit for the maintenance. The dentist will need us to have everything clear and understand what we are doing. If we make a mistake, it will affect the outcomes of the procedures. Everything should both accurate and efficient.

had earned the degree of bachelor science in healthcare administration and had been working in Dr. Wangâ&#x20AC;&#x2122;s Dental Clinic in Tainan, Taiwan for approximately 3 years. (2011-2014) She was a senior dental assistant specific in assisting dental implant surgery, and training junior dental assistants for the clinic. Now she is positioned as administrative staff in Taitung Veterans Hospital for further training.â&#x20AC;Š

Dentist is like the captain of an airplane. He/ she leads us to the way and control the diseases during the procedures. We, dental assistants are like cabin crews, we serve our patients to be satisfied and erase their nervous. All we want is to have the best results for our patients, and take care of their oral hygiene. * National Health Insurance care system is instituted by Ministry of Health and Welfare of Taiwan. It is founded to establish the equal access of health care to all the population. The finance is based on payroll tax and supplemented from regional government. General dental treatment including tooth scaling, dental caries, root canal fillings and etc. for more information, please visit: http://www.nhi.gov.tw

E7 dent., 2015;1:13-14

What is â&#x20AC;&#x153;3A - 2B Ruleâ&#x20AC;? ? Join Dr. Fernando Rojas-Vizcaya to access the harmony between function & esthetics, and achieve the next level in oral implantology

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Date:&&&OCT.&3,4&2015& Place:&Na6onal&Cheng&Kung&University&(Faculty&of&Medicine),&Tainan,&Taiwan& Organizer:&&STAID&(Southern&Taiwan&Academy&of&Implant&Den6stry)& Contact:&&+886&7&558,5177&staid2005@gmail.com

Hands-on: Single Sling Suturing Technique - lingual approach Chen-Che Hung, DDS. keywords: gingiva, periodontics, sling, surgical flap, suturing *the article is also available on perio.prostho.cc wordpress.com

The single interrupted sling suturing technique is the technique of choice when the goal of therapy is to reposition one of the surgical flaps at a particular occlusal apical level that is independent of the other gingival tissue height.ยน

the thread and following step-by step guideline in the following figures:

As an anchor type suture, the surgical flaps could be elevated, and positioned by the support of the adjacent tooth or implant.(e.g. healing abutment) The clinicians should notice the collapse of the soft tissue due to the incision procedures. (post-treatment) Tension release is indicated in this suturing to approach the final position of the gingiva contour that the clinicians expect. Fig.1 Step-by-step guideline for simple sling suturing. 1. first

The suturing material should be chosen according to its tensile strength and properties of the thread. Absorbable thread (e.g. Vicryl) is not advised for this kind of suturing technique due to the lost of tensile strength by time, effecting the support of the elevation. Braided (poly-filament) types of suturing generally have greater tensile strength, however, the oral hygiene should be monitored carefully because of the capillary effect of the suturing material.

needle penetration from the buccal side. 2. the thread is circulated at the lingual side of the tooth. (lingual approach) 3. the thread is again passed through the buccal side, the adjacent papilla side of the flap. 4. a knot is secured on the buccal side to ensure the strength of the thread, with forces holding the flap attached to the wound side.

The sling suture is widely used for root coverage, gingiva esthetics, open flap implant surgery and etc. The suture could be applied both buccal/ lingual side. Practical Session Models and animal cadavers with teeth are advised for the suturing practice. Focusing on the dissecting of the flap and the pathway of 16

Fig.2 Final stage/ result of the simple sling suturing. Buccal view of Step 4 from the previous guideline figure.

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Practical Photos The following practical session was using the pig jaw and the braided poly-filament silk thread for the suturing technique demo. Modification are established for the better presentation and recording trials.

Fig.6 Practical session using pig jaw with the step-by step guideline. (tension release 2)

Fig.3 Practical session using pig jaw with the step-by step guideline. (initial 1)

Fig.7 Practical session using pig jaw with the step-by step guideline. (final stage 1)

Fig.4 Practical session using pig jaw with the step-by step guideline. (initial 2)

Fig.8 Practical session using pig jaw with the step-by step guideline. (final stage 2)

Reference 1. Sliverstein L.H., The Suture Book, AEGIS Communication, 2011 Fig.5 Practical session using pig jaw with the step-by step guideline. (tension release 1)

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P&W | EViDENT 1st Session of Dental Presentation Courses P&W | EViDENT P&W | EViDENT 1st session event was held on the summer of 2014 in Valencia, Spain. A group of undergraduate dental students discussing the future and sharing the ideas for the next generation of the dentistry. The session included the lecture of designing your own story in slides, using Keynote from Apple Inc. and the introduction of GBR and bone augmentation in dental implants. It was also a training program for our members to experience the new philosophy of presenting in front of the audiences. This event was taken at Restaurante Coconut, one of the exclusive creative modern restaurant in Valencia. We are excited to have the 2nd session prepared in 2016, and taken to the next level.

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Road Trip to Black Forest - to travel is to take a journey into yourself Wei-Hua Chen keywords: black forest, europe, germany, romantic road, travel Easter vacation normally starts in April. It is always a perfect time to take a break to recharge and refresh from the studying. Germany is a lovely choice, where you could discover both high technology and there traditional culture at the same time. I have managed some places to visit during these holidays. Heidelberg, Black Forest and Mainz. Heidelberg Heidelberg is a beautiful town beside the Neckar River in southwestern Germany, its beauty and timelessness inspired the German Romantic Movement, and it continues to inspire people today. Known for its university and castle, Heidelberg celebrates both the old and the new, making it the perfect place for everyone. Visitors can ride the Bergbahn funicular to reach the castle and its gardens, which have sweeping views over the river and the baroque Altstadt (Old Town). Fig.2 S-Printing Horse, 15m X 4m X 13m (W*D*H) J端rgen Goetz, 1998-2000. Heidelberg, Germany.

There is a cool statue which is just right in front of my hotel is designed by Heidelberger Druckmaschinen which is a German precision mechanical engineering company with head offices in Heidelberg. (Figure 2)

Fig.1 Heiliggeistkirche (Church of the Holy Spirit, Heidelberg), one of the famous church stands in the middle of the marketplace.

E7 dent., 2015;1:19-21

One of the delightful visit would be the Heidelberg Castle, a famous ruin in Germany and landmark of Heidelberg. The castle ruins are among the most important Renaissance structures north of the Alps. Since it is situated on the hill, you can reach the castle by walking

and taking funicular. And apparently I chose the easy way! Black Forest - (Freiburg, Gengenbach) Next destination, Freiburg, where sits on the edge of the Black Forest. I would say this is the best part of my trip. Since it's foundation in 1120, Freiburg in Germany has become a cultural and historical mosaic of colours and variety. Situated in the heart of the Black Forest in the South Western tip of Germany, Freiburg is the home to those who thrive cultural diversity and high quality education, not to mention a tourist magnet for those who love a perfect European vacation. According to this massively large forest, renting a car would be advisable in Freiburg, and the what would match the lifestyle of German? Mercedes-Benz of course! (Figure 3) Another amazingly lovely town would be Gengenbach, a town in the district of Ortenau, Baden-W端rttemberg, Germany and a popular tourist destination on the western edge of the Black Forest with about 11,000 inhabitants.

Fig.4 Path on the Black Forest. (Romantic Road)

Cobble stone streets were edged with mountain water was flowing freely toward the river all around Gengenbach, which is like a beautiful puzzle you could decorate in your home. Without any specific plan, you could drive around the Black Forest (Figure 4) to find somewhere away from the tourist attractions; and according to that, there are no English descriptions among these towns so just enjoy the beautiful views!

Fig.3 Enjoy the speed in Germany! Mercedes-Benz E Class Wagon is great for the pleasure of driving through Romantic Road and carrying your luggages in a easy way.

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Mainz Mainz, is famous for its university, its Roman heritage, its status as a media hub and regional capital, and its three most defining features: the Romanesque cathedral, the Gutenberg printing press and the Rhineland carnival. The people of Mainz have good reason to be proud of their city's history spanning almost 2,000 years. This rich cultural heritage incorporates a well-established wine growing tradition, which only adds to Mainz's appeal.

Fig.7 Railway passing through the Black Forest. (1)

Fig.8 Railway passing through the Black Forest. (2) Fig.5 Der Hohe Dom zu Mainz. (Mainz Cathedral)

About Author

Wei-Hua Chen Fig.6 Downtown of Mainz.

I've always enjoyed traveling and having experience with different cultures and different people and it's also a wonderful thing to be able to benefit and enable to relax my mind, not only in our country but around the world. Focus on the journey, not the destination. Joy is found not in finishing an activity but in doing it.Black Forest is one of my favourite place to travel, and also itâ&#x20AC;&#x2122;s the top recommendation I would tell my friends to go! E7 dent., 2015;1:19-21

is one of our senior editor of E7 dental epublishing, and also the co-founder of P&W | EViDENT., studying Dentistry in Valencia, Spain. He has been traveling in Europe over 3 years, with great experience in managing the tours for backpackers, and organizing tours for academic events. [specific research field: general dentistry, clinic managing, oral surgery]

Aesthetic Dental Workshop