The Dental Technician Magazine April 2020 by The Dental Technician Magazine

VO L 7 3 N O. 4 I A P R I L 2 0 2 0 I B Y S U B S C R I P T I O N

DENTSPLY SIRONA

CHAMPIONS FEMALE LEADERSHIP IN DENTISTRY PAGES 12-13

Inside this month...

THE MERIT AWARDS

FIRST NOMINATIONS REACTION! PAGES 26-27

VERIFIABLE ECPD FOR THE WHOLE DENTAL TEAM

SUPPORTING COLLABORATION BETWEEN DENTAL PROFESSIONALS By Mark Ambridge. CDT PAGE 14

E X T E N D Y O U R S U B S C R I P T I O N B Y R E C O M M E N D I N G A C O L L E A G U E - S E E PA G E 3 w w w.d e n t a l t e c h n i c i a n .o r g .u k

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NEW

CONTENTS

Editor - Larry Browne FBIDST. FDTA, ITI Fellow, LCGI, RDT. E: editor@dentaltechnician.org.uk T: 01372 897461

CONTENTS

APRIL 2020

Designer - Sharon (Bazzie) Larder E: inthedoghousedesign@gmail.com Advertising Manager - Chris Trowbridge E: sales@dentaltechnician.org.uk T: 07399 403602 Editorial advisory board K. Young, RDT (Chairman) L. Barnett, RDT P. Broughton, LBIDST, RDT L. Grice-Roberts, MBE V. S. J. Jones, LCGI, LOTA, MIMPT P. Wilks, RDT, LCGI, LBIDST Sally Wood, LBIDST Published by The Dental Technician Limited, PO Box 430, Leatherhead , KT22 2HT. T: 01372 897463 The Dental Technician Magazine is an independent publication and is not associated with any professional body or commercial establishment other than the publishers. Views expressed in this journal are not necessarily those of the editor, publisher or the editorial advisory board. Unsolicited manuscripts and photographs are welcome, though no liability can be accepted for any loss or damage, howsoever caused. No part of this publication may be reproduced in any form without the express permission of the editor or the publisher. Subscriptions The Dental Technician, Select Publisher Services Ltd, PO Box 6337, Bournemouth BH1 9EH

Extend your subscription by recommending a colleague There is a major change in CPD coming soon. The Dental Technician Magazine is a must read. Tell your colleagues to subscribe and if they do so we will extend your subscription for 3 months. The only condition is that they have not subscribed to the magazine for more than 12 months. Just ask them to call the Subscriptions Hotline. With four colleagues registered that means your subscription would be extended for a year free of charge.

Welcome Welcome to your magazine by Editor Larry Browne

Case Studies Case study with author and operating dentist, Dr. Finlay Sutton. Part 3 Full dentures: A complicated case solved according to the GERBER concept. Part 3

8-9 17-19

Focus Dentsply Sirona champions Female Leadership in Dentistry Ceramic Designs and Den-Tech denture charity

12-13 13

Education Supporting collaboration between dental professionals By Mark Ambridge. CDT

Dental News BADN launches Health and Wellbeing Hub for members Gold for Dental from Deutschland Illegal Dentistry on Channel 4!

15 28 29

Marketplace Candulor AG/Zirkonzahn/3Shape/Bredent

22-23

ECPD Free Verifiable ECPD & ECPD questions

24-25

DTGB Merit Awards first winners

26-27

Insight Letters to the Editor

Classifieds

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WELCOME

Welcome

TO YOUR APRIL 2020 ISSUE By Larry Browne I Editor

APRIL SHOWERS AND THE CORONA VIRUS - WHAT NEXT!!

April should hopefully be showing a warmer and less wet prospect for our day to day activities. It really has been a wet and windy first half of March, but the temperatures are already promising to rise and hopefully the rain will lessen. There is a lot going-on in the dental marketplace with all the companies all preparing to offer the best they have at the May DTS in Birmingham. Time to start making a list of whatever it is you may be interested in finding out more about. From new laboratory benches to the very latest digital labour-saver, it will all be there. All of course, depending on whether we are allowed to even think about attending, with the potential Corona virus situation. It is a real worry, from the patients’ deciding not to attend the clinic to the effect on the staff, including Laboratory technicians and process workers. We are already hearing reports of Dentists refusing to treat patients, even after their hygienist has been allowed to do so! The situation is becoming somewhat clearer, but nobody knows when and the extent of infection we really face. The Budget statement suggests the government has every intention of spending money where needed, but I fear that will not, for the short term at least, include dentistry. There are of course precautions we can incorporate into our business plan, but working from home, unless you are already set up to do so, will be limited perhaps to the computer-based processes. Health and safety will of course need to be observed and many of you might well have a suitable space in your attic or garage which you can convert for the short term. The government are offering financial compensations for some activities which are

suspended, some including the salaries of staff affected. You will need to check early to see if you qualify but do check. The letter page is beginning to yield some response, but slowly. This month a long-time reader, James Bennett, from Surrey includes some old copies of an article by Peter Mackie in March 1990 querying VAT payments which featured in the magazine. It would be nice to see if any of you are further interested in the subject or indeed any other subject affecting our working lives. He also included an old printed photo of his first ceramic furnace, a ROST air fired which was the most popular until the coming of the Vacuum furnace. You had to judge the porcelain bake by looking through the very small aperture in the door. The Vacuum furnaces certainly changed the whole process of ceramic applications and led the way for Ceramists as a separate specialist in Technical dentistry. It would be god to hear some stories from you or indeed raise a query on charges or other concerns for everyday dental laboratory concerns. Just to keep you up to date with the registration queries. The GDC have still not responded to my letter, despite promising so to do. I am told I must be patient!! Now they have had the letter for over a year I would have thought someone would answer, if they were interested. But we may be registrants, but you must remember we are technicians, and they are not interested in anything but the money they take from us. Because it is the law to be registered we have to pay, if the organisation in charge of supervising the whole process has chosen to ignore us!! Well even those at the GDC must realise they cannot keep on taking

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money without providing something in return. Recognition would be a good start. I have managed to make contact with the DTA, The DLA, The OTA and as a group we are supposed to be making overtures for information but it does seem as if even these organisations are ignored when it comes to treating technical registrants responsibly and on a par with the others requiring registration. I will keep on and keep you informed if there is any headway. Please don’t hold your breath! Quite a few of those I have spoken with seem not to want to be seen “rocking the boat “but I do think if we do nothing, nothing will follow. Eventually we will be paying, The DTA, The DLA, The GDC and other representative organisations who seen only to represent anything that does not get to the ears of the GDC or MHRA. Why do you pay these fees if your organisation will not at least stand up for your absolutely basic rights? We are after all only asking for recognition of the fact, that we work for patients and are responsible to the patient and to the GDC/MHRA to provide an appliance fit for purpose based on our training and qualification. We are part of the restorative dental team and should therefore be respected by the very organisations to which we are required to pay registration fees. Something which they appear reluctant to acknowledge. They are behaving like committees for the sake of being committees without moving the interest of their paying member forward. Indeed, ignoring representatives of the body of people for whom they are paid to support. I am told its political. Politics is said to be the art of the possible!! Why do they not make it possible? Remember I still await an answer from the GDC to my letter of February 2019.

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EXTEND YOUR SUBSCRIPTION BY RECOMMENDING A COLLEAGUE There is a major change in CPD coming soon. The Dental Technician Magazine is a must read. Tell your colleagues to subscribe and if they do so we will extend your subscription for 3 months. The only condition is that they have not subscribed to the magazine for more than 12 months. Just ask them to call the Subscriptions Hotline. With four colleagues registered that means your subscription would be extended for a year free of charge. At only £39.95 per year, for UK residents, this must be the cheapest way of keeping up to date. Help your colleagues to keep up to date as well. Ask them to call the subscriptions Hotline on 01202 586 848 now.

CASE STUDIES Part 3 -continued from March issue...

FULLY EDENTULOUS REMOVABLE PROSTHETICS By Dr Finlay Sutton and team from the specialist practice based in Garstang Nr Preston

n the past two issues we have looked at the step by step construction of full upper and partial lower dentures. The patient had some extractions of a some remaining teeth and a provisional set of dentures were constructed, to provide function and support during the healing phase. Occlusion, appearance and comfort could also be assessed. In this day and age, you might expect almost an automatic reaching for dental implants, but Dr Sutton took the view, correctly in my opinion, that the patient’s soft tissue history and his continued tendency to smoke was a contraindication for implants.

The tissue now looks very stable and healthy. It was time to begin the final phase to construct the MK 11 dentures. Beginning with careful mounting of the new models to the new records.

ABOVE: Final models mounted on the Denar Articulator to the Centric Records shown.

ABOVE:12 months after removal of failing teeth. During this time Mk 1 immediate dentures were fitted, periodontal therapy (including periodontal flap surgery) was provided.

ABOVE: Cobalt chromium framework trial insertion in the mouth. The lingual bar does not rest on the soft tissues - blocked by a wash of wax less than 0.5mm thick.

ABOVE: Bite blocks on resin bases with central bearing apparatus bite records, plus silicone centric confirmation record.

Lower chrome cobalt with pink opaque in the saddle areas. Note the fit over the carefully constructed composite stabilising build-up on lingual aspects of the front teeth. Also note the excellent fit in the mouth.

The Chrome Cobalt bases are Constructed as shown (Chris Hesketh) and a pink opaque layer added to the retentive areas. Please note the pink opaque on the upper distal palate for application of acrylic post dam area. Allowing for corrective reline in the future, if required. Rowan Garstang technician DCP

ABOVE: Mandibular cobalt chromium, based framework (Chris Hesketh) – pink opaque saddle areas - Scandinavian hygienic design showing composite rest seat indentations on the lingual surfaces of the frame with 0.9 mm wrought gold clasps on LR4 and LL3

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ABOVE: Cobalt chromium base for complete upper denture for increased fracture resistance (Chris Hesketh). This will have an acrylic post dam which “I find results in increased suction (retention) and enables relining in the future should this be needed”.

CASE STUDIES

ABOVE: Definitive Set up of Mark 11 Dentures ready for try in. ABOVE 1ST ROW (L): Metal based Maxillary denture with acrylic post dam area for improved and adjustable fit. ABOVE (R):Well-fitting and discreet Mandibular denture. ABOVE 2ND ROW: Mandible and Maxilla finished dentures

ABOVE: Mk 2 maxillary metal-based denture with subtlety characterised Schottlander Enigmalife teeth. Gum colouring – Vertex.

The try-in, based on the transferred records and the patient’s observations of the provisional dentures, proved very satisfactory. Occlusion, appearance, phonetics, were all satisfactory and it was time to finish to the carefully worked and approved try-in.

ABOVE (L): Mk 2 finished dentures fitted with 0.9 mm wrought gold clasps on LR4 and LL3. ABOVE (R): Mk 2 finished dentures on the articulator with Schottlander “Enigmalife” teeth.

ABOVE: Mk 2 mandibular metal-based denture. Lateral views showing gum contours and gum colouring Vertex with 0.9 mm wrought gold clasps on LR4 and LL3.

ABOVE: Mk 2 definitive denture try in - at this visit the patient assesses the aesthetics by 1. video, 2. still photographs comparing Mk 1 with Mk 2, and direct observation in a mirror. Only when he was completely happy do we proceed with finishing.

The tried in metal-based wax-ups were invested and packed using the conventional method, with careful handling of the detail as agreed. You can see clearly the attention to detail of the acrylic materials and the artistic, but lifelike reproduction of the pink soft tissue detail and natural colouring using Vertex with the Schottlander “Enigmalife” teeth which were subtly characterised by Rowan Garstang DCP, the inhouse technician member of the restorative team.

ABOVE (L): Mk 2 maxillary metal-based denture with subtlety characterised Schottlander Enigmalife teeth Gum colouring – Vertex. ABOVE (R):Before treatment and after, with Mk 2 maxillary cobalt chromium based complete denture and mandibular cobalt chromium based partial denture fitted.

A rewarding end to what must have seemed, for the patient, a long process but the end result is comfortable and functional dentures, that look and feel really like the teeth he wanted. The change is dramatic when seen in a before and after photo, but the smile seems very real and soft tissues and lip support look original and

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healthy. A true confirmation that the process was correct and well completed by all involved at Dr Finlay Sutton’s specialist practice. Thank you to Dr Finlay Sutton, his technician Rowan Garstang and the patient, for access to the case.

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FOCUS

DENTSPLY SIRONA CHAMPIONS FEMALE LEADERSHIP IN DENTISTRY

n support of this year’s International Women’s Day theme, #EachforEqual, Dentsply Sirona continues to promote gender equality in the dental industry and oral health sector. Every year, the company sponsors a variety of programs and events dedicated to the career advancement and leadership of women in dentistry. This support ranges from hosting awards events, which honour visionary treatment solutions and outstanding achievements in research, to providing networking opportunities and knowledge exchange through panel discussions and conferences. Charlotte/Bensheim, March 9th, 2020. This year’s International Women’s Day theme highlights the importance of gender equality as a catalyst for thriving economies and communities. Under the hashtag #EachforEqual, this year’s campaign emphasizes how individual and collective efforts can contribute to empowering women in society. As the world’s largest manufacturer of professional dental products and technologies, Dentsply Sirona is committed to advancing women’s interests in the dental and oral health sector. “We want to empower all women in dentistry by supporting their professional development and recognizing their outstanding achievements in research and development, entrepreneurship, mentorship, and education,” says Dr. Terri Dolan, Chief Clinical Officer and Vice President at Dentsply Sirona. “As part of our mission, we support several programs for the advancement of women dentists, hygienists, and technicians within the dental industry.” Examples of programs and events supported by Dentsply Sirona in 2019 and 2020 follow. SMART INTEGRATION AWARD The Smart Integration Award celebrates women’s expertise in dentistry by recognizing their innovative ideas and successful and visionary treatment concepts that elevate networked treatment centers to the next level. In November 2019, the awards ceremony was hosted for the first time by Dentsply Sirona as part of the Company’s commitment to integrate women’s expertise more closely into the development of new products. In total, 24 winners were honoured for their creative

CLOCKWISE FROM TOP LEFT: The inspiring winners of the Smart Integration Award in 2019; Dentsply Sirona VP and Chief Clinical Officer Dr. Terri Dolan receives the Dr. Edward B. Shills Innovator Award for Excellence in Industry; Dentsply Sirona employees who attended the Women in Dentistry Breakfast in February 2020, in Chicago; Dentsply Sirona employee, Harpreet Atwal showing the motto of this year’s International Women’s Day #EachforEqual

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FOCUS ideas and impressive success stories that make work processes at treatment centers more efficient and convenient. WOMEN IN SCIENCE NETWORK AWARDS Research and innovation are at the forefront of Dentsply Sirona’s purpose and mission to empower dental professionals all over the world to provide millions of patients with better dental care and make people smile. Dentsply Sirona is proud to be the sponsor of two International Awards for Research in Dentistry. ASSOCIATION FOR DENTAL RESEARCH (IADR) WOMEN IN SCIENCE AWARDS The Distinguished Female Mentor award recognizes female researchers who have made a significant impact on the careers of fellow female researchers through their role as a mentor. The Award for Distinguished Research recognizes female scientists for outstanding accomplishments in oral, dental or craniofacial research. Dentsply Sirona is honoured in 2020 to sponsor these awards for a second year. 2019 ADEA INTERNATIONAL WOMEN'S LEADERSHIP CONFERENCE Celebrating female leadership is an important pillar for the empowerment of women in the

dental industry. Dentsply Sirona co-sponsored the 6th International Women’s Leadership Conference in Brescia, Italy, hosted by the American Dental Education Association (ADEA). Promoting female leadership within the health sector, the conference brought together 120 women from 23 countries to tell their stories and share knowledge. WOMEN IN DENTISTRY (WID) BREAKFAST Dentsply Sirona co-sponsors the annual WID Breakfast hosted each year by the AEGIS Dental Network and other industry partners. With 130 participants, the event aims to raise industry leaders’ awareness of women in dentistry, as well as highlight their roles as speakers at conferences and other industry events. Initially focused on the laboratory side of the business, the breakfast has expanded over the years to include women from all areas of dentistry and oral healthcare. ANNUAL GNYDM WOMEN DENTISTS´ LEADERSHIP CONFERENCE Dr. Terri Dolan, Vice President and Chief Clinical Officer at Dentsply Sirona, was invited to speak at the 1st Women Dentists Leadership Conference at the Greater New York Dental Meeting (GNYDM) on December 1, 2019. The meeting was created to empower and mentor current and future

women dentists. Dolan enjoys sharing her experience and inspiring career in dental research and education, having served as professor and dean of the University of Florida College of Dentistry for more than a decade before joining Dentsply Sirona. Recognized for her advocacy of diversity and support for women in dentistry, she inspired conference attendees with her presentation on mentorship, leading by example and mentoring others. She had the opportunity to share stories about the people who inspired and mentored her throughout her career. LEADING BY EXAMPLE: EXCELLENCE IN INNOVATION AND EDUCATION In October 2019, Dolan’s outstanding accomplishments in clinical education were honoured with the Dr Edward B. Shils Innovator Award for Excellence in Industry. As the leader of Dentsply Sirona’s Clinical Affairs team, Dolan is the driving force behind the conceptualization and implementation of the Company’s global clinical education program. In 2019, the program reached more than 470,000 dental professionals from 99 countries. The Clinical Affairs team also focuses on the development of new products and solutions designed to empower dentists and technicians to offer the best treatment and service to their patients.

CERAMIC DESIGNS

PROUD TO ANNOUNCE THEIR COLLABORATION WITH DEN-TECH DENTURE CHARITY The charity aims to relieve poverty by the provision of affordable/free dental appliances to those patients who are in need and unable to afford them. We will be donating some of our technician’s time to help improve the smiles and lives of those less fortunate. Andrea Johnson continues with her hard work to promote this excellent dental charity which takes dental technology to some very poor and deprived African countries. They organise for technicians to work and teach and raise awareness of the craft and together with clinicians try to set up treatment centres wherever they are most needed. Anything any of you can do to raise awareness and perhaps support Andreas efforts would be greatly appreciated.

CONTACT THE CHARITY: Linked In: www.linkedin.com/company/den-tech Facebook: @Dentech1 Website: www.den-tech.org

#healthcare #dental #denture #health #dentechcharity

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EDUCATION

SUPPORTING COLLABORATION BETWEEN DENTAL PROFESSIONALS By Mark Ambridge. CDT.

ark Ambridge was recently appointed as the Director for Dental Technicians at the BACD. He explains his motivation for joining the Academy and why other dental technicians can benefit from doing so as well: “I’ve worked closely with one of the BACD Past Presidents, Dr Donald Sloss, for over 30 years. He always saw me as a forward-thinking dental technician with an interest in the cosmetic aspect of dental technology. He suggested that the BACD would be a great community for me to get involved with, so I joined the Academy many years ago not only to be able to support Donald, but also to further my individual style of work with other likeminded dental professionals. “As an incredibly valuable and professionally run organisation, the BACD steps into the middle ground of general dentistry and guides those in the profession who wish to progress and provide the exceptional cosmetic dentistry that we see all the time on TV, film and social media. Therefore, the BACD is instrumental in maintaining high standards of practice, particularly in regard to the many elective dental procedures we now have. It provides access to national educational programmes presented by internationally recognised and respected experts from the field who are considered to be at the top of their game by their peers. This helps further the education of dental professionals, enabling them to augment workflows, strengthen working relationships, and provide high-end cosmetic dental treatments that many of today’s patients seek. “Additionally, the BACD helps improve professionals’ exposure to the trade, through its events. Dental technicians who are too busy to attend specific trade-shows, or are in the market for new materials or equipment, only have access to company representatives armed with brochures. Therefore, being able to browse a mini tradeshow at a BACD event – where you can also benefit from

valuable learning and CPD opportunities – is especially important and useful for busy dental technicians.” Looking to the year ahead, Mark hopes to invite world-renowned dental technicians and other relevant leaders from the dental technology field onto the BACD educational programme, making these speakers more accessible. He explains: “My aim is to offer access to more BACD educational events across the UK that are relevant to dental technicians, which should facilitate better communication with the dentists they support. We at the BACD want dental technicians to reap the rewards of education that they can put into practice in a day-today laboratory setting. For this reason, I’m also hoping to introduce and promote a special BACD membership scheme for dental technicians, so that they benefit from greater value membership.” Mark believes that treatment cannot be completed to the high aesthetic standards that the dentist is looking for if the dental technician is not involved in the process. “We can all agree that the patient is the most important element to the success of treatment,” he says, “but it is also vital that the dentist and the dental technician work together. There has to be effective communication between these professionals. The dental technician typically remains in the laboratory and will often just receive a prescription with a patient’s name on it, although nowadays they may get digital images or video footage. They might even be lucky to meet the patient in the flesh for consultations about their restoration shade, shape and texture. However, this should happen more and more if the outcome of treatment that the patient expects is going to be achieved as the dentist has suggested. “The BACD can help facilitate and support working relationships within dentistry by bringing dentists and dental technicians together at educational events,

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where these professionals can learn so much more from each other and further their understanding of dental procedures. There are a handful of dental technicians that regularly attend BACD events at the moment, as these sessions aid in demonstrating what dentists are expecting to achieve with treatment. However, with the introduction of the PDP in the CPD process, access to balanced and targeted education is now more important than ever. That’s why I hope to encourage dental technicians to accompany their dentists to BACD educational events that they wouldn’t normally attend, where both professionals can then learn something outside of their usual range of knowledge. “This can add enormous value to treatment when engaging with patients – the dentist will be much better informed about what is involved with the procedure, particularly in relation to lab processes. We’re lucky at my lab as we often meet patients who are sent to us by their dentist. Once they see for themselves that their restorations are skilfully handmade, these patients are blown away and suddenly appreciate the value of their bespoke treatment.” Dentists are highly dependent on effective collaboration with their dental technicians in order to deliver the best possible care. Mark adds: “The closer the synergy between dentists and dental technicians, the better the outcome of treatment provided to patients. This is what the BACD is all about – creating beautiful, natural-looking smiles that patients deserve.” If you are a dental technician looking to take advantage of the educational and networking opportunities provided by BACD membership, contact the Academy today. FOR FURTHER ENQUIRIES ABOUT THE BRITISH ACADEMY OF COSMETIC DENTISTRY, VISIT: www.bacd.com

DENTAL NEWS

BADN LAUNCHES HEALTH AND WELLBEING HUB FOR MEMBERS 5 February 2020

BADN is pleased to announce the launch of a Health and Wellbeing Hub for its members, with access through the BADN Benefits platform. The Health and Wellbeing Hub will offer members articles, tips and practical advice on wellbeing across hot topics including stress management, financial wellbeing and resilience. Every two months the wellbeing hub will launch a new topic and content will continually be refreshed.

Health and wellbeing has never been so important to BADN members and their families. As well as access to the Health and Wellbeing Hub, BADN members also have access to a free legal advice helpline (in January 2020 BADN members used the helpline for nearly 300 minutes of advice) and a 24/7 counselling support line and Health e-Hub mobile application.

BADN Benefits offers a range of discounts and free services to BADN members on a host of everyday purchases. Whether you are looking for cashback on your weekly shopping, discount on your next holiday (either in the UK or abroad), free eye tests or a trip to the cinema – BADN benefits will have you covered. Full Membership of BADN is open to all Registered Dental Nurses, working in all areas of dentistry including education and management, and costs £50pa. Student e-membership is open to all student dental nurses on or awaiting a place on an accredited course leading to a registerable qualification and costs £10pa. Associate membership is open to all retired, former and overseas dental nurses. Full Members are also eligible to apply for the special BADN rate indemnity scheme.

BADN, the UK’s professional association for dental nurses, celebrates 80 years of supporting dental nurses in 2020, and will be holding its National Dental Nursing Conference as part of The Dentistry Show at the NEC on 15-16 May, when BADN again will host the Dental Nurse Forum. The BADN stand will include a lounge area for BADN members; and there will be a Celebratory Afternoon Tea at the NEC Hilton on 16 May. BRITISH ASSOCIATION OF DENTAL NURSES ® Room 200, Hillhouse International Business Centre. For more information on BADN membership and to join, visit www.badn.org.uk. For more information on the National Dental Nursing Conference, Dental Nurse Forum and the Afternoon Tea, contact events@badn.org.uk

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CASE STUDIES

DIFFICULT DENTURE CASE PART 3 CONTINUED FROM MARCH ISSUE By Vittorio Capezzuto LEFT ROW OF POSTERIOR TEETH Following the upper wall further and with a view to making only the palatal cusps effective as support cusps, the second premolars and the lower molars were set up. According to the GERBER concept, the force should always be directed perpendicular to the residual alveolar ridge. In practice, the set-up follows the alveolar ridge corridor or static line, which is marked as a black line on the margin of the model. The STATIK POINTER (CANDULOR) is suitable for precise and reliable control as its light point directs the occlusal force direction of the tooth onto the static line and thus onto the alveolar ridge, and can therefore be used quickly and unambiguously to achieve autonomous chewing stability.

Fig 1

Fig 2

This is followed by setting up the upper molars. According to the position of the stop line and taking into consideration the implant support of the lower overdenture, it seemed reasonable and functionally appropriate in this case to dispense with an upper first molar on the left side and to set up another second upper premolar (Figs. 1, 2). The reason being to direct the chewing force in parallel to the red stop line as a boundary line for the beginning rising lower jaw branch and thus to steer it statically stable to the lower jaw ridge in order to avoid forward movement. This generally applies to the lower jaw, but it cannot be ruled out - especially in the case of a KELLY syndrome - that it may also be appropriate in the upper jaw.

As shown in the case described, it may be necessary to place the set-up differently on one side from the other, following the same basic rule - autonomous chewing stability - in variants. Fig 3

Fig 4

Fig 8

Fig 7

Fig 9

Fig 5

Fig 6

RIGHT ROW OF POSTERIOR TEETH For example, when setting up the lower right first premolar in the centric, it would have been necessary to place it significantly further in lingual position to direct the force on the antagonist (tooth 14) to the middle of the ridge (Figs. 3, 4, 5, 6). However, this would have questioned its cheek contact and prevented reaching the neutral, chew-stable zone. Setting up teeth on atrophied and incongruous alveolar ridges often means not having sufficient contact with the cheek and narrowing down the active range of the tongue. Under these conditions, a free space is created between the cheek on one side and the artificial teeth as well as with the outer surface of the prosthesis body. On the one hand, food particles accumulate in this region and it becomes difficult for the cheek to return or transport these to the chewing area or chewing tube. The free space between the cheek and teeth also prevents the cheek muscle (M. buccinator) from neutralizing the outward force exerted by the tongue. The neutral zone of natural dental arches is formed under the influence of genetic factors and forces exerted by the muscles of the tongue, lips and cheeks during tooth penetration. The work of muscles lasts a lifetime and continues even after the loss of teeth or chewing units. If the latter are lost, a free space is created in the oral cavity, the so-called "intermaxillary space", an area in which the "neutral zone" is located. This area can be defined as the area in which the outward directed forces of the tongue are neutralized by the inwards directed forces of the cheeks and lips during chewing. These forces exert their effect not only when chewing, but also when speaking and swallowing.

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Fig 10

It is therefore very important to set up or dimension the artificial teeth and the outer surfaces of the prosthesis within the neutral zone, as ignoring this would expose the prosthesis to continuous horizontal thrust, which could have caused further damage to alveolar ridges, as given in this patient due to the previous insufficient restoration. To achieve a statically correct occlusal contact as well as a myo-dynamically sufficient cheek contact, we decided to depart from the usual set-up schemes and set up an upper right 5 instead of the lower right 4 (Figs. 7, 8, 9, 10). The objective being to maintain statically stable conditions for both sides. In addition, the increase of the lower jaw branch on this side of the jaw required sacrificing the first premolars (Figs. 11, 12, 13). The set-up on this side of the jaw was performed statically consistent in the cross bite, i.e. the lower buccal cusps were ground recessed for the upper buccal cusps as support cusps. Fig 11

Fig 12

Fig 13

p18

CASE STUDIES CONSTRUCTION OF THE ANCHORAGE FOR THE LOWER OVERDENTURE (MDT SALVATORE CHIMENZ) Following the esthetic try-in, one proceeds to the retention phase, the adaptation of the spaces for the lower part of the dentures. The choice of the occlusal plane for autonomous chewing stability has been explained and therefore we have chosen an implantsupported, mucosa-based retention system. The implemented solution is the simplest in terms of safe retention, advantageous in terms of stability and acceptable to the patient from a psycho-physical point of view. Based on this principle and the clinical situation, the attachments must not compensate for sagittal sliding movements, the so-called "forward movement" of the prosthesis body, as would have happened with loading on an inclined plane due to premature wear of the retention part, the caps, and with the risk of the denture failing. Two titanium posts with patient-adapted transmucosal profile (Fig. 14) in the form of the RHEIN 83 with OT eQUATOR abutment were prepared, on which a passive bar with SEEGER system was fabricated. The insertion direction was determined for the bar construction (Figs. 15, 16), which in our case coincided with the occlusal plane. This condition is necessary to allow the abutments to work horizontally and to prevent premature wear of the retention part. After fabricating two silicone masks for the lingual and vestibular sides to determine the remaining free spaces (Figs. 17, 18) into which

the bar and the reinforcing counterpart were to be inserted, the polymerizable SEEGER containers (Fig. 19) were positioned and connected to auto-polymerizing modelling resin so that the bar could be shaped. After curing, the bar was separated, and the resulting segments connected with a small amount of acrylate to achieve maximum retraction control. With the aid of a parallelometer, the polymerizable OT Cap Normo attachments with external threads were mounted (Figs. 20, 21), which compared to other systems have a flat head ball and an elastic cap with a spherical interior. This allows for vertical yielding when chewing, which in some cases harmonizes with the yielding of soft tissues, also due to the sensitivity of the nylon caps, which behave adequately in moist environments. The profile was modeled in wax (Fig. 22). With the classical and traditional methods, we would have had to cast the bridge separately, adapt it, polish it and then build the superstructure on it, but with suitable measures it is possible to already construct the counterpart in this phase and implement it in metal.

RESIN FINISHING AND POLYMERIZATION (DT VITTORIO CAPEZZUTO) We used an injection system with ALU BIG (TRANSFORMER) investment ring for finishing the resin dentures. Beforehand, however, the dentures were characterized with AESTHETIC COLORS (CANDULOR) (Figs. 29, 30, 31). Intermediate polymerization was performed to sufficiently fix the first part of the PMMA and to better control shrinkage as well as any movements during the subsequent injection phase. Fig 29

Fig 30

The application of a layer of Teflon tape created a cavity (Fig. 23) which served to prevent the counterpart from coming into contact with the bar due to the desired elasticity (Fig. 24, 25). This phenomenon increases in a controlled manner after polishing the bar (Figs. 26, 27). Experience leads to the conviction that in many cases stability can be achieved through minimal adjustments at relatively low cost (Fig. 28).

Fig 14

Fig 15

Fig 16

Fig 18

Fig 19

Fig 20

Fig 21

Fig 23

Fig 24

Fig 25

Fig 31

Fig 17

Fig 32

Fig 22 Fig 26

Fig 27

Fig 28

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The cold-curing AESTHETIC BLUE denture resin in COLOR 34 was injected with a syringe (Fig. 32) and cured for 30 min at 60 °C in a polymerization unit. During the curing phase, cold-curing polymers reach a temperature of more than 100 °C, so that the water at 60 °C is used for cooling during this time to avoid worrying about excessive shrinkage after curing.

CASE BAR STUDIES HEADER

Fig 33

Fig 36 Fig 37

ABOUT VITTORIO CAPEZZUTO

Fig 34

Fig 38

Fig 35

After devesting and before separation from the models, the dentures finished in resin (PMMA) are mounted in the articulator with the references with which the models were previously oriented, and the articulator was set, in order to check the occlusal contacts again during re-occlusion (Figs. 33). It was found that the vertical height had remained unchanged. Selective grinding is performed (Figs. 34, 35) to compensate for small deviations associated with insertion into the investment ring. Even with injected PMMA, minimal displacement can occur. Therefore, the occlusal surfaces were equilibrated to obtain a wide and long centric, which is absolutely necessary for the antagonist contacts. Lateral and protrusion (Figs. 36, 37, 38) and retrusion were checked; the latter can be simulated with the ARTIKULATOR CA 3.0 (CANDULOR) (Figs. 39, 40).

Fig 39 Fig 40

As soon as everything had been reoccluded within the functional clinical parameters, the dentures were separated from the models. To be continued next issue...

ABOVE LEFT: Dr. Gennaro Galasso RIGHT: MDT Salvatore Chimenz

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l Vittorio Capezzuto, born 11.09.1967 in Capua and resident in Sparanise (province of Caserta, Italy). After graduating from the vocational school for dental technicians in Cassino (province of Frosinone, Italy), he has been the owner of his own laboratory since 1994 and since then has mainly been involved with full dentures. He gained his experience according to the philosophy of Prof. Gerber and attended numerous advanced training courses throughout Italy and in Switzerland (Zurich). In 2015, he worked with the ANTLO Campania Association on the “Girovagantlo” project and qualified in second place in the first Trasformer competition with the “Full denture with Trasformer technique”. He is co-author of the book “Aspetti clinico-tecnici nella protesi combinata” (Clinical and technical aspects of combined dentures), teamwork media. Since 2017 he has been working for Candulor as a specialist speaker throughout Italy, with training courses and workshops on the methodology of Prof. A. Gerber. In the same year he worked as an external tutor at the Institute of Dental Technicians Alfonso Casanova in Naples on the project “Donare un sorriso a chi soffre” (“Give a smile to the suffering”) and achieved 5th place in the international competition “Create the best Candulor”. He currently works in his dental laboratory in Sparanise (province of Caserta), Via Martiri 22 Ottobre 65. Email: vittcap@gmail.com

ADVERTORIAL

PICTURED LEFT: Monolithic zirconia crown stained with Vintage Art Universal on the right side, made by dental technician Tomoyuki Edakawa.

WORK SMART WITH VINTAGE ART:

THE NEW UNIVERSAL STAIN AND GLAZE SYSTEM BY SHOFU Vintage Art Universal provides groundbreaking options for 2D and 3D characterisation of monolithic restorations.

RATINGEN Until now, dental technicians had to accept that the high strength of monolithic crowns and bridges made of zirconia or lithium disilicate comes with the downside of subop-timal aesthetic results. The new Vintage Art Universal Stain and Glaze System by Shofu Dental is designed to solve this problem; it can be used on absolutely all dental ceramics and substantially expands the range of creative options.

staining technique), with or without fluorescence, de-pending on the substrate. Yamamoto True Color Mixing Liquid brings out the best in Shofu’s stains and glazes: When mixed with this special liquid, the materials create the illusion of spatial depth even on monolithic restorations (3D staining technique). What is more: Thanks to the glass-like refractive index of Yamamoto Liquid, users already see during the mixing and application steps what the final colour and translucency will look like after firing.

AGAINST THE TREND: OPTIMISED POWDER BEATS PASTE! “Although there is clearly a trend towards ready-to-use paste stains, we deliberately DOUBLY GOOD: TWO MIXING decided to develop a powder LIQUIDS – TWO APPLICATION material”, says Ingo Scholten, OPTIONS who is responsible for Vintage Art Universal Liquid Shofu’s laboratory Vintage Art Universal allows technicians to products. “Only a is now available from dental traditionally stain and powder can offer distributors. A product brochure, glaze the surfaces such a wide range step-by-step instructions and an of layered ceramic of creative options overview of individual materials, restorations (2D in combination assortments and order numbers can be found on: www.shofu.de/en/produkt/ vintage-art-universal-uk www.dentaltechnician.org.uk

with different liquids and glazes – from traditional staining and glazing to impressive 3D effects on monolithic zirconia or lithium disilicate.” The new powder stains are much finer than previous powders and therefore denser. This results in vibrant colours with good opacity. A higher glass load in the powder further in-creases the strength of the bond created between the stain and the underlying monolithic restoration during sintering. Vintage Art Universal is ideal for any dental laboratory fabricating or processing full or par-tial-contour monolithic CAD/CAM restorations. The system can be used by both ambitious beginners, who need to achieve good results when pressed for time in their daily work, and experienced professionals, whose customised restorations should satisfy even experts. SHOFU DENTAL GMBH Email: info@shofu.de Web: www.shofu.de

ADVERTORIAL

SAGEMAX

NEW PRODUCTS NEW STYLE Welcome to the zirconia expert Sagemax Bioceramics, Inc. at DTS 2020 presenting authentic pictures from the dental laboratory, CAD/ CAM products featuring an intuitive color coding system and a lively new corporate design. The new look is only one of the highlights that the company will present at the trade show. Sagemax is focusing on dental customer centricity with a brand new multi-layer zirconia and a strong product portfolio for labs.

NEXXZR+ MULTI - A NEW ESTHETIC MULTI-LAYER ZIRCONIA The existing product portfolio has been extended to include the new NexxZr+ Multi: a polychromatic zirconium oxide for the manufacture of esthetic monolithic restorations with an integrated shade gradient. The new disc allows laboratories to maximize their workflow efficiencies by completing restorations in three easy steps: milling, sintering and glazing. Featuring a high biaxial flexural strength of 880 MPa, the discs can even be used for 3-unit bridges in the posterior region. SAGEMAX WEBSHOP – ORDERS ACROSS GREAT BRITAIN From now on customers of Sagemax in Great Britain can conveniently order the new NexxZr+ Multi and all the other CAD/CAM products of the company’s portfolio via the integrated webshop at www.sagemax.com. An intuitive user interface and a modern design make shopping a pleasant experience. NEW BRAND APPEARANCE – INNOVATION MEETS EXPERIENCE Proven features combined with innovative ideas: this is the key of the

rebranded appearance of Sagemax. Customers will be able to experience the company’s innovative new appearance directly at DTS 2020. The international Sagemax team is looking forward to exciting conversations with dental professionals in Hall 5 Stand D26. ABOUT SAGEMAX AND NEXXZR Sagemax Bioceramics, Inc. is one of the world’s leading manufacturer and supplier of dental zirconia and accessories for CAD/CAM laboratories. The company is consistently extending its competitive range of products for leading CAD/CAM systems. NexxZr

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T, the translucent zirconium oxide for monolithic crowns, received the Top Product award 2019 from the Dental Advisor in the product category 'Esthetic Zirconia' for the second time in succession. The company is certified by the notified body TÜV SÜD according to EN ISO 13485, Medical Device Single Audit Program (MDSAP), and MDD 93/42/ECC. For further information, please visit: www.sagemax.com Tel: +46 8 59441257 Email: info@sagemax.com

MARKETPLACE CANDULOR AG: RELAUNCHES THE TOOTHSCOUT WITH IMPROVED AND NEW FUNCTIONS IN THE CLEAR CANDULOR LOOK w After nearly 10 years we have revised the ToothScout completely. The usability of apps has changed so much over the course of a decade that customers are now using mobile apps quite differently. Apps should be more intuitive, and of course with a clear benefit.

in your profile. Write the dealer an e-mail with your list of wishes directly from the app. WE PROTECT YOUR DATA

We have opted for professional e-mail communication to keep the exchange at a business level and not to mix it with private content. Therefore the photos are only saved locally in the app and not under «Photos».

WHAT HAS CHANGED? WORKING WITH A PROFILE

You create your profile. Your data is stored for you and you can also select your working partner (e.g. dental technician) with whom you would like to exchange information by e-mail. The focus is always on the patient. CREATING PATIENT FILES

Create short, succinct and interesting profiles of your patients to help your work partner or yourself, including photos you can take directly with the app. The photos are only stored in the app, so they don't appear in private folders. TOOTH SELECTION À LA CANDULOR

A ToothScout would be nothing without teeth. Find the right teeth for your patients.

Furthermore, the patient data only remain in the app. These are the property and the responsibility of the user. CANDULOR has no access to patient data. Enter the width of the alinasal and choose from a variety of tooth molds. We give you the correct references of maxillary molds to mandibular molds and the matching posterior teeth. Whether tooth-to-two-tooth or toothto-tooth setup, everything is available. SELECTING THE RIGHT DEALER

If you choose teeth, you also want to use them. CANDULOR gives you suggestions for dealers in your area. You can store the data and save it

AVAILABILITY

The ToothScout was developed for the iPhone and iPad. It can be found in the App Store under CANDULOR or ToothScout. FOR FURTHER INFORMATION PLEASE VISIT: www.candulor.com T: +41 (0)44 805 90 00 FAX: +41 (0)44 805 90 90 E: candulor@candulor.ch

CANDULOR AG: NEW - THE STAY YOUNG COLLECTION w CANDULOR AG launches the new tooth lines PhysioSelect TCR & BonSelect TCR. Young shapes for a new patient and customer generation. The development and manufacture of artificial teeth has been at the core of CANDULOR for over 80 years. The Swiss company attaches great importance to development feedback from both an internal and external perspective. A vibrant collection was created especially for the new generation of "Best Ager", to match their self-confidence and agile aspirations. "Dental technicians, dentists and prosthodontists have motivated us to develop a new tooth line - consisting of proven materials and molds - for the patients of the coming decade and to inspire customers and patients alike." Claudia Schenkel-Thiel (Managing Director) A piece of Switzerland, also in terms of design. A rejuvenated design was developed from proven, attractive molds to create 18 maxillary molds - delicate, prominent and universal - and 4 mandibular molds. Layering and surface structure support the young appearance and are a reflection of the patients' attitude to life in our times. "The objective is to meet contemporary customer and patient expectations. We are very grateful for the feedback from the dentists, dental technicians and prosthodontists involved in this tooth development." Jody Paul Spalt (Head of Product Management)

BONSELECT TCR

One for all, all for one. Be it for tooth-to-tooth or tooth-to-two-tooth placement, the BonSelect TCR posterior tooth was endowed with a bifunctional, semi-anatomic occlusal surface. It can therefore be easily integrated into existing laboratory workflows, particularly when different set-up methods and occlusion concepts need to be implemented. One for all, all for one is possible in 4 sizes with the BonSelect TCR. THE RED ONE FROM CANDULOR

The tooth rack which is optimized for the dental storage in the laboratory is a mirror image of the entire brand appearance. The "Red" represents the Swiss flag in the tooth cabinet, which presents the new anterior and posterior teeth harmoniously in both mold and shade. "CANDULOR supplies its customers all over the world with high-quality, durable and esthetic, natural-looking products. When it comes to tooth selection in the tooth cabinet, quick orienta-tion is essential. We are Swiss, and proud of it, and this should be reflected by the PhysioSe-lect TCR and BonSelect TCR. Their red beats the usual black and gray." Alexander Ewert (Marketing Director) MADE OF DURABLE TOOTH MATERIALS

Adaptation to the alveolar ridge, to abutments and antagonists requires tooth materials that can be processed quickly. But also materials that reliably bond chemically to the base resin, and which are plaque resistant and abrasion resistant.

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The new PhysioSelect anterior and BonSelect posterior teeth are therefore made of the resistant TwinCrossedResin, the 3rd generation TCR material, a modified polymethyl methacrylate (PMMA) variant. The polymer, but also the matrix, are evenly cross-linked and additional-ly tempered. This means that the pre-crosslinked polymer is again linked to the matrix and condensed during production. This way the tooth material meets the high requirements for plaque and abrasion resistance. The new PhysioSelect TCR anterior tooth will be available for trial purposes as from April 2019 together with the BonSelect TCR posterior tooth. More information at candulor.com or live at the IDS. CANDULOR AG, Boulevard Lilienthal 8 CH-8152 Glattpark (Opfikon) Tel: +41 (0)44 805 90 00 Fax: +41 (0)44 805 90 90 Web: www.candulor.com Email: candulor@candulor.ch

MARKETPLACE

NEW ZIRKONZAHN’S OPEN-DATA MILLING UNITS: M2 AND M2 DUAL WET HEAVY METAL w More user comfort and higher flexibility: these are the distinctive features of the new Zirkonzahn M2 milling units! The M2 milling unit is available in two different versions: the M2 Wet Heavy Metal and the M2 Dual Wet Heavy Metal. The M2 milling units allow for a particular precise and clean elaboration of all materials, both through wet and dry processing. According to the users’ needs, the M2 Wet Heavy Metal milling unit is also available without wet processing function (M2 Dry Heavy Metal). What differentiates the M2 Dual Wet Heavy Metal milling unit are instead the two separate, flexibly configurable milling chambers for sequential wet and dry processing of all soft and hard dental materials without inbetween cleaning. In all M2 milling units, elaboration processes are particularly stable due to the proven 5+1-axis simultaneous milling technology with orbit and opposed rotary axes. Also hard-to-reach areas – such as undercuts and divergences – can be milled without difficulty and several work pieces can be fixed and processed in the orbit by

In the two-chamber M2 Dual Wet Heavy Metal, all materials can be elaborated with wet and dry processing sequentially, without in-between cleaning

using various blank holders, e.g. glass ceramics or Raw-Abutment® blanks. All M2 milling units are stand-alone solutions: indeed, is it possible to start milling and calibration processes or load elaboration tools directly from the machine, via the integrated PC with touchscreen. The machines are provided with spaciously designed, optimally illuminated and easily accessible milling chambers as well as with a tool chamber

with dust protection equipped with 21 tool compartments (3x21 in the M2 Dual Wet Heavy Metal milling units). In the M2 Wet Heavy Metal milling unit, additional tool chambers permits to store tidily further milling burs. The milling units are also equipped with a water collecting tray, an automatic tool changer function with optical tool detection – which ensures the appropriate selection of milling tools resulting in greater safety and precision – as well as an automatic self-cleaning function at the end of the milling process. See the M2 Dual Wet Heavy Metal live in action: visit us at the Dental Technology Showcase in Birmingham on May 15-16, booth C10 NEC! To book an appointment with our experts contact carmen.ausserhofer@zirkonzahn.com, +39 0474 066 662.

3SHAPE TRIOS READY: BRINGING THE BEST CLINICS AND LABS TOGETHER w We live in a connected world. The faster and simpler the connection between clinics and labs, the easier it becomes for doctors and technicians to find each other and work together.

CONNECT WITH COUNTLESS NEW CUSTOMERS

More and more dentists and orthodontists are going digital with intraoral scanners like 3Shape TRIOS. Our 3Shape Ready programs allow you to promote your lab to many potential customers and show them that you are qualified to work with their TRIOS digital impressions.

BENEFIT FOR LABS

Increased confidence Get guidance and practice the complete digital workflow together with 3Shape experts. Free advertising Your lab is promoted as an approved TRIOS lab in our solutions and on 3Shape.com. New customers Get access to a wealth of practices - every TRIOS user becomes a potential customer.

FIND OUT MORE AT: https://www.3shape.com/en/ services/ready-programs or contact ukenquiries@3shape.com

BREDENT UK LTD: BOND.LIGN w bredent has, for many years, been at the forefront of priming and bonding protocols. The development of large-scale restorations involving composite veneering as well as implant restorations involving titanium bases has led to a requirement for the predictable and consistent bonding together of many differing materials. These combinations include composite to zirconia, composite to pmma, NP metal to pmma, peek to composite or composite and peek to ceramic, lithium silicates or other high strength glass.

bredent’s bond.lign products give the busy laboratory reassuringly consistent bonding options. The range is available separately or as a full kit. The Full Range Bonding Kit Ref: 5400bond is priced at £399.95 + vat. Bond.lign products are available direct from bredent UK Ltd. FOR FURTHER INFORMATION: Speak to your bredent technical specialist or call 01246 559 599 and speak to our friendly and knowledgeable service team.

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FREE VERIFIABLE ECPD As before if you wish to submit your ECPD online it will be free of charge. Once our web designers give it the all clear there will be a small charge. This will be less than the CPD submitted by post. This offer is open to our subscribers only. To go directly to the ECPD page please go to https://dentaltechnician.org.uk/dental-technician-cpd. You will normally have one month from the date you receive your magazine before being able to submit your ECPD either online or by post. If you have any issues with the ECPD please email us cpd@dentaltechnician.org.uk

4 HOURS VERIFIABLE ECPD IN THIS ISSUE LEARNING AIM

The questions are designed to help dental professionals keep up to date with best practice by reading articles in the present journal covering Clinical, Technical, Business, Personal development and related topics, and checking that this information has been retained and understood.

LEARNING OBJECTIVES REVIEW: n Strength of Zirconia n Implant planning n Customised Special trays n Business of Management

LEARNING OUTCOME

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ECPD

VERIFIABLE ECPD AS YOU NEED IT VIA THE DENTAL TECHNICIAN Payment by cheque to: The Dental Technician Magazine Limited. NatWest Sort Code 516135 A/C No 79790852 F/P. Denture case from Dr Finlay Sutton.

Q1. Why were Implants not used in this case? A. Patient was unwilling to pay for implants. B. Patient did not like the idea of implants. C. Dr Finlay Sutton felt the case was not suitable for implants. D. The patient wanted removable dentures. Q2. A. B. C. D. Q3. A. B. C. D.

Why did the clinician decide against Implants? Poor bone quality. Patients Periodontal history and Smoking. Insufficient bone for Implants. High Cost for parient. What was done to the lower teeth to improve stability of the metal plate? Cast gold posterior crowns with milled slots. Undercuts created on the distal of the LR4 and LL3. Rest Seats cut into LR4 & LL3. Composite, retentive and stabilising build up on lower lingual surfaces.

Q4. What design modifications were added to the lower partial? A. A hygienic Swedish design to assist continued maintenance. B. Precision attachments for free end saddles. C. Interdental spacing to assist cleaning. D. Pink opaque to mask metal saddles. Q5. A. B. C. D.

What unusual design feature was included in the Full upper? A soft tissue suction device. Soft reline of the buccal margins. Plastic retentive area for post dam. Deep Torus Palatinus relief.

Q5. What type of clasps were used? A. Cast Gold Roche clasps. B. Wrought Gold C clasps. C. Stainless steel wire wrought clasps. D. Cast Cobalt Chrome clasps.

Difficult Denture Case Q6. A. B. C. D.

According to the author where is the neutral zone located? Mid way between the alveolar ridges. Within the inter-maxillary space. The free space between the tongue and cheeks. The Patientsâ&#x20AC;&#x2122; rest position.

Q7. A. B. C. D.

Why is the neutral zone important? It helps when swallowing. It allows good saliva flow. It stops denture clatter. It enhances the stability of the dentures.

Q 9. A. B. C. D.

How did the author control shrinkage, of the Pink gum-work? By using an injection technique. By using Rapid cure for the denture bases. By controlled two stage polymerizations. By using Composite filler on the pink plastic.

Q10. A. B. C. D.

What does the static line represent? The center line. The neutral line. The Alveolar ridge corridor. The of the occlusal plane.

Q11. A. B. C. D.

When would it be appropriate to substitute lower molars with premolars? If the patient has a sensitive tongue. When dealing with a patient who grinds. In the case of KELLY syndrome. When the curve of Wilson is steep.

Q12 A. B. C. D.

How does the Retention element differ from other retentive ball attachments? Less expensive than equivalent retention elements. It Allows movement under load to compliment the bearing soft tissues. It is smaller and more discrete. It is easier to maintain and replace.

Q13. When was the gum characterisation carried out. A. After the injection moulding and polishing of the Gum Work. B. Before the Injection process during the first stage of the PMMA. C. Processing procedure. D. When finishing the Gum contour and before adding a glaze to the polished gum surfaces. Q14. A. B. C. D.

How was the bar position determined prior to construction? Two Silicone Masks were constructed around the finished dentures. The ridge and the occlusal plane were used. The bar was made to the fit surface of the dentures. The Bar was made to the horizontal plane above the ridge.

Q15. A. B. C. D.

How were the ball anchors attached? By spot welding after casting. By post metal finishing solder. Cast as part of the bar construction. Screwed into the bar after finishing.

Q16. How was the occlusion verified after devesting from the injection process? A. By the clinician, chairside. B. By remounting the dentures after finishing and polishing. C. By using squash bites from the original articulation and re-mounting. Q8. What method was used to control the potential muscle activity D. By mounting the processing models, with dentures attached, within the neutral zone? to the articulator. A. The Bucco-lingual dimension was controlled by using, a cross- bite configuration and a controlled flange shape. You can submit your answers in theÂ following ways: Via email: cpd@dentaltechnician.org.uk or by post to: The Dental B. Premolars were substituted for molars to reduce width. Technician Limited, Po Box 430, Leatherhead KT22 2HT. You are C. A reduced occlusal contact area was created by shortening required to answer at least 50% correctly for a pass. If you score below the dental arches. 50% you will need to re-submit your answers. Answers will be published in D. A Dynamic occlusal design was incorporated with lower cusp the next issue of The Dental Technician. Certificates will be issued within profiles and cusp fissure contacts. 60 days of receipt of correct submission.

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DENTAL TECHNICIANS GREAT BRITAIN

THE MERIT AWARDS GET OFF TO A GOOD START By Larry Browne I Editor

The merit awards scheme has started well and with some impressive examples of the talent within UK and Ireland. Many of you may have been wondering what exactly would be needed to send in your own examples of technical work and now you can see clearly what is required. In last month’s journal we featured the first batch of submissions. Very Impressive examples of what is required. Now you have seen these perhaps you will feel like submitting your own examples of your work. The aim of the Awards scheme is to have technicians judging technicians, not some commercialisation for extra sales or for the submissions to be encouraged by a particular manufacturer or agent for a particular material. All materials and every mixture you decide is needed for the case should qualify. So now there may be a time of things getting a little quiet, coming up, perhaps it is a good opportunity to show what you are made of. Prosthetics, Ceramics, Crown and Bridge, Max Fac. and Orthodontics are all equally included and will be judged by a recognised expert in the field.

You may be curious about what the general standard is, you may want to see what is judged to be the best in your own area of interest, you may just want of show the world of dentistry how good you can be, but whatever the reason you will know it will be judged fairly by experts. The following are chosen as the first batch of winners, which will be added to until it is time to announce the overall winners in each category. There is still plenty of time to add your own examples. I think you

will agree that those who have already submitted have set a high standard. Why not show you can fit into this quality of excellence with yourown examples. We are looking forward to seeing quite a lot more submissions before the final date and we intend to continue with the Merit Awards every year. Perhaps it is time to be recognised as one of the elite and able technicians in these Islands. Make your statement with a piece of technical magic to impress the judges.

ALAN WRIGHT - DENTAL TECHNICIANS GREAT BRITAIN FACEBOOK GROUP

Well the first nominations were announced in the various skill sets and some fantastic work on show from all those nominated. Thank you to our judges who take the time to go through the various cases that members profile in the group and please keep sharing that’s what it’s all

about, we all learn from each other, ask questions, there are never any stupid questions, if you don’t know ask, we are fortunate to have some world renowned techs as members of our group, but I am sure they will all empathise with the fact that they didn’t get to where they are with their skills without watching others, asking questions, and trying things time and time again to improve what they are able to produce.

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We all start somewhere, so show your work off, take pride in the knowledge that in this Country we have some of the best Dental technologists in the world, strive to be the next one passing on your skills. Bang the Drum of British Dental Technicians. Stay safe all. Alan Wright

DENTAL TECHNICIANS GREAT BRITAIN

Best Ceramics/Crown and Bridge Technician Nomination Sylwia Arizpe Dtg for emax Crowns

Best Cobalt Chrome Technician Nomination Dan James - Dentacast

Best Prosthetics Technician Nomination

Leon Paul Zanre - Elite Dental Restorations

Best Hospital Tech/Maxfac Nomination

Dhrumil Shah Harcourt House Dental Studios

Best Innovative Technician Nomination Jamie Scarborough

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Best Orthodontics Technician Nomination

David Baldry - Atomic Dental Laboratory for the Clarke Twin Block Appliance

DENTAL NEWS

WHO SAYS THE GERMANS DON’T HAVE A SENSE OF HUMOUR. READ ON!

GOLD FOR DENTAL FROM DEUTSCHLAND HEALTHCARE MARKETING: VHF TRIUMPHS AT THE SPOT OF THE YEAR

Ammerbuch/Hauppauge, NY; March 9, 2020: The vhf video Dental from Deuchland looks at German virtues with a winking eye – happy ending included.

The winning logo: Gold medal for “Dental from Germany” in the category Digital (B2B)

The jury of Healthcare Marketing and Dental Marketing was so convinced of the clip that they awarded it with a gold medal in the competition for the Spot of the Year.

“Our agency SSW from Frankfurt has congenially realized this challenging task with ‘Dental from Deutschland’: in a humorous story about German clichés and virtues and with a lot of courage for self-irony. High-tech from Germany, sold with a wink and extraordinary humour – this was immediately well received, both internally and by our international customers. Which proves two things: firstly, that communication can change the image of a brand in the long term. And secondly, that Germans are very capable of laughing at themselves.”

Around 40 industry experts selected the best films from the winners of the video competition Spot of the Month. The result: the vhf clip was the only work from the dental industry, which won gold in the B2B category. Four gold medals were awarded in total; the other three came from the B2C sector.

Healthcare Marketing published the jury’s verdict and more about the individual winners in a special issue of the Spot of the Year, which appeared on February 24, 2020.

The star of the clip is the Z4 – a highprecision milling and grinding machine for same-day dentistry applications.

THE VIDEO DENTAL FROM DEUTSCHLAND CAN BE FOUND ON THE WEBSITE: vhf.de/en/dental and on the You-Tube channel of vhf.

Its futuristic housing contains latest hightech that produces perfect dental restorations within minutes. The objective was to develop a film for this dental machine that can be used at trade shows worldwide, on the vhf homepage and in social media. The intention was to tell Made in Germany in a completely different way and as surprising as possible.

THIS PHOTO & ABOVE: The hero of the film practices German virtues and checks the results of the ZHF Z4.

The winner: Christine McClymont, Head of Marketing and Communications at vhf camfacture AG.

ABOUT VHF: Founded in 1988, vhf is a leading manufacturer of CNC milling machines, milling tools and CAM software for the dental sector, industry and sign making. Headquartered in Ammerbuch, Germany, vhf employs more than 250 people and is constantly expanding. With its subsidiary vhf Inc. in the state of New York, it provides North American customers with inventory, sales, service, and support. GLOBAL: vhf camfacture AG, Lettenstrasse 10, D-72119 Ammerbuch, Germany T: +49 7032 97097 000 E: info@vhf.de W: vhf.de

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ILLEGAL

DENTAL NEWS

DENTISTRY ON CHANNEL 4! By Larry Browne I Editor

I am sure some of you must have seen the programme on Channel 4 regarding the gentleman who is making tooth jewellery directly to the patient. He takes the impression, makes the models and takes them to jewellery manufacturers in Hatton Garden and has them made. Charging from £600 up to £6000. He has apparently been doing it for at least three years and tells the viewers he is making a fortune. It is clearly illegal. Is he registered? Is he trained? He is clearly not a dentist. I suspect he is not a technician!! The mainly young clientele queue up his stairs and across his landing, to have him take the impressions. I have not seen the programme but there is a link to Youtube if you wish to take a look: https://www.youtube.com/ watch?v=yoaDtIGEKYQ Brings a whole new meaning to ignoring the legislation designed to protect the patient. This is a very clear example of how the legislation is not working, and yet we still see nothing being done by the GDC or the MHRA with regard to illegal activity. Dentists doing restorations without registering with the MHRA. Indeed, there appears to be no attempt by the registration watch dog, THE GDC, to ensure training of undergraduates, or indeed post graduate dentists, is undertaken. My own enquiries into this area have met with a blank wall of silence. It is clear from the numbers of unregistered Dentists and DSA’s that nothing is being taught about this essential

“Brings a whole new meaning to ignoring the legislation designed to protect the patient.” awareness of the LAW. There does not seem to be any training of clinical support staff about the regulations. Hospitals have claimed exemption when the case for exemption is nothing like the original European directive on which it is based. The whole administration of the act of Parliament is, to say the least, non-existent. We have seen many examples of Technicians reported for illegal dentistry. And quite a number appear to have been found guilty and heavily fined or closed down. But not one report of a single one of their dentist clients has been seen. It is, after all, illegal to deal with an unregistered laboratory or technician. The dentist will of course know this as they will not have been receiving the STATEMENT OF MANUFACTURE! The patients’ proof of the validity of the restoration source and material. Only legally issued by a registered manufacturer. Can this mean the dentists are immune from prosecution? That would of course be a nonsense as they are the prime contact with the patient. So, what on earth is going on? The representative

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bodies of the technician groups, the DLA the DTA, The OTA and a few other, representatives of interested parties, have earlier this year met together to decide on a strategy to tackle the problem. Beginning with a strategy of education. As with all committee-based organisations, things can move exceedingly slowly. Can any of you readers who belong to these organisations and perhaps some of the other representative bodies please text, phone or email the committees or its members and let them know this is important to you. You are paying to be registered, you are abiding by the rules and regulations and yet the people taking your money appear not to be interested in you. After all, “your only a Dental Technician.” Nothing will be done if we do not make a noise. Up to now nothing has been done, except, target dental technicians doing illegal dentistry. Well if the gentleman on channel four can make a fortune, as he claims to have done, without training or skill, why not the rest of us? We at least know how to do it safely! So do not just accept the situation. They have obviously decided to ignore those of us who want the matter aired and it would seem as if the representative organisations are trying not to get involved? Because it might look like rocking the boat? I think unless you “rock the boat" they will choose to ignore the matter. I believe it is too important to ignore. If you care about the future of Dental Technology in Britain and Ireland, I think it is the time to say so.

BAR INSIGHT HEADER

LETTERS

to the Editor

Email your letters to: editor@dentaltechnician.org.uk

In 1979 and fed up with paying 15% VAT on gold alloys, materials, equipment and a too frequent replacement of furnace muffles, all for the purpose of making dental ceramic crowns and bridges, I had written several times to HM Customs and Excise in an attempt to register for VAT.

The ROST air-fired porcelain furnace

Not satisfied with their responses, I proceeded to VAT Tribunal to present my case. Having been first an apprentice ‘dental mechanic’ in a dental hospital prosthetics department, then as dental technician for National Service in the RADC, followed by employment in a couple of different dentist’s group practice, again as dental technician. It was when becoming a laboratory owner with a partner, that I felt my job description had once again evolved. For example, would the job title of a garage proprietor be that of ‘car mechanic’ after having starting out working on the shop floor as car mechanic to later become garage owner? By 1979, having made a full range of other dental appliances, I had already made many PJC’s in a ROST air fired furnace and had also been accepted by the Institute of British Surgical Technicians, with certificate as licentiate of the British Institute of Surgical Technologists.

The Tribunal was held in central London, and representing my own case, I would leave it up to the three judges to determine if I was a dental technician or ‘surgical technologist’ and for a second limb to my case, that my supplies were to a ‘disabled’ person (Fourth Schedule), after a full morning, and a lunchtime break and then continuing into the afternoon (my wife having to keep dashing out to feed the parking meter) HM Customs and Excise had what seemed to me to be a barrister to represent their case and I later received a written decision to dismiss the appeal. By 1972 I had placed an order for a Vita Austromat 2001, which had a 9 months waiting list for delivery, so I took a post as full time lecturer grade 1, at Brooklands College. When the furnace arrived, it was not until about 1975 that the demand for bonded crowns (I was using VMK68) began to take off. Unlike the little air fired oven that had required a torch to observe if the crown (or perhaps two) had reached a glaze, the Austromat 2001 allowed firing of about 10 or more crowns in one cycle, at controlled temperature. The rest of my working life became solely that of dental ceramist. Perhaps I should have gone to the VAT Tribunal as a ‘dental ceramist’, but as LBIST I did have a certificate? So, I found the included copy ‘BS 5750 or VAT registration?’ by Peter Mackie as included in The Dental Technician March 1990 to be spot on. The only difference today and 30 years on is that BS 5750 has been replaced with MHRA!

From James Bennett, retired Dental Ceramist (never GDC- DCP)

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