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Also this month...
VERIFIABLE ECPD FOR THE WHOLE DENTAL TEAM
DENTAL LABORATORIES WORKING FROM HOME ANDREW WHEELER PAGE 12
ASERVICE TECHNOLOGY DIGITAL GUIDE MATTEO NERONI
PAGES 18-19
PHOTOCENTRIC PRINTING PARTS FOR COVID19
PAGES 22-23
3D PRINTED PPE DENTISTRY’S PLEDGE By Sharaz Mir of Blueprint Dental PAGES 8-9
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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CONTENTS
Editor - Larry Browne FBIDST. FDTA, ITI Fellow, LCGI, RDT. E: editor@dentaltechnician.org.uk T: 01372 897461
CONTENTS
MAY 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. At only ÂŁ39.95 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.
Welcome Welcome to your magazine
Insight Welcome to Dental Doris
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Feature 3D printed PPE - Dentistry’s Pledge By Sharaz Mir of Blueprint Dental
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Focus Matt Everatt: S4S and Covid19 Why we were the first to close our doors! Andrew C Wheeler: Dental Laboratories working from home? Andy Chibeba: UK Special Risks Martyn Lewis: Central Dental Laboratory BioHorizons Camlog supports CIRDIC in Reading Peter Harling: PPE - Our Journey
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Case Studies Vittorio Capezzuto: Difficult case solved according to the GERBER concept - Part 4
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Digital Technology Matteo Neroni: Aservice Technology SRL Digital Guide
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Dental News Photocentric: Printing Parts for Covid19 British Association of Private Dentistry
22-23 26-27
ECPD Free Verifiable ECPD & ECPD questions
24-25
Marketplace Candulor AG/Zirkonzahn/3Shape/Bredent
28-29
DTGB Dental Technicians Great Britain members doing their bit for PPE
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Classifieds
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WELCOME
Welcome TO YOUR MAY 2020 ISSUE
By The Dental Technician Magazine Team
COPING DURING THE COVID-19 PANDEMIC l
“Unchartered and unprecedented times” appears to be one of the main summaries of where we are currently. With the lockdown well and truly in to month two all of us have had to make severe changes to our lives to protect ourselves and the NHS.
and think that all organisations should be pooling resources to help the industry, membership or not!
Many laboratories have closed and are not operating, Dental practices have been forced to close. Most of which have never been in this position having to make these types of decisions before.
The Dental Technician Magazine and Dental Technicians Great Britain Facebook group work very closely together to provide the platforms to reach out and support each other. The various movements in place to push against the organisations are made up of pro-active clinicians and dental technicians but there is always the need for more people to support.
This industry is made up of hardworking professionals that care passionately for patients, their work and of course their businesses. Many workers are seeking help and reassurance that their employment can continue from employers who don’t have the answers yet. Every scenario is unique and important. Conversations are firstly surrounding concern for well-being and health, physically and mentally. Some of us are able to encourage, some of us need encouraging. The “lockdown” and social distancing in place is to preserve the future, but what about now? In this issue we hear from the first wave of technicians and laboratories to discuss how this pandemic is affecting them, their businesses and what they see for the future. We have seen some incredible efforts to support the national PPE shortage As many are aware, there is considerable traction in the dental fraternity to claim against the Business Interruption element of
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As always it would be good to hear stories or concerns from you. You can do so by sending to info@dentaltechnician.org.uk
their business insurance which in the most part have already been generally refused, but why wouldn’t you, unprecedented times call for unprecedented measures? A large dental group which has now financially been backed by the BDA is looking to formally contest the refusals. But what are the other support organisations doing to help support their members and industry as a whole. The DLA is understood to be now looking to support the project, then wondering what the BDIA are doing to help support the supplies industry as not all suppliers are large multi-nationals who could possibly ride the wave of lockdown through cash reserves. The dental supply industry is also classed as front line staff, supporting the industry by offering an invaluable service which facilitates clinical treatment, do they not deserve the same support? It’s a cold fact that many smaller independents may not appear on the other side of this lockdown
It seems that all events and showcases have either been cancelled or postponed; most notably The Dental Technology Showcase (DTS) which will now take place on Friday 11th September - Saturday 12th September and will remain at the NEC Birmingham. As it says on their website “The safety of communities is of paramount importance to us a business so we have therefore taken the decision to postpone.” In these times we are seeing how important webinars and online learning can really be. Most of them are easily available online and are free. If you are not a member of Dental Technicians Great Britain Facebook group join now and you will find many lecturers and suppliers offering online development including ECPD hours. There are courses offering expert advice on areas such as re-storing implants, intraoral scanners, 3D digital printing, advanced telescopic dentures, tray design, custom abutments, full digital workflow and more.
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PERFECTED BY MASTERS Convincingly real.
BY CANDULOR
DEALERS IN THE UNITED KINGDOM TOOTH EXPRESS LTD.
Unit 35 / Jessops Riverside / 800 Brightside Lane / Sheffield S9 2RX / UK / T + 44 114 242 4048 / tooth_express@btconnect.com / tooth-express.co.uk
ABBEY DENTAL SUPPLIES
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WELCOME TO... DENTAL DORIS
Dental Doris has worked in dentistry for many years and likes to muse about all kinds of dental and non-dental topics
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y the time you read this we will be either consumed by the Coronavirus or it will be all over and things will have returned to normal... My guess is it will be the former!
I’ve lived through several world events and recessions and at the time they always seemed to present us with ‘end of the world’ scenarios. Now I don’t want to be the bearer of negative news but it does seem to me that the current situation could change most of our lives for ever and most of us are very bad a dealing with change! So, I thought a few tips on dealing with change might help us all... Acknowledge that things are changing Sometimes we get so caught up in fighting change that we put off actually dealing with it. Denial is a powerful force, and it protects us in many ways. However, stepping outside of it and saying to yourself, "Things are changing, and it is okay" can be less stressful than putting it off. Keep up your regular schedule as much as possible The more change that is happening, the more important it is to stick to your regular schedule - as much as possible. Having some things that stay the same, like walking the dog every morning at 8 am, gives us an anchor. An anchor is a reminder that some things are still the same, and it gives your brain a little bit of a rest. Sometimes when you are going through a lot of change it helps to write down your routine and check it off as you go. It's one less thing for your brain to have to hold inside. Try to eat as healthily as possible When change happens, a lot of us tend to reach for carbs - bread, muffins, cake, etc. This may be because eating carbs boosts serotonin - a brain chemical that may be somewhat depleted when you undergo change (stress). It's okay to soothe yourself with comfort foods - in moderation. One way to track what you are eating is to write it down. You can either do this in a notebook or use an app. When you see what you are eating, it makes you take a step back and think about whether you want to eat that second muffin or not. (If you have a history of eating disorders, it is not recommended that you write down what you are eating.) Also notice if you are experiencing an increased use of alcohol or other substances; your use can sneak up on you when you are under stress.
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Exercise Keeping up regular exercise could be a part of the "keep up your regular schedule" tip. If exercise is not currently part of your routine, try adding it. Exercising two to three times a week has been found to significantly decrease symptoms of depression. Even just walking around the block can help you feel better. Seek support No one gets through life alone. It is okay to ask for help; that's a sign that you know yourself well enough to realise you need some assistance. Think of your trusted friends or family members. Chances are that they are happy to help if you need them to watch your kids while you run some errands, or if you just need some alone time Get proactive Being proactive means taking charge and working preventatively. This means you figure out what steps you need to take before something happens. Being reactive means you wait until something has happened and then you take action.
if you are comparing your life to your friends' lives on social media, remember that most people post only the "highlight reel" of their lives, not the stressful moments. This can give you a skewed view that everyone else's lives are going just fine. Everyone has battles they are fighting; it's just different battles with different people. Step away from social media if you are starting to compare your life to others. Give yourself a break In a time of change, you may feel a little out of control. You may feel like you are not living up to your expectations for yourself. Remember that you are allowed to do less than what is humanly possible. Nothing says you have to function at 100 percent all the time. Finally, and this might be hard under the current circumstances but try to make a point of incorporating more laughter and fun into your life. Laughing increases dopamine, serotonin, and endorphins - and that makes you feel good. Laughing also decreases cortisol - a stress-producing hormone
Back away from social media When you go through change, you may gravitate toward social media - maybe posting to your friends on Facebook what is going on in your life. First, make sure you are in a calm state when you post - and keep in mind that whatever you post never really disappears. Also,
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FEATURE
3D PRINTED PPE DENTISTRY’S PLEDGE By Sharaz Mir of Blueprint Dental WHERE IT STARTED Universities, tech firms and 3D print enthusiasts with their own printers have been responding to the shortage of healthcare workers' personal protective equipment (PPE) - and in some case more complex hospital medical supplies - by making it themselves. It's been called a "citizen supply chain". Much of this was born out of a situation at a hospital in Brescia with a number Coronavirus patients requiring breathing machines which ran out of the respiratory valves needed to connect the patients to the machines. The original supplier was unable to meet the sudden high demand and the hospital quickly found itself in a crisis. Quick to respond to the situation, the CEO of a Brescia-based engineering firm, used 3D printing to meet the hospital’s demands and, resultantly, patients’ lives were saved. THE INDUSTRY Closer to home the dental industry itself, which has adopted 3D Printing quite extensively for the production of various prosthesis also heard the call to action and started a number of movements from both the clinical and laboratory sides of the business. One notable movement which offers both fundraising to pay for said PPE as well as taking requests for PPE to place them based on demand was the 3D PRINTED PARTS - JOINT DENTAL & MEDICAL COVID-19 INITIATIVE UK & WORLD (https://www.3dprintcovid19.com/) set up by Prof. Adam Nulty who is President of the International Digital Dental Association, a UK based clinician. This multifaceted group is both trying to raise £25,000 to fund the production of PPE, and can help coordinate these dentists and technicians to improve the production capabilities of the UK and indeed foreign countries in an initiative to help the NHS/ medical services in general to save lives with providing ventilators, intubators and general parts needed in the fight against Covid-19. What is hugely notable is how a number of dental labs both large and small have been busy adapting their traditional production processes to manufacturing an array of PPE and accessories even though they have been forced to close during this period. Many labs have been working tirelessly to produce PPE for distribution on a national basis, many
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TOP: Ben Johnson - #3dvfaceshield -1250 Visor frames printed at home MIDDLE: Brescia 3D Printer respirator valves BOTTOM: Printer Covid parts Initiative
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BARFEATURE HEADER who initially we funding the costs themselves. Thankfully a number of donation sites have sprung up and many in the dental industry, especially technicians who don’t have 3D Printers have been donating vast sums to help facilitate the production. What seems to be a common feature in discussions with those who have been involved in the supply of PPE is how proud they are of the industry in coming together to help facilitate this and so quickly. (Sorry to those not mentioned here, as the list is remarkably, endless!) Speaking with Keith Morgan of Toothworx in Cardiff, who has been exceptionally busy with his 3D Printer, ‘It was amazing to see the unity and networking, a lot of us have been talking and throwing ideas and solutions around it’s been brilliant to be part of, it’s been something else.’ And he is only one of a number of labs both large and small who have been producing PPE now in their 10’s of thousands. MANUFACTURING Even the 3D Printer manufacturers have been getting in on the act, two notable projects one in the US is from Ex0ne, a metal 3D Printer manufacturer have been working urgently with its partners, such as Open Health Solutions, an affiliate of digital dentistry provider Core3DCentres, to gain approval and commercialize its customized 3D printed face mask that is completely sterilisable and reusable. Customers can scan their face with a free smart phone app, have a custom-designed face mask 3D printed in a biocompatible and autoclavable surgical resin. A reusable metal filter 3D printed by ExOne, either in copper or stainless steel, would be inserted into a cartridge on the front of the mask and can also be sterilized and reused. The other manufacturer is more home grown, from the UK Photopolymer and 3D Printer manufacturer Photocentric. Based in Peterborough, Photocentric who’s other side of the business was being one of the world’s largest craft industry manufacturers saw a downturn in that side of the business and turned to PPE manufacturing. They streamlined a resin printed design for a face visor and are now producing 12,000 visors a day on 15 3D Printers with well over 100,000 pre orders. In the face of adversity over the past months, we have seen how the UK healthcare sector excels in the support its offering to those affected by this virus. We commend the resourcefulness of our dental laboratories which have shown how the possible future of dentistry can be encouragingly applied to a wider concern. TOP: Toothworks Cardiff, next consignment of visors ready to ship, produced on his Asiga 3D Printer 2ND ROW: Byrnes Dental, 3D Printed Ear Defenders from the Carbon 3D Printer 3RD ROW: Ex0ne 3D Printed face mask 4TH ROW: Photocentric 3D Printer farm
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S4S AND COVID19 WHY WE WERE THE FIRST TO CLOSE OUR DOORS! By Matt Everatt FOTA of S4S Dental & Smilelign UK
I
think we were all taken by surprise and probably still in shock or can't quite get our heads around the situation we find ourselves in at this very moment in time! The term 'unprecedented times' seems to fall out of the mouths of everyone so easily and rightly so. These are times that will forever remain in the history books, a time when the whole World is at war with this terrible invisible enemy. Rewind back just a few weeks and we were sat pretty behind our desks, joking about the coronavirus, seeing the silly jokes on social media and memes of the Mexican beer, making out it was the cause of the yet to come global pandemic. Each day got that little bit more real, nay surreal, going from the 'unbelievable, this won't happen here', to the 'this could happen here', then 'omg, this is real'. Now we are experiencing, daily, moments that we could never had envisaged and hear of friends and family who are Covid19 positive and sadly some who have died. So here we are, I was asked to write about our lab S4S, and why we took the decision early on, to close our doors and what I think life will be like in the long, medium and
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short term for us as business owners and dental technicians. On Monday the 23rd March, our directors and management team took the decision to close the laboratory following the government announcement on the Sunday evening urging as many of us to stay at home and protect the NHS. It was a decision that we didn’t take lightly, particularly as we were still receiving requests and impressions from practices that were remaining open. We felt duty bound to our team, clients, patients and the wider population to close. By taking this decision, we felt we were playing our part in preventing the spread of the Covid19 virus and importantly protecting the NHS and saving lives. We considered that we had patients that are mid treatment with aligners, some patients need new retainers or their appliances are in need of service or repair. We felt that whatever short term inconvenience this may cause; the benefits far outweigh the negatives. Monday the 23rd and Tuesday the 24th of March were the toughest two days. I personally was stuck at home self-isolating due to our son having a persistent cough. With just a handful of staff in the building, we handled the post, cast all perishable impressions and sent out emails to almost 10,000 clients to notify them we were closing. As you can imagine, the next few days were busy dealing with emails and phone calls from practices asking us to fulfil their last minute requests. We frustratingly had to refuse and stand by our decision to remain closed, protect our team and reduce the risk of spreading the virus. Sadly we did have a couple of clients who weren't happy and threatened to take their business elsewhere. My opinion was that we may be better off without those type of customers, I mean, come on, if a global pandemic was not a decent enough excuse to close the lab then I am not sure we need those customers.
On Tuesday the 24th of March the doors were closed and we 'Furloughed' all but 3 staff. As I write this, the doors remain closed. Our London lab, S4S London, also took the decision to close and all staff 'Furloughed'. As I lay in bed writing this article, just a day after we held a very passionate and direct management meeting, I begin to wonder what the future will look like for us and my fellow dental professionals. We continue to have a weekly meeting with our management team of 11 people. The idea is to allow them to speak with their teams prior to the meeting and bring any questions, concerns or suggestions to the table. This weeks meeting, there was a feeling of apathy and the only real burning issues raised were about holiday entitlement and if staff would still be accruing annual leave whilst being 'Furloughed'. I am known to have my outspoken moments and this was one of those. I mean, I am not an angry boss, I simply verbally process my thoughts. My outspoken points ranged from, 'Holidays? Do people think they will be going on holiday anytime soon?' to 'Do people not realise the enormity of what is currently happening? They are worried about holiday entitlement? I would suggest they worry more about if they have a job to return to.' It was said that my mention of job losses was perhaps a little unsettling for the management team to hear and perhaps I should not have shared my opinion with them at this time. I felt it had to be said. For sure, we do not know what the future looks like for our labs, hopefully, nothing but positive changes will be ahead of us, however, to some degree it will all look a little different for each of us. What will the future be like for our labs? The government are being pressed by the opposition to share their exit strategy for coming out of lockdown. The Scottish 1st Minister being the first to issue a statement, the crux of it being that Coronavirus is here to stay for a long time and any lifting of restrictions will be done, slowly, measured and may even need to be reversed if we see another
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BAR HEADER FOCUS surge in infections. I suspect our government aren't sharing the exit strategy, as it is yet to be finalised, there is so much unknown about this virus and any mention of lifting restrictions may lead to the general public becoming more relaxed about staying home. I think we all know that there is no way the lockdown will simply lift and we will return to the life we had in 2019. I am certain strict social distancing rules will be in place, only businesses that can apply these will be allowed to open. What does that mean for dental practices, our only source of income? Will dentists be allowed to operate normally as long as they have the most isolating PPE? At best, they will be able to do this and it will mean seeing less patients due to the cleaning time and having to dispose and replace all the enhanced PPE they use between each patient. At worse, dentists may only be able to undertake 'non-aerosol producing procedures'. This would mean no Crown and Bridge work, no veneers and no implant procedures. We may see more extractions and provision of temporary prosthesis. Good for prosthetic labs, not so for the Crown and Bridge labs. Orthodontic labs may see an increase in requests for retainers and aligners in the short term to catch up from the lockdown period. I suspect in the midterm we will see a drop in new cases for aligners or contemporary orthodontics as people will feel that they have less disposable income and may look at less costly cosmetic procedures such as tooth whitening. On the other hand, the lucky ones who have had little or no loss of income may find they have a lot more disposable income as they have had nothing to spend their money on during lockdown. It is a difficult one to predict. My hope is that the general public will have confidence and begin spending again. From what I have experienced about our older generation, pensioners and those who choose to work for their holiday funds, dare I say, they are perhaps the ones who are experiencing less hardship during lockdown, our denture wearers, or patients that will now be faced with having to have XLAs due to dentists being restricted in their practice. To be provided with partial dentures whereas an implant or bridge would have previously been offered ,ay be the new norm for a period of time. I feel Prosthetics may be an area of growth in the short to midterm. This of course is based on my own meandering thoughts and opinions, we do not know to what extent this pause in business will do to our livelihoods in the mid to long term, we only know what is happening right now and await every daily government announcement. I think dental practices will re-open before we have a vaccine, to what extent and what procedures will be allowed is anyone's guess.
The term we are all too familiar with and one I now dislike hearing; ‘these are unprecedented times’ for sure. Times, I hope we will never experience again. I do hope more lab owners, sole trader labs, and dental technicians bounce back from this quickly. I hope as a group we can come together and learn from this experience. As business owners, let's be serious about our pricing, the way we run our businesses, how we reward ourselves, ensure we have a good work/life balance and how we look after ourselves and our teams. Remember, this time will pass and we will return to some kind of normality, we don't know exactly when that will be yet, it will come. We can use this as a reset button or a reboot. Let's not return to those days of working every hour god sends to scrape a living. We are better than that. Why not take this time to have a good look at our businesses and what we want to achieve and start a fresh from there. Look at those clients who are bad payers or the ones who always barter your prices down, ask yourself are you better off without them? I do expect there to be dentists who will be looking to switch labs to save a few pounds and maybe open multiple lab account to help their cash flow in the early days of a return. Do you want to consider doing some background checks such as asking for references from their other suppliers? This is very common practice for most businesses. In fact, it was a requirement of our ISO9001 standards and is very normal for us lab owners to have to do this for our suppliers when asking for a credit account. What next? In truth, we don't know when we will be able to safely reopen. I certainly expect there to be restrictions on social distancing and we are already discussing strategies such as shift
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working to have the lab open longer with less people in at any one time to allow safe social distancing. If you haven't already, take a stock check of your PPE and consider what you may need when you open. I expect it to be in short supply for a period then there'll be an abundance of it. For now, our lab S4S, remains fully closed despite the daily requests for us to replace retainers or fix broken appliances. We still feel we should be staying home, protecting the NHS and saving lives. I personally hope to see some restrictions lifting in the next few weeks in order to get our economy back up and running again. At some point, a decision will be made by people way above our pay grade. A decision that will be to keep the economy shut down for any longer will see a larger impact and loss of lives due to increased poverty and suicides than those lost to the virus. It is a decision that I am glad I won't be making! For now, I hope you all stay safe, enjoy this time with your family, partners, husband, wife, children and pets. Fix those things you've been meaning to fix, wash the car, make bread, cut your own hair, have some fun. We won't get a time like this again, hopefully! I hope it ignites something inside us all to make better work/life balance choices in the future. Stay safe everyone. I hope to see you all on the other side of this lockdown and hopefully in a better place than you were previously. It's not always easy to think this way, let me leave you with this last thing. These are difficult times and we will all be facing problems of some sort, let's change the narrative. Let's look at those problems as challenges, from a challenge we can see opportunities.
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DENTAL LABORATORIES
WORKING FROM HOME?
By Andrew C Wheeler
A
t the time of writing this article we are beginning the fourth week away from the lab, affectively being in ‘lock down’.
We are in unchartered and unprecedented times, collectively and individually. All of us are in a state of flux trying to navigate an unclear path. It has affected us all in different ways and will continue to do so for many years to come. The ones who have vulnerable family members, lab owners with staff, businesses with limited cash flow, employees, the list goes on. Personally, I have noticed the wave of different emotions as I come to terms with being away from a profession, that favours those of us who enjoy the solitude of our work. I am now at home with the family, learning how to handle two young boys with the energy levels of a small country! WORKING FROM HOME? So, is it possible to take the government advice and work from home? Thanks to growth of digital technology, those who have taken it onboard do have some options to keep ticking along. If not, it is surely time to consider making the move. In the current situation work has all but dried up but there is work that can be done from home. There is a plethora of online courses running, it’s refreshing to see that many of these are being run by people who normally wouldn’t have had the time to do so, sharing their home-grown talents. CPD hours, which most technicians I know add to the bottom of the to do list, can be updated. Journals such as the Enhanced CPD dentistry cover all the required points we need alongside the online courses being offered. This is invaluable time to ‘play’ with the software we use daily. Exocad and 3Shape are very comprehensive pieces of software which most of us don’t fully use, a brief search on
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YouTube will reveal a mass of ‘how to’ videos. These areas don’t necessarily bring in much needed income but importantly they help to keep our minds active might sow a seed for the future direction of our careers.
Thought needs to be given to where business will be when we finally get over this period, a change of direction, refocused priorities. We all have our journey to walk and this might be the time for that long overdue change.
FINANCIAL HELP A great concern is the affect this will have on our expenses. We now have a much better understanding of how the government intends to help the numerous different situations we’re in. Most of the companies I have contacted have procedures in place to take a payment holiday, this combined with government support will hopefully see most people through this time. But sadly, I’m sure we will see some labs close as a result of this pandemic. There is some very helpful general advice to be had online while the DLA is regularly updating their advice to lab owners on the options.
THE FUTURE No one knows when life will return to normality. But as we can see from the fantastic effort in printing PPE from dental laboratories across the country there is cause for much hope. Now it’s a time to draw close to our loved ones, re-evaluate our work life balance because at some point all the patients who have postponed dental work will walk into a dental surgery. It’s at this point UK dental labs will step up to that challenge and start the wheels of production again. Hang in there and stay safe!
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UK SPECIAL RISKS
By Andy Chibeba I ACII Director of Sales and Marketing
D
ear all Dental Labs, hope you are keeping healthy and safe. We feel that this is a time where we need to show support to each other and are advocates of the view that the best way to deal with a crisis is to work together.
We wanted to try and communicate to all of you regarding the cover provided by your commercial insurance policy as a result of the recent Coronavirus / Covid-19 pandemic. We have been honest and upfront from the outset that the Business Interruption cover under our Dental Lab policy is not going to provide any cover for Business Interruption - it’s no worse a situation than other commercial insurance policies - see below info:This link from the Association of British Insurers confirms the position for most/ all - and is a pretty good summary of the situation: https://www.abi.org.uk/productsand-issues/topics-and-issues/coronavirushub/business-insurance/ In summary this outlines that pretty much all commercial insurance policies are not providing cover specifically for loss of business arising from Coronavirus / Covid-19. However, we also wanted to explain that our policy was never intending to provide this cover, and if you had asked insurers 6 months ago whether this was covered the answer would still have been in the negative. The reason a small number of polices with other providers may find they are able to get some cover, or think they are going to be able to, may be because wordings were not written well enough, and especially without the moral high ground insurers will be beholden to stand by the wording. We are upfront, honest and professional and false hope or propaganda were not on our agenda when a crisis broke out, instead we provided correct and reliable advice that can be trusted. We viewed it as if we are your employee, who you pay to do a job
for you, and when you ask that employee a question no one wants to be misled, hence we gave the true position as it was so as not to waste anyone’s time. Thus enabling other avenues and options to be explored such as government backed grants and Furloughing employees, which were going to be a better use of your time and energy. However we are happy to advise that your policy with us has no exclusions in respect of Coronavirus and Covid-19 in respect of Employers Liability / Public and Products Liability, and is providing cover as per policy terms, the Professional Indemnity would apply and the property cover is not directly restricted.
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Your insurer has also extended/relaxed the terms given the current circumstances, to account for the present situation, we have e-shotted our client’s separately regarding these cover enhancements which came at no additional charge, if you want further info please contact us. We are all involved in this evolving and ever changeable situation, and we all hope for a positive outcome and an effective return to normality as soon as is practicable, but rest assured whatever the future holds, we are as committed and dedicated to serving the Dental Lab Industry, as we have been for the last 15 years. If you have any queries please let us know.
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EDUCATION FOCUS
CENTRAL DENTAL LABORATORY & PPE By Martyn Lewis
I
t was distressing watching the whole Covid-19 crisis unfold in front of us, causing us to temporarily close down our lab for the first time in 26 years. I decided to see if our Digital dept could actually help the ones in need in the search for PPE. Using the designs supplied by the digital team at Asiga & with help from Peter Harling I put our 2 printers to work. They created a basic Face Visor and an Ear protector to help some of the frontline workers in the fight against Covid-19. I quickly discovered many sources of need for this PPE in local GP’s, Police staff , Ambulance & Paramedic teams along with care home & nursing staff at local hospitals. I spent the next 2 and a half weeks printing and supplying and working closely with other Dental lab owners, Peter, Malcolm Murton and Keith Morgan. This whole project has been very rewarding and very worthwhile if only for the wonderful people I have helped along the way. I would like to thank those lab owners and all the generous people who helped me by donating to my GoFundMe page which certainly helped bare the brunt of the financial costs at this hard time.
BIOHORIZONS CAMLOG
SUPPORTS CIRDIC IN READING
Diane Hopkins (left), Logistics Support Operative and Naomi Pleasants, Marketing Manager, BioHorizons Camlog holding a thank-you letter from CIRDIC
THE COMPANY AND TEAM MEMBERS DONATED URGENTLY NEEDED PRODUCTS FOR HOMELESS AND DISADVANTAGED PEOPLE IN THE COMMUNITY. l Bracknell, 04 March 2020 End of January 2020, BioHorizons Camlog, a leading supplier of premium dental implant systems, restorative components, and a comprehensive line of biologics products and digital solutions, donated blankets, sanitary towels, washbags containing wash cloth, soap, toothbrushes, toothpaste and lip balm, and recyclable cups for homeless and disadvantaged people to CIRDIC - Churches In Reading Drop in Centre. The centre is based in Reading and recognised as a safe and
14 THE DENTAL TECHNICIAN_MAY 2020.indd 14
welcoming drop in centre for homeless people who are disadvantaged and living in the local community. In addition, BioHorizons Camlog team members collected second-hand clothing like coats and shoes for visitors of the centre. * “People may end up homeless from all walks of life and for all kind of reasons. They often suffer a lack of access to hygiene that may easily result in social, medical, and dental health problems. Giving back to society is u
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DENTAL NEWS very important to our company and also to our team,” says Naomi Pleasants, Marketing Manager of BioHorizons Camlog in the United Kingdom. “I therefore thank the whole team for their spontaneous engagement and above all our Logistics Support Operative, Diane Hopkins, who spearheaded this project to ensure we could support the local homeless and disadvantaged fellow citizens.” BioHorizons Camlog is part of Henry Schein’s Global Dental Surgical Group offering dental professionals an exclusive and comprehensive portfolio of innovative surgical and regenerative products, and digital solutions for oral reconstruction. This donation is an initiative of Henry Schein Cares, the company’s global corporate social responsibility programme. Henry Schein Cares focus on three main areas: advancing wellness, building capacity in the delivery of health care services, and assisting in emergency preparedness and relief. The programme stands on four pillars: engaging Team Schein Members to reach their potential, ensuring accountability by extending ethical business practices to all levels within Henry Schein, promoting environmental sustainability, and expanding access to health care for underserved and at-risk communities around the world.
ABOUT BIOHORIZONS CAMLOG
n
BioHorizons and Camlog are leading suppliers of premium dental implant systems, restorative components, a comprehensive line of biologics products and digital solutions. They are committed to developing evidence-based and scientifically proven products, as well as continuous education according to highest standards.
powered by a network of people and technology. With more than 19,000 Team Schein Members worldwide, Henry Schein’s network of trusted advisors provides over 1 million customers globally with more than 300 valued solutions that improve operational success and clinical outcomes.
Headquartered in the U.S. and Europe, respectively, BioHorizons and Camlog’s geographic positions allow them to efficiently serve direct subsidiaries in the Americas and Western Europe, as well as their entire distribution network in more than 90 countries around the world.
The Company’s Business, Clinical, Technology, and Supply Chain solutions help office-based dental and medical practitioners work more efficiently so they can provide quality care more effectively. These solutions also support dental laboratories, government and institutional health care clinics, as well as other alternate care sites.
The companies are part of Henry Schein, Inc., a solutions company for health care professionals
FOR MORE INFORMATION, VISIT: www.biohorizonscamlog.com
* Source: CIRDIC
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THE DENTAL TECHNICIAN_MAY 2020.indd 16
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CASE STUDIES
DIFFICULT DENTURE CASE PART 4 CONTINUED FROM APRIL ISSUE By Vittorio Capezzuto FINAL FINISHING AND POLISHING OF THE DENTURES
The previous check of the wall thickness and the applied color characterization on the basis of the detailed coloration schemes (CANDULOR) made it possible to achieve a high degree of predictability and reduced the need for technical corrections. The dentures were then stored in water for 12 hours, after which they were finished and polished with the handpiece. Polishing was performed with pumice stone and the polishing paste KMG (CANDULOR) recommended by the denture resin manufacturer, Figs. 41, 42, 43.
Fig 41
Fig 42 Fig 43
Fig 44
INCORPORATION OF ABUTMENTS, FINISHING
After completion of the dentures, the bar was connected to the OT equator abutments by positioning the final SEEGER (Fig. 44). This system is in fact designed to allow the fabrication of bars with passive connection to tertiary elements. The upper full denture and the lower overdenture were delivered to the dentist. There, the fit of the denture bases was checked in situ on the mucosa using COLTENE PSI and the occlusion was checked again using occlusion foils (Fig. 45). The patient was happy and satisfied with her new dentures and expressed this joy and sincere appreciation to the treatment team for having regained impeccable chewing function as well as her original appearance (Figs. 46 left and right), which was very well received by the prosthetics team and regarded as an ideal reward.
CONCLUSION
The supply of insufficient and esthetically disadvantageous dentures made of partly
ABOUT VITTORIO CAPEZZUTO 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.
“outdated” materials, the lack of regular checkups as well as the increasing life expectancy are factors that lead us to deal with increasingly complex solutions on an ever, larger scale.
In the case described here, the above factors were relevant. Our experience and the resulting conclusion is that the well-being of the patient comes first.
Planning, careful analysis, selection of suitable materials and close cooperation between dentist and dental technician are fundamental prerequisites for the realization of long-lasting removable mucosa-supported and also implant-supported removable restorations.
This does not require searching for elaborate, complicated and sophisticated solutions at any price or solutions determined by current fashions. Even (relatively) simple solutions remain long-lasting, functional and esthetically pleasing if they are executed conscientiously.
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.
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Fig 46
Fig 45
Email: vittcap@gmail.com
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DIGITAL TECHNOLOGY
ASERVICE TECHNOLOGY SRL
DIGITAL GUIDE
By Matteo Neroni
Aservice is born from experiences in the field of guided surgery, orthodontics in dental aligners and commercial skills of its founding members. Aservice focuses on quality of service, product quality and a clear and simple protocol. I am able to create a digital protocol for the production and realization of artifacts. The advantage of this procedure is the versatility, reproducibility, adapting to the needs of professionals.
DIGITAL PROTOCOL
In the case of partial edentulia, the patient can be sent directly to the radiological center for the execution of the CBTC with the indications provided in the ASERVICE TECHNOLOGY manual. In case of total edentulia, a scan-prosthesis should be made and then sent the patient to the radiology center with the indications provided in the ASERVICE TECHNOLOGY Manual.
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DIGITAL TECHNOLOGY
CASE SETTING
PATIENT COMMUNICATION It is also possible to make a video to be shown to the patient during the connection to improve communication. If the dentist is equipped with iPad , downloading the application coDiagnostix, the case can be viewed through the application itself. If the doctor wishes, ASERVICE TECNHNOLOGY, accompanies the dentist in the design of the surgical guide, to better comply with his implant-prosthetic needs.
The working environment is created by ASERVICE TECHNOLOGY with the acquisition of DICOM files, provided by the radiologist, and the STL file, which represents the digital model of the patient.
CASE REPORT
With the remote connection, the clinician will have the advice of an ASERVICE TECHNOLOGY software expert to assist him in the realization of the prosthetic implant project. The ASERVICE TECHNOLOGY tutor will help the dentist technically in the realization of his implant project, providing all the necessary support for a quick mastery of the program.
3D PRINTING
The ASERVICE TECHNOLOGY Surgical Guides are made with DENTAL certified EQUIPMENT AND MATERIAL, of absolute quality.
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EDUCATION FOCUS
PPE Our Journey THE DENTAL TECHNICIAN_MAY 2020.indd 20
01/05/2020 12:50
By Peter Harling
W
e are a very small laboratory based on the Welsh-English border and due to the current climate had been closed. I noticed that someone had posted on a 3D printing forum that a doctor was handing out ear defenders to hospital staff due to the long hours they were doing. I asked a good friend of mine, Elena Belkins if she would be able to design something specific to my printer: the Asiga Max UV. She did and I was able to print between eight and ten ear defenders per hour. I shared the design to labs around the world, who also wanted to help, including to some good friends: Malcolm Murton, Keith Morgan and Martyn Lewis. I was contacted by Graham Turner (a Manchester lad), who works at Asiga in Australia, who had seen the post and wanted to help with a new design that would mean we could get more out faster. This design was fantastic in terms of use and speed of production. We were now producing 48 ear defenders per hour. By this point, we were doing as many hours as possible printing ear defenders for the local hospital and care home. We put a comment out on Social media asking if people needed any ear defenders and the response was massive and like my colleagues, we struggled to cope. We were also answering messages from around the world helping other labs to get up and running with their own PPE production. Asiga then created a face shield that would fit on the Max and this was really needed for Front Line workers. We tested the prototype, and it was great, but Asiga wanted to make it better. So within 24 hours a new and improved design was created. I then spent the next few hours working out how to stack the shields, so more could be printed at one time. We sent the file back to Asiga to be validated and it was then made available for Worldwide release.
These face shields and ear defenders have been going out regularly to hospitals, care homes, a children’s hospice, community nurses, and front line businesses in our area and beyond covering both England and Wales. None of this would have been possible without the help and kind donations of; our local community donating elastic, IPA and money to purchase resin; The Go Fund Me contributions; and the generosity of Asiga, Photocentric and particularly Alan Wright at Blueprint for fundraising and delivering PPE to local hospitals.
Keith noticed that the ear defenders were only being used at the inner most settings and discussed with Graham making them smaller, so there was less waste, this meant we could now make 105 units in an hour. This was how Asiga was: constantly, changing and improving designs to allow more and faster prints. We had three amazing companies contact us offering to help with resin, as they could see how much we were printing: Asiga, Blueprint and Photocentric, who we are hugely grateful to.
Seeing so many laboratories in the UK and around the world turn to providing PPE has made me feel so proud to be a Dental Technician.
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DENTAL NEWS
PHOTOCENTRIC
PRINTING PARTS FOR COVID19 We have changed our business since the outbreak. LCD technology can make vast numbers of parts. We are using our 3D printer machines to help lots of people by printing many thousands of plastic parts every day. We invite anyone who wants to utilise our technology to get in touch with us.
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DENTAL NEWS PROTECTIVE FACE SHIELDS The demand for face shields for healthcare workers has been immediate and large - and Photocentric is ramping up production of face shields to meet this demand. We have lots of LC Magna and LC Maximus 3D printers on site and are turning them all over to making parts for face shields. We are producing tens of thousands of them a day, and we’re enabling others to do so as well through providing the required files and video guidelines to get involved. LIQUID CRYSTAL MAGNA A standard Liquid Crystal Magna printer can print a full bed of 135 face shield separators. Time to print bed of face shield parts = 90 minutes with our fast printing technology. Our efforts to help COVID19 - our products, how we came to work on them and what allowed us a company to act so quickly and diversify The Italian ventilator valve story was the trigger for us to think about how we could help with making parts to support hospitals. Since the outbreak we have effectively changed our business. Our large format printers can make vast numbers of parts per day and we have mobilised both our Magna printers and our prototype large Maximus printers to produce various parts from masks, ventilator valves and more recently, protective face shields. Another printer manufacturer - Prusa released a design for a face shield made on filament printers. We wanted to maximise our printing however, so one of our engineers designed our own model. With demand from hospitals both local and
further afield across Europe for face shields, our focus has now shifted to help with the PPE shortage and protect our health workers. We will produce tens of thousands of visors each week and enable others to do so also, providing all the required how to guides and downloadable files via our website. The beauty of additive manufacturing is the ability to react quickly and when needed. We had several printers used in house to make test parts for customers and trial new resins. We turned these as well as our large format Maximus printers that were being prepared for beta testers, over for immediate use on site, here in Peterborough. Our dedicated and enthusiastic team is perhaps the biggest factor, however. We have some very passionate colleagues who love 3d
printing and want to help and are prepared to go the extra mile to make it happen. We knew our large format printers could make a difference quickly. Within a day we can design, print and test a 3D printed part. If the part needs modifying, it can be iterated in the same day too, often several times! We can enable the manufacture of goods locally and at speed and scale. Consider the traditional manufacture of shield separators, with injection moulding you are looking at around 1,000 units per day. With our fleet of large format printers in-house, we can produce ten thousand of these per day. FOR FURTHER INFORMATION : www.photocentricgroup.com/printingparts-for-covid-19
OUR PRODUCTS, SERVICES AND SPECIALITY
l
Since 2002 Photocentric have been manufacturing photopolymer resin, Patent holders in visible light curing technologies, over the last 20 years we have innovated in a broad range of applications: OFFICE STAMPS Where it all began with our patented unique concept called imagepac - pre- packaged photopolymer which simplifies stamp making.
CRYSTAL CLEAR POLYMER CRAFT STAMPS We are the world’s largest and most trusted manufacturer of craft stamps, all made using our patented image photopolymer package. (Since 2013 we have also made clear stamps in Phoenix, AZ to supply the USA with a “Made in USA” product).
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3D PRINTING More recently, we moved into the manufacture of 3D printers. We applied our understanding of photopolymerization in the visible light part of the spectrum to unlock the power of using widely available, high resolution LCD screens in 3D printers - today we are known for being world leaders in LCD 3D printing. Our 3D vision is to enable custom mass manufacture, through providing disruptive, fast large format machines and functional materials. These have been developed for a range of applications, one strong one is dentistry, in particular for aligner manufacture. Other sectors we provide solutions for include the entertainment, industrial and figurine industries.
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ECPD
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
By completing the Quiz successfully you will have confirmed your ability to understand, retain and reinforce your knowledge related in the chosen articles.
Correct answers from April DT Edition: Q1.
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As of April 2016 issue ECPD will carry a charge of £10.00. per month. Or an annual fee of £99.00 if paid in advance.
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3. Evaluation: Tell us how we are doing with your ECPD Service. All comments welcome.
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Payment by cheque to: The Dental Technician Magazine Limited. Natwest Sort Code 516135 A/C No 79790852 You are required to answer at least 50% correctly for a pass. If you score below 50% you will need to re-submit your answers. Answers will be published in the next issue of The Dental Technician. Certificates will be issued within 60 days of receipt of correct submission.
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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 Aservice Technology
Q10. Which ventilator valve story was the trigger to support hospitals? Mexican A B Italian C Turkish D Belgian
Q2. In the case of partial edentulia, the patient can be sent directly to where? The Dentist A An Orthodontist B The Radiological Center C D Hospital
Q11. A B C D
Q1. What is the advantage of the procedure? A Versatility Low Cost B C Quick Aesthetically pleasing D
Q3. A B C D
The working environment is created by ASERVICE TECHNOLOGY with the acquisition of which files? DICOM files ASDAC files TYPO files TELCO files
What is the traditional manufacture of shield separators? Three stage layering technique Using composite filler Injection moulding Spot welding
BioHorizons Camlog Q12. A B C D
What is CIRDIC? Churches in Reading Drop In Centre Central Intelligence for Restorations and Dentistry Information Centre Cobalt Injection Relative Design Information Centre Chrome in Restorations Dental Information Class
Q4. What equipment will the dentist need to use the application of coDiagnostix? A Scanner B Printer C iPad A furnace D
Q13. BioHorizons Camlog is part of who's Global Dental Surgical group? A 3Shape Henry Schein B C VITA D Straumann
Photocentric
Q14. A B C D
Q5. A B C D
What is the name of one of the Photocentric printers? LC Magna LC Lupa LC Mac LC Titan
Q6. A B C D
What technology is used to make the vast number of parts? YIP technology LCD technology HDMI technology PPE technology
Q7. How many face shields is Photocentric producing a day? A Tens of thousands B 100's C 50 D 10 Q8. A B C D
What is the time to print bed of face shield parts? 60 minutes 30 minutes 90 minutes 120 minutes
Q9. Since 2002 Photcentric have been manufacturing what resin? A Photopolymer B Acrylic C Paper D Chrome
Where are BioHorizons and Camlogs headquarters? U.S and Europe U.S and China U.S and Australia U.S and Russia
Q15. How many countries do their distribution network reach? A 50 B 60 C 70 D 90 Q16. A B C D
How many valued solutions do they offer? Over 300 Over 200 Over 100 Over 50
You can submit your answers in the following ways: Via email: cpd@dentaltechnician.org.uk or by post to: The Dental Technician Limited, Po Box 430, Leatherhead KT22 2HT. You are required to answer at least 50% correctly for a pass. If you score below 50% you will need to re-submit your answers. Answers will be published in the next issue of The Dental Technician. Certificates will be issued within 60 days of receipt of correct submission.
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DENTAL NEWS
BRITISH ASSOCIATION OF PRIVATE DENTISTRY The British Association of Private Dentistry (BAPD) represents Private Dentistry across the UK and promotes excellence in dental care for all patients. MISSION The BAPD is an organisation established in April 2020, whose mandate is to support and represent all those operating in the private dental sector across the UK. Our mission is to act as a conduit between our members, government and regulators, to ensure our voice is heard as a key contributor to decision-making in UK dentistry. We will endeavour to share our unique knowledge to support, advance and empower dental professionals to deliver choice, excellence and high-quality dental care to all their patients. MEMBERSHIP Membership is open to all providers of private dental services across the UK. With over 7500 experienced professionals including specialists and general dentists, hygienists, therapists, nurses, technicians, practice owners, practice managers and receptionists, this organisation’s membership reflects the teamwork that goes into delivering a high-quality service for patients. FOR OUR PATIENTS Practices have been ordered to cease face to face patient care by Public Health England and the Chief Dental Officer. Dental professionals are experts in oral health, which is a key element in maintaining overall health. We want to be sure our patients are fully provided for and we are gravely concerned that insufficient arrangements have been made to provide alternative arrangements for patients at this time. Many are in pain, dentists are being forced to remotely prescribe analgesics or antibiotics which are not ideal solutions, and in many cases will be ineffective, as many dental emergencies are inflammatory based problems requiring interventions. Urgent care centres that were promised are limited in their capacity to provide adequate care, and some patients have no availability for over 50 miles. It is also very difficult to actually refer patients to them; currently patients have to call NHS 111 which is already overstretched, and little help is offered. Vets are being allowed to open for vaccinations, so man's best friend has access to healthcare whilst his owner cannot get his own toothache resolved in a timely way. An experienced army of health professionals is waiting in the side-lines, with their hands tied by the government and unable to help their patients.
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AIMS & OBJECTIVES SHORT TERM AIM – MAINTAIN PATIENTS ACCESS AND BUSINESS CONTINUITY The BAPD has 3 immediate objectives: 1. To restore private dental services for patients as quickly and safely as possible using a logical, evidence-based approach. The BAPD was born out of a dire need for dentists and their teams to be able to provide a rapid and responsive service to urgently provide our own patients with urgent dental care. Each of our members have patients who have pain or swellings which cannot be managed remotely with advice, analgesics or antibiotics, but due to current circumstances we are unable to see them. Patients are trying to get help through NHS 111, but the NHS does not have the resources to provide anything other than a sparse and basic emergency dental service, so people are left in agony or resorting to trying to treat themselves. The BAPD is urgently working with partners within UK dentistry to shape policy regarding a scientifically credible and patientsafety focused return to the full provision of UK dental services as soon as possible. 2. To address the inequities of financial support for dentists and dental businesses providing dental care for their patients outside of the NHS. The collapse of dental practices and associated businesses (dental labs and suppliers) will take us back decades, and we are fighting for our survival. Currently, approximately 65% of primary dental care is provided privately through highly leveraged small businesses, yet all dental practices have been ordered to cease direct care and only NHS contract holders have been offered financial support (that too in proportion to their NHS earnings). Dental businesses (practices, laboratories, suppliers) in the UK which depend in the main or wholly on income from the private sector to survive have been given no financial provisions or support for overheads such as rent, business rates and other ongoing costs. Covid-19 is a Notifiable Disease; therefore, our insurers are not prepared to pay out under any interruption of business clause. Many dental services are provided through small Limited Companies or by self-employed
sole traders, and profits are ploughed back to invest in premises and equipment. They do not qualify for the Chancellor’s Self-employed Income Support Scheme, and the Directors of Ltd companies have not been offered sufficient support either. This has left them trying to pay rent, rates and other overheads from savings, overdrafts and loans. One in five practices are on the brink of collapse this month (The Times, 12 April 2020). 3. To unify the dental profession through the development of robust strategic relationships with other professional groups within dentistry. The Covid-19 pandemic has laid bare flaws within the leadership structure and functionality of UK dentistry. In 2018 total expenditure on dental services in the UK was estimated at £10.1bn, with £3.9bn (39%) spent on NHS services across primary and secondary care, and £6.2bn (61%) on private dental services in primary care (Clearwater International, 30 Jan 2020). As NHS dentistry is not free at the point of delivery, a significant proportion of the NHS spend is recouped by way of patient charges. The dental market is projected to grow to circa £11bn this year and £12bn by 2022, with all growth coming from the private dental sector, yet the contribution that private dentistry makes to the physical and mental health and wellbeing of our patients remains under-represented within the profession and in the media. BAPD’s overall aim is to change this. Our newly formed subcommittees are working hard to clarify scientific issues and liaise with key decision makers, in order to present a united front to shape future dental policy and guidelines for the good of all patients and the dental profession as a whole. MEDIUM TERM AIM – REMODEL DENTAL SERVICES The BAPD has 3 medium term objectives: 1. To campaign for clinical quality We strongly believe that professional skills and patient care have both suffered as a result of the poorly remunerated UDA target driven system that prevails in NHS dentistry. Advances in materials and medical/dental technology have transformed the treatments we
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DENTAL NEWS are able to provide for patients. Private general and specialist practices provide a significant alternative referral portal for patients who need or desire access to cost-efficient, high quality dental treatment that would be very difficult, if not impossible, for the NHS to provide with its current resources. A significant element of this includes preventative dentistry. We believe all dental clinicians should be able to access these advancements, as well as allocate the necessary time to carry out high quality examination, diagnosis, prevention, care planning and treatments with fair remuneration. Quality replaces the need for repetitive treatment, is more cost effective in the long term and will therefore save time and money for our patients. 2. To assist the DOH in formulating a workable system of funding for dentistry The Chief Dental Officer, Sara Hurley, recently said “we should be looking to emerge from COVID-19 ready to exploit the opportunities for reforms to the current NHS dental contract. Ready to ensure NHS commissioned dental care remains a universal offer. And that it maintains the increased access for children so we continue the decline in children’s admissions to hospital for dental extractions”. (Dentistry Magazine, 20 April 2020). The funds required to improve access for children will require reallocation of resource from another area, and it will be impossible to make a universal offer for a £12bn dental industry with a £3bn budget (after accounting for patient charges) for NHS Dentistry.
to value the important health, wellbeing and economic benefits of a high-quality dental service, and to improve the profession’s unified image. The growing interest in health, wellbeing, and enhancement of self-esteem have all contributed to an expanding demand for specialist treatment modalities, and the cosmetic dental treatment segment is projected to be worth £3.3bn p.a. by 2022 (Clearwater, 30 January 2020). Not only is this segment of the market pivotal to the survival of dental businesses and ongoing investment in technological advancements in dentistry, private dental service providers remain a grossly under-utilised primary care resource for the prevention of chronic physical ailments such as obesity and diabetes, and mental health conditions which result from low self-esteem and confidence. LONG TERM AIM – REDESIGN DENTAL SERVICE FRAMEWORKS The BAPD has 3 longer term objectives: 1. To regain control of professional indemnity We believe that indemnity costs should be both fair and transparent. Dental professionals must have the peace of mind that they are fully covered without the threat that indemnity cover can be withdrawn at the discretion of the provider without a sound reason being given and with the right of appeal against providers’ decisions. If there are discretionary rules applied by providers there must be a clear set of standards established that outline the details of such rules.
Private dentistry does not compete with NHS dentistry; it is an essential adjunct in a chronically under-resourced area of healthcare, and both operate in harmony. It is imperative that there is complete transparency about the complementary roles played by NHS Dentistry and Private Dentistry, in providing an integrated complete solution to meet the needs and desires of all groups of patients.
Where insurance-based products are utilised there should be an onus to be ensure there are no gaps in cover if switching between claims made, claims occurred and discretionary products.
The RAINDROP (Resource Allocation in NHS Dentistry: Recognition of Societal Preferences) STUDY from Newcastle University suggests the NHS should explore the reallocation of public funds from orthodontics and the scale and polish to online urgent care triage, improved local access, oral health promotion through local authorities and dental provision in care homes. (Nature, 3 May 2019).
2. To assist the General Dental Council (GDC) in its evolution We support the changes the GDC have already made and believes that this evolution should continue. We would urge the analysis of successful foreign models and reflection on how these could fit within the current legislative framework. We will urge the GDC to set realistic professional standards that are based solely on the provision of the best in patient care. Their recent communications regarding their intended approach to the issues that will be facing all registrants after the Coronavirus pandemic appears to be a step in the right direction, and we welcome that approach.
BAPD would welcome the opportunity to engage with the DOH to look at how foreign models in the funding of dentistry can lead to better long-term outcomes and help to provide more preventive dentistry, and more predictable results, to a wider public. 3. To provide quality education for patients and the public It is essential to educate patients and the public
Also, robust defending of spurious claims is imperative to ensure we mitigate the trend for defensive dentistry, which often doesn’t help patients.
3. To incorporate Private Dentistry in future dental service policy decisions Private Dentistry has: 1. Transformed treatments we can provide for
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patients thanks to technological innovations 2. Kept the burden of patient care away from an overloaded NHS by offering alternatives 3. Underpinned the mixed economy business model that keeps dental practices afloat. The growing demand for remedial and restorative dental care in the UK is fueled by a population that is increasing in both size and age. The over-60s population is projected to increase from 16.1 million in 2019 to 17.8 million by 2024 (Clearwater, 30 January 2020). Add to this the technological advances that now make it possible to mill dental restorations on site, to use lasers for impressions and treatments, to place digitally guided implants, and to align teeth using 3D printed aligners, and it is clear that Private Dentistry has to be embedded in the delivery of comprehensive and holistic services that truly meet the needs of all patient groups. It is important to acknowledge that the costs of delivering the more complex and advanced services that are usually provided privately are significantly higher than the costs of delivering NHS care via the current UDA system or any future capitation model. This is illustrated by the higher associate, lab and materials costs (and correspondingly lower earnings) seen in practices with predominantly private revenues, when compared with practices predominantly funded by the NHS (Cristie & Co Dental Market Review 2019). Expenses are likely to rise across the board in the future with the development of new PPE standards as a result of the Covid-19 virus. It will be important to have a coordinated strategy for ensuring that the true costs of delivering a high-quality dental service are understood. The time is right to ensure that the knowledge, skills and capabilities of our highly talented workforce are fully utilised, that future dentistry is fit for purpose, and that it offers patients the widest possible choice using a symbiotic system, rather than the two-tier system that currently fragments dentistry in the UK. ORGANISATIONAL STRUCTURE Our executive committee acts on the direction of the steering group. This executive committee is made up of chair persons from each subcommittee; each chairperson provides a voice for his or her committee. BAPD’s organisational structure is still being formulated and will evolve in coming weeks. CONTACT US Website: w ww.bapd.org.uk Email: info@bapd.org.uk Twitter: @TheBAPD Instagram: @TheBAPD
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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)
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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.
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
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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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DENTAL TECHNICIANS GREAT BRITAIN
DENTAL TECHNICIANS GREAT BRITAIN MEMBERS DOING THEIR BIT FOR PPE l Whilst things have come to stand-still in most areas, some members of Dental Technicians Great Britain are finding innovative ways to support the immediate need for more protective equipment for our front-line workers particularly in the NHS. Those that are able to utilise their setups, should they have access to, are creating shield bands using Asiga and Photon printers. Others are donating to the cause with elastic and cleaning materials. These are incredible efforts to support the PPE shortage, thank you! If you are operating from home and are having similar successes we would love to hear from you. Please send to: info@dentaltechnician.org.uk To find out more on how UK dental technicians are achieving such results join Dental Technicians Great Britain on Facebook.
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