The Dental Technician Magazine April 2021 by The Dental Technician Magazine

VO L 74 N O. 4 I A P R I L 2 0 2 1 I B Y S U B S C R I P T I O N

VERIFIABLE ECPD FOR THE WHOLE DENTAL TEAM

NEW FEATURE: A MONTH WITH...

MY NEW SCANNER WITH ELLIS BULLEMENT, OPERATIONS DIRECTOR AT S4S DENTAL LABORATORY PAGES 10 - 11

THIS MONTH... l

TECH INSIGHT: 5 THINGS I CANNOT WORK WITHOUT! I ROSS CHAPMAN P. 6

INSIGHT: DENTAL TECHNICIANS JOURNEY INTO A CAREER IN RECONSTRUCTIVE SCIENCE I CATHERINE TURNER P. 12-13

HEALTH & WELLBEING: TENSION-TYPE HEADACHES I JOHN FORDE P. 35

w w w.d e n t a l t e c h n i c i a n .o r g .u k

CONTENTS

APRIL 2021 Editor: Matt Everatt F.O.T.A. E: editor@dentaltechnician.org.uk Designer: Sharon (Bazzie) Larder E: inthedoghousedesign@gmail.com Advertising Manager: Chris Trowbridge E: sales@dentaltechnician.org.uk T: 07399 403602

EDITORIAL ADVISORY BOARD Andrea Johnson Ashley Byrne Ross Chapman Sharaz Mir Sir Paul Beresford

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

Welcome

Insight From the archives Dental Technicians Journey into a Career in Reconstructive Science. By Catherine Turner

6 8-9 10-11

5 things I cannot work without! By Ross Chapman Not all model trays are the same By John McCarthy A month with... By Ellis Bullement

Dental Technology Sagemax But It’s Just An Acrylic Baseplate! By Chris Maryan Zendura - the solution to a crack-resistant, durable clear retainer

14-16 18-19, 20, 22 28

Business Lifestyle Business or Growth Minded Business? By Matt Everatt FOTA - Editor and Senior Partner S4S (UK) Ltd

24-25

ECPD Free Verifiable ECPD & ECPD questions

26-27

Digital Technology Implant Drilling Guides. By Dr Gulshan Murgai - Implant Solutions Direct

DTGB

Interview An interview with Daryl Tyler

Extend your subscription by recommending a colleague

Tension-type headaches. By John Forde

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.

5 12-13

Technicians Insight

The Dental Technician, Select Publisher Services Ltd, PO Box 6337, Bournemouth BH1 9EH

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.

Welcome from the editor

Health & Wellbeing 35

Marketplace Exocad Shofu/DTS 2022 Zirkonzahn/DTS 2022

36 37 38

Classifieds

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BAR HEADER WELCOME

Welcome

TO YOUR APRIL 2021 ISSUE By Matt Everatt F.O.T.A I Editor

elcome to the April edition of your Dental Technician Magazine. Spring is upon us and I have been really happy to see lots of social media posts saying how busy labs have become and hearing less of the sad tales of labs remaining closed. I can only hope that the light at the end of the tunnel is here and shining brightly for us all. I wanted to thank everyone for your continued high praises for the new features in the magazine, and I am keen to hear of any new ideas or contributions that you would like to see. Over the past few months we have been working hard in the background at The Dental Technician Magazine to bring a whole new eCPD collaboration to give readers an opportunity to get access to free online CPD. I say we, I really mean Chris Trowbridge! He has been working hard with the team

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at ProDental to create the new initiative DTCPD, where we will have regular online webinars and education for all members of The Dental Technician magazine. Chris will be sharing more about this in the magazine and on the Dental Technicians Great Britain Group on Facebook. I wish you all the very best for April and I do hope you will all enjoy some downtime over the Easter break and look forward to life getting back to a more normal way of living very soon. Again, thank you to all of the contributors this month and open the invite out to more of you, we would love to hear your story, news about a staff member, an unusual case or you would like to praise the good work of a colleague. Please do get in contact with me, as always you can get me online usually via the facebook group or by emailing editor@dentaltechnician.org.uk

BAR INSIGHT HEADER

From the

Archives By Matt Everatt F.O.T.A I Editor and Author

MAY 1971 l I discovered this article written for apprentices and published as a 2 part piece. The article describes in great detail how one ‘sets up’ a Full/Full Denture. Now, I am no Prosthetic Technician, but this did bring back several memories from my college and university days and I would expect it will still be relevant to todays trainees. Here is the 1st part of the 2 part series.

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BAR HEADER INSIGHT TECHNICIANS

5 THINGS I CANNOT WORK WITHOUT! By Ross Chapman I Chapman Dental Solutions l By no means exhaustive here are the 5 things I currently can't work without at our clinic and laboratory: This month we speak with CDT - Ross Chapman from Chapman Dental Solutions – Denture Clinic and Dental Laboratory based in Newcastle Upon Tyne. We thought it would be interesting to gain an insight into what things a Clinical Dental Technician cannot work without.

1. MY TEAM:

Clichéd as it may sound I really can achieve nothing without the other cogs in our

machine. From our implant dentist through to my receptionist, everybody has their role to play and their area of expertise. We work well as a team, everybody knows their role and we try to have some fun along the way. I owe a huge debt of gratitude to my staff, both past and present, for helping my business get to where it is currently.

2. DIGITAL DENTISTRY:

I’ve written for The Dental Technician before about my journey in digital dentistry and I genuinely couldn’t and just as importantly wouldn’t want to work without it in my daily workflow. Analogue

knowledge is paramount but our digital workflow be it our Medit intraoral scanner, DOF desktop scanner, Exocad software or 3D printers just makes our life quicker, slicker and easier.

3. PATIENTS:

Self-explanatory really as a denture and implant clinic if we don’t have any patient we aren’t going to do very well, however, what I mean is the variation from patient to patient and case to case that keeps my job exciting and interesting. No two working days are the same and the adrenaline of a busy clinic day and the ability to changing people’s lives for the better can be intoxicating.

4. MUSIC:

I never have nor never will work in a job where I can’t listen to the radio or background music. I’m very jealous that my technicians can listen to what they want on Spotify all day every day as I have to have patient-friendly music in the clinic. I think most technicians take for granted what a blessing it is to be able to enjoy the beautiful escapism of music whilst at your place of work.

5. CHALLENGES & GOALS:

I’m not one to rest on my laurels and I find always having a goal or a new project keeps me motivated and according to the wife easier to live with! I’ve been lucky enough to work with and alongside some fantastic technicians and clinicians over the years and there is nothing wrong with absorbing what knowledge you can whilst in the presence and then using it to push your career and aspirations forward. Surround yourself with people you admire and it will rub off eventually. If you would like to participate in our ‘5 Things I Cannot Work Without’ feature please email: editor@dentaltechnician.org.uk

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BAR HEADER

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TECHNICIANS INSIGHT

NOT ALL MODEL TRAYS ARE THE SAME By John McCarthy I JPM Ceramics So I began exploring other options and must say my first experiences of what was on the market was not good, along with many others I was not impressed with the tray systems I tried especially the market leader, and to this day some people believe tray systems are all bad. It was at this point I decided that there was a need for a better model tray system designed by a technician for technicians and set about working towards this goal.

aving qualified as a technician in a small prosthetics only lab, I decided to move on to a much larger lab who had a Crown & Bridge dept which I was keen to learn.

My first strategy was to get samples of all the systems on the market at that time and trial them all in my own lab recording my likes and dislikes of each one, the dreadfully sloppy one that when you turn it upside down all the parts fall out, the one with the extra

In order to get the job in their C&B department without experience I had to start from the basics, “the model room”. This was run by Neil Man an ex military policeman, who didn’t suffer fools or shirkers. From day one I realised this was a clockwork operation where a hundred models a day was not unusual. The method back then was a stone arch, poured, hand pinned, then based with a second stone mix, trimmed up, sectioned, and dies trimmed. After a few weeks of this my mind began to wonder if there wasn’t a more productive system we could use, but questioning a well oiled machine of many years was not an option. So after going through the model room, metal department and then ceramics I decided to leave to set up my own lab. It was at this point as a one man lab I thought there’s got to be a more accurate and quicker model method than the one I was using, as it was a major chunk of the day being taken up.

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lugs to push in, the one with the removable central spine, the one with the many points inside it’s base etc I tried them all. Having trialled them all I categorised the various formats to have them studied independently by our local University engineering department. The end result of the independent analysis was pretty enlightening. The most surprising analysis found was that by adding “lugs” which push in and out to secure the sections was actually causing more inaccuracies than a design without . In the same way the more points projecting from the base of some designs to give more location for sections to be relocated, was actually giving more opportunities for debris to be caught in those concavities leading to inaccuracies on relocation.

TECHNICIANS INSIGHT

So the conclusion from the university study was actually that the simplest design was the most accurate for the use intended, which is to section and relocate those sections without increasing inaccuracies. With this now identified the objective now became how can the simple model tray be improved upon to maximise its accuracy, speed and ease of use.

internal and external corners, and taking into allowance the tongue shape which had previously been ignored. Finally for the first time with any model tray system we added an articulating ball & socket system to allow a plastic articulator to be used. This is particularly useful for those pesky part impressions which we all get sent more often than we’d like.

The needed improvements were identified as: (1) Improve the fit of the stone sections to the tray The popular tray system at the time was using a mould which was 20 yrs old, and had produced millions of trays therefore it had become sloppy, also identified was the wall depths were deemed to be to shallow and the incorrect angle. Our tray has been designed to address these issues. The walls are taller, the angle changed and it’s a brand new tooling (2) when producing a multi “tool” (that’s a mould to us ) With the best will in the world a very skilled engineer can not produce a 8/10/12 part tool that each part is absolutely identical, therefore if your stone sections become separated from your tray, they can not necessarily be put back into another tray with 100% accuracy.

Both the full arch tray and the quadrant tray work well without the use of a separator, and combined with a good quality crown and bridge stone, I have a video showing the working time of 2mins 28seconds to make a sectioned model from start to finish (not including setting time) This issue has also been addressed by making a four part tool with each part having a unique number imprinted on it, this is then reproduced inside each tray produced, so the stone sections from tray number 4 fit precisely back into another tray number 4 tray.

As a working lab ourselves we have used these trays for over 5yrs now and have had no issues using them for our digital work both sectioned or not. The sections relocate with great accuracy allowing us to do implant or large bridge cases regularly.

(3) There was not an ergonomic tray which was comfortable to the user. We addressed this by taking away the sharp angles of the former trays, adding ergonomic

If you would like to try our trays please email: John@jpmceramics.co.uk for free samples. Lab to lab prices are vat free. Tel: 0116 2368127.

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INSIGHT

A MONTH WITH... MY NEW SCANNER In this new feature we speak to Ellis Bullement - Operations Director at S4S Dental Laboratory. Ellis shares with us a month with their new scanner. Giving us their experience of the newly released Medit T710 Desktop Scanner.

f you’re a Dental Technician / Dentist / Orthodontist and you haven’t yet embraced the digital world in dentistry, you really should consider what you may be missing out on; Files of patients arches in a printable format at your fingertips, backed up and ready to go immediately, the opportunity to send work all over the world, and most importantly not having to ask the dentist for new impressions because of them being lost, dried, or dare I say - poor quality! Having been early adopters of digital workflows as a dental lab, we have always had our eyes peeled for the next big thing, and we feel we have found that in the new Medit T710 desktop scanner. We were lucky to give this new piece of equipment a test spin (I believe we were the first people in the UK to even see this scanner, with the exception of Lee Mullins) and have been putting it through its paces in our lab. At S4S we service in excess of 13,000 dentists in the UK, Europe, and beyond - this number has steadily grown and continues to. We feel this is largely in light of our commitment to advancements in digital workflow. Therefore, getting our hands on a new scanner at the cutting-edge of the industry was a great opportunity for us. My role in the business is to look after the operations, including work flowing in and out of the lab, so having machinery which does exactly what it says on the tin is crucial to help

MeditLink is also a platform which allowed dentists to send in intraoral scans for lab work we receive and this platform was very much the same to get used as was that. Simple, logical, customisable. No stress to put it simply.

me plan for workloads / staffing etc. I aim to make the life of the technicians easier by giving them as much administrative support to enable them to make full use of their technical skills. We can scan sets of models in a matter of minutes meaning we have been able to expand our model archiving service to practices looking to digitise their stores and gain back their garages / sheds! We had just taken on a huge archiving contract for a large group of Orthodontists and we thought this would be a perfect opportunity to put the scanner through its paces. These were for archives only - simple upper and lower models recorded in ICP, which the Medit scanner walks you through really easily, capturing the upper, lower, and finally the MMR. The software that comes with the scanner allows you to easily set up where you want the files stored. This worked well with us, as for this particular archiving task, we wanted to keep a backup to be saved on our server as well as on our online workflow system.

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We also had the opportunity to explore scanning impressions rather than cast models, which is uncharted territory for myself. I was sceptical at first, but the results spoke for themselves. We did control tests and carried out some scans of the impression vs the cast model and printed off the STL’s to then compare the difference and we were very impressed. It certainly does open up doors for us as the necessity to cast impressions before scanning is removed. When looking at increasing our fleet of scanners, we had spent very little on some scanners in the past, and spent significant amounts on others. Having had a relatively ‘problem-free’ experience with the most expensive scanner, the price point of the Medit scanner did make us wonder if it would be able to compete, but we were pleasantly surprised. Not only did it compete with what we already have, it’s actually faster and will now be our main scanner. Another issue we had with cheaper scanners were STL’s which presented ‘holes’ or gaps (missing data) in the file, which needed to be filled in by a technician in a separate piece of software to salvage the scan. Fortunately, this scanner already has this feature built in, so no messing around fixing files!

INSIGHT

The scanning is really straight forward to do, and compared to other machines we have used in the past (bearing in mind we run this machine Mon-Fri, at least 8 hours per day, we weren't ever held up by software or usability issues. The software does lend itself to production-lining to a degree, as you can set the next arch scanning while the database is sorting your file of the previous scan which is great for a lab with as many scans to put through as ourselves. The scanner currently resides in our digital department; an office with up to 15 staff in (when we aren’t encouraging home-working!) so an obnoxious, noisy scanner would not be very popular! Luckily for us, this scanner blends into the office, and fits in with the aesthetic of a nice clean, white, clinical look. As with any high-tech piece of kit, the more CPU power it has to play with, the better

results you get. We were recommended a spec of a PC to have ready for the scanner prior to its arrival and have had no running issues as a result of lack of juice! We could have spent more on a much faster PC, and I’m confident you could run this on a lesser PC, but we are happy with the recommendation of the support team at Blueprint.

many years of service out of this scanner and assuming our digital department continues to grow on the same trajectory I’m sure we will be looking to get hold of another one in the near future!

Speaking of which, we want to thank the team at Blueprint and at Medit for their help with setting up the scanner, the minimal amount of guidance they needed to give us to get started. Anyone can run this scanner (myself included!) - its software package is comprehensive and does everything we need in our digital workflow.

O’NEIL BUCKNOR, TEAM LEADER, S4S DIGITAL TEAM ALSO ADDED: We now have 7 desktop scanners from 3 different manufacturers in total within the Digital Department at S4S. As it currently stands, we can now mothball 4 or 5 of the older scanners as the workflow is now much quicker and it would make much better sense to scan quicker or less machines. I am sure, if the scanner continues to work as effectively as it has so far, I will be convincing the Directors to buy another T710.

Thanks again to the guys over at Blueprint and Medit for letting us get our hands on such a great piece of kit - I’m sure we will get

Ellis Bullement I Operations Director S4S (UK) Ltd

Note from the Editor - Special Thanks go to Blueprint Dental for working with S4S Dental Laboratory and Medit to make this new Magazine feature happen. We would like to take the opportunity to invite other suppliers, manufacturers and laboratories to take part in this feature. Do you have a new material that you would like to share with us, or a new piece of equipment? If you are a manufacturer or supplier, we can help by putting you in touch with Dental Technicians and Laboratories who may be able to participate in product testing and trials. This new feature is a fantastic opportunity to share new things with the Dental Technology family.

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INSIGHT

DENTAL TECHNICIANS JOURNEY INTO A CAREER IN RECONSTRUCTIVE SCIENCE By Catherine Turner BSc MSc MIMPT I Recontructive Scientist, Queen Elizabeth University Hospital Glasgow

t’s no cliché for me to say I’ve had my heart set on a career Maxillofacial prosthetics, from a young age. To me, working in the medical field means providing help, support and encouragement, but above all, is the importance of pushing boundaries to the limit and knowing that I have made a contribution to enhance people’s lives. That being said, I have also always been a practical ‘hands on’ person and wanted a career that would incorporate a blend of both the artistic and scientific aspects. It wasn’t until under the unfortunate circumstances that my Uncle lost two of his fingers, that I even became aware of the Maxillofacial Laboratory and that a career that combined two of my passions existed.

and patient specific nature of our work means no two days are the same. In our role we are fortunate enough to provide life-long care to individuals who are born with parts of the head or neck missing, or who may have lost these features due to cancer or injury. Our work involves not only all aspects of prosthetic rehabilitation (i.e. Eyes, noses, ears, fingers etc.), but also implant and surgical planning relating to trauma, oncology resections, reconstructions, and orthognathic treatment. We work very closely with our surgical colleagues throughout patient treatment and rehabilitation to allow patients an improved quality of life.

When my Uncle received his first prosthesis, frankly I was fascinated. The detail was incredible, but more than anything, it was the extent to which it gave him back his confidence. Before he had the prosthesis, he was always very cautious of showing his hand to my brother and I who were relatively young at the time. After the prosthesis, he seemed much more comfortable and natural around us. It was this aspect, combined with his high regard and praise for the Maxillofacial Prosthesis involved, which made me think that was a career I wanted to do. As I got older and found out more about the field and what it involved the more invested I became. The broad spectrum of work which is involved

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Obtaining my place on the Reconstructive Scientist Training Programme (STP) was probably one of the defining moments of my life. The three-year work based and academic programme leads to a Masters degree. I also gained an abundance of practical and clinical experience, a wealth of research skills and a varied work-based experience that has helped me get to the position I am today. I was paid throughout my training at an NHS band 6 (2020/21 approx £30,000) and all my MSc Course fees fully funded. On successful completion of the training the starting salary is an NHS band 7 (£38,879).

INSIGHT

WHAT IS RECONSTRUCTIVE SCIENCE?

Reconstructive Science is an evolution of the post graduate Maxillofacial Prosthetics courses. As part of the governments Modernising Scientific Careers programme, Maxillofacial Prosthetics now forms part of Healthcare Science in the theme of Physical Sciences.

I applied for the newly advertised Reconstructive Science STP course in 2013, and was fortunate to be included in the first intake. The application process consisted of meeting the relevant entry requirements; either a 2.1 or a 1st degree in Dental Technology (a 2.2 is also considered if you have a higher degree in a subject relevant to the specialism) and registration with the GDC. After completing the application form (which included listing my three preferred training centres) an aptitude test followed. Next was the interview process, which was undertaken in a ‘speed dating’ style, involving multiple stations. These varied from general science to specialist questions relating to the maxillofacial profession and there was also an opportunity to demonstrate your leadership skills and values. Shortly afterwards, I received the news that I had been selected and was allocated a place at King’s College Hospital in London. From there on, the three years seemed to fly by. The course itself does require a certain amount of drive and determination as juggling work based elements such as clinics and patient work responsibilities, with competency write ups, together with academic assignments and assessments is demanding. However, in my opinion the experience I gained from such an intensive course did give me a very good grounding for my future career. The course also required a certain level of flexibly with periods of relocation; academic blocks were hosted at both Manchester Metropolitan University and Guys Hospital (Kings College London) each year and visits to other units around the country were needed to ensure my competencies were met by the

OLAT completion date. This was inconvenient at times, but actually proved a huge benefit professionally as I got to experience a range of different Maxillofacial laboratories, surgeons and their working practices. The curriculum is comprised of both core and scientific modules, with the first year being more heavily weighted to generic scientific modules. These generic scientific elements of the training provided me with a range of transferable skills that I could carry forward into my career. The more specialised maxillofacial prosthetics elements of the curriculum are more concentrated within the last two years. It is also in these final two years that you plan and undertake your research project and dissertation. There is an elective element to the STP course, where I undertook a placement at IRSM in Canada, this element of the course, helped to give me a broader appreciation of

our work on an international scale, and how systems outside the NHS work. The STP programme has certainly been the perfect entry for me into a career that I have strived to follow from a young age, and although undoubtedly a huge learning curve, it was well worth the journey. Throughout the three year programme I gained a wealth of knowledge, practical and clinical experience that a purely academic option would not have provided. The experiences I gained from the Reconstructive STP course will stay with me, as it gave an excellent foundation for my chosen profession. I have not only grown professionally, but have made friends and established good working links for the benefit of all. To conclude; the course was a perfect progression from my undergraduate studies, to a career in the Maxillofacial Prosthetics field.

The Maxillofacial Laboratory Team at QEUH

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DENTAL TECHNOLOGY

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elcome to Sagemax - one of the world’s leading manufacturers and suppliers of dental zirconia presenting authentic pictures from the dental laboratory, CAD/CAM products featuring an intuitive color-coding system and a lively new corporate design. Sagemax is focusing on esthetic needs of dental labs with high-end dental materials like the high translucent multi-layer zirconia NexxZr+ Multi and lithium-silicate Glaze Spray. Founded in 2006, the company is a rapidly growing provider of aesthetic zirconia products for leading dental CAD / CAM systems. The development of materials and production takes place in Federal Way, Washington / USA. The global Sagemax Sales & Marketing team is growing and begins to expand the market presence in United Kingdom together with Iris Hauer, Sales Manager Europe (North/Southwest). Iris Hauer has more than 20 years of experience in dental sales & marketing and knows exactly why Sagemax products make a difference for dental Labs. All Labs in United Kingdom can order all products directly from AB Ardent (Sweden), the Sagemax distribution hub for Europe. Customers of Sagemax in UK can conveniently order the complete range of zirconia discs 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.

SAGEMAX SUCCESS IS BASED ON EXPERIENCE – ESTHETICS – QUALITY Experience Our experience in dental zirconia dates back to 2006. Since then we have become one of the leading dental zirconium manufacturers in the world. Esthetics Esthetics in dentistry is the imitation of nature. Our products are

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DENTAL TECHNOLOGY

designed to copy nature as easy and perfect as possible. 2018 & 2019 Winner of ‘The Dental Advisor Award’ in the category Long-Term Performer: Esthetic Zirconia. Quality Our mission is to produce materials to the highest quality standards. To ensure this, we continuously enlarge our knowledge and use only raw materials of the highest quality. Our quality standards are certified by TÜV SÜD.

FOCUS PRODUCTS:

The NexxZr zirconia range offers the right esthetic solution for different dental cases and indications due to the variety of colors and the 3 different degrees of translucency: • NexxZr S – high opacity. high strength. • NexxZr T – translucent. high strength. • NexxZr+ – high translucent. esthetic zirconia. • NexxZr+ Multi – natural esthetic. efficient process. NexxZr+ Multi is a dental multilayer zirconium oxide (4Y-TZP cervical, 5Y-TZP incisal) with natural color and translucency gradient and high flexural strength (880 MPa cervical, 630 MPa incisal). These properties enable the fabrication of highly esthetic, monolithic single-tooth and bridge restorations in the anterior and posterior region. The specially adjusted translucency gradient ensures good coverage in the cervical area and increased translucency in the incisal area. The integrated color gradient also ensures the efficient fabrication of naturallooking restorations. The ease of milling allows for particularly easy processing due to the low vickers hardness in the green state. This means less wear for the tools and less stress on the machine. Thanks to the innovative manufacturing process and the unique powder processing, the edge stability during the milling process is ensured. In addition, each NexxZr zirconia can be individualized with Coloring Liquids prior to sintering. The zirconia discs are offered in four different geometries, suiting most of the leading CAD/CAM systems. Using NexxZr Tools enables dental Labs high quality milling results – available in U (uncoated) and D (diamond-coated) for 6 different CAD/CAM machines: • NexxZr Tool U – high-performance dental milling tools made of premium carbide with an ultra-sharp cutting edge. • NexxZr Tool D – high-performance dental milling tools made of premium carbide with an ultra-hard, nanocrystalline diamond coating. NexxZr Tool D are high-performance dental milling tools made of premium carbide

with an ultra-hard, nanocrystalline diamond coating for an extremely long service life. The special microgeometry of the cutting edges is excellently adjusted to milling zirconium oxide and permits detailed milling results

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with a high surface quality. The optimized chip space design as well as the improved chip space surfaces ensure the best possible evacuation of the chips, which additionally reduces the chipping risk of zirconium oxide. u

DENTAL TECHNOLOGY

OTHER TOP PRODUCTS: PMMA DISC MULTI Efficient. temporaries. PMMA Disc Multi consists of a highly crosslinked polymethyl methacrylate (PMMA) with integrated shade gradient for the efficient fabrication of temporary full-contour crowns and bridges for the anterior and posterior region. The industrial production process for the discs results in a minimal residual monomer content and excellent biocompatibility. In addition to the high fracture

NexxZr GLAZE SPRAY Effective glazing. Efficient processing NexxZr Glaze Spray is a spray glaze made of extremely high-strength lithium silicate glass-ceramic for the finalization of monolithic zirconium oxide restorations. The optimal size of the glass particles as well as the finely adjusted spray nozzle enable a light, even and very thin application of the material. Already one thin layer provides for a high adhesive bond to zirconium oxide and results in a smooth, homogeneous surface - preserving even the most intricate surface details. The antagonist-friendly wear characteristics of the lithium silicate glass-ceramic provide a long-lasting protection for high-stress areas (e.g. contact points).

resistance, the material features excellent milling behavior as well as good polishing properties. The outstanding shade stability and the multi-layer technology used permit trueto-nature esthetic results. WAX DISC Digital wax-up. press & cast. WAX Disc is a synthetic wax disc for the CAD/

l For new customers in the United Kingdom, Sagemax offers a special deal: The first 10 customers can order all products online with a 25% discount for a limited period of time: 15.03.2021- 31.07.2021

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DENTAL TECHNOLOGY

BUT IT’S JUST AN ACRYLIC BASEPLATE! By Chris Maryan BSc(Hons), FIMPT, LCGI I formerly Principal Lecturer Manchester Metropolitan University Centre for Dental Technology. Currently part-time lecturer University of Bolton, Centre for Dental Technology & Matt Everatt FOTA I Editor ABOUT THIS ARTICLE

The manufacturing of even the simplest custom made dental device requires meticulous attention to detail and adherence to ethical and regulatory principles. All too often, we Dental Technicians take our own skills for granted and give such low value to the knowledge we hold and the professional standards we must adhere to. In this article the authors illustrate the amount of work, skill, knowledge and conformity required to make even the most discerning custom made dental devices such as an acrylic baseplate.

BACKGROUND

A hard acrylic baseplate with wax registration rim is used to provide optimum retention during occlusal registration and to enable the fit of the final denture to be assessed. This simulated case illustrates these issues. Method: The manufacture of upper and lower baseplates is described and the rationales for the techniques used and the applicable regulations and quality systems are outlined.

RESULTS

There are many variables during construction that can affect the performance of a device. The use of Metrocryl following the manufacturers instructions gave a satisfactory result. The device was successfully used and later formed part of the definitive prosthesis.

1. INTRODUCTION A patient was prescribed a replacement denture. To assess the accuracy of the original impression and to obtain the most stable base for the occlusal registration rim a hard acrylic base was prescribed. This was to have an area post dam and was to be fully extended to the reflection of the sulcus. 1.1 Registration rims The British Society for the Study of Prosthetic dentistry define a registration rim as “A ridge of material, whose shape can be modified, attached to a temporary or permanent denture base for the purpose of recording jaw relations and indicating tooth positions.” (BSSPD, 2005) 1.2 Dental Bases Registration rims can be made on temporary or permanent bases (BSSPD, 2005) the type of material used for the base affects the retention and stability of the device, it is also known as a baseplate. Heat cured bases are more accurate and stable than wax bases, bases must be rigid and stable, (BSSPD, 2005). 1.3 Case study A border-moulded impression of an edentulous mandible and maxilla was taken using a close fitting custom tray. A functional post dam was incorporated into the upper impression: note, if this was not undertaken it is the responsibility of the clinician to cut the post dam (BSSPD, 2005). The impression was disinfected by immersion compliant with impression manufacturers guidance and Department of Health (2013) prior to despatch to the laboratory. At the laboratory

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a contract review was undertaken, applicable patient records were stored compliant with Data protection legislation, GDC principles and the laboratory’s’ management system. 2. TECHNICAL PROCEDURES 2.1 Construction of the model The impression inspected, boxed in to ensure the border moulding was reproduced accurately and then poured in vacuum mixed Dentstone KD with a water:stone ratio of 30:100. The boxed-in impression was carefully supported during setting to ensure no distortion, and After 1 hour when the stone was set the impression was removed and the model trimmed to approximately 3mm from the reflection of the lower sulcus ensuring the border moulding was not compromised. After inspection of satisfactory models the contract was accepted and progressed to manufacture. The plaster waste was separated for disposal in accordance with UK waste disposal legislation. The plaster trap which is a possible source of microbiological contamination and industrial waste water contamination is cleaned in accordance with the guidelines from the local water companies and plaster trap manufacturers. 2.2 Wax pattern A sheet of denture baseplate wax (Anutex HS, Kemdent ltd) was cut to the desired size, softened uniformly over a Bunsen burner and applied carefully to the model ensuring and even application. Excessive pressure can lead to over-thinning. Over heating wax can create varying thickness and thin spots. The completed base should be approximately 2-3mm thick.

DENTAL TECHNOLOGY

The wax base was extended to the full reflection of the sulcus or where identified by the dental practitioner. Relief was provided for the labial, lingual and buccal frena to allow normal facial movement without discomfort or dislodging the baseplate. The wax base was sealed to the casts and flamed to achieve a uniform smooth surface and even thickness. If not fully sealed embedding plaster can seep under the wax affecting the model and thus the fitting surface of the baseplate. The model was dampened, if too dry the model can cause a suction effect on the embedding plaster changing its mechanical properties and weakening mould. If the model is too wet it can cause the embedding plaster to become too wet, thus difficult to manipulate, and weaker. 2.3 Flasking The flask was checked and greased with petroleum jelly to able removal; after processing (figure 1). Damaged flask edges and locating lugs will affect the flask apposition and relocation. Warped edges will reduce metal-tometal contact upon closing flasks and possible damage to embedding plaster and raised or reduced thickness of cured base. Metal knockout plates were positioned and checked to see if they fit accurately. Knockout plates improve the ease of deflasking and provide support to the embedding plaster and stone during the packing stages. If not present, excessive packing pressure may lead to fracture or crumbling of the embedding plaster. 150 grams of Dental Plaster (BPB Formula), was hand mixed at a water: powder ratio of 60:100. The mix was placed in the shallow portion of the flask and the model embedded into it (figure 2) with the posterior edges down to ensure any anterior undercuts are eliminated, and high lower posterior heels were protected (figure 3). Plaster was added to block out any undercut areas. Any undercuts present will cause the model to fracture or in extreme case to prevent the flask from opening. The plaster was smoothed; a rough plaster finish can increase difficulties in opening flasks and potential for particles of plaster to break off into the acrylic at the packing stage. When set PCS plaster coating solution (Metrodent) was applied to the model and embedding plaster to enable the flask to separate after boiling out. A 200-gram mixture of Dentastone KD and Dental Plaster were vibrated onto the wax and embedding plaster, with the excess placed into the opposing flask part (figure 4). A mixture of stone and plaster was used to improve the surface quality of the mould and increase its’ strength to accommodate the pressing forces when packing the acrylic dough.

Fig 1

Fig 2

Fig 4

Fig 5

Fig 3

Fig 6

Fig 7

Fig 8

Fig 9

Fig 10

Fig 12

Fig 13

Fig 14

Fig 11

Fig 15

Fig 1: Checking and greasing of the flask. Fig 2: Addition of investing plaster building up around the heels. Fig 3: Position of model showing heels down. Fig 4: Addition of a mixture of stone and plaster to the wax pattern. Fig: 5 Open flasks in the boiling out machine. Fig 6: Application of PCS plaster coating solution (Metrodent) Fig 7: Stone without sealant. Fig 8: Surface of fitting surface with one layer of sealant. Fig 9: Surface of fitting surface with three layers of sealant. Fig 10: Candida cells in crevices on silicone processed against dental stone, I layer sealant. Fig 11: Clump of candida cells behind deep scratch on polished acrylic. Fig 12: (orthoresin): Cured acrylic showing excellent wetting and mixing, the polymer beads are well integrated. Fig 13 (orthoresin): Cured acrylic showing poor mixing the polymer beads are poorly integrated and some have not bonded at all. Fig 14: Granular porosity integrated into denture base. Fig 15: Flask in press showing excess material (flash).

The top and bottom parts of the flask were placed together ensuring metal to metal contact. A lack of metal contact can lead to over closure during the packing stage with possible damage to mould, over thinning of base, inclusion of plaster particles into the acrylic.The flask is left to set for 30 minutes, Inadequate setting time before placing in boiling water could lead to mould damage upon opening due to reduced plaster strength. 2.3 Boiling out The flask was placed in a boiling out machine for 6 minutes. This sprays the flask with boiling water to heat the mould and soften the wax. The flask is taken out opened and returned to the machine to flush out the wax with boiling water and detergent (figure 5). Excessive time before opening can cause molten wax to soak into the embedding plaster. Insufficient flushing out can leave wax residues in the mould, which reduces the effectiveness of mould sealant and thus causes plaster to be attached to the cured acrylic. This has to be removed mechanically by grinding. The flask was removed from the machine and allowed to cool. Two layers of mould sealant were applied to all plaster surfaces. (figure 6) Additional layers improve surface quality of cured base plate and reduce finishing time, however Excessive thickness may reduce definition and may result in difficulty placing the acrylic dough when packing, compare

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figures 7,8 and 9. When you consider that bacteria are about 1-2 microns in size and yeast such as candida are 5-7 microns the surface roughness on the fitting surface provides significant opportunity for the micro-organisms to adhere and colonise, figures 10 and 11. 2.4 Mixing acrylic and Packing The acrylic is stored complaint with manufacturers recommendations, The dangerous substances and Explosive Atmospheres Regulations 2002, and CoSHH regulations. To meet GDC principle 1 and the laboratory quality system, the manufacturers instructions were carefully followed. For each base, 12.5g of polymer was added slowly to 5ml of liquid monomer allowing the powder to be completely wetted by the monomer, a small amount of excess polymer was removed. It was mixed for 2 minutes and then covered and left in a fume cabinet to avoid evaporation of the monomer affecting the mix quality and to simply with health and safety policies. To comply with CoSHH and the risk assessment impermeable gloves and suitable eye protection were worn. Note 1: Monomer fumes that can be damaging to health (Nayebzadeh & Dufresne, 1999). They can cause contact dermatitis, and peripheral neuropathy. It is the employer’s responsibility to provide health and safety equipment and the employee’s u responsibility to use it.

DENTAL TECHNOLOGY

Note 2: Excess monomer may lead to excessive contraction upon curing, excess residual monomer poorer mechanical properties. Insufficient mixing or leaving the lid off can lead to some of the polymer beads being insufficiently wetted, and if incorporated into the acrylic dough will lead to granular porosity, (figure 14) increased contamination due to porosity, and reduced mechanical strength figures 12 & 13. These images are from an orthodontic resin but illustrates the integration of polymer beads. At the full dough stage, after approximately 25 minutes, the dough was removed from the pot and worked into a ball to pack into the mould. Protective gloves were used when handling the dough so as not to contaminate it and to meet the health and safety requirements and avoid long-term nerve damage (Seppäläinen & Rajaniemi, 1984) Note: Packing before the full dough stage can lead to insufficient pressure and thus acrylic in the mould thus leading to contraction porosity. Packing at the rubbery stage can lead to damage to mould or increased thickness of the baseplate. Excessive handling the acrylic dough can lead to it drying out and possible areas of granular porosity. The heat of the hand can accelerate the rate of doughing. The two parts of the flask are carefully positioned to ensure their correct location and the acrylic dough was carefully pressed into the void. The flasks were closed gently by hand and positioned under denture press. No trial closure was done, as this was a baseplate and any minor increase in thickness was not important. The press was screwed done slowly enabling the dough to flow (figure 15). When completely closed the flask was left in the clamp for 20 minutes to minimise the chance of porosity as the material continues to flow (Metrodent 2008). Excess material was removed and disposed of in a solid chemical waste container. Note: Incomplete closure can lead to loss of pressure and contraction porosity (figure 16), a spring clamp ensures continued pressure during curing. The flask was removed and placed in a spring clamp and processed according to the manufacturers instructions given below. Immerse in cold water and slowly raise the temperature, preferably in two stages, to approx 60oC in the first half hour, then slowly to boiling point in the next half hour. Simmer for a further half hour. Note: if the temperature is raised too quickly the outer surface of the acrylic cures and the monomer in the inner areas boils causing bubbles in the cured acrylic (gaseous porosity), this is more common in thick areas (figure 17).

Fig 17

Fig 16 Fig 18

Fig 20

Fig 21

Fig 19 CUTS

Fig 16: Contraction porosity where the porosity is throughout the denture. Fig 17: Gaseous porosity Fig 18: Easing the two sections apart with a plaster knife. Fig 19: Location of saw cuts. Fig 20: Checking the cured baseplate. Fig 21: Trimming with tungsten carbide bur.

Note: Cases of patient reactions to polymethyl methacrylate have been reported in the dental and medical literature since the early 1950s. The selection of acrylic and curing times can affect the levels of free monomer significantly which have been identified as a factor. Auto cure resins have been reported to have significantly higher levels and the longer curing times have reported lower levels. If an issue was raised where a patient had suffered a reaction to the denture base, it is likely that the laboratory would have to provide evidence of the materials used such as batch numbers and evidence of the process used to produce the device. These should be in the technical file held for MHRA Medical Devices purposes. It may not go down well in court, or in a fitness to practice case if there was insufficient information held by the lab. The material manufacturers go to a lot of trouble to ensure their materials meet international standards and advise on use, their legal teams will be able to argue that not following their instructions will make it the laboratory’s problem not theirs! 2.5 Deflasking When cured and cooled the flask was removed from the spring clamp. Using a wooden mallet the flask and knockout plates were lightly struck repeatedly to loosen the embedding plaster and remove it from the flask. Too much force can lead to fracture of the baseplate. A wooden mallet is preferred as a steel hammer can damage the surface of aluminium or brass flasks. The embedding plaster and model were separated using a plaster knife carefully easing the two sections apart (figure 18). The baseplate is removed from the embedding stone mixture by carefully sawing to within

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approximately 5 mm of the baseplate (figure 19). Saw into the embedding plaster and, using a plaster knife, lever the plaster until it fractures and the baseplate can be removed (figure 20). The embedding plaster is carefully cut to easily prose out the cast. Note: use of hammers and pincers can be significantly quicker but can have a higher risk of fracturing the baseplate. Care must be taken on deflasking not only to avoid injury but also to avoid fracture, a patient is paying for a new denture, not one that has been repaired during manufacture. The plaster waste was separated for disposal in accordance with UK waste disposal legislation. The baseplate was carefully removed and checked (figure 20). 2.6 Trimming and polishing Appropriate eye protection and dust extraction is prepared, acrylic trimmings are comparatively heavy but can create eye injuries and the particles on the floor can create a significant trip hazard. The excess material (flash) from around the baseplate periphery and any surface irregularities on the upper surface of the baseplate were trimmed using a medium cut crosscut tungsten carbide bur at speed of approximately 8000 rpm (figure 21). It can be ground at higher speeds, e.g. to a maximum speed of 15,000 rpm, however excessive speed and/or pressure could of u led to too much friction and heat that can distort P.22

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DENTAL TECHNOLOGY ucontinued from page 20 the baseplate, clog the bur and leave acrylic trimming residue (figures 22). Care was taken not to over trim the periphery, which could have led to loss of fit and retention of the baseplate. The fitting surface was checked for surface pimples and inclusions. These were removed and the surface lightly smoothed. Surface defects can create pain for the patient, and surface inclusions e.g. Plaster, will detract for the appearance and be unacceptable in the mouth. The periphery and non-fitting surface was lightly sanded. The baseplate was then polished. Fresh pumice was mixed Note: New dentures should not be polished in equipment used for repairs. There are significant micro-organism on the hands and in the environment, pumice is an excellent growing medium so should be changed regularly. Disinfectant may be used but the laboratory has to be aware of potential allergy amongst staff over time. Brushes and mops should also be regularly cleaned and disinfected. Pumice slurry was repeatedly applied to the surface of the plate to gently abrade the surface using a dental lathe at 1500 rpm and a large four-row 75cm lathe brush. For the frena a smaller brush, 2 row x 50cm brush was used. The process continued until the base and periphery was uniformly smooth. The brush was moved in various directions to eliminate unidirectional grooves. Excessive pressure and speed can lead to the acrylic surface being burned. When uniformly smooth the plate was washed, checked and returned to the polishing lathe to be polished using tripoli with a rag mop at a high speed (3000 rpm). The base and periphery was checked for smoothness and to ensure there are no sharp edges. The mop was moved in various directions to eliminate unidirectional grooves. Excessive pressure and speed can lead to the base becoming warped or the acrylic surface being burned. When finished to a high lustre the plate is carefully washed and ultrasonically cleaned to ensure all traces if polishing media have been removed. The baseplate was again carefully checked for sharp edges, blemishes fit and extension (figure 23), and passed for final inspection. The device is then sent for final inspection using the DAMAS checklist the following was undertaken: • Check prescription has been followed correctly (Contract Review) • Fit of appliance to model is accurate • Check that models are clean and presentable • Check that item of work has been cleaned in accordance with manufacturing procedures • Ensure job is booked out to the correct client. • Check packaging and correct dispatch date and time

Fig 22

Fig 23

Fig 22: Melted acrylic on the surface of acrylic. Fig 23: Checking fit.

During manufacture means of identification should be considered to be included within the cured acrylic. It was prepared for despatch, with invoice and the records appended as appropriate. If this was a final device then it should be accompanied by a statement of conformity, this should include: • Name & Address of the Laboratory • Description of the Device and any specific characteristics as indicated in the prescription • The name of the Prescriber and if applicable the address of the clinic • The statement of conformity, i.e: YOUR ATTENTION IS DRAWN TO THE FOLLOWING STATEMENT: This is a custom-made medical device that has been wholly manufactured within the EU and satisfies the design characteristics and properties specified by the prescriber for the above named patient. This device is intended for exclusive use by this patient and conforms to the relevant essentials requirements specified in Annex 1 of the Medical Devices Directive and the United Kingdom Medical Devices Regulations. This statement does not apply to medical devices that have been repaired and/or refurbished for an individual patient’s use. Storing, handling and instructions of use: The appliance is supplied in a non-sterile condition. It is recommended that before use this medical device is stored in a clean and safe environment that prevents it from coming into contact with materials, equipment, acids, alkalines or bleaches that could cause physical or chemical damage. The device should not be subjected to extremes of temperatures when stored. You should take care when removing the device from its model. Where applicable, instructions on how to clean this device may be obtained from the prescriber. This prescription has been placed under (name of Lab) T&C of supply and it is assumed that you have complied with any other. 3. CONCLUSION Careful following of the manufacturers instructions for the materials and care and attention to detail ensured a high quality baseplate. Heat cured acrylic has the advantages of a lower free monomer content and higher stiffness than cold cure resins but the higher temperature can leave higher stresses in the material that can lead to crazing or distortion (Obrien WJ, 1997).

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There are a number of Legal, Ethical, Regulatory and scientific issues that must be addressed for the manufacture of even the most insignificant dental devices. These include cross contamination, materials safety, waste disposal, quality assurance, regulatory compliance and the overarching ethical requirements to put patients interest first, complying with the Standards for the Dental Team. A dental laboratory must be registered with the Medicines and Healthcare Products Regulatory Authority. If devices are supplied when not registered the laboratory owner/dental technician can be prosecuted and could carry a penalty of an unlimited fine and / or 6 months in prison. In addition of you are registered with the GDC this could lead to a Fitness to Practice hearing. REFERENCES British Society for the Study of Prosthetic Dentistry 2005 Guides to Standards in Prosthetic Dentistry - Complete and Partial Dentures (online) available at https://www. bsspd.org/About/BSSPD+guidelines.aspx (accessed 29 March 2021) Department of Health 2013, Decontamination, Health Technical Memorandum 01-05: Decontamination in primary care dental practices Nayebzadeh A, Dufresne A. 1999 Evaluation of exposure to methyl methacrylate among dental laboratory technicians. Am Ind Hyg Assoc J. Sep-Oct;60(5):625-8 Obrien WJ, 1997, Dental Materials and their Selection, Quintessence, Illinois Seppäläinen AM, Rajaniemi R. 1984, Local neurotoxicity of methyl methacrylate among dental technicians. Am J Ind Med.;5(6):471-7.

MATERIALS Kemdent Ltd, Anutex HS (online) available at http://www.kemdent.co.uk/anutex-hs-67 (accessed 29 March 2021) BPB Formula, 2000, Dentstone KD (online) available at https://www.saintgobainformula. com/product/dentstone-kd (accessed 29 March 2021) Metrodent PCS plaster coating solution (online) available at https://www.metrodent. com/product/pcs-plaster-coating-solution (accessed 29 March 2021) Metrodent Metrocryl (online) available at https://www.metrodent.com/product/ metrocryl-clear/ (accessed 29 March 2021)

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BUSINESS

LIFESTYLE BUSINESS OR GROWTH MINDED BUSINESS? By Matt Everatt FOTA - Editor and Senior Partner S4S (UK) Ltd

BUSINESS

any Dental Technicians and Dental Labs have classically started out as a small, one person set up in a garage or outbuilding, some have survived their whole career running these 'Lifestyle Businesses' or 'Mom and Pop Shops' as our American cousins refer to them as. Can you truly run a 'Lifestyle Business' in this very fragmented and often, very competitive arena of Dental Technology? By definition, a Lifestyle Business is focused on earning enough money to fund a reasonable living for the proprietor/owner. Whereas, a Growth Minded Business will focus on developing a business with profits for shareholders being a primary concern and the ultimate aim of exiting the business at a point in the future, hopefully selling at a reasonable value.

WHICH IS THE BEST, A LIFESTYLE OR GROWTH BUSINESS?

Well, this is a decision for you to make and one that is best to make from the outset. Whilst a Lifestyle Business may appear less risky and more attractive from the outset, try taking annual leave when your customers still want your services. Or, as we found out this year, try getting some of the benefits dished out by the government when you're a sole trader. No sick leave entitlement, you make your own pension contributions and you have to ride out the busy and quiet periods on your own. It's not all doom and gloom though. You are your own boss, to a degree, makers of your own destiny, as long as dentists keep sending the work in, you charge a reasonable rate for your work and keep your overheads down, you can make a comfortable living. You have no shareholders to please with dividends and the money you make is yours to do with as you please, once you’ve paid the tax man of course.

THE ROUGH WITH THE SMOOTH

You can find you are more sensitive to pricing with a Lifestyle Business. You will tend to have fewer customers and as long as they keep sending the work, life is good. The moment you have a big customer call to say they are trying another lab because they can do it cheaper, you have to make a decision. Be willing to hold your nerve and stand by your prices, or take the hit. Inevitably leading to working harder for less money. If you're lucky, your customers may be extremely loyal throughout your tenure and accept that you close for a couple of weeks during Christmas and summer and they are OK if you have to return cases late because you had an unexpected illness. Those clients are gold dust, I still have a few of those who have followed me wherever I have worked and have become close friends, more so than customers. They accepted my 'higher than most labs pricing, in return for a quality and personal touch they liked and wanted.

A Lifestyle Business is definitely OK and some of us may spend the last few years of our career out by servicing the needs of a few key customers to top up our pensions or make a bit of pin money. Or it may just suit your personality and family situation, these are great reasons to own a Lifestyle Business. Dental Technicians or Small labs with 1 or 2 owners are plentiful in the UK. They seem to work well for many reasons, the ease of startup and low cost of market entry. Equally, the relationship between technician and dentists can be quite a personal one and lends itself to small Lifestyle Businesses. The personal touch is often something that larger labs have to work harder at maintaining as they grow.

WHAT ARE THE PROS AND CONS OF CREATING A 'GROWTH BUSINESS'?

I should start by defining what I mean by a 'Growth Business'. Essentially, I mean a business that is scalable, different to a Lifestyle business in many ways. Firstly, the structure of the business would tend to look different, although you may not start out as a Limited company, it is very likely that once you begin scaling up, you would register the business as a Limited company. You may have shareholders or fellow directors. Your business will have a mission or vision statement of where you aim to be and what sort of business you hope to run. If you are looking to start a business with growth in mind, you certainly need to think about your exit strategy. Yes, it seems odd that you begin thinking about exiting the business before you've even started, however this is a genuine consideration. You don't want to spend years of your working life building value into a business if you just let it dwindle away when you retire or feel like winding down. A carefully planned exit strategy will ensure you get the most value out of the business when that time comes. Exiting a business does not mean you will necessarily sell up 'lock, stock and barrel'. You may retain some shares and become a silent partner, there are many options, we can discuss more on exit strategies in future articles. Safe to say, it is an important consideration, I have seen so many Dental Labs close their doors when the owner retires. It is simply a lifetime of goodwill gone in the blink of an eye. Growing your business will require a good team of likeminded individuals who share the same vision. A mistake many of us lab owners make is, we think we need duplicates of ourselves. I thought this for many years, ‘If only I could replicate myself’. I soon learned that, if my business had two of me, we would probably have been bankrupt in the early stages and would have bought every gadget under the sun that would be sat gathering dust under a lab bench somewhere.

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Having a management team of varying skills and knowledge is key. Ashley Byrne covered lots on Leadership and Management in previous articles last year. If I could recommend a book to read, it would be Simon Sinek’s ‘Start With Why’. The author discusses leadership and organisations, he suggests that when we are running our organisations we should first look at WHY we exist, what is your purpose/cause/ belief? We all know WHAT we do, we run dental labs and make dental devices in varying guises. Some will know HOW we do it, but very few owners/leaders know WHY we do what we do and this is a great start to pulling together your Vision and Mission Statements for your growing business. The real benefits I see with a Growth Business is longevity and future planning. There is one thing for sure, both business types will no doubt require a lot of leg work from you in the early stages, getting new customers, organising marketing, doing the work and so on. With a Growth Business you will start to build a team of managers that can share the burdens and tasks. They can help with new ideas, be a sounding board too, and very important, you will be able to take annual leave without the constant worry of a client calling needing an urgent case doing or sorting out a disgruntled dentist who is struggling to fit one of your crowns.

FURTHER DOWN THE LINE

We are all humans and made of the same stuff, we get older, lots of us have families and life changes many times throughout our working lives. If you create a business that is not reliant upon one individual, you, it is likely that it will be more valuable should you wish to exit or want to invite colleagues to invest in the business. If you are a small 1 or 2 person lab and one of you gets sick, you are going struggle and god forbid the worst happens, your family may be left with no income and the lab has a huge hole that may not be easily filled and clients will migrate to other providers and the business dies with you. If you have been growth minded and created a valuable business you will have many more options for your future. You may have a family member that takes over your shareholding, you may have external investors interested in buying your business, you may have managers interested in buying into the business. Or you may just retire and have your management team run your business for you as a silent partner. Whichever path you choose Lifestyle or Growth Business and I understand there are personal reasons why you may choose one path or the other. It is more likely you and your family will benefit from the years you have put into growing the business if you have grown the business with your exit plan in mind and you have grown a management team that can run the place without you in the business.

BAR HEADER 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

0.5HRS VERIFIABLE ECPD 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 n To understand where the

anatomical landmarks lie on the Edentulous Maxillary and Mandibular ridges. n To understand the importance

and principles of selecting an appropriate stock tray for Primary Impression taking. n To gain knowledge of capturing as much detail as possible in the primary impression stage of treatment, so that we can take full advantage of the Denture Bearing areas of the edentulous ridge.

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 the March 2021 DT Edition: Q1: We need to understand what landmark detail we need to capture. Q2: So that appropriate custom tray design can be made. Q3: (1) Rigid and strong, not too thick. (2) The tray must retain it's shape throughout. (3) The handle must allow for appropriate relief of lips during impression procedure. Q4: The procedure involves a large, catheter tip syringe loaded with alginate material. This is used to load the sulcus with alginate material before insertion with the loaded tray. Q5: A stock tray is loaded with impression material and then inserted into the mouth. Q6: On the crest of the residual ridge. Q7: Buccal Shelf and Retromolar pads.

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Question 12

3. Evaluation: Tell us how we are doing with your ECPD Service. All comments welcome.

...................................................................................................................................................... ...................................................................................................................................................... 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. You can submit your answers in the following ways: 1. 2.

Via email: cpd@dentaltechnician.org.uk By post to: THE DENTAL TECHNICIAN, PO BOX 430, LEATHERHEAD KT22 2HT

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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BAR HEADER ECPD

VERIFIABLE ECPD AS YOU NEED IT VIA THE DENTAL TECHNICIAN

VERIFIABLE ECPD FOR THE WHOLE DENTAL TEAM

Payment by cheque to: The Dental Technician Magazine Limited. NatWest Sort Code 516135 A/C No 79790852

Dental Technicians Journey into a Career in Reconstructive Science Catherine Turner BSc MSc MIMPT Q1. What does STP stand for? A - Scientist Training Programme B - Squamous Test Programme C - Separate Training Protocol D - Scientist Test Protocol

Q2. What is the salary amount for an NHS Band 6? A - £20,000 B - £22,000 C - £25,000 D - £30,000

Q3. Reconstructive Science is an evolution of what post graduate corse?

Q5. What registration is needed to apply?

Q9. Intra-oral data can be taken from what?

A - MHRA B - TMA C - DCP D - GDC

A - An impression B - A scan C - A scalpel D - A diagnostic

Q6. Academic blocks were hosted at which university? A - Manchester Metropolitan B - Leeds C - UCL D - Queen Mary

Implant Drilling Guides - The Digital Way by Dr Gulshan Murgai Q7. How long ago did Dr Gulshan Murgai start placing implants?

A - Computer Science B - General Science C - Maxillofacial Prosthetics D - Prosthetics

A - 14 years B - 16 years C - 18 years D - 20 years

Q4. What is the entry requirements for the STP course?

Q8. What analysis is used with restorative-led implant planning?

A - 2.1 or 1st Degree B - A Level C - GSCE D - B-Tech

A - CBCT B - CAD C - CTB D - CBT

SAGEMAX - Zirconia. For dental designers Q10. The NexxZr Tool U is a high performance dental milling tool made of what material? A - Lithium Silicate B - Premium Carbide C - Zirconium D - Polymethyl

Q11. What year was the company founded? A - 2006 B - 2009 C - 2010 D - 2011

Q12. Esthetics in dentistry is the imitation of what? A - Colour B - Shape C - Nature D - Translucency

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 TECHNOLOGY

THE SOLUTION TO A CRACKRESISTANT, DURABLE CLEAR RETAINER

or anyone doing orthodontic treatment, there’s nothing more aggravating than hearing a patient report a cracked clear retainer. It sets in motion a chain of often time-consuming, unpleasant and always costly events. An additional patient visit, lost chair time, possibly another scan, retainer fabrication cost, ultimately a longer treatment time, and too often an unhappy patient. Plus, you know there’s a good chance the new retainer isn’t going to last much longer than the previous one. The first and most important step in the solution to fabricating a durable, crackresistant retainer is material selection. Any retainer you make will never be any better than the plastic material you use to fabricate it, no matter how experienced and talented a lab technician you are. Use an inexpensive commodity plastic engineered for broad use across many applications and chances are you’ll ultimately end up with a retainer that’s prone to cracking and deformation. There are two basic categories of thermoplastic material used today to fabricate retainers. The first and most common is made mostly from commodity resins, mostly polyester, or PETG for short. Most of the retainer plastics from wellknown manufacturers suppliers are all PETG. Relatively inexpensive and easy to work, PETG is commonly used as the base resin for consumer products like plastic Coke and Pepsi bottles. All general and cosmetic dentists know PETG plastics well, since they’re a staple material used for a range of dental appliances like splints and bleaching trays. But PETG doesn’t have the properties essential for a crack-resistant, long-lasting retainer.

Many of the clear aligner companies use only 100% PU material for their aligners. They also use it in their retainer materials. The exceptional performance and durability of those materials has played a key role in the success and lifespan of the aligners. Zendura developed PU further and is a new generation plastic, meaning it’s hardier and more crack and stain resistant, most Zendura users buy 0.76mm thick Zendura A for all of their retainers. Even though it is about 25% thinner than most retainers, a properly made Zendura retainer will last from one to five years. Being able to use a thinner profile retainer material with confidence is a huge plus. The thinner the retainer the more comfortable it is in the patient’s mouth -and most important -- the better the patient compliance. This is particularly important with pediatric patients. Zendura retainers today are widely considered the benchmark in the orthodontic community for clear retainers. So, if you want to fabricate retainers to the caliber of those made by the large aligner companies, really your only material choice is Zendura. It may cost more up front, but if you analyze the final cost of a cracked retainer, the cost of a premium material like Zendura pays for itself many times over in giving you the confidence of knowing the

Hence the reason why most suppliers of PTEG plastics recommend using 1mm (040”) think material for retainers. Anything thinner will be too susceptible to cracking and likely won’t last more than a month or two. The second category of plastic commonly used today for retainers is made from a specialized resin called polyurethane, or PU for short. It’s more expensive and harder to work with than PETG, but it provides the optimum balance of all the key properties essential for a highly crack resistant, durable, long lasting and highly stain resistant plastic.

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retainers you provide to your patients won’t crack and will perform exactly as prescribed for probably years to come. Says Matt Norie, GM of S4S, one of the U.K.’s leading labs, “We have been using Zendura at S4S for a couple of years now. The strength and durability of the material is fantastic. Retainers made from this material last significantly longer than other standard pressure formed retainer materials, in fact, I can't remember having to remake a retainer made of Zendura.” Distributed in the UK and Ireland by OrthoCare, Zendura is broadly used by orthodontists, dentists, and dental and orthodontic labs. OrthoCare also distributes Bay Materials’ highly acclaimed Zendura FLX material, engineered specially for clear aligners. Introduced to the marketplace less than 2 years ago, it has already become the new benchmark in the clear aligner treatment market. For helpful guidance on how to fabricate top-tier retainers, OrthoCare provides its customers with an illustrated guide titled Zendura Thermoforming Tips & Tricks Guide. It also has available on request another illustrated guide titled How to Manually CutTrim-Finish Aligners & Retainers.

Clear Aligner & Retainer Material

The Recognized Solution to Eliminating Cracked Retainers Superior ... þ Crack resistance

þ Stress retention þ Wear resistance þ Clarity þ Safety

The Superman of Retainer Materials

Zendura is exclusive to: Ortho-Care (UK) Ltd. 1 Riverside Estate, Saltaire. West Yorkshire BD17 7DR Email: info@orthocare.co.uk Telephone: +44 1274 533233 www.orthocare.co.uk Facebook: www.facebook.com/OrthoCareUKLtd

DIGITAL TECHNOLOGY

IMPLANT DRILLING GUIDES – THE DIGITAL WAY By Dr Gulshan Murgai BDS Dip Imp Dent RCS Ed. I Managing Director – ISD. I Lab Owner – 4D Ceramix I Clinical Director – Skin & Smiles With patients become savvier about implants, people will not accept mediocre results. They want implant teeth to look like real teeth and so they should. So, we bring to the stage, restorative-led implant planning with CBCT analysis. With this kind of planning and collaboration with a lab, surgeons can know whether they can deliver a particular type of implant restoration based on accurate CT analysis before they lift the scalpel. This can then be used to confirm or amend a treatment plan which can then allow the patient to have a good idea about the complexity and outcome of the case. For technicians it means that they should be getting cases that are less stressful to restore and look great.

mplant dentistry is big business these days both for the dental practices that offer it and also the labs that support them.

Using CT scans to plan implants is not new and there are several packages on the market. One of the newest to the market, and now in its second-generation version, is exoplan from exocad.

Since I started placing implant 18 years ago a lot has changed on both the surgical and restorative side but more importantly the planning element aspects as well. Back in the day we used to take impressions and ask a lab to create a diagnostic wax-up and then some kind of stent from that. If we were meticulous, the model would be duplicated and then one model would be sectioned through the area of interest. Now, with the reduction in price of CBCT scanners and the increase in popularity of digital dentistry, many surgeons are asking their labs for drilling guides that are much more complex than the one described above. Why is that? Well, at least in the UK, the level of litigation against dentists continues to soar. Many technicians will have seen cases they are asked to restore where it looks like the surgeon had one (or both) eyes closed when the implant was placed. The excuse always tends to be, “… I placed it where I could find some bone…”

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With this product dental surgeons and dental technicians can accurately correlate intra-oral data taken from either an impression that is physical or digital and combine that with CBCT data. Once combined, this package allows for easy and accurate planning of implant placements and then the subsequent design and production of surgical guides for the accurate placement of those implants. Furthermore, the plan can then be used to facilitate immediate loading when used in combination with one of exocad’s CAD programmes. Exoplan is a great addition to a lab that is already using exocad for design as many of the tools used are the same. The design of the surgical guide is amazingly easy, and fabrication is done using a 3D printer which many labs have already invested in. To discuss any aspect of digital dentistry or to arrange a trail of exoplan please get in touch with us at Implant Solutions Direct.

Suppliers of Compatible Implant Components for 26 Implant Systems including:

Agents for:

Suppliers of:

Milling Accessories

Consumables & Equipment

Equipment

DIGITAL DENTISTRY SOLUTION PROVIDER l l

Suppliers of milling machines, 3D printers and scanners

Suppliers of branded, trusted consumables from Vita and others Zirconia, PMMA, titanium, PEEK, CoCr, Alloys discs Vita milling blocks in all sizes and shades

ORDER ONLINE 24/7 @

www.implantsolutionsdirect.com Implant Solutions Direct I 18 Whippendell Road I Watford I WD18 7LU I T: 03333 448540 E: admin@implantsolutionsdirect.com I orders@implantsolutionsdirect.com

Dental Technicians Great Britain and The Dental Technician Magazine are proud to support Den-Tech and Veterans Bite Back and work together to continue raising the profile for the amazing work these charities do. Find out more at den-tech.org

DENTAL TECHNICIANS GREAT BRITAIN FACEBOOK GROUP l Dental Technicians Great Britain Facebook group reaches a new milestone this month hitting 1800 members! That is 100 new members joining since the turn of the new year; the forum is made up of authentic dental technicians across the UK. The Dental Technician Magazine works closely with the group to help raise awareness for dental technicians of all abilities and specialisms whilst also supporting many suppliers and vendors with providing leading product solutions plus much-needed tips and techniques.

Here are some screenshots of posts shared by dental technicians throughout the month...

INTERESTED IN JOINING DENTAL TECHNICIANS GREAT BRITAIN ON FACEBOOK FOR FREE? SCAN THE QR CODE TO FIND THE GROUP AND THEN ANSWER THE THREE SIMPLE QUESTIONS - CERTAINLY WORTH YOUR TIME!

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Workstations & Equipment

for 21st Century Lab Technicians WORKSTATIONS Ergonomic Secure Sustainable Modular, unlimited layout possibilities, wide range of materials and colours to suit your laboratory and style

VACUUM MIXERS MODEL TRIMMER Fast Effective Efficient

TWIST mixers create a perfect, homogeneous mass without bubbles, lumps and agglomerates

SANDBLASTER Safe Durable Precise

Strong Fast Effective

Wet or dry operation. High torque and powerful, yet durable and safe

Precise, even sand flow for perfect surface preparation. Hands-free operation with pneumatic foot switch

Head Office & Showroom Trident Court, 1 Oakcroft Road, Chessington, Surrey KT9 1BD T: 0800 228 9828

E: info@blueprintdental.co.uk

W: blueprintdental.co.uk

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INTERVIEW

AN INTERVIEW WITH...

DARYL TYLER

Recruit4Technicians.com talks to Daryl Tyler from Tyler Crown & Bridge What size team do you have at Tyler Crown & Bridge and what types of staff do you employ? There are 10 of us – 2 ceramists, 3 acrylic technicians, 2 on CADCAM (including the manager) and 2 admin, plus a driver.

When you’ve recruited in the past, how difficult have you found it to ﬁnd good quality candidates? Very diﬃcult - at times almost impossible!

How long does it usually take to ﬁll a role at Tyler Crown & Bridge?

We are at a size that we are comfortable with and do not have a great turnover of staff, so we haven’t need to recruit that often. So it's difficult to be exact, but months usually - I think over the years what we've tended to do is wait for the right person to come along and then reorganise the lab to incorporate them. Rather than having somebody leave and saying "right, we definitely need to replace that person". Although we had someone leave just before lockdown, and would have tried to replace them immediately, but because of the uncertainty we waited. Once lockdown #1 ended, we started looking for a replacement and found someone through a Facebook ad. We would have taken them on full-time, but they only wanted part-time, so we could do with someone else now.

And what methods have you used to ﬁll roles in the past? We've used a recruitment agency once and we've used Facebook. Social media seems to have worked be[er than anything else. In the dim and distant past before social media we used dental magazines

Typically, how long does it take to embed a new team member into his/ her new role?

From two days to two years! We've got one member of staﬀ that came in and within 2 days and it's like she's been here all the time. It depends on the candidate, on their personality, it depends on a lot of factors such as what job you're asking them to do, what expectations they've got of the job and what expectations you've got of them.

What makes somebody a good fit for your team (e.g. personality, technical, behavioural, work ethic)? Personality, work ethic, flexibility and technical skills. Within dental technology there is a tendency for candidates confine themselves to "a role". For example, they will be "a ceramist" or they'll be "a CAD/CAM technician" or they'll be "a metalworker", yet the ones that are most valuable to us are the ones that can actually turn their hand to numerous skill sets. For example, our latest recruit that came to us just before Christmas when we advertised for a Dental Technician had worked for the last 8 years as a ceramist. We said that we don't need a ceramist. She told us that she had done acrylic work before that, so she is now doing that for us. She's not come along and asked to specifically do ceramics, she's just done whatever we wanted. We told her there's digital work as well, she understood our needs went to the computer and said, "I don’t know much CAD/CAM,

Have you tried using recruiting through Indeed.com?

We’ve not used Indeed for recruiting Dental Technicians. We've been in business over 30 years, and I don't think it's ever been easy to ﬁnd employees. Over the years, we've used numerous ways, and I don't think that any 'one' method works any be[er than the others. I think part of the issue is that we're not near a college. When you're in Birmingham, Cardiﬀ, Manchester and London where the colleges are, there tends to be a greater pool of technicians. Where we are based, Gloucester, out in the sticks, that's not the case.

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but teach me and I will do it!" That is what we need, someone who is a dental technician albeit with particular strengths and interests.

In your experience, what do you think are the most common mistakes that candidates make in an interview?

Just being unaware of the fact that ﬂexibility is key in this industry, and not having done any research into what we do, and want we are looking for from a candidate. Also, coming into an interview and thinking that they're the answer to our needs, rather than being open, asking questions and ﬁnding out what the lab needs.

And ﬁnally, what’s the best thing about working for Tyler Crown & Bridge dental laboratory?

It was funny because just as we were reading this question, the lady that does our admin walked in, so I said "Right Karen, what's the best thing about working for Tyler Crown & Bridge?" Her answers were "the boss, convenience" (because she lives just across the road!), "friendly atmosphere, variety of work, flexible hours and but definitely the boss, lol!" I don't know what the best thing about working here is, but I'd like to think that Karen has hit the nail on the head. One of the best things about working here is that no two days are the same. We're designing wonderful things, and figuring out how to do more. It's a very interesting profession, and actually I think in the next few years it's just going to get even more interesting!

HEALTH & WELLBEING

TENSION-TYPE

HEADACHES By John Forde I Physiotherapist at Katie Bell Physiotherapy and Wellness

common problem we as Physiotherapists see when treating Dental Technicians are tension-type headaches. Accordingly, we thought this short article would be a good opportunity to shed some light onto this complaint as it is generally poorly understood, with the aim of helping you manage your tension headaches more effectively and have a better quality of life as a result! Tension-type headaches are the most common headache disorder and usually symptoms include feeling a tight band or pressure around your head and/or neck, with symptoms lasting anywhere from several hours to several days. These headaches range from mild to moderate in intensity and don’t have any of the associated symptoms which are found in migraines. If you suffer from these headaches you will most likely know that they can lead to missed workdays and hugely affect your day to day activities.

Episodic tension headaches are common and are reported by more than 70% of some populations, whilst chronic tension headaches tend to only affect 1-3% of adults. Tension headaches usually begin in the teenage years and you are at highest risk of experiencing them between the ages of 30-39. Sadly, it is largely unclear as to what causes tension headaches. The current hypothesised theory is that these headaches are the result of neurotransmitter (chemical within the body which acts as a messenger between different bodily structures) imbalances. It is likely that there is an association between muscle tightness in the upper back & neck which contributes to this neurotransmitter imbalance but this has not been scientifically proven. The mechanism tends to be a combination of stress related factors associated with musculoskeletal problems in the neck such as muscle tightness/ weakness/stiffness.

Every person who suffers from tension type headaches will have different triggers but the following tend to be common triggers: stress, eye strain, over exertion, hormonal changes, depression, anxiety, sleeping in an awkward position and holding your head in one position for a long time. Do you resonate with any of these triggers? As Dental Technicians, your work is often close up work or you may particularly find you are inadvertently holding your head in an uncomfortable position for prolonged periods. So, we have briefly described the key information regarding tension type headaches, now onto discussing the medical & physiotherapy management. As the specific cause of tension headaches are still largely unknown, it makes managing the condition difficult. However, it has been found that over the counter analgesics such as ibuprofen are more effective than paracetamol. Before starting or changing your medication for tension headaches, speak to your pharmacist / GP to ensure that it is safe to do so. Physiotherapy management for tension headaches will include one or a combination of the following techniques: • Stretching & strengthening exercises for the neck & upper back • Acupuncture / acupressure points • Spinal mobilisation & manipulation • Deep tissue massage & trigger point therapy • Heat & ice packs • Tracking a headache diary to analyse triggers As always, Dental Technician readers are welcome to discuss any issues you may have or for more information how we may be able to help, do get in touch. W: https://katiebellphysio.com E: hello@katiebellphysio.com

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BAR HEADER MARKETPLACE

EXOCAD ANNOUNCES ROLL-OUT OF DENTALCAD 3.0 GALWAY – THE PRODUCTIVITY BOOSTER WITH INSTANT ANATOMIC MORPHING

w DARMSTADT, Germany – March 30, 2021 - exocad GmbH (exocad), an Align Technology, Inc. company, today announced that DentalCAD 3.0 Galway, with new additional improvements to reduce design time is currently being rolled out to end users by exocad distributors. With this new release, initially made available to distributors in December 2020, the company introduced the new Instant Anatomic Morphing, offering automatic adaptation of teeth in real time, with improved speed and precision for the anatomic tooth placement. “We have systematically analyzed, in which steps dental technicians around the world spend the most time on during restorative design," said Tillmann Steinbrecher, exocad CEO. “Based on the extensive analysis, we developed technologies such as the new Instant Anatomic Morphing, which enables users to reduce design time by as much as 2030%, on average*." “Thanks to the advanced process automation, dental technicians will get from the automatic proposal to their individual design goal faster, as the anatomy of teeth is adjusted in real-time with each movement, resulting in a major increase in productivity.”added Steinbrecher.

TOP: exocad’s new software release DentalCAD 3.0 Galway, with 90 new and 80 optimized features, is now available. With this new release, the company introduces the new Instant Anatomic Morphing, offering automatic adaptation of teeth in real time, and thus improving speed and precision for the anatomic tooth placement. (Source: exocad GmbH) BOTTOM LEFT: With the new DentalCAD 3.0 Galway release, exocad introduces AI technology for its Smile Creator. Facial features like the lip line or the eye position are automatically detected to assist the smile design. This helps the user reach aesthetic proposal faster and saves valuable time when designing cases. (Source: exocad GmbH) BOTTOM RIGHT: Improved bridge connector editing for a faster workflow in every situation and three additional cut views can be optionally activated in the bridge connector step, providing the user with a faster workflow. (Source: exocad GmbH)

With the new Galway release, exocad additionally introduced AI technology for its Smile Creator. Facial features are automatically detected to achieve an esthetic proposal faster to save valuable time when designing cases. Another new feature offers printable clip-on mockups of the planned anatomic result. Instead of a purely visual representation of the smile makeover on screen, patients can physically experience their new smile with try-ins, resulting in higher patient engagement and opening up new possibilities in consultation.

• New Instant Anatomic Morphing for reduced design time and increased productivity

Inspired by Google Material Design, DentalCAD 3.0 Galway comes with a new, modern user interface and improved integration with exoplan, exocad's implant planning software. All features of the new release are built to improve ease of use in CAD design and to expand the possibilities of digital dentistry.

• New and modern exocad user interface, offering a user-centric design to make digital interaction as fluid, intuitive and efficient as possible

With this new release, exocad introduces 90 new and 80 optimized features. Key highlights of DentalCAD 3.0 Galway include:

• AI-assisted technology for Smile Creator: facial features are automatically detected for faster smile design • Parametric shape adjustment: all tooth libraries are continuously adjustable from a newer to an older anatomy, seamlessly applying natural abrasion to all selected teeth

• New tools for easy and intuitive controlling of the individual path of insertion • Improved bridge connector editing with split screen view and tools to change several connectors at once, for a faster workflow in every anatomic situation

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• Mockup tooth setups for improved patient communication. Clip-on try-ins, wax-up models, virtually prepared models and virtual tooth extractions are now supported • Model Creator now supports conical stump dies for easier fitting even with lower accuracy printers • Bite Splint Module can now add anatomic shapes directly to the designed bite splints DentalCAD 3.0 Galway is available immediately worldwide and can be accessed by all users with a valid upgrade contract. exocad names its releases after current “European Capitals of Culture” and selected the Irish city of Galway for this release. ADDITIONAL INFORMATION IS AVAILABLE AT exocad.com/dentalcad-galway *User test performed in February 2020. Data on file.

MARKETPLACE

ZIRGLOSS – ACHIEVE A HIGH GLOSS IN SECONDS

HIGH-PERFORMANCE POLISHING COMPOUND PERFECTS THE SURFACES OF MONOLITHIC ZIRCONIA AND LITHIUM DISILICATE RESTORATIONS w Only perfectly polished zirconia surfaces minimise plaque formation and protect the natural antagonists. A perfect polish is crucial to the sustainable aesthetics, durable and precise function, and high wearing comfort of metal-free monolithic restorations. ZirGloss, the new high-performance polishing compound by Shofu Dental, is designed specifically for professionally polishing monolithic, all-ceramic zirconia and lithium disilicate restorations to a high gloss in just a few seconds.

ZirGloss high-performance polishing compound

Ratingen – Hardness is not the reason why high-strength zirconia restorations may damage antagonist teeth: It is the rough surface of inadequately polished zirconia that abrades natural antagonists to a greater extent than enamel . This makes flawless final surface polishing so important – not only to technicians, but also to clinicians, e.g. after performing occlusal adjustments. THE NAME SAYS IT ALL

ZirGloss allows you to polish zirconia surfaces to a high gloss in a minimum of time. The compound is based on diamond and alumina particles of well-matched grits, which are embedded in a carrier paste and optimise the removal rate and the gloss level. The carrier paste keeps the abrasive mineral particles in the layer that is in contact with the ceramic surface and controllably releases them, depending on the contact pressure applied to a goat or bison hair brush and the temperature development when polishing with a handpiece. You can accurately polish even the finest details of the occlusal anatomy. The result is a dense, high-gloss surface with all contours, virtually eliminating the need for final firing.

ZirGloss is very economical to use. Thanks to its firm consistency, the compound does not splatter when loading the brush. CREATE A PERFECT SURFACE IN THREE STEPS

Ingo Scholten, the responsible product and project manager at Shofu, sees the use of ZirGloss as an integral part of a systematic three-step polishing process: “ZirGloss gives restorations the final touch after contouring with the proven Dura-Green DIA diamond abrasives and prepolishing with the ZiLMaster Coarse silicone polishers. This trio reduces the steps needed to create a perfect surface from four to three. Systematically increasing fineness step by step from coarse to fine, the

three components quickly create surfaces that are micro-fine and perfectly sealed – as if they were glazed. Nothing has ever saved you so much time.” ZirGloss Polishing Compound comes in 20-g jars and is now available from dental distributors. Please view or download the product brochure https://www.shofu.de/en/ produkt/zirgloss-uk/ FOR FURTHER INFORMATION, PLEASE CONTACT THE SHOFU OFFICE: E: sales@shofu.co.uk T:01732 783580 SHOFU UK: https://www.shofu.de/en/

PROTECT THE FUTURE OF YOUR BUSINESS DENTAL TECHNOLOGY SHOWCASE (DTS) 2022 w It’s been a difficult year for UK dental labs, with various challenges needing to be overcome with, innovation, grit and determination. To position your business for a stable future and long-term success, don’t miss the Dental Technology Showcase (DTS) 2022.

The trade show will also be a useful arena in which to source innovative technologies and network with product experts to further protect the future of your business. All this and more will be available at DTS 2022 next May, we look forward to seeing you there!

Among the exceptional educational programme will be various lectures, workshops and interactive sessions designed to help lab owners optimise the operation of their laboratories for the new-world dentistry of today. Individuals will share their own experiences and offer advice and guidance on what works and doesn’t work for different businesses.

The next DTS will be held on Friday 13th and Saturday 14th May 2022, Birmingham NEC, co-located with the British Dental Conference and Dentistry Show. For the latest information, please visit: www.the-dts.co.uk, call 020 7348 5270 or email dts@closerstillmedia.com

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BAR HEADER MARKETPLACE

ZIRCONIA FROM THE DOLOMITES – PRETTAU® LINE, MANUFACTURED WITH PRIDE

FROM ZIRKONZAHN’S CLASSIC PRETTAU® TO GRADUAL-TRIPLEX-TECHNOLOGY, FOR EVERY CASE THE RIGHT ZIRCONIA w As unique as the Dolomites mountains (South Tyrol), is zirconia the dental material of choice. Inspired by the base properties of zirconia, MDT Enrico Steger founded his Zirkonzahn company in 2003 with the aim of getting the best out of this dental material. In the heart of South Tyrol, Zirkonzahn’s team of dental technicians constantly works to imbue zirconia with unique properties, to infuse it with luminosity and extraordinary attributes. The result is a special material: Prettau® zirconia. All Prettau® materials are conceived, produced and tested under one roof without compromise. This is the only way to ensure the best quality to the clients you value. Prettau® Bridges (monolithic, 14-unit Prettau® zirconia bridges) have been used for more than 10 years to provide patients with aesthetic and long-lasting restorations. Starting from Prettau® zirconia, Zirkonzahn’s classic dental material, the Prettau® range has been expanded over the years with new materials, to meet your and your clients’ requests even better. Prettau® 4 Anterior®, with its extremely high translucency, is particularly indicated for max. 3-unit bridges in the anterior region and is the ideal alternative to lithium disilicate. Prettau® 2 combines high flexural strength values with excellent translucency, thus becoming the optimal solution for particularly aesthetic full-arch bridges (both monolithic and reduced). With the Dispersive® variants, the path of monolithic design has been brought to a step forward: indeed, Dispersive® materials are characterised already during the manufacturing process by a natural colour gradient thanks to a special technique that does not blend colours into

layers but disperses them evenly. In this way, ceramic layering and manual colouring are not necessary anymore but can be performed upon desire for more patient-appropriate restorations. The latest innovation within Zirkonzahn’s range of zirconia materials is Prettau® 3 Dispersive®. This new material is produced with Gradual-Triplex-Technology, a triple gradient of natual colour, flexural strength and translucency. Thanks to this special feature, the material is particularly suitable for monolithic restorations.

guides composed of monolithic Prettau® zirconia sample teeth have been developed. Zirkonzahn Shade Guides are available for all Prettau® Dispersive® materials, in the shape of a premolar as well as upper and lower incisor (also with minimal cutback for individual characterisation). For the dental practice, Zirkonzahn Shade Guide Prettau® Line has been conceived, for an easier determination of the tooth colour on the patients.

For final restorations reflecting 100% the patient’s natural tooth colour, specific shade

FOR MORE INFORMATION VISIT www.zirkonzahn.com

LEARN, LAUGH AND GROW

DENTAL TECHNOLOGY SHOWCASE (DTS) 2022 w We are all just about ready to start getting back to some normality and to have a laugh again with friends and colleagues. The next Dental Technology Showcase (DTS) – to be held in May 2022 – will provide the perfect platform from which to do all this and more. The two-day, lab-dedicated programme will offer lectures, workshops and interactive sessions designed to engage all members of the lab community. There will be world-leading experts in a range of fields sharing their

expertise and guidance, as well as the chance to gain verifiable and core CPD. The trade floor will also host a variety of dental product manufacturers, developers and training providers, with live demonstrations, bespoke advice and networking available throughout. For your chance to learn, grow professionally and have a laugh with friends in the industry once again, don’t miss DTS 2022.

www.dentaltechnician.org.uk

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The Dental Technician Magazine April 2021

Articles inside

Zirkonzahn/DTS 2022

Shofu/DTS 2022

Exocad

An interview with Daryl Tyler

Implant Drilling Guides. By Dr Gulshan Murgai - Implant Solutions Direct

A month with... By Ellis Bullement

Lifestyle Business or Growth Minded Business? By Matt Everatt FOTA - Editor and Senior Partner S4S (UK) Ltd

DTGB Interview

5 things I cannot work without! By Ross Chapman

Tension-type headaches. By John Forde

Welcome from the editor