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Editor: Matt Everatt F.O.T.A.
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Extend your subscription by recommending a colleague
There is a major change in CPD coming soon. The Dental Technician Magazine is a must read. Tell your colleagues to subscribe and if they do so we will extend your subscription for 3 months.
The only condition is that they have not subscribed to the magazine for more than 12 months. Just ask them to call the Subscriptions Hotline. With four colleagues registered that means your subscription would be extended for a year free of charge.
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From the Editor 6
From the archives 8 5 things I need for my job. By Alan Wright 12-13
The Christmas bonus. What does it mean for tax? 10
Zirkonzahn: New implant prosthetics components available for more than 140 implant systems 14 D esktop Printing. By Leonora Ward 16-17 3Shape Dental System 2022 – What’s new! 22
The patient’s need: Economic aesthetics and functionality. By Daniel Lavrin, Dental Technician and Denturist 2 4-27
Review: BACD 18th Annual Conference - A Technician Masterclass 18-19 BACD thanks trade sponsors for Conference support 20 BACD welcomes new Board and Committee Members 20
Wellbeing - 2 Minute Tips. By author, Matt Everatt FOTA 21
Free Verifiable ECPD & ECPD questions 28-29
The Life of a Dental Technology Student (Part 10 of 10). By Richard T Lishman 30-31 Can you fire a client? By Ashley Byrne 32-33
The plaster room. By Andy Sanson 3 4-35 Marketplace
Zirkonzahn 36 Medentika®/Createch Medical 37 Kemdent 38
Classifieds 39
www.dentaltechnician.org.uk
l Welcome to your December and final edition of 2022. I do hope you have all enjoyed the Magazine this year. We have been striving to provide interesting and relevant content and would like to thank all of you who have written articles, provided technical pieces and of course our advertisers for whom we would not be able to produce the magazine each month.
I genuinely cannot believe we are here again, another year end! I do see lots of promising developments and I strongly feel we as Dental Technicians are in demand and the realisation of dentists having to pay a sensible amount for custom made appliances is becoming a reality.
I have been outspoken about the negative effects of labs providing an ‘NHS Service’ when indeed the NHS do not hold any type of contract with labs and it was clear when we all went into lockdown, the NHS were not going to offer any support to those laboratories that had supported NHS Dental Practices for many years. With the mass exodus of Dental Practices leaving the NHS contracts behind and providing only a ‘Private Service’ for their patients, I would suggest there has never been a better time to look at your pricing and start charging properly for your skill and expertise.
There has been lots of talk recently about prices of certain items made by labs and it appears many of us are charging very little for certain devices such as partial dentures provided to the NHS. It was suggested we could try to publish some recommended minimum prices for lab cases. I do feel this would be a great move forward for us a profession. For many years, we have kept our prices and fees close to our chests and many of us have been unwilling to speak out about prices.
The Dental Technician Magazine is the original magazine for our profession, dating back to the 1940’s. We are so proud to have so many great people on our Editorial Board and we are always keen to encourage new writers to join us. Being a writer or being on the editorial board isn’t daunting, it isn’t onerous. It is as much about encouraging others to provide content as it is providing something written yourself. You may have a new material or technique that you would like to share with fellow techs, or you might have had a rep from a company who you can encourage to write about a new material or piece of equipment.
If you think you can help or would like to be considered for a spot on the Editorial Board, please drop me an email to editor@dentaltechnician.org.uk
It goes without saying really, I want to take the opportunity to thank all of you for continuing reading our magazine and from all of us at The Dental Technician Magazine, we wish you all a very merry Christmas and a truly wonderful and prosperous New Year. See you all in 2023
lI was scouring our DT Magazine archives in hope to find a story that would be amusing or interesting to today’s readers. Whilst searching I came across this article by an unknown author.
THE PARABLE of the MONKEY and the GOURD resonated with me. So the parable goes; When the hungry primate discovers the rice filled gourd he squeezes his hand down through the slender neck of the gourd and grads a hand full of rice. He closes his hand into a fist to hold the rice, but when he tries to pull his hand out of the gourd he cannot because it is now too big. Unwilling to let go of his treat, the monkey is trapped!
Sound familiar? Dentist offering lots of cases, big business, guaranteed work, steady income. But…… its NHS work, so it must be cheap…..you’re now trapped…..you’re an NHS Lab (although there is no such thing!) I’ve read so many social media posts recently about the NHS and Dentists striving to drive down prices of work for an NHS service that cares very little for those labs providing cheap cases. Fortunately, times seem to be changing and lots of Labs are waking up to this and in general prices are being set at a more realistic rate.
Enjoy the read. I am intrigued as to who the original author is.
It is at this time of year as an employee we may be dreaming of receiving a Christmas Bonus or Gift from our employers.
If you’re a Lab Owner, you may want to think about the most tax efficient way to give your team members a gift or bonus. Unfortunately, giving and receiving gifts as an employer/ employee isn’t quite straight forward and may have tax implications associated with it.
[SOURCE – HMRC WEBSITE]
lAs an employer providing Christmas bonuses to your employees, you have certain tax, National Insurance and reporting obligations.
This depends on:
• whether you give cash bonuses or goods (gifts) to an employee
• if you give goods to an employee, whether or not they can be resold for cash
What to report and pay
You may have to report any Christmas bonuses to HM Revenue and Customs (HMRC), and deduct and pay tax and National Insurance on them.
Cash bonus
Any cash you give to employees as a Christmas bonus counts as earnings, so you’ll need to:
• add the value to your employee’s other earnings
• deduct and pay Pay As You Earn (PAYE) tax and Class 1 National Insurance through payroll
If you give goods as Christmas gifts, and they can’t be counted as trivial benefits, you must:
• report on form P11D
• pay Class 1A National Insurance on the value of the benefit
You don’t need to pay tax on all benefits
You don’t have to pay tax on a benefit for your employee if all of the following apply:
• it cost you £50 or less to provide
• it isn’t cash or a cash voucher
• it isn’t a reward for their work or performance
• it isn’t in the terms of their contract
This is known as a ‘trivial benefit’. You don’t need to pay tax or National Insurance or let HM Revenue and Customs (HMRC) know. You have to pay tax on any benefits that don’t meet ALL these criteria.
Having spent 22 years in the military, I fall back heavily on my training and lessons learnt whilst in that environment. In particular, I would highlight the importance of the following skills and experience which I use on a daily basis:
l Communication
l Man management
l Adaptability
l Understanding of the task in hand and means to achieve that goal
l A sense of humour is definitely needed in this job!
l Value of both the individual and the team
l Honesty
For me, service and support team members are invaluable to a company and its products, and I have been fortunate to have worked alongside some great engineers.
Without their interaction with the customer and their product support, we would be left with a ‘sell it and on to the next one’ approach, which I don’t agree with!!
It has always been important to me, and none more so than when given the responsibility of establishing the laboratory division at Blueprint, to incorporate some of the things I learned from my time at Chaperlin and Jacobs, with Lynford Chaperlin. Lynford taught me that a potential customer will already have a good idea of what they want and that it’s up to us to listen and then provide that solution to them, whilst being mindful of the need to offer them support and service after they’ve placed their trust and investment in you and the product.
In addition, the old adage that ‘people buy from people’ has really proved itself over the years.
I am proud of where Blueprint Dental stands now in the dental trade. We are a company that has a great product portfolio and relationships with some of the biggest names in the business, but we never forget the responsibility we have to our customers, be it a single person lab or some of the large groups and businesses we have been involved with helping them become established.
3. The Dental Technicians and Labs Customers! Without doubt the most important part of my job every single day and the thing I value most is the trust and time that people give me to be able to discuss solutions on how we can work together and move their business forward. Both are invaluable to me and very much appreciated.
I count myself fortunate at Blueprint Dental and the other supply companies I have worked with including:
l Bracon l Chaperlin and Jacobs
l Skillbond
And now Blueprint Dental Ltd. www.blueprintdental.co.uk
Having been a Dental Technician in the Military, mainly in Maxillofacial and Prosthetics, I am able to listen to my fellow technicians, speak their language and understand their requirements.
I relish the fact that it’s technicians and not dentists that I am involved with. Those reasons are best explained over a few drinks, but I salute my fellow colleagues at Blueprint who are the specialists in those disciplines!
The lab trade has recently evolved rapidly into the digital world. This has brought added pressure as to what suits your needs as a dental technician, together with the ever-present pressure of cost and how to balance passing that onto your fellow professionals at dental surgeries.
For me in my job role, I have found that lockdown has changed the way I work. Gone are the days of sitting in a car on a motorway trying to see as many busy labs as possible in a chosen area, of hastily bombarding lab owners, who kindly allotted me time in their busy day, with offers and product information and the advantages over what they are already using.
Now I find lab owners generally know what works for them and if it’s doing the job, unless they are let down by the product or its supply, they tend to stick to the adage “If it’s not broke…”
Our main focus, as the lab division of Blueprint Dental, is equipment and the sundries which support that equipment, so I find myself heavily involved with online meetings every day with labs that are looking for solutions to add to their business or to take them further in the growth of their business.
Also having been the person who set up the Dental Technicians Great Britain Facebook group, initially just as a means to get technicians talking to each other, it fills me with a great sense of pride that there are now over 2000 members! Technicians can now jump online, create a post and receive multiple solutions from the amazing membership to help them with the question in hand, and not forgetting some great banter along the way too!
The DTGB Facebook group and Dental Technician Magazine also raise a great deal of money for Den-Tech (Andrea Johnson) and the Veteran’s Bite Back which I also set up. So, thank you to everyone who donates equipment or buys some of the Den-Tech merchandise, I can’t thank you enough.
All this illustrates that definitely having an online media presence and means to reach out to each other via multiple routes of communication is invaluable nowadays.
Just to be able to message a customer or friend to see how they are getting on with their new piece of investment into their business or simply to see how they are doing is priceless.
The instant ability to reach people via Facebook, WhatsApp, Instagram or even TikTok is great and it’s just a button away.
We all know what the last few years have been like for everybody and we have all been touched by issues during this time, and I count myself as very lucky to have an amazing family and friends behind me.
I have met some brilliantly talented individuals in this job and never cease to be amazed at the level of skill British Dental
Technicians bring to their job for the betterment of the patient. I count myself privileged to be in a position to sometimes be involved with bringing that technology to that technician to aid the customer.
In summary, I think there are exciting times ahead for our industry. Having been involved with a number of teaching centres with their digital development, it’s great to see that they are giving today’s students - tomorrow’s technicians and future business owners - the cutting edge knowledge to be successful.
Especially when manufacturing implant restorations it is important to optimally adjust components to one another.
Zirkonzahn’s line of implant prosthetic components, which includes Scanmarkers, White Scanmarkers, White Metal Scanmarkers, ScanAnalogs (laboratory analogues used as scanmarkers), impression copings, laboratory analogues, Multi Unit Abutments, Raw-Abutments® and healing caps has recently been expanded with new products:
l Zirkonzahn LOC-Connector, a snap attachment system for implants and bars to fix removable dental prostheses on the implant;
l Multi Unit Abutments 17°, characterised by a 17° angle to compensate for any implant inclinations and with two different anti-rotation connection types which allow intermediate positions;
l Titanium Bases K85, with the chimney height adjustable to the individual tooth length;
l Titanium Bases K80 Angled Screw Channel, with a chimney height adjustable to the tooth length and the possibility to tilt the screw access channel from 0° to 30°;
l White Metal Scanmarkers, reusable scanbodies to acquire the implant position
and orientation during intraoral and model scans.
All Zirkonzahn components are available for more than 140 implant systems and are fully integrated in Zirkonzahn.Software. Zirkonzahn grants up to a 30-year warranty on all implant abutments used, including implants from other manufacturers used with Zirkonzahn implant abutments. With Zirkonzahn Library Download Center also 3shape and exocad® users can implement the libraries into their design software.
Visit www.zirkonzahn.com and check if the wide range of components is compatible with your implant system!
Before simply buying a 3D printer for your lab, you need to look beyond the upfront acquisition cost. It’s important to carefully weigh the options and find the best possible machine for your needs.
3D printers for dentistry generally fall into one of two major categories. On the one hand we have the industrialgrade, high-throughput machines that feature huge capacity and pinpoint accuracy. While these machines are often a good choice for larger dental labs that create hundreds of appliances per day, their high upfront cost, large size, and maintenance requirements mean that they’re often an impractical solution for individual, smaller labs.
Desktop 3D printers, on the other hand, feature excellent quality at a significantly reduced price and are a much more
manageable size. Desktop 3D printers are just as versatile as their larger counterparts but tend to feature smaller build platforms and lower overall throughput.
With the decrease in price, size, and maintenance offered by high-resolution desktop 3D printers, that technology is now within reach for many smaller labs. They’re an incredible tool to help speed up delivery times, increase efficiencies, and impress your dentists. But if you’re new to the tech, where do you even start? In the following sections, we work through some of the most commonly asked questions relating to 3D printing in dentistry.
Over the last decade, the widespread proliferation of dental 3D scanners, CAD/CAM treatment planning software, and dental mills have contributed to an improved patient experience in dentistry.
If you already have an intraoral scanner and planning software in place, a 3D printer is the missing part of the jigsaw – the final step in the process which will bring everything together and enable you to maximise your other digital investments.
3D printers can provide highly customised manufacturing for single-unit or small-batch parts at a significantly lower cost than traditional methods, with much less labour and greater reliability and repeatability. Because they’re capable of printing disparate objects without the need for retooling, they’re ideal for the type of production required in dentistry.
Fabricating multiple copies of slightly different parts (such as models for clear aligners) or a single copy of a single part (such as a surgical guide) is a very expensive, labour-intensive process in the world of traditional dental manufacturing.
3D printing technology is moving at an incredible pace, so if it is something you have just started looking into, you’ll be forgiven for thinking it’s a bit of a minefield!
Pouring-up models in stone creates a lot of waste and can be very time-consuming. 3D printing has the potential to make this process much faster and less expensive.
3D-printed dental appliances cut across a wide selection of therapies and disciplines, including orthodontic treatments such as models for making clear aligners, retainers, and indirect bonding trays. General dentistry can benefit from many of these same treatments with the addition of biocompatible full-arch surgical guides, splints and nightguards, digital dentures, cast, retainers, removable die models, and temporary crowns. This list will grow as the technology and material capabilities develop. With such a wide variety of uses from a single tool, it’s clear to see how 3D printing can provide a huge benefit to dental laboratories.
The adoption of 3D printers by the dental industry has been driven by innovation in three areas:
The development of biocompatible printing materials is at the heart of dental 3D printer adoption. While the production of dental models is crucial for many labs, the ability to create intraoral dental appliances such as nightguards, surgical guides, and digital dentures, vastly increases the usefulness and functionality of the machines.
Since the introduction of biocompatible materials for 3D printing in dentistry, there has been an emphasis on improving mechanical properties in order to provide printed intraoral parts that have enough strength and resistance for patient use. Because new and better materials could come from a variety of suppliers, it’s important to choose a 3D printer that supports third-party materials.
With many companies scrambling to add certified dental resin capabilities to their 3D printer line-up, it’s clear to see that 3D printing in dentistry is only set to increase in popularity. A cursory look at the most popular printers will give the impression that any of their machines will dramatically improve your dental workflow. But if they cannot print final dental appliances with certified biocompatible resin, their usefulness in dentistry will be limited.
The primary requirements of dental manufacturing are high accuracy and repeatable results. It isn’t enough for a single print to provide good results; they need to be consistent and repeatable over time and across various environments.
Accuracy and repeatability are essential qualities for a dental 3D printer. Recent advancements in materials and printing technology have supercharged the accuracy of 3D printers, propelling them beyond what was originally thought possible.
To keep pace with a busy lab, a good dental 3D printer should offer rapid print speeds and high overall production throughput. To this end, build plate size and light delivery technology are features that should not be overlooked. Although your lab may not need high throughput immediately, production needs can scale up rapidly. A printer that seems adequate before you start may become a bottleneck when requirements increase.
While dental 3D printers are sometimes used to manufacture only one or two parts at a time, many cases require the rapid fabrication of a large number of parts. Clear aligner cases are the obvious example of this, but batched nightguards, surgical guides, and denture bases all require large print volume as well.
There are still big differences in production speed and scalability between individual printers, and the discrepancies are largely due to the technology.
Digital dentistry is primarily served by a type of 3D printer that falls under the umbrella term stereolithography. There are three ways to deliver light to cure photosensitive, liquid resin - each with its own advantages and drawbacks.
The post processing of resin models and appliances can sometimes be overlooked. It’s important to understand the process and whether it’s compatible with the resins you want to use.
When working with resin, a wash and cure station drastically simplifies postprocessing. Since you’ll need to wash, dry then harden resin 3D prints, a wash and cure station is a must-have.
Many manufacturers will have their own units that work with their printers, offering features like pre programmable materials and timings to ensure resin materials are processed correctly.
3D printing for dentistry is developing at a rapid pace, and there’s no doubt that it will continue to make amazing advances in performance and reliability in the coming years.
Understandably, this can give rise to concerns about machines quickly becoming outdated. After all, when you’re making a significant investment in new kit, you want it to stand the test of time.
However, if you carefully consider your choice and select a printer that allows for 3rd party resins, and has a robust software and hardware ecosystem, you’ll quickly see the benefits as it will dramatically improve speed, quality, customisability, and costs. If you want to future-proof your lab and invest in 3D printing, there’s never been a better time than right now.
The BACD Annual Conference – On The Shoulders Of Giants –delivered an exceptional educational programme for everyone with a passion for ethical cosmetic dentistry. More than this, it was a chance for the profession to come together, collaborate, engage with the trade and make the most of the community and family that the BACD is so well-known for.
For dental technicians, an entire day was dedicated to you, with a comprehensive session presented by Mr Peter Pizzi. Entitled “Understanding the Synergy Between Face, White and Pink”, the day’s lecture was more of an interactive discussion, with delegates encouraged to engage with the speaker throughout, to ask questions, challenge comments and share their own experiences.
Covering a huge range of topics within the given time, Peter looked at various ways in which technicians can impact the aesthetic and functional outcome of restorations. The relationship with the dentist, as well as communication of diagnostic and planning information, will influence the results significantly. So too will the technician’s understanding of the materials they are using – this is essential if individuals are to optimise properties and deliver the very best solutions. Interestingly, Peter did not believe that the specific brand was wholly important. With around 400 ceramic products on the market and only approximately seven manufacturing facilities worldwide, he was of the belief that many offered very similar benefits in experienced hands.
A thought-provoking discussion took place regarding shade guides and how the technician can or should be matching
their products to the dentists’ prescription. Peter shared his own unique approach to shading, including the shades he uses to layer restorations and achieve fluorescence that very cleverly mimics the natural dentition. The core message was that the technician is responsible for manipulating how light is absorbed and reflected in a restoration – this is how aesthetics are optimised and made to look as natural as possible.
Peter also talked about photography, describing it as “the most important tool in cosmetic dentistry”. Not only do they support diagnostics and treatment planning, but they also improve communication, self-development, case monitoring, legal documentation and marketing. He showed the typical photo series that he uses, emphasising the importance of a patient keeping their head completely straight during the shoot!
Looking at materials in more detail, Peter considered lithium disilicate and silicate, as well as composites and ceramics. He believes that “hybrid materials are the future for us” as they will provide the best combination of strength and aesthetics. He also went on to discuss implant restorations, highlighting the
technician’s role in helping to prevent excess cement leading to peri-implant disease and implant failure – retrievability of the prosthesis is essential.
We caught up with Peter straight after the session and he said: “It’s an honour to be invited to speak - people wanting to learn is what keeps speakers like me going. And being able to engage in-person again is fabulous. The main benefits of this event are how the BACD treats speakers and the chance it provides to meet friends. I often feel a sense of comradery when I visit the UK and I feel it here. Plus, professionals seem to have a big interest in improving and growing, which is a nice feeling as a teacher.”
Delegates were just as positive about the day. Danny Cleary from DSD Dental Lab Ltd commented: “An amazing lecture by Peter, I learnt so much in such a short amount of time. The BACD have done a great job inviting Peter! I will want to see him again or go on a course of his after today.”
Dafydd Daves from Precision Dental Lab added: “Really good day, very informative. Will definitely do it again - I learnt a lot about ceramic build-ups.”
Aside from the all-day session, technicians also had access to the exhibition, where an array of dental manufacturers and service providers were on hand to provide further information and demonstrations. This was an excellent platform for networking and enjoying some down time with friends across the profession as well. Plus, the BACD Gala Dinner provided a stunning winter wonderland for an evening with excellent food and even better company.
Chris McConnell, now the Immediate Past President of the BACD, commented: “For me, the BACD is a family. I would like to thank the Board, the trade and everyone else who helped make this Conference such a great event. I really appreciate all your support!”
The BACD remains focused on supporting the entire dental team in order to promote ethical cosmetic dentistry across the UK and even further afield.
If the 2022 Annual Conference was anything to go by, you won’t want to miss next year’s event – registration is now live on the website!
Part of what makes the BACD Annual Conference the massive success that it is every year is the support it receives from the trade. Their involvement is integral to bringing world-class speakers to the stage and ensuring up-to-the minute topics for all delegates.
Platinum Sponsor for 2022, Boutique Whitening, commented: “There was excellent organisation for this event, we received great customer engagement at the stand and the socials were enjoyable.”
Gold Sponsor, Wrights, added: “Excellent venue with easy access and superb facilities. We found the delegates to be very engaging and the Gala Dinner was superb!”
DMG, also a Gold Sponsor, said: “A fantastic and well-organised event - as always. The delegates are high quality who are interested in our products and take the time to have genuine interaction throughout the event. We are looking forward to 2023!”
Anyone interested in supporting the BACD 19th Annual Conference in 2023, please contact the BACD for more information!
BACD 19th Annual Conference, New Horizons, London www.bacd.com 9-11th November 2023
l As part of the AGM at the BACD 18th Annual Conference, the Academy was delighted to welcome new individuals to the Executive Board and Committees.
New Board Members:
• Gina Vega
• Sheila Nguyen
New Committee Members:
• Simon Chard – President
• Luke Hutchings – President Elect
• Sam Jethwa – Vice President
Congratulations to all on their new appointments and we look forward to seeing what the BACD can achieve in the year to come. Well done also to newly Accredited members: Thomas Sealey, Dipesh Parmar and Richard Coates!
For now, don’t forget to save the dates or register for your place at the BACD 19th Annual Conference in 2023 – now live on the website! www.bacd.com
l A huge issue I see with Dental Technicians and Laboratory owners is that they do not have a healthy work-life balance. Particularly at this time of year, Dental Techs are often pushed to meet crazy deadlines and high volumes of work, running around not having time to unwind.
If you’re like me, I find it particularly difficult to set myself time to unwind and don’t plan to take days off, particularly when it is really busy. The key to this is to put time aside in your diary. Block out a day, put it in your diary to have a ‘Night of Netflix’ or take a morning off to treat you and your partner/friend to brunch.
Put a Christmas shopping day in the diary, if you begrudgingly rush out to grab a few last minute Christmas present in haste, you’ll be stressed out, it won’t be a nice experience. This is a tip I learnt from my wife, her efficient way of making sure things like this happen, “put it in the diary, then you’ve committed to it!” It really works, although I definitely need to get better at this, I am working on it!
You may be thinking that while you aren't working it means the business isn't being productive, in actual fact, taking time off enables you to clear your head, step back from the coalface, it is a great platform to conjure up new ideas and return to work feeling revived, refreshed and ready to go.
If you never stop and are constantly busy, you never give yourself chance to think of new ideas or to reflect on how things could be improved.
Give yourself the opportunity to have a few hours off every now and then, it will reap dividends for your own wellbeing and your colleagues, business partners, wife, husband, son, daughter, cat or dog will thank you for it too.
Having a healthy Work-Life balance is so important to you and all others around you.
3Shape Dental System 2022 , the newest version of the power-packed CAD software for dental labs has now been available since October. Check out some of the exciting new features and updates in this article!
Virtual preparation gives more control over the restorative design workflow when virtually recommending tooth prep designs to dentists.
Dental System creates a URL link to a lab’srestorative design to make it easier for dentists to review treatment proposals. With the link, dentists can now preview designs from any device - even when not using 3Shape solutions.
Dental System preserves space for screwholes in implant supported dentures and STUD (locator) attachments for overdentures designs to make planning restorative designs more predictable.
Dental System’s superior sculpt tools help you to design digitally the way you always have done conventionally.
It is now so much easier to go from digital back to analog because Dental System adds print material, based on the lab's physical articulator brand, to digital dental models.
Book a FREE demo by scanning the QR code, contact our local team at ukenquiries@3shape.com or find out more at www.3shape.com
By Daniel Lavrin , Dental Technician and Denturist
Listening to what patients want and need is a crucial factor for a successfull rehabilitation. When it comes to dentures, many older patients are looking for an economic solution. On the other hand, what they don’t want, is a denture that lacks functionality and aesthetics. The following user report profiles how to accomplish efficient and economic aesthetics and functionality with an established treatment protocol and denture teeth of choice.
A 72 year-old female patient presented in the office because she could not eat properly with her removable rehabilitations. The partial denture in the lower jaw broke several times and was uncomfortable and unstable. Because of that she stopped wearing it. Despite the age-appropriate bone atrophy, the remaining teeth, 32 and 33, did not show any signs of inflammation. Tooth 32 had a mobility of one. The patient wanted to keep both teeth and refused implants, which would have distributed the forces more evenly. The disadvantages of an uneven load and the accelerating effect on her remaining teeth were explained. In case of necessary extractions in a later stage, an easy denture teeth addition to the new partial denture could be provided, which was satisfactory to the patient. She was currently only using the full denture in the upper, which did not function well, as the occlusal forces were unbalanced. She desired an improvement of aesthetics and eating conditions with new rehabilitations. Her limited budget made an economic solution necessary. Based on these factors, VITA Multi Functional Teeth (VITA MFT) were chosen for the new full denture in the upper and a partial denture in the lower to guarantee aesthetics and functionality for an ideal price-performance ratio. u
After anatomic impressions of the upper and lower jaw, models were fabricated on which individual trays were created for the mucodynamic impression. Master models were manufactured to be able to produce fitting bite registration plates with a wax rim to record the position of the mandible in relation to the maxilla and to transfer the mid-line, the canine position, the incisal length and expansion of the buccal corridor. According to the clinical bite registration, the two master models were articulated and the model analysis was performed.
VITA MFT Anterior was used for the set up in the anterior area. For a budget denture tooth, the anterior sets are very aesthetic. They are designed naturally in morphology and texture. The anatomical structure is simulated with neck, dentine and enamel layers, which leads to a three-dimensional play of light and colour. Tooth axis and coordinated angle characteristics, according to the aesthetic rules, make a quick match of the front teeth possible. Due to the position of the remaining canine and incisor, all lower teeth were used in addition to the natural incisor 32 to provide stability while eating with the new denture. So altogether, there were five lower central incisors established. The set up was performed edge to edge to the remaining natural teeth to improve the aesthetics of the upper smile line.
In the molar region, the lingualized VITA MFT Posterior easily enabled finding the centric position and establishing buccal contacts, due to the multifunctional occlusal surface design. The lingualization of the teeth offered more space for the tongue and a more stable function on the atrophied jaw ridges. Extra care was also taken during the contouring of the lower lingual aspect to implement space and free movement of
the tongue. During the try in, a final bite registration was taken with the set ups in order to recheck static and dynamic occlusion in the articulator.
After a succesfull clinical try in and final anatomical contouring, the rehabilitations
were transferred into polymer. First, the set ups were duplicated with hydrocolloid. Then the teeth were cleaned, conditioned and repositioned in the hydrocolloid index. Before the flasking of the denture base with the autopolymerizing and pourable Castdon Resin, internal colours of the DentureArt System (both Dreve Dentamid, Unna, Germany) were applied into the flask to simulate the
TOP ROW (LEFT): Altogether five lower central incisors were established to offer stability.
(MIDDLE): The palatal anatomy was also reproduced meticulously. (RIGHT): Both wax set ups in the articulator. 2ND ROW (LEFT): The upper and lower rehabilitations after their transfer into polymer. (RIGHT): Gingival anatomy was simulated with internal colors. 3RD ROW (LEFT): The new rehabilitation appeared very natural intraorally. (RIGHT): The lifelike appearance and the functional integration of the rehabilitations.
appearance of the gingival anatomy. After the polymerization, finishing and polishing was performed. The new rehabilitations were inserted intraorally and checked by the practitioner and the patient. Both were very satisfied with the lifelike appearance and functional integration. The patient’s requirements of an economical, aesthetic and functional rehabilitation were all met.
l Daniel firstly qualified as a Dental Technician in Paris (France) and then achieved further post graduate qualifications in denturism with the Ontario College Advanced Diploma for the Denturist (IDEC) Program in Toronto (Canada), he then furthered his education and was awarded his UK Diploma qualification in Clinical Dental Technology via the Royal College of Surgeons of England.
This means that not only Daniel is trained to the highest technical and clinical standards, it also ensures that you will be treated in a safe professional manner.
Daniel specializes in making and fitting Dentures. He is committed to patient care and believes in providing a professional, comfortable and caring service.
By working with you and listening carefully to your needs and expectations he is able to design and deliver a personal and bespoke denture service. Unlike a dentist who sends their dentures away to a technician to be made, Daniel will not only see you as a patient, but will actually make your new dentures for you as well.
Having worked in the industry for over 25 years, Daniel can therefore offer an in depth consultation and range of services to suit all your denture needs and budget. You will be seen by a Clinical Dental Technician that has a wealth of experience, knowledge and technical expertise in the construction of Cosmetic and Natural Dentures.
The questions are designed to help dental professionals keep up to date with best practice
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.
Q1. Listening to what patients want and need is a crucial factor for a successful XXX?
A - Rehabilitation
B - Impression C - Scan D - Implant
Q2. How old is the female patient?
A - 42 B - 52 C - 62 D - 72
Q3. What was the patients issue with her removable rehabilitations?
A - Could not eat properly B - Could not talk properly C - Could not smile properly D - Could not swallow properly
Q4. Which teeth did not show any signs of inflammation?
A - 11 and 13 B - 22 and 23 C - 32 and 33 D - 42 and 43
Q5. Which tooth had the mobility of one?
A - 22 B - 23 C - 32 D - 33
Q6. The patient was only using the full denture in the upper, which did not function well, as the occlusal forces were XXX?
A - Unbalanced
B - Not aligned
C - Too small
D - Too large
Q7. Wha type of impressions were taken of the upper and lower jaw?
A - Mucodynamic B - Incisal C - Natural D - Anatomic
Q8. According to the XXX bite registration, the two master models were articulated and the model analysis was performed?
A - Maxilo B - Clinical C - Anterior D - Anatomical
Q9. The anatomical structure is simulated with neck, dentine and XXX layers?
A - Static B - Resin C - Enamel D - Colour
Q10. Tooth axis and coordinated XXX characteristics, according to the aesthetic rules, make a quick match of the front teeth possible?
A - Axis B - Angle C - Texture D - Occlusion
Q11. How many lower central incisors were established?
A - 5 B - 6 C - 7 D - 8
Q12. The set up was performed edge to edge to the remaining natural teeth to improve the aesthetics of the XXX smile line?
A - Middle B - Complete C - Lower D - Upper
Richard Lishman, award-winning Founder of The IFA’s –a specialist firm of Independent Financial Advisers that provides guidance and advice for some of the wealthiest individuals and businesses in the UK and around the globe – heads this series of editorials for lab technicians.
Previously, our character, Bridget Crown, retired from working. However, as the years advance, it’s important that Bridget has her affairs in order so that her loved ones are well provided for even after she’s gone.
At this point in her life, it’s likely that Bridget has already made a will. It’s generally recommended that a person should make a will after marriage, buying a property or any other significant life step.
However, circumstances change, and there’s every chance that Bridget will want to adjust her will to implement how she wants to divide and gift her legacy. For instance, if she has now become a grandmother she may want to provide for her grandchildren in her will – or perhaps she wants to change it to favour her children instead of her partner –there are plenty of reasons why a will could need adjustment.
To change her will, Bridget will have to make a new one or add a codicil (effectively an amendment). This will mean speaking to her solicitor and making any changes that she wants to ensure her affairs are in order.
Inheritance Tax can be hugely expensive and mean that a lot of Bridget’s hardearned money won’t be given directly to her loved ones. The current nil rate band for Inheritance Tax is £325,000 – meaning that any assets over this worth will be subject to a 40% tax. This rate is in place until 2026, when it is likely to be revised again.
One option is Estate Planning. This service effectively involves a financial adviser looking at Bridget’s assets and calculating the amount of money she will potentially need to maintain her lifestyle (and even cover later life care if necessary) while also advising about gifting money and assets where possible so that they are no longer eligible to be taxed.
Unfortunately, it’s important to remember that any gifts given up to seven years before death may still be subject to tax depending on factors including the value of the gift, the relationship between the gifter and the giftee and when the gift was given. As such, gifting is not a fool-proof way to avoid future tax.
Another avenue Bridget can explore is finding ways to cover the Inheritance Tax bill without the amount being taken from the value of her assets. Pension policies, for example, are generally not included when an Inheritance Tax bill is calculated, so if Bridget can afford to leave her pension untouched while she funds her retirement, this amount could be used to pay off the resulting Inheritance Tax bill on her estate (or, at least, part of it).
Trusts are also an excellent idea for any money that Bridget wants to set aside for a
specific reason. For instance, let’s imagine she wants to ensure that the cost of her granddaughter’s schooling is covered – this way Bridget could gift an amount and only make it accessible for this reason. Life Assurance policies can also be set up as a trust, and this is another smart way to use a policy to cover an Inheritance Tax bill in a lump sum. In this scenario, the Life Assurance policy will be set up to only pay out in the event of Bridget’s death, giving her loved one(s) the capital they need to cover the Inheritance Tax.
If she does proceed with this idea, Bridget will need to ensure that she is not the sole trustee, as otherwise the money will be considered as part of her estate upon her death and therefore be inaccessible until Inheritance Tax has already been paid.
When all is said and done, these final financial considerations will hugely depend on the state of Bridget’s assets during this period and the eventual time of her death. Planning ahead and starting processes early is the best way to safeguard capital as much as possible, however, this could make estimating the money Bridget will need for the remainder of her life more difficult.
By seeking advice from experts such as the award-wining team at the IFA’s, Bridget will be able to make the most of her estate and ensure that Inheritance Tax is minimised. The team looks at everyone’s individual circumstances and offers high quality estate planning that will cover all eventualities.
As we’ve come to the end of our Bridget Crown series it’s important to reflect on how important financial advice is at every stage of life. Financial assistance is not just a valuable guidance – it can truly change your life by giving you a sense of security surrounding your finances that can enhance your everyday life immeasurably.
For more information, please call 0845 345 5060 or 0754 336 8478 or visit www.theifas.com
This article originally featured in Dentistry.co.uk - Dental Lab Expert (21/11/2022) Some client relationships just don’t work.
This month, the Dental Lab Expert, Ashley Byrne, discusses the tricky topic of how and when to fire a client, and the benefits of doing so.
Ihad to think carefully about the title for this months article, for fear of sounding arrogant or egotistical.
Clients, dentists for the most of us, are the only key to our success. They pay our wages, rent, and allow us to make profitable businesses, so in no way is this a dentist bashing article.
I would consider 99% of my clients to be outstanding practices to work with. They work with us and we share mutual success as well as mutual failures. But that is what dentistry should be.
Ultimately, we need to provide outstanding healthcare, but we also need to make a profit, and ideally have a good working relationship in that process.
Can and why you fire a client is a question asked of me on many occasions. The simple answer is yes, you can. The when is when you feel it’s right as a business owner.
As the vast majority of our industry is small labs, clients with large monthly bills can be the bread and butter of running a lab. But equally, those large clients can sometimes also be a thorn in our side.
Many years ago, I had a client that was regularly in my top three and often the largest bill of the month. However, they took up a lot of phone time, we had a lot of remakes, and the practice team were rude.
Also for consideration was that the bills were often between 30-60 days overdue. But on the other side, they did always get paid.
Despite this person being a core part of my business, my team started to really resent doing their work, as well as working with the practice. The relationship was going south and if I didn’t step in, I was going to start losing employees.
The decision was made with the team. We had to fire them as a client
despite what they spent with us. I wrote them a letter stating that we felt we were not good enough as a lab, we could not deliver the level of service they required, and could they please find a new lab to work with. It was painful dropping that into the letter box but it also felt like an incredible weight was lifted off my shoulders.
The client actually apologised but the damage was done and we agreed to part company.
They took a good chunk of my monthly sales with them, but the team were relieved – some elated. Whilst they were happy to be free, I was nervous of the lack of sales. The following month end came and guess what? We were up on sales, and up by quite a lot.
Simply down to the lack of phone calls, remakes and adjustments, our other clients were given more time. We pushed more work through with less stress and more satisfaction. Not one month followed where sales were less.
It was a valuable lesson for me. I should, however hard it was, have acted sooner to cut ties with this client. Despite quality, practice teams, price, and the lab team, it has to be said that sometimes relationships just don’t work.
Focusing your teams energy with practices that align with your principles and values actually helps both parties. And both parties prosper.
One of the key things I learnt from this experience was to regularly evaluate my clients by discussing with the team. Who do we enjoy working with, how much do they spend, do they pay on time, what is their remake rate? All of these are factors.
As a result, we found several clients that seem to take up so much of our time and yet deliver almost no profit. We are in healthcare and that must always come first. But we are also in business. A successfully run business aligned with the same type of business, brings a higher standard of healthcare and patient satisfaction with vastly less stress and pain.
Saving the best to last, this is Andy’s final piece of 2022. Here we take a satirical look at ‘The Plaster Room’, many of us will have a wry smile on our faces as we recognise the images Andy conjures up in this fun, light hearted piece.
By Andy Sanson
Returning to the subject of The Lab and the goings-on therein I hope you will indulge me for a few moments if I go off about the part of it that, even to this day, sits burned on my memory in vivid, living colour. The Plaster Room. What about it? It’s a room where things are done with plaster. It’s mixed up, twenty percent of it used and the rest thrown down the sink, on the floor or in the bin. There’s nothing to be said. It’s not a room, like the Cabinet War Rooms, The Oval Office or the Palace of Justice in Nuremburg, a seat of world shaping events and decisions. It’s not the 007 Stage at Pinewood or the Abbey Road Studios. It’s a room - with a sink, a worktop and a few cupboards full of bags of gypsum and other, incongruous stuff much of which has been there as long as the room itself. What could there be to say about it? How could I keep on about it for, say 1000 words?
The difficulty I have is keeping it below ten thousand.
The Plaster Room measured about twelve feet by five, most of which was taken up by the cupboards and fittings already mentioned. I have seen eight people, including ‘Fred’ who was six foot four and twenty stone, crammed in there at one time trying to conduct their duties in conditions that would have today’s Health and Safety apoplectic in a twinkling.
The room itself was like some sort of hideous anti-Tardis; smaller on the inside than it looked from without. You would be imprisoned therein for lengths of time most effectively measured on a geological scale and, when you emerged, nothing had changed. At the very least you felt you might have earned the privilege of being transported to Mechanus to witness the final battle between the Daleks and the Mechonoids but, no, there you were, still in The Lab in your shackles with the all-pervading stink of pre-HSE monomer drifting midway between floor and ceiling, its ice-cold claws of methacrylate and, probably, plutonium, slithering behind your eyes, and the Junior Partner presenting you with his order for the Chinese.
As for the ‘décor’ - it’s not beyond possibility that, had the existence of the Plaster Room Walls come to the attention of any of the world’s great pharmaceutical companies, it may have become the focus of an aggressive takeover bid from one or more of them. Strange cultures grew on those walls; green, mouldering murals of living matter, seething with the raw materials for chemical experimentation and the production of narcotics and potions both legal and otherwise.
Into this terrifying catacomb was introduced, sometime in the late fifties, the added hazard of ‘that new-fangled electric’. With twelve vulcanisers bubbling away like Merrie Melodies train whistles and the Paco belching superheated steam into the atmosphere with the verve and gusto of Old Faithful and Vesuvius on a weekend razz at Krakatoa’s gaff, the humidity in the place was a bit like that at the bottom of the Marianas Trench. Only worse. Niagaras of water cascaded down from the ceiling into every socket and plug. If any of you have seen the cover of the Captain Beefheart compilation ‘Electricity’ you will have some idea of the conditions you might expect should the desire to venture into the place ever take its icy grip. If you haven’t, type ‘beefheart electricity’ into Google, click on ‘Images’ and you’ll see what I mean.
Such was the organisational brilliance of those concerned that it usually fell where impression casting and boiling out took place at exactly the same time. The choreography was exquisite. I’m sure that the elders of The National Ballet would have been overwhelmed by the glistening expertise
with which plaster, wax, soggy cotton wool, indelible pencil and scalding water danced about one another with nary a touch nor bump, the whole melding into one flowing operation whilst shaking at the seams like that contraption on the front cover of Pink Floyd’s Relics album, ever on the point of explosion yet always holding together as though in the grip of an unseen, mystical force.
Of course, there was a gas supply as well. That was something else to worry about. Much of the time the overlong tubing that connected each of the three rings to the mains was coiled into serpentine convolutions that came dangerously close to the naked flames. This was evidenced by the discolouration and scorch marks along their lengths. Our minds were generally put at ease by Management telling us to get on with our work and stop picking flies. After all, they’d been like it for years so they weren’t going to burn through now. Were they?
And the plumbing - ahh! The Plumbing. How that ever worked is anybody’s guess. The tons of half-set plaster and congealing molten wax that went down the sink somehow managed to make it into the sewers without setting like concrete in the great vascular maze under the floors.
Places like The Plaster Room could never be designed. Not even by a committee. Like a quaint Cotswold village it grew over the years, bit by bit, scar by scar, gouge by gouge until it became what it was. Tolkien must have dreamt about it once for from where else would have sprung the idea of Mordor or the Mines of Moria?
I believe the floor had once been made up of quarry tiles or some such durable material. No longer. Prior to my tenure it had degraded into a ruddy powder of a similar grade to the very plaster for whose use the room existed in the first place. It was suggested we might save money for The Lab by shovelling it into the hoppers to boost supplies but it was felt that this would be counter-productive as the colour would cause The Gentlemen to question the quality of our product. Anyway, excavating the floor of such a place might give release to all manner of evils best left alone - visions of Hieronymus Bosch and Poe haunted our waking hours.
I believe the Plaster Room has now been upgraded. I suspect that means given a coat of whitewash and the half inch coating of condensed wax scraped off the ceiling (recycled as raw material for the construction of bite blocks no doubt) and the vulcanisers piled up at the back of The Shed after failed attempts to interest various museums and collectors/retailers of antiques and curios. I have no desire to confirm the rumour by personal visit.
w More user comfort and higher flexibility: these are the distinctive features of the new Zirkonzahn M2 milling units! The M2 milling unit is available in two different versions: the M2 Wet Heavy Metal and the M2 Dual Wet Heavy Metal. The M2 milling units allow for a particular precise and clean elaboration of all materials, both through wet and dry processing. According to the users’ needs, the M2 Wet Heavy Metal milling unit is also available without wet processing function (M2 Heavy Metal). What differentiates the M2 Dual Wet Heavy Metal milling unit are instead the two separate, flexibly configurable milling chambers for sequential wet and dry processing of all soft and hard dental materials without in-between cleaning.
In all M2 milling units, elaboration processes are particularly stable due to the proven 5+1-axis simultaneous milling technology with orbit and opposed rotary axes. Also hard-to-reach areas – such as undercuts and divergences – can be milled without difficulty and several work pieces can be fixed and processed in the orbit by using various blank holders, e.g. glass ceramics or Raw-Abutment® blanks. All M2 milling units are stand-alone solutions: indeed, is it possible to start milling and calibration processes or load elaboration tools directly from the machine, via the integrated PC with touchscreen.
The machines are provided with spaciously designed, optimally
illuminated and easily accessible milling chambers as well as with a tool chamber with dust protection equipped with 21 tool compartments (3x21 in the M2 Dual Wet Heavy Metal milling units).
In the M2 Wet Heavy Metal milling unit, additional tool chambers permits to store tidily further milling burs. The milling units are also equipped with a water collecting tray, an automatic tool changer function with optical tool detection – which ensures the appropriate selection of milling tools resulting in greater safety and precision – as well as an automatic self-cleaning function at the end of the milling process.
In the two-chamber M2 Dual Wet Heavy Metal, all materials can be elaborated with wet and dry processing sequentially, without in-between cleaning
w Versatility grants you the choice to work in a way that suits you and your clients.
With Medentika®, a Straumann Group brand, you can produce robust and reliable solutions using the Multi Platform Systems (MPS). These abutments and components are compatible with all major implant systems, providing an uncompromised performance while being an economical option for your dental laboratory.
With expert German craftsmanship, the Medentika® components and abutments have been manufactured with the highest interface precision. They also come with a lifetime guarantee, demonstrating the Straumann Group’s assurance of quality.
Choose Medentika® and work in a way that benefits your business and your clients. Find out more today by visiting the website.
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w The Straumann Group is proud to partner with Createch Medical, offering busy dental technicians a direct-to-lab milling service.
For laboratories looking to expand their capabilities, while still providing beautiful prostheses to clients, this service is ideal. The Createch Medical facilities are equipped with ultra-precise measuring devices and fiveaxis high precision milling machines. The results are frameworks for implant-supported prostheses that are robust, long-lasting and aesthetic, optimised by strict quality standards. Each dental framework comes with a Createch Excellence warranty card, to reflect the excellence of the product and Createch Medical’s dedication to their customers.
If you’re looking to outsource some of your lab work, consider choosing Createch Medical. For more information, get in touch today.
Register for your account with Createch Medical at http://www.createchmedical. com/en/file-sending/login-registro/
For more information on the Createch Medical direct-to-lab milling service from the Straumann Group, visit https:// www.straumann.com/gb/en/dentalprofessionals/products-and-solutions/ implant-borne-prosthetics/products/ createch-medical.html
w Kemdent’s Straight Wax Bite Blocks help to save time, eliminate the risk of porosity and also suit a wide range of temperature and climactic conditions.
Neil, a dental technician at M&M Dental Laboratory, shares his experience of the Straight Wax Bite Blocks:
“I’ve been using the Kemdent Straight Wax Blocks for a while now, and have never had a problem with them.
“They’re really good and easy to use; you put them in water to soften up and they hold together well.
“Kemdent’s customer service is good; you can phone up and usually receive the product the next day.
If we don’t receive them, the Kemdent team are always really helpful and let us know if there are any hold-ups.”
For more information, please visit www.kemdent.co.uk or call 01793 770 256
w The Kemsil Precise Lab Putty, from Kemdent, is ideal for dental technicians seeking an easy-to-use and versatile lab putty.
This addition-cured solution can be prepared effortlessly, as it’s easy to measure and mix with no messy activator. The Kemsil Precise Lab Putty delivers results with outstanding accuracy, with up to 70% less shrinkage than conventional condensation-cured putties.
The Kemsil Precise Lab Putty can be used for the production of copy denture moulds, processing denture repairs, dental implant work and the construction of partial dentures.
Dental technicians have trusted Kemdent for over 100 years, thanks to their continuous dedication to quality. If you’d like to discover more, get in touch today.
For more information about Kemdent Kemsil Precise Lab Putty, please visit https://www.kemdent.co.uk/ or call 01793 770 256.
