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VERIFIABLE ECPD FOR THE WHOLE DENTAL TEAM
DTS 2020
THE BIG ONE IS COMING PAGES 20-21
CBCT AND YOU
Cone Beam Computer Tomography and planning PAGE 16
Dentsply Sirona 24 hours live coverage around the world PAGE 17
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DENTAL NEWS STUDY SHOWS FILLINGS MAY NOT BE BEST TREATMENT FOR CHILDHOOD DENTAL CARIES PAGE 23
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DTGB SEND YOUR ENTRIES FOR “THE TECHNICIANS MERIT AWARD SCHEME” PAGE 12-13
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Inside this month
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CONTENTS
Editor - Larry Browne FBIDST. FDTA, ITI Fellow, LCGI, RDT. E: editor@dentaltechnician.org.uk T: 01372 897461
CONTENTS
JANUARY 2020
Designer - Sharon (Bazzie) Larder E: inthedoghousedesign@gmail.com Advertising Manager - Chris Trowbridge E: sales@dentaltechnician.org.uk T: 07399 403602 Editorial advisory board K. Young, RDT (Chairman) L. Barnett, RDT P. Broughton, LBIDST, RDT L. Grice-Roberts, MBE V. S. J. Jones, LCGI, LOTA, MIMPT P. Wilks, RDT, LCGI, LBIDST Sally Wood, LBIDST
Welcome Welcome to your magazine by Editor Larry Browne
Marketing Marketing By Mike Bond
Dental Doris James Bennett - An exercise in Dentatus Articulator repair
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Digital Technology
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Dental Technology CBCT and you - Cone Beam Computer Tomography and planning
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Company News Dentsply Sirona - 24 hours live coverage around the world
Evaluating ceramic crown margins with digital radiography
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DTS 2020 DTS 2020 - The Big one is coming in May
20-21
Dental News
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Periodontitis could increase stroke risk, new study says Study shows fillings may not be best treatment for childhood dental caries
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WELCOME TO YOUR MAGAZINE
A HAPPY AND PROSPEROUS NEW YEAR TO YOU ALL!
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A New Year and another chance to get it right. Whatever you have been putting off, this is a great time to start it going. New enthusiasm and energy towards your working ambitions. Are you looking to learn and master a new skill set? Perhaps wanting to immerse yourself in Digital Dental techniques and show it can rival anything created so far. It really is a good time to take that route as the companies are falling over themselves to get the message across. With a bit of effort, you can get on courses and often without charge. Digital dentistry is a wonderful innovative technology, but it relies heavily on the skill and experience of the technician operator. Good technical knowhow can only be learned by working with skilled and interested colleagues and hopefully, demanding and interested clinicians. There are new methods being added by the companies, new techniques requiring new skills. All must be learned and be driven by dental technician knowledge. Perhaps you want to work abroad in another market place. If you are a skilled technician you will never find it difficult to be employed. The need for all areas of technical dentistry, is growing world-wide. Fears there may not be enough technicians to meet the rapidly growing demand is very much on the minds of those dealing with the necessary provision of personnel. While at the moment digital is seen as a potential threat it is in fact a real boon. A real incentive to become skilled in the art and science of technical dentistry and be ready to be the clinical technical advisor to the many thousands of chairside clinicians who don’t have a clue, how to construct a tooth! Whatever the material and method. Undergraduate training of clinicians seems to confirm it can all be done by computer. It of course cannot. Just look at the understanding of the “new young associate” and the skill and appreciation level. They need us more than ever. But digital is an
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inevitable progression, it won’t remove their total lack of three-dimensional concepts, but does confirm their need for technical assistance, if they are to make restorations, of whatever type, to meet the patients’ needs. Learn to talk with them on a daily basis. Get to understand about patients and their demands, where possible create a situation where you get to see patients and even get involved with the clinical situation. Shade taking, being there to discuss cases, either simple or complicated, where your technical knowhow ensures a really good outcome. Get to listen to both patients and clinicians and build an understanding of their situation and the working day to day environment. Only talking to clinicians “under your breath” helps nobody. Since legal registration you are directly responsible to the patient, by law, to ensure the restoration is fit for purpose. No longer can you continue to criticise the inability of the operator to do the impression correctly or to prep correctly or to record the bite correctly because if you continue working on the case, which you consider will not meet the prescription without telling the operator, you will be considered equally guilty of failing in your legally required duty, to the patient. Yes, another reason to be struck off!! If you have been interested in the Technicians Award contest, them please let me know your feelings. It is an attempt to raise awareness of the excellent work available and the real commitment to excellence many of you make every day. To be a good and able craftsman and be recognised by your peers is something to be proud of for your working life. Many of you are sitting there thinking it’s not for you, but you won’t now that, unless you join in and try. As we go into the New Year can you please consider sending something, however small to the magazine. A nice piece of work
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and the story behind it!! A complex case you have been involved in or a really nice single crown or inlay. Concerns you may have about your working conditions or about your career. Perhaps you have some questions about registration, training or indeed your wage rates. You may be aware of illegal manufacture or indeed technicians or clinicians engaged in such malpractice. You may have a good story about a trip abroad to a dental show or indeed a laboratory. It is all of interest to the readers of the magazine and would be interesting. Just a word about the statement of manufacture! It is essential that you ensure that if you are manufacturing a dental appliance the statement is sent with the device or restoration when it is sent to be fitted. It is illegal for a manufacturer not to supply the statement, which is the patients guarantee that the device has been made to prescription by the registered manufacturer. I have been told by too many that they don’t bother sending them out. Others say they only send them when the dentists’ ask for them. It does certainly suit the clinicians not to have to bother but the whole point of the recent legislation was to protect the patient. Without proof of manufacture the patient has no protection. It also allows those who are manufacturing illegally not to bother. If the clinician is not receiving a statement with each job it would be easy to use anybody without a statement. I hear complaints all the time about the clinicians finding cheap work, often with un-registered manufacturers or indeed from imported work without a statement. If they are not daily reminded of the importance of the statement, as required by law, how can the illegal manufacturers be stopped. Yes, you have to do your bit. I know many of you find it all a bit of a nuisance but think about the importance of the statement, in real terms, and insist on it’s production. Stay Legal.
Larry Browne, Editor
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MARKETING
MIKE BOND – DENTAL MARKETING SPECIALIST l Mike is a self-employed marketing consultant who has worked
in the dental and healthcare sectors for over 25 years.
THE PRICE IS RIGHT?
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couple of weeks ago I read a post on Facebook from a technician who had been asked by a practice to reduce his prices and, rightly so, he refused. The practice stopped sending work for a few weeks and then requested a pick-up and resumed sending work as if nothing had happened! I’m sure most of you have similar tales to tell and I think it’s interesting to explore how your work is priced. This article might also give you a few tips to help explain to practice owners why you cannot discount your work or change your fees on demand. When working out your pricing structure it's essential to start with your baseline costs, including rent, staff wages, general overheads, and don't forget your wages! This will give you the per month cost of running your business. For example: ITEM PER MONTH Rent ................................. £1000 Wages.............................£12000 General Overheads ........... £3000 Cars ................................... £500 Insurance ............................ £200 Total ................................£16700 On average 20 working day per month £16700 / 20 days = £835 per day to run the business BEFORE PROFIT! It’s good to have the numbers worked out as they focus your thoughts on making a profit and not just servicing work for sake of it. Once you have your baseline number you need to work out how many units a day you can produce with the workforce you have – In the good old days this was quite simple to do as most technicians could produce between 8 – 12 units a day of either ceramic or metalwork but in these days of CADCAM the number of units per day is probably higher. But for argument's sake let use an average of 10 units per day per technician to illustrate the point.
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You have 2 technicians plus yourself and an admin person so 4 people in total. Cost per day to run the business = £835 / 3 production staff = £278 per person Average cost per unit £55 – £278 / £55 = 5 units per person to meet baseline costs. Using these figures (which are for illustration only) would mean that each technician would need to produce 5 units a day to cover the costs of the laboratory. By doing a few simple calculations you can start to work out what your pricing structure needs to be to make the profits you would like to generate with the staff you have. If you are thinking of growing your business and adding staff, it’s always worth running these types of calculations and knowing how many extra units you need to maintain profitability. If you need help with the numbers, it can be a good idea to chat to your accountant or bookkeeper as they should be able to give you the key numbers without too much trouble. A WORD ABOUT DISCOUNTS It can be very easy to give a discount when you’re under pressure not to lose work, but understanding the cost of a discount and how this can erode your profits is essential. A dentist that sends you £5000 worth of work a month phones to say he likes working with you but he thinks your prices are too high and can they have a discount. The first thing to say is that you don’t routinely give discounts
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and you need to have a couple of days to work something out. Agree a day and time to phone back. If you give this dentist 10% discount it will take £500 out of your pocket and if you give them 15% it will cost you £750! This would put pressure on your profits and potentially erode your business. If the regular selling price of a crown is £50 and the cost of production is £25 this leaves £25 profit. When you give a discount of 10%, your costs don’t change but your profit will be reduced to £20 and if you give a 15% discount you will be left with only £17.50 profit per unit. A 15% discount would mean that you now need to produce a third more work to standstill! You need to ask yourself - Can my business afford to offer this level of discount and do I want to go down this spiral. Once you have considered all the facts it’s time to call the dentist back and have a conversation to explain ‘business owner to business owner’ how offering a discount could erode your business and ideally you would like to add value to the dentist by offering a complimentary service – for example, free shade taking. If you really feel its necessary to offer a discount you might want to consider asking the dentist for more work to help with the shortfall a discount would leave or negotiate better payment terms, however both of these options can be hard to control in the longer term. At the end of the day, it's all about the bottom line and looking after costs and pricing will result in better profits…And after all, you're not a charity!
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INSIGHT
WELCOME TO... DENTAL DORIS DENTAL DORIS HAS WORKED IN DENTISTRY FOR MANY YEARS AND LIKES TO MUSE ABOUT ALL KINDS OF DENTAL AND NON-DENTAL TOPICS
HAPPY
New Year
INSIGHT
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ongratulations, we've all reached another milestone and are beginning a new year full of hopes and dreams. That's one way of putting it. Another way is, "I'm a year older and what have I done so far in my life?" Both are ways in which we can reflect on our lives. The first starts with a promising first step whereas the second doesn't guarantee that our thoughts will go in a positive direction…UNLESS we follow the question with the second phrase, "And where do I want to go now?" That's the idea of new beginnings. You start off with a clean slate, wipe away all the past stuff that's negative and a downer, and focus on that which is optimistic and encouraging. Why not? It doesn't cost you any more to be upbeat than to be critical. It's just the opposite. It's like putting money in the bank because you are doing something very good for yourself which will pay big dividends. Being critical is withdrawing funds and can soon leave you bankrupt, bereft of motivation and hope. Nigel is a 42-year-old married father of three teenagers. He has a small lab that he runs with his wife and he really doesn’t have much time to himself. Lately, Nigel has been feeling "blah." he’s tired, a little overweight, and concerned that he hasn’t had much time to do any exercise. At a recent Christmas social event, Nigel seemed to be surrounded by middle-aged men who had taken up a competitive sport of one kind or another and when he got home he felt determined to start the New Year on a
different foot. The day after New Year's he saw an ad for a health club offering a discount on annual membership and he decided to join and for a full month. Nigel enjoyed the time exercising and being able to “free” his mind of the pressures of the lab. However, he soon fell behind in meeting his family and business obligations. Within a few weeks after joining the club, Nigel stopped going. Before too long, he was back to his old ways and life but with a new problem - the belief that this was all he could expect to have. Nigel’s situation is not that uncommon; in fact, it’s far too common. He was able to realise some of the problematic issues he had in his life and made an effort to change them. But, the effort was short-lived. Why? We all know how hard it is to change when you are stuck in a routine. It takes a lot of: • Effort • Determination • Will power • Endurance in the face of obstacles • Time • And self-promotion Making changes in your life should be done because you really want to and can see its benefits. The changes you want to make should enhance your life and help you fulfil your dreams. But you also have to be realistic and know that these changes may not come easily. Especially if you’re changing a longstanding trait or behaviour. You have to make a COMMITMENT to yourself that you will do this because
you believe it is psychologically and/or physically good for you. It is these beliefs that you will fall back on when you feel frustrated or thwarted by situations and people who may try to derail your dreams. It’s important to understand that when one person makes changes, it has a ripple effect. The changes in that person may affect others. For example, if Nigel is devoting less time to his children, someone has to pick up the slack or the family lives has issues. When one person tries to change, she or he may get some, a lot, or no support from others, which can affect how successful the change will be. It always helps to have someone who encourages and supports you. But, ultimately, you have to believe in yourself and that even if you fall down (which we all do, sometimes a lot), you will be able to pick yourself up, start again, and achieve your dreams. This is your life. How do you want to live and experience it? You have to take ownership over it and direct yourself along the path you want to travel. Life is a journey, full of twists and turns, bumpy roads and newly paved streets. We can never be fully prepared for what lies ahead. But, if you want to go on this new path, don't let the roadblocks stop you from fulfilling your hopes and dreams. Starting today, pledge to make your life the best trip you can. Happy 2020!
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DENTAL TECHNICIANS GREAT BRITAIN
Happy New Year to all The Dental Technician Magazine subscribers and Dental Technicians Great Britain Facebook group members!
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There have been many positives to take from the last year of the decade!! The joining of forces between The Dental Technician Magazine and Dental Technicians Great Britain has brought around many exciting opportunities. It had become clear over the years that we both share the same vision; to be a trusted support system when it comes to all things technical in the dentistry world (but most importantly here in the UK!)
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The Dental Technician Magazine has always respected the integrity of a very carefully run Facebook group that is Dental Technicians Great Britain; we strive to provide the content that will engage and inform its members to really help with improving as many aspects of technicians work. Here are some examples of supplier content featured on the group. If you want to feature your business email: sales@dentaltechnician.org.uk
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DENTAL TECHNICIANS GREAT BRITAIN
One of the most prominent ideas for this was the creation of "The Technicians Merit Award Scheme"
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An awards scheme like no other to allow dental technicians to showcase their talents by submitting entries be it a picture, video, case study or even articles of interest. We selected a judging panel for six different categories made up of some of the most respected technicians around: Best Ceramics/Crown and Bridge Technician Judged by Andrew Wheeler (Precision Ceramics) Sponsored by Ivoclar Vivadent Best Prosthetics Technician Judged by Chris Wibberley (CW Dentures) Sponsored by Bredent Best Orthodontics Technician Judged by Andrea Johnson (OTA and Den-Tech) Sponsored by WHW Plastics Best Chrome Technician Judged by Dave Smith (Phoenix Dental Castings) Sponsored by Blueprint Dental Best Hospital Tech/Maxfac Judged by Iain Mur-Nelson (St George’s University) Sponsored by 3Shape Best Innovative Technician Judged by Magnus Underhay (MJ Underhay Dental Lab) Head Judge is Bill Sharpling (LonDEC, King’s College London) The awards scheme is running until December 2020 and we want as many of you to participate! It couldn't be simpler. If you are a dental technician in the UK, Join Dental Technicians Great Britain Facebook Group and post pictures, a video or anything that showcases your work or talents to be considered by our judging panel. Alternatively you can send to: awards@dentaltechnician.org.uk We want to see what you have to offer. A nomination for each category will be chosen every three months to be shortlisted for the winner in December! HERE ARE SOME EXAMPLES:
“WE LOOK FORWARD TO CONTINUING TO WORK WITH DENTAL TECHNICIANS GREAT BRITAIN TO SUPPORT YOU ALL FOR 2020 AND THE FUTURE” CHRIS TROWBRIDGE
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EXTEND YOUR SUBSCRIPTION BY RECOMMENDING A COLLEAGUE There is a major change in CPD coming soon. The Dental Technician Magazine is a must read. Tell your colleagues to subscribe and if they do so we will extend your subscription for 3 months. The only condition is that they have not subscribed to the magazine for more than 12 months. Just ask them to call the Subscriptions Hotline. With four colleagues registered that means your subscription would be extended for a year free of charge. At only £39.95 per year, for UK residents, this must be the cheapest way of keeping up to date. Help your colleagues to keep up to date as well. Ask them to call the subscriptions Hotline on 01202 586 848 now.
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DENTAL TECHNOLOGY
CBCT AND YOU
CONE BEAM COMPUTER TOMOGRAPHY AND PLANNING
H
ow many of you are involved, during your working week with CBCT scanning and planning? It has a real potential to change the way we approach the x-ray information with its 3D imaging and the improved information for diagnosis of, the otherwise buried bone and tooth root. I do believe it will replace the present 2D standard as it offers so much more information and the cost of the CBCT equipment reduces. As a Technician working with and restoring on implants, the three-dimensional image offers so much more information and is somewhat easier to accurately relate to the patients’ situation. So often the equipment and techniques and training are offered as a direct from surgery option for implant planning but of course that would assume the clinician had some real technical ability, which is most often not the case. The companies who are marketing the equipment are in general unable to understand the difference between a clinician who does implants and a technician who is involved. The idea is that the companies will supply library shots of restorations and the clinician just needs to select his replacement tooth of choice from a picture!! It really is very exciting technology and is very useful for planning your implant cases accurately in conjunction with the clinician. Using distortion measures (ball bearings) during the scan will give a really
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accurate potential for measuring. The distortion measure carrier will often need to be made by the laboratory, i.e. a partial or full plate so it is worth your while to pursue the whole area of planning for implant surgery and your part in it. While there have been some practitioners who have shown their own solely planned restorations as an example, the good ones are extremely rare. All The best speakers will be using a technician service and have a close relationship with the technician. You don’t need to be digitally equipped but it does make transfer of the images very efficient. You can use the x-ray printed images equally easily and make the measurements needed to aid your planning processes. Not being digital you will need to produce models and the waxup etc. with the normal (analogue) method. It very much depends on the amount of this type of work you already do and how much you wish to grow that aspect. Going digital certainly makes information transfer and scanning, planning and manufacture, much more direct and time saving. If you are looking after just one or two clinicians then the required financial investment, would probably not be justified. I do think you should think about making yourself familiar with the technology and be able to discuss its use, or not, for cases.
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Because of the expense of the equipment needed and the expertise required there are several specialist centres around the country who provide the option for general practitioners and to those who feel it too great an investment. While many who are seriously into Implant restoration and general restoration have invested in the technology, and find it a real boon, it is quite a commitment, so the specialist centres provide an excellent service. Where patients attend for the imaging process and the image is produced in X-ray format or digitally and sent to the referring dentist.
CBCT used for Implant Planning
COMPANY NEWS
24 HOURS LIVE COVERAGE AROUND THE WORLD DENTSPLY SIRONA ENGAGES WITH EMPLOYEES TO FOCUS ON CULTURE, PURPOSE AND CUSTOMERS
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n an unparalleled and innovative 24-hour livestream event Dentsply Sirona engaged with more than 13,000 employees worldwide to discuss the company culture and its purpose “to make people smile”. From a TV studio created in the middle of the company’s production facility in Bensheim, Germany CEO Don Casey and members of the leadership team connected with 90 global sites to talk about how the company culture and purpose supports their work and facilitates a focus on the customer. Charlotte/Bensheim, December 5, 2019. From November 20th into the 21st, Chief Executive Officer Don Casey, together with Chief Financial Officer Jorge Gomez, Chief Commercial Officer Walter Petersohn, Chief Segment Officer Bill Newell, Chief Supply Chain Officer Dan Key and Chief Human Resources Officer and Communications Lisa Yankie hosted an all-company event for over 24 hours. The event called ‘DS24hours’ addressed employees all over the world in individual sessions, reaching more than 13,000 employees from more than 90 global sites on five continents. The event also reached more than 58,000 people on social media platforms, such as Facebook or LinkedIn. “‘DS24hours’ was a unique experience unlike anything that we have done before”, says Don Casey, CEO of Dentsply Sirona. “The energy and motivation of all employees around the world to contribute to our culture was amazing. It’s great to work for this company and to make people smile all over the world.” The goals of the event were to create awareness for the importance of the shared company culture and engage with employees globally. During the 24-hour event, employees had the opportunity to get in touch with the leadership team, ask their questions and to talk about the company purpose of how to empower dental professionals all over the world to provide millions of patients with better dental care. From a TV studio in Bensheim, Germany, which was especially set up for this event in the middle of one of the world’s most modern dental production facilities, the sessions were broadcast as live video stream to company sites around the globe. Each of the one-hour sessions was tailored to the questions and expectations
CLOCKWISE FROM TOP LEFT - FIG. 1: Corporate Communications Marion Par-Weixlberger, CCO Walter Petersohn, CEO Don Casey, CFO Jorge Gomez, CHRO&Communications Lisa Yankie, CSCO Dan Key and CSO Bill Newell conducted DS24hours out of a TV studio in the middle of a production facility in Bensheim, Germany. FIG. 2: 24 One hour slots covering more than 90 locations required plenty of technical preparation and production work. FIG. 3: Japanese employees getting ready for the livestream town hall. Fig. 4: Employees from Moscow (Russia) warmly welcoming CEO Don Casey to their town hall.
of each region. Don Casey and his executive team addressed hundreds of questions employees submitted about how to create an inspiring work environment and put the customer at the center to achieve excellent results. Argentina, Australia, Brazil, China, Egypt, France, Germany, Israel, Italy, Mexico, Poland, Russia, South Africa, Spain, Sweden, Thailand, United Arab Emirates, Vietnam and the United States were just a few countries which participated in this dialogue and shared their experiences. This was a special and inspiring experience for all our employees. ‘DS24hours’ demonstrated the great commitment of our management team for an inspirational and transparent company culture and how our employees engage by putting the customer at the center of everything we do”, says Lisa Yankie, CHRO and Communications at Dentsply Sirona.
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AN INSPIRING PLACE TO WORK As an industry leader, engaged employees are key to the success of Dentsply Sirona. The company invests a lot in its employees and ‘DS24hours’ underlines the commitment of the leadership team to enable an open and inspiring work culture. Offering global career opportunities and a variety of training and development programs to employees helps Dentsply Sirona continue to achieve market leadership and earn the reputation of being an employer of choice. Dentsply Sirona knows the importance of personal development, job satisfaction, and maintaining an inclusive, safe and healthy work environment. Employees at Dentsply Sirona have many opportunities for training and development and, as a company with a large international footprint working in many locations around the world, the talent development program is built around the concept of working as one global team.
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DIGITAL TECHNOLOGY
Evaluating ceramic crown margins with digital radiography WILLIAM MAXWELL WAHLE, DDS, MSa I RADI MASRI, BDS, MS, PhDb I CARL DRISCOLL, DMDc I ELAINE ROMBERG, PhDd
Statement of problem Radiographs aid in clinically determining crown fit, specifically interproximal margins where tactile and visual methods may be limited. However, investigations of the utility of digital radiographs as a tool for evaluating the marginal openings of ceramic crowns are lacking. Purpose The purpose of this in vitro study was to assess whether marginal adaptation for ceramic crowns and for metal–ceramic crowns with a metal collar can be identified with digital radiographs. Material and methods One lithium disilicate crown, 1 fluorapatite crown, and 1 metal–ceramic crown, were fabricated for a maxillary premolar.
The crowns were attached to a customdesigned device that allowed the marginal discrepancy to be changed. A total of 10 increments were measured starting at 0 to 20 μm and increasing every 20 μm to a maximum opening of 180 to 200 μm. At each increment, 2 radiographs were made of the crowns, using a digital sensor, 1 perpendicular to and 1 at 80 degrees to the long axis of the tooth. To test whether digital radiographs could be used to accurately identify “acceptable” and “unacceptable” margins, 21 dentists were asked to rate the radiographs as “acceptable” or “unacceptable.” The chi square test was used to analyse differences between the dentists’ evaluations and the actual marginal opening (α=.05). For the purposes of this study, a marginal discrepancy greater than 80 μm was considered “unacceptable.”
Part-time study for trainee dental technicians Our specialist DipHE in Dental Technology provides trainee dental technicians with the knowledge and technical expertise to enable them to manufacture, repair and provide advice on custom-made dental appliances. Teaching is delivered both online and on campus allowing technicians to study while working. The programme starts in September and is completed part-time over 36 months. On qualifying students will be eligible to register with the GDC to practise as dental technicians. For more information and to apply visit: abdn.ac.uk/study/ug/dentaltech
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Results Of all marginal discrepancies exceeding 80 μm, 78.6% of the metal–ceramic crown radiographs were incorrectly scored as “acceptable” (P<.001). These radiographs were identified as false positives. Lithium disilicate (66.1%) and fluorapatite (45.8%) crowns were more likely to be incorrectly evaluated as “unacceptable” (P<.001) and identified as false negatives. Conclusions Using digital radiographs to evaluate marginal adaptation without clinical examination is not by itself an accurate method of evaluating the marginal fit of complete coverage crowns. The marginal fit of the tested metal–ceramic crowns tended to be evaluated incorrectly as acceptable. The marginal fit of the tested ceramic crowns tended to be evaluated incorrectly as unacceptable.
INSIGHT
AN EXERCISE IN DENTATUS ARTICULATOR REPAIR James Bennett (Retired Dental Technician) I Surrey
I
n the 1950s with the NHS still in its early years, the full denture had become the main work of the dental technician. Starting my apprenticeship in the prosthetics department of the Eastman Dental Hospital and joining three others more advanced through their apprenticeship. I was, soon after the first year, mounting edentulous models and bite blocks on the Dentatus articulator and then taking the full/ full case right through to finish. All of this while taking turns to make the tea for twelve technicians, cleaning metal impression trays, and then with all three other apprentices, clearing up the plaster room every evening. With a first-year wage of just 36 shillings (£1.80) a week, getting to the EDH, meant that most days I would cycle from Southfields SW18 to Gray’s Inn Road. Then once a week, during term time, for day release studies. I would take the train from Earlsfield Station to Waterloo and walk to the Borough Polytechnic. An occasional weekly rail ticket, bought out of proceeds working weekends as a gardener, would give me a break from the long daily cycle ride. From Waterloo Station was a fair walk to the EDH and then back again after work, sometimes a change of route to Russell Square if I was using the underground/ District line to Southfields, this would result in my gaining a lasting knowledge of the many streets and routes through London. So, for nostalgic reasons I decided to search the internet to see if there were any ‘Dentatus articulators and face bows for sale. and immediately found a used one at £49.90, checking the ‘sold items’ I then found three ARH types, complete with a face bow sold as a job lot for £67.45. I began to find these articulators coming up for sale with parts missing, or with the incisal pin clearly pictured the wrong way round in the upper arm of the Dentatus. Some weeks ago, two Dentatus articulators were offered for sale, without either the segmented/adjustable incisal table, or without any incisal table at all? It therefore occurs to me, that in various UK or dental laboratories around the world, there might be drawers or boxes containing discarded orbital axis plane indicator
down onto the base of the upper model. What is the technician to do, adjust the orbital pointer (guess work or ‘doctoring’?), or return the face bow to the dentist? As for dispatching a face bow from a dental practice to a commercial laboratory, the sticking out bite fork and orbital pin would require a large protective box. I never received any such face bows, and my Dentatus ARO, bought in anticipation remained brand new, finally sold never used. As an independent commercial laboratory, all the full/full dentures that we ever constructed, were on a plain line articulator.
(ARH-K), lock nuts (ARH-34), support rods (ARH-39), solid incisal tables (ARH-G) or segmented/adjustable incisal tables (ARH-P). The face bows on offer, are no better. The two clamps are usually included, but I found many with the bite fork and/or orbital pointer missing. One face bow recently sold, had both the calibrated rods (AEB-B) missing. Hardly usable as a face bow! I can understand how in the lab a bite fork goes missing, as once having been used to mount the models on articulator, the face bow would be removed by having the calibrated rods and screws released, leaving the bite fork still sticky waxed into the bite blocks. Then, once setting up is started, the bite blocks complete with the fork, might be put to one side. Eventually the face bow returned to the surgery minus the bite fork. In my experience of dentures constructed at a dental hospital, the face bow complete with bite blocks would be carefully carried by hand to the in-house prosthetics department, hopefully with clamp screws fully tightened, and the bite fork and orbital pin exactly as set by the dentist. But even then, on the odd occasion, with the face bow attached to the articulator, the upper model would be found to be positioned so high by the orbital pointer, that even after further grinding at the base of the upper plaster model, and still leaving enough depth for scoring relocating grooves, it would be impossible to bring the upper articulator arm
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Watching items online recently, I finally ‘pulled the trigger’, placed a £20 bid, and won a used Dentatus ARH, with a bent and split Incisal foil and support rod missing. (I had to buy it just to repair the damage). When the articulator arrived, I found that the seller had also kindly included a face bow, but with no bite fork. I obtained a quotation for spare parts:- 1x Incisal table plate ARH-25 €15.50, 1x Long support rod ARH-39 €16.30, and 1x Bite fork (standard) AEB-G @49.90. My order for spares might have amounted to €15.50 + €16.30 + €49.90 = €81.70 + €30.00 special processing charge (where orders amount to less than €200.00) + shipping (say) €10.00 then plus 25% Swedish VAT (payable unless a VAT registration number is included with the order). Like the UK dental technician (VAT Exempt), I have no VAT registration number, so Swedish 25% VAT would need to be paid, the total order (for the 3 small parts) becoming €152.12. Even then, the package might still be subject to our 20% VAT and Post Office handling charge £8.00 if shipped by mail. For anyone interested, I found that a 110mm long bright finished coach bolt with a 5mm metric thread will screw in and serve as a Dentatus support rod. To replace the damaged foil, I purchased a strip of 0.1mm gauge stainless steel foil and cut a disc to replace the damaged bite plate foil. If attempting this, watch out and try not to lose any of those four tiny pins that hold the two flappy incisal segments. With the 4 pins out, the foil is still difficult to remove, as the pins will have dented in the foil!
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DTS 2020
DTS20: THE BIG ONE IS COMING IN MAY “HERE ARE A FEW TASTERS OF WHAT YOU SHOULD PLAN FOR” DIGITAL DOESN’T HAVE TO BE DAUNTING
Dr Gulshan Murgai
Digital technologies offer many benefits to dental professionals in their everyday lives. The latest solutions available on the market are designed to simplify routine tasks, ultimately enhancing the quality of service provided – whether that is from practice to patient or from laboratory to practice. Dr Gulshan Murgai will be discussing the topic at the Dental Technology Showcase (DTS) in May 2020. He is the owner of 4D Ceramix Dental Lab, Clinical Director and CEO of Skin & Smiles Ltd and Managing Director of Implant Solutions Direct. Here he summarises what he feels are the main advantages of digital dentistry. “It’s fast, easy and more accurate than traditional methods,” he says. “It also adds a wow factor for patients, is more comfortable for them and is kinder on the environment. In terms of the standard of service that can be provided to patients, digital allows sameday dentistry. Dental laboratories can often fabricate products and devices in less time than they once could, enhancing the service to dentists and patients. It also improves record keeping with documents that are easier to find and don’t degrade. In addition, businesses benefit from tax efficient purchases when investing in the digital workflow.” Despite the multiple potential advantages of digital, there are still some barriers that may prevent some dental professionals from investing in the field. Dr Murgai goes on to explain how to overcome some of these: “The learning curve is one possible barrier to digital, so it is important for professionals to ensure that they have access to sufficient training and on-going support. The upfront cost of equipment can also prove difficult
for some businesses but utilising one of the many finance options now available can help significantly. Thirdly, the amount of NHS work completed in a lab or practice may influence decisions about digital solutions. There is a perception that the time required for learning and data acquisition may eliminate the possibility of introducing digital. However, as already mentioned, there are some simple solutions that make investment in digital viable for all dental businesses.” Dr Murgai will be presenting at DTS 2020 on “VITA – Chairside Solutions”, sponsored by VITA. He will discuss the digital workflows involved in different clinical scenarios, covering the capabilities of intraoral scanners and CAD options now available. He will also explore the differences between open and closed digital systems, as well as the various material choices currently on the market. He says: “If delegates only take one thing home with them, I hope it is that you must get involved with CAD/CAM and digital workflows, if you are going to benefit from them! These processes and technologies have been around for over 30 years now and the material options are growing.”
DTS 2020 will offer a dynamic educational programme, with sessions designed for all members of the team from dental technicians to clinical dental technicians, orthodontic technicians and lab owners. One of the key themes of the event will be focused on digital technologies – what they can do, how they can benefit the profession and who provides which products. The show has also partnered with MediFinance to provide finance options for equipment purchases, helping more labs invest in solutions that will drive their businesses forward. Despite the comprehensive learning opportunities, DTS 2020 won’t be all work and no play. It offers the ideal place to catch up with friends and colleagues throughout the industry, meet new people and strengthen existing working relationships. The extensive trade floor will be the perfect platform from which to put faces to names, meet your local reps and gain advice from like-minded professionals. “It’s a place where the extended dental team can go and learn, mingle with colleagues, network and see their suppliers all in one place,” adds Dr Murgai. “It’s a place where a technician can show his clients what technology they are willing to invest in and where they can gain education by way of lectures with their extended team. “Trade shows in the UK will remain useful for the profession if the profession attends. Patients won’t be impressed if their dentist hasn’t invested in the technology and services that another clinic has. Similarly, dentists won’t be impressed if their lab team hasn’t made time to educate themselves with the latest technology and materials.” To make sure you don’t miss Dr Murgai and several other highly esteemed speakers at DTS 2020, get the dates in your diary today!
DTS 2020 will be held on Friday 15th and Saturday 16th May AT THE NEC in Birmingham, co-located with the British Dental Conference and Dentistry Show. 20
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DTS 2020
THE WHOLE TEAM IS COVERED A
t the Dental Technology Showcase (DTS) 2020, there will be education and learning opportunities for all members of the dental lab community. Lectures will be presented by leading lights in the global field, each offering expertise and insights into the latest and greatest technologies, materials and concepts. Whether youâ&#x20AC;&#x2122;re looking to enhance your existing skills, learn new techniques or grow your business, there will be something for you. Plus, why not bring your whole team? Sessions will be tailored to dental technicians, clinical dental technicians, orthodontics technicians and lab owners, ensuring relevant information and guidance for all.
PROMOTING SAFETY OF DENTAL TECHNICIANS The dental lab is a dangerous l environment for indoor air quality. Thatâ&#x20AC;&#x2122;s why finding ways to enahnce air
quality and the safety of dental technicians is a priority for DTS 2020. The Dental Technology Showcase (DTS) will feature two days of motivational and informative talks, while also encouraging discussion and debate among delegates. One of the key themes of the event will be promoting safety within the lab. We will explore what can be done to improve air quality and what solutions are currently available to help the transition. For this, plus an array of lectures and interactive sessions catering to the whole dental lab team, get DTS 2020 in your diary!
For more information please visit:
www.the-dts.co.uk, call 020 7348 5270 or email dts@closerstillmedia.com
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DENTAL NEWS
PERIODONTITIS COULD INCREASE STROKE RISK, NEW STUDY SAYS
Dental Tribune International I December 09, 2019
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BELÉM, Brazil/RUGBY, UK: A recent study has investigated the association between stroke and periodontitis, one of the most common human diseases affecting over 700 million people worldwide. The data indicated that inflamed gingivae lead to changes in how blood and oxygen flow to the brain and may, therefore, increase the risk of stroke. According to the Oral Health Foundation, periodontitis is still one of the most common health conditions across the UK, currently affecting around 45% of the adult population. To tackle the issue, the charity is encouraging everyone to maintain good oral health to reduce the risk of developing periodontitis and other health complications.
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“Gum disease is incredibly common and most people will suffer from it during the course of their lifetime. It is one of the main causes of tooth loss in adults and is increasingly being linked to other general health conditions like heart disease, diabetes and some forms of dementia,” said Dr Nigel Carter, OBE, Chief Executive of the Oral Health Foundation. The prevalence and severity of the disease increase with age. Smokers tend to experience worse levels of periodontitis, and diabetics are particularly susceptible to the disease. Carter continued: “All gum disease is caused by plaque which forms on the surface of the teeth every day. The good news is that this can be managed with a
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simple daily routine. You need to make sure you remove all the plaque from your teeth every day. This is done by brushing twice a day with a fluoride toothpaste and cleaning in between the teeth with ‘interdental’ brushes or floss.” The Stroke Association estimated that over 100,000 strokes occur in the UK every year. There is an elevated risk of strokes and heart disease around the Christmas period. The study, titled “Periodontitis as a risk factor for stroke: A systematic review and meta-analysis”, was published online on 6 November 2019 in Vascular Health and Risk Management.
DENTAL NEWS
STUDY SHOWS FILLINGS MAY NOT BE BEST TREATMENT FOR CHILDHOOD DENTAL CARIES Dental Tribune International I December 06, 2019
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LEEDS, UK: Though dental fillings are an established method of treating the presence of dental caries in permanent dentition, their usefulness for treating caries in primary dentition remains under debate. A new study has cast further doubt on the appropriateness of this approach, suggesting that there is no evidence that conventional fillings are more effective in stopping further caries and/or pain in children than other treatment modalities are. The study analysed the results of the FiCTION (Filling Children’s Teeth: Indicated or Not) trial, which involved 1,144 UKresiding children between 3 and 8 years old who suffered from caries. Each participant was randomly assigned one of three treatment options for the duration of the trial (which
lasted up to three years for some children): the standard “drill and fill” approach, which involves drilling out the decayed tissue; a minimally invasive approach of sealing the caries under a metal crown or filling; and the avoidance of any fillings being placed while also emphasising a reduction in sugar intake and the necessity of taking greater care of the child’s oral health. A total of 450 participants reported that they continued to experience further caries and pain. There were no significant differences between the outcomes for each of the three treatment groups. “Our study shows that each way of treating decay worked to a similar level but that children who get tooth decay at a young age
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have a high chance of experiencing toothache and abscesses regardless of the way the dentist manages the decay,” said Prof. Nicola Innes, chair of paediatric dentistry at the University of Dundee School of Dentistry and lead author of the study. “What is absolutely clear from our trial is that the best way to manage tooth decay is not by drilling it out or sealing it in—it’s by preventing it in the first place,” Innes added. The study, titled “Child caries management: A randomized controlled trial in dental practice”, was published online on 26 November 2019 in the Journal of Dental Research, ahead of inclusion in an issue.
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MARKETPLACE VITA LUMEX AC: EASY VENEERING CERAMIC FOR ALL! w The ultimate material for all-ceramics – VITA LUMEX AC makes beautiful veneers easy! Experience a new level of ease and efficiency with the universal ceramic for every ceramic framework. Drawers full of various veneering concepts and ceramic materials are a thing of the past. Anyone can use VITA LUMEX AC! Whether you are a novice technician or an experienced ceramicist, this easy-to-handle material will bring out the best in your individual craftsmanship. full veneering – the choice is yours. Simplify your laboratory workflows with highly esthetic, long-lasting stability. Discover the ease of VITA LUMEX AC – the “VITA – perfect match.” for every user, every laboratory and every situation.
Benefit from a luminous dentin core and well-balanced opacity and translucency. Effect materials, opalescence and fluorescence provide quick, easy and natural-looking
individualization. Even the classic standard layering offers diverse esthetics and our timetested VITA shade determination for reliable reproduction of tooth shade. Micro, partial or
FIND OUT MORE: https://www.vita-zahnfabrik.com/LUMEX VITA® and other VITA products mentioned are registered trademarks of VITA Zahnfabrik H. Rauter GmbH & Co. KG, Bad Säckingen, Germany.
Perfect Packaging Solutions
GP1
Whether you need packaging to contain your product, or you’re looking for a solution to a working practice issue – we have an impressive range of plastic packaging available from stock. From bottles to boxes, containers to caps and tubes to ties – you’ll find it all available for immediate delivery. With over 80 years’ experience, environmental production credentials and exceptional customer service, we think you’ll find Measom Freer has your perfect packaging solution.
• Bottles & Plugs • Dropper, Flip & Screw-on Caps • Containers, Boxes & Jars • Scoops & Measures • Spoons & Spatulas • Tubes, Ties & Clips • Spray & Gel Pumps • Bespoke Packaging www.measomfreer.co.uk
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Now Buy Online Tel: +44 (0) 116 288 1588 Email: sales@measomfreer.co.uk Web: www.measomfreer.co.uk 37-41 Chartwell Drive, Wigston, Leicestershire, LE18 2FL, England.
Made in England
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MARKETPLACE
TAKE NOTICE: ZIRKONZAHN SYSTEM IS OPEN! Zirkonzahn CAD/CAM systems are designed to generate open data files generally compatible with all open CAD software, milling units or 3D printers. Similarly, materials as well as open scan and design data from other manufacturers can be processed with Zirkonzahn software and milling units. And along with data formats, also Zirkonzahn’s doors in the Italian Alps are always open to curious dental technicians!
w In its homeland nestled in the Italian Alps, Zirkonzahn develops and produces - under nearly one roof - CAD/CAM systems, dental materials, elaboration instruments and over 100 implant prosthetic components. What’s more? Zirkonzahn CAD/CAM systems, including the Face Hunter 3D facial scanner, are designed to generate and process open data files (STL, OBJ). The data are generally compatible with all open CAD software, milling units or 3D printers. Similarly, materials as well as open scan and design data from other manufacturers can be processed with Zirkonzahn software and milling units. Freedom and flexibility are important aspects to consider. Zirkonzahn’s workflow is therefore crafted to alternate seamlessly between analog and digital. With a workflow permitting seamless transition between digital and analog, Zirkonzahn offers a flexible and complete solution for the fabrication of exceptional dental restorations. By producing almost everything at its manufacturing sites - never surrendering control to others - the familyowned company perfectly calibrates each workflow component to the next: Zirkonzahn’s first aim is to provide laboratories a symbiotic ecosystem of innovative hardware, software, restorative materials and implant prosthetic components. This ensures a 100% smooth work process for technicians and clinicians - from patient data acquisition, articulation, virtual design and milling to placing the restoration in the patient’s mouth. For the skeptical or curious readers, it is important to note that, along with data formats, Zirkonzahn’s doors are always open to eager-to-learn dental technicians and dentists: come to our homeland in the heart of the Alps, South Tyrol, and see in person our team, manufacturing sites, headquarters, dental lab and education centres. Otherwise meet us in the UK us at the Implant Dentistry Show in London on 1 February 2020, or join our upcoming lecture tour ‘Creating excellence with speed and precision’ in Inverness, Glasgow, Leeds and Manchester from 27 to 30 January. FOR MORE INFORMATION ABOUT OPEN CAD/CAM SYSTEMS AND UPCOMING EVENTS IN THE ALPS: E: carmen.ausserhofer@zirkonzahn.com T: +39 0474 066 662 W: www.zirkonzahn.com
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ECPD
FREE VERIFIABLE ECPD As before if you wish to submit your ECPD online it will be free of charge. Once our web designers give it the all clear there will be a small charge. This will be less than the CPD submitted by post. This offer is open to our subscribers only. To go directly to the ECPD page please go to https://dentaltechnician.org.uk/dental-technician-cpd. You will normally have one month from the date you receive your magazine before being able to submit your ECPD either online or by post. If you have any issues with the ECPD please email us cpd@dentaltechnician.org.uk
4 HOURS VERIFIABLE ECPD IN THIS ISSUE LEARNING AIM
The questions are designed to help dental professionals keep up to date with best practice by reading articles in the present journal covering Clinical, Technical, Business, Personal development and related topics, and checking that this information has been retained and understood.
LEARNING OBJECTIVES REVIEW: n Strength of Zirconia n Implant planning n Customised Special trays n Business of Management
LEARNING OUTCOME
By completing the Quiz successfully you will have confirmed your ability to understand, retain and reinforce your knowledge related in the chosen articles.
Correct answers from December DT Edition:
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VERIFIABLE ECPD - JANUARY 2020 1. Your details First Name: .............................................. Last Name: ........................................................Title:................ Address:.............................................................................................................................................................. ................................................................................................................................................................................ ............................................................................................................ Postcode:............................................... Telephone: ......................................................Email: .................................................. GDC No:.................. 2. Your answers. Tick the boxes you consider correct. It may be more than one. Question 1
Question 2
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As of April 2016 issue ECPD will carry a charge of £10.00. per month. Or an annual fee of £99.00 if paid in advance.
Q9.
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You can submit your answers in the following ways:
Q10.
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3. Evaluation: Tell us how we are doing with your ECPD Service. All comments welcome.
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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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ECPD
VERIFIABLE ECPD AS YOU NEED IT VIA THE DENTAL TECHNICIAN Welcome to your magazine
Q. 1. What is the significant legal change for technicians since registration?
Q. 9. How can you at the laboratory assist in accurate dimensional interpretation?
Q.2. What is the legal position regarding the statement of manufacture?
Dentsply Sirona 24hour World staff meeting
A. B. C. D. A. B. C. D.
They have to be registered. They need to do ECPD. They are responsible directly to the patient in law. They have to pay for their registration.
You can supply it when the dentist asks for it. You can send some out when you have time. You are required by law to supply one with each restoration, otherwise you are working illegally. You don’t have to do it if you don’t want to.
Marketing with Mike Bond
Q.3. How does Mike Bond suggest you work out your pricing?
A. B. C. D.
Begin with working out your costs and applying the costs to each restoration and then adding your margin. See what the market place is charging and charge 10% less. Find out what your dentist client wants to pay & charge that. Just charge the same as the last place you worked.
A. B. C. D.
By using an accurate slide rule. By providing an image distortion device for the process. By having a photograph of the mouth. By having impressions of the mouth.
Q.10. Which countries are featured in the photos?
A. B. C. D.
Russia and Japan. USA Japan and Russia. UK, USA, Germany and Mexico. USA, Russia, Germany. Japan and Australia.
Q. 11. Approximately how many countries were included in the meeting over the 24 hours?
A. 48. B. 68. C. 90. D. 87.
Q. 12. Approximately how many employees were contacted.
Dental Doris
Q.4. What is the third suggested area for change in the list of six?
A. Self-promotion. B. Will power. C. Determination. D. Time.
A. 4,000. B. 25,000. C. 90,000. D. 110,000.
Digital radiography used to evaluate crown margins Q.13. How successful was the process?
A. Extremely increased accuracy. B. Promising with future technique changes. C. Inconclusive. D. Not at all successful.
Q.5. What is the ultimate requirement for success?
A. B. C. D.
Having a trusted support. Having a target to achieve. Being determined. Self-belief.
Looking back with James Bennett
DTGB
Q. 6. What is the case featured in the newsletter?
A. B. C. D.
A full upper removable on a milled bar. A full implant retained denture on the mandible. Implant fixed screw retained dentures. Full milled bar upper removable with implant screw retained lower.
Q.14. What was the first-year weekly salary for Mr Bennett at Eastman’s Hospital?
A. B. C. D.
Three Pounds. Thirty six shillings. (£1.80s.) Two pounds ten shillings. One Pound Seven and six.
Q. 15. Which Articulator model did he repair? Q. 7. How many Implants have been placed in the maxilla?
A. Six. B. Five. C. Four. D. Eight.
Dentatus ARH 25. Dentatus ARH. Dentatus AEB 15. Dentatus ARB.
Periodontitis and heart disease
CBCT and you
Q.16. What percentage of the adult population suffer from periodontitis?
Q8. What is the primary difference between CBCT and an OPG?
A. B. C. D.
A. B. C. D.
A larger picture of the site, A more detailed reproduction of the site. A three-dimensional image of the site. A clearer picture of the site.
A. B. C. D.
20 % 63%. 29% 45%.
Payment by cheque to: The Dental Technician Magazine Limited. NatWest Sort Code 516135 A/C No 79790852 You can submit your answers in the following ways: 1. Via email: cpd@dentaltechnician.org.uk 2. 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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