The Dental Technician Magazine July 2021 by The Dental Technician Magazine

VO L 74 N O. 7 I J U LY 2 0 2 1 I B Y S U B S C R I P T I O N

VERIFIABLE ECPD FOR THE WHOLE DENTAL TEAM

A STEP BY STEP GUIDE ON HOW TO CREATE AND IMPLEMENT A QUALITY MANAGEMENT SYSTEM FOR A DENTAL LABORATORY - PART 1 BY PETER J NATT PAGES 14-16 AN INTERVIEW WITH... MARK WELCH RDT/DIGITAL EXPERT AT BRACON PAGE 20 A WEEK IN THE LIFE OF A DENTAL MECHANIC BY ANDY SANSON PAGES 30-32

EASY TO USE EASY FOR ALL!

ONE CERAMIC. FOR ALL CERAMICS. • Leucite-reinforced glass ceramic for all ceramics • Easy handling thanks to high stability during layering • Reliable esthetics thanks to the VITA shade formula

Simply scan and discover interesting clinical cases! www.dental-visionist.com ©

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CONTENTS

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

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

PUBLISHED BY THE DENTAL TECHNICIAN MAGAZINE, PO BOX 2279, PULBOROUGH, RH20 9BR. T: 01372 897463

Welcome Welcome from the editor

Health & Wellbeing Mental Health Awareness. By Steve Taylor

Dental Technology Sagemax NexxZr® VITA: New veneering ceramic shows ideal light dynamics and high firing stability Relationship between dental materials in use in the digital field. By Matteo Neroni

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Business

NEW ADDRESS

The Dental Technician Magazine is an independent publication and is not associated with any professional body or commercial establishment other than the publishers. Views expressed in this journal are not necessarily those of the editor, publisher or the editorial advisory board. Unsolicited manuscripts and photographs are welcome, though no liability can be accepted for any loss or damage, howsoever caused. No part of this publication may be reproduced in any form without the express permission of the editor or the publisher.

A Step by step guide on how to create and implement a Quality Management System, Part 1. By Peter J Natt

Insight Progress versus perfection. By Matt Everatt, Editor

18-19

Interview An interview with... Mark Welch, RDT/Digital expert at Bracon

DTCPD Snoring & Sleep Apnoea: A role for the Dental Technician. By Matt Everatt, Editor

Technicians Insight Life outside the lab. With Phil Reddington A week in the life of a Dental Mechanic. By Andy Sanson

24-25 30-32

ECPD

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Marketplace

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.

14-16

Exocad announces its largest ever presence at the International Dental Show (IDS) 2021

26-27

3Shape/ Createch Medical Zirkonzahn/DTS

36 38

Classifieds

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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BAR HEADER WELCOME

Welcome

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

elcome to your July edition of The Dental Technician Magazine. Last month I wrote about our ‘Freedom Day’ on the 21st of June, which clearly didn’t happen. Prime Minister Harold Wilson once said ‘A week in politics is a long time.’ As I sit writing this welcome, we have seen the resignation of our Health Secretary and appointment of the incoming Sajid Javid. Political allegiances aside, as a Healthcare Professional, you can’t help but feel miffed at the rule makers. If we were flagrantly breaking the rules/laws set by our Secretary of State for Health we would likely be faced with being struck off the professional register. Let us move on!

I was kindly invited to present the first webinar on behalf of the collaboration between ProDental CPD and The Dental Technician Magazine. I write a little more about this experience in the magazine. I would really urge fellow technicians to come forward to speak and deliver a session. As a group of professionals, our access to CPD is not the best. We need to help each other and what is better, it is free CPD! In general, I am hearing really positive things within our sector of the dental profession. Business seems to be thriving for the majority of us. The biggest crisis seems to be the ability to attract new recruits. The June edition had an article by Julie Barker, Academy Leader at Sheffield College. Students have had a really rough time with the pandemic, not only limiting their training time in college, but accessing work experience has been almost impossible. If we want to get new blood into the profession, we as a collective need to come together to help these students gain valuable experience to enable them to achieve a registrable qualification. I do hope you continue to enjoy the features and content of the magazine. As we speed our way through another year, we hope that July brings a new hope for freedom as well as the sunshine. Please do get in touch if you would like to contribute any content to the magazine and the future webinar sessions.

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HEALTH & WELLBEING

MENTAL HEALTH AWARENESS By Steve Taylor I PCDT DipPs(Implantology) FBIDST I Chair of BIDST I Board member of DLA

ental Health has always been an issue within dentistry due to the very nature of the pressures all members of the dental family work under on a daily basis. This was acknowledged by the Dental Professionals Alliance (DPA) in late 2019. A working group was established to create a initiative to help deal with the problems by providing a framework at would highlight a pathway to allow each dental workplace to install a mental health wellness lead.

be neglected as we put our patients’ needs ahead of our own; this professionalism and care needs to be extended to our own colleagues, enabling us to perform our roles in healthcare. This programme has been put together by [Dental Professionals Alliance, Chaired by Fiona Ellwood and Roz McMullan] and has the support of the dental care professional organisations listed below. It encompasses the entire dental profession and provides a framework to allow us all the opportunity to look after one another, as dental care professionals supporting mental care.

The British Institute of Dental and Surgical Technologists as part of the DPA was pleased to be involved with this timely and important initiative. We are supportive of the dental profession and recognise the value of promoting Mental Health and Wellness to all members of the dental team. All the member groups who were involved are listed at the foot of this piece. The concept of the Mental Health and Wellness working group was to create a framework by which all dental businesses, practices or laboratories could have someone within them that was suitably trained to act as a mental health lead. The role of the lead is to be a confidential support for anyone needing help or some guidance with his or her mental health. It is the role of the lead to try to spot someone who may be showing signs of being engaged with a mental health struggle and to offer help by being able to signpost them to various resources that are available. Sometimes the lead by simply asking some questions “are you ok?, is everything alright, shall we take 10 minutes to chat” may find that is all someone needs, other times having a trained lead point the

This is every bit as vital in the dental laboratory setting and the technicians, staff and owners who they employ. A powerpoint presentation is available free of charge which has been customised for dental laboratories and technicians, please engage with this vital initiative and encourage a mental health wellness lead to undertake the role within each business.

colleague in an appropriate direction will put the colleague on a pathway to a more successful outcome. It is hoped that the entire range of dental businesses will engage with this concept and allow a mental health lead to carry out their role with full support from that business. Being healthy means more than the absence of disease, and healthcare provision should not be seen as just being for the patients we serve. We also have our health needs that ought not

“Being healthy means more than the absence of disease, and healthcare provision should not be seen as just being for the patients we serve.” www.dentaltechnician.org.uk DT_JULY 2021.indd 5

It is hoped to set up a network so that the MHW leads can share experiences, and know that support is also available for them. It will be an ongoing development role that will be reviewed at least annually.

THE STAGES ARE:

1. Undertake stress awareness training (the whole team) 2. Identify a Mental Health Wellness Lead 3. Undertake Mental Health First Aid Training (Required) 4. Participate in Suicide Awareness Training (Desirable) 5. Engage in self-care regularly and maintain skills annually. The complete Framework is also available FOC to help each step of the way. Please visit http://www.mhwd.org/ to help everyone.

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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

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ultra-hard, nanocrystalline diamond coating for an extremely long service life. The special microgeometry of the cutting edges is excellently adjusted to milling zirconium oxide and permits detailed milling results with a high surface quality. The optimized chip space design as well as the improved chip space surfaces ensure the best possible evacuation of the chips, which additionally reduces the chipping risk of zirconium oxide.

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DENTAL TECHNOLOGY

NEW VENEERING CERAMIC SHOWS IDEAL LIGHT DYNAMICS AND HIGH FIRING STABILITY

Dr.-Ing. Berit Gödiker, Bad Säckingen, Germany

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Modern, all-ceramic veneering materials are required to meet a variety of criteria in terms of mechanical, esthetics and application technology. For example, they should allow for reliable reproduction of tooth shade and play of light, remain stable during the modelling process and also guarantee firing results that are dimensionally stable. Furthermore, the material is expected to ensure a good bond to conventional framework ceramic and the veneer is expected to remain stable throughout its long-term clinical use. A new veneering ceramic, VITA LUMEX AC (VITA Zahnfabrik, Bad Säckingen, Germany) has been developed, thanks to meticulous materials research that meets the wide range of expectations to a high degree.

VITA LUMEX AC is a leucite-reinforced, glassceramic veneering system. What are the special characteristics of the material and how can laboratories benefit from using it?

In the following interview, dental material expert Dr.Ing. Berit Gödiker answers questions concerning VITA LUMEX AC, with regard to special material characteristics and insights gained from laboratory tests.

In order to achieve a vibrant play of color and light, you need ceramic material that offers the best light dynamics. What does the new veneering ceramic offer in terms of translucency, opalescence and fluorescence?

The leucite content of the glass allowed the new veneering ceramic to be adjusted in such a way that ensured an optimum bond to conventional all-ceramic framework materials such as zirconia and glass ceramic. In addition, leucite also contributes to high material strength, which means that excellent long-term durability can be expected with VITA LUMEX AC veneers. Shade fidelity is a central criterion forensuring that restorations integrate harmoniously into the rest of the dentition. What degree of shade fidelity, with respect to the shade standard, does the new ceramic show and why?

VITA LUMEX AC achieves a very high degree of shade fidelity when compared to the VITA shade standards. For a precise shade formula, you need a lot of experience, modern shade measurement technology and expert specialists. VITA has developed dental shade standards that are applied worldwide, allowing us to draw on nearly a hundred years of experience, and to familiarize ourselves with the original formulas of the shade standards. In addition, the visual analysis of shade samples in the form of material samples and restorations by experienced specialists is a key success factor.

The degrees of translucency of OPAQUE DENTINE, DENTINE and ENAMEL materials are ideally matched to each other for an excellent play of light. Special opal materials have been developed to achieve a particularly vibrant opalescence. In addition, all of the base materials and a large amount of the effect materials exhibit nearnatural fluorescence. The highly fluorescent FLUO INTENSE materials were also designed with the aim of targeted control of in-depth fluorescence.

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DENTAL TECHNOLOGY

Opalescence

Translucency

Documentation of the photo-optic properties of VITA LUMEX AC shown by photographing sample crowns using different lighting conditions and sources

During the modelling process, it is important for the ceramic to have good stability. What are the technical material requirements for stability, and how well does VITA LUMEX AC perform in this respect?

Fluorescence

The stability of the moistened ceramic is determined by the particle shape and surface of the powder particles, as well as by the distribution of the particle size of the powder. The shape and surface of the ceramic particles must be configured in such a way that micro-serration of the particles occurs during the layering process. That is why VITA LUMEX AC ceramic particles are irregularly shaped and have a structured surface. Furthermore, VITA LUMEX AC ceramic is designed so that the fine, medium and coarse grain size components exhibit an ideal ratio to one another. The dimensional stability of the ceramic after firing is another important success factor for the laboratory. How dimensionally stable did the new veneering ceramic prove to be in your studies?

Material samples made of VITA LUMEX AC ceramic have been examined in countless series of tests and have always demonstrated high dimensional stability, even after repeated firing processes. The visual inspection of the test samples showed, for example, that the inserted edges do not round down. One reason for this is that with VITA LUMEX AC, the material shrinkage typical of veneering ceramic has been significantly lowered as a result of the high u density, homogeneous material structure.

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DENTAL TECHNOLOGY

Patients, dentists and technicians are looking for materials that offer longterm durability. What values does VITA LUMEX AC achieve in terms of mechanical properties, as compared to other materials?

VITA LUMEX AC exceeds the flexural strength required by the ISO standard for veneering ceramic by more than twofold, demonstrating excellent material stability in laboratory tests. In addition, the bond strength in relation to the framework material also plays an important role. Excellent bonding values were achieved with VITA LUMEX AC on both zirconia and glass-ceramic frameworks, in some cases significantly exceeding the bonding values of competitor materials. VITA® and the names of the VITA products mentioned are registered trademarks of VITA Zahnfabrik H. Rauter GmbH & Co. KG, Bad Säckingen, Germany.

Sample representation of the visual inspection of the shade fidelity of a VITA LUMEX AC sample crown to the VITA shade standard, and for the implementation of a shade formula using ceramic powders mixed with color pigments.

Fig 2

Fig 1 Fig 3

Fig 4

Fig 1: Results graphic based on bending strength tests using the abovementioned all-ceramic veneering materials. SOURCE: Internal investigation of VITA R&D, Measurement of 3-point bending strength, according to ISO 6872 with the abovementioned materials, Report 08/19, Dr.-Ing. B. Gödiker. Test report is available via www.vita-zahnfabrik.com/lumex Fig 2: Sample, simplified visualization of particle size distribution/micro-serration in VITA LUMEX AC, as well as sample photographic documentation of an intermediate result during layering. Fig 3: Sample, simplified visualization of particle size distribution/micro-serration in VITA LUMEX AC, as well as sample photographic documentation of an intermediate result during layering. Fig 4: Photographic documentation of the firing results of test samples of the above-mentioned veneering ceramic after several firing processes. SOURCE: Internal investigation of VITA R&D, Analysis of firing stability after four firings with test samples of the abovementioned materials, Report 08/19, Dr.-Ing. B. Gödiker. Test report is available via www.vita-zahnfabrik.com/lumex.

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BUSINESS

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BUSINESS

A STEP BY STEP GUIDE ON HOW TO CREATE AND IMPLEMENT A QUALITY MANAGEMENT SYSTEM FOR A DENTAL LABORATORY - PART 1 By Peter J Natt This is a 2 part step by step guide that will run over to the August 2021 issue of The Dental Technician Magazine. The first part will prepare you to begin implementing a Quality Management System (QMS). Part 2 will go through the practical aspects and help you physically implement your QMS. THE MEDICAL DEVICES REGULATIONS AND TRACEABILITY OF DEVICES

The Medical Devices Regulations were implemented as a result of the concerns caused by the breast implant scandal where implants containing dangerous substances had been implanted within patient’s bodies. The Medical Devices Regulation EU MDR 2017 superseded the Medical Devices Directive EU MDD 1993 because of Brexit. As from January 2021 Great Britain (England Scotland and Wales) will be following the existing UK MDR 2002 which was amended at the end of 2020 to incorporate the EU changes. Northern Ireland will still follow the EU implementation requirements from 26 May 2021 and will have to comply with the EU MDR 2017. This is due to the Northern Ireland Protocol Agreement. The Medical Devices Regulations has an enhanced Traceability element contained within it so as to ensure that a record is kept of the materials that a device is constructed from so that if there is a concern in the future about a specific material that it contains that it is possible to identify the Devices containing the suspect material and the Patients can then be contacted and alerted to the issue. Another big advantage of Traceability to the Dental Team and Patients is that for instance the manufacturers of Devices (i.e The Dental

Laboratory) have to keep detailed records of the materials and components that they use within a Device. So for instance a Device containing pre-manufactured implant components would mean that the following details would be required (i.e. manufacturers name, the brand, type, size and product identity code). The same also applies to the artificial teeth used on dentures as details of the artificial teeth such as the manufacturers name the brand, mould and shade of the teeth should be recorded. This means that it will be possible to determine from the records which implants or teeth where used on a specific device, which make it far easier for them to be repaired, altered (i.e additions), serviced or re-made. The Patient will have the details of the manufacturer of their Device on their ‘Statement’ so it will be easy for them to then request the details from the manufacturer of the Device as to which materials and components were incorporated within their Device. The Dental Laboratory industry needs to be seen to be ‘Whiter than White’ in its compliance with the Medical Devices Regulations if the public are to have confidence in it so it is important that every Dental Laboratory complies with the Medical Devices Regulations.

LEGAL OBLIGATIONS

Whether you manufacture 1 or 1,000,000 Custom Made Medical Devices per year you must comply with the Medical Devices Regulations. This is a legal requirement and there are absolutely no exceptions. Failure to comply with all the requirements of the Medical Devices Regulations means that you are manufacturing Medical Devices illegally. This could have serious consequences for you as you could receive a large fine or even a prison sentence, and also be reported to the GDC and referred to their ‘Fitness to Practice’ committee. In addition, your product liability and third-party liability insurance policy may be invalidated if you are operating illegally.

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As a result of being found not to be complying with the Medical Devices Regulations you may find yourself at the receiving end of legal action and suffer the financial consequences not forgetting the anguish caused to you and your family in having to deal with the consequences.

SUB-CONTRACTING WORK

It is important to ensure that any Devices that are sub-contracted to another Dental Laboratory or Milling Centre are manufactured by someone that is fully compliant with the Medical Devices Regulations so always check that they are registered with the MHRA and that they have an audited Quality Management System such as DAMAS in place. Keep their details (i.e a copy of their current Quality Management Certificate such as DAMAS) recorded in the ‘Approved Suppliers’ section of your Quality Management System Manual and always ensure that it is updated each year.

WHAT YOU MUST DO TO COMPLY WITH THE MEDICAL DEVICES REGULATIONS

Manufactures of Custom Made Medical Devices must comply with the Medical Devices Regulations and to do this they must: 1. Be Registered with the MHRA and have a MHRA Registration Number (Anyone having a Registration Number beginning with CA must Re-Register immediately on the new MHRA online DORS Portal – see my article ‘A Step to Step Guide on how to Register with the MHRA’ in the March 2021 Issue of The Dental Technician Magazine. This is the link to check to see if you are registered with the MHRA: https://aic.mhra.gov.uk/era/pdr.nsf/ name?openpage&start=1&count=200 or search: ‘MHRA Register of Custom Made Devices.’ Also check that your address is correct and that all the Devices and Products you manufacture are listed. 2. Have a documented Quality Management System in place.

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BUSINESS

WHAT IS A QUALITY MANAGEMENT SYSTEM?

A Quality Management System is a formalized procedure that documents the policies, procedures, documentation requirements and processes that manufacturers use to ensure that their products are both safe and effective for the end user. The MHRA (Medical Health Products Regulatory Agency) mandates that all Medical Device companies that market product in the U.K maintain a Quality Management System.

THIS QUALITY MANAGEMENT SYSTEM The Quality Management System that I shall describe compiles with both the requirements of the Medical Devices Regulations and DAMAS so if Dental Laboratories wish to be third party audited to DAMAS then this Quality Management System will form the basis for doing so.

ADVANTAGE OF HAVING A THIRDPARTY ACCREDITED QUALITY MANAGEMENT SYSTEM

The advantage of having a third-party accredited Quality Manuel System is that you can provide your clients and anyone that sub-contracts work to you with a copy of your current Quality Management Certificate (such as DAMAS) which will demonstrate your compliance with the Medical Devices Regulations.

QUALITY MANAGEMENT SYSTEMS AND THE CARE QUALITY COMMISSION (CQC)

If your clients are inspected by the Care Quality Commission (CQC), who regularly inspect Dental Practices (be they NHS or Private) then it is easy for your clients to demonstrate that the suppliers of their Medical Devices are compliant with the Medical Devices Regulations by showing the auditor a copy of their Dental Laboratories Quality Management System Certificate (DAMAS).

HOW TO CREATE YOUR QUALITY MANAGEMENT SYSTEM

I would suggest using a word processing software and creating a Folder specifically for all your Quality Management Files and also save each page as a different file. This will also make it easy when carrying out your ‘Internal Audit’ prior to your annual review and audit. In addition, any updates to the system as a result of changes to the Medical Devices Directive can be easily carried out. This will also make it easy for you to print out the pages for your various files.

Microsoft 10 Operating System • A word processing Software such as Microsoft 365 Software which includes Microsoft Word to produce the pages of your Quality Management System. • A Computer Printer (Laser or Ink Jet) - Even better a Printer/Copier/Scanner • Spare Ink Cartridges or refills for your printer • A4 White Paper • A Paper Punch • Two separate computer data Back-Up Systems to ensure that if your computer is corrupted there is always an up to date backup available. i.e a separate hard drive and a separate system for backing up to the cloud. • A Laminating Machine capable of laminating A4 size sheets of paper • Glass Clear Laminating Pouches (A 4 Size 2 X 125 um Thick) • Velcro Stick On Loops Male • Velcro Stick On Loops Female

FILES AND THEIR CONTENTS

• Lever Arch File 1 Quality Management System Manuel (Insert a 1-15 Index) • Lever Arch File 2 All Correspondence Relating to the MHRA • Lever Arch File 3 Equipment Instructions (Insert an A-Z Index) • Lever Arch File 4 Material Instructions (Insert an A-Z Index) • Lever Arch File 5 Staff Training and Staff Qualification Records (Insert an A-Z) Index • Lever Arch File 6 Cleaning Records • Lever Arch File 7 Maintenance and Servicing Records (Insert an A-Z Index) • Lever Arch File 8 Current Orders • Lever Arch File 9 Completed Orders • Lever Arch File 10 Superseded Documents (Insert a 1-15 Index)

HOUSEKEEPING AND CONVENTIONS Create a folder within Microsoft Word Documents called QMS to keep all your individual files within it so that they are accessible and easy to find. At the bottom of each page of each document put the name of the file and the date it was created. i.e 10.06.2021 i.e c:documents/qms/compliance.001

TO START OFF YOU NEED TO DOWNLOAD A PRINTED VERSION OF:

• A Copy of the Medical Devices Regulations. www.legislation.gov.uk (In the search title field type Medical Devices Legislation and in the Type field select All Legislation (including originating from the EU). • A Copy of the requirements of your Quality Management System (i.e DAMAS). www.damas.co.uk Click on Downloads Then Click on DAMAS Specifications Issue 8.

FIRST TWO THINGS TO DO IN YOUR DENTAL LABORATORY

If you manufacture new or repair worn dentures, carry out additions or relines to worn dentures then you need to ensure that you have two completely separate polishing lathes, pumice baths and polishing baths so that cross-contamination cannot occur between worn and new dentures as pumice will allow micro-organisms to survive and grow within it. You also need to have a documented system which shows you regularly clean out and renew the pumice in your polishing lathes and keep separate grinding stones and burs for new and repaired dentures. Also ensure that you have a disinfectant bath for all devices leaving the laboratory and again have a documented system that shows you regularly clean out the bath and change the disinfectant. To reduce the risk of cross-contamination have a separate disinfectant bath for worn appliances/restorations and another one for new appliances/restorations. Mark them as to what they are so that there can be no doubt or mistakes. THE SECOND PART TO THIS ARTICLE, WHICH WILL GUIDE YOU THROUGH THE CREATION OF THE QMS WILL BE PUBLISHED IN THE AUGUST 2021 EDITION OF THE DENTAL TECHNICIAN MAGAZINE.

SUGGESTED LIST OF WHAT YOU WILL REQUIRE TO CREATE YOUR QUALITY MANUAL SYSTEM:

• Your MHRA Registration Number • The Name of the Quality Management System you wish to comply with • 10 X Lever Arch Files of Foolscap (A4+) Size • 4 X A-Z Indexes for Lever Arch Files • 2 X 1-15 Indexes for Lever Arch File • A Desk Top or Lap Top Computer using the

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DAM

DA MAS COMPLIANCE MADE EASY

●

Provides a public demonstration of compliance with the MDD/MDR

●

Ensures that dental appliances meet the relevant requirements of the MDD/MDR

●

Gives your clients confidence that you are MDD/MDR compliant

●

Provides a framework for continuous improvement in your business

●

Step by step learning system that you implement without leaving your laboratory

●

Be ready for your first audit in as little as 8 weeks

DEVELOPED BY THE INDUSTRY FOR THE INDUSTRY

DAMAS OFFICE NBV Enterprise Centre I David Lane I Nottingham I NG6 0JU E: damasoffice@btinternet.com W: damas.co.uk T: 0115 964 8249

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INSIGHT

PROGRESS Versus

PERFECTION

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INSIGHT

By Matt Everatt I Editor FEAR OF FAILURE

I sat in a clinical lecture recently when the speaker gave us all something to ponder. He put it to the audience that ‘our profession shackles us and teaches us that we cannot and should not accept failures.’ We should always achieve 100% perfection each and every time we treat patients. In Dentistry, we have to fix things, we are made to feel we have to give a 100% guarantee with every piece of clinical or technical work we do. Should the restoration fail, or the tooth has to be removed, the clinician or technician feels a degree of responsibility. I won’t even begin to discuss the fear of litigation when a failure occurs. In no other profession is this acceptable or achievable. Consider our medical colleagues; when they prescribe medication, they will list a million potential side effects and will almost certainly always suggest ‘we will try this first’. Accountants don’t guarantee that the HMRC won’t come knocking for more. Lawyers would never give a 100% guarantee on winning a case in court. So why do so many of us, in our profession, see anything other than perfection as a failure? On the whole I would say in our profession we have a pretty unhealthy relationship with failure. Failures give us an opportunity to learn. Failures can help us diagnose what went wrong and what could potentially go wrong and help us better understand the success of a process or action more so than trying to analyse what elements may have led to the success of the process or action.

Is it not surprising that we see so many of our peers within our profession struggle on a daily basis seeking the panacea of perfection. Our exposure to Social Media can only make those feeling inadequate when it comes to seeking to perfect themselves or their work. According to The National Archives, Dentists and Healthcare occupations are amongst the highest in terms of mortality from suicide. Could this daily struggle be contributing to the negative impact on the mental health on ourselves and our colleagues?

WHY IS GOOD ENOUGH, NOT ENOUGH? Actually ‘Good Enough is Enough!’ as honourable as it is that we strive for perfection, as long as we aren’t negligent, ‘good enough’ is just fine. Negligence happens when a task is undertaken without effort and attention to detail. I think most, if not all of us undertake our tasks as professionals with great effort and best intentions. Mistakes and failures happen, it’s a given, we are only human! Failures and mistakes are actually brilliant opportunities to learn. Failure is when a project does not turn out as we hoped it would, despite our best effort, we make progress and we improve.

PERFECTION PARALYSIS

This is a term I have heard a lot just recently whilst listening to one of my favourite speakers Mel Robbins, a motivational speaker, author and regular TEDx speaker sums up this struggle we have with attaining perfection beautifully.

Clearly there are some mistakes that are costlier than others and we should not confuse failures with negligence. It is important to readjust our mindset in regards to mistakes and failures and it is critically important to distinguish between negligence and failure. The culture in our profession is that we must always produce perfection. Is perfection even possible? The minute we think we have nailed it, something new pops up, or a colleague produces an amazing piece of work that you immediately judge yourself against. In an online article, Dr Jessica Zucker writes “Perfection is not possible”. She goes onto say that research has discovered that those individuals that live their lives with the mission of perfection can suffer greatly with depression, anxiety, or body image dissatisfaction.

I have seen an area of my own business suffer from Perfection Paralysis. We were looking to create or purchase some software to replace our old production planning and accounting system. We spent far too long seeking perfection that we spent nigh on 5 years looking for something that didn’t exist. By the time we bit the bullet to ‘just do it’, our old system had grown to an unstable point where we couldn’t migrate with our preferred system. It led to a further 2 years of development and we still aren’t finished yet! It was a costly exercise to seek perfection, it cost us almost 7 years in time, let alone the staff hours put into this project. Perfection /pəˈfɛkʃ(ə)n/ - the action or process of improving something until it is faultless. Progress /ˈprəʊɡrɛs/ - development towards an improved or more advanced condition.

PRACTICE MAKES PROGRESS

Practice makes Progress! I know that’s not the correct saying! Practice make perfect, and I don’t buy this anymore! The constant internal battles we have aiming to seek perfection can sometimes stifle innovation and development, inevitably preventing progress. On my search for material on perfection I have stumbled upon several great quotes and one liners that I hope will help us all to think twice when we begin to feel inadequate when we have achieved short of perfection. Don’t let the fear of being anything less than perfect prevent you making progress. Be bold, be willing to listen to feedback, do not take anything personal, it is all progress. Perfection is exhausting. Progress is invigorating.

“Have no fear of perfection - you'll never reach it.” Salvador Dali

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She talks of ‘Perfection Paralysis’. The fear of not being perfect prevents us from progressing.

Perfection focuses on what's not working, the flaws, the not-enoughs, the old paradigms. Progress looks at what is working, the improvements, the discoveries, the ‘eureka’ moments that come from the realisation of looking at things from a new perspective. Perfection is bound by time. Progress doesn't measure time because it's right now and endless. It's a journey of the right-now and, the next.

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INTERVIEW

AN INTERVIEW WITH...

MARK WELCH

RDT/Digital expert at Bracon How did your career in dentistry start?

For the sake of our readers, can you explain the differences between LCD printers and DLP Printers and which type do you think will be more popular in the future and why?

I found an advert in the local newspaper for a model maker and delivery driver at a local dental laboratory.

The difference from my experience is that DLP printers can be highly accurate and reliable, they also print at a faster rate. The downside is that they can be expensive to repair and this will usually need to be undertaken by a qualified engineer. DLP printers can also have significant consumable costs.

After working there for a short time, I was told about a job going in London. I arranged an interview and remember walking up Harley Street and thinking "wow what an incredible place to come and work!" the rest is history! Give us an interesting fact about you?

I won the boys 400m in athletics for my secondary school at the Sussex championships.

LCD printers are capable of high accuracy but are cheaper to purchase and easier to repair. The consumable costs may be less, but the LCD panels themselves will need to be replaced from time to time to maintain accuracy.

Do you have any interests or hobbies?

Dentistry, particularly digital of course! But my number one interest is music and I have been a DJ for some time. I have been collecting music since I was 8 years old. I also enjoy playing video games in my free time as a source of relaxation. What is your favourite part about your current role?

I have always been a bit of a techno geek, always having had a fascination with technology and having played video games since I was a child, so naturally digital dental technology is a great role for me. I'm very lucky as in my current role as I to get to play with all the latest digital technology hardware and software in dentistry. My passion lies especially with 3D printing and additive manufacturing, also the immense pleasure I get from training and supporting our digital customers at Bracon Ltd. Where do you think digital dentistry is heading in the future?

In the last couple of years there have been some manufacturers working on the creation of additive manufacturing systems for manufacturing zirconia and ceramics. I personally think there are huge benefits to be had from additive manufacturing. These may include increased accuracy, faster build times and much less waste of materials. These systems may be expensive when they first enter the market but after time the prices will come down to a point where laboratories will be able to afford them.

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We are still waiting for the next generation of denture base materials and these will see improvements in materials for long term appliances. The next big thing to cause a shake-up will be direct printing of aligners, watch this space....

Historically they are slower as they use a less powerful light source thus taking longer to cure each layer, although I believe the new generation are now able to print faster. I think that both types of light sources will continue to improve in the future and may get to a point where there is not much difference between the cost, quality of printed parts and variety of materials that can be used.

What has been the most innovative technology that you have seen to date for digital printing and milling?

How do you see intraoral scanners changing the digital workflows for the Clinicians and Dental Laboratories?

There has been some research into Holographic 3D printers as of late, it looks like something from a 70’s Sci-fi movie!

Now that the pricing of intraoral scanners has dropped significantly and an IOS with a hi specification laptop can be purchased with all the scanning software for just under 10K, adoption of IOS devices will increase significantly. Already we are seeing a significant increase in enquiries from dentists and laboratories, which will eventually lead to these optical devices becoming standard pieces of equipment in every dental practice, much like digital radiographic equipment. This is already changing the workflows in those Dental Laboratories that can accept and process digital scan files.

What are some of the new applications to look out for in the future of 3D printing?

Looking ahead at new technologies do you think that holographic printers will be the next revolution in additive manufacturing?

I think there may be some useful uses for these including laser printers, especially when printing metals as they could help the distribution of power in 3 dimensions instead of two. Reading up on this, the theory is that the power output can be monitored much more efficiently thus producing much stronger parts.

www.dentaltechnician.org.uk 06/07/2021 16:44

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EVENTS TECHNICIANS DTCPD INSIGHT

SNORING & SLEEP APNOEA A ROLE FOR THE DENTAL TECHNICIAN By Matt Everatt I Editor The first in the series of free webinars in conjunction with The Dental Technician Magazine and ProDental CPD. Sponsored by WHW

everal months ago we (The Dental Technician Magazine) were approached by Rob Dyas of ProDental CPD. ProDental CPD provide online CPD for Dentists and Dental Professionals. Rob, a practicing Oral Surgeon, wanted to offer free CPD sessions for Dental Technicians and wanted to join forces with the magazine to provide speakers for Dental Technicians. I suppose it was inevitable that I was going to be the ‘Guinea Pig’ so to speak! My main area of interest is Snoring and Sleep Apnoea, I thought it best we open with this subject. The content of the sessions was designed to give Dental Technicians a basic background on Snoring & Sleep Apnoea, to discuss the aetiology, signs and symptoms and current treatments available. There was around 50 delegates attending the lunchtime session, the difficult thing for me, I’d much rather speak to people in the flesh. For others I would imagine presenting to a blank screen is much less daunting. The session went according to plan, I asked that all questions be saved until after the session, this way I don’t get distracted as I have a tendency to go off subject, I am easily distracted these days! The format of the session allows attendees to build up questions as the presentation goes on, it is great as it builds a bank of questions to go through at the end. In teaching terms, it is always good to recap and go back over some of the most important aspects. I think the subject and content was well received and judging by the number of questions it seemed that everyone enjoyed the session.

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We covered lots of background information on Snoring and Sleep Apnoea and closed the session with lots of examples of different Mandibular Advancement Splints available to Laboratories to offer their customers. We looked at varying degrees of clinical efficacy, listing the pro’s and con’s of each design. The hope being more technicians will consider offering these devices to their own customers. The session was recorded allowing attendees to watch it back, particularly great if they had to leave the session or didn’t quite understand any particular aspect. It is also available for Dental Technicians that couldn’t make the live session. I thoroughly enjoyed delivering the session and I am looking forward to being an attendee listening to future speakers, particularly as its FREE CPD! I would really like to encourage others to come forward and offer a presentation.

It is a great way to start out if you have never done any public speaking before, you essentially sit talking to your computer screen for 1 hour. Some may say its therapeutic! I wanted to say a special thank you to Rob Dyas and his amazing team at ProDental CPD and Chris Trowbridge from The Dental Technician Magazine team for seeing this vision through to actually delivering the first free CPD event. Another huge thank you to WHW for their sponsorship of the lecture. They are Exclusive suppliers of The Sleepwell MAS discussed on the webinar. Our hope is to bring a monthly webinar, to keep them free and deliver interesting content for our readers. If you think you could help us by offering to deliver a webinar, please do get in touch with us via email editor@dentaltechnician.org.uk

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TECHNICIANS INSIGHT

LIFE OUTSIDE b a L The P

hil, Thanks for agreeing to chat with me and taking the time to gives a bit of an insight into what you get up to outside of your professional life. Although we converse lots online via facebook, I don’t think I have met you in person!? Or maybe we did briefly at one of the Showcases, they seem to be such a distant memory don’t they? Why did I ask you to help me with this feature? Well, you seem to share some similar values and interests to myself. Lets start there! You’re a bit of a petrol head right? Tell me a bit about that...

What’s on your drive at the minute?

At the moment its the latest Porsche Cayenne hybrid fully loaded. I pretty much chose every optional extra as I was worried I would find it a

little boring after driving high performance cars for the last 25 years! Only thing I miss is engine noise as I no longer drive fast. Honestly. What’s the best/worst/fastest car you’ve driven?

Best car I think I would say is either my competition pack 4 litre V8 BMW M3. It was the 1st car that felt special and joint 1st with that was the Porsche 911 C4S. I loved that car, wish I had kept it as I drive past it occasionally and it still looks mint! The worse car has to be the 1st Audi TT. I had the 220 version and it was forever in the dealers getting repaired, everything went wrong on it, servo unit, turbos, steering. I got sick of it and traded it in for a Mini Cooper S after 9 months. I did also have an Audi S3 which was an awesome car, so I thing I just got a dog with the TT.

I approached Phil Reddington – Technical Director at Beever Dental Technology about his life outside the lab. Phil seems to be a prolific technician who clearly enjoys his work and looking at some of his cases he kindly shares on social media, his quality looks amazing.

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TECHNICIANS INSIGHT

I seem to remember you posting lots of pics with your daughter and playing around with photography editing. You are clearly a family man. How do you ensure you take time away from the lab?

The older I get the more I realise I’m in a very fortunate position, I get paid very well to do a job I enjoy. It’s almost a hobby, so when it gets to the point that I’m spending too long at work I instantly look for the reasons why. Usually it’s just team members on holiday or a rush of cases I actually want to do myself. Although I’m really not precious about that these days. I’m very fortunate to be part of a team where I’m now the worst ceramist in the lab and I’m pretty decent so that has allowed me to take a step back and look at the daily running of the lab which leads to me having more free time. What I decided around 7 years ago, I was pretty much the lab and everyone helped me as much as I would allow them to. As soon as I realised this was a crazy way to run a business I decided we had to make some changes. The first thing I needed was another ceramist, one with experience. I was lucky enough to have one recommended who was working in Germany who I thought would be perfect. I had skype meetings and we got on, so I flew her in to spend the week at the lab. By day 2 I knew they were exactly the type of technician I needed. I continued that approach continuing to add great team members as we needed them and re-shuffling the team to follow trends in digital. I started taking a step back from certain duties and getting the other team members to do way more duties I even stopped attending training sessions when we were being shown new technology. I did this to try give ownership of the new products or systems to the team rather than everything flowing through me. This has revolutionised the lab, I now know very little of what goes on behind the scenes with the cad cam departments. Yes I can sit down and design frames etc but I would not have a clue how to get to the point where I’m in the design window, no idea what script to select for a BDT type bar or angle corrected screw ret crown etc. Same with the removable department, I’ve invested in a new (to us) system the Ivobase denture system from Ivoclar and would not even know how to turn it on! I think this has been the main reason I now have free time to enjoy time with my family and friends. Getting the right people with the right attitude and then get them the right training. Now my job is to ensure that that happens. Do you play any sports?

I started playing golf a few years ago when my dad was diagnosed with Alzheimer’s, I thought it would be a great way to spend quality time with him. We play snooker when the weather is bad, but I’ve become

a little obsessed with golf even though I’m rubbish at it, I just love playing it. I now play every week, usually on a Friday as I only work 4 days a week and Friday is now golf day. I used to play a lot of football but the lab took over my life in the 2000s and almost every hobby went out of the window. I also used to go out biking on the weekend usually do 50-60 miles on a Saturday off road and on and a good few pints afterwards. My knees are both kaput now so golf fits into that easy to manage category. The other thing I do is spend as much time with my daughter as possible, we like to go bowling together once a week and to farms and wildlife parks too. She loves eating out, which we do almost every night as I’m a rubbish cook. What about music?

I’m obsessed with music! In my youth I was in a band, it was traditional rock, a bit like The Doors, I played bass. The other love was electronic music. I still dabble with this, I had an album released in 2019 on all the major sites, I have not really felt like using my studio much since then as it can take up a lot of time and leads to late nights sat squinting at a DAW screen. Whatever I’m doing, other than watching TV, I’ll have music on in the

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background from the moment I wake up, to the moment I go to bed. My daughter is also obsessed with music which is great, however I can’t get her to pick up the instruments I have laying around. I’m sure there’s time yet though! Do you do any investing for your family/ future? If so, what sort of things do you invest in?

Only thing I’ve invested in is property. I’ve only ever sold one house, every time I’ve moved house I’ve kept the old ones as rentals. My wife manages them, we have a nice portfolio now which will see us through a comfortable retirement. We also have personal pensions and a few shares but the property is the main investment. Tell me a bit more about your work/life balance. How many days a week do you aim to work? How do you ensure that happens?

I work in the lab 4 days a week never weekends. Are there any other interests you have outside the lab?

I love travelling and meeting people. People fascinate me, I have friends all over the world and the job I do has definitely helped me travel. I love spending time with friends and family too and the odd beer.

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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

0.5HRS VERIFIABLE ECPD

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

LEARNING OBJECTIVES

VERIFIABLE ECPD - JULY 2021 1. Your details First Name: .............................................. Last Name: ........................................................Title:................ Address:.............................................................................................................................................................. ................................................................................................................................................................................ ............................................................................................................ Postcode:...............................................

n To understand the key offerings

Telephone: ......................................................Email: .................................................. GDC No:..................

of the Sagemax milling tools n To understand the importance of a Quality Management System for a Dental Laboratory

2. Your answers. Tick the boxes you consider correct. It may be more than one.

LEARNING OUTCOME By completing the Quiz successfully you will have confirmed your ability to understand, retain and reinforce your knowledge related in the chosen articles. CORRECT ANSWERS FROM THE JUNE 2021 DT EDITION: Q1.

Q2.

Q3.

Q4.

Q5.

Q6.

Q7.

Q8.

Q9.

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Q11.

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Question 1

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Question 10 Question 11

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

...................................................................................................................................................... ...................................................................................................................................................... As of April 2016 issue ECPD will carry a charge of £10.00 per month. Or an annual fee of £99.00 if paid in advance. You can submit your answers in the following ways: 1. Via email: cpd@dentaltechnician.org.uk 2. By post to: The Dental Technician Magazine, PO Box 2279, Pulborough, RH20 9BR 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

VERIFIABLE ECPD FOR THE WHOLE DENTAL TEAM

Payment by cheque to: The Dental Technician Magazine Limited. NatWest Sort Code 516135 A/C No 79790852 MILLING TOOLS. FOR CAD/CAM MOVERS BY SAGEMAX

Q1. What year was the company founded? A - 2004 B - 2006 C - 2008 D - 2010

Q2. How many different CAD/ CAM machines are NexxZr tools available for? A-6 B-7 C-8 D-9

Q3. What material is the NexxZr Tool U made of? A - Zirconia B - Acrylic C - Polymer D - Premium Carbide

Q4. What is the coating of the NexxZr Tool D made of? A - Nanocrystaline Diamond B - Hydroxyapatite C - Yamada D - Polycrystaline Diamond

Q5. What does this type of coating help with? A - Extremely long services life B - Cost C - Lasting colour D - Durability

Q6. The NexxZr+ Multi has XXX flexural strength? A - Soft B - Medium C - Low D - High

Q7. What is the translucency of the 630 MPa? A - 30% B - 40% C - 49% D - 64%

A STEP BY STEP GUIDE ON HOW TO CREATE AND IMPLEMENT A QUALITY MANAGEMENT SYSTEM FOR A DENTAL LABORATORY BY PETER J NATT

Q10. What does this ensure?

A - Simplified Workflow B - Low Cost Materials C - Alerts for Faulty Materials D - That a Record is Kept of the Materials

Q11. What must you do to comply with the Medical Devices Regulations? A - Be Registered With The MHRA B - Be Registered With DAMAS C - Hold a Software License D - Hold a Medical Licence

Q12. What else must you do? A - Be GDC Registered B - Be A Member of DTGB C - Have A Documented Quality Management System In Place D - Have a CQC inspection

Q8. The Medical Devices Regulations were implemented as a result of the concerns caused by which scandal? A - Heart Surgery B - Breast Implant C - Hip Replacement D - Hair Transplant

Q9. The Medical Devices Regulations has a XXX contained within it? A - Enhanced Traceability Element B - Tracker C- CRM System D- IOS System

YOU CAN SUBMIT YOUR ANSWERS IN THE FOLLOWING WAYS:

NEW POSTAL

ADDRESS Via email: cpd@dentaltechnician.org.uk or by post to: The Dental Technician Magazine, PO Box 2279, Pulborough, RH20 9BR. You are required to answer at least 50% correctly for a pass. If you score below 50% you will need to re-submit your answers. Answers will be published in the next issue of The Dental Technician. Certificates will be issued within 60 days of receipt of correct submission.

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DENTAL NEWS

EXOCAD ANNOUNCES ITS LARGEST EVER PRESENCE AT THE INTERNATIONAL DENTAL SHOW (IDS) 2021 Presentation of exocad’s latest software innovations at the world’s leading dental trade show

DARMSTADT, Germany – July 6, 2021. exocad GmbH (exocad), an Align Technology, Inc. company, today announced its expanded presence at the International Dental Show (IDS) 2021 taking place between September 22-25 in Cologne, Germany. exocad will showcase its newest software releases and innovations for dental technicians and dentists on 360m² at booth A-020 in hall 3 with a multitude of demo stations. IDS is one of the most important dates on exocad’s calendar. The international trade show is held bi-annually in Cologne and offers additional opportunities for the company to connect with new partners and deepen longstanding relationships.

“Proximity to dental technicians and clinicians is key for us at exocad, and for that reason we are delighted to finally reconnect in person. It was always clear for us that we'd participate in IDS, but noticing how keen our users and partners are for trade shows, we've decided to extend our presence at this year’s event,” said Tillmann Steinbrecher, exocad CEO. “At IDS 2021, we will showcase our wide spectrum of innovative solutions for labs and practices, inviting them to discover these at our interactive demo stations.”

exocad’s very own experts as well as the renowned dental trailblazers Waldo Zarco Nosti and Dr. Gulshan Murgai.

Participants can experience exocad’s variety of software solutions DentalCAD, ChairsideCAD and exoplan and meet

exocad can be found at booth A-020 in hall 3. Additional information is available at exocad.com/ids

exocad will present a new booth design at IDS 2021, reflecting the company’s continued innovation and growth. For those who will not be able to attend IDS 2021, the trade show will offer a virtual experience that will feature many exocad highlights.

exocad announced its expanded presence at the International Dental Show (IDS) 2021 taking place between September 22-25 in Cologne, Germany. exocad will showcase its newest software releases and innovations for dental technicians and dentists on 360m² at booth A-020 in hall 3 with a multitude of demo stations. (Source: exocad GmbH)

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TECHNICIANS INSIGHT

A WEEK IN THE LIFE OF...

A DENTAL MECHANIC By Andy Sanson

I This is the first in the series of diversionary and humorous articles, it is a modern iteration of the previous feature titled ‘Lateral Thinking’ by Andy Sanson. Andy is a retired Dental Technician who has kindly offered to share some of his stories and experiences throughout his career.

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t was never my intention to be a dental mechanic. Before I found myself pressganged into seeking a job I didn’t even know such a thing existed. The thought never occurred to me that the bleached objects Aunty Dolly immersed each night in her bedside glass of diluted Domestos must have been made by somebody. It wasn’t the sort of thing a fifteen year old acne carriage in Early Sixties’ Merseyside dwelt upon very much. Mini skirts, the Space Race, Dr Who and the Rolling Stones, yes - false teeth, I don’t think so. I lived on the Wirral, a short ferry ride from the Cavern Club. The Beatles, the Stones, the Who, Small Faces and the Kinks took up the percentage of my time that didn’t involve falling down wells and dreaming up more and more destructive ways of using the Standard bangers and rockets I had squirreled away in little hideyholes for use in the school holidays.

By the time it came to seeking gainful employment, Merseyside had become the Welsh Borders, fireworks had become motorcycles and jelly and ice cream, testosterone, which, for those whose attention may already be wandering, is not a triangular, Alpine-themed confection of chocolate, honey and nougat. It was the summer of ’69. Neil and Buzz had just walked on the Moon, the Beatles had all but fallen apart at the seams and the Great Hippie Peace and Love Ideal would shortly come crashing down around the ears of us all at Altamont. Ah, yes, the summer of ’69. That’s 1969 and not reference to an indeterminate summer during which I discovered the existence of certain activities from which I had been hitherto shielded by well-meaning ‘grown-

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TECHNICIANS INSIGHT

ups’. I was about to launch myself on the great Voyage of Life, drink loads of beer, have lots of girlfriends and... get that job. My parents insisted that I should have a job to go to before school restarted in September, otherwise I would have to go back and become a sixth former. It may not have been as bad as I imagined, but at the time the prospect terrified me. There were no JobCentres, Plus or otherwise. I shambled along to The Labour Exchange, exhibiting something less than the total conviction expected of me. I’d already been for one interview; for the post of Office Junior in the local County Surveyor’s Department… not at all what I had in mind for myself. In truth, I had nothing in mind for myself, but had I so done it would not have been anything involving the words Office, Junior and Department, neither singly, severally or in any order. I made sure I didn’t get that one. When I returned home with the news that I was to start work as an apprentice dental mechanic it was as though I had announced my imminent succession to the Throne. “Ooooh, that’s a good job”, “Those get good money, you know” and, “Well, there you are. After all your fuss you’ve certainly landed on your feet”. ????????? Perhaps everyone imagined the end result of all this would be my qualification as a dentist, but whatever they envisaged for me was not the same as the thing in which I ended up embroiled for the next nineteen years. Whilst not wishing to doubt the value and esteem of the trade of Dental Technology today, back then it was something of a poor relation to just about anything else that existed with the possible exception of toilet cleaning. Wages were pitiful, conditions Dickensian and prospects non-existent. The Laboratory (hereinafter referred to as The Lab) was usually nothing more than a perfunctorily converted cellar, attic, shed, flowerpot or other unimportant - and preferably unseen cubby hole or broom cupboard. The mechanic himself was weedy, sickly, pasty-faced, blinking, myopic and a general, all-round embarrassment. The patient rarely got to know of his existence save that, when something went wrong it was the fault of ‘the bloody mechanic’. Otherwise the patient, newlyfitted and grinning would, in the lounge bar of the Spleen and Sneezewort, laud the “smashing pair of teeth my dentist made me”, all the while beaming, piano-like about the room.

Most of the customers (The Gentlemen) were of the old school, believing that both patient and mechanic should be kept firmly in their place. Only The Boss, and on rare occasions, the Senior Partner, ever got to meet them face to face. Even when we ragamuffins were allowed to go on The Round, work was passed to us via the nurse so the Master wouldn’t have to suffer the indignity of consorting with minions. I turned up, scrubbed and sparkling, for my first day, expecting to be taken under the wing of an experienced tutor, shown the ropes and gradually honed into the finished product - a fully fledged Dental Mechanic. During my interview I had been given to understand that, in the ensuing five years, I would learn all there was to learn about my ‘chosen’ vocation. In the event it transpired that I did indeed acquire many skills, very few of which had even the most tenuous connection with Dental Mechanics. Had it been my wish to forge for myself a career in painting and decorating, window cleaning, construction, gardening (landscape or cultivation), roofing, electrical engineering, plastering, catering, freight forwarding, secretarial duties, domestic services and so on and so forth, I would have had no cause for complaint. When I queried this ostensible disinclination towards the advancement of my education in those matters relating to the terms of my indentures, I was told it was due to lack of time, lack of get-up-and-go on my part, lack of resources and the fact that “you haven’t been here long enough”. My fellow apprentices and I were actively discouraged from attending college where we might have acquired our City and Guilds on account of it being “a waste of time” and “you don’t need to know about all that rubbish to be a dental mechanic” Of course, it was our interests which were held at heart and nothing at all to do with the fact that, not only would it cost them, but there would be the added indignity of having to give us a day off for the insult.

Monday

09:00 - Make tea 09:10 - Feed cat 09:15 - Tidy rubbish in front garden (lab was extension to Boss’s house); chip papers, beer bottles and new-fangled cans with finger-slicing ring-pulls, vomit residual from weekend (pub down road) 09:30 - Turn that thing over to Radio 2 09:31 - Clean oven 10:30 - Dig patch in back garden ready for planting spuds 12:45 - Lunch (home) 13:45 - Make tea 13:55 - Tidy kitchen 14:30 - Sort rubbish and put in trailer for Boss to take to tip 15:30 - Make coffee 15:40 - Ask if allowed to mark up impressions for casting. Told not to be stupid 15:41 - Sent to chemist to buy Durex for Junior Partner 16:00 - Do up post 16:15 - Go to Post Office 16:30 - Can’t we find summat for that lad to do? 16:32 - Wash down walls in Chrome Department 17:00 - Home, but call at DIY shop and pick up emulsion. Be sure to ask for trade discount

Tuesday

09:00 - Make tea 09:01 - Turn that bloody thing over to Radio 2 09:10 - Begin emulsioning walls of Chrome Department 09:11 - But feed cat first 09:15 - Carry on emulsioning (starring Sid James, Hattie Jaques, Charles Hawtrey etc) 12:45 - Lunch (chip shop) 13:45 - Make tea 13:55 - Carry on emulsioning 15:13 - Haven’t you finished that %^%$£^& painting yet? Bloody kids, I don’t know, in my day etc etc…. 15:30 - Make coffee 15:40 - Ask if allowed to cast impressions. Told not to be stupid 15:41 - Finish emulsioning 16:00 - Tidy up. Do up post. Post Office 16:30 - Clean splashes of emulsion off Boss’s hat 17:00 - Home, but call at garden centre to pick up seed potatoes (put on account)

Wednesday

09:00 - Make tea 09:01 - Turn that %^%$£^& thing over to Radio 2 09:10 - Clean windows 09:35 - Feed cat (late)

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So, a typical week in the life of an apprentice dental mechanic, circa 1969:

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TECHNICIANS INSIGHT

09:40 - Apply ointment to scratched hand 09:45 - Sort out trailer (items brought back from tip by Boss; broom handle, electric flex, old paint brushes, black and white bathroom tiles, art deco lamp shade) and clean 10:30 - Plant seed potatoes 12:00 - Phone order to Chinese takeaway 12:05 - Rescue cat from pear tree 12:30 - Go to Chinese to pick up order 13:05 - Lunch (late - Chinese not ready) 13:50 - Bollocking for being late back Chinese excuse invalid 13:53 - Make tea 14:05 - Wash cars 15:00 - Clean toilets 15:30 - Make coffee 15:40 - Wash hands 15:41 - Ask if allowed to repair midline fracture. Told not to be stupid

15:42 - Fetch plaster from shed. Suggest access to shed awkward due to proximity of the wall. Told to stop whinging 15:45 - Might as well start doing up post 16:05 - Post Office 16:30 - Weed front garden 17:10 - Home, but call at DIY shop to pick up tile cutter and cement (trade discount)

Thursday

09:00 - Make tea 09:01 - Turn that %^%$£^& thing OFF! 09:02 - Lecture about lack of manners, consideration, ideas of fun etc of emergent generation 09:15 - Feed cat 09:20 - Fix tiles round sink in main lab (paint dog poo in pretty colours) 11:00 - Boss returns from wherever. Remove tiles and fix alternately black and white 12:45 - Lunch (pub!) 13:46 - Make tea 13:55 - Boss suggests shed too near wall 13:57 - Begin dismantling shed for removal to far end of garden 15:30 - Make coffee 15:40 - Don’t bother asking is allowed to do anything connected with dental mechanics. Asked if I shouldn’t be giving serious thought to commitment to the job. Ask if allowed to grind flash off dentures. Told not to be stupid 15:45 - Carry on moving shed (no post today) 17:15 - Home, but call at hardware shop for padlock for shed to replace one lost during relocation (cost to be deducted from wages)

Friday

09:00 - Make tea 09:01 - Boss smashes radio with deflasking mallet and chucks in trailer 09:02 - Asked if I might like to consider paying visit to barber tomorrow. Don’t want any beatnik types working here, thank you.

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What do you think this is, that Woodstick or something (Man)? 09:10 - Connect shed electrics 09:45 - Switch on compressor in shed 09:46 - Mend fuses 10:15 - Attacked by ravenous cat. Feed it 10:20 - Boss worried about news report last evening warning of imminent n uclear holocaust 10:22 - DIY shop to buy spade, trade discount etc… 10:38 - Begin digging fallout shelter 10:45 - Boss makes phone call to Lodge member - oops! - business associate 10:50 - Stop digging 10:55 - Return spade to DIY shop 11:15 - Fit new screen to Boss’s Raleigh Wisp (blew over in gales) 12:00 - Roof leaking. Go up to discover source 12:05 - Remove last Autumn’s leaves from roof. Apply mastic 12:45 - Lunch (pub!!) 13:59 - Told off for being late back. Don’t care. Make tea 14:07 - Make more tea. Hot water this time 14:13 - Phone travel agent to order brochures for Boss’s holiday (Majorca) 14:28 - Rake gravel on path 15:30 - Make tea 15:35 - Pour tea down sink 15:36 - Make coffee 15:40 - Told to get repair model 15:45 - Regain consciousness. Asked if still required to get repair model. Told not to be stupid 16:00 - Post etc…. 16:55 - Asked why so long at Post Office, Don’t have answer. Don’t care 16:59 - Chip shop 18:00 - Pub… hic……

Saturday

01:30 - HIC!!!!!!!

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DENTAL TECHNOLOGY

RELATIONSHIP BETWEEN DENTAL MATERIALS IN USE IN THE DIGITAL FIELD By Matteo Neroni During the period in which I ran the laboratory in Belfast, several times, I found myself using different types of materials, always looking for the best functional and aesthetic relationship between them. The case that will be presented in this article is the perfect example of how using 4 types of materials can coexist side by side, without compromising aesthetics and functionality.

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DENTAL TECHNOLOGY

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DENTAL TECHNOLOGY

As in any case I dealt with, everything is set through a detailed analysis of the physiognomy, facial conformity and vertical dimension of the relationship between the two jaws.

Zirconia

In the above case, 4 types of materials and an aesthetic and functional test in 3D printing have been used. • Zirconia • Porcelain • Composite • Acrylic resin Regarding the upper part of my reconstruction, I used a mobile prosthesis approach, because the patient could not put implants (fig.1). In the lower part, in this case an A04 was chosen (fig.2). Because of this choice of completely different materials, the teeth chosen for the mobile prosthesis are individual millings made of zirconia, to have the same degree of friction. Certainly, the first problem would have been the heaviness of the prosthesis itself, but following all the protocols and taking an excellent dental impression made us obtain a perfect suchtion, so eventually there were no problems with prosthetic displacement (Fig.3, 4, 5).

Porcelain

Regarding the lower rehabilitation (A04), I adopted the same protocol developed and illustrated in the previous article in September. I left the composite part to my colleague to try making the difference between composite and porcelain as similar as possible.

Fig 1

Fig 2

Fig 3

Fig 4

Using his best abilities, he was able to solve this problem of difference. Like every finalizer, I used some composite stains to mask the difference between the materials and I think I have succeeded. Constructive criticisms, observations and different points of view are accepted for both the design and the finalization of the product.

Fig 5

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well as providing labs with a tight integration to 3Shape Automate – the world’s first AI driven design service for single unit monolithic molar and pre-molar crowns.

w 3Shape Dental System 2021, the choice of lab technicians around the world, enables labs to power up their productivity with AI supported, new and improved integrated workflows for the most profitable and indemand services like crown & bridges, implants, dentures, clear aligners, and splints.

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BE AT THE CUTTING-EDGE WITH CREATECH MEDICAL w You might be streamlining your processes and optimising efficiencies throughout your lab, but there are still opportunities to develop your service. Why not work with Createch Medical to make use of its leading direct-to-lab milling service and offer your clients something new? Createch Medical measures, designs and mills custom-made frameworks for an array of implant-retained prostheses. The Createch Excellence warranty provides full traceability and accountability of the manufacturing process for complete peace of mind. Alongside access to on-going advice and support, you will also be able to utilise its Createch Additive service – providing a range of framework solutions that employ SLM (Selected Laser Melting) technology for ultimate efficiency and economics. Bring your laboratory to the cutting-edge of the profession without significant personal investment with Createch Medical – part of the globally trusted Straumann Group. 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-TOLAB MILLING SERVICE FROM THE STRAUMANN GROUP, VISIT https://www.straumann.com/gb/en/ dental-professionals/products-andsolutions/implant-borne-prosthetics/ products/createch-medical.html

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WE ARE A BUSY DENTURE LABORATORY LOOKING TO RECRUIT A FULL-TIME CLINICAL DENTAL TECHNICIAN At Dental Design we make private and NHS dentures for local dentists. We also have a state-of-the art 4 surgery clinic on site where we make dentures direct to the public. The successful candidate should want to produce work to a high standard, be technically sound, have good customer service and communication skills. Being able to set up high-end smile makeovers is a must. As a small laboratory you will have the opportunity to get involved with a wide range of tasks, including being an integral part of the future development of the lab. We have a large amount of denture patients which the successful candidate would inherit. Days would be split, 3 days in the Lab and 2 days in the surgery. Working hours are 9:00am-5:30pm. Need to be GDC registered. OFFERING:

• Competitive Salary + Bonus structure • Proﬁt Sharing • Pension • Training • Assistance with CPD • Involvement in the transformation of the lab Contact Dino Goncalves at dino@davidnealdental.co.uk for the opportunity to join the Dental Design Team!

PROSTHETIC TECHNICIAN An experienced prosthetic technician is required to take over a centrally heated, air conditioned and long established laboratory with a denture clinic below, run by a Clinical Dental Technician. (Due to age and health problems retiring from the laboratory.) At present the laboratory services the downstairs clinic and is situated in an expanding area, with a growing population.

Location: Southend-on-Sea, Essex Contact: p.stibbards@btconnect.com

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w With the new ceramic pastes Fresco Gingiva and Fresco Enamel, monolithic and slightly reduced zirconia structures can be quickly and easily veneered in the gingival and vestibular regions. Especially in the gingival region, a characterisation with stains is no longer necessary, since a natural gingiva reproduction can be achieved by purely applying the ceramic paste. Compared to conventional ceramics, Fresco pastes remain moist for a longer time and can be modelled for several hours. The consistency of the pastes can be further personalised by adding the two mixing liquids Fresco Liquid and Fresco Gel, depending on the preferred working method. Due to their high primary density, the pastes exhibit very low shrinkage. This means that one Fresco firing cycle is usually sufficient to finish the tooth shape and the gingiva. With this firing process, zirconia structures of different sizes can be fired simultaneously. No parameters such as holding time and/or temperature need to be changed: heating and

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DTS: REACH YOUR DIGITAL POTENTIAL IN 2022

DTS: HEAR FROM THE LEADING VOICES IN DENTAL TECHNOLOGY w Don’t miss out on the opportunity for your lab to hear from the industry’s preeminent figures at the next Dental Technology Showcase (DTS).

w Don’t miss the next Dental Technology Showcase (DTS) for the chance to be a part of the inaugural Digital Dentistry Acceleration Forum - inspiring collaboration between clinicians and technicians. Brand new for 2022, the Forum is a unique space for lab owners and clinicians, together with the leaders in dental technology, to collaborate and discuss how the sector can harness emerging digital opportunities. In partnership with Henry Schein, Ivoclar Vivadent and 3Shape, the Digital Dentistry Acceleration Forum is a not-to-be-missed feature for dental laboratories looking at incorporating the digital workflow. Including a series of educational sessions led by renowned experts, you and your team will have the chance to pose questions to those who have already successfully implemented innovations, and achieve a better understanding of the digital transformation opportunities for your lab. Don’t miss DTS 2021 and get set for your lab’s digital transformation.

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DTS 2022 WILL BE HELD ON FRIDAY 13TH AND SATURDAY 14TH MAY, BIRMINGHAM NEC, CO-LOCATED WITH THE BRITISH DENTAL CONFERENCE AND DENTISTRY SHOW. FOR THE LATEST INFORMATION, PLEASE VISIT: www.the-dts.co.uk, call 020 7348 5270 or email dts@closerstillmedia.com

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The Dental Technician Magazine July 2021

Articles inside

Classifieds

Zirkonzahn/DTS

A week in the life of a Dental Mechanic. By Andy Sanson

3Shape/ Createch Medical

Relationship between dental materials in use in the digital field. By Matteo Neroni

Exocad announces its largest ever presence at the International Dental Show (IDS) 2021

Life outside the lab. With Phil Reddington

Sagemax NexxZr®

Snoring & Sleep Apnoea: A role for the Dental Technician. By Matt Everatt, Editor

An interview with... Mark Welch, RDT/Digital expert at Bracon

A Step by step guide on how to create and implement a Quality Management System, Part 1. By Peter J Natt

Progress versus perfection. By Matt Everatt, Editor

Mental Health Awareness. By Steve Taylor

VITA: New veneering ceramic shows ideal light dynamics and high firing stability

Welcome from the editor