The Dental Technician Magazine May 2021 by The Dental Technician Magazine

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VO L 74 N O. 5 I M A Y 2 0 2 1 I B Y S U B S C R I P T I O N

12 MONTHS OF COVID19 HOW ARE OUR LABS DOING? PAGES 24 - 26

VERIFIABLE ECPD FOR THE WHOLE DENTAL TEAM

THIS MONTH... l

DIGITAL TECHNOLOGY: THE BENEFITS OF RECEIVING DIGITAL IMPLANT IMPRESSIONS I SARAH HODGKINS P. 8

TECH INSIGHT: 5 THINGS I CANNOT WORK WITHOUT! I PAUL MARTIN P. 18-19

HEALTH & WELLBEING: BATTLING STRESS P. 27

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

S AVE !

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CONTENTS

MAY 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

Digital Technology The benefits of receiving digital implant impressions - Sarah Hodgkins 3Shape - Automate Bracon -the complete digital workflow

8 30 34

Insight Domestic abuse. Why act now? Rhian Scott

Dental Technology

NEW ADDRESS

NexxZr®+ Multi - Sagemax Reproducing Patient - Specific Natural Vibrance with VITA LUMEX AC Veneering Ceramic

Technicians Insight 5 things I cannot work without! By Paul Martin, Prestige Dental Milling, drilling and billing. Would I, could I, should I? By Darren Kelsey

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.

Dental News

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12-13 15-16

S4S Dental laboratory welcomes new blood into board of directors Normalization of Dental Care . By Sir Paul Beresford Illegal Device Manufacture/Import - Kingsholm Group Update

18-19 20

22 28 28

Business 12 months of COVID19 - How are our labs doing?

24-26

Health & Wellbeing Battling stress

32-33

Marketplace Exocad Shofu Neoss/Zirkonzahn

36 37 38

Classifieds

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BAR HEADER WELCOME

Welcome

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

elcome to your May edition of The Dental Technician Magazine. As we start the new financial year I am very optimistic about the future. The tone within the industry seems to be a very positive one at present. A recent post within the DTGB facebook group and the very positive responses were of most labs being very busy at the minute. In theory, we should get even busier as there are still lots of dental practices that are not operating at capacity yet. When practices start seeing even more patients and consumer confidence increases with COVID19 restrictions being lifted in June, we should see a further increase in cases arriving at our labs. I would like to take the opportunity to give a quick mention to The Kingsholm Group (the DLA, the DTA, the OTA and DAMAS). The group has been discussing illegal manufacturers/importers of custom made dental appliances as well as education for the whole dental team. Larry Browne, previous Editor of The Dental Technician Magazine, was a staunch supporter of the group and his investigative journalism led him to report several suspected illegal manufacturers to the GDC. The group are still awaiting an official response from the GDC. I understand there will be more information from the GDC and

the group soon. I am keen to carry on Larry’s support of this group and will of course update you all with any news. I recently asked the DTGB facebook group members for feedback and suggestions for other features and articles. A number of members showed an interest in having a Podcast. After a recent chat with fellow Dental Technician and co-Northerner, Andy Fairbanks, we discussed a few ideas on Podcasts and have hatched up a plan to host a ‘Chat Show’ type Podcast on Friday May 14th. The hope is to get Dental Technicians chatting with each other and helping fellow colleagues. We both felt we are entering a new era for Dental Technology. We really could take a leaf out of other professionals books and begin helping each other out more and being more united. We will share our Dental Technology journeys, discuss working life, education, our fondness for cars, flat caps, ale and life in general. Who knows, it might even be fun! I wish you all the very best for May and hope that summer brings us lots of sunshine and new hope for the remainder of 2021. Please do keep in touch with us, if you have not already joined the Dental Technicians Great Britain Facebook group, please do. It is becoming a great asset to all of us, lots of great stories being shared and some nice technical pieces too.

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DIGITAL TECHNOLOGY

THE BENEFITS OF RECEIVING DIGITAL IMPLANT IMPRESSIONS Sarah Hodgkins, Laboratory Sales Specialist at Henry Schein Laboratory explains why labs need to be digital-ready.

he global pandemic has had a major impact on the dental industry and has already created significant changes to the way in which dental practices and laboratories are working. With the backlog of patients now awaiting treatment for prosthetics and dental implants in particular, laboratories need to be ready to take advantage of the pent-up demand by working efficiently and effectively. Nowhere is the impact of digital technology more influential that in the field of dental implants – in this discipline a digital approach speeds up the entire restorative process and increases efficiency across the board.

about being tied to a specific implant system or manufacturer, allowing clinicians and technicians to work together as a team for the benefit of patients.

FAST TURNAROUND

Infection control has become a major factor over the past 12 months. Conventional impressions must be disinfected before leaving the surgery and entering the lab and sometimes these procedures are not as robust as they might be. The advantages of using digital technology minimises patient contact and removes the need for disinfection for the lab or physical transportation and there is minimal staff exposure to any sort of virus or infection that might be carried on an analogue impression.

A digital impression, anything from a single arch to a full mouth scan, can be taken in just a few minutes, with no impression materials or disinfection of the impression required. Once completed the case can be immediately transferred securely to a digitally-enabled laboratory, where the scans can be checked for accuracy. The speed of this process reduces errors and enables the technician to check the scan and immediately query any issues.

With both parties seeing exactly the same electronic file and digital prescription, decisions can be made collaboratively to create the best possible outcome - no more trying to read illegible handwriting on a prescription that can be open to misinterpretation. The electronic files ensure all the vital information required is clear and concise, with the dentist’s requirements easy to understand.

INFECTION CONTROL

IMPROVED ACCURACY

The accuracy of digital impressions is particularly important in implant treatment, where every fraction of a millimetre counts. There’s no need to worry about air bubbles, poorly taken impressions or inaccurate margins, making the life of a technician much more straightforward. A digital impression can be viewed as soon as it reaches the lab and if there’s a problem it can be retaken immediately, while the patient is still in the chair, virtually eliminating the need for time-consuming and costly remakes and adjustments.

IMPROVED COMMUNICATION

Today’s open digital platform offers fast and secure connectivity between the practice and the lab, meaning there are no concerns

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THE WAY FORWARD

Digital impressions are more comfortable for patients, reducing chair time and ultimately leading to an improved patient experience - an important tool in helping to improve the public perception of dentistry. The digitisation of implant placement starts with a digital impression and this process is revolutionising the relationship between dentists and technicians. Laboratories should now be looking to take advantage of the many benefits of digitisation in an effort to radically improve the efficiency and viability of their business. To see the full range of Henry Schein digital solutions, visit hsdequipment.co.uk To speak to one of our specialists or to request a demonstration call 0800 028 4870 or e-mail info@henryschein.co.uk Web: www.henryschein.co.uk Twitter: @HenryScheinUK Facebook: HenryScheinUK

INSIGHT

DOMESTIC ABUSE

WHY ACT NOW? By Rhian Scott 30TH APRIL 2021

In a week when we have seen the landmark Domestic Abuse Bill signed into law organisations should be using this moment to consider its correlation with work. Domestic Abuse has always been an issue however it feels like a relatively new issue for employers and possibly one that hasn’t been considered in the context of your obligations as an employer. Simply acknowledging that domestic abuse is an issue isn’t enough, so what positive steps can you take?

EXPERIENCED HR CONSULTANT - RHIAN SCOTT

Experience has taught me that every business is unique therefore I offer a flexible HR service, tailored to meet the needs of your business delivering HR support and advice either remotely or on site. If you would like any HR Support in your laboratory, see our website for more information. Web: www.rjsbusinesssupport.co.uk Email: Rhian@rjs-bs.co.uk

A great place to start would be to improve your own knowledge and understanding so that you can raise awareness of it throughout your organisation and take an active supporting role. Domestic abuse can involve a single incident or a pattern of incidents. It can also take many forms including psychological abuse, physical, sexual, emotional, verbal and economic. How it impacts on an individual can differ. The signs may not always be obvious and could manifest in other ways such as high absenteeism, low productivity, increased lateness, sudden changes in behaviour or tiredness.

should include acknowledging/recognising the problem, responding appropriately, offering support and referring to the appropriate help. Some organisations are also including their position on paid time off and performance management. Finally, encourage and create an open and supportive culture where everyone is comfortable discussing their problems knowing that they will be supported. As employers we are not expected to be the experts however if you always look to approach things with empathy and support, seeking advice when you are unsure then you can’t go far wrong. If you would like to discuss any part of this article further or discuss how I may be able to support you with your HR requirements, I would be delighted to hear from you.

Next I would recommend developing a domestic abuse policy so that anyone within the organisation understands clearly how they will be supported. It is also important to ensure that it is clearly communicated to managers with clear steps on how they can support an employee. As a minimum this

There are a lot of professional charities and organisations who support victims of domestic abuse including: l National Domestic Violence Helpline, run in partnership between Women’s Aid and Refuge. Freephone 0808 2000 247 l ManKind: www.mankind.org.uk/help-for-victims

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DENTAL TECHNOLOGY Natural esthetics. Efficient process.

N exxZr®+ Multi

NexxZr®+ Multi is a dental multilayer zirconium oxide (4Y-TZP cervical, 5Y-TZP incisal) with natural color and translucency gradient and high flexural strength (880 MPa cervical, 630 MPa incisal). These properties enable the fabrication of highly esthetic, monolithic single-tooth and bridge restorations in the anterior and posterior region. The specially adjusted translucency gradient ensures good coverage in the cervical area and increased translucency in the incisal area. The integrated color gradient also ensures the efficient fabrication of natural-looking restorations.

Technical data

Type

Flexural strength

Translucency

4Y-TZP (cervical)

880 MPa (cervical)

46 % (cervical)

5Y-TZP (incisal)

630 MPa (incisal)

49 % (incisal)

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Indication Single-unit restorations and 3-unit bridges

Processing techniques Infiltration technique Staining technique

Cut-back technique

(CTECeramic < 9.9 x 10 - 6/K)

DENTAL TECHNOLOGY

Highlights

Natural color gradient Efficient fabrication of natural looking restorations

630 MPa

Multi

49 % Translucency

High translucency

46 % Translucency

Natural color and translucency gradient

Specially adjusted translucency gradient Good coverage in the cervical area and increased translucency in the incisal area

True translucency gradient

880 MPa

Lifelike esthetics

Good coverage in the cervical area

High flexural strength Single-unit restorations up to 3-unit bridges

Individual possibilities

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DENTAL TECHNOLOGY

REPRODUCING PATIENT-SPECIFIC NATURAL VIBRANCE WITH VITA LUMEX AC VENEERING CERAMIC VITA LUMEX AC offers virtually unlimited “possibilities for precise and reliable reproduction of shade effects and multi-faceted light effects. ” Dental Technician Michele Prosperino, San Severo, Italy

hen the natural dentition exhibits very pronounced shade characteristics, this poses a special challenge for dental technicians. In order to reproduce all the individual nuances of the natural play of colors, veneering ceramic and a wide range of effect materials are required. In addition, reproducing natural vibrancy becomes particularly complicated when the enamel shows a multi-faceted play of color and light, for example in the form of greyishwhite transparency. Here it is necessary to reproduce the individual degree of translucency with different enamel- and effect materials. VITA LUMEX AC (VITA Zahnfabrik, Bad Säckingen, Germany) is a new veneering system that offers virtually unlimited options for precise and reliable reproduction of shade effects and multi-faceted play of light. In the following case report, Dental Technician Michele Prosperino (San Severo, Italy) shows how he successfully handled one of these very sophisticated cases with the new veneering ceramic.

FIG. 1

FIG. 2

FIG. 3

PATIENT CASE AND MATERIAL SELECTION

A 52-year-old patient suffered fractures on all mandibular front teeth as a result of a trauma. After the teeth were preserved, the patient did not experience any discomfort. The teeth that had been loosened by the trauma had stabilized once again. After a longer temporary restoration phase, the patient now requested a definitive reconstruction. After this restoration, he wanted to be able to smile again as he did before the accident. In order to stabilize the teeth after the traumatic loosening, the dentist and patient decided to use a splinted crown restoration for teeth 32 to 42. When selecting the material, the decision was made in favor of zirconia crown frameworks, which were to be veneered with the new leucite-reinforced, glass-ceramic veneering system VITA LUMEX AC.

FIG. 1: Initial situation: Framework try-in and tooth shade determination using the VITA shade guide. FIG. 2: The washbake is done with FLUO INTENSE sand and the incisal with sesame. FIG. 3: The basic assessment of the dentin portion is carried out with DENTINE A3.

SHADE DETERMINATION AND FRAMEWORK FABRICATION

The four front teeth were given a local anesthetic. This was followed by systematic and precise tooth shade determination using a VITA shade guide. After the preparation, a mould of the stumps was made, which was used as the basis for the master model. The translucent, pre-shaded

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zirconia VITA YZ T Color in brightness level LL1 was selected for the framework fabrication. Digitization was carried out using the S600 ARTI laboratory scanner, the framework design was created with the zirconia tooth software and the framework was fabricated using the CAM unit M5 Heavy Metal (all Zirkonzahn, Pustertal, South Tyrol, Italy).

DENTAL TECHNOLOGY

u HIGHLY PRECISE VENEER WITH SHADE FIDELITY

For the washbake, FLUO INTENSE sand and incisal sesame were applied cervically for indepth control of the fluorescence. The basal dentin portion was layered with DENTINE A3, according to the determined basic tooth shade. A 50:50 mixture of DENTINE A 3.5 and DENTINE MODIFIER copper was then applied to the central palatal area. An intensification of the cervical margin was performed laterally with A3.5, in combination with some FLUO INTENSE sand. The central ceramic application of A3 followed with added OPAL TRANSLUCENT opalneutral. Finally, ENAMEL light was added and the

first dentin firing was carried out. For the ceramic application, the new veneering ceramic was particularly impressive, due to its outstanding modelling properties, and thanks to its excellent stability. The final enamel layering for the corrective firing was carried out in the upper third of the crown with a 50:50 mixture of ENAMEL medium and clear. After the final firing, the end result showed remarkable shade fidelity. Precise reproduction of the initially determined tooth shade was inc redibly successful using the VITA LUMEX AC veneering ceramic. Finally, fine rotating diamond tools and a glaze firing with VITA AKZENT PLUS GLAZE were used for the finalization.

FIG. 4

IDEAL DYNAMICS OF LIGHT IN THE RESULTS

The splinted crown restoration was permanently incorporated with a selfadhesive luting composite. The patient was very enthusiastic about the highly esthetic result. The restoration showed an ideal interplay of opacity, chromacity and translucency. The specific shade characteristics of the natural teeth were reproduced precisely, resulting in a reconstruction that integrated harmoniously into the natural dentition. The ceramic could be processed very precisely and showed impressive excellence in shade fidelity, resulting in outstanding light dynamics. FIG. 5

FIG. 6

FIG. 7

FIG. 8

FIG. 9 FIG. 4: A 50:50 mixture of DENTINE A 3.5 and DENTINE MODIFIER copper was applied palatally. FIG. 5: The intensification of the cervical margin was performed laterally with A3.5, in combination with some FLUO INTENSE sand. FIG. 6: The central ceramic application of A3 with added OPAL TRANSLUCENT opal-neutral. FIG. 7: ENAMEL light was added before the first dentin firing. FIG. 8: The final enamel layering for the corrective firing was carried out with a 50:50 mixture of ENAMEL medium and clear. FIG. 9: Results: A highly esthetic result was achieved using VITA LUMEX AC.

VITA® and the names of the VITA products mentioned are registered trademarks of VITA Zahnfabrik H. Rauter GmbH & Co. KG, Bad Säckingen, Germany.

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TECHNICIANS INSIGHT

5 THINGS I CANNOT WORK WITHOUT! By Paul Martin I Prestige Dental I www.prestige-dental.co.uk l Paul Martin is well known figure in the industry and is particularly renowned for his expertise and advice regarding dental attachments. In fact, he has been tinkering with these bits and pieces for over 40 years and is often referred to as ‘Mr Attachment’. A Director of Prestige Dental, Paul specialises in the laboratory side of the business, ensuring a pedigree range of products make up Prestige’s laboratory offering. He is also on hand to answer a myriad of technical queries, whilst offering repair and re-calibration services for Denar articulators and still makes time to ensure the company’s course loan equipment is maintained in tip-top condition.

Here, in his own words, are the five things that in his working day he just cannot do without.

1 SOCIAL MEDIA

At the risk of being a little sycophantic, the Dental Technicians Facebook forum is an impressive resource for DT’s. Presenting many discussion points (and of course the occasional rant!), it’s great for keeping in touch with colleagues across the country and more so this past year throughout the pandemic. Alongside FB Messenger and WhatsApp, it’s also responsible for my ‘Mr Attachment’ title, these being the key platforms where many queries are initially raised and photographs shared. It’s not

unusual for me to receive a query almost every working day so without these easily accessible comms tools I would be quite overwhelmed and even slower to respond!

2 BACK CATALOGUES

Busted - I admit it - you can’t beat a bit of old school. As much as technology is an essential part of our world, my stack of hard copy catalogues is still an integral part of my working life. This is largely because I can (and often) face questions involving components that have been in patients mouths for 20 years or more. With the constant requirement to keep things ‘up-to-date’, particularly online, previous kit disappears and then pertinent information can be lost forever – but not with my well-thumbed reference books. Accurately identifying original components is absolutely essential before I can advise on any type of repair and/or replacement, so to me, retaining this level of detail is vital.

3 EQUIPMENT ESSENTIALS

Despite my fascination with precision components, the two pieces of equipment that I reach for the most are very simple, and have been with me for most of my working career. I suppose you could call them my comfort blankets as without these I would be lost – these are my eye glass and gauge. Being able to see the finer detail of any given piece is fundamental to providing the correct solution whilst it’s the gauge that often provides the final piece of the jigsaw. Whilst I fully appreciate the lovely pictures and make of the item(s) in question, more times than not I just need a measurement. Particularly with ball attachments. There are so many variants. 1.7, 1.8, 2.2, 2.25, 2.5mm and there can be many more, particularly with older worn constructions. This kind of measuring gauge helps enormously.

If you would like to participate in our ‘5 Things I Cannot Work Without’ feature please email: editor@dentaltechnician.org.uk

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TECHNICIANS INSIGHT

4 FIELD GAUGE

I was originally trained how to use this piece of equipment at the Whip Mix factory in Colorado. It is used for calibrating and repairing articulators to their original factory settings. Through normal wear and tear the settings go out of sync and can cause discrepancies when cross mounting. For the true techy, the field gauge “ensures the correct condyle height and verifies the correct triangulation between the upper and lower members”. At present these procedures are being undertaken in the repair studio at Prestige, but when time and Covid allows I enjoy being let out to visit customer’s own premises and carrying out the necessary repairs in their labs.

and I are the two halves that together make up the Prestige business that would not be complete if either was missing. She’s also a great co-driver when we go visiting customers and attending the courses that we support and makes sure I’m permanently stocked up with coffee and biscuits which is worth a lot! (I did even toy with idea of naming coffee and biscuits as a sneaky extra in this list!).

5 MY BUSINESS PARTNER, LUCY GABBITAS

Lucy and I have worked together at Prestige since 1995. We bought out the business and became 50/50 partners some years later and that pretty much describes our business relationship ever since. The combination of our previous dentistry careers – Lucy in dental surgeries and myself in labs - means our offering is unique in the marketplace, together with the experience we each bring to it of both sectors. So, like Yin & Yang, Lucy

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TECHNICIANS INSIGHT

MILLING, DRILLING AND BILLING WOULD I, COULD I, SHOULD I? By Darren Kelsey I DK Dental Lab Father, Husband, Dental Technician

’m in my 21st year working as a tech and 10th year as a business owner. I qualified in 2003 from Langside college Glasgow, graduated in 2013 from UCLAN in clinical dental technology, I’m a Weld One immediate load ambassador, I’ve recently become a 3shape KOL, and I genuinely love dental technology. I’ve met some great people along my way and it’s taken me to some places I thought I’d never be - companies, trade shows and labs all over the place, amazing experiences! Cologne IDS 2017 was the first time I saw the soon to be released Ivoclar PM7. Ivoclar showcased all the new digital denture workflows in conjunction with 3shape designs, it looked great - 24 months later I finally had my own.

IVOCLAR PM7 IT LOOKS THE PART, WHO WOULDN’T WANT ONE?

AT A GLANCE

CONS Writing strategy’s - no support breakdowns/repairs drills/materials, stocking issues

MY JOURNEY 20 MONTHS IN WITH MY FIRST MILLING MACHINE

What didn’t: Full arch Abutments Breakdowns/repairs Stock

Many issues!

Right from the off on digital dentures my Ivobase became an ornament, no more casting models, articulating, wax ups, flasking and packing - what a relief, I hated all that!

SUPPORT III

Aesthetics? Great, I spend the same amount of time finishing the denture off, in comparison to analog using pink composites.

PRACTICALITY III COSTS IIII

What about abutments? There is a 15 months delay releasing the holder, this coupled with Brexit, make these little pre mills hard to get a hold of! Breakdowns/repairs - I have experienced far too many, at times I thought if this was a car I would have towed it and left it in the forecourt.

What I do now is scan/design and mill, it’s that easy.

DESIGN IIIII

a frustration, considering all the talent in Ivoclar, from the software companies they own to the resources they have at their disposal. Ivoclar sell the machine based on it milling metal, they sell Ivoclar branded ti/chrome discs/drills but provide zero support.

What worked: BPS digital dentures Emax Zirconia

OPERATING IIII

PERFORMANCE III

PROS Looks great Multi disc changer Mills wet/dry ti/chrome

It mills Emax and Zirconia with ease, it is literally a beast for speed and quality on these fronts.

FULL ARCHES

I’m still recovering from learning. I didn’t anticipate having to learn how to read and write CNC milling strategy’s, which has resulted in plenty of 17 hour days, lots of broken drills, making all the mistakes. It’s

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STOCK

Nothing properly stocked by Henry Schein, which was difficult until recently, as they originally had exclusivity on all Ivoclar drills and discs. 90% of stock on a 2 week back order. All in all would I do it again? 100% There was always going to be a sacrifice to get the services up and running on a product that’s in it’s infancy, in these instances it’s sometimes better the devil you know, I would buy another! Now that I’ve up-skilled my knowledge and the strategies it’s predictable and consistent. Current state, the full arch service we provide to labs and dentists provides good quality, turnaround times and cost. The time saving on dentures is a no brainer, the fits are fantastic and it’s a great relief being able to back up all the denture cases digitally.

WHAT I WOULD DO DIFFERENTLY? Have release dates confirmed formally in writing.

DENTAL NEWS

S4S DENTAL LABORATORY WELCOMES NEW BLOOD INTO BOARD OF DIRECTORS ENSURING A SOLID FUTURE FOR THE SHEFFIELD BASED LAB

hree new directors have been welcomed on the board at Sheffieldbased dental lab, S4S, securing the wealth of knowledge of some of the long-standing management team.

S4S Dental Laboratory have announced that John Bevan, Ellis Bullement and Matthew Norie have been appointed Commercial Director, Operations Director and Technical Director, respectively. Previously all three have been employed at S4S Dental Laboratory in management roles, and this move ensures that their knowledge, along with their understanding of the company’s vision and mission, is retained and used to drive the business forward. Matt Everatt and Neil Bullement - both founding directors - started the successful dental laboratory in 2005 with just 4 staff members. They now employ more than 80 staff over two sites, with their main headquarters in Sheffield and a second site in London. “This is a great for S4S - not only does it clearly state how committed our team is, it also means that we are able to retain and build on the wisdom, expertise & knowledge of

Matt Everatt Director

three cornerstones to our business.” Says Matt Everatt. “Our vision in 2005 was to create a different Dental Laboratory, break the mould of traditional and create a business that can innovate and impart knowledge to our dental customers, having the new directors on the board adds longevity and new blood to the business for many years to come.” “John, Ellis and Matthew know that we stand for quality. They know that assisting the dentist and their patient is at the centre of all that we do. They understand where we want to go with the business,” furthered Neil, “and they have all the skills needed to get us there.” S4S Dental Laboratory serves dentists and their patients up and down the country with a focus on sleep-related breathing disorders (Snoring and Obstructive Sleep Apnoea), Bruxism and TMD, and orthodontics, including their clear aligner brand, Smilelign. S4S also offer mouthguards and are the exclusive manufacturers of Boutique Whitening trays.

Neil Bullement Director

Ellis Bullement Operations Director

Find out more at: www.s4sdental.com/news

Experienced Orthodontic Technician Role S4S London are seeking an enthusiastic orthodontic technician to join our fast growing laboratory. We are seeing month on month growth in all departments and are seeking an enthusiastic individual to work in our close knit team. THE ROLE - REQUIREMENTS FOR THE APPLICATION:

• • • • • •

John Bevan Commercial Director

Experience in orthodontic manufacturing Vacuum forming Plaster room experience Digital orthodontic manufacturing Occlusal splints Registered dental technician

We offer an attractive salary, company pension scheme, a great fun dynamic team and scope to train further for career progression. Salary based on experience.

To apply please email: jineshp@s4s.london Matthew Norie Technical Director

www.dentaltechnician.org.uk www.dentaltechnician.org.uk

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BUSINESS

MONTHS

OF COVID19

HOW ARE

OUR LABS DOING? Interviews with... Ian Parvess, Ashley Byrne, John Ridley and Andy Chatterton

IAN PARVESS l We are MultiChoice Dental Lab that produces Private Dentistry throughout the UK mostly Implants.

business interruption?

What an odd 12 months it has been for our profession. Tell us, did you close your lab in the March of 2020?

What has business been like since opening back up?

No I did not. I didn’t close because I worked from home and did emergency work for Clients. What sort of practices do you server, NHS or Private, or is it mixed?

Private What was business like pre March 2020?

Lots of work to be completed and emergency work that came in. Did you need any or manage to get any grants/CBILS/Insurance payouts for

No insurance paid out and did apply for the kick back loan which I never used.

Brilliant, I have had my best year in the COVID period. Have all of your clients returned back to normal?

Yes and more work Have you altered anything you do or offer in the last year?

No Is there anything you would have done differently?

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Did you lose any staff during the last 12 months?

No Are you hoping to employ any more staff?

In a few words, how do you feel about your business and Dental Technology going forward?

Unfortunately, it is a dying trade and it needs something to be done. I work closely with The City of London Dental School and are talking to incorporate a Diploma in Dental Technology into the school. The education of Technicians are not sufficient at this moment. I would ask you to promote the idea to strengthen my case to the school when I talk to them again.

BUSINESS

ASHLEY BYRNE I BYRNES DENTAL LABORATORY l We are Byrnes Dental Laboratory and offer crown and bridge, prosthetics, implant work and a lab to lab printing service. A team of over 30 people, we work solely in the private sector and have a very digital bias to our work and the workflow. What an odd 12 months it has been for our profession. Tell us, did you close your lab in the March of 2020?

No we didn’t and that was for multiple reasons. As labs all around us started shutting we decided to have an open and honest team meeting about dealing with the pandemic. Whilst we knew that most of the team would go on furlough, we wanted to know if the team would support us in staying open and it was unanimously yes from them. Our major printer supplier has started working with us to print PPE and face shields and through sponsorship, we printed some 6,000 plus face shields which did not cost the NHS a penny. Through the incredible generosity of lab owners, dentists and suppliers we managed to provide paramedics, front line staff, care homes and NHS workers with much needed face shields. We kept two people on from the team to help myself and my wife, and we personally moved into the lab and worked 24 hours a day for 5 weeks. We also felt a moral obligation to offer denture repairs for the elderly so in between print runs and finishing we would fix dentures from all over the UK. We didn’t shut but we lost two of our technical team, we furloughed most of the team, and we made one redundant from our operations team. A hard decision but in times of crisis you have to act fast and that’s what we did on multiple levels. It was late April when we bought our first team member back from furlough. Whilst the UK market was shut, we were thankful that our overseas clients started sending work so we had 20% of the work coming in before UK dentistry opened. Each week a few more were back and slowly we got back to a full team. What sort of practices do you serve, NHS or Private, or is it mixed?

We only service the private market and have always been that way. We do the odd NHS work but that's at our full private price when they need assistance on complex implant work.

What was business like pre March 2020?

We were on for a record breaking year, we were stacked, the team was driven and we were flying. We were working on a large price rise as we were struggling to cope with the volume. It was happy days all round until the talk of ‘coronavirus’ started. Did you need any or manage to get any grants/CBILS/Insurance payouts for business interruption?

In addition to furlough, we successfully applied for a CBILS loan but had deliberated about it for quite a while. It was tough to gauge how far to jump in and our initial numbers were eye-watering. We haven’t needed to use it (touch wood) but it had given us some breathing space as there was so much uncertainty ahead. We had always planned for tough times and thankfully that planning from Alison and Tania in my team meant we had buffers in place. Never ever underestimate the importance of a great accounting team. Those ladies saved our lab hands down and still they are working on budgets, forecasts and everything to make us not only survive but thrive. What has business been like since opening back up?

We had a great run till December then Jan and Feb were quiet, really quiet. Thankfully we picked up by March but 2021 has been challenging so far and each month more and more comes in. Sales are not back to normal but we can’t take our eye off the ball. The team have taken some time to settle back into the work flow but they all seem to be there now. It has been a tough year for everyone and everyone has dealt with this year in different ways and we mustn’t forget that. Have all of your clients returned back to normal?

No, we have seen a good 10-15% reduction from all our clients and yet we are 25% up on new clients. As fallow time goes and they return to normal levels I think we may be busier than ever. What we have seen is a huge spike in wax ups and diagnostic stages and all that work will need to be completed at some point so the future is bright. Have you altered anything you do or offer in the last year?

Technically not really but we have upped our customer service. We know we can’t let clients down normally but not now as dentists are fully booked, a missed appointment is a massive no no. By working with the Ops team, and the technicians, we want to ensure we deliver 100% quality 100% of the time - on time, every time. It’s

www.dentaltechnician.org.uk

proven to be very successful and the Ops team are really making a huge difference to our clients and the lab workflow. Is there anything you would have done differently?

No, not even in the light of being trolled and abused for staying open and printing PPE. We had some quite horrible public attacks and attempts to slur our name and reputation from both inside our industry and outside. We brushed it off and carried on, with the letters of thanks from so many in the NHS that made our work all the worthwhile. The early stages of this pandemic made me reflect on the good and the bad of our industry. We were incredibly fortunate to have many people and companies rally around us and we thank everyone who supported us and helped us keep it going. I was also happy with how the lab coped and the team worked to build us back. At the end of this I’m an incredibly proud lab owner with how my team dealt with the crisis. Did you lose any staff during the last 12 months?

Yes we did. We lost three of the team, one decide they wanted changes in their life and left dental technology completely, another went back to Hungary for the birth of his first child, and we lastly we made a senior operations team member redundant. Losing 10% of the team helped us in our recovery so whilst that’s hard to take as a lab owner, sometimes you need to look at the bigger picture. Are you hoping to employ any more staff?

On the technician side of things we have replaced those that left and we have decided to take a few more on. I feel we are going to be busier than ever this year so we have made the decision to employ now and train up rather than wait will we are over worked and stressed. It’s a little risky but we didn’t get to where we are without taking those risks. In a few words, how do you feel about your business and Dental Technology going forward?

I’m incredibly optimistic and excited about the future of both Byrnes and Dental Technology. We are seeing more and more digitally focused clients and more clients want to work with us than ever before, as well as an increase in digital innovation. I think patients will be spending a lot on dentistry this year and that can only be a good thing for dental technology. The next few years I feel will really change dental technology and take it closer to a high tech modern industry which will benefit lab owners and technicians as a whole.

BUSINESS

JOHN RIDLEY l My name is John Ridley and I’ve been a dental technician since I left school in 1986. I’ve worked in numerous labs across the north east and as far afield as Dortmund, Germany. I started my business up 9 years ago, we are a small one man and his dog prosthetic Lab based in South Tyneside in the North east of England (yes, I take my dog to work with me - great company she is). The vast majority of my work is Dentures, but we also do Splints, Gumshields and Retainers. What an odd 12 months it has been for our profession. Tell us, did you close your lab in the March of 2020?

It’s been until late, a very difficult last 12 months. We closed down last March and reopened again in June, but only part time hours, the business was running at total loss every month for the first few months, not even covering the bills, never mind wages. If it wasn’t for a local Authority Grant I wouldn’t be here now. If so, when did you open back up again?

We reopened in June, more as a service than to make money.

What sort of practices do you serve, NHS or Private, or is it mixed?

Is there anything you would have done differently?

I now do work for 3 large practises one of which I picked up due to the sad demise of another lab, I would say 75% of the work I do is NHS, and the rest is Private.

No, not really, but I think the main thing I’ve learned is to have plenty reserve funds.

What was business like pre-March 2020?

No, as I work on my own, but it was touch and go at some points.

Business was ticking over nicely and had plans for expansion.

Did you lose any staff during the last 12 months?

Are you hoping to employ any more staff? Did you need any or manage to get any grants/CBILS/Insurance pay-outs for business interruption?

Yes, I got a Local Authority Grant of £10,000 “Small Business Rates Relief Grant” I think it was called, which, I’ll be honest, has kept me afloat. What has business been like since opening back up?

June to September was very slow, posting losses every month. I actually broke even in October and picking up steadily ever since, mainly because of picking up the additional practice. Have all of your clients returned back to normal?

No, I would say not, most are sticking rigidly to the 45% and now 65% of their normal contract. Have you altered anything you do or offer in the last year?

No, not really, just concentrating on my core products.

Yes, I think that will have to happen at some point if the work keeps picking up as it is as there only so much one person can physically do. In a few words, how do you feel about your business and Dental Technology going forward?

In the North East there were a fair few labs that called it a day and a lot of labs making staff redundant(downsizing), as there is no training up here now. I think the power could be turning in favour of the labs, which will be good for business if I can get the right staff to pick up any slack which may be difficult, due to this lack of training. I actually think some Surgeons have actually started to appreciate labs a lot more as they can’t squeeze extra appointments in and need work correct first time. I seem to be spending a lot more time giving advice on the best way forward with cases, which can save time and money for both me and them. I also think with all the new technologies coming in the whole of dentistry is on the way up for the better.

ANDY CHATTERTON I WEST COUNTRY DENTAL CRAFTS l We are fully crown and bridge and pre COVID were roughly 50/50 NHS/ private. I have a business partner and had a team of eight working with us that included six other gdc registered techs, my son who is finishing his second year at Cardiff and my partner who helps with admin and generally anything else admin wise that I require. Our focus is now implant work and all ceramic restorations. We did close on 23rd March 2020 and to be honest at that point I was seriously concerned we never reopen. The financial aid through furlough and the BBL’s were a real help.....we obviously now have a debt of 50k that we never had before but I’m a pragmatist and eternal optimist so I’m sure it will work out fine. Malcolm and I officially reopened on June 8th although for the first month we just redecorated as there was very little to do.

Business precovid was good but challenging as per normal, mixed practices including corporate and when the nhs was busy we were really busy.... high volume but low profit, so busy fools really. As mentioned earlier we needed a bounce back loan, Malcolm and I didn’t really qualify for much furlough as we were directors and most of our pay was a dividend so we needed something to use as capital. We were insured with U.K. special risks who made it clear from the outset that we were not covered so we did not get any insurance payouts. Since openening in June 2020, things have steadily grown but only in the private market and I would say we are now 90/10 private/nhs. Volume is about 60% of what it was but turnover is at about 90% now so profitability is up. Most of the private sector are back up and running but the NHS practices are really not doing much c & b at all.

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We offer the same as pre COVID but with lower volume we have been able to really drill down on quality and service as for doing anything differently, my whole mindset has changed now, COVID and our abandonment (a strong word but one I feel justified to use) by those in charge of dentistry has meant I had to restructure and re-evaluate how we worked. We now do less for more, I go home at a reasonable time and don’t work weekends and the remaining team are less stressed, happier and more productive. Unfortunately, I did have to let two techs go, one had really lost interest in the job and the other was experienced but was the most obvious candidate for redundancy. I have no plans to employ again at the moment to be honest, we have moved into digital, my son is leading this and I see a very bright future but with a smaller, happier and ultimately more productive team.

HEALTH & WELLBEING

BATTLING

STRESS

he importance of looking after our health and wellbeing has very much been in the spotlight in recent months. Though this is because of the threat to health posed by the pandemic, it has at least raised awareness among the population and encouraged many people to better care for their mind and body. Sadly, it has also been a very stressful time for many, including UK dental technicians, which presents new challenges in maintaining one’s health.

MENTAL IMPACT

Stress can have a number of detrimental impacts on individuals, their ability to work and their quality of life. For instance, high frequency or prolonged periods of stress can affect mental health quite severely. It can contribute to the symptoms of depression and cause significant behavioural changes (with increased risk of turning to smoking, alcohol or drugs as a coping mechanism). According to Government figures, approximately one in four people in the UK experience a mental health problem at some point during their lives. The “Thriving at Work” document attempts to determine core standards for employers to implement within the workplace so as to support workers’ mental health. This is especially important given that 828,000 UK workers suffered from work-related stress, depression or anxiety according to the 2019/20 Labour Force Survey, amounting to a lost 17.9 million working days. As would be expected, this was up by more than 37% compared to 2018/19, when 602,000 workers were suffering - in turn leading to 12.8 million working days lost. In a profession like dental technology, where an already reducing number of technicians is reported regularly, loss of working days due to staff sickness could be of great concern.

PHYSICAL SYMPTOMS

This is not the only way in which stress can manifest. In terms of psychological distress and physical disease, stress has been associated with a higher risk of succumbing to acute respiratory illnesses like the cold virus, as well as the development of an autoimmune disease. There is also evidence to suggest that persistent stress can lead to long-term high blood pressure, high cholesterol and type 2 diabetes, either directly or indirectly. In addition, stress has been associated with various cardiovascular diseases. This is

especially true among groups who are more socioeconomically disadvantaged. In all cases, factors related to stress like smoking, excessive alcohol consumption and overeating are believed to affect heart health. However, initial research has been conducted into whether there is a link between brain activity resulting from stress and cardiovascular disease. Published in The Lancet, the study suggests that amygdalar activity (responsible for emotional response) could be used to “independently and robustly” predict cardiovascular disease. Though this is a very interesting new field of study, the evidence so far is quite limited and further research is required to confirm the link and determine the exact mechanisms at play.

STROKE AWARENESS

This is all particularly relevant at this time of year, given that May is Stroke Awareness Month in the UK. There are two different types of strokes ischaemic and haemorrhagic. The former occurs when a blood clot blocks the flow of blood and therefore prevents oxygen from getting to the brain. Haemorrhagic strokes are usually caused by smoking, obesity, high cholesterol, diabetes, excessive alcohol intake or high blood pressure. Haemorrhagic strokes are less common, but they happen when a blood vessel within the skull bursts and causes bleeding into and around the brain, which is typically caused by high blood pressure. As stress has already been identified as one of the main risk factors of high blood pressure, reducing stress is an important step in minimising the risk of stroke.

LOWERING STRESS LEVELS

Consequently, it is essential to find effective management strategies for stress. These will vary greatly between individuals, day-to-day and business-to-business, but finding a healthy outlet that works for you and your staff is crucial. While many sources of stress - especially in recent times - may be out of your control, making small changes where you can will help. You might need to reorganise workstations, delegate caseload among colleagues or consider replacing materials or technology to streamline the daily workflow. Individuals may also find it useful to speak to friends in the industry who will likely be facing similar challenges and could offer simple solutions that have worked for them.

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Outside of the laboratory, being more active - whether going for a lunchtime walk or getting out the running trainers - will help to improve both physical and mental wellbeing. This should be supported by avoiding unhealthy habits like excessive alcohol and caffeine consumption and smoking, sticking to a balanced diet. Ultimately, it’s about working smarter, not harder. As the UK begins to return to some form of normality, it is important to prevent stress from impacting your health and that of your team wherever you can. For a chance to discuss this and many other relevant topics with like-minded colleagues, save the dates for DTS 2022 in your diary Friday 13th and Saturday 14th May 2022, Birmingham NEC, co-located with the British Dental Conference and Dentistry Show. For the latest information, please visit www.the-dts.co.uk, call 020 7348 5270 or email dts@closerstillmedia.com REFERENCES 1 Mental Health Foundation. Stress. https://www.mentalhealth.org. uk/a-to-z/s/stress [Accessed March 2021] 2 Health and Safety Executive. Mental health conditions, work and the workplace. https://www.hse.gov.uk/stress/mental-health.htm [Accessed March 2021] 3 Mental Health at Work. Thriving at work: the Stevenson/Farmer review of mental health and employers. October 2017. https://www. mentalhealthatwork.org.uk/resource/thriving-at-work-the-stevensonfarmer-review-of-mental-health-and-employers/?read=more [Accessed March 2021] 4 Health and Safety Executive. Work-related stress, anxiety or depression statistics n Great Britain, 2020. https://www.hse.gov.uk/statistics/ causdis/stress.pdf [Accessed March 2021] 5 Health and Saefty executive. Health and safety at work. Summary statistics for Great Britain 2019. https://www.hse.gov.uk/statistics/ overall/hssh1819.pdf [Accessed March 2021] 6 Cohen S, Tyrrell DA, Smith AP. Psychological stress and susceptibility to the common cold. N Engl J Med. 1991 Aug 29;325(9):606-12. doi: 10.1056/NEJM199108293250903. PMID: 1713648. 7 Song H, Fang F, Tomasson G, et al. Association of StressRelated Disorders With Subsequent Autoimmune Disease. JAMA. 2018;319(23):2388- 2400. doi:10.1001/jama.2018.7028 8 British Heart Foundation. Stress. Information & support. Risk factors. Stress. https://www.bhf.org.uk/informationsupport/risk-factors/ stress#:~:text=It's%20normal%20for%20your%20blood,body%20 cope%20with%20the%20situation. [Accessed March 2021] 9 Lantz PM, House JS, Lepkowski JM, Williams DR, Mero RP, Chen J. Socioeconomic factors, health behaviors, and mortality: results from a nationally representative prospective study of US adults. JAMA. 1998 Jun 3;279(21):1703-8. doi: 10.1001/jama.279.21.1703. PMID: 9624022. 10 Tawakol A, Ishai A, Takx RAP, Figueroa AL, Ali A, Kaiser Y, et al. Relation between resting amygdalar activity and cardiovascular event: a longitudinal and cohort study. The Lancet. February 2017. 289 (10071); 834-845 DOI:https://doi.org/10.1016/S01406736(16)31714-7

DENTAL NEWS

NORMALIZATION OF DENTAL CARE By Sir Paul Beresford

The time has come for the Government to bring forward a progressive strategy of normalisation of dental surgery care. Obviously, this will have to be undertaken with care and all according to scientific data. Priority must be given to safety of dental staff and patients. Dentistry, especially complex restorative dentistry, with the much feared aerosol spray, is difficult enough without all the PPE, masks and visors. I have huge respect for paedodontists having to treat already worried children made more nervous by a clinician dressed up like someone from outer space advancing upon them. Even the BBC have accepted that the combination now of Boris’s action of Lockdown and vaccination is progressively winning the battle against Covid. Fortunately, the number of daily deaths is heading towards the prospect of zero. Similarly, those being hospitalised have dramatically diminished as have the numbers of positive Covid tests. Significantly the reduction in this last figure comes at a time of increased testing. Perhaps more telling is that the R factor that now seems persistently below one and if was steadily below 0.5 consideration of relaxations is reinforced. Interestingly I do not think that there is any evidence of Covid transmission in the dental surgery. This indicates the

comprehensive protection procedures undertaken by dental practices. I believe that a new high-speed more reliable lateral flow type test is in the offing. The use of this test plus the now normal triage of extensive questioning and temperature taking should mean that the dentists could be able to ensure that any patient entering the clinic is Covid free and could be safely treated with what was pre-Covid normal sterilisation and protection methods. There has been much indignation raised at the possibility of inoculation ID cards being required. It is foreseeable that in a relatively short time a 100% of the population will have been offered inoculation. It is understandable that some, such as pregnant women may wish to resist the inoculation. Some, for what I believe are erroneous religious reasons, also have the right, at least in the United Kingdom, to refuse the inoculations. Already we are seeing a move towards the expectations that proof of inoculation will be required in certain circumstances, but not necessarily by Government. It seems to me that these are circumstances where a duty of care predominates. The most obvious of these will be care homes for the vulnerable. If one was choosing a care home for an elderly relative it should be important that your

care home of choice required evidence of full inoculation for anybody entering the home, be it staff other clients or visitors. Already some airlines and cruise ships are likely, as part of the duty of care to staff and travellers to require all to prove they have the inoculations. After all this has been a requirement for many decades for ships calling into yellow fever ports. If that becomes acceptable it does not seem unreasonable for dentists to ask for evidence from their patients that they have had the inoculations. This would support early scientific indications that those who have been inoculated are less likely to be Covid carriers. Interestingly, the public opinion on some form of Covid inoculation passports is heavily supportive. It would be sensible for the Government to provide some means of providing such a document for every inoculated individual. Of course, detractors will point out that documents can be forged, that people will go to some lengths to get round the system but it would be an additional protection for those who need to exercise a duty of care including dentists. Let us have a pathway back to normality set out. Safety first and guided by the scientific data.

ILLEGAL DEVICE MANUFACTURE/IMPORT - KINGSHOLM GROUP UPDATE The Kingsholm Group is made up of a number of organisations - the DLA, the DTA, the OTA and DAMAS and it is held under Chatham House rules. It has discussed illegal manufacturers/importers of custom-made dental appliances as well as education on medical device regulation in dentistry.

also done the same and reported suspected illegal importation to the MHRA. Mr Browne told the group that the GDC had acknowledged his concerns but would not tell him the outcome of the cases. Mr Browne also told the group that he had requested an update from the GDC but had not received a response.

Larry Browne former Editor of The Dental Technician and one-time GDC registrant acted in line with recent DTA guidance to technicians to follow GDC standards and report suspected illegal manufacturers to the GDC and the MHRA. One Dental Technician reader has

The GDC has told the group that there is no formal policy to educate dentists and nurses on medical device legislation. Dental hospital exemption from the MHRA is also in question after recent guidance from the MHRA saying dental hospitals are not exempt.

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The Kingsholm Group broadly agreed to ask for more information from the GDC on how illegal activity is handled and how regulators exchange data. The Kingsholm Group has been on hold during Covid at the request of one of the member organisations. The group has agreed to meet again. The GDC has been approached again for more information and has now agreed to provide more detailed information in these areas. The Dental Technician will keep its readers updated as things progress over the next couple of months.

The Dental Camera

NEW: Video feature and cross polarizer! Easy and quick to disinfect in accordance with current hygiene guidelines.

www.shofu.co.uk

DENTAL TECHNOLOGY DIGITAL

LIFE JUST GOT SO MUCH EASIER FOR LABS WITH THE LAUNCH OF AUTOMATE

ast week 3Shape launched 3Shape Automate - the world’s first AIpowered dental design service platform for dental labs.

Hosted on the 3Shape website, dental lab technicians simply setup an unlimited number of design orders with their customized instructions and upload their scans to the design service. Automate’s AI technology then returns every dental design proposal in as little as five minutes - regardless of the number of designs ordered. You only pay for the designs that you approve and download. 3Shape CEO, Jakob Just-Bomholt talking about the ground-breaking new service said, “AI technology is revolutionizing the world. At 3Shape, we began applying AI two years ago to make intraoral scanning with TRIOS effortless. We then used it with our dental software to make workflows much more efficient. Now with the launch of 3Shape Automate, dentistry takes a huge leap forward. It’s simply, a game changer!”

In an interview with Dentistry Today, Karl Hollenbeck, 3Shape’s head of the 3Shape AutodontiX business unit, a division dedicated to AI technology within dentistry and the mad scientist behind Automate, was asked about what he felt the biggest advantage of Automate was for labs. In the story,Hollenbeck says, “There are three very big advantages: speed, consistency, and scalability. But for me, I think that the greatest advantage Automate gives labs is scalability.

more efficient because you collect cases and simply match them with the right blanks. And remember, because Automate is AI driven and hands-free, you can upload an unlimited amount… 100’s of cases, to the platform, and still choose your deliver time for five minutes. They will be ready when you are. For me, scalability is really the name of the game. Automate gives you instant scalability, production-wise, and in managing your lab.”

Most labs experience rush periods or have times when they need to cope with an overflow of orders. Maybe a designer is out sick or on vacation, Automate instantly reduces any need for overtime or stress for your technicians. You simply fill the gap by taking advantage of Automate for your basic restorative design needs, choose a delivery time and bam, you are ready for production.

HOW TO GET STARTED

Think about how much more costeffective your manufacturing processes can be. Your lab’s blank management is much

3Shape Senior Vice President for product strategy, Rune Fisker, talks about Automate and its benefits for labs. “More and more dental workflows are going digital. Because of this, we felt that labs could really benefit from an easy-to-use self-service design service to supplement their caseloads. A service that could support them with, for example, a posterior CAD crown design, when they’re in a jam and don’t want to work overtime or search for an extra designer.

Labs can try Automate for free with a USD 50-dollar (€40) credit to see how it works. The self service is available 24/7 from the 3Shape website at www.3Shape.com/automate Automate is currently available for monolithic, single posterior crowns - premolars and molars.

AN OPEN PLATFORM

Because Automate is AI-driven, labs can take advantage of it twenty-four hours a day, seven days a week. Importantly, Automate is also an open platform, so technicians using 3Shape Dental System, Exocad, or even select scanners, can send their files to Automate and get a design file back in as little as five minutes. Although, 3Shape LabCare subscribers do get a 10% discount on the service. It is really about making life easier for labs.

www.dentaltechnician.org.uk

3Shape Automate Consistent. Fast. Scalable.

AI design for your dental crowns. Try it for free and learn more at 3Shape.com/automate

3Shape Automate is a dental design service platform powered by AI technology. Automate will design any of your single unit molar and bicuspid crowns. Set up the order and Automate is able to design a proposal for you in minutes. You pay for only the designs that you approve and download. Prices starting at only $1.99 per unit. 3Shape LabCare customers receive a 10% discount.

Check for availability in your region 3Shape.com/automate

ECPD

FREE VERIFIABLE ECPD

As before if you wish to submit your ECPD online it will be free of charge. Once our web designers give it the all clear there will be a small charge. This will be less than the CPD submitted by post. This offer is open to our subscribers only. To go directly to the ECPD page please go to https://dentaltechnician.org.uk/dental-technician-cpd. You will normally have one month from the date you receive your magazine before being able to submit your ECPD either online or by post. If you have any issues with the ECPD please email us cpd@dentaltechnician.org.uk

0.5HRS VERIFIABLE ECPD

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

LEARNING OBJECTIVES n Reproducing natural vibrancy

VERIFIABLE ECPD - MAY 2021 1. Your details First Name: .............................................. Last Name: ........................................................Title:................ Address:.............................................................................................................................................................. ................................................................................................................................................................................ ............................................................................................................ Postcode:............................................... Telephone: ......................................................Email: .................................................. GDC No:..................

n Choice of restoration n Framework choice

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

n Scanner benefits

LEARNING OUTCOME

Question 1

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By completing the Quiz successfully you will have confirmed your ability to understand, retain and reinforce your knowledge related in the chosen articles.

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Correct answers from the April 2021 DT Edition:

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

REPRODUCING PATIENT-SPECIFIC NATURAL VIBRANCE WITH VITA LUMEX AC VENEER-ING CERAMIC MICHELE PROSPERINO Q1. Reproducing natural vibrancy becomes particularly complicated when the enamel shows a multi-faceted play of XXX?

A - Shade B - Colour and light C - Veneer D - Translucency

Q2. In order to stabilise the teeth after the traumatic loosening, the dentist and patient decided to use a XXX for teeth 32 to 42? A - Splinted crown restoration B - Direct tooth restoration C - Indirect tooth restoration D - Partial denture

Q3. When selecting the material, the decision was made in favour of XXX? A - Modified peek B - Endocrown C - Margin elevation D - Zirconia crown framework

Q4. The four front teeth were given a XXX? A - Local anesthetic B - DPH 1% solution C - Benzyl Alcohol D - Lidocaine

Q5. What mixture of DENTINE A 3.5 and DENTINE MODIFIER copper was then applied to the central palatal area? A - 60:40 B - 50:50 C - 70:30 D - 80:20

MILLING, DRILLING AND BILLING - WOULD I, COULD I, SHOULD I? DARREN KELSEY Q6. Darren qualified in what year from Langside college Glasgow? A - 2001 B - 2002 C - 2003 D - 2004

Q7. Which showcase did Darren see the Ivoclar PM7? A - IDS B - BDIA C - DTS D - Dentistry Show

LIFE JUST GOT SO MUCH EASIER FOR LABS WITH THE LAUNCH OF AUTOMATE - 3SHAPE Q8. Automate’s AI technology returns every dental design proposal in as little as X? A - 5 minutes B - 10 minutes

C - 15 minutes D - 20 minutes

Q9. Hollenback says “There are three very big advantages: speed, consistency and XXX? A - Reliability B - Scalability C- Durability D- Adaptability

Q10. Automate is XXX driven? A - S.I B - A.G.I C - A.I D - G2

BRACON THE COMPLETE DIGITAL WORKFLOW - BRACON Q11. What type of data does the Audit Cameo Intraoral Scanner remove? A - Extraneous B - Exterior C - Extrinsic D - Extrados

Q12. What is the scanning tine for a full arch? A - 1 to 2 minutes B - 2 to 4 minutes C - 3 to 5 minutes D - 5 to 7 minutes

YOU CAN SUBMIT YOUR ANSWERS IN THE FOLLOWING WAYS:

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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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DIGITAL TECHNOLOGY

BRACON

THE COMPLETE DIGITAL WORKFLOW

or almost 70 years, Bracon Ltd has always been at the forefront of the very latest technologies and with the advances in Digital Dentistry, equipment, materials and CAD/CAM software, that statement remains true today. They can now provide the complete digital workflow, from the Cameo Intraoral Scanner or the Lab Scanners, through to digital design with Exocad. Those design files can then be imported into nesting or CAM software for printing or milling. Bracon have everything including, laptops or desk top computers and all the other equipment and materials required. The newest addition has been the Aidite Cameo Intraoral Scanner, which has some unique features that some of even the most expensive IOS devices do not have. This is a game changer as it brings a state-of-the-art IOS device within reach of the average high street dental practice, CDTs, and the rest of the dental team. Some laboratories are even making these IOS devices available to their clients. The Cameo IOS is a truly open scanner, as such any file can be exported as STL, OBJ, PLY, formats. It comes supplied with everything you need, including a flight case and a very high specification laptop with pre-installed scanning software. There are no license fees, free software updates and no file upload or download fees. This IOS even has purpose-built AI software that makes scanning a simple procedure - It automatically removes any extraneous data and any unwanted artifacts from the scan to accomplish fast data optimisation for high quality digital impressions. Motion sensing software also enables the operator to perform the whole procedure without touching a keyboard, mouse or the monitor screen. With automatic Articulation and a Clinical Toolkit built into the software, which enables the clinician to check undercuts, plot margins, check occlusion, adjust coordinates for ortho and smile design cases, this is a scanner that is hard to beat. There are no hidden ongoing fees or charges at all and Bracon are delighted to bring this to the UK and Ireland.

TECHNICAL: Data Cloud Platform Convenient free data uploads and downloads through a dedicated encrypted cloud server. For simple communication between clinics and laboratories, also ideal for referral cases.

Scanning Time 3 to 5 minutes for a full arch, at a scanning speed of 15 frames per second (video based.) From 3D printers like Asiga and the WhipMix Veribuild to wet or dry milling machines such as the Aidite AMD500, Ceramic Furnaces, Sintering Furnaces, Bracon are also able to supply 3D printable resins, zirconia, lithium disilicate, PMMA, Biomic and many others. Being able to supply the complete digital workflow ensures that customers

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can be secure in the knowledge that they will be fully supported. With dedicated experienced front line support teams including registered Dental Technicians and Clinicians and second line support from manufacturers. If you were even thinking about a digital workflow or any stage in that process, you would be wise to get in touch with Bracon Ltd. Contact on 01580 817000 Email: sales@bracon.co.uk Web: www.bracon.co.uk

Thinking digital? Think Bracon.

Asiga MAX 3D Printer • Whip Mix VeriBuild 3D Printer • Cameo CFP-100 Porcelain Furnace Aidite AMD-500 and AMD-500DC Milling Machines • Asiga PRO 4K 3D Printer Aidite ASDS-Mix and A-IS Pro Lab Scanners • Cameo Intraoral Scanner • Cameo Zirconia Fast Sintering Furnace Aidite 3D Pro Zirconia • Aidite Biomic Stain & Glaze • Cameo Lithium Disilicate Blocks • Plus many more

BRACON Digital Dental Products

For more information, contact Bracon today! t: 01580 817000 e: sales@bracon.co.uk w: bracon.co.uk

BAR HEADER MARKETPLACE

EXOCAD ANNOUNCES ROLL-OUT OF DENTALCAD 3.0 GALWAY - THE PRODUCTIVITY BOOSTER WITH INSTANT ANATOMIC MORPHING w DARMSTADT, Germany - March 30, 2021 - exocad GmbH (exocad), an Align Technology, Inc. company, today announced that DentalCAD 3.0 Galway, with new additional improvements to reduce design time is currently being rolled out to end users by exocad distributors. With this new release, initially made available to distributors in December 2020, the company introduced the new Instant Anatomic Morphing, offering automatic adaptation of teeth in real time, with improved speed and precision for the anatomic tooth placement. “We have systematically analyzed, in which steps dental technicians around the world spend the most time on during restorative design," said Tillmann Steinbrecher, exocad CEO. “Based on the extensive analysis, we developed technologies such as the new Instant Anatomic Morphing, which enables users to reduce design time by as much as 20-30%, on average*." “Thanks to the advanced process automation, dental technicians will get from the automatic proposal to their individual design goal faster, as the anatomy of teeth is adjusted in real-time with each movement, resulting in a major increase in productivity.”- added Steinbrecher. With the new Galway release, exocad additionally introduced AI technology for its Smile Creator. Facial features are automatically detected to achieve an esthetic proposal faster to save valuable time when designing cases. Another new feature offers printable clip-on mockups of the planned anatomic result. Instead of a purely visual representation of the smile makeover on screen, patients can physically experience their new smile with try-ins, resulting in higher patient engagement and opening up new possibilities in consultation. Inspired by Google Material Design, DentalCAD 3.0 Galway comes with a new, modern user interface and improved integration with exoplan, exocad's implant planning software. All features of the new release are built to improve ease of use in CAD design and to expand the possibilities of digital dentistry. With this new release, exocad introduces 90 new and 80 optimized features. Key highlights of DentalCAD 3.0 Galway include: • New Instant Anatomic Morphing

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

for reduced design time and increased productivity • AI-assisted technology for Smile Creator: facial features are automatically detected for faster smile design • Parametric shape adjustment: all tooth libraries are continuously adjustable from a newer to an older anatomy, seamlessly applying natural abrasion to all selected teeth • New and modern exocad user interface, offering a user-centric design to make digital interaction as fluid, intuitive and efficient as possible • New tools for easy and intuitive controlling of the individual path of insertion • Improved bridge connector editing with split screen view and tools to change several connectors at once, for a faster workflow in every anatomic situation

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

MARKETPLACE

SHOFU EYESPECIAL: THE DENTAL CAMERA FOR YOUR PRACTICE OR LABORATORY

EyeSpecial C-IV - The Dental Camera

w Creating professional photo documentations after only a short learning curve? No problem - with Shofu EyeSpecial, the dedicated dental camera. The EyeSpecial has everything your dental practice or laboratory really needs. It possesses smart special features, is easy to operate, reproducibly takes excellent images, and its use can be delegated to your assistants without any lengthy training. Ratingen - There are many ways to take good dental photographs: You can use a modified smartphone, a mirrorless compact camera or an upgraded single-lens reflex camera. However, all these “that-works-too” options have their drawbacks. They may be impractical, require in-depth photography knowledge, training and investments in additional equipment, fit into everyday workflows only with great difficulty - or even combine all these disadvantages. EITHER THE PHOTOGRAPHER IS AN EXPERT - OR THE CAMERA “The EyeSpecial has built-in photographic expertise. The camera relieves users of their worries about ring flash, lateral flash, aperture, depth of field and so on”, says Ingo Scholten, who is responsible for this product in Europe. “The EyeSpecial has everything you need to easily take informative patient images - without any specialist knowledge of photography, without any additional equipment. Thanks to its smart integrated features, the EyeSpecial reliably produces excellent pho-tos: high in contrast, razor-sharp and true to colour. The camera itself creates the conditions necessary for taking a good image, without any time-consuming alignment of flashes or other settings and adjustments.” PERFECTLY HYGIENIC What is absolutely essential today: Like no other camera, the EyeSpecial supports modern hygiene practices in your operatory, helping to effectively prevent infections. The completely smooth camera body is water and chemical-resistant and can be quickly and thoroughly disinfected with sprays and wipes between two patients. This minimizes the risk of cross contamination, and the camera is ready again in less than one minute. Another hygienic benefit: The intuitive menu navigation on the display does not require any direct skin contact, because the high-resolution 3.5" touch panel re-acts properly even when you wear disposable gloves.

HANDY AND LIGHTWEIGHT ALL- INONE CAMERA Since launching the first camera generation in 2014, dental manufacturer Shofu has geared the EyeSpecial to the special needs of dental photography. This ul-tralight high-performance camera produces great results without any heavy ac-cessories. It can easily be held with one hand, freeing the other to hold a cheek retractor or a mirror.

“MOTION PICTURES”: THE NEW VIDEO FEATURE Shofu has developed the latest generation, the EyeSpecial C-IV, to meet various user requests. A new video feature, for example, allows you to show functional aspects in motion and also videodocument case histories, functional analyses and successes before, during and after treatments. This is an advantage that pays off, not only in orthodontics.

The flash system with different flash heads and exposure programs is integrated in the camera. Irrespective of the ambient light conditions, it provides the opti-mal light in all situations typical of dental photography, be it intraoral images, patient portraits, shade selection or model photos.

FOR OPTIMIZED, GLARE-FREE VISUALIZATION: THE NEW CROSS POLARIZ-ER With the optional cross polarizer attached, the EyeSpecial C-IV allows you to look inside a tooth: Chroma, internal light effects and individual tooth characteristics are visualized without being distorted by light reflections occurring on the enam-el surface. Shade and colour effects of hard and soft tissues can also be assessed more accurately when using the cross polarizer.

EASY ENOUGH TO BE DELEGATED Nine special shooting modes designed for ease of use help you to achieve quick-er and better results. The focusing is done by a precise autofocus feature, so you can just concentrate on choosing the right image section and releasing the shut-ter or, even better, delegate photo documentations to your assistants. Besides, a special mode for shade selection automatically masks any soft tissues. This makes shade taking much easier.

www.dentaltechnician.org.uk

WOULD YOU LIKE TO LEARN MORE ABOUT THE NEW EYESPECIAL C-IV? Please view or download the product brochure at: https://www.shofu.de/ en/produkt/eyespecial-c4-uk/ Or please contact Shofu on: 01732 783580, sales@shofu.co.uk, www.shofu.co.uk

BAR HEADER MARKETPLACE

NEOSS - EXCELLENT PRIMARY STABILITY WITH ONLY 1 TO 2 DRILLS, EQUAL OR BETTER THAN PREMIUM MARKET LEADERS, ALL WITH THE NEW NEOSS PROACTIVE® EDGE IMPLANTS. w A Neoss ProActive® Edge is a one-of-a-kind implant - an empowering addition to the Neoss implant family giving you outstanding primary stability even in soft or compromised bone. WHAT ARE THE DATA SAYING? Data from a recent EAO study shows that that the Neoss ProActive® Edge implants achieve equal or better implant stability than the top premium brand implants. In addition, Neoss ProActive® Edge was the only implant that maintained outstanding implant stability in all situations, even with over-prepared osteotomies, making it highly predictable to use.1 HOW A revolutionary 1 to 2-step drilling protocol prepares the site with minimal bone removal giving you immediate feedback during placement. The drills are directly matched to the implant and thread designs, making placement faster, simpler and reducing chair time for you and your patients. WHAT ARE KEY CLINICIANS SAYING? “The things I really love with the Neoss ProActive® Edge Implant are the primary stability and you can use fewer drills. The primary stability makes it fantastic for my 4+ full arch cases too, it’s really my go-to implant for that.” Dr. John Hodges, USA “The Neoss Edge is a fabulous implant in soft bone or immediate sites. Precise placement with high primary stability.” Dr. Scott Davis, Australia

WHY The predictability of the Neoss ProActive® Edge implant has been further confirmed in a clinical use study. High primary stability was achieved for all implants, allowing for immediate or early load in support of single crowns, partial bridges as well as for full arch restorations. All implants remained in function during the entire one-year observation period with minimal (-0.5 mm) bone remodeling.2 AND THAT’S NOT ALL! Like all Neoss implants, Neoss ProActive® Edge features the clinically proven super hydrophilic ProActive® surface and the highly trusted NeoLoc® connection.

One prosthetic platform across 3 implant ranges with one screwdriver connection! That is Intelligent Simplicity! TO FIND OUT MORE ABOUT THE NEOSS PROACTIVE® EDGE IMPLANT VISIT www.neoss.com/edge or email info@neoss.com REFERENCES: 1. Turra M, Petersson A, and Sennerby L. Primary stability of three different aggressively threaded and tapered implants in low-density polyurethane. COIR. 2020; 31(S20): 60 2. Turra M, Andersson P, Verrocchi D, Sennerby L. A retrospective case series report on a novel aggressively threaded and tapered implant. COIR. 2020; 31(S20): 257

ZIRKONZAHN'S DIGITAL WORKFLOW EXCLUSIVELY COMBINED WITH THE PLANESYSTEM® w Zirkonzahn’s workflow can be carried out 100% digitally with an intraoral scanner, but depending on one’s working procedures, analogue steps can also be included. Zirkonzahn’s workflow is exclusively combined with the PlaneSystem® (MDT Udo Plaster, in collaboration with Zirkonzahn), an innovative working approach that permits acquiring the patient’s specific occlusion information and transfer it 1:1 in the virtual world without the loss of important data. In the software, the data acquired can be matched with 3D scans of the patient’s face obtained by means of the Face Hunter 3D facial scanner. This allows for a better achievable function and aesthetics design of restorations in the digital world and permits the technoclinical team to work anywhere and anytime on a “faithful” 3D virtual reproduction of the patient’s physiognomy and oral situation. In

With the PlaneSystem® and the Face Hunter 3D facial scanner, it is possible to transfer patient information 1:1 into the virtual world without the loss of information, to create a 3D virtual reproduction of patient’s face and oral situation.

this way, dentists can reduce the number of chairside appointments, yet providing their patients with a comprehensive consultation based on 100 % individual and predictable outcomes, improving patient engagement and satisfaction.

www.dentaltechnician.org.uk

Learn more about Zirkonzahn’s digital workflow with the PlaneSystem ® and the Face Hunter 3D facial scanner! Join our webinars and have a look at our vast archive of web conferences: visit www.zirkonzahn-education.com

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THE ONLY IMPLAN WAY FOR PERF T REHABIL EC ITATION? T By Matteo Neroni

WORKING DURING LOCKDOWN: PART 1 BY ANDREA JOHNSON

PAGE 14

PAGES 20-21

AL TO DENT TRIBUTES N TECHNICIAE´S MAGAZIN Y EDITOR LARR BROWNE PAGES 8-12

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Workstations & Equipment

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W: blueprintdental.co.uk

The Dental Technician Magazine May 2021

Articles inside

Classifieds

Neoss/Zirkonzahn

Shofu

Exocad

Bracon -the complete digital workflow

Reproducing Patient - Specific Natural Vibrance with VITA LUMEX AC Veneering Ceramic

S4S Dental laboratory welcomes new blood into board of directors

5 things I cannot work without! By Paul Martin, Prestige Dental

Battling stress

Domestic abuse. Why act now? Rhian Scott

Welcome from the editor

The benefits of receiving digital implant impressions - Sarah Hodgkins

Milling, drilling and billing. Would I, could I, should I? By Darren Kelsey