The Dental Technician Magazine August 2019 by The Dental Technician Magazine

VO L 7 2 N O. 8 I A U G U S T 2 0 1 9 I B Y S U B S C R I P T I O N

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MHRA

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RECRUITMENT HR LESSONS FROM THE TRENCHES BY ROBERT GITMAN PAGE 14 & 16

INTERVIEW ZIRCONIA AND THE ART OF DENTISTRY BY KURARAY NORITAKE DENTAL PAGE 10

YO BY UR R S A EC UB C O S SE OL MM CR E LE EN IPT PA A D IO G GU IN N E E G 3

MARKETING BECOMING INDISPENSABLEâ&#x20AC;¦ MARKETING TIPS FROM SUE KARRAN PAGE 6

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CONTENTS AUGUST 2019

Editor - Larry Browne FBIDST. FDTA, ITI Fellow, LCGI, RDT. E: editor@dentaltechnician.org.uk T: 01372 897461

Welcome

Designer - Sharon (Bazzie) Larder E: inthedoghousedesign@gmail.com

Marketing

Advertising Manager - Chris Trowbridge E: sales@dentaltechnician.org.uk T: 07399 403602 Editorial advisory board K. Young, RDT (Chairman) L. Barnett, RDT P. Broughton, LBIDST, RDT L. Grice-Roberts, MBE V. S. J. Jones, LCGI, LOTA, MIMPT P. Wilks, RDT, LCGI, LBIDST Sally Wood, LBIDST Published by The Dental Technician Limited, PO Box 430, Leatherhead , KT22 2HT. T: 01372 897463 The Dental Technician Magazine is an independent publication and is not associated with any professional body or commercial establishment other than the publishers. Views expressed in this journal are not necessarily those of the editor, publisher or the editorial advisory board. Unsolicited manuscripts and photographs are welcome, though no liability can be accepted for any loss or damage, howsoever caused.

Thoughts from the Editor

Marketing By Sue Karran

Insight 8-9 12

MHRA & GDC: What does it mean for you? Welcome to Dental Doris: A holiday is good for your health

Technology: Interview 10

Zirconia and the art of dentistry By Kuraray Noritake Dental

Dental Technology 13 20

Zirconia implants: The future of oral implantology? By Misch Implant Institute What is the science saying about modified Zirconia restorations on implants?

Recruitment HR Lessons from the Trenches By Robert Gitman

14-16

Company News Zirkonzahn / Bredent / Candulor

18-19

Focus 21-23

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THOUGHTS FROM THE EDITOR

WELCOME to your magazine AUGUST AND YOUR HOLIDAY READ! l

While most of you are on holiday some of us must continue to â&#x20AC;&#x153;grind it outâ&#x20AC;?!! I have been looking at the interest and the trends as I can observe them, and it would seem as if Digital techniques have really gotten hold. Not surprising, seeing how much they can help to improve production and even the quality of the restoration. With a consistent reproductive ability similar crowns can be manufactured with little more than a push of a button and some little modification. The trend towards price cutting however, does concern me. For too long we have continued to accept our lesser role in the restorative field of dentistry and ridiculously low pricing just underlines our lack of status. Value for money is seldom linked with low pricing and medium and long term would show that quality at the right price is sustainable and long term and must remain the goal for all of us. One of the great manifestations that consistently continues to please me is the confidence of technicians seems to be growing. More and more are, as they say, getting a word in, and adding to and expanding interesting discussion. I have been asked by one or two long standing readers to bring back the letters page which I do think would be a good idea. If you have something to say or questions to ask or tips and helpful suggestions, it would be good to hear from you. With the circulation continuing to grow we are reaching more and more of your colleagues who may share your concerns and perhaps need the occasional bit of help with a tricky bit of work. But you do have to write the letters!! I could I suppose, make up a few from A N Other or L E Cron but I really would like your continued support and perhaps be able to help you in turn. If something is bothering you, about the market or you want just to

quality of what you produce will be judged. From inlays to bridgework in whatever chosen material. If any of you are working on very new materials and can tell us about them, please do. Any individual concerns or answers will be welcomed.

moan about something write it down and send it. By email or by letter or text to me larry@lsbroene.com or to the mail address at the beginning of your Technician copy. The Dental Technicians Great Britain is a real example of a well used forum for technicians. Our collaboration with them is proving very rewarding and I believe is stimulating more interest and interaction across a wider field for technicians. The Joint DTGB and Dental Technician Magazine commitment has received real approval from readers and Facebook users alike. The idea that the Merit Award is for technicians, created and controlled by technicians and judged by technicians, all of whom are appreciated by their peers for their commitment and talent, is seen as a real breakthrough. The aim of course is to highlight the technicians at work and the quality which is produced widely across the countries of Great Britain and Ireland. Those of you who have felt un-invited in the past please take this opportunity to introduce your work and talent without fear of a commercial bias acting against you. These cases do not have to be large cases just the

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If you are working CDT. please get in touch. I do think you can enter several of the categories for the award and perhaps show photos of the finished cases fitted. I would very much like to work with any of you who want an open forum for Clinical Dental Technicians within the present journal. You have all given a lot of your time and money to achieve the lawful qualification. If you want to tell us about your journey and the cost and time committed it would help other technicians to judge their potential and attraction to follow your footsteps. I would very much like to hear of your experiences with practice owners and perhaps other clinicians, good and bad. The closing of the gap, that has been there for many years, would be a great step towards recognition of our vital place in restorative dentistry. Raising standards is about raising expectations and appetites for learning to be better. Being better rises confidence and self- esteem. For too many years technicians have just put their heads down and worked. Too many have stopped looking to improve and learning from others, because there is no time. There is always time if you care enough to change. Rub on plenty of sun cream and worry about the lovely food you have eaten when you get back. I am sure there will be a spike in jogging and cycling and other strenuous exercises in Sept and up to Christmas when the eating starts all over again. Enjoy your break to come back and face the winter quarter with renewed energy and ambition.

Larry Browne, Editor

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MARKETING

BECOMING INDISPENSABLE… SUE KARRAN EXPLAINS A FEW EASY TIPS TO HELP MARKETING YOUR BUSINESS

’ve worked in dental marketing for the past 35 years and over this time I’ve seen many changes but the fundamentals of getting and keeping clients remain the same. Consistency and communication are the keys to long-term success and in this article, I will explain a few tips on how to get the most from the precious time you dedicate to ‘marketing’. Most dental labs think they don’t need ‘marketing’ as they’re offering a service that dentists will choose to buy or not buy usually based on price and obviously this is correct if the only thing you are offering is a transactional relationship… Why wouldn’t a dentist go the cheapest supplier for their lab work? How do you move past price and make yourself and your business indispensable to the dentists you work with or want to work with?

HERE ARE A FEW TIPS THAT ARE WORTH A TRY: #1 Decide what your selling In these days of ever-changing technology being ‘all things to all dentists’ is a very tough place to be and it might be better to focus in on a particular type of work or restoration. For example, you might become experts in e.max restorations and market these services to dentist across a large geographical area, especially if you except digital impression files. Focusing on one type of restoration would also streamline production and lead to increased profits. You could decide to brand your e.max services to attract attention and give you a marketing edge, for example giving the service a name like ‘Simply e.max’ which makes it clear what you are selling, your unique proposition and why a dentist should choose you for these types of restorations. Think about your business and the type of work you like to do and then hone down your options to get to the products and services you want to market and produce… you really don’t need to offer everything! This kind of niche service offering minimises the chance of competitors overtaking you whilst ensuring there are customers out there interested in your service. By finding your niche market, you

can identify potential clients and partners to work with, not to mention the fact that you’ll present yourself as an authority in your niche. It’s likely that, through niche marketing, you will also build trust and credibility for your business within the industry and your visibility will grow to the point where your lab can no longer be overlooked. Also, you can clearly drive for a better price, after all, you are the ‘experts’ for this type of work in the market place. #2 Be Client-Centric This doesn’t mean saying yes to all the demands a dentist can throw at you, it simply means understanding the needs of your customers and helping them to understand how you can help them be more effective in some very simple ways. Think about what your client wants; what issues affect them on a day-to-day basis? How are they currently dealing with these issues? This could be helping them to understand more about digital dentistry by either offering to go to see them to discuss the latest advances in technology or creating a simple prep and bonding guide which would give them a better understanding of your needs when it comes to margins. Being helpful and knowledgeable with your clients can really pay dividends as you become the ‘expert’ (a drip under pressure as my husband likes to say!) and start to develop long-lasting valuable relationships that are worth much more than the price of a crown.

#3 Use social media So this is the tip you don’t think you can do, but you can! Now you’ve got your service sorted and you’ve started communicating with your regular clients about the products you are ‘selling’ you need to consider the outside world! You don’t need a fancy website and SEO; you just need a Facebook account and a little imagination. Facebook has a massive reach; you can join closed groups and start to chat about the things you do each day… you might not think that anyone's interested but you'll be surprised. Most dentists don't have a clue how to make a crown and they are fascinated by the process’s technicians use to create their work. You might feel uncomfortable with the written word, not a problem as video content now makes up over 80% of all traffic on the internet. Simply get your smartphone out and make little short videos of your daily activities and post them out… Bang you've got an audience lapping up your content and the next time they're thinking about trying a new lab you're top of the list. The only downside is that you do need to post content regularly – 2 or 3 times a week is a good frequency. And don't forget to use popular hashtags as a dentist will use these to search out topics, they are interested in. If you really struggle to get your head around social media enlist the help of a younger member of the team or even your children! From a marketing perspective, these few simple tips could revolutionise your lab, leading to a more profitable and enjoyable working life.

SUE KARRAN l SUE QUALIFIED AS A DENTAL TECHNICIAN IN THE 1980’S AND THEN WENT ON TO OWN

AND RUN THE LEADING DENTAL MARKETING AGENCY IN THE UK. SUE CAN BE CONTACTED VIA EMAIL: Suekarran@outlook.com

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INSIGHT

MHRA

& GDC WHAT DOES IT MEAN FOR YOU?

Well it does look as if I am not the only one concerned about the validity of registration. Designed to protect the patient. The following letter suggests that not a lot of dental professionals are paying much attention to the require guidelines and indeed the GDC and the MHRA are far from attending to clinical professionals not being registered with the MHRA (quite illegally) while continuing to produce and manufacture chairside and via laboratories who are not registered. The clinician using the unregistered laboratory or technician or nurse or hygienist, to construct dental appliances is also breaking the law. The GDC and the MHRA appear to be budding up not to enforce the registration or check the abusers (unless of course they are technicians!!!) On the opposite page is a letter I received from a registered Laboratory owner voicing a concern, which the technical or clinical bodies do not seem to choose to deal with. If any of you have concerns, please let me know. The Editor

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I regularly read The Dental Technician, with great interest and enjoyment of the variety of articles covering such a myriad of topics.I’m writing in for the first time regarding two articles in the May 2019 edition ‘The GDC Dilemma’ and ‘GDC Considering Illegal Registrant Manufacturers’ and would like to offer my thoughts on this, along with a recent experience with the MHRA. Upon attending the DTS in May of this year I saw, as did many other technicians, a particular laboratory with a stand in the ‘clinical’ side of the showcase advertising their laboratory crown services, with their price point seemingly their USP. I have since seen this laboratory and their DTS stand as a topic of discussion on the Dental Technicians Great Britain Facebook page, with responses usually leaning toward the negative impact such business practices have on UK dental laboratories, and the everpresent topic of ‘the race to the bottom’. Following on from the DTS and the social media post I had a quick look at this lab’s online presence which all looked very well presented via a website and social media pages. This led me to further look into the company itself via Companies House which showed two GDC technicians (amongst other people) registered as company directors, which was hopeful. However, I then spent a fair while searching the MHRA website for any company registered under their name or at their business address, but to no avail. From here, I decided to email the MHRA to request the laboratories registration details. The email was sent on 23/5/19 and a response received on the 29/5/19. The response confirmed the company was indeed registered with the MHRA and provided their registration number. With this registration number I used the website search function again and this laboratory now appeared under the search result, albeit with a date of registration of 24/5/19… This date is of course a few days after my initial email was sent, at least a week after the DTS where they were so publicly advertising, and from what has been said by one laboratory employee on social media, well after the two years they have already been operating! I replied to the MHRA email the same day asking for further clarification on the date of registration, and if this was indeed date of FIRST registration, and if so how to further raise my concerns that the laboratory had by all appearances been “illegally” providing medical devices for a two year period prior to this. Some three weeks later with no response I followed up with another email and finally got a response confirming it was the date of first registration along with the following helpful information. “This is a gentle reminder that registering devices with MHRA does

not mean that we are giving any form of accreditation, license, certification or approval for the device. It is just a notification of your activities.” Under Standard 1.9 of Standards for the Dental Team it is stated in regard to registrants who manufacture dental appliances mainly outside of the mouth (for example- fixed bridges, bleaching trays, crowns, splints, retainers, etc.) “If you make a dental appliance, whether you are a dental technician, dentist, or any other registrant, you must understand and comply with your legal responsibilities as “manufacturer” under the Medical Device Regulations (MDR). This includes the legal requirement to register with the Medicines and Healthcare products Regulatory Agency (MHRA).” So really, is MHRA registration considered a legal requirement to provide custom made medical devices? Does the MHRA or GDC care to look into such matters? The topic of unregistered laboratories naturally leads on to the clinicians that choose to use such laboratories. In my experience of running a laboratory, working with around 70 surgeries, I would estimate only around a quarter of these have ever asked for our MHRA registration details and/or our technicians GDC registration details, and then only usually when they are due a CQC inspection. It raises the matter of the provision of ‘Statements of Manufacture’, which I suspect rarely, if ever gets passed along to the patient as required. But if a laboratory is not even MHRA registered, then presumably there is no Statement of Manufacture provided to begin with? I would say I’m not one to usually take much notice of what other laboratories choose to do with their business practices, after all ‘each to their own’ and so forth. However, when a laboratory decides to advertise so publicly in the dental world, with what feels like utter disregard for any promotion of UK dental technicians skill and knowledge level, instead choosing to focus on price alone (with said price printed loud and clear on the carpet at the DTS), one can’t help but feel utterly dejected by the whole thing. With ever increasing demands on Dental Laboratories and Technicians to keep up with regulation, legalities, registration, CPD, best practice, and other such demands, we can only hope that the ‘powers that be’ namely the MHRA and the GDC can offer the advice, help and support needed to those trying to ensure compliance, as well as treat those that chose not to comply with a significant degree of seriousness. If after all, the various measures are in place for ‘the good of the patient’ what will the outcome be if a laboratory not compliant with the necessary regulations provides a device which results in harm?

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INSIGHT

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TECHNOLOGYY

INTERVIEW

ZIRCONIA AND THE ART OF DENTISTRY By Kuraray Noritake Dental July 25, 2019

hough one is a master dental technician and the other a dentist, Daniele Rondoni and Dr Nicola Scotti share a passion for discovering new materials and technologies to better provide aesthetic, durable restorations for patients. Here, they discuss their dental journeys and how they have integrated Kuraray Noritake Dental’s KATANA Zirconia range into their workflows. How did you get started in dentistry, and what was it about dentistry that first interested you? Dr Nicola Scotti: Well, my professional interest goes back 15 or 20 years at this point, but I was first introduced to dentistry as a child through my father, who was a dentist himself. I grew up looking at teeth, looking at models, and it was something that was just in my blood. When I had to decide what to study, I followed my heart and decided to become a dentist, and ever since I have remained dedicated to learning new things about it. Daniele Rondoni: I have a similar story to Nicola. My uncle was a dental technician and that influenced my decision to become a

dental technician and open up my own dental laboratory. Though there were many things that interested me, I have always focused on the major possibility that this profession offers, the opportunity not only to use your hands but also to combine this skill with the newest dental technologies available. Regarding this combination of manual and digital skills, do you still see a role for the dental professional as a craftsperson in this increasingly digital industry? Scotti: Dentistry, even if the digital influence continues to grow, will surely continue to be a profession defined by what we can do with our hands. You cannot complete a restoration, for example, without having these manual skills. There is also the matter of personalisation. Though machines can create flawless dental restorations in great numbers, it is the artistry of the dental technician that allows our patients to have customised solutions made with the materials and the shapes that suit them best. If you want to provide natural-looking restorations for your patients, digital dentistry is a great tool to use, but you need to have manual skills and a passion for the work as well.

Dental technician Daniele Rondoni (left) and Dr Nicola Scotti both employ Kuraray Noritake Dental's KATANA Zirconia in their everyday workflows. (PHOTOGRAPH: KURARAY NORITAKE DENTAL)

Rondoni: As a dental technician, it is important to remember that my work depends on technology, and so in this way, digital dentistry and the new-generation dental materials have helped my work greatly. Using this technology for individual situations is an essential part of my role, and excellent materials like Kuraray Noritake Dental’s KATANA Zirconia range make my artistic vision regarding these situations more easily achievable. Scotti: In my opinion, even if 90% of the workflow is digital in nature, you need that artistic input and vision for the remaining 10% in order to really create a successful restoration. With KATANA Zirconia, these two aspects come together and allow you to create something really amazing. Speaking of the KATANA Zirconia range from Kuraray Noritake Dental, is this material a part of your everyday workflow at this point? What do you see as its benefits? Rondoni: It is definitely a part of my everyday workflow. I have worked with Noritake materials for many years, but when Kuraray released its newest generation of zirconia, it totally changed my approach in the dental laboratory. Over the last five years, KATANA Zirconia has greatly influenced my workflow; it allows me to use certain technologies without forgoing artistic needs, and since it’s available in different translucencies and shades and so on, I can create aesthetic restorations for individual cases with ease. Scotti: In the past, I didn’t regard zirconia as a material for dentists. We used to take the impression and then ask the dental technician to use zirconia to make a restoration, but we didn’t use the material ourselves. What the KATANA Zirconia Block for chairside has introduced is a totally new concept of how zirconia can be used by dentists themselves. Having a material that can create monolithic full-contour restorations, even single crowns, is incredible. Its aesthetic qualities are fantastic as well, as Daniele mentioned, and it gives us a truly new option for treating patients.

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INSIGHT

WELCOME TO... DENTAL DORIS DENTAL DORIS HAS WORKED IN DENTISTRY FOR MANY YEARS AND LIKES TO MUSE ABOUT ALL KINDS OF DENTAL AND NON-DENTAL TOPICS

A HOLIDAY IS GOOD FOR YOUR HEALTH!

hen you run your own business, it can be very tempting not to take a holiday and often, we make the excuse that ‘I just have too much to do and people are relying on me'… Well, think again as according to recent research*, the average UK dental lab owner takes only half of their allotted holiday time. Unsurprisingly, they're suffering from being overworked, overwhelmed and overwrought.

week off each year. Even missing one year's holiday was associated with a higher risk of heart disease. Studies find similar results with women: Women who took a holiday once every six years or less were almost eight times more likely to develop heart disease, have a heart attack, or die of a coronary-related cause than those who took at least two holidays a year. These statistics are not to scare you but to persuade you that time off is important to your health in the long run.

It's time we say, "enough is enough" and learn to put yours and your family’s needs first.

3. Improved productivity In our perpetual rush to be productive, we often undermine our very ability to consistently perform at peak levels. Getting more done in less time allows us to get ahead and be more productive, but it takes consistent focus to be truly productive. Professional services firm Ernst & Young conducted an internal study of its employees and found that for each additional 10 hours of holiday time employees took, their year-end performance ratings improved 8 percent. What's more, frequent holiday goers were significantly less likely to leave the firm. Another study by the Boston Consulting Group found that high-level professionals who were required to take time off were significantly more productive overall than those who spent more time working. When you're more productive, you're happier, and when you're happier, you excel at what you do.

Taking time off is good for your mental and physical health, and you can come back more productive and effective. It's a win-win. HERE ARE FOUR SCIENCE-BASED REASONS YOU SHOULD BOOK A HOLIDAY VERY SOON: 1. Stress reduction A study released last year by the American Psychological Association concluded that holidays work to reduce stress by removing people from the activities and environments that they associate with stress and anxiety. Similarly, a Canadian study of nearly 900 lawyers found that taking holidays helps alleviate job stress. The effects last beyond the duration of the holiday, too: A small study from the University of Vienna found that after taking time off from work, people who had holidayed had fewer stress-related physical complaints such as headaches, backaches, and heart irregularities, and they still felt better five weeks later. 2. Heart disease prevention A host of studies have highlighted the cardiovascular health benefits of taking a holiday. In one, men at risk for heart disease who skipped holidays for five consecutive years were 30 percent more likely to suffer heart attacks than those who took at least a

4. Better sleep Restless nights and disrupted sleep are common complaints-often stemming from the fact that we simply have too much on our minds. When we can't stop the chatter it affects our

sleep, and a lack of sleep leads to less focus, less alertness, impaired memory, an increased likelihood of accidents and a decreased quality of life. Researchers say that holidays can help interrupt the habits that disrupt sleep, like working late into the night or watching a backlit screen before bed. If you have stress from work and you find your sleep is disrupted because of anxiety or tension, take time off and learn to reset your sleep pattern. Don’t let the summer of ‘19’ pass without a holiday… Take some time off so you can sleep better and be more productive, more relaxed, and healthier.

DENTAL TECHNOLOGYY

ZIRCONIA IMPLANTS: THE FUTURE OF ORAL IMPLANTOLOGY? By Misch Implant Institute I January 09, 2019

irconia implants have recently been introduced into dental implantology as an alternative to titanium implants. Zirconia is an ideal implant material because of its toothlike color, favorable mechanical properties, excellent biocompatibility and low plaque affinity. Since receiving FDA approval in 2011, zirconia implants have become increasingly popular and have been taunted as the next generation of dental implants.

Initially, zirconia implants were only available as a one-piece implant, which had numerous disadvantages. The one-piece implant is susceptible to fracture, especially if the implant had to be altered because of nonideal positioning. In addition, because of its one-piece design, it is susceptible to premature overload. However, recent research and development have led to the introduction of two-piece zirconia implants. These two-piece implants allow for abutments to be modified and customized to enhance esthetic results. Two of the more popular two-piece zirconia implants available today are the Straumann PURE Ceramic Implant System and the NobelBiocare: NobelPearl. Advantages: • Ideal for patients with metal hypersensitivities. • Increased esthetics.

PHOTO BY MISCH IMPLANT INSTITUTE

Zirconia implants were initially used in cases of metal-free dentistry and for patients with known metal hypersensitivities. Studies have shown a prevalence of titanium allergy to be approximately 0.6 percent.

• Retains less plaque and calculus (biofilm) in comparison to titanium • Excellent flexural strength and fracture toughness. • Favorable bone-implant-contact in comparison to titanium. Disadvantages: • Lack of long-term clinical studies. • One-piece may be premature loaded. • One-piece implants may require modification depending on positioning. • Zirconia modification leads to the reduction of physical properties of the material. • Slightly higher fracture rates than titanium. In summary, zirconia dental implants are

becoming a new and exciting development in implant dentistry. To date, limited preliminary studies have shown positive results with less inflammation, less biofilm accumulation, excellent esthetics, and a favorable boneimplant-contact. With the advent of two-piece zirconia implant systems, zirconia dental implants have the potential to become the ideal alternative to titanium alloy dental implants. However, only time will tell as longer-term clinical studies are needed. (Source: Misch Implant Instituteant Institute January 09, 2019)

l A Study carried out at the University of Washington which compared the strength of denture base with composite layering to the standard PMMA base material showed a superior result for the layered materials. The CadCam materials which come as pre-polymerised sections in different thicknesses were matched by the

PMMA polymerized samples. The prepolymerised layered materials showed significant strengths at all thicknesses The comparison was between Lucitone 199 and a CADCAM Ava Dent prepolymerised material. The CADCAM material was layered with composite (GRADIA) and with varying thicknesses.

www.dentaltechnician.org.uk

The resulting test showed clearly the CADCAM layer with Composite to be stronger at every thickness than the traditional produced PMMA material. In simple terms the CADCAM Dentures with composite layering have a significant greater fracture resistance than polymerized PMMA.

DENTAL NEWS

EFFECT OF LAYERING GINGIVA-SHADE COMPOSITE RESIN ON THE STRENGTH OF DENTURE BASE POLYMERS

RECRUITMENT

ROBERT GITMAN GENERAL MANAGER AT NDX - THAYER DENTAL LAB · MECHANICSBURG, PA l Robert Gitman is the General Manager of NDX Thayer, a full service, Certified Dental Laboratory, specializing in cosmetic and implant restorations. He has been active in the dental business for nearly 40 years.

hirty years ago, you needed two things to be hired in a laboratory: a heartbeat and a pair of hands. Except for management positions, applicants went through a very informal interview and, if they answered the questions reasonably well, they were immediately placed at a bench and started to learn “over the shoulder.” In today’s environment, even with a shortage of skilled technicians, you need more than just a heartbeat and hands. Laboratory personnel are expected to be effective communicators, understand the goals and vision of the business and, most importantly, learn to develop critical-thinking skills along with technical acumen. After 40 years of being in the personnel trenches, I’ve compiled some of my best tips for recruiting, hiring and retaining staff members: RECRUITMENT Get on board with social media. In the past, technicians were only hired via word of mouth or classified ads in local newspapers. Today we cast a much wider net and every open position we have gets posted on social media. We use Facebook, Craigslist and our website to target drivers, front office people and entry-level technicians. For more seasoned personnel, we use indeed.com and LinkedIn; on LinkedIn we find that resumes are often more up-to-date. Tap into local schools. Twice a year, we invite dental assisting and hygiene students at local colleges and vocational schools for a 1.5-hour tour of our facility; groups range in size from 20 to 40 students. The tours are conducted by Craig Yoder, CDT, TE - our Quality Assurance Manager and a 40-year laboratory veteran - who takes great pride in presenting our laboratory and the profession to the students. The intent of the program has always been to assist the schools with their

IMPLEMENT A TESTING PROTOCOL: Samples of a math test, 20 word spelling test and a drawing test

curriculum; the unintentional by-product is a group of potential employees and we’ve filled positions in our model department, CAD scanning, CAD design and customer service. About 10 years ago, we also started reaching out to local art and high schools to find prospective CAD design technicians. Students with graphic design skills translate well into CAD design and we found there’s a lot of graphic design students but not enough jobs to go around; we’ve hired five CAD technicians using this approach. Offer internship opportunities. Our internship program ranges from one to six months and gives both high school and college students a chance to experience life in the laboratory - anywhere from six to eight hours per day - while earning credits toward their degree. Once the intern has spent a day in each department, he’s assigned to an area that’s predicated upon his interests as well as our production needs. For instance, one hygiene

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student was fascinated by Sirona Connect and inLab. She quickly learned to retrieve scans, design single units and send them to the mill. Consider offering a referral bonus. Of all the strategies we use, our best resource for finding new employees is our current personnel. To encourage referrals, we offer a $300 bonus to anyone who recommends a new staff member; the referring employee receives the money after the person has worked at the lab for 90 days. THE HIRING PROCESS Implement a testing protocol. We require applicants to complete a series of tests to ensure they possess some basic skills, including: A math test. We’ve been using Jim Glidewell’s math test for over 20 years and it’s been a good indicator of applicants’ math aptitude. l A 20-word spelling test. l A tooth drawing test. (See above for samples of all three tests.) p16 l

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RECRUITMENT

The IDI dental technician series test, which measures technicians’ manual dexterity, ability to visualize objects in two and three dimensions, extroversion vs introversion and general stability/emotional balance. A package of five tests costs $85; for more information, visit bit.ly/metritech.

While assessing this characteristic in advance can be difficult, one way to get a better sense of the applicant’s personality and if he would be a good fit for your laboratory is to ask some of these open-ended questions commonly posed by NDX Thayer managers: Can you tell me about a time when you suggested a better way to perform a process?

Conduct working interviews. Once an applicant passes the testing and initial interview phase, we ask him to work for a short, set period of time - during which he’s paid - to demonstrate his skills before being officially hired. This “technical tryout” gives us time to get to know each other better. We can evaluate skills, aptitude, attitude, communication style and teamwork, and the applicant gets a better sense of the job requirements, lab environment and our expectations. Consider having the interviewee work for more than just one day or afternoon. For instance, since one technician-applicant only worked Monday through Thursday, he worked for us every Friday for 16 weeks. These Friday “tryouts” provided extra income for him and gave us the opportunity to assess his skill sets over time before we made him an offer of fulltime employment. (Click here to read 5 Tips to Make Working Interviews Work for You.) Look beyond skill set. Skills are important, but they’re not the only hiring factor. Warren Buffet once said, “Look for three things in a person: intelligence, energy and integrity. If they don’t have the last one, don’t even bother with the first two.” I take this advice to heart when hiring new employees. A person can have the skills you need but if he has no integrity, it will create dissention in the lab. People without integrity - those who milk the clock or even pilfer precious metals - are like a cancer in your laboratory.

Tell me about a career goal you have accomplished and why that was important to you.

What would you have liked to do more of in your last position? What held you back?

RETENTION Providing a competitive wage, offering a robust benefits package and committing to ongoing training are all critical elements to building a happy, loyal and productive team. Here are five other ways to motivate your staff and earn their trust: Be an authentic leader. People can respect you and your position, but if they don’t trust you they will not follow you. One key strategy we use to build trust among our team is having an open-book management style. We have morning huddles every day with our managers to discuss anything and everything about the laboratory’s performance, like stats on late case delivery and remake factors, our profit and loss statements, marketing initiatives, and new/ returning/lost customers. Then we share that same information with all of our staff members at our monthly lab meeting. It puts us all on the same page and helps us work together as a team to make things even better. Tap into your team. Your staff members are in the trenches every day and are rich with ideas for improving daily procedures; let them know their opinions are welcome and valued. For instance, at one recent meeting, I asked staff members to share their ideas and we got over 150 suggestions! We narrowed it down to the top 10 and implemented the ones that didn’t require a big financial investment. Here’s a sampling: l Place an “inspected by (technician’s name)” in each case to help build accountability and customer confidence.

Re-institute on-site lunch and learns for dental assistants to learn proper modelpouring techniques.

l Offer lab tours and lunch for dentists and their staffs. This will put names with faces, show off our facility and help strengthen our relationships.

Offer creative perks. We have a host of “bonus benefits” such as an extra paid day off per year for CDTs who maintain their certification; no-cost laboratory services for the employee and his immediate family; $100 on the anniversary

date of employment; and a 10% discount on auto repairs at a local shop. We even offer an educational reimbursement program of up to $2,500 annually for courses not directly related to the employee’s primary job duties; for instance, some technicians recently took a course on assertiveness for women in business, while others have begun courses in English Composition and Business Ethics to earn credits toward a college degree.

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Make work fun. One of the best ways to our technicians’ hearts? Food! For instance, staff members’ birthdays are celebrated with donuts and, sometimes after a great sales month, we bring in an ice cream truck for a cool afternoon treat. We’ve also thrown some pretty great parties; for instance summer picnics with a dunk tank, chili cookoffs and holiday-themed parties like Halloween or Superbowl fiestas. These events are great for morale and they don’t cost much at all. IS A RECRUITER RIGHT FOR YOU? Before we became a NDX laboratory, we worked with several national recruiters and hired six management-level employees using this strategy, including one who has been with us over 15 years. The primary benefit of working with a recruiting firm is its reach or scope of influence; it simply provides you with more candidates to choose from. However, working with a company does come with certain challenges. For instance, you must continually maintain effective communication to verify the firm is actively searching on your behalf and that it understands why a candidate is - or is not - qualified for the position. Also, because candidates we hire through a recruiter are usually highly compensated management positions, they undergo an even more stringent interview process. We usually begin with telephone conversations, move on to Facetime meetings and then have several in-person meetings. Most recruiters work on a fee that’s based upon a percentage of the employee’s first year of annual wages. Some also request a non-refundable commitment fee upon the execution of the recruiting contract. The companies usually have a guarantee that if the employee isn’t a good fit within the first 90 to 120 days, they’ll initiate another search and replace the employee. The fee is then adjusted according to the annual wages of the replaced employee. Another consideration: if you offer to pay moving expenses (a common practice when working with recruiters) don’t pay in advance; we learned this lesson the hard way. We paid a technician’s moving costs up front but, within a short period of time, he left the job. We now stagger payments over the first year and put the payment schedule in writing.

ELMFIELD HOUSE DENTAL PRACTICE EXPERIENCED FULL DENTAL CERAMIST REQUIRED FOR PRIMO DENTAL LABORATORY ATTACHED TO OUR BESPOKE DENTAL PRACTICE IN THE LONDON BOROUGH OF RICHMOND, SURREY TO START AS SOON AS POSSIBLE. We are a small but State of the Art Dental Laboratory managing the workload of the Dental Practice and we are also developing the laboratory with a view of ‘growing’ the business by expanding services externally. We currently use Sirona CAD-CAM technology with direct patient interaction for shade matching, Intrao-oral scanning for same day teeth and there will be a close working with dentists to deliver high quality restorations. All-on-4 experience can be provided if required. Spoken English essential and UK based candidate with minimum 3 years experience preferred. Pay commensurate with experience. If you want to be part of a dynamic team and help grow with our business please send your CV. Working hours: Monday-Friday 9-6pm and alternate Saturdays 9-1pm. (approx 44 hours per week).

REQUIREMENTS:

Flexible work load and training can be provided in areas for the right candidate as highlighted. Casting and trimming metal frameworks. Sirona Scanning and Milling PMMA and EMax Crowns and Bridges. All on 4 acrylic and Prettau Ceramic teeth processing. Porcelain build up and firing on Emax crowns and Zirconia/Metal Frameworks.

JOB TYPE: FULL-TIME OR PART TIME AVAILABLE

CONTACT HARPAL CHANA

Tel: 0208 614 1995 Email: Harpalschana@gmail.com

COMPANY NEWS

THE DENTAL TECHNICIAN MARKETPLACE ZIRKONZAHN.IMPLANT-PLANNER w With Zirkonzahn’s implant planning software dentists can receive from their dental technicians all components required for an implant case simultaneously: surgical guides, immediate load restorations, custom impression trays and/or milled models with laboratory analogues. With this software, the design of the prosthetics restoration can be considered already during the implant planning phase, allowing the dentist to determine

implant systems and completely integrated into Zirkonzahn’s workflow and software via corresponding libraries.

the optimal implant position in terms of function, anatomy and aesthetics, taking bone structure and set-up into account. Zirkonzahn also provides implant prosthetics components available for more than 100

In particular, Zirkonzahn’s implant abutments are warrantied up to 30 years in addition to the legally prescribed warranty obligation, including in the warranty also the implants of any manufacturer used in combination with Zirkonzahn’s abutments. For more information and to test the demo version of Zirkonzahn.Implant-Planner visit www.zirkonzahn.com

BREDENT: NEW TECHNICAL SALES SPECIALIST JOINS THE BREDENT UK TEAM w bredent UK Ltd is pleased to welcome Rob Pratt back to the team as a Technical Sales Specialist. Rob completed a Dental Technology Apprenticeship in 1984 and joined the Royal Army Dental Corps as a Dental Technician in 1989. On completion of a 22 year career he left the Army as Corps Regimental Sergeant Major. Rob initially joined the bredent UK team in 2012 where he gained a wide range of knowledge and experience with all bredent technical systems, building great relationships with fantastic laboratories in the process. The experience gained at bredent

stood him in good stead for his next project in 2015 which was as the Lead Prosthetic Technician with ADG Dental Lab. Now, four years later, Rob has re-joined the bredent UK team to support dental labs across the country. Managing Director of bredent UK Ltd, Stephen Denman said: "It was an easy decision to ask Rob to re-join the team. I am very passionate about supporting dental labs across the country and ensuring they get to see

and test the latest bredent products - and Rob was the perfect person for the role. We are extremely pleased to welcome Rob to the fantastic team we have in the UK." Rob said: "I really enjoy offering help and advice and demonstrating bredent products. I look forward to catching up with old friends and hopefully making some new. My appointment will mean that labs will have faceto-face contact more regularly from bredent.” Rob's appointment comes as bredent release a new formula crea.lign paste and the 2nd edition of the thermoplastic resin, Biodentaplast. For more information about the latest bredent products or to arrange a free demo at your lab, visit www.bredent.co.uk/demo

CANDULOR: KUNSTZAHNWERK AWARD 2019 – THE WINNERS w Zurich, March 2019: The 11th KunstZahnWerk, the competition for removable prosthetics in the dental field: the coveted CANDULOR KZW Award was presented at the 38th International Dental Show (IDS). THE COMPETITION Many old and new fans gathered at the IDS to view the custom-made KunstZahnWerk pieces. They had come from all over the world to admire the works and to gain new impressions. In numbers: 120 registrations from 4 continents and 49 entries from 16 countries. The challenge was to fabricate a combination consisting of a mucosa-supported full denture for the maxilla and a partially removable restoration for the mandible with four CAMLOG implants. All work had to be prepared using the Gerber setup method.

example, she emphasized how important it is to approach removable prosthetics with a high degree of passion to be able to restore the patient's individual joie de vivre.

This competition was held in cooperation with CAMLOG - a leading supplier of complete systems and products for implant dentistry and implant-supported dentures. Ms. Claudia Schenkel-Thiel, Managing Director of CANDULOR AG, opened the award ceremony with a cordial welcome to all participants and praised the submitted pieces of art. With a short patient history as

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THE AWARD WINNERS 2019 Mr. Simon Janes from Wolfisheim (France) won first place. The winner competed against 48 other excellent participants from across the world and received € 1,500 as well as the Golden CANDULOR Award. Second place went to Ms. Theresa Handl from Cham (Germany), who was delighted with € 1,000 and the Silver CANDULOR Award. Third place went to Mr. Nima Mohammadi from Breitenberg (Germany). He too, was the proud winner of € 500 and the Bronze CANDULOR Award.

Ms. Mona Stumpf from Hüde (Germany) took 1. place in the category "Best Documentation". She was delighted with the special prize in form of a Victorinox Swiss Champ XLT pocket knife donated by teamwork media Germany. Further prizes for 2. and 3. places went to Mr. Nima Mohammadi from Breitenberg (Germany) as well as Mr. Attila Forró from Budapest (Hungary). Mr. Mohammadi received a subscription voucher for the "das dental labor" magazine of the publishing house Verlag Neuer Merkur and Mr. Forró received a subscription voucher for the Labline magazine of DentAvantgArt. A special prize was awarded this year for the "Most Creative Presentation of the Work". This prize went to Ms. Deborah Sommer from Berne (Switzerland). She received a Bose SoundLink Mini Bluetooth speaker II from the publishing house Oemus Media.

COMPANY NEWS

Participants who made the top 15, received material prizes in the form of subscriptions or book prizes which were generously donated by the trade publishers Quintessenz, Verlag Neuer Merkur, Spitta, Oemus Media and teamwork media Germany and Italy as well as DentAvantgArt.

The Jury

THE JURY To do justice to the task in hand, the international jury consisted of competent experts: • Frauke Müller (Professor and Chair) University Clinic of Dental Medicine, Division of Gerondontology and Removable Prosthodontics. University Geneva • Arian Deutsch, CDT, DTG, Winner KZW North America 2012 & KZW International 2011, Owner Deutsch Dental Arts (USA) • MDT Andreas Kunz, Andreas Kunz Zahntechnik (Germany) • DT Martin Koller, CANDULOR AG This team of experts checked, discussed and finally assessed each individual piece of work. The function, esthetics, overall craftsmanship as well as the documentation of the entries were assessed using a complex process.

Visitors to the IDS were able to view the best competition entries at the CANDULOR exhibition stand in person. The next CANDULOR KunstZahnWerk competition will be in 2021 at the next IDS in Cologne. CANDULOR AG, Boulevard Lilienthal 8 CH-8152 Glattpark (Opfikon) Tel. +41 (0)44 805 90 00 Fax +41 (0)44 805 90 90 www.candulor.com candulor@candulor.ch

TO ADVERTISE IN THE DENTAL TECHNICIAN

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DENTAL TECHNOLOGYY

WHAT IS THE SCIENCE SAYING ABOUT MODIFIED ZIRCONIA RESTORATIONS ON IMPLANTS?

f interest to those of us working with the new technologies and materials are published studies to show how they may be performing and in particular when compared with more conventional processes. One such interesting study, first published in the march edition of the Journal of Prosthodontics, looked at the comparison of posterior implant supported crowns of Metal Ceramic (MC) and the Modified Monolithic Zirconia (MMZ) alternative. The study period covering one year and included 70 crowns in the mouths of 38 individuals.

Metal Ceramic Bonded Modified Monolithic Zirconia

With 36 MMZ crowns and 34 MC Crowns. The one year follow up looked at all complications and compared each group. One Implant failed in the MMZ Group with crown and implant survival rate for one year of 97.2%. For implant and crowns in the MC group it was 100%. However, complications such as screw loosening, loss of retention and ceramic failure all contributed to a poorer performance in the MC group. Screw loosening was 14.7% with loss of retention at 5.9% and ceramic fracture at 2.9%. The overall complication-free rates for the MMZ group was 97.1% and for the MC Group it was at 79.4%. Conclusion: The modified monolithic zirconia design applied to the posterior implant‐supported Single Crowns had a significantly lower technical complication rate than did the metal‐ceramic one.

SO MUCH FOR SINGLE IMPLANT SUPPORTED CROWNS. WHAT ABOUT SPLINTED CROWNS OR BRIDGEWORK? The use of implant‐supported fixed dental prostheses crown and bridgework in the rehabilitation of partially edentulous patients has been shown to have a predictable clinical outcome on both a short‐ and long‐term basis. Dental implants restored with single crowns have also been reported to have a comparable survival rate and fewer technical complications compared to multiple‐unit implant‐supported bridgework. When considering the fixing method, it is clear that the cement retained crowns and bridges have a marked lack of complications compared to the screw retained designs. The major technical complications were ceramic fracture, screw loosening, and loss of retention. Zirconia has been used for some time now for implant supported crowns and bridges because of it potentially superior aesthetics. Implant‐supported zirconia‐based restorations have been reported to have high survival rates clearly showing that the fracture resistance of zirconia frameworks was high enough to withstand expected occlusal loading. One randomized clinical trial with posterior implant‐supported metal‐ceramic vs. zirconia‐ based FDPs reported outcomes with survival rates above 90%. But caution; high fracture rates of veneering porcelain ranging from 6.5% to 90% have also been observed with implant‐ supported, zirconia‐based FDPs for partially and completely edentulous patients. The majority of these were porcelain failure of the porcelain veneer interface (cohesive porcelain failure). Modified monolithic zirconia design without veneering porcelain has been reported to be an effective way to strengthen zirconia but we must wait and see if the modern aesthetic claims can be confirmed. Monolithic materials with an aesthetic cutback and buccal porcelain added have been shown in a 5-6 year published study to have no complications, and that includes porcelain fracture. Single full arch rehabilitation using onepiece MMZ have shown, in a 1year study of 17 mandibles opposing complete dentures, a favourable result with one restoration failing due to framework fracture but the notable complications were in fact, fracture of the opposing denture teeth. A retrospective analysis of 26 full‐arch implant‐supported zirconia prostheses with modified monolithic design observed that only three porcelain veneered teeth had minor cohesive porcelain fracture, with

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a prosthesis success rate of 94.8%. The opposing arches were a mix of natural teeth crowns and implant supported crowns. Regarding dual‐arch implant rehabilitation with monolithic zirconia, few clinical reports with 6‐, 12‐, and 24‐month follow‐up periods reported good outcomes. It seems clear that there is an inherent possible weakness when the opposing arch is also of porcelain. The caution would be to think about using something else as a good rule of thumb. Perhaps Acrylics or Composites. With modern toughened acrylics (composite) the aesthetics can be matched very well. The advancement in these materials may indicate it is a more problem resistant material than ceramics, particularly when restoring both arches. It is a bit worrying that screw loosening should be such a big problem. Yet the Modified Monolithic Zirconia (MMZ) showed a lower incident in the various abovementioned trials. Perhaps the protocols were more carefully adhered to in manufacture because it was a ceramic material? Who really knows but it is an interesting anomaly? The porcelain fracture was lower in the MMZ group of crowns than the CeramicMetal crowns even though both groups included patients with a Bruxing habit history. Perhaps the newer and more current material MMZ has a more scientific material design than the long-standing metal ceramic versions. Clearly ongoing observations and extended studies are required on all of these aspects so we can understand better the; design requirements, material mixes and material handling requirement in order to maximise the result and patient comfort and confidence. I will attempt to pass on any study results which add to our understanding of the optimum requirements for the best results.

DTGB

DENTAL TECHNICIANS GREAT BRITAIN AND THE DENTAL TECHNICIAN MAGAZINE These are your pages for comment, questions, case pictures, and anything you want to share with your fellow technicians.

THE DTGB FACEBOOK PAGE JUST GROWS AND GROWS JUST TAKE A LOOK AT WHAT YOUR COLLEAGUES ARE SHOWING ON THE FACEBOOK PAGE FROM DTGB: They continue to grow and attract more and more members. We at the Dental Technician are delighted with the interaction and the many positive comments on the Merit Award scheme.

Some of the examples shown on the recent screenings are to me already contenders from a quality point of view! I am so pleased that at last, technicians are realising just what a talented bunch of crafts people they are. Add any helpful

comments or ask questions to get some tips from your technical colleagues. Just take a look at the following pages for a sample of what is happening every day now on the Facebook page.

WITH LOTS OF COMMENTS ON WORK WELL DONE www.dentaltechnician.org.uk

p22

DTGB

DENTAL TECHNICIANS GREAT BRITAIN AND THE DENTAL TECHNICIAN MAGAZINE

WHAT QUERIES DO YOU HAVE? YOU SHOULD GET YOUR ANSWER HERE!

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DEN-TECH AND VETERANS BITE BACK ALAN WRIGHT, BUSINESS DEVELOPMENT MANAGER, BLUEPRINT DENTAL LABORATORIES. HEAD OFFICE:15B OAKCROFT ROAD, CHESSINGTON, SURREY, KT9 1RH. T: +44 (0) 800 228 9828 F: +44 (0) 845 003 6275 M: +44 (0) 7904 413 211 E: alan@blueprintdental.co.uk W: blueprintdental.co.uk

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DENTAL NEWS

SUCCESSFUL COLLABORATION BETWEEN FRAUNHOFER SCIENTISTS AND DENTSPLY SIRONA: AWARD GOES TO ZLS RESEARCHERS

The Fraunhofer-Gesellschaft (Fraunhofer), Munich, a globally recognized link between basic research and applied sciences, awarded its renowned Joseph von Fraunhofer research prizes on May 8, 2019. In the category "Technik für den Menschen" [Human-Centered Technology], Dr. Bernhard Durschang and Dr. Jörn Probst from the ISC (Fraunhofer Institute for Silicate Research, Würzburg, www.isc.fraunhofer.de) won the award with the prosthetic material ZLS (zirconiareinforced lithium silicate). A wealth of ideas and successful collaboration with industrial partners, including Dentsply Sirona Lab (formerly: DeguDent), contributed to the success, but the main factor here was courage.

Charlotte/Bensheim, July 18th, 2019. German Chancellor Dr. Angela Merkel did not miss out on personally appearing at the awards ceremony and making a welcome speech, which included offering her congratulations for the big anniversary (70 years of Fraunhofer). "The Fraunhofer Model is a shining example of successful collaboration between science and the economy," she said, outlining in her speech a whole series of various fields of innovation, from digitalization to artificial intelligence and robotics, right through to battery cell production. In the category "Technik für den Menschen" [Human-Centered Technology], the Fraunhofer-Gesellschaft honored two

researchers who developed a new material for prosthetic restorations in collaboration with the industry. The high level of effort with which the partner Dentsply Sirona carries out its research and development paid off. Dentsply Sirona's investments in this field amount to around 150 million dollars each year. This results in a multitude of innovations in the digital and analog fields of dentistry. The high number of equally competent and motivated employees in the various research departments secures the company's leading role and makes it the partner of choice for universities and other scientific institutes. "The project to develop ZLS shows an outstanding example of these successful collaborations," said Dr. Markus Vollmann, Research & Development at Dentsply Sirona Lab. WHY DID IT NEED SUCH A HIGH LEVEL OF COURAGE? Quite simply because the researchers attempted something that was supposedly physically impossible. Until six years ago, glass ceramics were considered to be exhausted for use in dentistry. People were more or less resigned to this fact: Zirconia ceramics for structures with high strength (e.g., posterior bridges) and glass ceramics for beautiful, high translucency, but with considerable limitations regarding the indication.

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A seamless transition into digital impressions and CAD/CAM dentistry: With the new Primescan from Dentsply Sirona, the new Connect software and the Connect Case Center, it's a breeze. The portal for cooperation with the lab, which has been known as Sirona Connect until now, has been completely overhauled and is now even more convenient and flexible. Validated interfaces enable secure transmission of data to many important partners.

Charlotte/Bensheim, July 15, 2019. Easy, quick, and above all, accurate – intraoral scanning with the new Primescan from Dentsply Sirona meets the clinical requirements for impressions, making it a first-class method. The Connect Case Center is a portal for further processing of the scan with versatile options and full flexibility. The Connect Case Center replaces the Sirona Connect Portal which, until now, has enabled practices to link to laboratories that use the inLab software. The basic function of the new platform is the secure transmission of scan data and case information. Photos can also be transmitted to the lab as attachments. If you want to communicate directly with the dental technician, you can make use of the chat function.

FROM DENTAL TRIBUNE UK I JULY 09, 2019 l LONDON, UK/SHANGHAI, China: In a new global survey, King’s College London has been ranked fourth in the world in terms of dentistry and oral sciences research. The survey, conducted by Shanghai Ranking Consultancy, ranked King’s as the only European institution in the top ten and the only one located outside the US to have made it into the top eight.

Numerous interfaces, improved communication with the Inbox The new Connect Case Center has numerous validated interfaces to important partners of the dental practice: The seamless connection to Simplant enables users to use the Dentsply Sirona implant planning service quickly and easily. There is also a seamless interface to Atlantis, the central production service for patient-specific abutments and suprastructures on implants. The connection to SureSmile was created for the IDS 2019. This enables the user to order full service aligners, a model print, IDB trays for indirect bracket bonding and the production of aligners directly from the practice following the clinical diagnosis and Smile Design in the lab. Labs that work with the inLab software are also seamlessly integrated and can offer CEREC users an attractive design service. One significant new feature is the Connect Case Center Inbox – receiver software that enables all labs to access the Connect Case Center, regardless of their CAD software. The Inbox clearly displays all of the cases that need to be processed with the corresponding information on a dashboard and it also enables a 3D preview of the order, which can be accepted with a mouse click. For further processing with the preferred lab software, the Inbox generates common open data formats, such as STL and OBJ.

dedication and expertise of a wide group of staff from multiple disciplines.”

These results continue an upward trend for King’s in the Shanghai Rankings. In 2017, the faculty was ranked seventh, and in 2018, it was ranked fifth.

“This recognition feels just reward for our focus on delivering excellence in dental education to both undergraduate and postgraduate students, and world-leading research activity in clinical dentistry and oral and craniofacial sciences. The success of the institution owes much to the collaborative working between our staff, our students and our administrative staff who have collectively earned this important accolade,” he continued.

Prof. Mike Curtis, Executive Dean of the Faculty of Dentistry, Oral and Craniofacial Sciences at King’s, said: “The faculty at King’s feels tremendously proud to increase our high standing in the Shanghai rankings. To be ranked fourth in world and the only institution from Europe in the top ten is a remarkable achievement which rewards the effort,

As with previous years, American institutions dominated this year’s rankings, occupying the top three positions and eight of the top ten. The University of Michigan School of Dentistry, one of the oldest dental institutions in the world, took first place globally, ahead of the University of Washington School of Dentistry. The only other dental school besides King’s outside of the

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DENTAL NEWS

CONNECT CASE CENTER: SEND AND MANAGE SCAN DATA QUICKLY AND RELIABLY The Inbox has proven to be particularly convenient in the workflow with inLab or exocad labs that are connected via appropriate interfaces: It provides a format that is validated by exocad that includes model and case data, color information and preparation margins. In this way, dentists also have the option of cooperating with exocad labs in a validated workflow. Portal for all intraoral scanners from Dentsply Sirona When purchasing a Primescan AC or a new Omnicam AC, dentists also receive the Connect software, which enables quick and easy access to the Connect Case Center. The user also gets a license for the Inbox, which can be passed on to the lab of choice, so that the lab is also able to access the portal. Of course, labs can also buy their own Inbox license to obtain access to the Connect Case Center. "Users of both Primescan and Omnicam benefit from modern digital impression technology, while remaining flexible in selecting partners for the manufacture of restorations, orthodontic devices and implant abutments," explains Dr. Alexander Völcker, Group Vice President CAD/CAM and Orthodontics at Dentsply Sirona. "The new Connect Case Center thus provides the ideal environment for the digital workflow between laboratory and practice."

US to gain a place in the top ten was that of the University of São Paulo in Brazil, which was placed ninth. Shanghai Ranking Consultancy is a fully independent organisation, which, in its own words, is dedicated to researching higher education intelligence and consultation. Since 2009, it has been the official publisher of the Academic Ranking of World Universities, which measures several indicators of 4,000 universities worldwide, including research quality and productivity, as well as the extent of international collaboration, the amount of research published in top journals and the number of significant academic awards the academic staff have received from professional organisations. It currently ranks 52 academic subjects in five categories. One of these categories is that of medical sciences, which includes both dentistry and oral sciences.

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4 Hours Verifiable ECPD in this issue LEARNING AIM

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LEARNING OBJECTIVES REVIEW: n Strength of Zirconia n Implant planning n Customised Special trays n Business of Management

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VERIFIABLE ECPD AS YOU NEED IT VIA THE DENTAL TECHNICIAN MARKETING Q1. What is Sue Karran suggesting in point 2 of her article? A. Use Social Media. B. Use Local Press. C. Mail Shots. D. Lectures and demonstrations. ZIRCONIA AND THE ART OF DENTISTRY Q2. What does DR. Scotti believe makes Zirconia special? A. Its strength. B. The technicians handling of it. C. Its Chairside use for single crowns. D. Its bridge framework strength. Q3. A. B. C. D.

What do both parties see as the big advantage of the Zirconia? The Increased Strength. The production methods. The artistic possibilities. The speed of the process.

DENTAL DORIS: TAKING A HOLIDAY Q4. Which Expert Group showed a connection between holiday time taken and performance improvement? A. American Psychological Association. B. The Society for Medical Research. C. The Boston Consulting Group. D. Ernst and Young. Q5. A. B. C. D.

How many weeks later was the holiday benefit still evident? 2 Weeks. 2 Months. 3 Weeks. 5 Weeks.

Q6. A. B. C. D.

What was the performance rating percent improvement in one year? 20%. 8 %. 6 %. 12%.

HR LESSONS FROM THE TRENCHES Q7. What is the bonus offered for referring new staff? A. $500.00. B. $300.00. C. $150.00. D. $350.00. Q8. A. B. C. D.

How many tips are given for Working Interviews? 10 Tips. 20 Tips. 5 Tips. 12 Tips.

Q9. A. B. C. D.

What is the No.3 tip for Interviews? Keep it Legal. Supervise and evaluate. Don’t Force it. Set Expectations.

WHAT IS THE SCIENCE SAYING ABOUT MODIFIED ZIRCONIA RESTORATIONS ON IMPLANTS? Q10. What were the relative complication free rates for each group? A. MMZ Group 97.1% and MC Group 79.4% B. MMZ Group 97.2% and MC Group 95.5% C. MMZ Group 87.4% and MC Group 96.0.% D. MMZ Group 76.0% and MC Group 67.0.% Q11. A. B. C. D.

What is the most recurring complication reported? Porcelain fracture. Loss of retention. Opposing Restoration Failure. Screw Loosening.

SUCCESSFUL COLLABORATION BETWEEN FRAUNHOFER SCIENTISTS AND DENSPLY SIRONA Q12. What is the annual spending on research into Human - Centered Technology by Dentsply Siron? A. Fifteen million dollars. B. One hundred and fifty million dollars. C. Fifty- five million Dollars. D. Ninety-five million dollars. KINGS COLLEGE LONDON PLACED 4TH IN THE WORLD Q13. Which other, Non-American reached the top ten? A. University of Edinburgh. B. Sao Paulo Brazil. C. University of Bern. D. University of Copenhagen. Q14. A. B. C. D.

Which University took first place? University of Boston School of Dentistry. University of Washington School of Dentistry. University of Michigan School of Dentistry. Philadelphia Centre for Medical Studies.

Q15. How many University were considered, Worldwide? A. 4,000. B. 1600. C. 2800. D. 3280. ANGLO-SAXON TEETH COULD HELP IDENTIFY MODERN HEALTH ISSUES Q16. What was the title of the original study? A. Primary Anglo-Saxon teeth in medical research. B. Anglo Saxon Children’s teeth Collagen scores. C. Comparing Apples and oranges. D. Comparing the utero values of Nitrogen in Teeth.

You can submit your answers in the following ways: 1. Via email: cpd@dentaltechnician.org.uk 2. By post to: THE DENTAL TECHNICIAN LIMITED, PO BOX 430, LEATHERHEAD KT22 2HT You are required to answer at least 50% correctly for a pass. If you score below 50% you will need to re-submit your answers. Answers will be published in the next issue of The Dental Technician. Certificates will be issued within 60 days of receipt of correct submission.

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DENTAL NEWS

CIDRR JOURNAL PUBLISHES SCIENTIFIC EVIDENCE ON NOBEL BIOCARE’S LATEST SURFACE INNOVATIONS By Nobel Biocare I June 28, 2019

l MADRID, Spain: With the launch of its

Xeal abutment surface and TiUltra implant surface this year, Nobel Biocare recently initiated the Mucointegration era for implant dentistry. Now, clinical evidence supporting these pioneering surface innovations for soft-tissue integration has been published in a special supplement of Clinical Implant Dentistry and Related Research (CIDRR). Scientific research building on the scientific track record of the TiUnite surface has been a key driving force behind the development of Xeal and TiUltra. The CIDRR supplement contains seven articles on the surfaces, including in vitro, preclinical and clinical studies conducted by researchers around the globe over the last five years. They focus on how clinical and biological needs must be balanced, and how surface chemistry can enhance tissue integration, as well as the Muco-integration concept. One of the studies, a randomised controlled clinical study from the Brånemark Clinic in Gothenburg in Sweden with two years of follow-up, produced promising results. It showed better soft-tissue parameters, such as statistically significantly greater mucosal height, when using the new abutment surfaces compared with machined titanium abutments. With their unique surface chemistry and topography, Xeal and TiUltra were introduced

According to Nobel Biocare Systems President Hans Geiselhöringer, scientific evidence is a priority in Nobel Biocare's product development. (PHOTOGRAPH: DTI)

with the goal of optimising early tissue integration and long-term tissue stability. Both surfaces are currently available in European Economic Area markets and will be released to dental professionals in other regions throughout 2019 after clearance, licensing or registration. Extending their benefits to the next generation of implants and abutments, they will also be an integral part of the company’s new Nobel Biocare N1 implant system. According to Nobel Biocare President Hans Geiselhöringer, the Muco-integration concept is the next milestone for achieving both

immediacy and longevity for successful treatment outcomes in implantology. “Having launched this next generation of dental implant and abutment surfaces with such a wealth of scientific information already available at market release, we are once again confirming our role as a company that puts science first for the benefit of patients.” All seven studies from the CIDRR supplement are available for download from nobelbiocare.com/surface. There, dental professionals can also find more information about the clinical benefits and availability of Xeal and TiUltra.

HEALTH EDUCATION ENGLAND SURVEY OF HEALTHCARE WORKERS USE OF TECHNOLOGY l In 2017, Health Education England (HEE) commissioned educational research company Towards Maturity to undertake a learner experience survey across healthcare to help understand NHS attitudes and experience of using technology in learning. Over 1500 NHS staff helped to complete the survey which provided a rich picture of how different staff

groups were using technology to access education and their experience of using Technology Enhanced Learning. This year, BADN is assisting HEE to help gather information about where there have been changes and if the use of technology enhanced learning is improving the education of the health and care workforce and the care that we provide our patients.

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We are particularly keen for dental nurses to complete this survey. The survey is anonymous and easy to complete, taking on average around 15 minutes. To take part in the survey, visit: https://heeli2019.questionpro. eu/?ext_ref=BADN Pamela A. Swain MBA LCGI FIAM FCMI, BADN Chief Executive Tel: 01253 338365

l BRADFORD, UK: Unlike bones, children’s teeth continue to grow during periods of undernourishment and record high nitrogen values, providing a kind of archive of diet and health. A new study analysing the primary teeth of Anglo-Saxon children has found them to be more reliable an indicator of the effects of diet and health than bone is and could help identify modern children at highest risk of conditions such as obesity and heart disease. For the study, researchers from the University of Bradford looked at children’s skeletons from a tenth century site in Northamptonshire in England. The skeletons came from a group that was known to have been undernourished, which limited the growth of their bones and thus limited the evidence able to be gathered from bone analysis alone. By analysing dentine from the primary teeth of the skeletons, the research team was able to create a picture of the development of these children from the third trimester of pregnancy onwards. They were also able to look at children of different ages to see if those who survived the first 1,000 days from conception, a period during which factors

“We find that when bone and teeth form at the same time, bone doesn’t record high nitrogen values that occur during stress. Our hypothesis is that bone isn’t growing but teeth are. So archaeology can’t rely on the evidence from bones alone because bone is not forming and recording during high stress and we can’t be sure, for example, of the age of a skeleton. Teeth are more reliable as they continue to grow even when a child is starving,” she continued.

Researchers from the University of Bradford analysing primary teeth from Anglo-Saxon children's skeletons have found these teeth to be a more reliable indicator of health and diet than bone. (PHOTO: UNIVERSITY OF BRADFORD)

such as height are determined, had different biomarkers for stress than those who died during this period. “This is the first time that we have been able to measure with confidence the in-utero nitrogen values of dentine,” said Dr Julia Beaumont, lecturer in biological anthropology at the University of Bradford’s School of Archaeological and Forensic Sciences and coauthor of the study.

“There is a growing consensus that factors such as low birth weight have a significant impact on our likelihood of developing conditions such as heart disease, diabetes and obesity and that the first 1,000 days from conception onwards set our ‘template’. By analysing the milk teeth of modern children in the same way as the Anglo-Saxon skeletons, we can measure the same values and see the risk factors they are likely to face in later life, enabling measures to be taken to mitigate such risks,” Beaumont explained. The study, titled “Comparing apples and oranges: Why infant bone collagen may not reflect dietary intake in the same way as dentine collagen”, was published on 6 September 2018 in the American Journal of Physical Anthropology ahead of inclusion in an issue.

SCOTTISH PROFESSOR WINS INTERNATIONAL DENTAL RESEARCH AWARD l DUNDEE, UK/VANCOUVER, British Columbia, Canada: In recognition of his prominence in the world of dental academia, Prof. Graham Ogden of the University of Dundee has been awarded the 2019 International Association for Dental Research (IADR) Distinguished Scientist Award in Oral Medicine and Pathology Research. Ogden was presented with this accolade at the recent 97th General Session and Exhibition of the IADR held in Vancouver in Canada. The award is one of the highest honours bestowed by the IADR and recognises Ogden’s outstanding and sustained body of peer-reviewed research that has contributed to an understanding of the mechanisms governing the health and diseases of the oral cavity and associated structures, which principally encompass skin, bone and the oral soft tissue. The award consists of a monetary prize and a plaque.

Ogden is currently Professor of Oral Surgery at the University of Dundee, as well as Vice President of the Dental Faculty of the Royal College of Physicians and Surgeons in Glasgow. Since completing his PhD at the University of Dundee, he has published more than 100 peer-reviewed works on the topic of oral cancer ranging from basic science to chairside management. For raising public awareness about oral cancer and for his contribution to professional education on the subject, Ogden previously received the 2012 Ian Stevenson Award for Excellence in Public Engagement with Research.

Prof. Graham Ogden is currently Professor of Oral Surgery at the University of Dundee, as well as Vice President of the Dental Faculty of the Royal College of Physicians and Surgeons in Glasgow. (PHOTO: THE

UNIVERSITY OF DUNDEE) FROM DENTAL TRIBUNE INTERNATIONAL

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“I am deeply honoured to have received this award from the IADR, which represents colleagues from around the world,” said Ogden. “It is obviously very nice to be the focus of such recognition from one’s peers. It also shows the impact Dundee has made in dental research and the international reputation we hold.”

DENTAL NEWS

ANGLO-SAXON TEETH COULD HELP IDENTIFY MODERN HEALTH ISSUES

DENTAL NEWS

SCOTTISH PUBLIC HEALTH MINISTER DESCRIBES DENTAL TREATMENT WAITING TIME AS UNACCEPTABLE l EDINBURGH, UK: Scotland’s Minister for Public Health, Sport and Wellbeing, Joe Fitzpatrick, has admitted that some dental patients are experiencing completely unacceptable waiting times for hospital treatment. New figures show that the number of patients waiting for longer than 12 weeks for treatment has risen dramatically over the past four years. The data, which was released as a result of an information request from the British Dental Association (BDA), showed that NHS Grampian has five times as many patients waiting for longer than the 12-week target than it had had in 2015 and that NHS Highland has seen a tenfold increase in this number over the same period. Scottish Liberal Democrat Health Spokesperson Alex ColeHamilton, MSP, who raised this issue in the Scottish Parliament, said that patients can effectively expect to wait much longer and quoted figures which show a 14.7% drop in NHS dental staff in the last five years. In response, Fitzpatrick said, “I do accept that some of the waits that we know about—particularly some of the more challenging cases—are entirely unacceptable, particularly when you are talking about children who are often in pain.” Commenting on the situation, BDA Scotland blamed consultant shortages as well as a failure of regular patient check-ups for the long waiting times being experienced by hospital dental patients. In a press release, the trade union pointed to statistics showing that the proportion of those registered with a dentist in Scotland who actually visit has fallen significantly over the last few years, from 76% in 2014 to below 70% in 2018. Furthermore, BDA Scotland called on the Scottish government to ensure that the right investment and resources be put into dentistry in order for it to achieve the actions outlined in its Oral Health Improvement Plan, which was launched in early 2018. Of the 41 actions outlined in the plan, only two have been completed to date.

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The number of dental patients in Scotland waiting for longer than 12 weeks for hospital treatment has risen dramatically in recent years, according to new data. (PHOTO: FIZKES/SHUTTERSTOCK)

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