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DENTAL
TECHNOLOGY
SHOWCASE
(DTS) 2019 SPEAKER PREVIEW PAGE 12 & 14
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TECHNICAL A REVOLUTIONARY PARADIGM SHIFT IN DYNAMIC SURGICAL NAVIGATION PAGE 22
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DENTAL NEWS THE FMC LABORATORY AWARDS AT THE ROYAL GARDEN HOTEL PAGE 10
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MARKETING SIMPLIFIED SETTING TARGETS IS IT NECESSARY? BY JAN CLARKE PAGE 8
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
Inside this month
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CONTENTS FEBRUARY 2019
Editor - Larry Browne FBIDST. FDTA, ITI Fellow, LCGI, RDT. E: editor@dentaltechnician.org.uk T: 01372 897461 Designer - Sharon (Bazzie) Larder E: inthedoghousedesign@gmail.com Advertising Manager - Chris Trowbridge E: sales@dentaltechnician.org.uk T: 07399 403602 Editorial advisory board K. Young, RDT (Chairman) L. Barnett, RDT P. Broughton, LBIDST, RDT L. Grice-Roberts, MBE V. S. J. Jones, LCGI, LOTA, MIMPT P. Wilks, RDT, LCGI, LBIDST Sally Wood, LBIDST 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. No part of this publication may be reproduced in any form without the express permission of the editor or the publisher. Subscriptions The Dental Technician, Select Publisher Services Ltd, PO Box 6337, Bournemouth BH1 9EH
Extend your subscription by recommending a colleague There is a major change in CPD coming soon. The Dental Technician Magazine is a must read. Tell your colleagues to subscribe and if they do so we will extend your subscription for 3 months. The only condition is that they have not subscribed to the magazine for more than 12 months. Just ask them to call the Subscriptions Hotline. With four colleagues registered that means your subscription would be extended for a year free of charge. At only ÂŁ39.95 per year, for UK residents, this must be the cheapest way of keeping up to date. Help your colleagues to keep up to date as well. Ask them to call the subscriptions Hotline on 01202 586 848 now.
Welcome 4
Thoughts from the Editor
Digital Technology 6
HTSC Meeting
Marketing 8
Marketing Simplified by Jan Clarke
DTS 2019 12 14
Tom Behaeghal, VITA Zahnfabrik Sean Wilkinson, dental technician, lecturer and instructor at Zirkonzahn
Dental News The FMC Laboratory Awards South East Dental Study Club SICAT now independent: Dentsply Sirona transfers shares to management team GC Corporation ranked 2nd in the Quality Management Level Research in Japan for 2018 Survey highlights high demand for aesthetic dental treatments in U.K Renishaw collaborates with University Dental Hospital of Wales Obituary - George Bisterfeld Using PEEK frameworks for full arch implant supported prosthetics
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Focus Teeth within an hour: a ticking time bomb
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Technical A revolutionary paradigm shift in dynamic surgical navigation
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Company News Henry Schein Zirkonzahn / Shofu
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Recruitment Implementing equal pay in dental laboratories by Andy Foster
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Digital Dentistry Digital vs. analogue workflow on ten ceramic veneers in the maxilla
ECPD
Free Verifiable ECPD & ECPD questions
Classifieds
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25 - 27
28 - 29 31
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THOUGHTS FROM THE EDITOR
WELCOME to your magazine DENTAL TECHNICIANS GREAT BRITAIN JOIN THE DENTAL TECHNICIAN MAGAZINE IN CREATING THE ULTIMATE FORUM FOR DENTAL TECHNICIANS The merger of the Dental Technicians Great Britain Facebook group, with The Dental Technician Magazine has been in planning and discussion for some time now. I firstly would like to thank the work of our admin and moderators team for helping with the running of the group to get us to the stage of being of interest to a publishing company. The admin and moderator team will stay involved with the running of the online group.
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This will bring many advantages to our online group, with CPD points being a must. Again maintaining our existing identity of being for the benefit of all levels of Dental technicians within the UK industry will be maintained, and our interaction with each other via “tips and tricks and general encouragement “, to the humour and banter that has helped many of us through our working days will stay the same.
For me the merger will bring an ongoing opportunity of an income to the two charity’s the group has worked at supporting. These are Den-tech and Veterans Bite back. There will be an awards event that will be influenced and voted on by the members, and this also will hopefully raise income for our chosen charities. There will be articles and topics on all aspects of the Dental Technicians rapidly evolving world and I hope everyone will enjoy and benefit from this coming together of the media’s.
Alan Wright, Dental Technicians Great Britain
A REAL AND EXCITING JOINING OF MINDS AND IDEAS! The UK’s largest online Facebook l group for dental technicians is joining with the UK’s longest running print title to provide an authentic and genuine cross-platform solution giving all dental technicians their deserved voice.
The Dental Technician Magazine will share compelling and engaging content across both magazine and online platforms through editorial and video posts, maintaining the integrity of the group by being informative with leading tips and techniques. This WILL NOT included standard advertisements! We share the same vision and voice for technicians across the UK as Dental Technicians Great Britain. We are widely known as "The Technicians Journal" and is the only title that offers free CPD along with its unique and compelling content; this will now be made available to all members of Dental Technicians Great Britain! The opportunity to join forces with, and create synergy is a hugely exciting prospect. This extremely popular forum offers a great opportunity for the Journal and the Facebook group to share and enlarge the content. The Dental Technician Magazine will strive to understand potential advertisers goals and requirements and act as the agent taking care of all content sharing and posting activities; effectively working as a representation for the advertiser. All content will be featured on
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behalf of the advertiser under the "umbrella" of The Dental Technician Magazine. This offers the advertiser the credibility of being associated with the magazine and the members, the security of good compelling content. An awards scheme will be created within the group giving each member the chance to vote for who they feel have excelled in their field over the many various niches of the technical world of dentistry! More information on this exciting project will be revealed further into the year! For any further information please do contact Chris Trowbridge on sales@ dentaltechnician.org.uk I do think this is a great move towards providing a real voice for the whole of the various groups of dental technology. The Facebook group has proved its popularity with so may of you interacting. Offering opinions, asking questions in order to be heard. The Dental Technicians Great Britain site has become popular because of its accessibility and the potential speed of the response from other professionals. Popular topics raised within the Facebook forum page can be developed further in the Dental Technician Magazine and visa-versa. This gives us an opportunity to reach many more technicians and hopefully encourage them to speak out and where appropriate be published in the magazine. It is also an opportunity for those hard working colleagues who have created and grown the site to get some help from others involved in their
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area of interest. Bringing Technicians together and offering a combined forum both on line and in print variations and so reaching many more, both nationally and internationally. Speaking with one voice can and does open doors and can allow our voices to be heard by those we target. Those of you who do not already log on to the website should seek it out and you will see the varied and interesting content created by your colleagues. The exciting connection between the website and the magazine is they both started because technicians wanted to exchange knowledge and opinions and learn from each other. The Technician in the late 1940s and the website much more recently. Our aims are still the same and it makes very logical sense to combine our efforts and by so doing increase all our knowledge and understanding of the craft and the world in which we need to live. Dentistry is changing and some of the changes are profound. Now you can keep up to date with the help of these popular areas of common interest. The combined group will continue to inform and hopefully encourage response from all of you. I do think the future looks good and the contributors can now have a broader forum for both the opinions and case tips. Welcome The Dental Technicians Great Britain I and my team look forward to working with you and your members for a long time to come.
Larry Browne, Editor
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DIGITAL TECHNOLOGY
HTSC MEETING WEDNESDAY 23RD JANUARY 2019
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ednesday 23rd January was a big night at the HTSC. The AGM and the speaker Enrico Steger presenting his history and the remarkably successful story of his company ZIRKONZAHN. The AGM was seeing a change at the top with the present chairman David Coppen who has been responsible for keeping the organisation going through tough times handing over to his new Chairman Noel Pach.The HTSC has been in existence for more than 70 years and continues to attract some very interesting international and National speakers. Enrico Steger
David opened the evening to a full house of members and guests. Various offices of committee were voted on and in the main most positions were unchanged. The Treasurer gave his report, which was satisfactory, but with a potential call for an increase in membership fee proposed. The AGM business was soon concluded and it was time to introduce the speaker for the evening Enrico Steger ZTM. Enrico spoke of his wanting to become a Dental technician and pursued the normal course with his initial training Enrico’s Laboratory and one day release for his primary dental technicians qualification and then his continuation towards a Meister degree at the Meister School. To open and run a laboratory in Germany and Austria you need to be qualified as a Dental Technician Meister
(ZTM). Enrico passed his exams and started as many of us do as a one-man laboratory. He feels strongly that by offering the best quality possible together with the best materials at the right price success is assured. He went on to say that marketing is a essential part of the everyday needs for a successful business. Whatever you believe should be shared with your potential clients and hopeful will be taken up. Enrico’s experience is just that. He was charging more than other laboratories in his area because he believed he was using better materials and producing superior work. He discovered Zirconia in the late 1990’s and was excited by its aesthetic and restorative potential. Scanning and digital manufacture was very much in its infancy in those days. A difficult material but Enrico decided to find a way of manufacturing by hand. In time scanning and digital manufacturing came along, so he invested in a system, which proved less that satisfactory, at the time. (A familiar story to many of us!) He decided to continue his searching for the answer and eventually came up with his own digital manufacturing system. He had it produced to his criteria and it proved to be very successful and he eventually began to sell it and found he had a real international business.
A modern digital laboratory by Zirkonzahn
The company has offices across the world from its original headquarters in the South Tyrol to Germany, Spain, Mexico and several major offices in the United States. Including New York and California, another in Atlanta Georgia. At all of these sites there is also a school facility to teach interested technicians from learners to highly able craftsmen . Uniquely Enrico offers a course at his Helden Campus in the south Tyrol aimed at the true masters of Dental Technology where three participants can spend 5 days improving their skills and learning all about the Digital processes. Attendance is by invitation only and the invitation can only be from Enrico. He loves his original home in the south Tyrol and as a consequence he has several educational sites based there. From these centers he runs courses for all levels of Dental Technical learning. He truly understands that if you teach the techniques of creation and manufacture well it will bring its own response and of course its own reward. Throughout his talk Enrico showed examples of work from his Zirconia as well as milled bar retained full dentures and showed examples of his Prettau aesthetic Zirconia crowns and bridges. A truly impressive story with a full operational international company, to supply and teach the techniques, services and support for the users and their equipment and materials. There followed many questions from the large audience and eventually David stood to close the meeting for the evening. He was interrupted by his successor Noel Pach who presented him with a token of the members thanks for all his hard work - an engraved crystal mounted clock. A grateful round of applause from the gathered audience. The business of the meeting being finished the audience relaxed to enjoy the food and drink and to continue their subject of the evening and the speaker.
SOME OF THE CASES PRESENTED BY ENRICO DURING HIS TALK ARE SHOWN BELOW
TOP ROW (L to R): A case of telescopic metalwork, with CAC/CAM procedures; Master model; Scanned Dies and master model; Milled dies within overall impression for denture work; Scanned and designed metalwork, for milling; Metalwork in the milling phase; Teeth set up; Pink Gum-work in composite; A happy patient BOTTOM ROW (L to R): INTERESTING CASE WITH MILLED OVERDENTURES: Virtual articulation, with edentulous models in position; Virtual Set-up; Milled full denture base A CASE WITH MILLED BARS AND STRENGTHENED POLYMER BAR SLEEVE: Master models with implants in-situ; Milled superstructure; Colouring the Zirconia superstructure; The complete bars and superstructures; Completed Dentures.
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A���e�e ����e�s With Zirkonzahn’s digital workflow, all data acquired during digital patient analysis can be transferred 1:1 into the virtual world for predictable and 100 % individual restorations
VISIT US AT THE IDS IN COLOGNE, 12-16.03.2019, STAND J-019, G-010 | HALL 4.2 LECTURE TOURS IN THE UK “DIGITAL: IMMEDIATE LOADING IS HERE!” +39 0474 066 662 – CARMEN.AUSSERHOFER@ZIRKONZAHN.COM
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Zirkonzahn Worldwide – South Tyrol (Italy) – T +39 0474 066 680 – info@zirkonzahn.com – www.zirkonzahn.com
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MARKETING SIMPLIFIED JAN CLARKE BDS FDSRCPS MARKETING
l Jan qualified as a dentist in 1988 and worked in the hospital service and then general practice. She was a practice owner for 17 years and worked as an Advisor with Denplan. Jan now works helping dental businesses with their marketing and business strategy and heads up the Social Media Academy at Rose & Co.
Web: www.roseand.co Email: jan@roseand.co Facebook: Jan ClarkeTaplin Twitter: @JanetLClarke Instagram: janlclarkeacademy LinkedIn: Jan Clarke BDS FDSRCPS
SETTING TARGETS - IS IT NECESSARY? ith 2018 well and truly behind us I hope W you are able to analyse some of your business headlines over the year? • How many units of work did you complete? • How many clients did you serve? • What was your most profitable item of work? • What was a loss leader? When you see these figures in the cold light of day you can start to see where you may prefer to lead the business. Before we talk about setting targets for the coming year though, let’s talk about the business you are in. It’s always worth reflecting on your “Why?” and what your business is about. Remember there is no wrong or right about what your business is but you do need to be very honest with yourself about where you stand in the market place. Are you: • Pile it high and sell it cheap or • Exclusive, few clients and high quality Perhaps you have even been thinking about changing the direction of the business? If so, now is the time to look carefully at this. Each of these business models has its own particular challenges. PILE IT HIGH AND SELL IT CHEAP Here there has to be tight control on expenses, everything from material costs through to wages and also building costs. It’s important you don’t join the race to the bottom by just doing everything cheaper and cheaper because eventually you will be out of business. With good buying power and cost per unit analysis it is possible to make this model work.
EXCLUSIVE, FEWER CLIENTS Perhaps it is your dream to have few clients providing very high quality work who pay the right price for an exceptional level of work. Fewer clients does mean that if you lose one or two you can find yourself short of work and all of a sudden the dream becomes a bit of a nightmare! SETTING TARGETS Once you’re clear on what your business is about, it’s time to set some targets and look at the growth you would like to achieve. Of course, once you start to increase your numbers you will also need to be realistic as to how much work you can take on without expanding your team. If you will need to take on more staff then factor this into your figures. With the numbers for the whole year in front of you start to break this down into 3 monthly segments so you know what your growth needs to be at these points to achieve the yearly target. You can then go further and look at how much new work you will require in the first month and each and every subsequent month. These are your monthly targets and gives you somewhere to start to plan your marketing. GOALS Before the marketing planning starts it is worthwhile considering writing your goals down and committing them to paper, or screen. Why? There is quite a lot of evidence to suggest that people who write their goals down are more likely to be successful and achieve these goals than people who don’t. It’s not a given that if you do they will magically happen but I think the commitment to the process helps focus the mind and affirms exactly what you are wanting to achieve. I also think it is extremely useful to be able to revisit these notes during the year when you are wavering and the road is feeling rocky. It is also a great sense of achievement to be able to look back at the end of the year and know where you started. VISION BOARD This is something you may wish to consider or it may be a step too far, again extremely useful in growing a business and setting out plans for your
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future. Google vision boards and you will find lots of ideas and help as to how to make a board. You can have one board for all aspects of your life or split into areas. Certainly if you have one board just for your business and the dreams you can visualise for the business I would have this visible to your team so it is a constant reminder of why you are working so hard to achieve your goals. Vision boards are fun and allow further time for you to reflect on your goals, hopes and desires in your life. MARKETING Now we know exactly where we are travelling and what our goals are it is time to plan how this will happen and where the extra work will come from. As with the vision boards you can find templates for marketing plans on line and they can be simple or complicated. I prefer to keep it simple, straightforward and uncomplicated and favour use of an Excel spreadsheet split into monthly activity. Please feel free to email me for a copy. For each month I will look at activity in each of these areas: • Website • Search Engine Optimisation • Social Media • Blog • Email Newsletter • Advertising • Direct Mail • Events – educational information evenings • Networking As the year progresses you can chart your growth and report which marketing area was most successful, this allows some reflection as to the areas that may not be working for you. Your marketing plan isn’t set in stone and should be a dynamic, working document that can be tweaked and redirected if necessary. Good luck with your planning and may 2019 be a super successful year for you. As ever I am here to help with any of these issues so do email or connect online with me, I look forward to meeting some of you in cyberspace!
DENTAL NEWS
The FMC Laboratory Awards BY LARRY BROWNE 30TH NOVEMBER 2018 ROYAL GARDEN HOTEL KENSINGTON
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his was something of a surprise to me. My wife and I had some friends staying for the weekend. We had arranged certain visits around London, for our friends from Manchester, to show them something of England’s Capital City. Most of the arrangements were left in the safe hands of my wife (Sue Karran). On the evening of Friday 30th I was told we were going somewhere special and should dress with black tie! This we did and at the appointed time set off in the hire car to this mysterious destination. Until the car stopped at the Hotel I was still in complete ignorance as to the purpose of the journey. Not really being a fan of Award Ceremonies I was a little dismayed to be there. However there were a few old friends and some former work colleagues fully ready for a banter and I was more than happy to join in. The food and wine was duly tasted and approved and everyone began to relax and enjoy the evening in impressive surroundings. Once the dishes were finished there was a warning of the award ceremony approaching. The general atmosphere was friendly and jolly with quite a lot of old friends exchanging hellos and some sarcastic joking. As the time approached the focus became the stage set up at the head of the hall and looking very impressive indeed. The MC announced the awards ceremony would begin and for those who had applied for or were nominated for awards there was a positive concentration on the proceedings. As each award was called the lucky companies or individual technicians went to the stage with a good deal of applause and hand waving. (I have listed the categories and winners on a following page.) Some categories were also awarding highly commended awards and technicians and companies are also listed in last months DT awards list. There is quite a spread of categories and individual and company awards which obviously reflect the energetic and talented industry which represents todays world of dental technology. As the categories show it is a changing world but still requiring the art and ability of the craftsmen and women technicians to function at the highest level. The food and wine this evening was certainly a celebration of the ability and service of dental technicians across the UK. I was
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certainly enjoying being in the company of the assembled technicians and noting those who won and others who were highly commended. The podium was then taken by Julian English the Editorial Director of FMC, who announced a special award. A Lifetime Achievement Award for Outstanding Contribution to Dentistry. He went on to list some of those contributions and then announced me as the winner. My wife smiled and I then knew why we were there!! She had been let in on the secret. Julian was very gracious and presented the award, and I was a little tongue tied when asked to speak. I really would like to record a very serious thank you to the judges and FMC Publications for choosing me as the recipient. I would very much like to celebrate these award ceremonies as an official recognition of dental technologies contributions to restorative dentistry. Perhaps I will reconsider attending in the future. It was certainly a
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very enjoyable experience relaxing with friends and other technician colleagues. To celebrate the skill and dedication of those of us who toil daily for others who may not fully realise the ability and quality of the technician team member.
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DTS 2019
IT’S A MATERIAL WORLD W
ith constant innovation driving the dental profession to ever-higher standards, it’s important for professionals to remain abreast of the latest product developments. The rapid growth in restorative materials, in particular, means that technicians and dentists alike have a choice when it comes to selecting the most appropriate option based on each patients’ needs. Function and strength have always been important features in restorative dentistry, but an increase in aesthetic demands from patients further adds to the challenge. By working together as a team, technicians and dentists can combine their knowledge about materials to aid the decision-making process and utilise the most appropriate solutions in each case. This is one of the many interesting topics that will be covered at the Dental Technology Showcase (DTS) 2019. Tom Behaeghel, Technical Consultant for VITA Tom Behaeghal, VITA Zahnfabrik
Zahnfabrik North/West Europe, will be speaking in the DTS Lecture Theatre and hopes to help delegates improve their material selection. Having qualified as a dental technician in Belgium in 2002, Tom went on to become a Technical Advisor for VITA Zahnfabrik, responsible for Belgium, the Netherlands, Luxemburg, the UK and Scandinavia. He will be discussing “All-ceramic Restorations – A Complete Overview” and here, he shares the main themes of his session:
“I will be discussing the indications and contraindications for a wide range of different materials. I will cover bonding protocols and provide practical advice to improve daily workflows. I will also offer a preparation guide to help delegates organise their processes so as to maximise their chance of consistently creating outstanding restorations. All of the concepts I will present will be supported by scientific evidence and clinical studies to reassure delegates that they work.“All-ceramic restorations are relevant for dental professionals right now, because there is a clear demand for the aesthetic and strength benefits afforded by the materials. However, there are so many solutions to choose from and many dentists and dental technicians often struggle to select the best one. Choosing the wrong material for a particular indication can cause many problems later on, including the chipping, fracture or de-bonding of a restoration, and non-aesthetic results. All of these issues lead to loss of time, efficiency and quality of service, causing stress for the technician and the dentist, as well as additional costs. Such things can also disrupt the relationships between technician, dentist and patient, ultimately impacting the quality of care the patient receives. “With sufficient knowledge about the different materials available and their various properties, dental professionals can make better decisions for each individual case. They can avoid the potential pitfalls and deliver the highest quality care for patients.”
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So, what can you expect to take away from Tom’s session? He explains: “I hope delegates will leave my session with a comprehensive overview of the different restorative materials currently available on the dental market. I hope they will gain an improved understanding of the key differences between the materials and how they can be utilised for the best results. Consequently, I believe they will be able to improve their work and reduce the risk of restorative failures. My session will also be suitable for both dental technicians and dentists who are interested in crown and bridge work or CAD/CAM solutions.” For professionals wanting to find out more about the various restorative materials available, the trade floor will offer the ideal platform to do so. More than 100 labdedicated companies will have an array of cutting-edge solutions on display, with product experts on hand to offer information and bespoke advice. Plus, delegates can discover the benefits afforded by becoming a member of a dental organisation such as the Dental Laboratories Association (DLA), Orthodontic Technicians Association (OTA) or Dental Technicians Guild (DTG). Completely free for all delegates to attend, DTS 2019 will offer plenty of learning, networking and socialising opportunities for all members of the dental lab community, including dental technicians, orthodontic technicians, clinical dental technicians and lab owners. Tom adds: “This will be my first time attending DTS and I am looking forward to a great show with lots of delegates to speak to!” MAKE SURE YOU SAVE THE DATES. DTS 2019 will be held on Friday 17th and Saturday 18th May at the NEC in Birmingham, co-located with the British Dental Conference and Dentistry Show. For further details, visit www.the-dts.co.uk, call 020 7348 5270 or email dts@closerstillmedia.com
TO ! S EE D TE 019 FR TEN DA Y 2 AT THE H MA T VE 8 SA H & 1 T 17
THERE’S MORE TO THIS...
...THAN MEETS THE EYE
FOR MORE INFORMATION WWW.THE-DTS.CO.UK In partnership with:
Sean Wilkinson
DO THIS SHOW! Do you want to see the latest and greatest dentistry has to offer?
DTS 2019
Tired of scouring the web for what you need? Shows come and go, but the Dental Technology Showcase (DTS) 2019 is one you can’t afford to miss. DTS is a wonderful opportunity for you and your team to mix with fellow professionals, get hands on demonstrations of the latest and greatest technologies, find deals and partake in some CPD. Don’t miss out! DTS 2019 will be held on Friday 17th and Saturday 18th May at the NEC in Birmingham, co-located with the British Dental Conference and Dentistry Show. For further details, visit www.the-dts.co.uk, call 020 7348 5270 or email dts@closerstillmedia.com
GO COMPLETELY DIGITAL WITH CONFIDENCE
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Among the speaker line-up at DTS 2019 will be Sean Wilkinson (dental technician, lecturer and instructor at Zirkonzahn, Italy) discussing “CDD – Computer Dental Diagnostics” in the Digital & Innovation Theatre. “My session will be ideal for those who haven't yet made the leap into completely digital workflows. “I hope delegates will leave my lecture with a significantly improved understanding of the digital workflow developed by Zirkonzahn. I will also describe my own immediate implant loading protocol, to help delegates take their business forwards.”
DENTAL NEWS
DENTSPLY SIRONA AND CARBON ANNOUNCE STRATEGIC COLLABORATION TO REVOLUTIONIZE DIGITAL DENTURE MATERIALS
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Dentsply Sirona, the largest manufacturer of professional dental products and technologies, and Carbon®, a leading Silicon Valley-based digital manufacturing company, today announced a strategic collaboration to deliver groundbreaking denture materials for Carbon digital 3D printing production solutions. York, PA / Redwood City, CA. The past few years have yielded technology advancements for digital denture fabrication. However, the majority of units are still produced using traditional methods. Dentsply Sirona and Carbon are committed to taking the category to an entirely new level, by bringing to
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market the first premium printable denture material system that will provide significant advancements in terms of material benefits, laboratory process, and patient function. “We’re very excited to team with Carbon to deliver a total seamless workflow for increasing laboratory efficiency and elevate state-of-art materials for removable appliance fabrication in the 3D dental printing space,” said Julie Mroziak, Vice President Lab at Dentsply Sirona. Leveraging Carbon printers and innovative Digital Light Synthesis™ technology for high-resolution output and high-throughput
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capacity, the new Dentsply Sirona materials will establish a paradigm shift in terms of strength, aesthetics, and laboratory efficiencies for 3D printed dentures. Dentsply Sirona brings over 100 years of experience in the development of denture materials, as well as extensive expertise in scanning, and CAD/ CAM software including well-known brands such as Lucitone, IPN, and inLab that are globally recognized for quality and durability. “This partnership with Dentsply Sirona is a testament to Carbon’s global vision and mission to enhance the digital ecosystem,” said Brian Ganey, General Manager of Carbon’s Dental Business. “Together, we will be able
Carbon offers a revolutionary alternative to 3D printing, using light and oxygen to rapidly produce highquality, end-use products from a pool of resin. Its robust and reliable family of 3D printers based on proprietary Digital Light Synthesis™ technology, coupled with its innovative software and broad portfolio of materials, deliver a complete and comprehensive digital manufacturing solution for all dental production needs. Carbon solutions significantly improve efficiency and accuracy, reduce time from design to manufacture, and provide important features such as part
traceability and serialization through next-gen software design tools. With Carbon, everything is digitally traceable, down to a unique ID that can automatically be engraved or embossed on any part. This capability is particularly valuable for highly regulated industries like dental, where the FDA will increasingly require partspecific data to ensure product performance and patient safety.
headquarters is located in York, Pennsylvania, and the international headquarters is based in Salzburg, Austria. The company’s shares are listed in the United States on NASDAQ under the symbol XRAY.
The Dentsply Sirona denture materials for Carbon digital manufacturing solutions are slated to be available in the US later in 2019.
ABOUT CARBON Carbon’s mission is to reinvent how polymer products are designed, engineered, manufactured, and delivered, toward a digital and sustainable future. Based in Silicon Valley, Carbon brings together innovations in hardware, software, and molecular science to deliver industryleading digital manufacturing solutions.
ABOUT DENTSPLY SIRONA Dentsply Sirona is the world’s largest manufacturer of professional dental products and technologies, with over a century of innovation and service to the dental industry and patients worldwide. Dentsply Sirona develops, manufactures, and markets a comprehensive solutions offering, including dental and oral health products, as well as other consumable medical devices under a strong portfolio of world-class brands. As The Dental Solutions Company™, Dentsply Sirona’s products provide innovative, high-quality and effective solutions to advance patient care and deliver better, safer and faster dental care. Dentsply Sirona’s global
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DENTAL NEWS
to offer the marketplace a complete digital denture solution that is superior in terms of strength and aesthetics. With Carbon as the leading digital manufacturer in digital dentistry and Dentsply Sirona’s global leadership in removable appliances, we can deliver an unmatched offering that benefits both the dental laboratory and the patient.”
DENTAL NEWS
SOUTH EAST DENTAL STUDY CLUB WEDNESDAY 16TH JANUARY
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agnus Underhay and his wife Julie continue to run an interesting and regular study club for the South East area. Magnus welcomed us all and happily introduced the speaker for the evening. On Wednesday 16th the invited speaker was Karl Brown who is a qualified CDT and a working technician who did his early years of training at the Royal London. Karl remembers these early years with some pride as he was able to learn from some of the very best Senior technicians who were willing to work on to share their knowledge and experience with the younger interested trainees. In recent times the focus on higher quality prosthetics has gotten people and a lot of technicians interested in producing realistic looking dentures with natures hall marks of colourful and realistic gums and interesting set-ups of teeth. Karl spoke of his skill being passed down by his grandfather who was an engineer at Aston Martin Cars where attention to detail was an everyday expectation. Hand made and finished parts were a norm during his working day and helped earn the car company its unequalled reputation. Karl has earned himself a reputation for the excellence of his restorations and has been recognised by finishing in he last four in the prosthetic WMDA of the international DTG group’s. A competition where different skills and abilities, from across the world, compete in their chosen area of Dentistry. Karl stressed that everything we need to use to improve the appearance and function of dentures are around us within dentistry every day. Seeing patients or photos of patients soft tissues and noting the vein patterns, looking and measuring the colour mixtures and changes which include thin soft tissue stretched over bony areas of the alveolus with interdental papilla plump or thin. Seeing the detail of the attached gingiva around teeth running to the unattached but healthy gingival cuff. Noting the undulating nature of the gingival margins and including the occasional slight rotation characteristic of a slightly higher gingival margin. He showed examples of subtle changes in the gingival pattern and noted the colour and shadow, which normally accompanies such changes. He further went on to demonstrate the individualisation of teeth. Patients with extensive dentures are unlikely to be in their late teens so why should the teeth look as if they have never worn? Some subtle edge changes and abrasion marks, sometimes with coloured stain to emphasise incisal wear or increased blue grey translucency near the edges for the same purpose. In short bringing the learned skills of the aesthetic restorative technician into greater use of his existing knowledge and
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Pictured above (L to R): Magnus welcomes and introduces the speaker; Karl Brown at the WMDA prosthetic competition; Karl delivers his useful presentation
experience. No longer the poor relation within the restorative field the full denture is now being taken seriously and with the predicted growth in the number of edentulous patients over the next 20 years, the ability to make them really natural and secure is in increasing demand. Karl discussed the use of palatal colouration and showed the need to be aware of the patients’ differing smile characteristics. Some patients show their palate when talking or laughing or smiling. The clear palate, which has been used as a standard answer, can often look black in-situ and is far from discrete. Natural colouration and reproduction of the soft tissues contours can give the patient a realistic and a natural feel. Using colour variation to reproduce the potential shadowy areas and adding papilla and subtle nodules will often transform the smooth and polished standard denture appearance to more clearly reproduce a natural palatal reproduction. The first cases discussed were over-dentures on Implants with ball anchor type retention which had sadly worn over the period of the patients use. Despite there being sufficient implants on both the top and bottom jaws it was clear that over time the dentures had become mobile and had caused uneven wear of the retention balls. The patient was not willing to replace the ball anchors so Karl was forced to reproduce, from a silicone impression, all of the implant abutments in-situ. Quite often the simple use of a plastic modelling material (Duralay) would be adequate but the wear, on up to seven retainers, was badly erratic. Karl decided to reproduce and cast the ball anchors in Cobalt/Chrome, which were then inserted into the impressions for casting. Thus producing a hardwearing copy of the situation within the mouth. He then created
space around these areas in the denture base and relined those spaces with a silicone which acted as the replacement matrix of the attachment and coped with the varying angles of the placement which was present. Using silicone adhesive and undercuts in the denture base around the attachment it meant a secure and long lasting answer to a very difficult problem. The Silicone was a particularly resilient material with a core strength somewhat better than the super flexible we normally see in impressions. A clever and thoughtful answer, to a difficult problem. Karl went on to look at various smiles, both natural and with dentures and pointed out the most salient features. The subtle tilt of a lateral or even a mismatching center line. A slightly prominent canine or a mismatch in the lengths of the central incisors. Looking at smiles of celebrities in the press and comparing the slight variations that nature brings will teach you just how irregular smiles can be but remain very natural. Karl emphasised the contours of the denture base should not plump up the lip by its convexity or indeed any other soft tissue contour unless it is required for the patients appearance. Careful formation of the denture base can make the difference between. A natural looking restoration and a typical denture smile. He went on to talk about your choice of teeth and sensibly using colour to fit the patients’ face and smile. We all have favourite teeth which we think are great to work with. It is important to be able to have a varied choice so we can answer the questions for all our patients. An interesting evening with lots of tips an hints from a very able craftsman. Thank you Karl for sharing your knowledge with your fellow technicians. A natural smile is everyone´s right
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INSIGHT DENTAL TECHNICIANS DANGEROUS ROLE IN WW2 PART SIX BY TONY LANDON PAGE 26 - 27
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DENTAL NEWS
SICAT NOW INDEPENDENT: DENTSPLY SIRONA TRANSFERS SHARES TO MANAGEMENT TEAM BY DENTSPLY SIRONA
I JANUARY 04, 2019
Michael Geil, Managing Director of Dentsply Sirona, Bensheim and Group Vice President Equipment and Instruments. (Photograph: Dentsply Sirona)
BONN, Germany: The world’s largest manufacturer of dental products and technologies, Dentsply Sirona and SICAT, provider of software and hardware solutions for the dental sector, have agreed that
SICAT will be taken over entirely by its own management from 1 January. Dentsply Sirona announced that it will sell its shares of SICAT to HICAT, which is owned by the management and employees of SICAT. However, the two companies will continue their strategic partnership without any changes experienced by their customers. The existing SICAT products that are sold by Dentsply Sirona will continue to be offered to their customers as before. “Both Dentsply Sirona and SICAT profit from this agreement. We look back on over 14 years of shared history where both companies have grown. Now, we are taking our successful collaboration to a new level. This will offer each partner more flexibility in their options
GC CORPORATION RANKED 2ND IN THE QUALITY MANAGEMENT LEVEL RESEARCH IN JAPAN FOR 2018 l The Quality Management Level Research is conducted by the
Union of Japanese Scientists and Engineers (JUSE) and sponsored by Nikkei Inc. The results of the 10th edition were announced on 28th November - GC Corporation was ranked 2nd. Among the top 10 companies from the overall ranking are popular names, like Konica Minolta, Inc. (1st), Canon Inc. (2nd) and NEC Corporation (10th). GC Corporation is proud of being the only company ranked in top 10 for five consecutive years. GCC’s long-term targets to assess its corporate quality and conduct Global Customer Satisfaction Survey are highly appraised as the basis for continued improvement. Based on these efforts, GCC received the following evaluations from the Quality Management Level Research: 1st in Dissemination of Quality Management, 2nd in Commitment of Top Management, 3rd in Creation of customer value & Cultivation of human resources for realization of quality management, 5th in Collaboration capability among departments and 8th in Establishment and thorough implementation of a process. GC Group continues to strive to become one of the leading oral-health companies, supplying world-class quality products and services to all dental professionals. GC Europe N.V. Interleuvenlaan 33, 3001 Leuven, Tel: +32.16.74.10.00, Fax: +32.16.74.11.99 Web: www.gceurope.com
and put them in better positions to diversify their products individually,” said Michael Geil, Managing Director of Dentsply Sirona’s Bensheim site and Group Vice President of Equipment and Instruments. “We are very pleased to have found such a good solution for the future of SICAT and to manage the company completely independently. SICAT will remain a strategic partner of Dentsply Sirona for the development of software-based solutions for X-ray imaging. We will continue our excellent collaboration, but can now focus more specifically on our customers. In addition, we are now able to offer our solution to the entire dental market,” added Jochen Kusch, Managing Director Marketing and Sales at SICAT.
SURVEY HIGHLIGHTS HIGH DEMAND FOR AESTHETIC DENTAL TREATMENTS IN U.K BY DENTAL TRIBUNE UK
I JANUARY 10, 2019
London, UK: A survey by the cosmetic treatment website RealSelf has found that 40 per cent of UK adults are considering undergoing cosmetic treatment in some form over the next 12 months. Among the respondents, 43 per cent stated that they were considering aesthetic dental treatments such as tooth whitening, veneers and clear aligner treatment. The survey received responses from more than 1,000 UK residents over 18 years of age and found that overall 76 per cent of the respondents reported at least one area of their bodies that they would like to change. Teeth were the area most cited, highlighted by 35 per cent of the respondents. The millennial generation is largely responsible for driving the demand for cosmetic treatments, according to the survey. Sixty-two per cent of the respondents between 18 and 34 years of age said that they were thinking about undergoing a non-surgical treatment within the next 12 months, compared with 28 per cent of those aged 35 and above. The most common motivating factor cited for undergoing or considering cosmetic treatment was to improve self-esteem and confidence, and the most common concern listed was a fear of complications and/or poor results stemming from subpar treatment. Cosmetic dentistry has continued to increase in popularity over recent years as patient demand for procedures that enable whiter teeth and improved smiles has risen. A recent report from market research company Global Info Research predicted that the global cosmetic dentistry market will grow at an average rate of 2.4 per cent annually until 2023, reaching a value of US$17.6 billion (approximately £13.79 billion). The findings of the RealSelf survey have been published in a report titled U.K. Aesthetics Interest Survey, which can be found at: https://drive.google.com/file/d/1xh0x0ar-PW_ fSGcJDr3vUBBi58FGnVSm/view
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l
Global engineering technologies company Renishaw has collaborated with University Dental Hospital of Wales (UDH), Cardiff, to help overcome some of the challenges associated with surgical implants. UDH has previously used Renishaw’s additive manufacturing (AM) services to manufacture a series of dental products, including cobalt chrome frameworks. However, the hospital has also been using AM to produce custom maxillofacial implants and surgical guides. By using custom made devices, hospitals can reduce surgery time considerably as, unlike standard ‘off the shelf ’ implants, each device is designed to fit the patient. Standard implants may need modifications or the patient’s surrounding bone may need extra trimming for the device to fit. Not only is this highly likely to improve patient experience and reduce the risks related to extended time under anaesthesia, but it can also save significant time in surgery and therefore cost. By using AM to produce a wider range of implants, UDH is bringing these benefits to its patients and staff. “AM allows hospitals to achieve high precision when producing implants,” explained Ed Littlewood, Marketing Manager of Renishaw’s Medical and Dental Products Division. “By collaborating with Renishaw, UDH can develop their maxillofacial implants further, seeing improvements with each case and helping a wider range of patients and surgeons across different departments.”
“Several hospitals are reaping the benefits of additive manufacturing in implant production,” explained Roger Maggs, Senior Chief Dental Technologist and Head of Dental Technology Services at UDH. “We have the advantage of having worked with Renishaw for three years in the dental field. This has put us ahead of the game and in a position where we can now start thinking about producing more unique designs that will benefit our surgeons. “The staff at UDH are also benefitting from the partnership,” continued Maggs. “The team are involved in every stage of the development of new technologies for medical applications, including inputting CT data and making and manipulating digital models ahead of surgery. It is admirable that our staff are at the forefront of the latest medical technology and has allowed for the evolution of some very talented technologists such as Luke Maxwell and Paul Clark who must be considered leaders in this technology.” UDH treats 100,000 patients per year and acts as a teaching hospital for Cardiff University’s School of Dentistry. It is the only teaching dental hospital in Wales and provides unique and important leadership in dental research, teaching and patient care. Renishaw is fast becoming a major supplier of dental and medical AM solutions. The company is the only UK
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manufacturer of metal AM machines and works with hospitals across Europe to develop innovative manufacturing that ultimately benefits surgeons and patients. For more information on Renishaw’s additive manufacturing products for the dental sector, visit www.renishaw.com/en/dental-products UK-based Renishaw is a world leading engineering technologies company, supplying products used for applications as diverse as jet engine and wind turbine manufacture, through to dentistry and brain surgery. It has over 4,500 employees located in the 36 countries where it has wholly owned subsidiary operations. For the year ended June 2018 Renishaw recorded sales of £611.5 million of which 95% was due to exports. The company’s largest markets are China, the USA, Germany and Japan. Throughout its history Renishaw has made a significant commitment to research and development, with historically between 13 and 18% of annual sales invested in R&D and engineering. The majority of this R&D and manufacturing of the company’s products is carried out in the UK. The Company’s success has been recognised with numerous international awards, including eighteen Queen’s Awards recognising achievements in technology, export and innovation. Further information at www.renishaw.com
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DENTAL NEWS
RENISHAW COLLABORATES WITH UNIVERSITY DENTAL HOSPITAL OF WALES TO PRODUCE UNIQUE SURGICAL IMPLANTS
FOCUS
TEETH WITHIN AN HOUR: A TICKING TIME BOMB
DR GÖRAN URDE: EVOLUTION OF SURGICAL PROTOCOLS IN IMPLANT DENTISTRY
I
n my lecture at this year’s EAO meeting, attendees received an overview of over 50 years of working with implants and why we did it in certain ways back then and why we do it differently today. When I started placing implants, they were only for specialists in oral surgery and prosthetics. Periodontists were not even allowed to listen to our lectures. One also had to be thoroughly trained if one wanted to purchase implants. Companies kept records of the clinician’s success rates and if he or she had a higher than normal failure rate, they showed him or her the door to figure out alone what had gone wrong. In some instances, the warranty did not even apply if the dentist was not very good. I wish we had a similar system today to save patients from less skilled peers. Later, everyone was allowed to take a course and to place implants. Often, these were just weekend courses after which the dentist was supposed to be a fully qualified surgeon and prosthodontist and knew everything, including single- tooth restoration, full-arch rehabilitation of severely resorbed jaws with bone grafts and immediate loading concepts. It was totally absurd. To place implants, one needs to be well trained always learn to walk before one starts to run. To my delight, I see that more and more implant companies are abandoning weekend courses and instead offering high-quality courses over a longer period. Attendees have to treat patients under supervision and companies even offer mentor support, which means clinicians are receiving guidance in conducting their treatments. The best courses are of a general nature, where the sole purpose is to train dentists to place implants and do this well and not how to do it with a specific implant system. One thing that worries me a great deal is all the copy-cat versions of implants that are being marketed to less experienced dentists who cannot determine what a good product is.
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I always tell my audience to never treat patients differently to how they would treat their own family. The unfortunate thing is that I often see members of the audience looking down because they feel admonished. They do not understand that they get what they pay for and that failures are very costly and can hurt both their reputation and patients. Another topic that gets me going is the marketing of new teeth in an hour. Patients that for decades have not taken care of their natural dentition are now being treated in accordance with concepts like immediate loading. Within an hour, any remaining decayed teeth are removed and replaced with implantsupported crowns and bridges in the belief that the patients will start taking care of their new teeth. Unfortunately, this is not realistic. In my opinion, this is a ticking time bomb. It is just a matter of time before patients will come back with problems like peri-implantitis and failing implants. Who is going to sort that out? In the good old days, patients had to cooperate first and then we placed the implants. Maybe this was a bit harsh, but success rates were higher then and fewer patients ended up with problems. One does not have to be a rocket scientist to understand that, with a mouth full of pathogens, the success rates will go down. I have been heavily involved in developing
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concepts like “Tooth Now”, according to which a tooth is extracted and immediately replaced with an implant and loaded with the final abutment and a temporary crown, with extremely high success rates when it comes to both implant survival and even more so the aesthetic outcome. Therefore, I am not against immediate loading at all, but case selection is very important. That is why good training courses conducted over longer periods are so important. Guided surgery is both, good and bad. The saying of “garbage in, garbage out” is apt in this regard: if one has the wrong information or interprets the digital information incorrectly, one might get into trouble if a fully guided surgical template is based on that. I do not agree with fully guided surgery as it is today, as I believe our brain needs to be connected instead of just computers. Do not get me wrong, I love to work with digital planning tools like NobelClinician (Nobel Biocare) to optimise my treatments, but instead of fully guided I prefer to use simpler surgical and/or pilot bur guides that do not force me to drill in a certain way. At EAO 2017, Dr Göran Urde presented a paper titled “Evolution of surgical protocols in implant dentistry” as part of the scientific programme. Dr Göran Urde is the director of the Futurum Clinic at the Malmö University’s Faculty of Odontology in Sweden.
- OBITUARY -
GEORGE BISTERFELD GEORGE BISTERFELD, Export Manager of Shofu Dental, has passed away at the age of 64. George joined Shofu in October 1987. With great dedication he built up the export department and developed the international Shofu business. He was a substantial part of Shofu’s success in Europe and the company it has become over the last three decades. With close ties to dealers and opinion leaders all over the world, he is a well known figure around the dental industry. George was well respected for his profound product and market knowledge, his kind personality and his great sense of humour. In his private life, George shared his passion for travelling and different cultures with his wife Marlene, who preceded him in death. He will be sincerely missed. May he rest in peace.
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TECHNICAL
A revolutionary paradigm shift in dynamic surgical navigation - is this the end of surgical stents or templates? BY GEORGE MANDELARIS, DDS, MS I FEBRUARY 28, 2018
A
revolution in surgical guidance is afoot. A new dynamic navigation technology called “Trace and Place” (TaP for short), was developed by ClaroNav and will soon become available with its Navident system. I have had the opportunity to try the technology in a range of cases, and I am very impressed. Here’s a brief description of my experience. Registration is accomplished using any recent CT scan of the jaw by selecting on-screen and then tracing three of the patient’s teeth or other structures (such as braces or abutments). The process is done in the chair, immediately before surgery. No stent or guide needs to be prepared, and the entire registration process is typically accomplished in about three minutes.
In the rare case something goes wrong during registration and an accuracy check fails to demonstrate the accuracy expected, the registration can be immediately repeated by tracing the same or other structures. Once the jaw is registered with its CT scan, on-screen guidance of the drill position and orientation is provided. The jaw surface is fully exposed, just like with free-hand drilling. Because the jaw often moves during the operation, the system continuously tracks the position of the jaw and adjusts the registration to keep the jaw and its on-screen image in accurate alignment. Tracking the upper jaw is accomplished using a special head-tracking frame, which is not affected by movements of the lower jaw or changes in facial expressions.
COMPANY NEWS
THE DENTAL TECHNICIAN MARKETPLACE HENRY SCHEIN DENTAL DISCOVER ZIRLUX® RESTORATION MATERIALS w Visit the brand new Zirlux website today to discover the most innovative and advanced restorative materials and resources in the dental industry! Today’s patients demand an aesthetic restoration that matches or exceeds their natural teeth. The Zirlux portfolio enables dentists and laboratories to use the most innovative and quality controlled digital materials available today. The entire range is now available at the click of a button at zirlux.co.uk You now have flexibility in the materials you choose to deliver durable, consistent, and predictable restorations. Zirlux Zirconia enables dentists to provide patients with exceptional restorations that are strong, metal-free, and available for multiple restorative options. Zirconia is ideal for patients
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who value aesthetics, have minimal room for occlusal reduction, fractured existing restorations, or display signs of bruxism. When it comes to dental prosthetics and restorations, laboratories, dentists and patients all want the same thing: a natural result. Alongside advances in digital technology, dental materials have also been developed such zirconium oxide. Visit the website to learn more about this strong, highly aesthetic biocompatible alternative to ‘metalceramic’ restorations, which can be used to give patients high quality consistent restorations every time. For more information about the complete Zirlux portfolio visit zirlux.co.uk today. The complete Zirlux portfolio is available through Henry Schein Dental, visit Henryschein.co.uk or call 0800 023 2558 for more information.
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Tracking the lower jaw is accomplished by connecting a lightweight plastic “jaw tracker” part, marked with optical targets, to a single tooth using a light-cured composite. The motions of the drill are tracked using another plastic part marked with optical targets. After only a short experience with Trace and Place technology in my practice, I have come to believe that it is a real tipping point for dynamic navigation guidance. It has streamlined and simplified the workflow in both the diagnostic and surgical phases to allow state-of-the-art technology to be an everyday component of my surgical implant practice. I can’t imagine going back. Taken from Dental Tribune International, January 2019.
COMPANY NEWS
THE DENTAL TECHNICIAN MARKETPLACE ZIRKONZAHN.IMPLANT-PLANNER RELIABLE COOPERATION FOR IMPLANT INSERTIONS w With the Zirkonzahn.Implant-Planner implant planning software, the cooperation between the dentist and the dental laboratory can be taken to new levels, reconciling the planned aesthetic design of a prosthetic restoration with the planned implant situation (backward planning). Based on digitally merged patient data (such as DICOM data or data from model or face scans), the dentist can determine the optimal implant position in terms of function, anatomy and aesthetics, taking bone structure and set-up into account. The user is guided through the planning process one step at a time, making implant planning an easy task right from the outset and requiring only a minimum of user familiarity with software procedures. With the data transfer feature the data can easily be sent to the dental lab. Here, the surgical guides, the restorations, the custom impression trays and/or the models with laboratory analogues
The surgical guide and the immediate prototype matched with the 3D patient and the Dicom data
are made. This allows the dentist to receive all components required for an implant case simultaneously (immediate loading). All structures - from surgical guide to the prosthetic restoration itself - can be manufactured using the Zirkonzahn CAD/ CAM system. Every step fits perfectly with the
existing Zirkonzahn workflow. The open dataexchange feature allows the use of CAD/CAM systems by other manufacturers or 3D printers for the production of surgical guides or models. For more information: Tel: +39 0474 066 662 Website: www.zirkonzahn.com
CERAMAGE UP BY SHOFU – THE STATE OF THE ART IN COMPOSITE LAYER-ING! w The best of both restorative worlds: technologically sophisticated and aesthetically optimised. Ceramage UP, the flowable C&B composite system combines all the benefits of composites and ceramics in an in-novative high-performance material. Its high ceramic filler load and homogeneously compacted nanostruc-ture guarantee excellent abrasion resistance, flexural strength and col-our stability. At the same time, its perfectly structured layering concept with opalescent enamel and high-translucency colours
allows dental technicians to achieve amazingly natural aesthetic results, comparable to layered porcelain restorations. Ceramage UP is indicated for almost all anterior and posterior restora-tions and comes in a modular system featuring great ease of use. The individual shades are ready for use and thixotropic, so that tooth shapes can be freely sculpted using a probe or brush directly after dispensing. To further customise the appearances of anterior and posteri-or restorations, the flowable
materials can easily be mixed with each other or characterised with the light-cured stains of the Lite Art system. Thanks to the additive layering technique, only minor shape adjustments will be necessary. So the Ceramage UP C&B composite system, which is suitable for all types of crowns, bridges, inlays, veneers and long-term temporaries, uniquely combines costeffectiveness, efficiency and aesthetics. For further information, please contact the Shofu office on 01732 783 580 or email: sales@shofu.co.uk
IDS NEWS: SHOFU DENTAL NOW IN HALL 11.3 WITH EVEN MORE ROOM FOR INFORMATION AND COMMUNICATION w Clearly State of the Art: New Products for Layering, Milling and Bonding at the IDS More spacious, open and welcoming: At the IDS 2019, Shofu Dental will be in Hall 11.3 (Booth G010/J019) for the first time with a new concept including not only product presentation and information, but also communication and customer connectivity. The booth area of more than 240 square metres will provide sufficient room for new, extended and improved products, as well as a lively exchange of views with dentists, dental
technicians and distribution partners. Shofu will focus on direct and CAD/CAM restorative materials, polishing, porcelain systems, and digital dental photography. w Mutual Exchange for ForwardLooking Solutions Whether for the newly developed BeautiBond Universal multifunctional adhesive system, the innovative Shofu Disk ZR Lucent multilayer zirconia disks, the recently launched OneGloss M polishers, the new Beautifil Flow Plus X restorative in two viscosities, or the popular EyeSpecial C-III camera: A visit to Shofu’s booth at the IDS will definitely be worthwhile.
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Since products are only as good as their users, Shofu increasingly focuses on providing practical information and tips to users in both analogue and digital formats hence a variety of new Instructions for Use and electronic tools will be available at the IDS. “Communication in both ways, rather than one way: the motto of our new IDS booth concept. We not only wish to send messages to our customers, but also to enter into a dialogue with them and initiate a mutual exchange of views for new, forward-thinking solutions,” says Martin Hesselmann, the European Managing Director of Shofu.
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RECRUITMENT ANDY FOSTER, RECRUITMENT SPECIALIST RECRUITMENT
Andy Foster is a recruitment specialist for dental technicians. Andy manages www.DentalTechnicianJobs.net the online job-board for dental technicians. Andy spent 20+ years running his crown & bridge lab, before moving into dental recruitment and online networking. When he’s not working, Andy is a dedicated father, with an unhealthy weakness for coffee! You can contact Andy at andy@marshallhunt.co.uk
l
IMPLEMENTING EQUAL PAY IN DENTAL LABORATORY’S
I
n a recently conducted survey, we asked how employees felt about their roles in the dental industry. This survey brought up some interesting results, from job satisfaction to salary averages. The most interesting result was the difference between the salaries of men and women, plus their satisfaction with their current remuneration packages. Our salary results showed that the median for basic salary range is between £25,000-£29,000. The average basic salary for dental technicians reported in this survey was £28,400. However, compared to the average basic salary, female respondents earned 17% lower at £23,600. Male respondents earned 7% higher than the average basic salary at £30,500 Not surprisingly, our survey also showed us that 32% female respondents, working in the dental industry are dissatisfied with the total benefits package, that they are currently receiving. Whilst 33.7% of males working in the industry are satisfied with their benefits package. That said, our survey also showed us that both males and females felt that their remuneration packages were below average, compared to their peers. With all this in mind, it got us thinking about equal pay in the dental industry, what it means, and what we can do to help close the gap. WHAT IS EQUAL PAY? Equal pay means that you are entitled to the same wage as someone doing work of equal value. This could mean the exact same job, a job of broadly similar work, or work rated as “equivalent value”. Although not exclusively a gender issue, it is true that women are sometimes paid less than men for doing exactly the same work, which contradicts the Equality Act 2010. The Equality Act 2010 ensures consistency
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in what employers and employees need to do to make their workplace a fair environment and comply with the law. EQUAL PAY ISN’T JUST ABOUT BASIC SALARY IT ALSO INCLUDES… l Hours of work l Overtime rates l Performance related benefits l Access to pension schemes l Annual leave entitlements l Non-monetary Terms of Business TIPS ON HOW TO REDUCE A GENDER PAY GAP There are many steps you can put into place to help reduce the Gender Pay Gap within your company, such as: l Implementing
an HR system that enables your company to regularly review gender pay gaps, and build a monitoring process for annual pay and bonus reviews, to help close any existing gaps.
l Encouraging
Paternity Leave could help the process of closing the gender pay gap. By encouraging fathers to take shared parental
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leave aids workplace flexibility, and the opportunity for women to return back to work. As one of the reasons why women’s pay progression lags behind men’s is maternity leave and time taken off for childcare. l Eliminating salary negotiations can contribute
to decreasing the gender pay gap. Studies show that when women negotiate for higher salaries, people react more negatively, compared to men asking for a higher salary. By removing negotiations, it puts both men and women on a level playing field and removes any negativity surrounding the process. As long as both men and women are being offered the same salary based on role and experience of course!
Although our recent survey may suggest that there are some equal pay issues in the UK dental technology industry, we did not ask in-depth questions about how salaries were made up, which can affect how people are paid. However, the survey shows that many employees are dissatisfied with their current salary packages. If you’d like to read the full survey results, you can download the full report for free at www.DentalTechnicianJobs.net
BY DR STAVROS PELEKANOS
DIGITAL DENTISTRY
DIGITAL VS. ANALOGUE WORKFLOW ON TEN CERAMIC VENEERS IN THE MAXILLA I NOVEMBER 14, 2018
D
ifferent materials and treatment options are available in aesthetic and restorative dentistry for the anterior region. The conventional protocol, including an analogue impression with polyether or polyvinylsiloxane, a master cast and die fabrication, waxing and pressing of ceramic materials, requires exceptional skills and is technique-sensitive. Intraoral scanning and digital impression taking provide an accurate alternative method for transferring information from the mouth to the dental laboratory. The digital file is always on the computer and can be immediately processed or at any time, unlike with the conventional procedure. Regarding materials, various newer products, such as pressed or milled ceramics, offer enhanced strength and functionality; however, in thinner dimensions, they lack the inherent aesthetic beauty of conventional materials such as feldspathic porcelain. As patient demand for better aesthetics has increased in recent years so too has the need for restorative materials that closely mimic the patient’s natural dentition. Initially used for the creation of porcelain dentures, feldspathic porcelain has emerged as the premier aesthetic material for custom veneer restorations. In recent years, the use of hand-layered powder/liquid feldspathic porcelain has been revived based on its highly aesthetic values and little to no preparation requirements. By keeping preparation to a minimum, less tooth structure is removed and procedures are much less invasive, which is exactly what patients desire.[2]
In contrast, the conventional methods of ceramic fabrication have been described as timeconsuming, technique-sensitive and unpredictable owing to the many variables, and thus CAD/ CAM may be a good alternative for both dentists and laboratories. [3] CAD/CAM may also reduce the fabrication time of high-strength ceramics by up to 90 per cent. [1] Furthermore, industrially fabricated blocks are more homogenous, with minimal flaws, and CAD/CAM restorations have been found to compare favourably with other restorative options. [4,5] As far as optical properties and CAD/ CAM are concerned, the fact of complex optical illusion phenomena in anterior aesthetics cannot always be met with monochromatic
Fig. 1
Fig. 2a
Fig. 2b
Fig. 3
Fig. 4
Fig. 5
Fig. 6a
Fig. 6b
Fig. 7
TOP ROW (L to R): Initial photograph of the anterior teeth prior to orthodontic treatment; Anterior teeth after orthodontic treatment; Extraoral photographs after orthodontic treatment 2ND ROW (L to R): Digital smile design indicating crown lengthening of teeth #13, 12, 11 and 21 and restorative treatment of the ten anterior teeth; Wax-up on the stone model concerning the restorative treatment of the ten anterior teeth; Three-dimensionally printed model of the digital smile design planning, bearing a mock-up shell. A cervical opening was introduced for surgical access and guidance for crown lengthening 3RD ROW (L to R): Intraoral fi t of the surgical guide for crown lengthening; Intraoral fi t of the surgical guide for crown lengthening; Periodontal tissue of the anterior teeth six months after crown lengthening.
aesthetic materials without the need for final characterisation by a dental technician. In order to overcome such aesthetic disadvantages of a monochromatic restoration, multichromatic ceramic blocks have been developed to create a 3-D layered structure. These ceramic blocks offer a gradient of chroma from the cervical to the incisal areas that replicate dentine and enamel in the same block. [6-8] The aim of this case report is to compare the analogue versus the digital workflow on ten ceramic veneers in the maxilla, in terms of aesthetic outcome, length of procedures and technical sensitivity for both the dentist and the dental technician. CASE REPORT A 35-year-old patient presented at the office with the chief desire that the aesthetics in the anterior region be changed (Fig. 1). A diagnostic wax-up was performed, followed by mock-up fabrication, in order to obtain a preliminary visualisation of the final outcome. Orthodontic
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treatment was proposed in order to align the teeth in a more favourable position for veneers requiring minimal preparation and to reduce the overbite. One year after treatment, the patient returned for the final prosthetic rehabilitation (Figs. 2a & b). METHODS AND MATERIALS Digital smile design according to Coachman and Calamita9 was performed, from which a treatment plan of crown lengthening and veneers on teeth #15–25 (Fig. 3) was proposed. A conventional diagnostic wax-up was also produced (Fig. 4). Both digital and conventional mockups were applied, and agreement was attained concerning tooth shapes and proportions. Crown lengthening was performed, guided by the digital mock-up, with the use of an acrylic transparent double crown lengthening guide that indicated the borders of the gingivectomy and alveolectomy needed in periodontal surgery for aesthetic rehabilitation p26 (Figs. 5 & 6). [10]
u
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DIGITAL DENTISTRY
After six months of tissue stabilisation (Fig. 7), a mock-up was produced with Telio CS C&B (Ivoclar Vivadent) chairside (Figs. 8a & b), and tooth preparations with silicone guides were performed (Figs. 9a–c). Both conventional impressions with polyvinylsiloxane (Fig. 10) and digital impressions (TRIOS, 3Shape) were taken (Fig. 11). Provisionalisation was executed digitally, using Telio CAD (Ivoclar Vivadent) in the Wieland Select CNC milling machine. The design was performed with the 3Shape DentalDesigner 2015 software (Figs. 12a & b). Two sets of final restorations were fabricated. The set of feldspathic veneers was fabricated on a stone model using IPS Style (Ivoclar Vivadent), while IPS Empress CAD Multi (Ivoclar Vivadent) was used for the digitalset (Figs. 13 & 14). Both sets were examined intraorally with a try-in paste to compare the optical properties of the feldspathic and the CAD/CAM veneers (Figs. 15a–c).
Fig. 8a
Fig. 8b
Fig. 9a Fig. 9b
The subjective decision of the clinician and the patient was to cement the feldspathic veneers, owing to slight differences in the length of the central incisors between the two sets. Adhesive procedures followed (Figs. 16a–f ), and final intraoral and extraoral photographs were captured one week later (Figs. 17a–e). Fig. 9c
RESULTS Intraoral digital scanning is a perfect alternative clinical procedure compared with the conventional impression technique. The digital planning and mock-up procedure is a powerful communication tool for the dentist, although special skills in using computer software are required. Regarding the laboratory workflow, most of the analogue procedures require more time (refractory dies, built-up veneers, adjustments), except the staining/glazing (Figs. 18a & b). Although the aesthetic outcome of the feldspathic veneers was subjectively chosen in this case, the analogue workflow is much more demanding. The digital approach, because of the reduced difficulty, speed, complexity and patient discomfort, tends to be preferable (Figs. 18a & b). CONCLUSION Knowledge and application of virtual smile design procedures, coupled with innovative dental laboratory technologies, allow dentists to diagnose, plan, create and deliver aesthetically pleasing new dental compositions. Furthermore, advances in CAD/CAM technology have catalysed the development of aesthetic veneer restorations with industrially produced materials possessing superior biomechanical properties and good aesthetics. A list of references is available from the publisher. This article was published in the Cosmetic dentistry beauty & science No. 1/2018.
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Fig. 10 TOP ROW (L to R): Mock-up silicone index; Intraoral photograph of the mock-up; Preparation through the mock-up; 2ND ROW (L to R): Check of the preparation depth, with the use of the silicone guide, palatal aspect; Final preparation of the teeth BOTTOM PHOTO: Analogue impression with polyvinylsiloxane.
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Fig. 12a
Fig. 12b
Fig. 13
Fig. 14
Fig. 15a
DIGITAL DENTISTRY
Fig. 11
Fig. 16c
Fig. 15b
Fig. 15c
Fig. 16a
Fig. 16b
Fig. 16d
Fig. 16e
Fig. 17c
Fig. 17d
Fig. 16f
Fig. 17a
Fig. 17e
Fig. 17b Fig. 18b
Fig. 18a TOP ROW (L to R): Digital impression with TRIOS; Digital planning of the provisional restorations; Provisional restorations intraorally (Telio CAD) 2ND ROW (L to R): Analogue workflow (refractory dies, built-up veneers, adjustments, staining/glazing); Digital workflow (3-D printed model, CAD/CAM veneers, adjustments, staining/glazing); Feldspathic veneers with try-in paste. 3RD ROW (L to R): CAD/CAM veneers with try-in paste; First quadrant feldspathic veneers and second quadrant CAD/CAM veneers simultaneously with try-in paste; Isolation fi eld and try-in of the fi t of the veneers on teeth #11 and 21; Etching of the enamel for 30 seconds with a 32 % orthophosphoric acid; Application of the bonding agent 4TH ROW (L to R): Final polymerisation of the veneers; Veneers in situ before finishing and polishing procedures; Final outcome immediately after removal of the rubber dam; Final outcome one week later; Final outcome one week later, frontal view 5TH ROW (L to R): Lips at rest, exposure of the incisal edges; Wide smile; Extraoral final photographs; Subjective comparison criteria per step between analogue and digital workflows. PVS=polyvinylsiloxane; Laboratory duration per step between analogue and digital workflows. PVS = polyvinylsiloxane.
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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 HTSC MEETING 23RD. JANUARY 2019 Q1. Who is the retiring Chairman? A. Peter Fleming B. Richard Tyrell C. David Coppen D. Noel Pach
B. C. D.
Q2. A. B. C. D.
Who was the invited speaker for the evening? Karl Bloomfeld Stephen Shon Will Young Enrico Steger
Q3. A. B. C. D.
What was he talking about? Maxillo Facial techniques Digital Manufacturing Processes Lost Wax process of metal formation Working with Plastics in modern dentistry
Q4. A. B. C. D.
Who is to replace the present Chairman next month? Richard Tyrell Noel Pach Norman White Paul Dyer
Q5. A. B. C. D.
What was presented to David as a thank you present? A Gold watch An engraved Crystal mounted Clock A Magnum of Champagne An engraved Silver Salver
MARKETING Q6. What is the gist of this months article? A. Packaging and presentation B. Telephone Sales C. Good customer Communication D. Setting Targets Q7. What is recommended as a good first move? A. Talking to your friends with laboratories B. Reading the various textbooks on the subject of marketing C. Writing down your goals D. Talking to your bank manager DTS EVENT 17TH & 18 MAY AT NEC Q8. What is the main focus of Tom Behaeghal’s Talk? A. Correct material selection B. Bonding to metal frameworks C. Working with strengthened Plastics D. Creating Digital large span bridges Q9. What is Sean Wilkinson’s subject matter at DTS? A. Full aesthetic dentures
Traditional techniques in technical dentistry Computer Dental Diagnostics Occlusion and full arch bridgework
SOUTH EAST STUDY GROUP 16TH JANUARY 2019 Q.10 What was the subject of the presentation? A. Natural and life like denture work B Avoiding fractures in Porcelain Bridgework C. Dealing with complaints D. End of life care protocols Q11. A. B. C. D.
Where did Karl Brown do his early training? King’s College Hospital Guy’s Hospital Royal London Hospital Wilmslow General
Q12. A. B. C. D.
From where does Karl claim to get his best examples? From patients he sees as a CDT and photo’s of patients From textbooks and journals From colleagues at study clubs At international meetings
Q13. What did Karl prefer to reproduce damaged attachments in impressions? A. Duralay plastic B. Hard crown and bridge stone C. Cobalt Chrome castings D. Copper plated dies USING HIGH PERFORMANCE POLYMER FRAMEWORKS IMPROVES OUTCOMES Q14. What was the improved survival rate of the implants in the study? A. 8% B. 5% C. 10% D. 3% Q15. What was the comparative total score for oral health and quality of life? A. Zero difference B. 3 times better C. Half as good D. Twice as good DIGITAL VS ANALOGUE WORKFLOW ON TEN CERAMIC VENEERS Q16. Which did the patient prefer? A. The digitally produced veneers B. The laboratory made analogues C. The plastic temporaries D. The premade version by digital
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
USING PEEK FRAMEWORKS FOR FULL ARCH IMPLANT SUPPORTED PROSTHETICS BY MARCUS JARMAN-SMITH, PHD / INVIBIO BIOMATERIA
I FEBRUARY 15, 2018
T
here is increased interest in the long term clinical outcomes and quality of life of patients treated with a high performance polymer for the framework material for full-arch implantsupported dental prosthetics, rather than the traditionally used metal or ceramic materials. Dr. Bernd Siewert reported on his retrospective, single center clinical study using JUVORA frameworks for full-arch implant-supported prosthetics, made from PEEK-OPTIMA™ high performance polymer. Siewert conducted clinical and radiological assessments to measure the survival rates of the dental implants and prosthetics, rate of bone loss and the incidence of any biological complications. In addition, scores were collated to measure the oral health and patient quality of life and the satisfaction of patients fitted with a PEEK-based prosthetic. The retrospective data review investigated 21 patients which corresponded to a total of 96 dental implant fixtures. Patients were treated with full-arch implant supported prosthetics manufactured with an internal substructure made from Invibio’s PEEK-based polymer. The average follow-up post-prosthetic placement was 56 months (4 years, 8 months) ranging from the shortest time of 1 year and 2 months to the longest time of 8 years and 9 months. KEY FINDINGS Dental implant fixture survival rate was reported as high as 99 per cent, and PEEKbased prosthetic survival rate was 100 per cent, versus 89 to 95 per cent(1,2) and 92 percent(3,4) for titanium(5) respectively. An average bone loss of 0.2 mm (+ 1.0) on the mesial aspect and 0.3 mm (+ 0.8) on the distal aspect was observed versus 1-1.5mm(6,7) for
titanium. Patient peri-implantitis incidence was low at 1 per cent versus 10 per cent(1,8) for titanium. The mean total oral health and patient quality of life score was 3.1 points (± 3.3), with patient satisfaction deemed “extremely satisfactory.” For titanium the score averaged at 15.(9,10) Overall, when compared with the literature values of Titanium, JUVORA frameworks for full-arch implant supported dental prosthetics showed: • Up to 10 per cent better implant survival rate. • Up to 5x less bone loss. • Up to 10x less incidence of peri-implantitis. • Up to 8 per cent better prosthetic survival rate. • Nearly 3x better mean total score for oral health and patient quality of life. COMMENTARY These results from a retrospective, single
center study are limited, but do provide some initial clinical insight into the long-term outcomes and potential benefits of using a more shock absorbing high performance polymer substructure for full-arch implant borne prosthetics. Taken Dental Tribune International January 2019.
About Dr. Bernd Siewert l Dr. Bernd Siewert has been in private practice for over 20 years. Since 2007, he’s been an instructor at Germany’s International Training Center for Dental Implantology (IFZI), and authored and spoken internationally about his specialty, implantology.11
ABOUT THE AUTHOR l Dr. Marcus Jarman-Smith, PhD, is a strategic marketing manager with Invibio Biomaterial Solutions.
engineering, tissue engineering and biomaterials from the University of Bath, in the United Kingdom.
He has worked specifically on medical applications for the high performance polymer PEEK (polyetheretherketone) for dental applications, for over a decade. In 2001, he received a PhD in chemical
Commentary Author: Marcus Jarman-Smith, PhD – Invibio Biomaterial Solutions
Keynote Speech: B. Siewert (2017), PEEK in Dental Prosthetics (PEEK in der zahnärztlichen Prothetik Warum? Wann? Wie?), SSO Dental Meeting, Lugano, Switzerland, 11 February 2017
Original Presenter: Dr Bernd Siewert, Clinica Somosaguas,
Level Of Evidence: Level 3 Retrospective Cohort Study
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