The Dental Technician Magazine February 2018

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

ECPD DAVID SMITH PREVIEWS

AT THE HARLEY STREET TECHNICIANS STUDY CLUB PAGE 22 - 24

Inside this month

VERIFIABLE CPD FOR THE WHOLE DENTAL TEAM

BUSINESS

TECHNICAL

LOOKING BACK WITH JOHN WINDIBANK. FOA PAGE 10 & 12

COMPANY PROFILE MY VISIT TO GC DENTAL UK PAGE 13 - 14

EMBRACING THE DIGITAL WORLD WITH PETR MYSICKA PAGE 33

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BY SU X T R B EN A EC SC D C O O R I YO M SE LL M PT UR E IO E PA EA ND N G GU IN E 3 E G

INSIGHT

Focus on Teeth

So light, so simple, so precise!

www.shofu.co.uk

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Publisher - Michelle Donald E: michelle.donald@dentalcommunications.co.uk T: 07961 026682 Editor - Larry Browne FBIDST. FDTA, ITI Fellow, LCGI, RDT. E: editor@dentaltechnician.org.uk T: 01372 897461

CONTENTS FEBRUARY 2018 News

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

Thoughts from the Editor Cleancert - Infection control - a team approach?

Advertising Manager - Chris Trowbridge E: chris.trowbridge@dentalcommunications.co.uk T: 07399 403602

Insight

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.

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Dental opinion from Sir Paul Beresford, BDS. MP Looking back with John Windibank FOA

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8 10 & 12

Company Profiles GC Dental UK

13 - 14

Digital Dentistry GC host Digital Laboratory Day

15 - 16

Education Harley Street Technicians Study Club

16 - 17

Dental News UK Dental Devices unregulated by the GDC ADI Technicians Day 2019 David Smith - Another night at the HSTSC David Smith Previews ECPD at the Harley Street Technicians Study Club Vincent Fehmer - The growing importance of all-ceramic materials and digital processes for implant-borne reconstructions

18 18 20 - 21 22 - 24 25

Company News Digital Dental Photography - EyeSpecial C-III Marketplace

26 - 28 29

CPD Free Verifiable CPD & CPD questions

30 - 31

Technical Createch - The perfect fit for your lab’s needs Petr Mysicka - Embracing the digital world

32 33

Recruitment Andy Foster - Dental Lab Recruitment

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Classifieds

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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.

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NEWS

ALL HAIL TO THE Backroom Staff l Welcome to your February edition of the Technician. We hope the success we are enjoying with the growth of the magazine reflects your own circumstances and you are enjoying your involvement in your chosen craft. Many of you have commented positively to me about the new appearance of the publication during the last few months and indeed I can only agree. I would love to claim all the credit for the improved new look but in fact it is little to do with me. Just like our own experiences there is someone behind the scenes who actually does all the colouring and picture and Text management.

Many editors are sticklers for staying with the “established Formulae” but for me the talent for composition lays with the designer.

We are lucky to have the services of “Bazzie” (Sharon) Larder with her company “In the Dog House Design” who obviously enjoys making it all look good and has clearly got the talent so to do.

As Dental Technicians you will be aware of how often the patient is delighted with the restorations you have been involved with but are in the majority of cases not told of the patient pleasure. Or in fact the patient is totally unaware of our existence.

I am certain it is very much the same in the area of magazine and publication layout. I though it would be nice to mention Bazzie’s contribution and to pass on to her your appreciation of what she is doing. I do hope the altered dimensions and the modern format meets your approval. The New Year seemed like a good choice to launch this change on you all but it is a really practical size and the content will, I do believe, get better and better. However if you do not like the change of size please let me know.

A great many changes have come to us over the past 10 years and apart from the ongoing evolution of the digital manufacture we have had the registration of technicians passed into law. The means we need to be trained and registered. There is the annual registration fee and the continuing CPD to which we all need to commit money and time. When taken in the context of patient protection then of course there has to be a measurable check on the skills and materials being provided via the clinicians to the patient. After the heavily publicised

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breast Implant scandal the government via the Ministry of Health (MHRA) demanded quality standards and checks on the materials, methods and practices for all medical devices and particularly the Custom made devices such as dental restorations or indeed breast implants. A need to ensure the materials and the construction are in accordance with the agreed protocol for the particular restoration. The GDC supposedly acting on the patients behalf, demanded the patient interest must come first and subsequently went on to demand transparency, from the professionals involved in their treatment. As technicians our greatest duty to the patient is to ensure the correct materials are being used and the designs and manufacture comply with the required protocols for the particular appliance, which will generally be worn everyday within the mouth.

Of course registered technicians are required to complete, with every case, a statement of manufacture, which contains enough information to be able to trace the origin of the restoration and the design and material content. The professionals are required by law to inform the patient of that statement and their right to it, for the life of the restoration. The consequence of a patient complaint could be the local magistrates court via a police investigation.

The GDC and the MHRA are supposed to have common cause and an obvious need to communicate in order to ensure the patients’ interests are being safe- guarded.

What is actually happening in the vast majority of practices across the U.K? Well you the technicians know exactly what is happening. You know how many of the statements you prepare come back in the delivery boxes. I have myself asked a patient to ask for the statement and they have been laughed at and ignored. There does not seem to be a serious commitment to the idea of patient access to information as required by the legislation. So why are we bothering to register and carry out all the other duties required to be a dental technician. From the first step in the journey to inform the patient the protocol is being ignored. Why is this the case? Is it all too much trouble for the GDC to enforce? It would seem to be that way, despite their insistence that

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the patients’ needs must come first and the further requirement for transparency they have decided they are not responsible for to enforce the check on the whole statement of manufacture process. They will only act on a complaint.

For instance: is it being taught at undergraduate level at The Dental Universities? Not to my knowledge!

Is it being taught to the Dental nurses?

Not to my knowledge!

Are they filing in the various statements of manufacture within the hospitals and the teaching establishments and giving them to the patients being treated? Not to my knowledge!

Are the BDA ensuring their members are informed of the circumstances and the seriousness of their failure to comply with the requirements? Not to my knowledge!

Or has some deal been quietly agreed to which we are not privy?

Do the DLA or The DTA Know? If they do perhaps they could enlighten us and if they do not Why Not? After all we are doing the required work on the patients’ behalf in order to comply with the requirements but if it is just a sham, why are we bothering. Of course the imported work from Asia does not require a Statement of manufacture? Strange.

What then is the situation for those patients? Where is the Transparency?

I do think both the ministry and the GDC need to clear this one up or what is the point of pretending they are protecting the patient with this ridiculous charade?

If anybody out their knows the answers to the above questions perhaps you will be good enough to allow me to tell my readers, who are after all the most effected by the requirements. What is the point of Registration if it does not in fact protect the patient? Answers please on a Postcard or any other useful method of communication!!

Larry Browne, Editor

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NEWS

INFECTION CONTROL A TEAM APPROACH?

Simon Davies considers the responsibilities of the dental practice and laboratory in terms of infection control of items being passed between the two premises, and how to achieve ‘best practice’.

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n 20 October 2017, the General Dental Council’s Professional Conduct Committee made an order to erase a Cardiff-based dentist from the register and directed that his registration be suspended immediately.

This was, in part, due to the practice having ‘breached basic and fundamental standards of care and hygiene’, including a ‘standard of infection control [that] was appalling’.

This, thankfully, is extremely rare, but it does offer food for thought in terms of who holds ultimate responsibility for infection control systems within the dental practice and laboratory, to safeguard staff and patients when items are being sent between the two premises.

Despite the fact that, in many practices, dental nurses are at the forefront of everyday cross-contamination elimination, the fact is that the responsibility rests squarely with the dentist.

Guidance on decontaminating and disinfecting dental impressions is set out in the British Dental Association’s Advice Sheet A12:

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Infection control in dentistry. It states: ‘… the responsibility for ensuring impressions have been cleaned and disinfected before dispatch to the laboratory lies solely with the dentist.

It is good practice to agree the cleaning and disinfection process with the laboratory and label the device to indicate disinfected status.’1 Health Technical Memorandum (HTM) 01-05: Decontamination in primary care dental practices adds to this assertion.

Offering ‘best practice’ guidance when it comes to impressions, prostheses and orthodontic appliances, Section 7.1 states: “Decontamination of these devices is a multi-step process to be conducted in accord with the device or material manufacturer’s instructions. In general terms, the procedure will be as follows: a. Immediately after removal from the mouth, any device should be rinsed under clean running water. This process should continue until the device is visibly clean. b. All devices should receive disinfection according to the manufacturer’s instructions.

This will involve the use of specific cleaning

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materials noted in the CE-marking instructions. After disinfection, the device should again be thoroughly washed. This process should occur before and after any device is placed in a patient’s mouth. c. If the device is to be returned to a supplier/ laboratory or in some other fashion sent out of the practice, a label to indicate that a decontamination process has been used should be affixed to the package.2 CROSS-INFECTION CONTROL CONCERNS Despite clear evidence that infection control is the responsibility of the dentist, there is an lack of confidence among dental technicians that impressions have been appropriately decontaminated and disinfected before being sent out to the laboratory.3 Those fears are not unfounded; recent research carried out between CleanCert and one of the UK's largest dental laboratories (PDS Dental) found that, on average, just under a third (28%) of incoming impressions from both private (high street) and public sector dental practices had a loading over 30,000,000 cfu (colonyforming units) per swab.

TAKE NO RISKS Dental impressions - just one of the items received by dental laboratories on a daily basis - are a potential source of viral and/ or bacterial pathogens including, but not limited to, hepatitis A, B and C. If an impression is contaminated with saliva or blood, such pathogens can survive for several days - plenty of time to reach the laboratory.

What’s more, micro-organisms can transfer from impressions to dental casts. In addition, bacteria from the mouth can remain viable in gypsum for quite a few days.4 Since it is impossible to be 100% sure that items coming into the laboratory

have been effectively decontaminated and disinfected, it is essential that laboratories have a robust system in place to eliminate any residual cross-contamination risks before anyone starts work on them.

NEWS

You may ask: what constitutes an adequate level of kill? Well, although there are no exact guidelines in HTM 01-05 for items arriving into dental laboratories, decontamination to loadings 102 or less has been suggested by clinical specialists as being reasonable in managing risk for dental technicians working on prostheses, alginates, and impressions.

With this in mind, by using LabCert for 30 seconds prior to handling dental impressions, alginates or prostheses, dental technicians can be confident that ‘best practice’ infection control is in hand and they will not be exposed to cross-infection risks.

LabCert is available in 1L spray and 5L pour bottles from The Dental Directory or direct from www.cleancert.co.uk FOR FURTHER INFORMATION ON THE FULL RANGE OF PROVEN, INNOVATIVE DENTAL INFECTION CONTROL PRODUCTS AVAILABLE FROM CLEANCERT, PLEASE VISIT cleancert.co.uk, email sales@cleancert.co.uk or call 08443 511115. Please email for further details of this study.

SIMON DAVIES

l Simon Davies is the Managing Director of CleanCert, a company specialising in innovative dental infection control and water purification products.

REFERENCES 1. British Dental Association. Advice Sheet A12: Infection control in dentistry. British Dental Association, 2009 2. Health Technical Memorandum 01-05 - Decontamination in primary care dental practices (2013 edition); section 7.1, page 42 3. Almortadi N, Chadwick RG. Disinfection of dental impressions - compliance to accepted standards. BDJ 2010; 209(12): 607-611 4. Clark C. First impressions count. The Dentist 2015; 31(5): 66-67

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DENTAL OPINION FROM SIR PAUL BERESFORD, BDS. MP INSIGHT

COMMENT - NOW FOR SOMETHING DIFFERENT!

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e are all dental professionals and most of us run or work in dental professional businesses.

Of course, we all run a tight ship combining business efficiency and promotion don’t we?

It is a well-known “fact” that local government and central government are inefficient. In some cases and in some areas, that is true but often it is not. Occasionally as an outsider and in my case as a politician, one gets a chance to apply our business management to government.

In my case this is happened on three occasions. The first was as part of a Conservative team turning Wandsworth Council into an organisation with the lowest local tax and yet with the best services. The second was as a Conservative local government minister working predominantly on our English inner cities.

£6 million annually. It has been my drive to reduce this to zero and perhaps even into the black. To date this has been reduced by over 50% by a combination of efficiency savings and increased income.

Catering facilities are available from 8am until 30 minutes after House business closes, whatever time, even if it is 8 or 9am the following day.

The nature of House of Commons business means the hours are frequently unpredictable.

The catering department provides everything from a pack of crisps through to exceptionally high-quality silver service banqueting. There are 22 different food and drink outlets. Ever since my early days in Wandsworth I have approached business, including in government, on a basis of more, better, for less.

The third was about two years ago when I was asked by the then Conservative Chief Whip to chair the House of Commons Administration Committee. Although the Committee refers bigger decisions to the House of Commons Commission, it in effect the Board of a multi-million pound organisation running everything that happens in the House of Commons in coordination with a similar arrangement in the House of Lords.

It appalled me to see the banqueting facilities only partially used especially when the House of Commons was in recess which includes every Friday and Saturday. The Palace of Westminster in reality belongs to the public and as such I wish to open it to the public for them to visit, snack or have a full-blown reception or exceptionally high-class silver service dinner. The biggest obstacle is security, which has been both greatly increased but adjusted so that the public still has access to the facilities. You can now take a tour of the whole Palace finishing with tea, coffee and snacks in the Jubilee Café or a full cream tea on the terrace overlooking the Thames.

Funding is from the taxpayer and from income. The main source of income is from the catering department. This is probably the biggest and most complex catering organisation in the UK. Its initial role is to provide catering services for MPs, their staff, and the staff of the House of Commons all of whom have to carry security entrance cards are but number 14,500 with 650 MPs in total. All pay for food and drink purchased within the Commons. Unlike some parliaments the MPs pay for their meals.

There is a taxpayer contribution towards the costs of the catering department. It peaked at

The biggest change has been the drive to boost income from the magnificent facilities in the banqueting rooms and the Terrace. All are suitable for receptions and dining. Many organisations, both charities and business are increasingly recognising the opportunities to use these facilities for celebrations or promotions. At last count, last week, the catering department ran 38 to 40 separate functions.

SIR PAUL BERESFORD. BDS. MP. Dual UK/NZ nationality. New Zealand born, bred and educated, with post graduate education in UK. Worked as an NHS and private dentist

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in East and South West London. Private dentist in the West End of London then and currently in a very part time capacity in South West London. l Councillor including Leader of Wandsworth Council moving to the

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Receptions are exceptionally popular where the chefs produce up to an amazing 10,000 canapes a day to cater for perhaps 28 events.

Some of the dining rooms can change from dining, to reception to dining up to 4 times a day starting with an early breakfast and finishing with a silver service dinner closing around 10pm. The initial “open to the public” dinner for 150 guests was advertised on Twitter and sold out in 10 minutes. The bespoke dinner on Friday 26 January celebrated the Darkest Hour Churchill film opening that week. The menu carefully reflected some of Churchill’s favourites with novel differences of beef dripping candles to use instead of butter and chocolate cigars for desert. This event sold out in 35 minutes. I was too late!

The Members Dining Room is the largest facility currently open for lunch and dinner on Tuesdays and Wednesdays serving 150 guests.

It is a beautiful facility being a panelled room constructed in 1871 which embodies everything you would think of for our historic Parliament.

For a small dinner nothing surpasses the high-quality cuisine served in the spectacular Pugin Room (pictured below). If you have a special occasion come and dine. If you wish to present a special function be it dining or reception or a wedding, we at the House of Commons have the most wonderful facilities in the UK providing some of the best that London chefs can produce. Do join us for an amazing experience and to help me and the catering department reduce that subsidy to zero and perhaps even, in time, a profit.

All I and the Administration Committee are doing is the business approach you as dental professionals apply, although in a somewhat larger scale.

More, better for less!

House of Commons.

A Minister in the John Major Government, MP for the then Croydon Central, then elected as MP for Mole Valley as a result of the boundary changes for the 1997 election.

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LOOKING BACK JOHN WINDIBANK FOA INSIGHT

Our LOOKING BACK series published in these pages during 2017 was so well received I would like to pick up on it for 2018. This time from a different point of view with what I do think are really interesting views, back over the field of Orthodontics & Education. Through the undying commitment and energy of Andrea Johnson who has introduced me to the collection of John Windibank FOA, which I do believe you are going to find as interesting as last years excellent collection from Tony Landon, which so many of you enjoyed.

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eople of every age find their own way to survive and when needed they use whatever there is available. Through the mists of time we used the wind, water and animals, we burned wood and to sustain our industrial revolution the nation exploited coal. Coal was difficult and dangerous to extract from the ground but was absolutely vital to this country and in post war Britain it was still providing most of our heating, gas and electric and it also powered an important part of our transportation.

1984 Sirhowy Coal Mining Country

I had grown up with coal at my Granddads knee, he talked about his days as a miner and he told me of the massive seams of coal in the hills behind our house. In 1950 exactly where my Granddad had predicted, they dug out the coal, which would go on show at the Festival of Britain, in London in 1951.

One hundred years earlier for the great exhibition of 1851 at the Crystal Palace, an even bigger seam of coal was exhibited from the same area. (Both seams of coal are on view in Tredegar Park, Gwent) So sixty years ago back in the 1950's coal was still king and we used coal gas in the labs for furnaces, blow-torches and Bunsen burners.

Coal gas would easily ignite and burn with a steady reliable flame, and at the Queen Victoria Hospital (Q.V.) we added a gas pipe to hypodermic needles to use like pilot lights

to smooth wax, so I did not come across air blowers for wax smoothing until I went off to college. There were a variety of Bunsen burners in the lab some with pilot lights but these were mostly restricted to the surgical lab and I am not sure if this was from the choice of the technicians involved.

The furnaces of choice back then was the Solbrig which was a hinged metal and firebrick construction which was open at

the bottom to allow a bank of six burners to burn directly onto the casting rings and there was a funnel at the top to allow fumes to escape. The flame was controlled by the gas tap and the temperature of the ring was monitored by opening the furnace and looking down the sprue holes to see how red they were, cherry red was OK for silver and gold. The demise of the faithful Solbrig furnace occurred with the introduction of p12 natural gas in about 1965 when they had

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JOHN WINDIBANK FOTA Senior Chief Technician at West Hill Hospital, Dartford, Kent. l Represents OTA at CCHADT & Regional Delegate l

PASSED POSTS: Member of the first steering committee that founded the OTA. l Founder Member of the CCHADT l Member of the Whitley Council and Committees for 15 years. l

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Dental Technology Representative on the National Health Service Training Advisory Board l Member of the City and Guilds Dental Advisory Board l Member BTEC Dental Technology Higher Awards Advisory Board l Member DTETAB Representing MSF l Teacher of Orthodontics at Maidstone & Medway Technical College. l

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Vice Chairman OTA : Chairman CCHADT : Education Officer : Minutes Secretary : First Treasurer l Member of SLC Dental Advisory Committee l l

HONOURS: Fellow of the OTA l AE Dennison Award for services to Dental Technology l

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to redesign all gas appliances and for a long while following this everything was less reliable, with blowtorch flames becoming incredibly temperamental.

INSIGHT

Health and safety was not a big issue at the time but at the Q.V. lab, there was a hood over the furnaces in the casting room and a chimney to allow gases to escape, but if things got too smoky there were two windows to open, how lucky was that! There were masks available that looked like wartime gas masks and goggles to prevent the bits getting in the eyes but they restricted the vision and we never used them. No dust extraction or extraction fans anywhere in the building, not even in the fume cupboard where metals were heated and plunged into acid, a quick turn of the head as the fumes hit you was a good idea.

Asbestos was everywhere as the Solbrig caster used wet pads to produce steam to force the molten metal into the moulds and the pads were also used to support the components for soldering. With all that dust and asbestos about, no one I knew developed lung cancer or silicosis, I had a few friends who developed these diseases, but they worked in mining, the white asbestos we used hasn't in my experience been deadly, but health and safety measures are very important and I was always hot on it later in my career.

We had two model trimmers in the lab and this must have been a new innovation at the time, as I was constantly being told how lucky I was to have them and I had to regularly practice trimming models by hand. Fortunately this didn't last long as the technicians were not happy to work on lumpy uneven models and in all my career, I never had to either.

Boiling out in those days involved boiling huge kettles of water on gas rings, but at least you boiled out into a purpose made tank.

The wax floated on a cushion of water and every morning it was my job to chip out the wax when it had solidified. About 20 years

“Retirement after 45 years of work in the health service. I was proud the to be part of the health service and I always tried to make it better”. later when I wanted to replace a boiling out "Labourmat" in my laboratory, my hospital line manager rang the QV. Lab and asked them what they used, only to be told they were still boiling kettles! After this of course we had a hell of a job to get what we wanted, but with a long health and safety letter I eventually got the equipment we needed. The Q.V. lab is now very impressively equipped and bigger and better than ever. OK Mark?

(Mark Cuttler principle at QV).

Acrylic became the denture base material of choice just after the war, (W.W.II) when the bleaching problems were overcome and it was discovered that by letting the acrylic reach a dough consistency before packing, the pressups could be easily accomplished. Finishing dentures became a bit more of a problem with acrylic as it is a lot harder than dental vulcanite. Cable arm drills were available using No.5 hand pieces but they lacked torque and were always overheating and jamming, causing the cable to jump off the blocks. Hand files were used all the time and the wonderful quiet and indestructible "Rayway" induction motors were on every bench. These lathes were used with grinding wheels, but there were no scatter guards or dust extraction on any of them. Gradually hanging flexible drive motors were introduced but it was the very reliable "Kavo" hanging motors and hand pieces which were to provide the service we needed, but not with dust extraction of course.

The polishing room had standard unvented troughs with Rayway lathes which were considered to slow by some technicians, but again with no air extraction.

The orthodontic technicians had the privilege of two spot welders, a "Slee" valve powered and electrically timed new device, which sat in the corner unused and an old

100 yrs. of Coal (A Bevan Memorial, Tredegar Park, Gwent)

"Watkin" with its mechanical timing and multi shaped electrodes on its revolving head, which was used and understood. When I was to use the Watkin however, the foot control had a habit of twisting sideways and the wire I was trying to weld would impressively spark and blow the wire to bits. Years later I inherited a valve powered Slee welder, which was a little slow to warm up but worked really well and it gave me years of good service.

The demise of that welder was quite dramatic as I had got into the habit of repairing the consultant’s lawn mower, as you do! but on this day it was all to much and with a satisfying bang and a puff of smoke, with me taking shelter on the floor, the old Slee dramatically gave up.

Orthodontic screws at that time were made of brass and those available were the original Badcock screw or the Glenross screw favoured at Q.V. Both screws worked well but if used for prolonged periods the threads could wear badly and the modern stainless steel screws are a big improvement. All removable orthodontic devices were constructed using heat cured acrylics, cold curing was tried from time to time but until hydro flasks became available it was almost impossible to avoid air bubbles in the plastic. Ortho resins became popular in the 1970's but there was a lot of resistance to their introduction.

So technology improves and materials change but the standards of the finished products were as good then as any generation.

Professors, politicians and dentist tell us how we should be doing it better and cheaper, but hopefully these days somebody asks and consults with the experts, us.

TIME

Well my time has come and gone And everything has changed The things I do they feel the same But my world is rearranged I know I’ll miss the things I did I’ll miss the people more I’ll miss that Monday morning thing And Fridays out the door For I am proud of all those years Of struggle and despair Because we knew we did our best And people know we care But now it’s gone the memories good The love and sadness too And I know without a doubt We're the best, at what we do.

John 2002 / 5

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COMPANY PROFILES FOLLOWING OUR RECENT VISIT TO BRACON DENTAL WE HAVE DECIDED TO VISIT GC FOR THIS FEBRUARY ISSUE.

A WARM WELCOME TO GC FOR ME

A spacious and welcoming reception

THIS PHOTO: GC Offices Newport Pagnell UK; Inset: Founding day established; BELOW LEFT: Literature and stock. BELOW RIGHT: Posting on Time!

COMPANY PROFILES

w GC are a long established Japanese company with a real reputation for quality and innovative products, for both clinical and technical restorative dentistry. It was not always the case, (I say with tongue in cheek)!

During my visit, to the GC UK headquarters just off the M1 at Newport Pagnell, I was handed a book which told the story of the companies beginning and their on going dedication to quality products. The company was started in 1921 soon after the ending of the First World War. Three newly graduated friends who had all achieved their degrees in applied chemistry at the Tokyo Imperial University (currently the University of Tokyo) got together to jointly form their small chemical research laboratory.

With a great deal of pride in their degrees they decided to jointly pursue their dreams and aspirations. They began with a small laboratory in a 50 sq. metre space and set about building their “GC Chemical Research Laboratory.” Targeting the growing dental market they decided to concentrate on dental products and began their venture with an “innovative cement” called Standard Cement which was launched in February 1922. The product proved to be a commercial disaster and had to be withdrawn. Within three years they produced their “Crystalline Cement” which proved to be a world changing quality product. They had learned their lesson early and very well. Henceforth the founding day of the company would be 11 February 1922. As a reminder of what not to do, going forward. They henceforth committed to only producing products that added potential to the operators’ ability and improved the outcomes for patients. Today it is clear they have succeeded as so many of their products are now considered the gold standard for quality in their field.

The UK Headquarters is housed in a modern office block with a good and easy access to the M1 and ample parking facilities.

Downstairs is dedicated to reception and dispatch and warehousing while upstairs the rooms are spacious and modern with facilities or holding meetings and for hands on teaching of innovative products and techniques. I met with Chris Brown in his office on the first floor. Chris explained that he had joined GC in the mid to late 1990’s because they seemed to have some really interesting products and were a small company, within the UK. He found the first premises in Newport Pagnell and from the window of the present building pointed out the progress of growing across the building they now almost fully occupy over the past 19 to 20 years. Their growth has ben steady and continuous and they are optimistic it will continue. With an obvious desire to introduce products, which the clinicians and technicians would find helpful based on quality and good value for money. Which remains the cornerstone of the companies’ philosophy.

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GC has grown across the world with the European headquarters and distribution centre based at Leuven in Belgium. They also have a very well known training facility for clinicians and technicians based at Leuven to which many UK operators have been to learn and grow. But the UK headquarters are to continue their home based training programmes on the materials handling and the use of innovative equipment, which is part of the company’s commitment to growth.

They have created a well equipped teaching facility with all the necessary hand tools and incorporating their latest and impressive digital systems. Designed to deal with the digital learning needs of both technician and clinician it provides an individual scan design and manufacture unit for each trainee.

Housed on the first floor it an air-conditioned facility with everything the interest student professional should need. Chris explained how the philosophy of the company was changed by the first lesson of the cement and how the partners decided to commit to improving their

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COMPANY PROFILES approach. Those employed at all levels are called associates rather than employees and the philosophy of quality first in products and services is willingly undertaken by those who provide the sales and services on behalf of GC.

COMPANY PROFILES

Speaking with Chris Brown it is clear how much he enjoys his work and he is rightly proud of the support staff, many of whom have been working together for nearly as long as the company has been in the UK. Neil Clarke who looks after the Laboratory business for the UK, is a well known and a friendly familiar face who is always good to talk with about your favourite composite or porcelain product. Debbie S. Ward, who looks after sales for clinical products is responsible for sales management for the remarkable cements and composites. Debbie joined the company earlier in the same year 1997), that Neil joined. There was another long serving face which many of you may well remember, Patrick Kelleher who left the company in 2017 after 18 years, to become a Vicar and is now indeed pursuing that calling at University. Mark Groves and James Beck (18yrs with the company) are two other familiar faces with a knowledgeable approach to helping their customers experience something new and better with their products.

The company has launched their digital hard and software into the UK and are promising to deliver a very user friendly system for both clinician and technician. They provide the Aadva Lab scanner and the Aadva IOS intra oral scanner for clinicians. It is a compact and flexible system, with touch screen technology, for ease of use. The new teaching facilities lend themselves well to the continued need for educational development with built in digital screens and the scanners for interested parties to learn. They have a quiet confidence, which only comes from knowing that what you have to provide really works well. Their products are familiar to us, particularly when able technician demonstrators such as Mark Bladen show just how simple and beautiful the results can be with products you can enjoy and trust. It is interesting that their popular clinical composites were developed from the already very successful Laboratory materials, which had been on the market with laboratories for The GC Aadva Lab Scan

THIS PHOTO: Chris Brown Proud of the Euro connection RIGHT TOP: Training Bench Drawer RIGHT BELOW: Chris displays the teaching unit

some years before. Their Initial Lisi Press Lithium Disilicate Glass Ceramics is winning friends across the country with its variable translucency and innovative colouring system.

There I no doubt the company philosophy comes through in their products and in the confidence with which the demonstrators and the sales team show and offer them to their prospective customer.

The UK have proudly displayed their connection with Japan with their novel stand decorations at the various Dental Trade shows.

The classic Japanese house forms and some really oriental designs have been characteristic of of their displays in recent years. They are unmistakably oriental and a novel and refreshing outline to a exhibition trade stand.

Almost taking your mind through the attractive state of relaxed freedom of thought we so associate with the ethereal quality suggested by the Japanese traditions of contemplation and study and a committed philosophy.

There is certainly a great deal of Japanese influence in the care and attention the associates show to their customers. Despite being in a very competitive market place there is a feeling of homeliness about the welcome air of Chris Brown and his fellow associates running the GC operation within the UK. I really did find my visit very interesting and am grateful to Chris for giving of his very busy time to show me around and introduce me to his fellow associates throughout the day. Thankyou.

Show stand 1 Show stand 2

A friendly associates farewell

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www.dentaltechnician.org.uk

GC HOST DIGITAL LABORATORY DAY AT THEIR NEW UK TRAINING CENTRE

G

precision fitting Zirconium, Titanium, Chrome-Cobalt, Hybrid-Ceramic and PMMA crowns and bridges.

project import workflow for stabilized import functionality of projects scanned with the Aadva IOS 100 intraoral scanner.

Any work submitted to the GC Milling Centre can be turned around within 2 to 5 days, depending upon the complexity of the case, and is VAT exempt. There is also a free collection and delivery service.

The speakers included Ward Gerets from GC Europe, who spoke about the GC Milling Centre; Francois-Xavier Coch from GC Europe, who spoke about the ALS Laboratory Software update 3.0; and GC UK’s own Neil Clark and Tim Colebrook, who spoke about LiSi Press and the IOS intraoral scanner respectively.

Finally, to make things easier for their UK clients there is now a UK Price List with all invoices in Pounds Sterling and paid into a UK Bank Account.

The Aadva Lab Scanner is a fully automated lab scanner featuring the most recent projection and measurement technology. The use of a high-end dual camera system with blue LED structured light, in combination with GC's implant scan-technology assures the highest accuracy and extremely fast scanning of objects. It provides an open system (exchange of STL data) for a full range of indications and materials.

Throughout the day the audience received a host of tips and tricks of scanning techniques and file transfer techniques between the IOS and ALS to help them integrate these innovative pieces of equipment into their workflows and gain the best from their GC digital equipment.

GC MILLING CENTRE During his presentation, Ward Gerets highlighted how GC had recently invested in an extended range of new machines and operators at the GC Milling Centre in Leuven in order to be able to better serve their growing number of clients throughout Europe. He also informed the audience that there is new packaging for the finished goods which can be employed when returning work to clients.

Accepting either STL files or physical models, the GC Advanced CAD-CAM Milling Centre is an open system which means they can accept every type of work, even the most sophisticated cases, and deliver exactly what the Technician needs in return. Each piece of work going through seven equally important stages – initial inspection upon receipt, Aadva scanning to an accuracy of < 6 microns, modellation (CAD), milling (CAM), manual finishing, outgoing quality check, secure delivery.

The GC Advanced CAD-CAM Milling Centre delivers high quality tailor-made implant supported constructions for most commonly used implant brands including Titanium implant bars; Titanium, Chrome-Cobalt, Zirconium and PMMA implant bridges; and tailor-made abutments in Zirconium, Titanium and Chrome-Cobalt. They can also fabricate

ALS LABORATORY SOFTWARE UPDATE 3.0 In his presentation Francois-Xavier Coch highlighted the most recent software developments for the Aadva Laboratory Scanner.

Available to customers with an active update license, the Aadva CAD 3.0 update includes a new Scanflag workflow feature which enables the two-piece abutment workflow to be combined with the use of Scanflags. You can now create multi-layer implant born designs while scanning the unique GC Scanflags There is also a “speed” scan protocol which is 20% faster than the normal “accuracy” scan. The “speed” scan option is designed for use with overview scans, antagonist scans, bite scans and wax-up scans – situations where precision accuracy isn’t critical. The “accuracy” scan option is designed for situations where accuracy is critical for example scan flags, scan bodies and die scans.

Designed for use when time saving is more important than accuracy, depending upon the scan type the software will automatically choose between “speed” and “accuracy” scanning protocol.

Other features include enhancements to Exocad including virtual gingiva design, chain mode for fast tooth setup, automated design suggestions for single crowns, a cutback library, thimble crown and retention libraries, more advanced cutback features, option to display additional interactive cut views, more advanced design of the cement gap, and the ability to design bridges and wax-ups over scanned bars.

There is also an improved Aadva IOS 100

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DIGITAL DENTISTRY

C UK invited some of their closest Laboratory Partners to a Digital Day at their new Training Centre in Newport Pagnell in order to update them on the latest developments at the GC Milling Centre in Leuven, Belgium, Initial LiSi Press, the Aadva IOS intraoral scanner and software update 3.0 for the Aadva Laboratory Scanner.

Implant supported restorations require the highest accuracy level from scanners and design creativity from CAD software, in order to ensure a perfect and passive fit of the implant restorations when seated, a clinical prerequisite. The Aadva Lab Scanner delivers it all and within a very short time. Thanks to the use of its unique GC Scanflags, it enables precise capture of implant position and orientation with the highest degree of accuracy in seconds. The result is a highprecision virtual model and the perfect base for Aadva CAD design, even for extremely complex geometries such as bars and implant supported screw-retained frameworks.

Aadva is flexible, intuitive and functional.

It meets any clinical case from crowns to implant supported frameworks.

IOS INTRAORAL SCANNER Whilst primarily designed for use within the Dental Surgery, in his presentation Tim Colebrook highlighted the basic features of the IOS intraoral scanner so that the audience would be able to understand how it interfaces with their Laboratory technology to enable them to deliver optimized restorative solutions for their surgery-based colleagues.

INITIAL LISI PRESS In his presentation, Neil Clark informed the audience about the latest developments in the Initial LiSi Press range, which included ingot selection and colour range, and also cementation.

GC Initial LiSi Press is a revolutionary new pressable ceramic which combines unparalleled strength with exceptional aesthetics. Best of all it is faster to process,

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u

it is optimized for use with both GC Initial LiSi veneering ceramic and Lustre Pastes, and leaves virtually no reaction layer using the LiSi spray, making the laboratory more productive.

GC Initial LiSi veneering ceramic and Lustre Pastes to provide laboratories with the strongest, most user friendly, aesthetic, and stable option on the market today.

GC Initial LiSi Press is a high strength lithium disilicate ingot with High Density Micronization (HDM) Technology. This proprietary new technology provides unsurpassed physical properties while delivering the most aesthetic pressed ceramic option on the market.

GC Initial LiSi Pressâ&#x20AC;&#x2122;s features and benefits include cleaner presses; unparalleled aesthetics, fluorescence, a seamless learning curve; low abrasion and high wear resistance; virtually no reaction layer when divested; material and colour stability after repeated firing; lower chemical solubility than other leading brands; rich, warm and bright colours with excellent fluorescence; and an unsurpassed flexural strength (450 MPa) with HDM Technology.

GCâ&#x20AC;&#x2122;s new HDM Technology utilizes equally dispersed lithium disilicate microcrystals to fill the entire glass matrix, rather than using traditional larger size crystals that do not take full advantage of the entire matrix structure. As result, GC Initial LiSi Press delivers the ultimate combination of strength and aesthetics making it perfectly suitable for all different types of

dental restorations. Most importantly, this technology allows the product to be very stable without distortion and drop in value, even after multiple firings, it can also be polished in the mouth by Dentists.

GC Initial LiSi Press is also perfectly optimized for use with the already proven

For more information on how to register for the loyalty scheme please contact GC UK Ltd on 01908 218999, e-mail info@gcukltd.co.uk or visit www.gceurope.com

HARLEY STREET TECHNICIANS STUDY CLUB 70TH

S EDUCATION

aturday 13th January 2018 was a really good night for celebrating this great and long commitment to a study club. This night Sat 13th January 2017 was a time to celebrate this achievement with a dinner at the wonderful TATE Gallery in London. We duly assembled in the rather cold wet and windy evening at the Rex Whistler Restaurant. From close to the end of the second world war, in 1947, a group of enthusiastic and interested technicians began to gather regularly to discuss materials and methods which might just help increase their knowledge of the craft they had chosen to follow. The aim of the original group and the maintaining driver was to improve their understanding and therefore there ability to meet the patients wishes and for themselves to know they had. Education and the general support for technician education was in its infancy in those days and the traditional method of apprenticeship and in house training meant some were well trained and others were not.

How was anyone to judge? This group in the West end of London had the great idea to get people together and to get them to talk about their knowledge and to identify other speakers who may be able to add to the overall knowledge spread.

Of course they were concentrated within the Private Dentistry Area and needed to be a bit better than others. The idea was obviously the right one as here

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Keen to be in out of the cold

Meeting & greeting

we are all this time later and the meetings go on with enthusiastic members, despite the drastic reduction of technicians and laboratories in the area.

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As always with any extra mural activities its continuation is due to a dedicated handful of interested people who give their time to continue the tradition. David Coppen, the present Chairman, has spent many hours writing to and hearing from speakers and potential members and encouraging them to get involved. His cohort of members have maintained the tradition and quality of the content and the educational potential.

Inviting leading edge speakers on all the topics of interest to the technical professionals in general. The society have extended their welcome to others from outside the Harley Street area and enlarged their appeal. With National and International speakers on all

David Coppen with friends

Just one more perhaps

Happy meeting friends

subjects related to restorative dentistry.

Everyone dressed smartly with evening suits and wonderful dresses worn by the accompanying Partners and lady members.

Despite the unhelpful weather, there was an air of enjoyment building as the numbers grew. The restaurant and the bar area was set within this most impressive room with the wall painting by Rex Whistler entitled â&#x20AC;&#x153;The Expedition in Pursuit of Rare Meatsâ&#x20AC;? surrounding the diners. A long leisurely chat, with drinks began the evening.

Many conversations, picking up on ideas and cases and a really relaxing evening began to be enjoyed by those who had braved the poor weather outside. By the time we sat down to eat there was a real buzz in the room and a great many smiles.

A speech perhaps?

EDUCATION

The food and service lived up to the reputation of the TATE and everyone continued through the evening with the banter growing ever more enthusiastic. David and his committee had arranged for a speaker who attended as if he were just one of the group and later in the evening stood up and began to deliver some amusing observations on the members and their lives, he certainly knew many of those gathered and was able to poke fun without offence. David Coppen thanked everyone for coming to celebrate this 70th year anniversary and urged the membership to encourage friends in dentistry to attend coming meetings. We all raised our glasses and drank to the continuation of the organisation for another 70 years. With warm coats and taxis a merry and happy group headed to their various homes in around London and the Home Counties. The next meeting of the group was on the following Wednesday 17th and was a very full and enjoyable meeting. (See Report on page 22 & 23).

Sitting with friends and guests

What a beautiful setting

Togetherness

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THE UK DENTAL DEVICES NOT REGULATED BY THE GDC

I. A. A. FINDER

D

ental technicians must understand the laws that relate to their activities so how does the complex set of GDC requirements for UK technicians relate to those who import dental devices? Importing dental devices is legal and mentioned by the GDC in their guidance.

The Dental Technician has questioned the GDC and MHRA to find out. Many will be surprised that some UK dental device manufacture is outside of the GDC’s jurisdiction, but on paper looks the same as a regulated GDC technician made device.

DENTAL NEWS

An importer must register with the MHRA and meet their requirements and they must not call themselves a dental technician. Dentists are legally entitled to buy devices from such an importer. The person who actually makes the device does not have to have any qualifications.

The importer does not have to have any qualifications; pay to register with the GDC, understand or follow GDC standards, do CPD, or have indemnity insurance. If the device causes the patient a problem, as a non-registrant the importer cannot be held accountable at GDC Fitness to Practice. This device and importer is outside their jurisdiction.

Many UK technicians believe that there are two mechanisms that level the playing field and allow this regulatory anomaly to be visible in the market but this seems not to be the case.

IDENTIFYING UNREGULATED DEVICES One is that the GDC guidance on its website says that “if the device is made outside the EU the actual manufacturer must be disclosed to the patient.” Both the MHRA and GDC seem confused by this labelling requirement (which seems to be wrong and the GDC will not confirm that it is enforceable). Both organisations say that when a device is imported into the EU the address on the SOM is that of the importer or what the MHRA call the authorised representative not the actual manufacturer.

The UK importer ‘becomes’ the UK manufacturer and it will have a UK address just like a UK manufactured device made under GDC jurisdiction.

ANYONE CAN SIGN THE STATEMENT OF MANUFACTURE. The second belief is that the signature on the statement of manufacture (SoM) should be signed by someone ‘suitably qualified’, ie a GDC registrant. Both the GDC and MHRA have said that as far as they are concerned there are no requirements on who may sign the SoM. So it can be signed by someone who may be an untrained non-registrant (presumably this is also true in a UK manufacturing laboratory). While the patient may believe that the UK dental team is regulated by the GDC an unregulated device will not look any different to the patient if the dentist has decided to source the device outside the UK.

HELD TO ACCOUNT The mechanism the GDC uses to ensure parity for the patient and UK technicians is their policy to hold a dentist who uses non- registrants who ‘is’ themselves under GDC regulation to account, should an unregulated device cause the patient problems (and presumably complain about the device to the GDC). They are told “You will be held professionally accountable for the safety and quality of the appliance because you have chosen not to sub-contract or issue the prescription to a registered dental technician who would otherwise be accountable him or herself. You take on the dental technician’s responsibilities for the appliance and the GDC will hold you accountable for your decision”.

COULD BREXIT ALTER THE GDC’S ABILITY TO REGULATE? If dental devices are classed as ‘goods’ in the EU’s single market the UK must not put up ‘barriers to trade’ and must allow trade even though the devices do not meet the GDC’s strict requirement for UK manufacturers who are under GDC jurisdiction. Anything the GDC did to hinder trade could be seen as a barrier with legal consequences. If the UK leaves the single market the possibility arises to stop people outside the GDC’s jurisdiction who do not meet the GDC’s strict standards from being used in UK patient’s treatment.

I am sending copies of the above to DLA and DTA and invite comment from both representative organisations. ED.

ADI TECHNICIANS DAY 2019 ADI National Congress 2019 We want to hear from You! w In May 2019, the ADI hosts its national congress in Edinburgh.

I want to ensure we deliver a programme that meets the existing and emerging educational needs of dental technicians. To achieve this we need your input.

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The following survey will capture your ideas and preferences for the event. It takes less than 5 minutes to complete and closes at midnight on Monday 22nd January 2018.

Please feel free to share this link with your colleagues and industry contacts who may also be interested in shaping this event.

www.dentaltechnician.org.uk

(http://www.surveygizmo. com/s3/4057015/ADITechnicians-Day-2019) Thank you for taking the time to complete this survey and I am looking forward to the biggest and best ADI national congress in 2019.

Many thanks, Ashley Byrne ADI Technical Representative

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ANOTHER NIGHT AT THE HSTSC

YOUR GUIDE TO ECPD FOR AUGUST 1ST 2018 ECPD - TYPES OF ACTIVITY THAT CAN BE INCLUDED

Continuing professional development (CPD) describes the variety of activities that you can do to maintain and build your skills and knowledge in your field of practice. Whilst you may find that non-verifiable CPD is beneficial to your learning needs, you only need to declare your verifiable CPD to the GDC. Please refer to section 5.3 on the evidence required to show that your activity is verifiable.

Examples of types of verifiable CPD may include (but are not exclusive to): • Courses and lectures; • Training days; • Hands-on clinical training or workshops; • Clinical audit; • Attending conferences; • E-learning activity The GDC recommends that you carry out a diverse range of activities, with an emphasis on opportunities for discussions and interactive learning with fellow professionals.

Changes to ECPD due to affect all registered Technicians from August 1ST this year.

RECORD PLAN DO RECORD DENTAL NEWS

You must do at least 10 hours in any 2 year period PLANNING CPD FOR YOUR FIELD OF PRACTICE • The CPD rules state that you must choose CPD that includes activities relevant to each field of practice you work in during your CPD cycle.

• Your CPD may support you to maintain current skills, or develop new skills within your current or future field of practice.

• Your field of practice encompasses a variety of aspects about your work as a professional beyond just your scope of practice.

recommend that you do at least five hours in every CPD cycle. This applies only to those who undertake radiography. If you are a dental technician you can do CPD in materials and equipment instead of radiography and radiation protection: at least five hours in every CPD cycle.

You should consider the regular skills, practice and professional roles that you undertake.

We also recommend that you keep up to date by doing CPD in the following areas: • Legal and ethical issues; • Complaints handling; • Oral Cancer: Early detection; • Safeguarding children and young people; and • Safeguarding vulnerable adults.

• We make these recommendations because we believe regularly keeping up to date in these topics contributes to patient safety

• If you work in a specialist practice or laboratory, have a professionally focused area of work, or have educational roles, this should be reflected in your CPD planning and activity; REFLECTION • The aim of reflection is for you to think about the outcomes of your CPD activity, focusing on what you have learned from the activity and how this influences your daily practice and duties.

• The enhanced CPD scheme is not prescriptive about how you reflect, or how you record that reflection has taken place.

• For example, you might like to reflect on your CPD and PDP at the end of each year, by writing a summary of your reflections.

THE GDC'S RECOMMENDED TOPICS • To help and support you in your CPD choices, the GDC has identified some CPD topics that will relate to many dental professionals in their field of practice. These are highly recommended to do as part of the minimum verifiable CPD requirement: • Medical Emergencies: at least 10 hours in every CPD cycle –and we recommend that you do at least two hours of CPD in this every year; • Disinfection and Decontamination: we recommend that you do at least five hours in every CPD cycle; and • Radiography and radiation protection: we

Types of activity that can be included: • Whilst you may find that non-verifiable CPD is beneficial to your learning needs, you only need to declare your verifiable CPD to the GDC • Examples of types of verifiable CPD may include (but are not exclusive to): - Courses and lectures; - Training days; - Hands-on training or workshops; - Clinical audit; - Attending conferences; - E-learning activity.

The GDC recommends that you carry out a diverse range of activities, with an emphasis on opportunities for discussions and your annual CPD statement.

Your annual CPD statement includes: • A declaration of the number of hours of CPD you have completed during your CPD year or, if you have not completed any hours in that year, then confirmation that you have completed zero hours; • A declaration that you have kept a CPD record; • A declaration that you have a plan (PDP) in place; • A declaration that the CPD you have completed and recorded is relevant to your current or intended field of practice; • A declaration that your statement is full and accurate.

• You can make your statement up to 28 days after your CPD year has ended.

YOUR END OF CYCLE STATEMENT • A declaration of the total number of hours of CPD you have undertaken in your five year cycle; • A declaration that you have kept a CPD record; • A declaration that you have kept a plan (PDP); • A declaration that the CPD you have completed and recorded is relevant to your current or intended field of practice; • A declaration that, your statement is full and accurate.

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TRANSITIONAL ARRANGEMENTS Prior to 1 January 2022 for dentists and 1 August 2022 for DCPs and depending on where you are in your cycle, you may have to complete CPD based on both the 2008 CPD scheme and enhanced CPD scheme to be compliant at the end of your cycle. A pro-rata approach will be applied, taking into account the requirements of the old and new scheme. After you renew your registration for 2018, you will be able to log onto eGDC where an individual calculation has been done for each dental professional to show you what your specific requirements are over the transition period.

For a general idea of how the transition period works, please use our online transition tool. Once your current cycle ends, you will start the next cycle on the enhanced CPD scheme only.

PERSONAL DEVELOPMENT PLAN (PDP) For the GDC, your PDP must include: 1) The CPD you plan to undertake during your cycle, which must include CPD that is relevant to your current or intended field(s) of practice; 2) The anticipated development outcomes that will link to each activity; 3) The timeframes in which you expect to complete your CPD over your cycle.

You might find that your field of practice or learning needs change, and so you should adjust your plan and activity accordingly. The GDC encourages you to review your plan annually as it relates to your role and daily work.

YOUR CYCLE PERIOD https://gdc.onlinesurveys.ac.uk/ecpdtool TRANSITION TOOL

LOG OF COMPLETED ACTIVITY

- The date(s) that the CPD was undertaken; - The total number of hours of CPD undertaken; - The name of the professional who has participated in the CPD activity; - That the CPD is subject to quality assurance, with the name of the person or body providing the quality assurance; - Confirmation from the provider that the information contained in it is full and accurate.

• It should also include your registration number.

ACTIVITY LOG

Below is an example taken from the GDC website

Linking to the Standards for the Dental Team through development outcomes THE EVIDENCE REQUIRED FROM EACH ACTIVITY • As part of your CPD record you must also obtain evidence of having completed the CPD activity.

• The evidence from the provider must include the following details: - The subject, learning content, aims and objectives; - The anticipated GDC development outcomes of the CPD;

Lot’s more information available here: https://gdc.onlinesurveys.ac.uk/ecpdtool

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DENTAL NEWS

Name: Jo Bloggs Registration No. 153256 Cycle Period.

Date: Hours Completed: Evidence of Verification: Evidence of Verifiable CPD: Title of Provider and Content: CPD activity: Development Outcomes: 1. How did this benefit my daily work 2. Certificate: Harley St Study Club: David Smith: Vanishing Dental Technicians: eCPD: T Levels: Outcome: 1. Understood the changing role of dental technicians and why numbers are decreasing.

2. Learned about eCPD and how I must comply with the new CPD rules.

3. Learned about 'T Levels' and discussed if they are appropriate for dental technology

DAVID SMITH PREVIEWS ECPD AT THE HARLEY STREET TECHNICIANS STUDY CLUB

A

nother evening at the Harley Street Technicians Study Club proved to be an invaluable contribution towards beginning to get our heads around the whole registration issue and the requirements for the changes coming for technicians on August 1st 2018.

Chairman and Treasurer call for votes

DENTAL NEWS

It was also the groups’ AGM the business of which was very efficiently gone through with the Chairman’s report and the Treasurer’s report, which was good news. The group in recent years has expanded beyond just the Harley Street technicians as members. They have many interesting invited speakers through the year and the Chairman, David Coppen, the chairman, encouraged the membership to invite other technicians to their group. Various officers were elected and a call for others to come forward. The Chairman finished with a comment that the future looked secure and the group would continue it’s good work.

We were all anxious and interested in hearing our speaker for the evening. While 1st of August may seem a good way off, on these cold wintery evenings, the changes coming for Registration will need to be tackled. The topic of the evenings talk was just that. The talk presented by David Smith CEO of Phoenix Dental Castings in Exeter clearly showed we need to be aware that continued learning and its benefits

David Smith keeps us listening

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will be required and may become a bigger challenge for some. David, uniquely for a dental technician spent some years on the GDC Council and was greatly involved with the input for the dental technician registration and regulation process. David was presenting a complete and thorough update on the conditions for continued registration of Technicians. As of August 1st this year the requirements for CPD will change.

Technicians will only need to include their 50 hours verifiable CPD over a five year period, based on the guidelines. (See Page 30).

David showed the numbers of registrants that make up the total list. While there is an obvious difference between the Dentists, Dental nurses and others the Technicians numbers uniquely are falling: • In 2010 there were 7,200 registered technicians.

• This fell to 6,774 in 2013.

• And fell again to 6188 in 2016.

• A fall of 16%.

This despite the numbers in all other groups increasing considerably (15%) in the same period. So the question being put is why that should be? David proposed several influences, which may be having a direct affect.

Do these bodies help or hinder?

Education not being made relevant to the needs of modern dentistry and the number of facilities where technical courses are offered has fallen dramatically to a total of approximately 15 in the UK and Ireland. Of those 15 there is some evidence they may not be providing a true learning pathway for modern Dental Technological needs.

David also suggested that poor career opportunities and low pay prospects soon dampen any enthusiasm. A lack of meaningful dialogue, between the industry and the course providers and an obvious lack of a transition

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pathway from education to workplace is really not helping the situation. We are in great danger of slipping back into a Victorian attitude to learning while at the same time leaving the needs of the industry and the patients unaddressed.

There are of course pressures from the new Digital manufacturing methods but what is required is a coherent and targeted dialogue between the interested parties and the education providers. The new technology does not mean an end to technicians but a greater need to be taught and helped to keep pace with the changes, which will inevitably come. The technical knowhow will not be replaced by Digital techniques rather good technical knowledge will be even more required to ensure the integrity of the individual restoration is not subsumed by a mass produced lookalike.

David spoke about the department of education and there launch of a new T-Level exam for technical processes to which Dental Technology may be assigned. (Just like A-levels for technology). David has been involved as a consultant representative for technicians. The scheme seems well funded through the enhanced Apprenticeship projects of the DOE. It may fit well to restore a model on which to go forward with confidence.

Practical skills taught through practical contact and work experience. Reviving some of the good habits of the original apprenticeship schemes but not attaching dictatorial measures, which often act to lower self-esteem causing the trainee to walk away to do something more rewarding for a lot less effort. We are after all a small group of required craftsmen without which the restorative dental provision will struggle.

The challenge is there for all of us to contribute. Join your local study clubs and improve not only your knowledge of the techniques needed but your communication with other technical and clinical professionals.

Far from being pessimistic David was urging a committed attitude to advancing the craft and the skills so necessary for the restorative patients needs. There was a great buzz and lots of interaction and conversation. David had made the reality of the changes and the future for technicians much clearer and we all realised we need to do our homework to be sure of getting the process right.

DAVID’S PRESENTATION: MAIN POINTS WHAT I THINK HAS GONE WRONG • • • • • •

Poor career opportunities and low pay prospects No industry help with recruitment Industry not working closely with education providers Forcing our courses into the wrong boxes in the wrong institutions Too many different courses and too many qualifications Under funded courses

• • • • • •

Access We are not protected under the NHS umbrella Course content quickly becomes out dated Almost no transition from education to workplace Poor student admission selection Not integrated with the rest of dental team

WHAT ARE THE PRESSURES CAUSING THE REDUCTION IN THE NUMBERS OF TECHNICIANS 1. EDUCATION 2. NEW TECHNOLOGY MATERIALS 3. NEW MATERIALS CHANGE MANUFACTURE

3D Printed Special Trays Shellac S. Tray

Acrylic S. Tray Chair Side Scanning

4. NEW TECHNOLOGY LABORATORY SCANNER

5. DIGITAL MANUFACTURE

6. ADVANCED CHAIRSIDE TECHNOLOGY

New technology Cad-cam

Milling wax copings

DENTAL NEWS

Scanning implant position from impression

7. OUTSOURCING OF MILLING 3D PRINTING AND LASER MELTING

Cerec 3d omni cam in full colour

3D printing prosthetics

Planning and positioning

There are multiple temptations available for manufacture via third party centres. For Milling, 3dPrinting, Laser melting and other forms available to the digital technology. While design and scanning can be the source and quality control of all your digitally produced products.

The manufacture may prove to be economically and from a quality point of view better sent to specialist centres.. The investment costs associated with the manufacturing process and the innovative changes which continue can leave a big question mark over whether you make in-house or send to a specialist. All processes including model making and special tray or stent and splint manufacture are already being done digitally and it is undoubtedly reducing the technician pool.

But all those who have embraced the technology

are thriving. So perhaps that is the better lesson.

There has been much talk of overseas manufacture in Asia but the internal market is far from healthy as it is based solely on price and does not encourage quality. The financial sense around the competitive pricing in the UK makes no economic sense at all. Prices now quoted by the corporates for NHS crown work are less than in 1980’s. In real economic terms that makes such crowns 15-18 times cheaper than they ever were.

HEALTH REGULATORS PROTECT PATIENTS

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INDUSTRY SCHEMES PROTECT THE INDUSTRY

The situation I have outlined today has happened under the watch of all these bodies and I have no knowledge they have helped or hindered our situation.

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Should laboratories be regulated?

Technician or Process worker?

Should technicians be registered?

I believe we are important part of the dental team and play a vital role in the treatment of patients who require complex care. This role will become more important with the increased use of digital technology.

• Only the title of dental technician is protected • People can work in laboratories but not be registered • Lack of clarity as to the difference in roles of assistants and Technicians. Too easy for laboratories to take advantage of an unclear system

I believe patients should feel confident in everything manufactured to be fitted in their mouth and have confidence in the dental laboratory.

If they are to be regulated, and I believe they should, it must be under the supervision of a group committed to the patients welfare based on a quality process designed to produce a long lasting a suitable restoration with much less emphasis on the costs. We are continuing to delude ourselves if we think we can continue to produce suitable restorations under the economic strictures proposed year on year for the NHS. Of course the potential for direct manufacture from Chair side is another threat and there may well be a move by many of the corporates to attempt to cut these corners despite the evidence showing the quality of the restorations so produced are generally poor quality. Ask the NHS about the veneer remake rate for chair side cases!

Of course as technicians, we generally suffer from a clear marketing disadvantage.

The great majority of technicians are not visible enough to be even given recognition of their ability and contribution to the cases they complete, perhaps, because they are hidden behind the branding of the

particular manufacturers product and not their own. For example, Cerec crown, Vita .VMK. E-max. etc. Why not work a little harder on your branding and raise your profile within your society. “The John Smith crowns I have had are wonderful. I went to my local dentist but he uses John Smith and what a difference, they are just like my own teeth but better.”

Yes that will mean a mind set change but it is well worth considering. After all we call our cars after the manufacturer of the car not the steel in the bodywork.

Furniture household cutlery and very many of our luxury buys are named after the manufacturer why not a hand made item from the technician craftsman? You have made the effort to train and yet you only become known by the dentist you supply, but he is the middleman. You are the manufacturer, designer, and artistic finisher.

A well earned traditi onal thank you

Thank you David Smith for a thought provoking and timely Call to diligence.

We will now get on with checking the steps needed.

FIXED PRICE PURCHASING DENTAL NEWS

ACCOUNT NOW FOR OVER 25% OF NHS DENTISTRY!

WHAT HAPPENED TO BESPOKE RESTORATIONS?

• Only 5% DT’s have become CDT’s, most dual registered • So far all CDT students have been DT’s • I understand from September 2018 a UK University will introduce a 3 year full time BSc undergraduate course • Genix are currently developing a Trailblazer Apprenticeship in CDT** • Like Therapists, CDT’s at the moment have no role in NHS dentistry but this is likely to change • I think in future most prosthetic technicians will become CDT’s ** No pre-requirement to have been a Dental Technician.

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THE GROWING IMPORTANCE OF ALLCERAMIC MATERIALS AND DIGITAL PROCESSES FOR IMPLANT-BORNE RECONSTRUCTIONS There are a lot of things going on in the busy world of modern dentistry and it is difficult to always be able to choose what will be interesting and what is relevant to your everyday. The U.K. and Ireland ITI Congress is taking place in London from Friday April 8th to Saturday April 9th. With a Straumann Party on Friday at the very Chic Searcy’s seafood bar. With the theme of Modern Clinical Dilemmas in Implant Dentistry the programme will include a good deal on the digital processes around implant restoration and management. Including a series of presentations on full arch restoration. Immediate or delayed loading and the construction and design processes.

The Congress opens on Friday at 9.00. am with the Corporate Forum, featuring Vincent Fehmer who is a Meister Technician and ITI Fellow who has for some long time been involved in Switzerland with many of the great Implant restorative surgeons. He runs his own laboratory in Lausanne. I had the pleasure of seeing him speak early last year at the ITI study club at LonDEC. He is a great speaker and really does know his stuff. I would recommend you try not to miss this presentation from a recognised technical Master

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E

arlier this year Vincent gave an interview to Sue Karran at Manan Limited in which he spoke of the upcoming meeting. Below is a copy of the resultant questions and answers, which I believe you will find rather interesting.

Here he shares his thoughts on the growing importance of all-ceramic materials and digital processes for implant-borne reconstructions.

Finally, they can help to significantly reduce the cost of the final reconstruction since components such as the Straumann®

What do you see are the limitations of ceramic materials for implant-borne restorations?

Digital processes help to reduce technical complications such as chipping of the ceramics. Digital increases efficiency in the workflow, reduces treatment time, offers superior quality control and this combination of factors helps to reduce overall costs.

What alternative materials can be considered to all-ceramic materials without compromise to aesthetic qualities?

Hybrid materials in general as well as CADCAM-processed composite and acrylic.

Do you believe digital production methods deliver better overall results, and if so why?

Absolutely! I strongly believe that digital production methods always deliver better final results compared to traditional methods

for our patients. Maybe for very special and aesthetically demanding situations, the conventional approach can still be beneficial.

However, clearly in the long run CADCAM fabricated reconstructions are considered to be superior because we rely on high strength ceramics that can be applied monolithically and at the same time offer great aesthetic benefits, especially compared to traditional metal-ceramic reconstructions.

As an ITI Fellow, what does the ITI mean to you?

The ITI feels to me as though I’m part of a global professional family. As a member of the ITI you can exchange thoughts and ideas, share and solve problems and network with those involved in implant dentistry and related field around the world.

Vincent Fehmer will present ‘Implant-borne reconstruction: a contemporary approach’ at the ITI Congress UK & Ireland 2018 on Friday 27 April at 9.00am. www.iti.org

VINCENT FEHMER Vincent Fehmer received his dental technical education and degree in Stuttgart, Germany in 2002. In 2009, he was awarded his MDT degree in Germany. From 2009 to 2014 he was the chief dental technician at the Clinic for Fixed and Removable Prosthodontics in Zurich, Switzerland.

Since 2015 he has been working as a dental technician at the Clinic for Fixed Prosthodontics and Biomaterials in Geneva, Switzerland and runs his own laboratory in Lausanne Switzerland.

l

Vincent is an ITI Fellow, and a member of the Oral Design group, the European Association of Dental Technology (EADT) and German Society of Esthetic Dentistry (Deutsche Gesellschaft für Ästhetische Zahnheilkunde, DGÄZ). He is active as a national and international speaker. He has received various awards including the prize for the Best Master Program of the Year (Berlin, Germany) and has published numerous articles within the field of fixed prosthodontics and dental technology.

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DENTAL NEWS

What do you believe are the key advantages of all-ceramic materials over traditional metal ceramics?

Clearly the biggest advantage of all-ceramic materials is the excellent aesthetic integration they offer in comparison to traditional metal ceramics. They can help to prevent, or at the very least minimise the risk of chipping of the veneering ceramic that can lead to failures.

CARES® Variobase™ abutment or zirconia are much cheaper than gold alloys and castable gold abutments.

DIGITAL DENTAL

PHOTOGRAPHY

COMPANY NEWS

THIS CAMERA HAS EVERYTHING YOU NEED Ila Davarpanah, Praxisklinik fĂźr Zahnmedizin Hanau, Geleitstr. 68, 63456 Hanau, Germany

D

igital photography has successfully replaced traditional analogue film camera photography almost everywhere, except perhaps on the artistic side of bespoke photography. The instant capture and usability of the digital systems make it ideal for dental clinical and laboratory image transfer. The colour image of the subject tooth and its neighbours, when presented to the technician allows so much detail to be accurately understood and is a real boon to good quality reproduction of colour layers, translucency, shape and texture of the target teeth. Important detail, often otherwise not picked up, such as crack and stain lines, subtle colour transitions and surface morphology are instantly captured and can be read by the technician. For record keeping and documentation it is invaluable and shows at later review of treatment follow-ups, the original situation.

Smartphones are of course an option and are often a very useful and available method but in reality, for defined and reliable consistent results you need a camera built to capture the dental situation. If possible a dedicated and specialist camera built for the job. Designed with a controlled colour temperature and light source, which will allow the accurate capture of the teeth shade. Those who take their dental photography seriously, often spend a great deal of time and money on various lenses or LEDs or special flash attachments. Some even go to the extreme of special background light reflectors, worn by the patient, to ensure their light reflection is as they wish. There is a plethora of digital single lens reflex (DSLR) or (DSLM) systems, which can be fitted with a macro lens and a ring or lateral flash to meet the requirements of dental

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FIG. 1: With 4 LEDs and 4 lateral flashes, the camera optimally lights all photographic situations encountered in dentistry

photography. These cameras are doubtless the reference systems with regard to the image quality achievable. Unfortunately, they are relatively difficult to handle, which limits their use in dental practice. Not only shutter speeds, aperture and sensitivity, but also colour temperature and perhaps even exposure compensation need to be adjusted. Different lenses for intra-oral shots and for portraits mean lens changes and time consumed. Is it all really needed for dental photography?

Luckily, there is an additional option, namely the use of camera systems designed specifically for dentistry. These cameras are characterised by compact design, ease of use, and suitability for photographic situations typically encountered in dental practices and laboratories. They should allow users to take

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not only classical frontal images of anterior situations including the canines, but also intraoral images of distal aspects with the aid of a mirror. Special shooting modes for taking portrait images and, ideally, macro images at a ratio of 1:1 should also be available.

Such a camera system has been available from Shofu for several years now; the latest version is the EyeSpecial C-III. This compact 12-megapixel dental camera features a zoom macro lens with a focal length of 28 to 300 mm (converted for a 35 mm format) and a built-in lighting system consisting of 4 LEDs located near the lens and 4 lateral flashes. The inside flashes and the lateral flashes, which are angulated by 45°, can be activated separately, depending on the photographic situation. So the EyeSpecial C-III has an integrated flash

system, which optimally lights most dental imaging situations. The combination of the inside and outside flashes allows optimum light focus for frontal image capture and the intraoral lighting is eminently suitable for using with mirrors. The choice of flash is selected by the camera when the operator selects the shooting mode. That way the operator can concentrate on the image they desire.

FIG. 2: The low weight, the accurate autofocus system, and the optical stabilisation program of the EyeSpecial C-III allow users to operate it with one hand if needed

The EyeSpecial C-III basically limits the necessary settings to the choice of a shooting mode suitable for the respective situation.

The camera features 8 preset shooting modes which adjust the relevant exposure parameters (exposure time/aperture/flash setting). These settings also maximise the depth of field. This means that images with continuous sharpness ranging from the anterior teeth to the first molars can be taken. The shooting modes are selected using either the four function keys (F1F4) or the touch panel (Fig. 3). Especially when documenting on-going treatments, the camera may have to be operated with a gloved hand.

In this situation, mode selection with the aid of the function keys will prove advantageous.

FIG. 3: The EyeSpecial C-III features intuitive handling, with 8 shooting modes designed specifically for dental applications

FIG. 4: Documentation of an initial situation using the “Standard” mode

The first two shooting modes, “Standard” and “Surgery”, are suitable for classical frontal images, the difference being the camera-tosubject distance selected. The “Standard” mode can also be used to take frontal images (without a photo mirror) documenting clinical findings and supporting diagnostics (Fig. 4).

FIG. 7: Portrait photo taken with the EyeSpecial C-III without any accessories

The “Surgery” mode allows users to increase the camera-to-subject distance, as compared to the “Standard” mode. In terms of light and exposure control, it is identical with the “Standard” mode, which makes it ideal for the documentation of restorative treatment sequences or surgical procedures (Fig. 5)

FIG. 5: In the “Surgery” mode, images can be taken from a greater distance, which is particularly interesting when preparing intraoperative documentations

The “Mirror” mode is designed specifically for taking intraoral images with the aid of a photo mirror. In this photographic situation, the subject is lighted by the inside flashes.

The photo is automatically mirrored, so that it will be available as a right-reading image immediately after shooting without any further editing (Fig. 6). This is an advantage over other systems (smartphone or DSLR camera), which always require the user to perform this step separately.

FIG. 6: The “Mirror” mode automatically mirrors the photo taken, so that there will always be a rightreading image when a photo mirror is used

COMPANY NEWS

One of the advantages of the EyeSpecial C-III over a DSLR camera with a macro lens and an external flash is its highly compact design, allowing users to hold it with one hand. Its weight of approx. 590 g is only about one-third of the weight of a DSLR camera with the necessary accessories. Besides, the handling of the EyeSpecial C-III is very clear and intuitive. The low weight, the autofocus system, and the optical stabilisation program of this camera help users to minimise the risk of blurred photographs even during one-handed operation (Fig. 2).

When it comes to restorative therapy and cooperation with dental laboratories, the “Face” and “Isolate Shade” modes are particularly interesting. Especially in the case of comprehensive prosthetic treatments, e.g. the fabrication of a complete denture or the restoration of anterior teeth, portrait photos can be an important tool, helping dental technicians to optimally align the restoration with the aesthetic reference planes (interpupillary line/midline). In the “Face” mode, the camera allows the user to take highquality patient portraits without the need for accessories (Fig. 7).

Indispensible when recoding for Orthodontic case records and showing progress of treatment stages. The varying surrounding lighting conditions do not affect the portrait Image quality taken with the eyeshade C-111.

The shooting mode “Isolate Shade” is also important for cooperation with dental laboratories. This function takes two images: The first image shows the situation in true colours, whereas the second image automatically masks the gingival shades. All the soft tissues are displayed in grey, and only the teeth are visible in true colours. This

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allows the user to assess the tooth shade in detail and in comparison with the reference shade included in the photograph (Fig. 8).

Since the user just has to select “Isolate Shade” and is not required to further edit the image taken, this mode easily adds real value to the cooperation between dentist and laboratory.

FIG. 10A/B: Operating the camera in the “Tele Macro” mode with the macro lens included, users can take close-ups of indirect restorations or minimally invasive direct restorations

COMPANY NEWS

FIG. 8: The “Isolate Shade” mode creates two images particularly suitable for shade communication, because it masks the soft tissues, allowing the user to assess in detail any shade differences between the teeth and the shade reference included in the photograph

The “Low Glare” mode can be very useful for anterior restorations. This menu item helps to minimise reflections by slightly reducing the intensity of the lateral flashes.

This primarily improves the display of highly transparent incisal regions (Fig. 9). When documenting lab-made restorations, “Low Glare” allows users to photograph metallic and highly polished surfaces with only minimal reflections. In this way, dental laboratories can be provided with important information.

Finally, there is the “Whitening” mode, developed specifically for photographic documentations of tooth whitening procedures.

Like “Low Glare”, this mode reduces the intensity of the flashes to minimise the risk of reflections. In this way, “Whitening” optimises the display of the surface texture and also helps dentists to easily visualise the results of whitening procedures. Images taken in this mode are definitely of great value to clinicians in conversations with their patients.

The EyeSpecial C-III is a compact dental camera with a wide variety of shooting modes, allowing users to take high-quality photographs optimally adapted to situations typically encountered in daily dental practice.

Thanks to the intuitive operation and low weight of this camera, photo documentation can at least in part be delegated to dental assistants if required.

The camera is compact, its surface is smooth, and its housing is sealed. So it can easily be disinfected using a wipe with any commercially available ethanol-based disinfectant (Fig. 11).

FIG. 9: The “Low Glare” mode minimises reflections by a special light control function, improving the assessment of surface morphology and incisal translucencies

These 4 images provide dental technicians with comprehensive information, which they would otherwise get only by meeting patients personally. And patients also save a lot of time.

The EyeSpecial C-III can be fitted with an important accessory: A screw-on macro lens allows users to take intra- and extra-oral closeups in the “Tele Macro” shooting mode. This option is very useful for the documentation of both minimally invasive treatments and labmade restorations. Like the other modes, “Tele Macro” produces high-quality photographs without the need for any additional, external light sources. White or black surfaces, or also mirrors, can easily be used as backgrounds, and the images taken in this mode are ideal for patient information (Fig. 10a/b).

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Some extra helpful features of the EyeSpecial C-III include a number of image editing tools, a patient identification number or the patient’s name can be assigned to the images taken. This identification function simplifies communication and cooperation with dental laboratories. In addition, the

FIG. 11: Thanks to its compact design and sealed housing, the EyeSpecial C-III can easily and safely be disinfected

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dedicated SureFile photo management software (Shofu), which can be downloaded free of charge, allows users to create their own image archives.

Experienced users can, of course, manually adjust camera functions and correct automatic exposure settings.

Especially when taking portraits against black or white backgrounds, this may be useful. The autofocus function can be deactivated; the sharpness of the photo is then adjusted by moving the camera towards or away from the subject.

Two options are available for the transfer of image files: Photos are transferred in the jpg-format, by inserting the memory card into a PC or laptop, reading the data and then sending them by email. Alternatively, the data can be uploaded directly from the camera to a mobile device (smartphone or tablet) with the aid of a wireless memory card, which does not even have to be removed. When sending digital image data, all applicable privacy regulations have to be strictly observed: Check with your regulating authority if in doubt. Images must be transferred only in an anonymous form and not together with the respective patient data. The EyeShade C-111 really is a true high quality dental, everyday and every patient camera for all dental practices.

First published in DZW 46 and 47/2017

THE DENTAL TECHNICIAN MARKETPLACE UPGRADE YOUR KNOWLEDGE! EMBRACE THE CHANGES OF DIGITAL REVOLUTION

The conferences will be a great opportunity to “upgrade your knowledge” by learning about the latest digital tools and major international trends in the dental field.

The speakers, with their wealth of 'on the ground experience' from working in the dental sector in the UK, will present patient cases from digital patient analysis to the final restoration, with an in-depth analysis of the latest devices and software innovations

w Zirkonzahn, South-Tyrolean manufacturer and innovation driver for the dental sector, comes to the UK in March and April for a new lecture tour, with a live demonstration of the company’s special colouring technique for monolithic zirconia restorations.

SAVE TIME AND MONEY WITH KEMDENT WAX BITE RIM BLOCKS

Find all dates and register at www.zirkonzahn.com (events)

quality work. Kemdent recommends first immersing the wax in warm water to soften, the wax is easily mouldable in the softened state, without flaking, cracking or tearing.

To take advantage of this special offer or to find out more about Kemdent’s range of wax based products visit our website: www.kemdent.co.uk Tel: 01793 770256 Email: sales@kemdent.co.uk

Perfect Packaging Solutions Whether you need packaging to contain your product, or you’re looking for a solution to a working practice issue – we have an impressive range of plastic packaging available from stock. From bottles to boxes, containers to caps and tubes to ties – you’ll find it all available for immediate delivery. With over 80 years’ experience, environmental production credentials and exceptional customer service, we think you’ll find Measom Freer has your perfect packaging solution.

•

GP1

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Bottles & Plugs Dropper, Flip & Screw-on Caps Containers, Boxes & Jars Scoops & Measures Spoons & Spatulas Tubes, Ties & Clips Spray & Gel Pumps Bespoke Packaging

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Now Buy Online Tel: +44 (0) 116 288 1588 Email: sales@measomfreer.co.uk Web: www.measomfreer.co.uk 37-41 Chartwell Drive, Wigston, Leicestershire, LE18 2FL, England.

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Made in England

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COMPANY NEWS

The pre-curved wax blocks have a specially curved base to fit the model. It can be easily adapted to shape and carved with a wax knife. This enables a rapid set up, holding the teeth firmly in place.

Using preformed blocks is quick and easy plus it saves the technician valuable time and money!

w Kemdent, the leading UK manufacturer of Dental Wax has a money saving, multibuy offer available during February. Buy 2 x 50/box of Curved Wax Bite Rims £10.12 + VAT each or buy 4 boxes for only £9.49 + VAT each.

The unique wax rolling process used at the Kemdent factory, imparts excellent handling characteristics to the wax. These characteristics mean that Kemdent Wax Bite Blocks are an ideal wax for high

available in the market. They will point out the advantages of continuing education and give you an insight on how they are helping businesses handle the dental sector’s future challenges in the market place.

FREE VERIFIABLE CPD

As before if you wish to submit your CPD online it will be free of charge. Once our web designers give it the all clear there will be a small charge.

This will be less than the CPD submitted by post. This offer is open to our subscribers only.

To go directly to the CPD page please go to https://dentaltechnician.org.uk/dental-technician-cpd.

You will normally have one month from the date you receive your magazine before being able to submit your CPD either online or by post.

If you have any issues with the CPD please email us cpd@dentaltechnician.org.uk

4 Hours Verifiable CPD in this issue LEARNING AIM

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

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

LEARNING OUTCOME

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

Correct answers from January DT Edition:

CPD

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VERIFIABLE CPD - FEBRUARY 2018 1. Your details First Name: ............................................. Last Name: .......................................................Title: ...............

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

Question 1

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As of April 2016 issue CPD will carry a charge of £10.00. per month.

Or an annual fee of £99.00 if paid in advance.

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You can submit your answers in the following ways:

Q10.

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

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Via email: cpd@dentaltechnician.org.uk By post to: THE DENTAL TECHNICIAN, PO BOX 430, LEATHERHEAD KT22 2HT

Payment by cheque to: The Dental Technician Magazine Limited. Natwest Sort Code 516135 A/C No 79790852 You are required to answer at least 50% correctly for a pass. If you score below 50% you will need to re-submit your answers.

Answers will be published in the next issue of The Dental Technician. Certificates will be issued within 60 days of receipt of correct submission.

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VERIFIABLE CPD AS YOU NEED IT VIA THE DENTAL TECHNICIAN EDITORIAL Q1.

Who is responsible for informing the patient of the Statement of manufacture?

A. The Dental laboratory who made it B. The patient’s dentist C. The practice receptionist D. The dental nurse Q2.

A. B. C. D. Q3 A. B. C. D.

Comment. What is probably the biggest and most complex organisation of its kind in the UK? The House of Lords The House of Commons secretariat The catering organisation at the House of Commons The security management How many food and drink outlets are there in the House of Commons and the Lords?

8 16 10 22

LOOKING BACK Q4 What was the authors special dental interest?

A. Prosthetics B. Crown and bridge work C. Maxillo-Facial D. Orthodontics Q5.

A. B. C. D.

Who or what was still King in the 1950’s ?

The Bunsen flame Air-conditioning Coal Magnification

THE HSTSC AT THE TATE Q6. What was the name of the wall painting in the restaurant?

A. Monet’s garden B. The flight of the Golden Hinde C. The expedition in pursuit of rare meats D. The Garden of Eden Q7.

A. B. C. D.

Who was the artist?

Lansdowne Rex whistler Marco Oretti Gainsborough

ANOTHER EVENING AT THE HARLEY STREET TECHNICIANS STUDY CLUB Q8. How many registered Technicians were registered in 2016?

A. 7,200 B. 6,774 C. 6,188 D. 6, 598

Q9.

A. B. C. D.

How many registrants are recorded for all dentistry in 2016?

113,897 110,673 102, 573 109, 636

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A. B. C. D.

By how much has the number increased since 2010?

14,678 16,890 17,392 18,673

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A. B. C. D.

What are T. Level qualifications?

Top level, above A. Level Test Level. (During training) Technical Level. (A. level in technology) Tutoring qualification

Q12.

A. B. C. D.

What percentage of NHS work is set on fixed price fees?

25% 21% 29% 22%

DENTAL DIGITAL PHOTOGRAPHY Q13. How many Megapixels does the Shofu eyeshade C-111 camera have?

A. 5 B. 10 C. 12 D. 15 Q14. How many shooting modes are available for Dental Photography?

A. 6 B. 4 C. 8 D. 10 Q15.

A. B. C. D.

In the Isolate Shade Mode what is masked?

Adjacent Teeth Palatal shadow Spaces Soft Tissue

FINDING YOUR FIRST JOB AFTER GRADUATING WITH YOUR DENTAL DEGREE Q16. What was considered the biggest asset for the successful candidate?

A. Good marks in Technology B. Proactive attitude C. Positive manner at interview D. Having the right CV

CPD

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

You can submit your answers in the following ways: 1. Via email: cpd@dentaltechnician.org.uk 2. By post to: THE DENTAL TECHNICIAN LIMITED, PO BOX 430, LEATHERHEAD KT22 2HT You are required to answer at least 50% correctly for a pass. If you score below 50% you will need to re-submit your answers.

Answers will be published in the next issue of The Dental Technician. Certificates will be issued within 60 days of receipt of correct submission.

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31

CREATECH THE PERFECT FIT FOR YOUR LAB’S NEEDS

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hen it comes to the creation of perfectly fitting prosthetic structures, such as bars and implant support structures, every technician knows how important it is to work with a partner that has the latest technology at hand, and who takes advantage of the possibilities borne out of recent advances in engineering, digital technology and material science.

process is regulated by the strictest quality control regulations.

Technicians are aware that every mouth is different and therefore, the ability to personalise each prosthesis to the individual dentition, is essential to a successful outcome. They also know that every dentist has their own preferred way of working and range of implant products that work for them. Such is the reality of the world in which technicians operate; Createch know this and, in response, offers innovative, leadingedge, bespoke bars and support structures providing strong, longlasting and fit-for-purpose solutions in a variety of materials. They also manufacture customised abutments on hundreds of implant platforms in titanium and cobalt chrome with the option of screw channel angulation.

Straumann believe that an on going collaboration with this innovative company enables them to develop their own innovative and complementary products which will integrate seamlessly with their prosthetic structures in order to deliver the best possible restorative solutions to customers – to everyone’s benefit.

More adaptability than ever before - Createch have always striven to provide new solutions to their customers to help them tailor their solutions and achieve a perfect fit. Working closely with technicians and listening to their needs, they have developed innovations such as the 28° screw channel correction, which enables the emergence correction of screws in order to provide a more aesthetic finish. In recent years Createch have also developed direct to fixture head restorations, eliminating the need for abutments altogether, saving costs and leading to more accurate final restorations.

An integrated digital workflow -Createch are at the cutting edge of the digital workflow. They design virtual models from the data captured through intraoral scanners directly from the patient's mouth. Customers using Straumann CARES® digital solutions can also enjoy the extra benefits of immediate digital communication and file transfer delivering total integration between dental lab and Createch and even a digitallyenabled clinician, resulting in a faster, more efficient workflow.

Innovation through collaboration - Innovation is in Createch’s DNA; they actively collaborate with customers, universities, companies, technology centres and hospitals, researching in order to innovate and provide their customers with new solutions for their patients. Of their collaboration with Straumann , Xabier Egurbide, Sales Director at Createch, said “Through our partnership with Straumann, we are delighted to be able to work with UK technicians to help them deliver the precision and fit they require for their implant-borne restorations.”

The closeness that Createch have created with Straumann and their customers makes their work a true collaboration. The multi-disciplinary approach combining the expertise of engineers, laboratory technicians and implants practitioners allow them to unite the collective experience and knowledge of the industry in order to create new products adapted to the needs of all. Lab technicians who work with Straumann and Createch reap the benefits of this collaboration in providing high-quality, bespoke solutions to their patients, and achieving the perfect fit.

For more information on how your lab can benefit from the services that Createch provide, visit www.createchmedical.com

Strong, durable structures - Createch manufacture high-resistance structures, using medical-grade titanium and cobalt chrome, certified

by UNE-EN ISO standards. The structures are milled, one-piece frameworks which are stronger than standard cast metal bars as they have no solder joints or other issues such as cracks or porosities often associated with the lost wax technique for producing cast metal bars.

At the same time as being stronger, they can deliver greater comfort as structures milled from high-strength titanium alloy weigh less than the same structure made in gold, resulting in a lighter and therefore more comfortable prosthesis.

Dedicated to supporting dental professionals and laboratories for over 65 years, with innovative quality products, equipment and cabinetry.

TECHNICAL

Precise computer-aided design and manufacture- Through the Createch Excellence service, Createch can take care of the complete manufacturing process - from measuring implants with high-precision measuring equipment, through designing the structures with their advanced CADCAM design software, simulation using finite element analysis (FEA) calculations for maximum safety and reliability, to milling the structure with their accurate, state-of-the-art equipment.

For the very latest information and offers in analogue or digital technology, technical support, equipment servicing or repair and courses with CPD, call Bracon today!

Createch have some of the most specialised and sophisticated measuring and scanning technology available in the world. They recommend that their customers send both digital files and an analogue model for comparison, measuring the latter using a probe with a tolerance of just one micron. By using these processes, the customer has free rein with the design, secure in the knowledge that Createch can guarantee the fit.

...and now you can order online at

Createch ensure highly accurate milling by strict control of the environment in which these processes are carried out – temperature is fixed at the optimum level and machines are housed on ‘floating floors’ which are not affected by surrounding vibrations from other machinery or outside traffic. These measures deliver a passive fit and a unique accuracy complemented by a choice of straight or angulated screw channels at both implant and abutment level on multiple systems. The entire manufacturing

Bracon proudly represents the very best products from manufacturers around the world...

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09/11/2017 16:44

EMBRACING THE DIGITAL WORLD PETR MYSICKA Petr Mysicka, award-winning dental technician and speaker at the Henry Schein Digital Symposium 2018, gives us his thoughts on digital technology and introduces a revolutionary new digital approach to shade matching.

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igital technology is changing every industry around the world and dentistry is no different; as a profession we have to keep up with this evolution, or what can seem sometimes like a revolution. Being the owner of a dental laboratory, I have to think not only about what is happening now, but also about what the future holds, and the future is digital.

We can already see the changes happening; year by year there are new milling machines, better intraoral scanners such as 3Shape® Trios, new printing technologies, and we have to adapt.

These new technologies give us the opportunity to be more efficient and produce faster and more predictable results for our patients every time.

dental ceramist is able to be present during shade assessment and try-in. However, even under these ideal conditions the accuracy of shade match is still largely dependent on the ceramist’s experience, talent, and finally, a considerable amount of luck. Through intense research, countless trials and close collaboration between clinical and technical experts, a standardised protocol for dental photography has been developed by the Bio-Emulation Group using a regular digital single lens reflex (DSLR) camera, a macro flash and the new polar_eyes® filter. The digital photography is then processed to measure the desired shade from the computer screen.

The Digital Symposium is an important part of helping the dental profession understand these emerging technologies and how they will impact on the standards of patient care we deliver. It is the ideal event for those who would like to jump into the digital world but are not quite sure where to begin.

With the aid of a manufacturer-specific chart, the closest dentin shade is first selected and then individually adjusted in order to achieve a highly accurate shade match. A test mixture is then formulated using visual_eyes® liquid and applied on the framework in a realistic thickness before the shade of the build-up can either be measured or digitally tried in.

INTRODUCING ELAB® I am delighted to have been invited by Henry Schein to speak once again at this year’s Digital Symposium. This time I will be talking about eLAB® - a new digital approach for shade taking and shade communication between the clinician and technician - all without the need of a classic shade guide.

The first guide for choosing the shade of teeth was introduced in 1956. Today, more than 60 years later, we are still using more or less the same one. Nothing much has changed… until now. The eLAB® protocol has been developed by the Bio-Emulation Group - Sascha Hein, Javier Tapia and Panos Bazos. This new system has been designed to bridge the gap between intuition and evidence, with the objective of turning shade matching in dentistry into a didactic exercise and to deliver predictable results for our patients.

Clinical results can be optimised if the

industry and I believe the digital workflow will help us to produce the volume that is required without compromising on the quality.

The Digital Symposium 2018 will be another great event not to be missed and we should embrace this digital world.

Register today! The Digital Symposium is taking place at the Park Plaza London Riverbank Hotel on 27 - 28 April 2018.

For more information or to register, visit hsddigitalsymposium.co.uk, call the events team on 01634 877 599 or email hsddigitalsymposium@henryschein.co.uk Web: henryschein.co.uk Twitter: @HenryScheinUK Facebook: HenryScheinUK

CASE EXAMPLE Figure 1: Shade assessment- polarised picture with white balance® gray card taken by Dentist. All done digitally, no shade guides and without need for the patient to travel to the lab

Using this method, the dental ceramist is equipped to not only achieve highly accurate shade matches, but also to explore the possibilities, as well as the limitations, of the chosen combination of framework material and ceramic system.

THE FUTURE OF DIGITAL DENTISTRY For me, dentistry has changed rapidly over the last few years. 15 years ago, I would have laughed if anyone had told me I would be manufacturing full contour zirconia crowns or working with printed models. Today I could not imagine working without my scanner in the lab!

As I see it, today in the laboratories we face the challenge to maintain a level of good dental work in the future. The training system is simply not producing enough new young people to meet the staffing requirements over the next few years. This will be a big challenge for our

Figure 2: Digital try-in of the finished crown. Dental technician can evaluate the aesthetic outcome before sending the crown to Dentist, with this digital simulation we can adjust the shade accordingly to the situation

Figure 3: IPS e.max Press layered crown after final glaze

TECHNICAL

PETR MYSICKA

l Petr graduated from Dental Technician School in Usti nad Labem, Czech Republic, in 2005. He spent seven years in the Czech Republic as a Dental Technician developing his dental skills and techniques. In 2013 Petr relocated to the UK to further develop his experience, and shortly after, opened his own dental laboratory, PM Dental Studio located in Hove on the south coast

Figure 4: Final situation after fitting

Petr’s big passion is working with ceramic restorations and as previous winner of the Dental Technician of the Year, and multiple winner at the Aesthetic Dentistry Awards and Laboratory Awards he has had the opportunity to showcase first class work that has resulted from collaboration with leading dentists.

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DENTAL LAB RECRUITMENT

BY ANDY FOSTER Andy Foster is the founder of Marshall Hunt Recruitment, a niche consultancy that sources dental technicians for small, mid sized and large dental labs. Andy spent 20+ years running his crown & bridge lab – Fosters Dental Ceramics, before moving into recruitment and online networking. He also manages the popular online job-board DentalTechnicianJobs.net When he not working, Andy is a dedicated father, with an unhealthy weakness for coffee.

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FINDING YOUR FIRST JOB AFTER GRADUATING WITH YOUR DENTAL TECHNOLOGY DEGREE w Dental technology has always utilised a certain amount of science combined with artistry, but this ratio is changing. With newer computerised technologies being introduced, the number of graduate students is increasing because degree level education is frequently required for advanced level dental technologies.

It might seem reasonable to assume that if you qualify with an honours degree, that with only a little effort, you can immediately expect to get a good job in a dental lab. Unfortunately, this isn’t necessarily the case and this article looks at some of the difficulties faced by today’s graduates when they try to find that allimportant first job and the steps you can take to stand out from the crowd.

A while ago, Marshall Hunt Recruitment had the pleasure of working with Marina, a recent graduate looking for her first full-time job.

While she now has a good job in a private dental laboratory, her story illustrates the challenges faced by graduate technicians. Marina took an extremely proactive approach to finding her first job which helped tremendously, and she also developed a clear vision for the direction of her career while still at college.

There is no doubt degree-level graduates receive a well-rounded academic education but despite this Marina felt that college doesn’t prepare you for the day-to-day reality of working in a dental laboratory. Marina also commented that there wasn’t enough practical work, as she didn’t have a chance to make a partial denture until year three. Perhaps this is inevitable given the sheer scope of academic and practical work that must be covered during a degree course. However, Marina’s motivation enabled her to overcome this problem when only in her second year of college. By this time Marian had already determined that she wished to work in a private dental lab.

RECRUITMENT

VOLUNTEERING TO GAIN EXPERIENCE To help accomplish her dream, Marina approached 10 to 15 local dental labs while looking for part-time work during her second year at university. After interviewing with two dental labs, she accepted a position volunteering as an unpaid intern for three months, after which the lab began paying Marina for the next three months. In total,

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Marina spent six months working part-time at this laboratory during her days off and in between studying. Initially, the idea of working unpaid may seem unappealing but Marina only needed to do this for a short while before the lab considered her skills had advanced sufficiently to be worth paying for, all while she was still at university.

The following summer, Marina again volunteered, this time at a university where the hiring manager was willing to help Marina improve her skills through working part-time for four months. Marina was able to contact the hiring manager through asking her tutor for help and advice. After this experience, she was offered a hospital position through an NHS website.

This highlights the need to make the most of the resources available to you. It is always worth approaching your tutors for advice as they almost certainly have a list of useful contacts and above all, they want you to succeed!

DEVELOPING YOUR CV By taking these steps, Marina had gained valuable experience in the working world, developing her CV or resume before she had even graduated. Using your spare time at university to gain and increase your practical experience could help give you an edge when applying for your dream job. Before you begin applying for jobs, spend some time working on your CV, ensuring it highlights the time and effort spent on developing your practical skills while still at university. Even if other applicants may have acquired more experience since graduating, your attitude towards your career will prove your maturity and your willingness to develop and learn. This will count for a great deal with prospective employers, especially as the best companies will spend considerable resources in providing ongoing training and professional development for their employees. These employers will select their staff very carefully to help maximise their return on their investment.

DECIDING WHICH AREAS MOST INTEREST YOU Qualified dental technicians will generally choose to specialise in a key area. Traditionally these choices were orthodontics, crown and bridge work, prosthetics and maxillo-facial prosthetics. Nowadays, there is an increasing

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need for technicians interested in CAD/CAM. Marina chose to do her dissertation on CAD/ CAM, partly because of her interest in this field and partly due to the number of job vacancies advertised. Her practical experience in CAD/ CAM was limited, with this subject only being introduced during her final year. This experience was further constrained by lack of access to computers.

Given the lack of practical work during a degree course, it can be difficult to decide which area interests you most. Your choice may also be influenced by your wish to work in the private or public sector, as for example, maxillo-facial technicians are hospital-based.

While fascinating and rewarding, the number of available jobs for maxillo-facial technicians is likely to be far more limited compared to a technician with an interest in dental implants or crown and bridge work. Your chosen area of specialisation could also limit where you will need to live, and it is worth looking at the jobs available in areas where you would prefer to settle down. Having an open mind is extremely helpful and Marina chose to re-locate some 100 miles, so she could accept her current role.

Although the jobs market is continually changing, keeping an eye on the openings currently available will at least give you an idea as to which labs might be hiring when the time comes, and the types of skills that are most in demand. However, you will probably have an idea of which fields interest you most and volunteering during your summer holidays can be an ideal way to gain more experience and to find out where your true passions lie.

Marina, when asked what advice she would give to graduates looking for their first job, said “Among other things, my employer said he hired me because of my effort, mature attitude, professional CV and he could see that I was a serious person looking to develop, improve as a professional. I think this helped me a lot to find the position that I'm in today."

Getting your first job after graduation might seem a daunting prospect, but you can prepare while still at university. Marina’s positive experience is proof that a proactive attitude does pay dividends.

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