The Dental Technician Magazine November 2020 by The Dental Technician Magazine

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THIS MONTH... • TECH INSIGHT: 5 THINGS I CANNOT WORK WITHOUT! I MATT NORIE P. 10 • INSIGHT: THE PSYCHOLOGY OF THE SMILE I MATTEO NERONI P. 22-23

• BUSINESS: THE ‘COCKTAIL’ EFFECT - WHAT IS YOUR LEADERSHIP STYLE? I NICKI ROWLAND P. 28-29

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CONTENTS

CONTENTS I NOVEMBER 2020 Editor Matt Everatt F.O.T.A. E: editor@dentaltechnician.org.uk Designer Sharon (Bazzie) Larder E: inthedoghousedesign@gmail.com Advertising Manager Chris Trowbridge E: sales@dentaltechnician.org.uk T: 07399 403602 Editorial advisory board Andrea Johnson Ashley Byrne Ross Chapman Sharaz Mir Sir Paul Beresford Published by The Dental Technician Limited, PO Box 430, Leatherhead , KT22 2HT. T: 01372 897463 The Dental Technician Magazine is an independent publication and is not associated with any professional body or commercial establishment other than the publishers. Views expressed in this journal are not necessarily those of the editor, publisher or the editorial advisory board. Unsolicited manuscripts and photographs are welcome, though no liability can be accepted for any loss or damage, howsoever caused. No part of this publication may be reproduced in any form without the express permission of the editor or the publisher. Subscriptions The Dental Technician, Select Publisher Services Ltd, PO Box 6337, Bournemouth BH1 9EH

Extend your subscription by recommending a colleague There is a major change in CPD coming soon. The Dental Technician Magazine is a must read. Tell your colleagues to subscribe and if they do so we will extend your subscription for 3 months. The only condition is that they have not subscribed to the magazine for more than 12 months. Just ask them to call the Subscriptions Hotline. With four colleagues registered that means your subscription would be extended for a year free of charge. At only £39.95 per year, for UK residents, this must be the cheapest way of keeping up to date. Help your colleagues to keep up to date as well. Ask them to call the subscriptions Hotline on 01202 586 848 now.

Welcome Welcome from the editor

Dental Technology CANDULOR - New Xplex - the double maker

Marketing Marketing Simplified. By Jan Clarke

Insight From the archives The psychology of the smile. By Matteo Neroni Challenges, technology and other pandemic musings. Prestige Dental

8-9 22-23 24

Technicians Insight 5 things I cannot work without! Matt Norie

Digital Technology Dentsply Sirona - Primescan

Health & Wellbeing The importance of posture. By Katie Bell

Focus Dental Laboratory Software: Transactor Evident Lab Software - Fully digitising our lab. By John Bevan

16-17 20-21

ECPD Free Verifiable ECPD & ECPD questions

26-27

Business The ‘Cocktail’ Effect - What is Your Leadership Style? By Nicki Rowland Redundancy - a new reality during the pandemic. By Rhian Scott Having a vision for your team. By Ashley Byrne An interview with... WHW

28-29 30 31 32-33, 34

Digital Dentistry Our journey into digital dentistry. By Ross Chapman

35-36

Marketplace Shofu - EyeSpecial Zirkonzahn - Shade guide

37 38

Classifieds

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WELCOME

Welcome

TO YOUR NOVEMBER 2020 ISSUE By Matt Everatt F.O.T.A I Editor

elcome to your November edition of The Dental Technician Magazine. I am writing this welcome message whilst sat in a hotel in Norfolk during a quick half term break with the family. It’s crazy to think that we were making holiday decisions based on what Covid tier we lived in and what tier to travel to! As I sit here in Norfolk I can reflect on a couple of lovely days where we have pretty much done the usual family stuff and have not massively been effected by Covid restrictions. Yes, we had to do the annoying 'pop your face mask on to walk 10 paces to your table', which to me seems totally pointless, we obliged. Otherwise it's been a nice few days away, and I didn't quite realise how the change of scenery alone has such a positive impact on us all. I've had time away from emails and work related phone calls, well, mostly! I've watched the kids laugh and play and I've held my wife's hand whilst walking about, without the constant interruption of work calls. It was so needed. Back to business so to speak... November is a time where we are usually thinking of work Christmas parties and when to announce our Christmas turn around and closing times. I don't doubt this is very different for everyone this year. I do hope that business is returning to normal levels for more labs now, I know the NHS practices are still not operating anywhere near the levels they previously did and, I am sure, will be effecting many labs and techs. It is almost a daily, definitely weekly occurrence where I am referring friends or family to a private dentist because they can't get in to their own NHS Dentist. I do think it will all level out and we will see more private cases filtering through for everyone. I would love to hear from any of you about how you are recovering, good, bad and the ugly, please do get in touch and let us know what is going on in your world. How are you all finding the magazine? We have received some incredibly positive feedback from many of you and it is very encouraging that lots of the dental lab suppliers are also noticing our magazine again. This is great news, as I am sure

you are aware, without advertisers we wouldn't be able to survive. My aim is to ensure we far out way the advertising with quality features and articles. Without your contributions we have no magazine. I want to thank all of you who have so kindly provided content in previous issues and would urge more of you to get involved. I am no writer, I would never have anticipated becoming an editor of a magazine. I did find writing a technical article and getting feedback was incredibly rewarding though. Please do get in touch, if you need any help putting something together we can certainly help. I am always looking for more techs to take part in the features too, I personally love the '5 Thing's I cannot work without'. This month I went to one of my own team members Matt Norie. It was really enlightening to read his top 5. Despite working together for well over 15 years his top 5 was fantastic to read. If you would like to take part in this feature, please do drop me an email. It is a great opportunity to really think about what is important to your working day. Matt had named a company rep as one of his top 5 Things he couldn't work without, how fantastic is that and what a great way to give positive feedback to the company rep too.

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For now, I shall bid you farewell and I hope you enjoy this month’s articles as much as I do. I have loved Ashley Byrnes articles over the last few months. His leadership style, business mind and passion is very much in line with mime and I have picked up some real gems from Ashley's wise words. So, if you missed those, I would urge everyone to go back and read the last two previous editions. I hope to hear from more of you and do hope that our labs are getting back to a more normal path. I look forward to the day when we can get back to meeting more of our colleagues and peers face to face, I never thought I would say this, I look forward to treading the walkways of the NEC and ExCel again! Wishing you all a fantastic November, go well, enjoy these autumnal days. It’s easy to get drawn into the darkness of these dark winter months, I always try to think of the new start that follows autumn. The leaves falling is a reminder that we can shed those things that have been a burden and start a fresh. I look forward to December and to see how creative we can be in the lead up to Christmas, I particularly want to see how creative we can all get with organising our Christmas works parties!

DENTAL TECHNOLOGY

CANDULOR - NEW. XPLEX THE DOUBLE MAKER Zurich, October 2020: CANDULOR AG launches new HIGH-IMPACT resin with a polymer for dual use

PLEX is a dual use high impact modified hot and cold polymer for dentures. Product perfor-mance such as, for example, impact resistance meets the requirements of the EN ISO 20795-1 standard. The highimpact modification improves the physical properties of the mate-rial and thus offers high fracture strength. THE 2 IN 1 POLYMER. The new polymer is suitable for cold and hot polymerization. Whether mixing or applying, the choice of HOT or COLD processing, is governed by the respective HOT or COLD monomer component. ONE SYSTEM. NUMEROUS ADVANTAGES. The laboratory has the option of responding to the different preferences of the technicians, who are free to choose the method of completion. Whether packing, pressing or pouring, the different processing methods are covered within the system. COLD or HOT – XPLEX is a system with only three components. This enables optimized stock keeping and limits the source of errors. Corrections and repairs can be performed with XPLEX COLD within the system. Furthermore, the resin meets the standard requirements of customers: easy to dose, bubble-free workpieces, low discoloration and plaque adhesion, good polishability as well as a good bond to denture teeth. COLD PROCESSING

HOT PROCESSING

• Full dentures

• Partial dentures

• Combined dentures

• Implant prosthetics

• Repairs

PROCESSING The extended processing time was one of the most important aspects during development, to ensure that the technician feels comfortable with processing and is not put under stress.

LEGENDARY SHADES The CANDULOR shades for denture resins are legendary and set a standard in removable dentures. The original «Shade 34» semi-opaque denture resin has often been copied but nev-er surpassed. In addition to shade 34, the XPLEX portfolio includes the standard shades 1, 3 and 5 as well as the characterization shades 53, 55 and 57. FORMS OF DELIVERY (AS OF NOVEMEBER 2020) • XPLEX HOT Monomer 150 ml and 500 ml • XPLEX COLD Monomer 150 ml and 500 ml • XPLEX HOT/COLD Polymer 100 g (shades

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34, 53, 55 and 57) and 500 g (shades 1, 3, 5 and 34) • XPLEX TRIAL KIT (100 g polymer in shade 34, 150 ml HOT Monomer, 150 ml COLD Monomer) • Pack of 6 XPLEX HOT/COLD Polymer 500 g (shades 1, 3, 5 and 34) CANDULOR AG Boulevard Lilienthal 8 CH-8152 Glattpark (Opfikon) Tel: +41 (0)44 805 90 00 Fax: +41 (0)44 805 90 90 W: www.candulor.com E: candulor@candulor.ch

MARKETING

JAN CLARKE BDS FDSRCPS l Jan qualified as a dentist in 1988 and worked in the hospital service and then general practice. She was a practice owner for 17 years and worked as an Advisor with Denplan. Jan now works helping dental businesses with their marketing and business strategy and heads up the Social Media Academy at Rose & Co. Web: www.roseand.co Email: jan@roseand.co Facebook: Jan ClarkeTaplin Twitter: @JanetLClarke Instagram: janlclarkeacademy LinkedIn: Jan Clarke BDS FDSRCPS

THE COMPETITION

s we continue to navigate through this post Covid era and through a second wave, are we seeing any more dentistry being carried out and what about technical work? It does seem more dentistry is being carried out with fallow times reducing but what type of work is it? Are you managing to attract new work or is it still feeling harder and harder? Do you know what your competitors are doing? Are you checking their prices and considering dropping yours? Do you keep a track on what your competitors are up to? Perhaps you even obsess over it? Yes? If you do, you are definitely not on your own, it is a huge problem, but why? Having a grip on the trends in your market is good, especially at the moment, but being overly obsessed with your competitor’s activity is both unhealthy and counter productive. It would be easy to compete on price and just drop your prices but how long could you sustain that realistically? Isn’t that just a race to the bottom? UNDERSTANDING YOUR “PURPLE COW” Seth Godin, who is a world famous marketer and one I would recommend following for his superb blog, has also written several books, one being “Purple Cow: Transform Your Business by Being Remarkable”. If you haven’t read it I would recommend buying this, it is a quick read, a very short book, but wholly transformative when it comes to marketing your business. I make no apologies for repeating this definition of marketing that I feel explains the modern dilemma. “Marketing is everything a company does, from how they answer the phone, how quickly and effectively they respond to

email, to how they handle accounts payable, to how they treat their employees and customers. Done right, marketing integrates a great product or service with PR, sales, advertising, new media, personal contact. In other words, marketing is not a discipline or an activity - it is everything a company is - at least if the company wants to be successful.” B.L. Ochman President, What’s Next.

Marketing is everything you do in your business, from how you answer the phones, how your delivery drivers behave to how you treat your customers, how your team interact with each other, your Facebook page and so on. Many confuse marketing with advertising and whilst advertising is an aspect of marketing, marketing itself is so much more. I do believe that during difficult times being true to your business model and having a strong brand identity are even more important. It is very easy to see what everyone else is doing and jump on the bandwagon, not so easy to stand by your own business ideals and value proposition. Seth Godin’s book talks about your business being remarkable, having your own “Purple Cow”, whatever that is for you. Being remarkable doesn’t necessarily cost much nor does it need a large budget but it does need focus on your team, systems and procedures to ensure you are producing and delivering the best service you can. Being remarkable and understanding what your “Purple Cow” is, allows you to be different, stand out from the crowd and disrupts the marketplace. I personally feel smaller businesses have an advantage

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over larger ones in that they can control their systems, services and customer service much easier than larger companies. They can be remarkable and stand out from the crowd. You do need to put the fear aside and not follow the crowd. Be certain about who you are, what your business is about, your “Why?” Once certain about this everything else will follow, there is no need to check in with the competition and follow what they do obsessively, indeed you will become the business that others follow and look to. THE PLAN • Know and understand your “Why?” • Communicate this to your team. • Decide as a team the areas that require more work. • Do listen to your team and disrupt the status quo, allow things to be carried out differently. • Encourage those team members that do not embrace change and help by showing good leadership skills to help them change. • Agree what your “Purple Cow” is and start to be remarkable. “Being Remarkable” is a great marketing tactic and once you understand how you can be remarkable, marketing your business will become easier. Avoid a race to the bottom by concentrating on providing remarkable dental technical services that dentists rave about. I would encourage you all to be yourself, let others see who you are, face the fear and be different, don’t follow the crowd. Be so remarkable that the crowd follows you! All the best. I wish you all the best during this difficult period of transition and as usual should any of you require a face to face chat via Zoom with some pointers for your marketing I am more than happy to offer these free of charge, please just email and I will set up a call.

BAR HEADER

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INSIGHT

From the archives

LOOKING BACK AT THE 1980’S: HAND PROSTHESES

By Chris Maryan

In the early 1980s I was a Senior Chief Maxillofacial Technologist at Fulwood Hospital, Sheffield and had a patient referred to me for a prosthetic hand. The patient was in her early teens and a congenital issue of constriction bands in one hand. This meant the palm was foreshortened and each fingers was similar to a little toe. She was very conscious of this and really wanted to wear gloves without fingers in, which was the fashion at the time. This was going to be the first case of a hand prosthesis I had ever made. I took impressions of each hand in alginate, using deep bowls to contain the alginate. These were then cast in dental stone. I decided to make a partial glove covering all the hand, leaving the thumb free with a wristband incorporating a Velcro fixing. I waxed up the whole hand as a mirror of the opposite hand, taking wax copies of her opposing fingers, then adapting them for the correct side, and cutting away the nails to allow for acrylic nails later. The skin texture was replicated using slight bead blasting and multiple strands of 0.35mm wire dragged across the surface and lightly flamed, (a tip I got from someone at Madame Tussauds), the wax up took ages. The fingers were positioned in a relaxed posture. At trial it was assessed for size. I made an acrylic cast of the defect hand using a pouring modelling acrylic, and polished it to a high lustre to ensure a smooth inner surface of the prosthesis. The trial was sealed to the acrylic mould leaving about 2 inches of the wrist exposed, a couple of short lengths of 3mm rod were positioned in the wax in the palm area to provide stops when packing the mold so the acrylic inner would be positioned correctly. The hand was flasked using a large maxillofacial flask 12 x 8 inches and each half about 4 inches deep. The flask, which was brass when full of stone is heavy and difficult to handle, particularly when you are trying to control the edges and possible undercuts like a very heavy and awkward partial denture flasking. It was then mold sealed and topped with stone. Boiling out was a challenge at

TOP: Cosmesil in the early 1980s BELOW LEFT: Mixing Cosmesil and a large flask, here for a full face prosthesis BELOW RIGHT: First prosthesis

that time we didn’t have a large boiling out machine so it was placed in a dustbin on a large catering electric hotplate (borrowed for the hospital kitchen) and covered with boiling water and kept on the boil for about 20 minutes. It was then gingerly opened up and the luckily soft wax was flushed out, although some fine plaster edges snapped off. When dry the plaster surfaces were sealed with an acrylic varnish. The prosthesis was packed with about 300 grams of Cosmesil silicone, this comes in a semi translucent base material. The kit came with a number of base skin shade pigments, masters colour pigments and various coloured flocking. At that time I used skin shades as a starting points and then adapted the colour to match the various tissue shades in a hand (later I just used blue red

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yellow and white master colours). The coloured silicone was then packed into the mold in the correct places gradually building up the overall colour, and sufficient material to fill the mold. When there was sufficient on the palm side the acrylic defect mold was positioned and the top of the flask packed and closed. It was pressed in a large maxillofacial press and luckily a small amount of flash came out. It was left for 24 hours to cure and carefully opened up, the silicone however acts like a glue between the two halves requiring considerable force to separate casuing parts of the mold to break, with prostheses the mold can often be reused to make additional prostheses or second attempts if the colour is not quite correct or there are voids due to under estimating the amount of material required.

INSIGHT It was trimmed with scissors and Moloplast trimmers, however trimming flash with this silicone can create a rough surface so careful flasking is essential. For that prosthesis I used commercially available false nails which were stuck on using a self curing silicone (similar to bathroom sealant but medical grade). Two sides of Velcro were added in the same way. The prosthesis was fitted and the patient was delighted although the Velcro method was very bulky. When reviewed she was happy with the prosthesis and was wearing it regularly. Although the hand was not functional she could experience some feel with them and the vibrations could be felt through the prosthesis fingers to her residual fingers. A couple of years later she was ready for a new one. We had done a lot of full and partial hands, and fingers for a variety of patients predominantly with traumatic injuries. Then I was working with Andy Richmond who was then a maxillofacial trainee (now Principal Prosthetist at the Queen Elizabeth Medical Centre, Nottingham) and Frank Johnson, Chief Maxillofacial Technologist (now Dr Frank Johnson, Consultant Anaplastologist at the Northern General Hospital, Sheffield). Our techniques had improved considerably reducing the time taken and greatly improving the results. At this time we used two litre lemonade bottles that we removed the top from to take the impression (three litre for large hands). The bottle was filled with water, the patient

inserted their hand to displace excess water which was then poured into a bucket to which about half a bag of a slower setting alginate was mixed in rapidly and then poured back into the bottle and the patients hand inserted. For the final prosthesis we looked around the hospital for someone with a similar sized hand, took and impression of theirs and slush molded it in wax and adapted it to a polished acrylic mold of the hand. We had dispensed with the Velcro retention and made a prosthesis that covered the whole hand, with the use of talc it could be put on easily.

layer. It was then sealed with Vaseline and the rest on the wax covered with further stone. When set it was then embedded on the flask in dental stone, smoothed and when set, sealed and topped, firstly with the Beta Durr and the with embedding stone. When set, grooves were cut into the stone all around the hand radiating outwards, this minimised flash thickness and allowed the mold to be opened easily. These techniques enabled to mold to be used multiple times. I later used this technique with dentures to reduce raised bites without trial closures, and it was particularly useful with fragile or complex partial dentures, and implant cases.

The nail beds were cut away as before. We now used a four-part mold, the palm section separate, the acrylic hand, and the top and bottom section. We now custom made our own flasks with wood so we could make any size we wanted as we were using longer wrist sections so it wouldn’t fit in the brass flask. We used beta Durr 700 vacuum mixed to cover the wax trail and the palm to a thickness of about 2cm. To get strong junction lines we used stiff silicone putty between the fingers (Coltoflex) which we trimmed it with a scalpel to our desired position about half way up the long axis of the finger to eliminate possible undercuts. and then around the rest of the wax trial prosthesis itself we used Plasticine which we had cut and rolled to create right angled edges to improve the strength of the mold and minimise flaking of stone edges.

We now had a large Drufomat so boiling out was much easier although all the inner shelves had to be taken out to fit the large molds. The packing was similar although we then used 5mm syringes to position silicone more finely where required, particularly useful for positioning veins.

The first mix added stone to the palm section which was smoothed ensuring no undercuts and with with locating grooves for the next

Now we would be using the Spectromatch electronic skin colour matching system, https://www.spectromatch.com and possibly scanning, single digits may be implant retained.

Second prosthesis

For the nails we now made our own, we had two techniques., one used a mixture of clear Orthoresin and Stellon tooth colours, the nail sections were built up staining the Orthoresin monomer acrylic colours, using white for the half moon then the bulk of the nail and finally the tip with clear monomer. Then other technique we used was building up with coloured self-cure acrylics and clear monomer. When cured the nails were trimmed buffed and adhered with one system silicone.

FURTHER READING Alison A, Mackinnon SE. Evaluation of digital prostheses. J Hand Surg [Am]. 1992 Sep;17(5):923-6. Beasley RW, de Beze GM. Prosthetic replacements for the thumb. Hand Clin. 1992 Feb;8(1):63-9. Bender LF. Prostheses for partial hand amputations. Prosthet Orthot Int. 1978 Apr;2(1):8-11. Leow ME, Pereira BP, Kour AK, Pho RW. Aesthetic lifelike finger and hand prostheses: prosthetic prescription and factors influencing choices. Ann Acad Med Singapore. 1997 Nov;26(6):834-9. Leow ME, Prosthetist C, Pho RW. Optimal circumference reduction of finger models for good prosthetic fit of a thimble-type prosthesis for distal finger amputations. J Rehabil Res Dev. 2001 Mar-Apr;38(2):273-9. O'Farrell DA, Montella BJ, Bahor JL, Levin LS. Longterm follow-up of 50 Duke silicone prosthetic fingers. J Hand Surg [Br]. 1996 Oct;21(5):696-700 Pereira BP, Kour AK, Leow EL, Pho RW. Benefits and use of digital prostheses. J Hand Surg [Am]. 1996 Mar;21(2):222-8. Pilley MJ, Quinton DN. Digital prostheses for single finger amputations J Hand Surg [Br]. 1999 Oct;24(5):539-41. Schmaman J, Carr L. Acrylic resin finger prosthesis J Hand Surg [Br]. 1992 Dec;17(6):673-4.. Williamson R. Implant retained prosthetic digits. Ann R Australas Coll Dent Surg. 2002 Oct;16:133

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TECHNICIANS INSIGHT

5 THINGS I CANNOT WORK WITHOUT! With Matt Norie LOTA As part of our regular feature ‘5 Things I Cannot Work Without’ we interviewed Matt Norie – Laboratory General Manager at S4S & Smilelign and he enlightened us with his 5 things. We hope you like this feature as it gives an insight into the working worlds of our technicians and gives us an idea of the things that help them daily in their jobs. 1 OUR TEAM At the top of my list, if I had to put this in some kind of order, is our team, I know it sounds a bit soppy but we are a family and we all work so great together. Teamwork is key in our lab and I can honestly say, if we didn’t have such great team, we wouldn’t be where we are today. There is a fantastic culture that exists in our lab from the owners, managers, team leaders and team members. 2 WHW PLASTICS - SUPPLIER I can honestly say without Andy from WHW, my life as a dental technician would be much harder. From finding the weird and wonderful materials or repairing equipment, I know I can always rely on Andy anytime day or night. I can send him a random text late on a Sunday night and he always replies. Amazing service.

3 PHOTOCENTRIC 3D PRINTERS I think we have all seen the change in our industry over the last 10 years and printing was always going to become a huge part in all labs. As we print nearly 60% of our work from scans now, reliability is the most important point from a printer that’s why I couldn’t be without our 3 Magna printers from Photocentric. I know I can rely on these machines. As with all technology, things can go wrong but it is the way Photocentric deal with the problem that makes them part of my top 5. 4 EVIDENT Our lab software can do great things, however for me, there is one thing that has improved our service no end. The simplicity and the ease of taking a phone call, being able to load the case on screen and to see the prescription within a few seconds add the relevant notes to the case for all to see, rather than hunting around the lab trying to find that job all whilst the dentist is on the line waiting. It has improved our customer service levels massively. 5 FORMECH VAC FORM UNIT This unit plays a huge part in our lab! Together with the team at Formech, we redesigned this unit to house 9 blanks from 0.8mm to 6mm thick, all with individual heating elements. We can form any material from 1mm EVA to 4MM dual laminate, it is truly an amazing piece of kit. The ease of use and the time saving makes this piece of equipment a must for any production lab. It has increased our efficiencies by being able to form 9 appliances all at once.

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

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DIGITAL TECHNOLOGY

STILL LEADING THE PACK: NEW STUDIES CONFIRM THE EXCEPTIONAL ACCURACY OF PRIMESCAN Dentsply Sirona presented the latest generation of its intraoral scanners at the beginning of last year. Primescan enables users to take a digital impression of the entire jaw with outstanding accuracy. This has been demonstrated by several international studies that support the extensive positive feedback on Primescan from various dental practices with clear scientific data. Charlotte/Bensheim, October 29th, 2020. Primescan, the latest generation of intraoral scanners, is designed for different digital workflows - in practice with CEREC as well as with the dental laboratory or other partners. Using the Connect software, a digital 3D model can be transferred directly to the laboratory of choice for further processing. Using high-resolution sensors and a short-wave light, a scan of the tooth surfaces is accurately captured. Up to one million 3D pixels per second are captured by Primescan, and these can be executed more reliable than ever using optical high-frequency contrast analysis. New studies confirm high performance of Primescan Primescan enables highly precise digital impressions to be taken over the entire jaw, as evidenced by a 2019 University of Zurich study.1 Recently, Primescan’s accuracy has been further demonstrated once again by national and international studies.3-5 The study of Dutton et al. demonstrates the versatility of the acquisition technology of Primescan, as it not only records natural and prepared tooth surfaces with high precision, but also captures materials used in dentistry with a high degree of accuracy across all substrates and for complete arch scanning.3 They further tested the effect of different substrates on the trueness and precision of eight different intraoral scanners. In 11 out of 15 categories, Primescan ranked number one, and for the remaining four categories, Primescan ranked among the top three.3 EXPERTS ONCE AGAIN CONFIRM: Digital impressions made with Primescan are, fast and accurate and easy to take.1-5

Dr. Alexander Völcker, Group Vice President at Dentsply Sirona CAD/CAM, sees promising prospects for digital impressions in dental and orthodontic practices.

Primescan’s impressive degree of precision in taking digital impression over the entire jaw1 continues. An in-vivo study done by the University of Gießen confirms the accuracy of digital and conventional full-arch impressions in patients, and results show that among the tested scanners, only Primescan showed no significant deviations to long-span accuracies obtained with conventional impressions.4 A study by Beijing University tested the precision of Primescan and two other intraoral scanners in edentulous jaws. The precision of Primescan was significantly better than the other two scanners for maxilla.5 In trueness of the three scanners, when scanning the maxilla and mandible, there was no significant difference.5 The results of the 2020 in vitro study by the University of Zurich showed that the preparation margin accuracy of Primescan was significantly better than the other intraoral scanning systems involved in the study in local accuracy for single-tooth preparations.2 Dentists like the fact that, with Primescan, it is possible to scan deep regions (up to 20 mm). This allows a digital impression even with subgingival or particularly deep preparations. Almost all tooth surfaces are captured, even when scanning from a very sharp angle. Our customers are our compass “The studies confirm again that, with Primescan, we have provided our customers

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with a high-quality technology that delivers truly impressive results," said Dr. Alexander Völcker, Group Vice President CAD/CAM at Dentsply Sirona. "We continue to add and improve workflows with Primescan as we’re convinced Primescan’s outstanding technology opens the doors for more applications in digital dentistry. Thanks to the technology of high-frequency contrast analysis, Primescan enables our customers to achieve outstanding accuracy in digital impression. And the extensive positive feedback from our respected experts and users all over the world, our most important compass, encourages us to continue to lead in this area’s development and innovation.” “As a dentist, my expectation of myself is to deliver exceptional results for every one of my patients.” said Dr. Carlos Repullo, a dentist from Seville, Spain. “And with Primescan I can do so: the scan delivers a precision that one can scarcely imagine being improved. And this also applies to a full jaw scan, which can be prepared exceptionally quickly. This is exactly the quality we need in our practices.” More information about Primescan at: www.dentsplysirona.com/primescan REFERENCES 1. Ender A, Zimmermann M, Mehl A. Accuracy of complete- and partial-arch impressions of actual intraoral scanning systems in-vitro. Int J Comput Dent 2019;22(1):11-19. 2. Zimmermann M, Ender A, Mehl A. Local accuracy of actual intraoral scanning systems for single-tooth preparations in vitro. J Am Dent Assoc 2020;151(2):127-135 (doi.org/10.1016/j. adaj.2019.10.022). 3. Dutton E, Ludlow M, Mennito A et al. The effect different substrates have on the trueness and precision of eight different intraoral scanners. J Esthet Restor Dent 2020;32(2):204-218 (doi: 10.1111/jerd.12528. Epub 2019, Sep 30). 4. Schmidt A, Klussmann L, Wöstmann B, Schlenz MA. Accuracy of Digital and Conventional Full-Arch Impressions in Patients: An Update. J Clin Med 2020;9(3):688 (doi: 10.3390/jcm9030688). 5. Cao Y, Chen JK, Deng KH et al. [Accuracy of Three Intraoral Scans for Primary Impressions of Edentulous Jaws.] Beijing Da Xue Xue Bao Yi Xue Ban 2020;52(1):129-137.

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By Katie Bell I Physiotherapist

s a Physiotherapist working with a wide range of client occupations, from the sporty student, to the sedentary desk worker, or the exercise crazed retiree, one common theme of conversation in my consultations is always POSTURE. Posture is such an important topic because it relates closely with the common daily aches and pains of daily life! And I’m sure you can sympathise with this all too well... whether that be from the increased recent sedentary lifestyle or the occupational postural hazards from prolonged sitting as you return to work. On that note, I reminisce back to my University days. We used to have Dental students and technicians come into the Physiotherapy centre to act as postural assessment models, as the incidence of lower back pain was so common in these students! So, it’s only right that we address this postural conundrum today. So, what can you do as a dental technician to help avoid these postural aches and pains? “SIT UP STRAIGHT” – TIME TO RE-EVALUATE?

Despite common posture beliefs, there is no strong evidence that one optimal posture exists or that avoiding ‘incorrect’ postures will prevent back pain. It is completely safe to adopt more comfortable postures, even exploring those frequently avoided ones. Changing habitual postures may actually provide symptomatic relief! Frequently changing postures is a helpful technique to reduce the gradual build-up of postural aches as we pass through the working day.

IS SITTING DAMAGING MY BACK?

Sitting down for more than 30 minutes in one position is not dangerous. However, moving and changing positions can be helpful, and being physically active is very important for your health. Therefore, it is not the posture you are in that is causing your postural aches and pains, it is the amount of time you are in for without moving and changing positions. Having a minute or two every 30 minutes to stretch the legs, touch the toes five times and shake out is a great way to reset the postural clock to reduce the build-up of those postural aches and pains. STRENGTHEN YOUR POSTURAL MUSCLES

Do you know what the greatest endurance activity of all time is? Not cycling, not running... but sitting! When we sit for extended periods of time, the postural muscles in our

body are working overtime to keep ourselves sat upright. As with any endurance activity, lactic acid and other waste products build up in these muscles and contribute to the gradual build-up of postural aches and pains. However, the stronger our postural muscles are, the more able they can cope with the demands we place upon them, such as sitting for extended periods of time with little movement! DOES PILATES WORK MY POSTURAL MUSCLES?

Pilates is a brilliant form of strengthening exercise which focuses on all the important postural muscles of the body, with the added benefit of improvements in mobility, flexibility and balance. We have many desk based and sedentary workers on our Pilates memberships who feedback amazing benefits with regards to their postural aches and pains. We are running a full online Pilates schedule which includes Live and Pre-Recorded classes and we have some complimentary sessions running in September. Feel free to check out our Online & F2F Pilates Class Timetable at : https://katiebellphysio.com/ class-timetable/#tmup=/w519706/ p/519706-katie-bell-physiotherapy/%23!week-2020-09-01 If you are interested in joining in for a FREE ONE WEEK ONLINE TRIAL, just email hello@katiebellphysio.com and we will send you the list of options!

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FOCUS

DENTAL LABORATORY SOFTWARE:

TRANSACTOR Two users give an overview of Transactor Software in their labs.

Monthly statements are relatively easy to produce and they either print or email. There's lots to like about Transactor, and for the price £48 per month you get a neat, easy to use, fairly intuitive package. There are niggles though, for example, when inputting a new job it would be great if it would flag up that it might be a repeat name. If a case has been put 'on hold' for some reason, and when the case reappears if that isn't noticed you end up with a duplicate entry. Easy to fix but annoying. Or having to manually remove statements with a zero balance, that are only produced because there was activity on the account that month, ie a payment. We have looked at other programs on many occasions over the years, as a program with scheduling ability would be ideal, but have never found one that fitted our requirements and was value for money.

DARYL TYLER OF TYLER CROWN AND BRIDGE LTD

We've used Transactor for 15 years. It's primarily an accounting program, it doesn't have the ability to track work as it moves through its production process. It is a locally based program with the ability to back up locally or onto the cloud. It is a single computer license, extra terminals would require further licences. It allows work to be booked into the lab and then booked out, with the ability to produce both invoices and patient statements. (these can either be printed or emailed to the client). So it allows you to know what jobs you have in the lab and when you have scheduled them to leave but not where they are in the process. Documents can be attached to each job, ie photographs, but these make the database so large that backup becomes a problem. Notes can be added to each job and a daily 'outgoing' sheet with notes produced.

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FOCUS

SEAN WARD OF ECHO DENTAL SOLUTIONS

When I first started my lab just over 6 years ago I thought “Lab Software? me? Not for me, I’m not big enough, I only have a few clients so keeping track of the work will be ok.” How wrong could I be? Well very wrong and its only taken me 6 years to find out. Initially I had a book and I put the dentists name, patient name and appliance being made. As a prosthetics lab I have multi stage jobs in the main but my clients were very good at letting me know if patients weren’t coming back or if there was a delay so I really didn’t have to worry about having “lost work”. I managed to get a free accounting software package for my invoicing and I was flying. That is until my accountant asked me about my workflow and how I was spending money for them to sort my books out. My first go at organizing my work was to get Quickbooks. I was happy with my booking in and out system after all it hadn’t let me down (yet). Quickbooks was a godsend easy to use easy to keep track of my bills and relatively easy to invoice my clients, email set up, reminders, quotes and guestimates could be easily done. As I got busier I started to lose track of some of my work so I looked into getting some sort of lab based software. I didn’t need much I thought as I have quickbooks so just need a booking system….. I had tried Transactor before but I was so busy I didn’t really move forward with it at the time but when I saw it on offer from WHW I decided time was right to stop writing things in a big black book and join the 21St century. To be honest I haven’t looked back I found it so easy to set up as I made myself sit down on a Saturday morning and actually learn how to do it. Not bad for a dental tech as we usually get the instructions out after something has gone wrong. I set up my company just following the Wizard and added my first few clients and codes for different work stages and appliances. Its geared up for a large lab as much as a small one so allocations can be made to departments and or specific technicians. It tells you if your closed so you cant book work for those days (Saturdays and Sunday) though you can over ride this if necessary. The hardest part for me was thinking up the codes for the work I mean ST and BB are easy ( special tray and bite block ) but its when it comes to implant screw retained crown etc but you just get used to adding them and thinking up codes.

Booking in is easy when your used to it, though my assistant is a lot quicker at it than I am. You have selectable price bands and even an option to offer discounts if your stupid. Invoices are raised when a job is booked out finished and can be either sent by email, printed or both. I tend to just wait till the end of the month and send then all at once so saving paper for each one as you will get a months worth on a couple of sheets of A4 What I really like is I get to print the patient statement off in A5 so it’s a handy size for the patient. As part of the setup process you can put your logo onto anything you send out you can do mail shots, job cards, delivery routes. Loads of stuff that I don’t use myself but larger labs would benefit from. Whenever ive had a problem I find the help screens very informative but also the helpdesk staff are very good also. A drawback I think is I have a license for 1 user unfortunately this means 1 computer so I have to carry my laptop home if Im working there and back to work when I go in.

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It would be useful to be able to have this cloud based also so I could access this info easier. Im not sure how this would work for a large lab who were responsible for their own departments as it would save loads of time if different dept could access the system as they complete a job and then that would save admin having to book out everything themselves including adding notes that the tech may need added to each case file. On the whole a great system for me. I don’t utilize every aspect of this but I can see it being very useful for a medium sized lab. Cloud based support and multi user availability for the “one” company would be good. Sean ward owns and runs Echo Dental Solutions in Montrose, Scotland. They are a small lab with just 3 employees currently serving the greater Angus and Tayside area. Originally training as an engineer in HM Forces, sean went on to study Dental Technology in Newcastle. On qualifying he has worked in medium sized labs in the north east of England and also in Scotland where he has also worked on a large research project at Dundee Dental Hospital and School.

FOCUS

EVIDENT LAB

SOFTWARE

FULLY DIGITISING OUR LAB By John Bevan General Manager Commercial - S4S Dental Lab

t S4S we were always keen to be ahead of the bell curve in terms of being first to try out new technology. Our journey into the digital world started in 2005 when we looked in to digitising our plaster room. We knew digital was the future of dentistry and as a lab we knew we could be more efficient by going digital in all areas. The next stage was to digitise paperwork, this avoided trips to the basement looking through dusty old archives if we ever got questions about previous cases or looking at old purchase orders or invoices. We started out using Quickbooks for our booking in and out of cases, our commercial director Neil Bullement had a significant amount of experience with Quickbooks and with my previous knowledge we managed to use Quickbooks successfully until 2019. Due to our client base creeping up to as many as 10,000 customers, Quickbooks began creaking at the seams. We had as many as 30 staff at any one time accessing the accounts data. Our directors and marketing team were wanting to have a more sophisticated and easier way of generating reports and tracking customer buying journeys. Whilst our laboratory manager and his team wanted a better way to run the laboratory and have software help with scheduling and work tracking. Our research continued up to the official launch of Evident on 1st October 2019. This took us on a journey all across the world ending up in Canada. Well, initially it took us to Ripon to see Steven Campbell at Nexus Dental Laboratory in 2017. He showed us how he had implemented Evident into his lab and how it had helped his workflow.

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FOCUS We trialled a large number of software options and found that the majority of these had limitations. They could manage production but then would not offer cloud storage or vice versa. We realised very quickly that implementing a brand new piece of software and system of this complexity would require a lot of planning and it would not happen overnight. This was mainly due to the size of our customer and product file and that we were creating as many as 1000 transactions per day. EVIDENT TICKED ALL THE BOXES AND NOW OFFERS OUR CLIENTS: • Unlimited ‘cloud based’ storage of 3D study models • Customer gateway where customers can upload files, view active or past cases, make payments, print copy invoices and much more • Full lab traceability (showing exactly where a case is currently in the lab or where it has been) • Barcoded processing of stages and work completion • Production planning • Measure return rates • Monitor productivity

Following our integration with Evident we are truly ‘fully digital’. Each technician has a tablet or PC on their workstation where they can access all paperwork for a case. This is

system for our lab. The production planning allows us to see how many staff hours we have in relation to the amount of work we have in, this is so important when you are managing the work of 60 or more team members including technicians and digital administrators.

made possible by clients paperwork and records being photographed by the administrator on arrival. This really helps when a clients phones up to discuss a case the moment it is booked in. The biggest test has been Coronavirus. During lockdown, the Evident software enabled us to continue to be able to support our clients from home, or anywhere with an internet connection. It has also helped by allowing staff to work from home. Digital models can now be prepared from anywhere in the world, starting the moment a case becomes live on Evident. There is a lot of work that must be done in order to set up Evident correctly. However, the more you put in the more you get out. Although there are simpler systems to implement, we found that Evident provided much more functionality and options to provide a bespoke

We have included a barcoding system, every team member can use a scanner to access the cases details within the click of the scanner trigger. When each case is booked in on Evident we are able to attach a digital photograph of the prescription, attach any files such as STLs to the case and any case specific notes for the technicians or administration staff. From a marketing and customer service point of view, we have just started to use the in built CRM to help us track the customer journey and manage our sales funnel and marketing much better. For our directors and management team, there is access to unlimited reports for accounting and performance analysis. We are delighted with Evident, it has been a long journey to get to where we are today, the team at Evident and particularly Derek, have been amazing in helping us get the most out of the software. They have created many bespoke elements of the software to suit our needs and they are always keen to improve the software.

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INSIGHT

THE PSYCHOLOGY OF THE SMILE By Matteo Neroni

he strength of a smile is immense, living with a smile is self-esteem, willpower, the will to live away the risk of depression.

DENTISTRY = PSYCHOLOGY

A rigid concept of beauty centered on universally established canons has little reason to exist in a world where physical diversity is king; feeling good about ourselves is fundamental, and our judgment of ourselves should not be influenced by others. However, it must be said that some aspects of our body, if properly cared for, are able to significantly increase the level of self-esteem and simplify the process of interrelation with others. Going deeper into the question, we cannot fail to highlight the role that a beautiful smile assumes in everyday relationships. Whoever smiles at his neighbor, launches a bodily message at that exact moment, and it is an extraordinary method to communicate not only with the people who are closest to us such as our family members, but also with people who are distant to us by language and geographical origin. We could say that a smile can break down many barriers, and indeed it is! The care of the smile and facial expressions is important from a psycho-sociological point of view! Our face is a business card that we show to others, and facial expressions are an integral part of the interpersonal communication process; being able to freely show our smile greatly facilitates the expression of our feelings and helps us to open up more easily with others.

Those who fail to do this are because they often find themselves having a bad relationship with their smile (the causes can be various, from a dentition that is not perfectly aligned, to a color that is not very white, up to the lack of some teeth for reasons that can be traced back to to external trauma or disease). Whatever the cause, if you live with obstacles that help keep your smile hidden, you risk having serious difficulties in relating to others, and this can become a particularly disabling problem on a sociological level. The difficulties that negatively affect during socialization do not arise out of nowhere, but they are a problem that we easily become aware of (it is sufficient to look in the mirror and immediately see if our reflected image satisfies us) and that can affect our way of behaving (yes smiles on rare occasions, one tends to hide one's mouth, one has less propensity to entertain social relations). It is

Who knows how to laugh “ is the master of the world” Giacomo Leopardi 22

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clear, therefore, that the care of a smile cannot be declined to a simple habit, but takes on a psycho-sociological role in all respects.

SMILE = SELF-ESTEEM

The benefits that a smile brings to our body are numerous. Smiling positively affects our mental health! Laughter contributes to the production of endorphins, which produce greater physical relaxation and a greater feeling of serenity. The smile leads to improving our mental attitude towards the people with whom we relate and helps to face the day with the right attitude (it will only be a matter of appearance, but according to many, those who have a beautiful smile appear to most as a person sure of himself, interesting, pleasant and in control of his means; it is clear that from appearing to practice there is a lot of it!). A visit with an expert in dental aesthetics allows us to identify the problems that weaken us in the relationship we have with our smile every day. It will then be up to the dentist to identify the most suitable intervention for our case. In this edition I do not want to dwell on the practical-technical aspect of the realization of the case. But I will direct myself to a very short roundup of photos, aimed at illustrating the process and the classic protocols I used,

INSIGHT which were the protagonists in the old editions of The Dental Technician Magazine. This is a case that I particularly care about. The realization of it happened thanks to a mix of humanity, coincidences, and luck. This gentleman knocked on my door one morning asking me to help him because he could not chew, after a quick look at the oral cavity, I immediately understood that it was to be seen by a clinician. With extreme dignity and shyness he asked me to add two teeth to his partial denture. Given the critical condition of his partial prosthesis, worn out due to years of poor hygiene and care of the prosthetic device, it was impossible for me to satisfy this gentleman's request. Trusting me that he would be repaid, with a small monthly sum. Personally I am a technician who loves what he does extremely well, and I realized almost immediately that a dignified rehabilitation would be impossible for him to achieve, economically speaking. At this point I contacted Dr. Alampi Paolo, a specialist surgeon with whom I collaborate, presenting the case. As I imagined, the doctor accepted this situation with extreme delicacy and ethics, giving me the consent to start my technical evaluations, which he would then finalize with a surgical intervention. Once the case assessments have been made, everything Dr. Alampi Paolo needed is planned and yet another Clinical-Technical comparison.

At this point, having discussed the way to go, I digitally prepared everything that Dr. Alampi needed to start his surgery. The photographic documentation of the intervention has not been reported in this edition, because I wanted that the topic to be treated was focused only on the topic of the importance of "BEING ABLE TO DO WHEN THERE ARE THE POSSIBILITIES ". The phrase I quoted at the beginning of the article is from a very important Italian philosopher poet, named, Giacomo Leopardi. Its meaning is extremely clear, direct, precise, and this case is the perfect example. Leopardi said: "Who knows how to laugh is the master of the world". This phrase certainly born in a historical period not too prone to dental hygiene, contains in it the fundamental fulcrum of human psychology, that is, knowing how to face life! And the smile is the greatest weapon that mankind possesses, the mirror of the soul, into which all our frustrations, insecurities, uncertainties, shyness pour. Try to imagine at the time of our poet how difficult it could be to smile, the problems and mental blocks that afflict the world population now are the same ones that afflicted the Egyptians, the Romans, up to us. With one difference, that we are able to alleviate that suffering, that shyness, that shame that afflicts those who cannot smile, because society itself leads them not to.

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I and my team like to define ourselves as a little creators of happiness, the feeling you get is indescribable, seeing the patient make his first smile, after years of uncertainty, it's a bit like giving birth, he gives himself back to light a small part of the soul, which had curled up, waiting for help. We with our profession are able and have the duty to provide this help, paid, unpaid, it doesn't matter! This is the power of "BEING ABLE TO DO". I was not born as a dental technician, I can say that I almost happened to be there by chance. My first job was for a disabled boy to whom I had to get my first prosthesis. The magic happened there, I fell in love there, not with my profession, but with happiness in seeing the smile of that boy refracted in that mirror. A unique emotion, and I am extremely proud to say that I relive it with every single patient of mine, it never fades. I have them all in my head, and pay attention if you understand what I mean, pay attention to them because for our job, the search for this feeling is the keystone, for the success of the work. Once again thanks to Dr. Alampi Paolo and his team, who helped me make a big boy smile again who hadn't smiled for 50 years!

INSIGHT

CHALLENGES, TECHNOLOGY AND OTHER PANDEMIC MUSINGS

t the risk of parroting the usual pandemic terminology, the changes we have all had to face in these uncertain times continue to be challenging. However ‘challenging’ is not all bad. For those of us still craving the good old days of ‘personal service’ and other things like letter writing and family time, there has been good news. Plentiful examples exist of good Samaritans, helping neighbours, young children writing to residents in care homes, befriending strangers and gaining that all important commodity ‘time’, time to do things together as a family. And this against a back drop of a beautiful spring and hot summer encouraging outdoor explorations and discoveries often on your own doorstep. All in all, an unprecedented period, certainly in my lifetime. But here we are approaching Christmas with dark nights, colder weather and more lockdowns. Businesses continue to struggle, many people are out of work or still work from home and still no clear path indicating a way out of this situation. One of the stand outs in all this, is technology and the digital focus that the new order of life has had to take up. How else would we have been able to order our shopping, work out with Joe Wicks, found that new route for a walk, kept in touch with colleagues, customers, friends, family and been able to work from home? Businesses in particular have had to re-visit how they operate and making full use of the platforms available has become crucial. Whether it’s to provide information or advice, promote products or provide offers, or just to maintain contact, the list where technology continues to play an essential part is endless. The learning curve for some has been steep but if my 93 year old Mum can - with a little help - hold a Zoom call there is hope for even the most neanderthal of us! From the use of social media and all that entails, to the upgrading of the company website the last few months has certainly been educational. Here at Prestige, taking photos for social media postings has become second nature, filming little videos or should I say ‘vox pops’ are now scheduled into our work timetable and the addition of more interesting material to our website is a constant. We’re developing new areas on the site such as a section for dental learning where we aim to

provide opportunity for each organisation/ KOL we work alongside, to showcase their course offerings. We continue to upgrade the Resources Library with useful product details and how to care for and work with equipment, whilst connecting informative videos with each relevant product is ongoing. Using this time to learn has also prompted a rise in the webinar and we are grateful for the increasingly sophisticated material now made available by our trade colleagues. A recent online exclusive offered between Prestige and Rhein83 on Advanced Prosthetic Restorations created so much interest that a second opportunity has now been scheduled to accommodate everyone.

So where does all this leave us? Certainly not out of the woods, but at Prestige we remain positive for the future. We’ve refocused on our business and customer needs which meant taking some tough decisions. In order to adapt to the new normal, we continue to embrace technology and connect with industry colleagues, emerging leaner and hopefully fitter to meet whatever the coming months may bring, head on. PRESTIGE DENTAL W: www.prestige-dental.co.uk Social Media: @PrestigeDental T: 01274 721 567

BEST SOCIAL MEDIA PLATFORMS FOR BUSINESS 1. Facebook Though Mark Zuckerberg has gotten a lot of bad press over the last couple of years, there's no denying that he built the (overall) best social media platform for business currently available. 2. Instagram 3. Twitter (May 2020) 4. LinkedIn

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ECPD

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

4 HOURS VERIFIABLE ECPD 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 October DT Edition:

VERIFIABLE ECPD - NOVEMBER 2020 1. Your details First Name: .............................................. Last Name: ........................................................Title:................ Address:.............................................................................................................................................................. ................................................................................................................................................................................ ............................................................................................................ Postcode:............................................... Telephone: ......................................................Email: .................................................. GDC No:.................. 2. Your answers. Tick the boxes you consider correct. It may be more than one. Question 1

Question 2

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Question 7

Question 8

Question 9

Question 10 Question 11

Question 12

Question 13

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Question 16

Q1.

Q2.

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Q7.

Q8.

As of April 2016 issue ECPD will carry a charge of £10.00. per month. Or an annual fee of £99.00 if paid in advance.

Q9.

You can submit your answers in the following ways:

Q10.

Q11.

1. 2.

Q12.

Q13.

Q14.

Q15.

Q16

3. Evaluation: Tell us how we are doing with your ECPD 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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ECPD

VERIFIABLE ECPD AS YOU NEED IT VIA THE DENTAL TECHNICIAN PAYMENT BY CHEQUE TO: The Dental Technician Magazine Limited. NatWest Sort Code 516135 A/C No 79790852 CANDULOR - NEW. XPLEX - THE DOUBLE MAKER Q1. XPLEX is a XXX use high impact modified hot and cold polymer for dentures? A - Combi B - Dual C - Solo D - Single

Q2. How many components does the XPLEX system have? A-2 B-3 C-4 D-5

Q8. What thickness was the beta Durr 700 vacuum mixed to cover the wax trail and the palm? A - 2cm B - 3cm C - 4cm D - 5cm

5 THINGS I CAN’T WORK WITHOUT MATT NORIE of S4S Dental Q9. What percentage of S4S’s work is printed using scans? A - 50% B - 60% C - 70% D - 80%

Q3. What was one of the most important aspects during development?

Q10. What has improved their customer service levels? A - Lab software B - Telephone system C - New scanner D - Vac form unit

LOOKING BACK AT THE 1980’s : HAND PROSTHESIS Q4. The skin texture was replicated using slight bead blasting and multiple strands of XXX wire dragged across the surface and lightly flamed?

DENTAL LABORATORY SOFTWARE : TRANSACTOR

A - Extended processing time B - Low discolouration C - Good polishability D - Good bond to dentures

A - 0.30mm B - 0.35mm C - 0.40mm D - 0.45mm

Q5. The hand was flasked using a large maxillofacial XXX? A - Flask B - Plaster C - Press D - Wire

Q6. The plaster surfaces were sealed with what? A - Tissue B - Silicone C - Wax D - Acrylic varnish Q7. How long was it left to cure? A - 12 hours B - 24 hours C - 48 hours D - 64 hours

Q11. How long has Daryl Tyler used Transactor software for? A - 5 years B - 10 years C - 15 years D - 20 years

Q12. Who handles the technical support for the software? A - WHW Plastics B - Zirkonzahn C - Transcator D - 3Shape Q13. How long did it take Sean Ward to invest in a lab management software? A - 2 years B - 4 years C - 6 years D - 8 years

THE PSYCHOLOGY OF THE SMILE? Q14. Laughter contributes to the production of what? A - Endorphins B - Energy C - Self-esteem D - Hormones

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AN INTERVIEW WITH SOME OF THE TEAM AT WHW

Q15. How many PPE visors did WHW produces during 2020? A - 40,000 B - 50,000 C - 60,000 D - 70,000

OUR JOURNEY INTO DIGITAL DENTISTRY - ROSS CHAPMAN

Q16 . What year did senior prosthetics technician with CAD experience join the company? A - 2017 B - 2018 C - 2019 D - 2020

You can submit your answers in the following ways: Via email: cpd@dentaltechnician.org.uk or 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.

BUSINESS

THE ‘COCKTAIL’ EFFECT - WHAT IS YOUR LEADERSHIP STYLE? IS YOUR COCKTAIL A DISASTER?

In this article, Nicki Rowland, Director of Practices Made Perfect and co-owner of The Exceptional Leadership Academy, explores different leadership styles and the ‘soft’ skills required to nurture a positive environment in the workplace.

Working as a team is no mean feat. Every day that we go into work we face hurdle after hurdle. Difficult customers, broken equipment, time constraints and health and safety issues are regular events that add to the pressures that our teams face on a daily basis. Add to the mixture a drop of tension, a sprinkling of criticism and a dash of attitude and you have a cocktail for disaster. Team members fall out, motivation is lost and resentment sets in. The foundations of your once ‘united front’ begin to shake. As leaders, it is our job to identify the most appropriate leadership style that ensures harmony, commitment and accountability in our businesses and that we are formulating the perfect cocktail. You may be asking yourself “Why is Nicki likening what can happen in the workplace with the making of a cocktail?” Well, read on and find out...

Shaken or stirred?

The quote “Shaken, not stirred” is synonymous with the fictional, film character James Bond when ordering his martinis. Shaken and stirred are two words that mean nearly the same thing. However, for bar tenders the terms carry great significance as shaking or stirring a cocktail can greatly alter the attributes of the drink. In a similar way, whether your team is ‘shaken’ or ‘stirred’ reflects on the style of leadership in your business and can significantly influence how individuals perform, react and behave. Let me explain. Shaken refers to a cocktail that has been prepared after the ingredients are placed in a metal cocktail shaker and shaken vigorously by the bartender. In a shaken cocktail, the temperature drops significantly as ice cubes melt and make the drink very cold and more dilute. Similarly, the ‘temperature’ of your culture can be directly affected by the way in which you choose to handle a situation. Go in wielding a big stick to shake things up and hackles will rise, nerves will fray and individuals will become decidedly frosty. Motivation and morale then take a nosedive and standards and performance are ‘diluted’ across the board.

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Molecules in a shaken drink are also more volatile and reactive. The shaking action energises the particles and they react with other ingredients more readily. In a similar way, ‘shaken’ team members are more reactive and their tolerance levels to stressful situations at work are greatly reduced. All it takes is a low key event to overfill their ‘highball’ glass and negative emotions will effervesce and overflow. Some people believe that shaken gin is bruised and loses its original flavour. Likewise, team members who have had their self-esteem battered by an autocratic leader can become stubborn, resistant and do not perform to the best of their ability at work. Stirred refers to a cocktail that has been prepared by placing the ingredients in a steel jar and then delicately mixing them using a spoon. This results in slower chilling of the beverage due to the more gentle nature of stirring. In turn, the ice cubes do not melt as quickly. The goal of a proper stirring technique is to do the exactly the opposite of shaking, i.e. avoiding aerating and agitating the drink. In business, the benefits of ‘stirring’ your team using a democratic leadership style are far reaching. A good leader will always takes the initiative and procures others to go the extra mile in order to achieve the task in question. A good splash of charisma is a key ingredient to inspiring others. Once you have their attention, you should be able to gain your team’s commitment to achieve other goals. With a democratic leadership style, you should be able to coordinate tasks well, delegate them accordingly and complete them ahead of schedule. If team members are ‘stirred’ steadily and smoothly, every individual will move in one direction at a constant pace (just like molecules in a liquid) and the results will be very appertising.

Is stirring a lost art?

I have noticed in both bars and businesses alike that STIRRING IS BECOMING A LOST ART. Everywhere I go, bar tenders seem to be shaking drinks, regardless of their contents. This is most unfortunate because a well stirred cocktail will have a certain texture that cannot be attained

BUSINESS by shaking. Similarly, on walking into businesses that I consult for, I witness varying leadership styles. The Covid-19 crisis has shaken up the management of organisations even further and I see 5 main leadership styles emerging. There are pros and cons to each approach so let us explore them in more detail: 1. Authoritarian Leadership - a leadership style that imposes expectations and determines outcomes. It is often a ‘one man show’ with the leader having a ‘it’s my way or the highway’ mind set. This can be advantageous if the leader is more knowledgeable than the team and needs to give clear guidelines. However, creativity will be sacrificed with limited input from the team and a synergistic, collaborative way of working is lost. Team members can become disenchanted and resentful and staff retention decreases.

5. Transformational leadership - the leader inspires their team with a vision and purpose that encourages and empowers them to achieve it. The leader ‘leads from the front’ and shows their team the way. They are a ’yardstick’. They make expectations of quality clear, live those expectations and have a zest for life. Transformational leaders get a complete buzz from seeing their team flourish and grow. Staff are then motivated, energised and driven to achieve and develop. The downside to this leadership approach is that standards are high and expectations are even higher. It requires constant work from the leader to sustain standards and keep their team buoyant.

Developing your own recipe

No leadership style is a stand-alone entity. It is important to recognise which leadership style is most appropriate in varying situations. You are unlikely to be a successful leader if you simply mimic one of the above styles. It is all about creating your own cocktail, your own flavour, your own brand. Leadership is not just a process of delivering a certain response at a given time. It is about using your natural leadership strengths in an authentic way to inspire and motivate others. Much like a cocktail, it is getting the right blend of ingredients to produce a delectable result. As, American author and screenwriter, Elsa Maxwell, once said “Cocktails are society’s most enduring invention”.

2. Participative Leadership - this approach is deep rooted in democratic theory. The essence is to engage team members in decisionmaking and encourage a cohesive way of working. The leader will generally have the last word but everyone has a voice that is heard. This leadership style increases motivation and job satisfaction and allows individuals to be innovative. The downside is that the decision-making process can take a great deal of time and productivity can reduce. 3. Delegative leadership - this can also be described as "laissez-faire leadership" where the style focuses heavily on delegation. This can be positive and very empowering for team members if they are competent, motivated and given the required time to complete tasks. However, disputes may arise when ‘command responsibility’ is not clearly defined. A team may then become divided and morale plummets. 4. Transactional leadership uses rewards, punishments and other transactions to get the job done. This ‘give and take’ style means that the leader sets rigid goals and team members are rewarded for their compliance. This approach focuses on following institutionalised regimes and procedures in an efficient manner, rather than driving change or improvement to an organisation. The upside is that results can be measured, team members know exactly what they have to do and that appropriate rewards (or penalties) will follow. However, it is a ‘managing with a big stick’ approach where empathy is lost and team members become subservient.

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BUSINESS

REDUNDANCY - A NEW REALITY DURING THE PANDEMIC By Rhian Scott I HR Consultant I RJS Business and HR Support

s COVID-19 continues to impact on all aspects of life, many companies across the country are now looking at how they can survive this pandemic and come out the other side ready to grow again. For many this means looking at ways to save costs and with ACAS reporting an increase of 160% in redundancy related calls between June and August alone, compared to the same period in 2019 I suspect this is a key area companies are considering.

So what actually is redundancy?

Redundancies are often looked at as a way of reducing numbers of employees, however, the legal definition relates to job roles and not people. Redundancy includes three types of situation: 1. Business closure 2. Workplace closure 3. A reduction in the workforce. Therefore, the dismissal of an employee will only be by reason of redundancy if it is wholly or mainly attributable to: 1. Ceasing or intending to cease to carry on the business for the purposes of which the employee was employed 2. Ceasing or intending to cease to carry on your business in the place where the employee was employed 3. Having a reduced requirement for employees to carry out work of a particular kind or to do so at the place where the employee was employed to work

Are there other options?

The answer to this is yes, absolutely and implementing a redundancy process should always be a last resort. Other alternative ways to save costs can include; • Reducing training budgets • Delaying planned pay rises • Furlough • Temporary lay-off or short term working • Reduced hours • Reduced pay • Re-deployment • Unpaid leave You should always consider asking your teams for their feedback on how costs can be saved throughout the business. They are the people who often know best and I’ve worked with many companies who have been surprised by the options they have available to them. A recent client discovered that the CRM they were paying for was not being used effectively yet still cost hundreds of pounds per annum. Further research by an employee and they identified a free option available to them. This one action alone meant that a team member who had been asked to reduce their hours was able to continue at their full time hours.

When there are no other options.

When all other options have been exhausted it is usually time to implement a redundancy procedure. Employers should establish a genuine business reason for the redundancy and demonstrate they considered alternative options. At this stage planning the process is key. Up to date advice and guidance can be found on the ACAS website or you can engage the services of an experienced HR Consultant to support you through the process from start to finish. If engaging with a consultant my top tip is to identify someone before the process starts. It is always harder to go back once a step has been missed and may lengthen the process costing you both time and money. The stages you must follow include; 1. Identify the pool of employees who are ‘at risk’ of redundancy and the selection criteria. 2. Hold an ‘at risk’ meeting with affected employees

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3. Initial Consultation (the consultation process depends on how many redundancies are proposed at one establishment.) 4. Scoring 5. Second Consultation meetings 6. Third Consultation meetings (if necessary) 7. Redundancy notice / alternative employment Ensure that all conversations are 2-way and meaningful giving those affect an opportunity to give their suggestions.

Risks

I am sometimes asked if following the full process is necessary. Usually this is because a company is trying to avoid ‘worrying’ a whole workforce. My advice around this is that unfortunately the redundancy process is a stressful and daunting situation and whilst we cannot avoid that, we can ensure we are fair and transparent throughout. The process allows for this at every stage. Employees may not like the situation but they will know you are ensuring you follow the correct legal procedure whilst trying to manage both their needs and the needs of the business. If a genuine redundancy situation arises, a failure to follow a fair process could result in an unfair dismissal claim, negative relations with the remaining employees and reputational damage. For these reasons it is essential you get the procedure right first time.

Personal

I have had the pleasure of working with a large dental laboratory for the last 12 months and recently supported them through this process. Sadly, we weren’t able to avoid there being some casualties but we did manage to reduce the number of roles at risk by 50% and we genuinely believe this was a direct consequence of following this process and identifying other options we hadn’t previously noted. If you would like to discuss any part of this article further or discuss how I may be able to support you with your HR requirements, I would be delighted to hear from you. E: Rhian@rjs-bs.co.uk

BUSINESS

HAVING A VISION TO DRIVE YOUR COMPANY AND MAKING A GREAT CUP OF TEA By Ashley Byrne I Owner at Byrnes Dental Lab

“

We are going to be the best lab out there - that’s my vision, so let’s do this!” It’s probably a phrase that a lot of businesses and lab owners have cheered to their teams. I cringe with the admission to you all that I’ve actually said that to my team in the past too. For any company to really go in a direction, it needs... well... direction. That direction should be a clearly marked out path with a strategy and plan to get there. The problem with most company owners is we either do not really know what the plan is, other than maybe to become bigger or more profitable; or if we do have a vision, we don’t really have a clearly marked out path to get there. If we go back to the basics, all companies need growth and development. A company that is static is going backwards (or at the very least, being left behind). Dental technology needs a progressive outlook now more than ever as we continue our digital and high tech manufacturing evolution. More capital investment, rising costs and an increasingly challenging market means we need a clear vision of that company growth. This was really made clear to me when I attended a Straumann business event with some fantastic motivating and growth experts. They called it ‘Painting the picture’ and it was a bit of an epiphany for me. The picture of growth should simply be where the company wants to be in 1 year, 3 years or even 5 years, but it must be a clear vision of what you want that company to be. The next stage is to work out how to actually get there. Let's say, for example, you wanted

to become 100% digital - what equipment do you need; what training; how do you work with digital clients; how do you market that service, price it and still turn a profit? Now this article is not about explaining how to do that. The vision and path is solely yours and there is no right or wrong vision, but this is part 3 of a series about the team and how to improve that in the lab.

the individuals. Each stage must be explained in steps, not huge leaps of faith, so no one can get lost on the course. It's also essential that the team understand that this is a team event. If one person wins and the others all come last, the team comes last. Dental technology isn’t for single heroes, it’s a team event and all the team need to have a 100% clear understanding of that.

So back to my cheer of “We are going to be the best lab out there”... on reflection, it’s a completely worthless statement. Best at what? Best at digital? Best on price? Best at making tea? It also conveys nothing to my team about where we are going and how we are getting there. If the statement was more like, “we will make the best tea in the industry” I could at least start by telling the team we are going to buy a new kettle, better tea bags and do some training on using a teapot. I jest, but you get the drift.

So my last major vision meeting was not about being the best. I painted a vision of normal working hours, less stress, a calmer working environment that used technology to allow us to enjoy our jobs more and deliver the best product and value for money to our clients and their patients. I explained our investment plan and how each team member could help us to achieve this. The painting changes all the time so we meet monthly to discuss this as a whole team, as departments and as individuals where needed. The results have been incredible and now I understand the power of informed direction. We also make a pretty mean cup of tea by the way.

My painting of the future of Byrnes Dental Lab is in my head - I know the size, layout, volume and type of work, the digital shift, equipment investment, sales strategy, etc, etc. My painting is still not complete though. It needs detail - how do we fund the capital expenditure; what training is required to switch that to digital; how do we promote that and grow those sales. That and more is all added. Now the picture is complete but there is one major hurdle to cross. The team do not know what my picture looks like and if I am ever to get close to that idea painting in my head, I’m going to need the team on board in more ways than one. Imagine a group of highly trained athletes at the start line and the trainer tells you to run as fast as you can and we’ll win the race. The starter goes and the athletes run the fastest 100m ever, but there was no path and no guide to the finish line. They all dash off in their own direction and whilst fast, the end result is carnage and total failure. A business vision and painting is that race - it needs a trainer, a training schedule, a start line, a clearly marked path and a finish line. So when I share my picture, I need to break it down to the lab, the departments and then

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BUSINESS

AN INTERVIEW WITH...

SOME OF THE TEAM AT WHW It is my absolute pleasure to speak with Andy, Matt, Oliver and Jemma, some of the team at WHW in this feature. I invited WHW to participate in the business feature for a very good reason. WHW remained open throughout the lockdown and were very present from my own business perspective when we restarted in June. When chatting to the guys I thought the story they had to tell about their business, family and lives before, during and after lockdown was really interesting and one that I wanted others to read.

This photo: Head Office Below Left: Midlands Office Below right: Surrey Sales Office

As a Dental Technician, I have used WHW since I was 16, 29 years!!! This was in the days when Doreen would pop into our hospital lab. Times have moved on and the Hull based family firm have spread their wings and now have offices in Sussex and Birmingham too. I do hope you enjoy reading our interview and hearing how the business has been and how they have adapted, what their team members were doing during the furlough period and how they see the future of Dentistry and Dl Technology.

Can you tell us a bit about what you do within the company? Andy: My official title is Sales Director but I look after a lot of the purchasing and work very closely with Matt on various projects. Being based in Hull I put my hand to most things and love talking to the customers that I’ve been speaking to for decades. Jemma: As Senior Customer Service my responsibility is to deal with customer enquiries, orders and complaint handling. I also help with the large projects like the catalogue and website. Matt: I’m the Commercial Director and based in Sussex, I look after the commercial activities of the company that include the sales team and making sure we are hopefully going in the right direction

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Oliver: I am a qualified technician and have been working in dental sales for the last decade as a field based territory sales manager. How was business doing pre March 2020, were there any particular areas that were doing well? Matt: The business was on course for a record year, I think it was just a culmination of lots of things coming together. What was your overriding emotions when lockdown was announced? Andy: It was the fear of the unknown, after the previous years’ being managed and planned, suddenly we didn’t have control anymore. Matt: Fear and anxiety. I think we all saw it coming but when it was official, I like to think I was perceived as being calm and in

BUSINESS control on the outside but underneath it was pure unadulterated panic. What was business like during the lockdown period? Andy: We continually questioned whether or not to stay open but all the time the phone was still ringing, we were serving a purpose. Matt: It was one of the hardest things to endure. We stayed open not to gain some badge of honour but because we could and we could do it safely. I was based in the office in Sussex, Andy had a building to himself in Hull and so did Mike (director). The feedback that we had from the customers just before lockdown was that they wanted us to stay open and we felt obliged to do so. How did you feel when lockdown was happening? Jemma: For me it was a bit like the seven stages of grief! Starting out with total denial, on our last day in the office before lockdown when Matt told us it may be a few months before he would see some of us again, I thought “What is he on about?! See you in 3 weeks”. So when the weeks kept rolling into the next I eventually and begrudgingly had to accept he was right. Oliver: It was interesting! For the family it was actually really good. Especially for my daughter to have her big brother back in the house and us to all be under one roof again, back to family meals and long debates across the dinner table. It was something we all needed at the time. What was an average day like? Andy: Straight after lockdown things became very quiet like most companies I think and at first it gave us an opportunity to get some of those jobs done which were getting put off because we were so busy before lockdown. I think like most people we thought this would last a couple of months and that things would get back to normal quite quickly, however it became apparent that this was not going to be the case. Jemma: I decided to try and do something productive for a change and learn a new language. I’m still keeping up with it even now that I’m back working full time so it was nice having the opportunity to get started on that, otherwise I probably never would have. I did also spend some considerable time binge watching films I’ve been meaning to watch for years but that part didn’t sound quite as profound! Matt: I spoke to a lot of customers and sometimes they just wanted a chat. The orders still came through but they were sporadic in value and frequency. It was an incredibly lonely time. When you are left to your thoughts and you have seen everything that has been built fall like a house of cards

it’s hard to deal with. But then you switch on the TV and see the thousands of deaths, you have to think that conversely you, your family, your friends, the staff are in good health and everything else can be overcome. It created a time for a lot of reflection and planning, just considering if all things went well where we would want the company to be in the coming years. Oliver: It was like an insight into retirement. It was getting to do things around the house that I don’t usually have time to do like clearing out the garage and it has confirmed that retirement isn’t for me! That being said it was nice to spend a bit of time catching up with people on the phone, reading and topping up the tan of course. What concerns as furloughed staff did you have? Jemma: Firstly, I genuinely didn’t have any concerns for the safety of my job, some may say that was a naïve outlook but I trust in the successful company I have been with for the majority of my dental career and I knew everyone would do whatever it took to see us through. I only asked for a small bribe to say that. My main concern at the time was wanting to know how long it was going to last and when I could go and hug my mum again. I worried what would happen if the furlough scheme stopped, it’s all fun and games being paid a wage to soak up the sunshine but what would happen after that? Oliver: I suppose the main concern that crossed most people’s minds, will I have a job after this? My wife was also starting a new job in an environment that had known COVID19 exposure, as a black family we are in the higher risk category of catching it so I was concerned for her to be going into that. Did you speak to others in the profession? Lab owners? Andy: Yes to begin with many lab owners were doing very much the same things we were doing, discovering things in cupboards they didn’t realise they had and generally clearing things out whilst there wasn’t the work coming in. Over those first few weeks our attention turned towards what we could do in order to help the NHS and also how we could best support our customers’ safe return to work. We sourced various suppliers of masks and began producing visors, in the end producing over 70,000. Matt: On a daily basis, I would speak to the great team at the DLA, different members of the various dental bodies and other suppliers and manufacturers. It really seemed to be a time when relationships were forged or broken. In hindsight this was a positive of staying open but this was not by design, more so happenstance.

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Oliver: Yes, constantly. I was hearing about people’s situations and mindsets and it was really interesting to see how technicians were reflecting on things they could and might want to change moving forward, whether that be in the lab or starting something entirely new. Did you keep all the branches open? Matt: Birmingham was the only site that closed, as we couldn’t ask employees to take that kind of risk on our behalf. Have you managed to retain all of your team members? Matt: Unfortunately not but this decision wasn’t necessarily anything to do with COVID19 but rather moving forward what is best for the company. I even anticipate a bit of a recruitment drive in the New Year! This is obviously dependent upon what is going to happen with the pandemic and I think we have all given up trying to second guess this. In our lab, we have reassessed many processes and how we could be better and subsequently have moved staff around and changed some roles to better suit the business now, Have any roles changed for your team? Andy: I took the opportunity to systematically reorganise the whole warehouse making picking orders more efficient. Our time was also utilised to implement a much discussed project, the new automated discount pricing structure which includes thousands of products. Matt: Not directly but I think that plays a part in what I mentioned before. It was a chance to see and evolve the many things that aren’t working but most importantly work out ways of celebrating the successes more. Where are you now in terms of orders/ business levels/patterns? Matt: We are trading at about 80% and are very busy but juggling the staff numbers is the crucial aspect. While we would love to, we can’t blindly bring back all the sales team, all the manufacturing, all the engineers and admin staff. It’s a week to week plan. The day that some of the guys came back after the lockdown was a really special moment. I will be eternally grateful for the furlough scheme, without it the devastation would have been without equal. What has it been like since you have been back? Have your customers changed or received you differently? Jemma: I definitely think there has been a shift in the type of conversations I’m having with people on the phone. We all still manage to have a laugh and joke but people are genuinely interested and concerned to hear how we at WHW have been finding things and to hear about how their peers are getting on, it’s not just a cursory “Hi how u are you?”.

BUSINESS Oliver: It was a real slow start but is picking up quickly now. It’s not going to be easy for anyone. I don’t think anyone has received me differently but I can tell there is a change in the way some technicians are looking at what they charge, how many hours they feel they have to put in, they don’t want to be dictated to by their clients anymore. At the moment I am hearing a lot of the same feedback from my customers, blindly turning up at their lab might not be the most appropriate thing to do. People are excited about the prospect of seeing me again but understand the importance of it being done in as safe and risk free manner as possible. I hope to be on the road full time again as soon as possible but I am only now seeing people by appointment as per their wishes at the moment. What do you think 2021 will look like? Where do you think the wins will come from? Andy: A lot depends on what happens over the next couple of months and how the virus is going to be tackled, if we don’t get a vaccine at the early start of 2021 I can see an approach towards herd immunity, we know of many labs that have already let some of their staff go and others that have unfortunately closed. I can see the laboratory landscape changing significantly towards digital as there will be a shortage of dental technicians within the trade.

Jemma: Honestly? I think to some extent it’s still going to look a lot like it does now, at least for the early part of the year but my satisfaction will be in seeing how we are all stronger in the long run because of this and we will be!

Jemma: Can we just get through 2020 first! In all seriousness, I think as a trade we can only get stronger but I acknowledge it will probably never be quite the same. The businesses that tough it out can only be better for it.

Matt: I think private dentistry will continue to grow at a great pace and when NHS dentistry returns, it is going to be incredibly frantic. The biggest concern I think we all share is when the dentists are back full time, will their loyal laboratories be there? I am not sure we will all be prepared for this outcome either way.

Matt: Who knows? The obvious answer is going to be more digital products in the laboratories but this is a lazy answer! I think labs will be more commercially aware and maybe they will not be afraid of charging what their work deserves, could there be an element of a power shift?

Oliver: I think business will continue to increase, in fact I think a tsunami of work is to come. The need for the work and the trade is still there. Our wins will come from being able to continue to supply our customers throughout. On reflection, this has to be a benefit of staying open.

Oliver: In a word, digital. That train is coming at us down the tracks and everyone will have to hop on at some point. Sadly I think there will be less technicians because we are training less and less but being a dental technician is a very good and rewarding job, we need to spread the word. I would be really interested in how the powers that be are planning to recruit the next generation of dental technicians?

What do you think the Dental Laboratory business will look like in the next 5 years? Andy: I think many laboratories will start to look at other aspects of the industry and we are already starting to see this from the uptake in a greater variety of products that we are supplying. The key to their success and ultimately their future lies in them being able to embrace a future which I think will look different to what it does now.

From the WHW team: As always, we would like to take this opportunity to wish all of our customers and their families the very best of health. While these testing circumstances are continuing to prevail, please know that we will help whenever we can and are just at the end of the phone.

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DIGITAL DENTISTRY

OUR JOURNEY INTO DIGITAL DENTISTRY By Ross Chapman

ike most prosthetic guys I am somewhat of a latecomer to the digital dentistry party in purchasing our first Dof HD desktop scanner at the Dentistry Trade Show in summer 2017, hardly an early adopter considering many crown and bridge labs have been “digital” since the late 1990s. I was initially reluctant to make the push into the digital field as I originally failed to see how it would benefit the quality of my work, the experience for my patients or more importantly as a business owner, my pocket. Even when I did decide to take the plunge it was out of the fear of being left behind, rather than any burning ambition to sit behind a computer screen or a mouse all day. Unlike now, there was no set pathway or modulus to harness the power of digital technology in denture production. There were no “denture modules” or collaborations between dental companies and software providers like we see today, with 3Shape and Ivoclar Vivadent. The only area I could initially see it being regularly used in my lab was for designing implant substructures in house, as opposed to sending them away for design and mill service as we previously were.

resulting in lost time and a possible remake. This combined with the fact we didn’t at this point have an in-house output for our designs, such as a 3D printer or milling machine meant our CAD confidence and our overall progress stalled. This all changed in summer 2018 when we had a change of personnel in the lab, our new senior prosthetics technician arriving with some CAD experience from a previous position, we also at this time invested in our first 3D printer so we could tinker with designs and assess our end product. LIFTOFF: We soon experimented with basic design and prints, such as working moels, temporary base plates and custom trays with some early success. The learning curve with our printer was almost as steep as the CAD software but once we dialled it in the results were great. Custom trays we strong, light and perfectly spaced over the primary casts. As we practised more each week our designs got

better and quicker and it was now taking around 3-5 minutes to design a custom tray and stacking them up to print overnight. We watched endless YouTube videos of American prosthodontists such as Dr Baron Grutter and Dr Cory Glenn, designing and printing components to use in-house on their prosthetic patients. The once boring and labour intense “preliminary” stages of dental prosthetics became enjoyable and swift allowing us to spend more time on the more intricate aspects of our profession. We have since progressed quite quickly on to using our setup to produce copy dentures, gothic arch bite components, bite splints, implant placement stents and laser-sintered CAD chrome design. We also use our software and printer heavily in “All on 4” design, planning and fabrication, with the ability to send a digital file and communicate with a dentist partner remotely when treatment planning a big u implant case a godsend.

3D printed implant pick up tray

GETTING STARTED: I will be honest, when we first purchased our scanner it was probably the most expensive paperweight in Newcastle. The vast majority of my working day was then and still is now, spent in the clinic treating patients, so I had very little time personally to master the intricacies of the CAD software. The introductory training my lab staff had was very basic and mostly aimed at crown and bridge CAD design, so next to useless in our role as a private CDT clinic. We intermittently used the Exocad software for some implant planning and substructure bar design only and the rest of the time it gathered dust. In hindsight, I and the laboratory team I employed at the time, did not understand or fully commit to the challenging and steep learning curve ahead. In a very busy laboratory, it was easy to find a reason to make things quickly by hand rather than attempt things digitally knowing it may not be perfect due to our lack of competence,

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DIGITAL DENTISTRY We have recently invested further in adding a second 3D printer and smile design and full denture modules allowing us to create digital dentures in house. We are currently beta testing printing denture bases and adhering on stock or printed teeth, but this is only at R&D stage and not currently offered to our patients as we need to iron out our workflow a little. I’m still not currently convinced that printed or milled teeth can hold a light to a good quality stock tooth card in aesthetics and wear resistance yet, but the quality is getting better all the time and when you see what is possible in the US and Canada with experienced CAD techs and denturists such as Eric Kukucka, The Denture Centre, Toronto. it will not be long before the quality is paralleled if not bettered. THE FUTURE: In the summer we have just purchased our first intraoral scanner for our clinic and we have opted for the Medit i500. I had heard many great things about Medit as a company and in particular this scanner, I have to say I am very impressed with its accuracy, versatility and usefulness so far. I can now scan and duplicate a patients denture chairside in under five minutes. We have now as a business almost eradicate the requirement for all alginate primary or antagonist impressions and the associated mess and gypsum waste this process produces. Having to only take and pour functional impressions when we need border accuracy or sulcus depth is appreciated by both the patient and the busy lab technicians alike. Currently, around 30-40% of the cases we receive from outside dental clinics are intraoral scans, rising every month. As a once dubious and reluctant 40 odd year old, I have to say I now feel invigorated by the digital revolution in dentistry. The young newly qualified GDP’s are now leaving dental school with experience in intraoral scanning and a scanning wand is as familiar

to them as a mirror and probe. It’s amazing to think how much it has changed my business, daily workflow and re-energised the whole technical workforce in the short time frame since we adopted this technology. I look forward now to the twilight of my career and what the future holds for denturism and dental technology on this ever-evolving pathway.

CLOCKWISE FROM TOP LEFT: Cad gothic arch components; Printed copy denture technique; Medit i500 scan for All on 4 planning; Mediti500 denture scan

TO ADVERTISE IN THE DENTAL TECHNICIAN T: 01372 897 462 E: sales@dentaltechnician.org.uk

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MARKETPLACE BAR HEADER SHOFU EYESPECIAL:THE DENTAL CAMERA FOR YOUR PRACTICE OR LABORATORY w Creating professional photo documentations after only a short learning curve? No problem – with Shofu EyeSpecial, the dedicated dental camera. The EyeSpe-cial has everything your dental practice or laboratory really needs. It possesses smart special features, is easy to operate, reproducibly takes excellent images, and its use can be delegated to your assistants without any lengthy training. Ratingen – There are many ways to take good dental photographs: You can use a modified smartphone, a mirrorless compact camera or an upgraded single-lens reflex camera. However, all these “that-works-too” options have their drawbacks. They may be impractical, require in-depth photography knowledge, training and investments in additional equipment, fit into everyday workflows only with great difficulty – or even combine all these disadvantages. EITHER THE PHOTOGRAPHER IS AN EXPERT – OR THE CAMERA

“The EyeSpecial has built-in photographic expertise. The camera relieves users of their worries about ring flash, lateral flash, aperture, depth of field and so on”, says Ingo Scholten, who is responsible for this product in Europe. “The EyeSpecial has everything you need to easily take informative patient images – without any specialist knowledge of photography, without any additional equipment. Thanks to its smart integrated features, the EyeSpecial reliably produces excellent pho-tos: high in contrast, razor-sharp and true to colour. The camera itself creates the conditions necessary for taking a good image, without any time-consuming alignment of flashes or other settings and adjustments.”

EyeSpecial C-IV – The Dental Camera

HANDY AND LIGHTWEIGHT ALL- IN - ONE CAMERA

Since launching the first camera generation in 2014, dental manufacturer Shofu has geared the EyeSpecial to the special needs of dental photography. This ul-tralight highperformance camera produces great results without any heavy ac-cessories. It can easily be held with one hand, freeing the other to hold a cheek retractor or a mirror. The flash system with different flash heads and exposure programs is integrated in the camera. Irrespective of the ambient light conditions, it provides the opti-mal light in all situations typical of dental photography, be it intraoral images, patient portraits, shade selection or model photos. EASY ENOUGH TO BE DELEGATED

PERFECTLY HYGIENIC

What is absolutely essential today: Like no other camera, the EyeSpecial sup-ports modern hygiene practices in your operatory, helping to effectively prevent infections. The completely smooth camera body is water and chemical-resistant and can be quickly and thoroughly disinfected with sprays and wipes between two patients. This minimizes the risk of cross contamination, and the camera is ready again in less than one minute. Another hygienic benefit: The intuitive menu navigation on the display does not require any direct skin contact, because the high-resolution 3.5" touch panel re-acts properly even when you wear disposable gloves.

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

Shofu has developed the latest generation, the EyeSpecial C-IV, to meet various user requests. A new video feature, for example, allows you to show functional aspects in motion and also video-document case histories, functional analyses and successes before, during and after treatments. This is an advantage that pays off, not only in orthodontics. FOR OPTIMIZED, GLARE-FREE VISUALIZATION: THE NEW CROSS POLARIZ-ER

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

Would you like to learn more about the new EyeSpecial C-IV? Please view or download the product brochure at https://www.shofu.de/en/ produkt/eyespecial-c4-uk/. Do you wish to see a demonstration at your practice or laboratory and take advantage of an attractive offer? Please contact your Shofu representative. SHOFU UK E: sales@shofu.de W: www.shofu.co.uk

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MARKETPLACE ZIRKONZAHN SHADE GUIDE HIGH-QUALITY MONOLITHIC TOOTH SAMPLES MADE OF POLYCHROMATIC PRETTAU® DISPERSIVE® ZIRCONIA ACCURATE AND FAST TOOTH SHADE DETERMINATION

w From now on, for clinical cases treated with restorations made with Prettau® Dispersive® zirconia, the patient will be able to preview the final colour of his future prosthesis before starting the treatment. This is possible thanks to the new Zirkonzahn Shade Guides, composed of monolithic sample teeth made of Prettau® Dispersive® zirconia and available for all the three Prettau® Dispersive® zirconia versions (Prettau® 2 Dispersive, Prettau® 3 Dispersive and Prettau® 4 Anterior® Dispersive®). All sample teeth are monolithically designed then coloured with ICE Zirconia Stain 3D Base Glaze, and the natural tooth colour can be reproduced almost 1:1 in the finished planned restoration. The shade guides are inspired by the VITA colour range and comprise 16 colours (A1-D4) as well as 3 Bleach shades. The sample bars of the tooth colour keys are deliberately made of transparent, metal-free, temperature-

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resistant plastic in order to guarantee a neutral colour effect and avoid interference caused by translucent metal. Concerning hygiene requirements, they can be disinfected and sterilised. It is proved that the shape and surface structure of an object has a considerable influence on the colour effect: for this reason, shade guides for lower jaw and posterior region are also available for each Dispersive® material. The first shade guide available is the one developed for the brand new Prettau® 3 Dispersive® zirconia. The special features of this dental material, suitable for restorations with up to six units, are the harmonious colour, translucency and flexural strength gradients that fade towards the incisal margin, to achieve excellent aesthetic results, especially for monolithic restorations in the anterior region. FURTHER INFORMATION AT: www.zirkonzahn.com

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