Dental News June 2024

Don’t just go with the flow. Pick the right flow!

FLOWABLE YET STABLE RESTORATIVE MATERIAL

You have the choice:

• Light Flow – low viscosity

Precise application thanks to the very fine cannula and therefore optimally suitable for hard-to-reach areas and small cavities

• Flow – medium viscosity

Outstanding flow behaviour, universal and precise application

• Heavy Flow – high viscosity

Increased stability, i. e. universal application and no undesirable runoff

*Filler content by weight

Flowables

Also available as Caps

Experience the new packaging design of Dr. Wild Oral Care

Redesign Tebodont Packaging

Redesign Emoform Packaging

Based on the close and fruitful cooperation with dental institutes and practicing dentists since the 1940s, we have a uniquely broad portfolio of specially developed, innovative toothpastes, gels, sprays, mouthwashes and mouth baths. These products, which are marketed under the brands Tebodont®, Emofluor®, Emoform®, Depurdent® and Emofresh® are sold exclusively in pharmacies in Switzerland and in more than 40 other countries outside Switzerland, their various innovative formulations and compositions offer excellent solutions for daily dental care, addressing specific needs and problems (e.g. caries prevention, sensitive teeth, gum problems) and general oral health.

With the REDESIGN we have clarified the positioning of the oral care products: every toothpaste and every mouthwash now has a clear application area. At the same time, our new packaging is "digitalized": each product has a QR code that allows detailed information to be downloaded directly to the mobile phone. The redesign of the products should make the Wild brand tangible and perceptible.

• WILD will be used as umbrella brand on all products, which results in an easier promotion among the whole product range

• Same design for all brands leads to recognition and synergy effects across product range

• Clear unique main indication on the packaging avoids confusion among dental profession, pharmacists and end consumers due to overlapping benefits

• New design underscores clinical benefits and professionalism of the products which leads to cross-brand and cross-portfolio products awareness and helps to create trust among the dental profession, pharmacists and end consumers

• Unifying of the packaging system - all toothpastes in the same size and shape of tubes, all mouthwashes in the same size and packaging - leads to a uniform, eye-catching and space-saving shelf-impact

• Product portfolio becomes fresh, easy to recommend and attractive for the POS

Redesign Emofluor Packaging

Redesign Depurdent Packaging

Volume XXXI, Number II, 2024

EDITORIAL TEAM

Alfred Naaman, Nada Naaman, Khalil Aleisa, Jihad Fakhoury, Dona Raad, Antoine Saadé, Lina Chamseddine, Tarek Kotob, Mohammed Rifai, Bilal Koleilat, Mohammad H. Al-Jammaz

Suha Nader

Marc Salloum

Micheline Assaf, Nariman Nehmeh

Josiane Younes

Albert Saykali

Gisèle Wakim

DIRECTOR ISSN

Tony Dib 1026-261X

DENTAL NEWS IS A QUARTERLY MAGAZINE DISTRIBUTED MAINLY IN THE MIDDLE EAST & NORTH AFRICA IN COLLABORATION WITH THE COUNCIL OF DENTAL SOCIETIES FOR THE GCC.

Statements and opinions expressed in the articles and communications herein are those of the author(s) and not necessarily those of the Editor(s) or publisher. No part of this magazine may be reproduced in any form, either electronic or mechanical, without the express written permission of the publisher.

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INTERNATIONAL CALENDAR

EDSIC 2024

September 4 – 6, 2024 Intercontinental Citystars, Cairo, EGYPT www.edsic.org

FDI World Dental Congress 2024

September 12 – 15, 2024 Istanbul | TURKEY 2024.world-dental-congress.org/en

BIDM 2024

ATREO 2024

October 3 – 5, 2024 Seaside Arena | Beirut, LEBANON www.lda.org.lb

Association Tunisienne de Recherches et d'Etudes en Orthodontie

October 4 – 5, 2024 Hotel Hilton Skanes | Monastir, TUNISIA association.atreo@gmail.com

MAKKAH DENTAL 2024

AIDC Alexandria Int’l Dental Congress

37th CAPP International Dental ConfEx

SIDC

2025

AEEDC 2025

October 24 – 26, 2024 Hilton Makkah | Makkah, KSA makkahdental.com

November 13 – 15, 2024 HiltonGreen Plaza | Alexandria, EGYPT www.aidconline.net

November 15 – 16, 2024 Madinat Jumeirah | Dubai, UAE www.cappmea.com

January 16 - 18, 2025 Riyadh International Convention & Exhibition Center | Riyadh, KSA www.sidc.org.sa

February 4 – 6, 2025

World Trade Center | Dubai, U.A.E. www.aeedc.com

CONGRESSES ARTICLES

Zirconia over PEEK

Acteon 11

A-dec 23

Belmont 9

DMP 1

DURR 15

FKG 21

HU-FRIEDY 42-43

Hyperloupe 25

K Biocer 35

MESA 40-41

Mani 17

NSK C2

Promedica 37

Rekita 35

Rolence 45

Scheu 29 Shining 3D 27

SDI Pola 19

Septodont 84

Shofu 31

SIDC 73 Trident C4

Ultradent 13

VOCO C3

VOCO 2 Wild Pharma 3-4-5

6th INTERNATIONAL CONGRESS STMDLP 2024 February 23-24-25, 2024 HAMMAMET - TUNISIA THE 10TH LEBANESE INT’L DENTAL CONGRESS 25-26 & 27 April 2024, Beirut Arab University - Tripoli Campus

DIGITAL INNOVATIONS April 26 and 27, 2024 Antonine University, Baabda, Lebanon

IDEX - ISTANBUL 2024 8-11 May 2024 Istanbul Expo Center

BYBLOS DENTAL ASSOCIATION May 11, 2024 Byblos, Lebanon

LSP 8TH SCIENTIFIC MEETING 18 May 2024, Hilton Beirut Habtoor Grand

Natella I. Krikheli, Dmitrii N. Andreev , Svetlana V. Lyamina ,Filipp S. Sokolov, Marina N. Bychkova, Petr A.

Zirconia Over PEEK Structure

Introduction

At Zirconnet lab, we were early adopters of the polyetheretherketone (PEEK) material and marketed it to our clientele, creating a new line in dentistry in our region. Over the years we experimented with several zirconia generations on PEEK structure.

Contact: Mr. Marwan Khoury

Email: zirconnetmas@gmail.com

Our aim in adopting this service is to create an aesthetic metal-free line, that is easy to maintain and easy to repair and restore at any time.

This article discusses the use of PEEK structures in large implant cases, utilizing multilayer zirconia Zolid Bion (1100 MPa) of Amann Girrbach.

Large implant cases: from traditional old PFM to PEEK structure

• The old porcelain fused to metal (PFM) method is packed with complications, like high fracture risk especially after several firings of porcelain. It’s also difficult to repair in case of any breakage.

• Utilizing full-arch monolithic zirconia results in a heavy prosthetic that will transmit the occlusal stresses to the bones, which may lead to bones resorption. The lack of elasticity of full-arch monolithic zirconia inhibits the mandibular deformation during chewing, causing the temporomandibular joints (TMJ) problem. In case of fractures it’s impossible to repair.

• Hybrid solutions of PEEK structure

topped with zirconia crowns, and nanocomposite gum is an optimal solution, given the elasticity and light weight of the PEEK, and its shock absorption characteristic between occlusal stresses and the jaw bones. This technique allows us to crown the thimble with lithium disilicate or zirconia and the gingiva with nanocomposite.

Material of choice: Zolid Bion

Different kinds of zirconia generations had their own advantages and disadvantages carefully chosen to be most compatible and best for the case in use.

• 5Y-TZP Multilayer Zirconia (600–700 MPa): Super translucent, polychromatic, and aesthetically matching 16-color shade guides. One of its drawbacks is its low flexural strength.

• 4Y-TZP Multilayer Zirconia (> 1000 MPa): Highly translucent, polychromatic, less problematic than its prior iteration, but with diminished aesthetic appeal, it requires additional ceramic layering. This results in increased time and effort during the restoration process and greater complexity for any potential crown replacements later on.

• 4Y-/ 5Y-TZP Multilayer Zirconia Zolid Bion (1100 MPa): From Amann Girrbach is the latest generation of zirconia, used in the case described

EURUS

Embodies our belief of bringing highly reliable Japan-quality products to dentists in the world.

Touch Panel

Folding Legrest Chair (option) Wireless Foot Controller (option)

New Flushing tray (option)

below. In our experience, this product combines the best of previous zirconia generations and it provides better aesthetic quality due to its increased translucency at the incisal edge for a natural 3D effect.

Case presentation utilizing Zolid Bion:

A 65-year-old patient presented with two fullarch porcelain fused to metal (PFM) bridges that had sustained considerable chipping. The patient and doctor agreed it needed to be replaced for aesthetic and functional purposes.

Dr. Ovidiu Tudor at Clinica Identiq in Bucharest initially aimed for a replacement of the PFM bridges. However, he pointed out that the implants performed by the previous surgeon were not ideally placed. Therefore, after discussing the case we opted for the hybrid prosthetic solution for a better and safer result. Below is the full process, illustrated with photos.

the dentist (in order to place the prosthetic work on an Artex articulator) . Minor VDO adjustments and lateral movements were needed to avoid the porcelain chipping. (Problem that is revealed in Figure 2 and 3)

2. Preparation for digital impression and facebow registration

1. Chipped PFM initially seen by the doctor

The first pictures show us that the occlusal plane and profile of the patient are well placed. The interpupillary line is parallel to the occlusal plane. We can superpose the photos in a 2d smile creator software in order to verify the occlusal plane we are working on in addition to the facebow registration and occlusal table sent by

Figure 6, 7: Placement of the scanbodies of the Megagen implant, in both lower and upper arch, preparing for IntraOral scanner for digital impression.

Figures 8, 8a: Digital files–impression received from the dentist.

3. Designing and printing prototypes

Printed temp for prototypes using A.G. Ceramil NextDent 5100 printer with NextDent C&B MFH (Mirco filled hybrid) Liquid color N1,5. Colored gum using GC Optiglase.

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Caring People. Improving Lives

The key philosophies of ACTEON

Being a human centric organization focused on the needs of patients and care providers.

Providing tailored workflow solutions that maximize the total effectiveness, efficiency, and economics of achieving desired clinical outcomes.

Providing innovative and integrated healthcare solutions that address the continuous healthcare needs over patients’ lifetimes.

Figure 09: Designing the prototype relaying on pre-opp registration (initial situation of the patient) and occlusal relation provided by the dentist.

Figure 10: Printing the prototype using A.G. NextDent 5100 printer with temp liquid NextDent C&B MFH (Mirco filled hybrid) color N1,5 in order to verify and control all the given data.

Figure 11, 12: Sand blasting the TiBase with 110um AL2O3 at 2 bars …and the inner surface of the bridges to prepare for cementation, using VisioLink for Pmma and MKZ Primer fro TiBase and DTK resine cement to fix the TiBase to the bridge.

Figure 13: Verifing the occlusion and lateral movements on Artex prior to sending the printed temps to the clinic.

Figure 14, 14a: Trying the prototype allow the dentist to control minor adjustments and sending the new data back to the lab.

Figure 15 to 18: Artex Face bow registration essential for articulator mounting later at the Lab. Final bite registration with modifications and lateral movements control are sent back to the Lab.

4. Structure design and BioHpp milling:

Design with Ceramill Mind software. Milled on Ceramill Motion 2 DNA.

Figure 19: These modifications are introduced within the files to be adjusted, once done we start designing the Peek framework.

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Figure 20, 21: The framework is being milled with BioHpp (By Bredent) on A.G. Ceramill Motion 2 milling machine.

Figure 22: Same steps and protocol for cementing Pmma on TiBase is used to cement BioHpp on TiBase. (Figures 11, 12 steps)

Figure 23, 24: Sandblasting BioHpp with AL2O3, 110 microns at 2 bars pressure. Then applying Visolink on the inner surface to be cemented –VisionLink is cured using Bredent light curing unit for 90s.

Figure 25, 26: MKZ Primer on treated surface of the TiBase, sandblasted with AL2O3, 110 microns at 2 bars pressure

Figure 27, 28: Applying DTK (Bredent) resin composite to cement TiBase on structure, then cure it in Bredent curing Unit for 360s

Figure 29: Controlling the passive fit of the cemented structure on the printed model.

5. Crown design: A.G. Zolid Bion milling on Ceramill Motion 2 DNA generation.

Figure 30: Designing indivudual Bion crowns on the structure, relaying on the last printed model adjustements used as a 3d verification key.

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Video MyLunos Duo®

Figure 31, 32: Zolid Bion discs sent to us from Amann Girrbach to test the material and achieve the desired restoration case.

Figure 33, 34: Crowns are beeing milled on Ceramill Motion 2 DNA.

6. Sintering Zolid Bion on Ceramill Therm 3:

Figure 35, 36 and 37 to 40: Crowns are beiing sintered in Ceramil Therm 3 using special program for Zolid Bion. Duration 8 hours and optimum temrature of 1500 oC for 2 hours .

7. Minimal characterization of 12–22 upon request:

Figure 41 to 43: The dentist asked for characterisation of the anterior teeth (1222), so we desinged these crowns with a minimum cutback in order to apply a thin layers of translucent and opal ceramics using GC ceramic for zircon.

Figure 44, 45, 46: The crowns are placed on the structures to control the bite registration on Artex and lateral movements as desired.

Figure 47: prior to final cementation, one more trial in the patient mouth to verify everything.

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Figure 49: Applying MKZ primer on the inner surface of the Bion crowns sandblasted with AL2O3 50 micron at 2 bars pressure.

Figure 48: sandblasting the thimbles with 110 μm AL2O3 and appying a layer of Visiolink cured in Bredent curing unit for 90s.

Figure 50: Crowns are being cemented with DTK Bredent, cured for 360s in Bredent curing unit. F.

Figure 51, 52, 53: Visiolink is applied on Peek in the gum area to bond. Crealign Gum on structures with AL2O3, 110 microns at 2 bars pressure Nano composite is being mechanically polished and job finished

8. Gum work done with Bredent Crea.lign nanocomposite and outstanding result:

Figure 58: Upper and lower restoration placed again on Artex to ensure that the exact required results were achieved (no DVO changes during the process).

Final pictures 59 to 63: The job is finished and delivered to the clinic. Happy patient and mission accomplished.

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Products Utilized:

Digital impression scanner

Trios 3

3Shape

Articulator Artex Amann Girrbach

Luting system, adhesive

CAD/CAM system

Sintering furnace

Veneering porcelain

Glaze and stains

Implant system

Adhesive bases

Model system

Zirconia

PEEK structure

DTK-Kleber opak Bredent

Ceramill CAD/CAM motion 2

Amann Girrbach

Ceramill Therm 3 Amann Girrbach

GC initial

GC initial

GC

GC

AnyRidge MegaGen

TiBase on MUA MegaGen

Giroform Amann Girrbach

Zolid Bion Amann Girrbach

BioHpp Bredent

Gum veneering Crealign Gum Bredent

Printed models

Printed prototypes

Zirconia primers

2.0 Peach NextDent

NextDent C&B MFH (Mirco filled hybrid) Liquid color N1,5

MKZ

Composite primer Visiolink

Printer

Epilogue:

NextDent 5100

Special thanks to Dr. Ovidiu Tudor at Clinica

Identiq - Strada Popasului 12, Bucharest, Romania who collaborated with the Zirconnet team on this case.

Dr. Ovidiu Constantin Tudor

For more than two decades, Dr. Ovidiu Tudor has practiced in Bucharest, Romania focusing exclusively on combinations of smile design, aesthetic dentistry, oral surgery and prosthetic rehabilitation.

He graduated from the Carol Davila University of Medicine and Pharmacy in Bucharest, and specialized as a GP following a three-year residency. Since 2014, he has been a lecturer for MegaGen’s R2Gate guided surgery system (oneday implant concept). Dr. Tudor has taken part in several master classes, projects and seminars in Romania and the United States.

Contact Information:

Dr. Ovidiu Constantin Tudor

Identiq Dental Clinic

12 Popasului Street, Bucharest

Phone: +40 21 210 30 77

Mobile: +40 722 456 918

E-mail: dr.ovidiu_tudor@yahoo.com www.facebook.com/TudMedical www.identiq.ro

NextDent

NextDent

Bredent

Bredent

NextDent

Zirconnet M.A.S. Lab

The work discussed in this article was carried out at Zirconnet M.A.S. Romania in collaboration with Zirconnet Lebanon. MDT Marwan Khoury coordinated Zirconnet team effort to realize this project.

In its 30+ years of striving for excellence, Zirconnet has remained a foremost dental lab in the Eastern Mediterranean in terms of size and quality. It adopted digital technologies in 2009 and has been the only AG Live Lab in the Middle East and North Africa since 2014.

Contact Information:

Zirconnet MAS

Romania, Bucharest, sector1, calea floreasca 91-111, bloc f1, tronson 3, ap28

Email: zirconnetmas@gmail.com

Phone: +40731351611

Zirconnet, Lebanon

Zalka, Amaret Chalhoub

Phone: +96171661165

Zirconnet.com

Email: zirconnetdentallab@hotmail.com

Over 20 years of the Vector method

“Quite a few periodontal surgical interventions could be avoided”

Over 20 years of the Vector method: since 1999, this technique has been used to treat periodontal diseases with the aid of ultrasound – using a low-pain therapy that focuses on the cause of the disease. In our interview, Univ.-Prof. Dr. Andreas Braun and Dr. Johannes-Simon Wenzler from the Clinic of Restorative Dentistry, Periodontology and Preventive Dentistry at RWTH Aachen University tell us about their experiences and offer advice for application of the techniques in practice.

Question: Professor Braun, when did you first become aware of the Vector method?

Prof. Dr. Andreas Braun: To start with, it was Prof. Nolden from the University of Bonn who drew my attention to it. That was around 2000, just after market launch. Prof. Nolden told me in particular about how the Vector can be used for low-pain periodontal treatment. Because I had written my thesis on the objectification of sensory perceptions, I was very aware of the topic and quickly became fascinated with this new technique.

Question: Dr. Wenzler, what brought you to the Vector method?

Dr. Johannes-Simon Wenzler: During my time studying in Marburg, I had learned about conventional scaling and root planing, and I asked myself which options could be readily translated into a systematic treatment concept. This matter is particularly important for patients who are more sensitive to pain, as – based on my experience – they are not really well cared for either with manual curettage or with machine instruments, regardless of whether we are talking about acoustic scalers, magnetorestrictive ultrasonic scalers, piezoelectric ultrasonic scalers or jet powder devices. After consulting with Prof. Braun, I started treating patients who are more sensitive to pain with the Vector system. Coincidentally, this fitted in really well with my scientific endeavours at the time in the project area TransMIT, which was all about applications in dentistry involving energy transfer.

Question: How did you start using the Vector method, and how do you use the system today?

Prof. Andreas Braun

Dr. Wenzler

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Prof. Dr. Andreas Braun: Well, I started out pretty much as a pilot user, so I embarked on using the new system without any real prior knowledge. I quickly realized that I could use it very effectively, and that the process of using the instrument in the periodontal pockets involved noticeably less pain for the patient than with the other alternatives that were available. However, some of my practicing colleagues were irritated because they had hoped for a faster procedure. This is why I also felt it was my duty to promote the correct understanding of the Vector method among dental practitioners – that it was primarily not about speed, but about a low-pain and gentle alternative to conventional therapies. The manufacturer, Dürr Dental, subsequently developed and refined the system to the point where we now use a combination of two different piezoelectric handpieces to achieve much faster results than we did back in the early days.

Dr. Johannes-Simon Wenzler: I was impressed right away. With the Scaler handpiece and the slim Scaler instruments, my supragingival cleaning work is much faster. For subgingival instrument work, I then switch to the Vector Paro and apply the Vector Fluid polish suspension directly from the handpiece for treatment that is as effective as it is gentle in the removal of biofilm. I was first introduced to the system in 2015 and basically grew up with this combined approach.

Question: What exactly is it about the Vector system that makes it so successful for you personally?

Dr. Johannes-Simon Wenzler: I examine the classical periodontological parameters such as BOP, changes to the gingiva involving inflammation, periodontal attachment gain. Normally, initial success starts to show after just a few days. In addition, I always ask my patients to what extent they felt pain sensations during treatment with the instrument or afterwards.

Prof. Dr. Andreas Braun: Changes to the individual bacterial spectrum are generally not a sole indication of success. I will only perform special microbiological investigations if I suspect the presence of a specific pathogenic bacterial spectrum that I would need to tackle with targeted antimicrobial therapy. However, it is generally much more likely that a bacterial spectrum will shift in response to systematic periodontological treatment. When it comes to regular checks, it is primarily the clinically verifiable parameters that we look at.

Question: What is your assessment of the scientific evidence?

Dr. Johannes-Simon Wenzler: Based on my experience, the Vector method is almost always superior to other ultrasonic and powder jet treatments in terms of reduced pain and discomfort during treatment. Prof. Braun has also confirmed this in studies.

Prof. Dr. Andreas Braun: Yes, together with Priv.-Doz. Dr. Krause I was able to document this early on already. Initially, we asked the patients to gauge their pain sensitivity on a visual scale after treatment. Because, empirically speaking, the most recent perception tends to dominate, we also asked them to assess their sensitivity during the overall procedure. We gave the patients a pressure recorder they could hold in their hand and asked them to squeeze it according to the level of pain they were experiencing so that we could measure it – the more pressure they exerted, the stronger the

Interview with Prof. Andreas Braun and Dr. Johannes-Simon Wenzler

pain. This allowed us to record updated pain sensations once a second. In the process, the Vector method achieved significantly better results than both manual scaling and root planing and one other ultrasonic method. SRP and the second ultrasonic technique performed equally well as each other during this investigation.

Question: Which practicing colleagues would you recommend Vector to, and how should they approach the system?

Prof. Dr. Andreas Braun: Based on my assessment, actually I think the method is suitable for any practice that offers periodontology treatments. A vast store of knowledge has now been built up, so for anyone who is new to the technique I can recommend that they get training on the Vector method from an experienced colleague. In terms of patients with the highest sensitivity to pain, I would also perhaps recommend use of a topical anesthetic, which can often help. Patients often welcome the fact that they are not being given an injection. However, if a “Vector session” does ever need to be stopped, then I think it is acceptable for the patient to come back in one to two weeks’ time so that the quadrants that have not yet been treated can then be worked on with the instruments.

Question: Where are we at with the Vector method today, and how do you think things might evolve over the next twenty years?

Prof. Dr. Andreas Braun: The Vector method is currently a cost effective, low-pain method for periodontal therapy. It is not particularly fast, but it is very gentle on the surfaces of the tooth. Particularly in the root areas, I can use this method for selective removal of concrement without excessive abrasion of hard tooth substance and without leaving unwanted traces of my work. The fact that the process is slightly slower actually turns out to be an advantage. But, in particular, the Vector method can help to prevent quite a few periodontal surgical interventions. I believe that this particular aspect is not yet adequately recognised by the German health insurance providers in their assessments.

Dr. Johannes-Simon Wenzler: In the future, in addition to periodontal therapy, peri-implantitis treatments will also be increasingly in demand. I could imagine that the Vector system will also be able to demonstrate its strengths in this area as well – perhaps even with dedicated new working approaches specially developed for this application.

Prof. Dr. Andreas Braun: As part of the research work we have carried out, we have also looked at first experiments in endodontic applications. Subject to targeted further development in this direction, I believe that – under certain conditions – in the future it will be possible to establish the Vector method alongside periodontal therapy and peri-implantatis treatments in the field of endodontics as well.

Interview with Prof. Andreas Braun and Dr. Johannes-Simon Wenzler

Fiber Posts and Tooth Reinforcement: Evidence in the Literature

Leendert (Len)

Boksman, DDS, BSc, FADI, FICD

Gary Glassman, DDS, FRCD(C) Gildo Coelho Santos Jr.,DDS, MSc, PhD

Manfred Friedman, BDS, B.ChD.

“Traditional thinking that a post is only placed to retain a core and serves no other purpose may no longer be valid.” (1)

The preservation of dentin during access opening, shaping the canal, preparing the root for placement of a post, and during restoration with an onlay or full coverage preparation is critical to the clinical longevity and success of the final restoration. (2) It is now well recognized that excess removal of dentinal support, not only in the root, but also coronally, changes the flexural behavior and resistance to failure, and that overflaring the canal for straight line access to the canals weakens the dentinal complex. (3-6) Dentin coronally must be maintained, not only to give support to the core buildup, (7,8) but as well, because clinical and in vitro studies support the fact that survival of endodonticallytreated teeth restored with posts is directly proportional to the residual coronal dentin that remains. (9,10)

Post preparation of the root canal space must not remove additional dentin, as this contributes to a reduced fracture toughness. (Fig. 1) Ree et al. state that “no additional

dentin should be removed beyond what is necessary to complete the endodontic treatment”. (11) If this concept is to be adhered to clinically, then of course the use of parallel sided posts must be eliminated from our clinical protocol, as these posts usually require removal of sound apical radicular dentin, creating sharper internal line angles, resulting in a weakened root and a higher root fracture risk (Fig 2). (12) As well, the parallel post does not complement the tapered shape of the prepared canal, resulting in excess luting composite in the coronal aspect of the canal, which can decrease bonding efficacy and decrease dislocation resistance (Fig. 3). (13) If we adhere to the concept of minimal dentin removal in the root, and if we recognize that most root canals are ovoid in shape, then a wholly different treatment approach than what we have been taught in the past is indicated. Boksman et al. have recommended utilizing a tapered master quartz fiber post (MacroLock™ Post Illusion X-RO Clinical Research Dental, London, Ontario) with additional Fibercones (Clinical Research Dental, London, Ontario)

Treatment Options

The patient was presented with the following options to address her chief complaint. Option 1: Space Opening

Real-time data sharing and collaboration have revolutionized modern dental technology, making it easier for dental professionals to access patient data and engage with each other.

work seamlessly in the background to help scale the business. This means that once staff members have set up the technology correctly, they can rely on it to handle many routine administrative tasks automatically. As a result, staff and providers can spend less time on manual tasks and more time to devote to diagnosis, treatment planning, and patient education.

Cloud-based systems, for example, can handle the additional workload and data that comes with increased patient volume. They are an efficient way to store, process, and share patient data, helping to ensure the dental practice is prepared for growth and equipped to deliver the best possible care at scale.

With the power of modern technology, dental practices can position themselves for success in today’s fast-paced healthcare landscape, staying ahead of the curve and providing higher-quality care and, ultimately, better outcomes for all.

Wet & dry trial was done to check the marginal fit. Veneers were prepared for final bonding.

Fig. 11: Chairside Armamentarium for Bonding the Prosthesis9%HF by Angelus, Silane coupling agent(Angelus), Single bond Univeral bonding agent (3M), Relyx veneer light cured adhesive cement (3M)to lute the veneers.

Rubber dam isolation was carried out. The veneers were cleaned thoroughly & stabilised using a putty bed. This was followed by etching the intaglio surface of the veneer with 9%HF for 10-15 secs followed by rinsing & air drying. This was followed by applying a coat of the silane coupling agent.

After a tooth extraction, approximately 30% of the alveolar ridge is lost because of resorption¹. Using a membrane improves the amount, quality, and contour of the desired bone.

Thanks to years of research leading to a patented technology, R.T.R.+ Membrane is the first resorbable membrane composed of 100% vegetalbased polymer, making it effective and easy to handle. It is the perfect addition to the bone graft R.T.R.+ for a successful, synthetic procedure.

12: (L-R):1. HF application, 2.Frosty appearance of the intaglio surface, 3.Application of silane-coupling agent.

● With a resorption time of 4 to 6 months and a bilayer structure, R.T.R.+ Membrane is highly effective within an appropriate time frame for bone regeneration.

● R.T.R.+ Membrane has a great resistance to exposure. In case of suture rupture, it can be left in place to guide tissues to heal properly.

As the prosthesis was now ready for bonding the intraoral steps for bonding were carried out. 37% phosphoric acid was applied to the tooth surfaces of the central incisors for 20 secs. followed by rinsing thoroughly & the surface was air dried. Universal bonding agent (Single bond universal 3M) was applied & air dried to a thin uniform layer.

● R.T.R.+ Membrane is compatible with every bone graft and available in 4 sizes.

1 Hsi Kuei Lin, Yu Hwa Pan, Eisner Salamanca, Yu Te Lin 5 and Wei Jen Chang. Int. J. Environ. Res. Public Health 2019, 16, 4616; Prevention of Bone Resorption by HA/β-TCP + Collagen Composite after Tooth Extraction: A Case Series

more information, please visit www.septodont.com

Fig. 10 - (L-R): Veneers received from the lab. Lab credits: Precision Dental Lab, Thane, Mumbai

Fig.

placed into the irregularity (lateral spaces) of the canal (Figs. 4 & 5). (14) This technique is similar to using a master gutta percha point with accessory gutta percha points, which is well-understood. Utilizing this approach provides several clinical advantages (15-19) including more anti-rotational resistance, decreased volume of composite or cement lateral to the post to decrease the C and S Factor constraints (volumetric shrinkage), better adhesion to the root canal walls resulting in decreased microleakage and increasing resistance to dislodgement, as well as decreased likelihood for lateral perforation. The combination of a post, or multiple posts, that transmit light efficiently, with sufficient extended light curing time/output, results in better composite polymerization.

The indirect cast gold/metal/zirconia post and core has been largely replaced with a one appointment restoration of a direct post and core. Fiber posts such as the Ultradent Unicore Fiber Post (Clinical Research Dental, London, Ontario), the quartz fiber posts manufactured by RTD (St. Egreve, France), the Macro-Lock X-RO (Clinical Research Dental, London, Ontario), and the DT Light-Post (Bisco Canada, Richmond, BC) have many physical characteristics that make them more desirable clinically, rather than metal and zirconia posts:

1: The elastic modulus (or a material’s stiffness) of fiber posts more closely approximates that of dentin (18.6 Gigapascals-GPa) allowing some slight flex in function, dissipating stress, and reducing the likelihood of damage to the root. (20,21) Stainless steel has an elastic modulus of about 200GPa, titanium alloy 110GPa and Zirconia 300GPa. (22) The stiffness of metal and zirconia posts creates more internal stress, zones of tension and shear during function and parafunction, (23) which can result in unrestorable catastrophic root fractures.

2: Fiber posts have a high flexural strength, and in a study by Stewardson, “the flexural strength of fiber reinforced composite endodontic post materials exceed the yield strength of gold and

stainless steel and two of the FRC (fiber reinforced composite) posts were comparable to the yield strength of titanium”. (24) It must be noted here that not all fiber posts are created equal. There are differences in fracture load, flexural strength, fiber diameter, fiber/matrix ratio, type of fiber (with quartz fiber posts having higher failure resistance), light transmission, shape, post surface adhesion, quality of fiber, structural defects/voids, and manufacturing quality, which all affect the clinical outcome and longevity. (25-29,16) The clinician must make an informed choice for choosing a fiber post – looking for the best attributes above – in order to select the post with superior properties based on independent research. The dental practitioner must also be aware of the best adhesive combinations and techniques as there are some incompatibilities between dual-cure core materials and simplified acidic adhesives due to residual acidity. There is a variation in the results of the scientific literature when evaluating fiber posts, not only because of the differences in the posts themselves, but also because of the cementing/bonding/adhesive systems used. To date, multiple articles in the scientific literature support the statement that “only specific combinations of dentin adhesives and luting cements prove efficient, with total etch adhesives combined with dual-cure cement (composite) appearing to be the best choice”. (30,31)

3: Fiber posts are not subject to galvanic or corrosion activity. The corrosion of base metals predisposes to a high percentage of failures with cast posts which can also create a negative esthetic outcome of a dark root and darkening of the gingival collar (Fig. 6A). (32, 33) Milnar and others have published excellent papers showing that the use of a light transmitting post can eliminate this common esthetic challenge, allowing not only light transmission down the canal eliminating the dark gingival colour, but also the creation of superb clinical esthetics with translucent ceramics over a composite core (Fig. 6B). (34-36)

4: Clinically, heavily restored teeth may hold up to normal occlusal function but many fail in cyclic fatigue–repeated functional stress and torque.

21 Fiber than metal posts, and the quartz fiber post is found to be more than twice as fatigue resistant as the stainless and titanium alloy posts. (37) During repeated fatigue loading, the flexural strength of metal posts can decrease by 40%, whilst there is only a 14% decrease in a fiber composite post. (38)

5: Endodontic procedures do fail, either due to faulty technique, the inability to access or completely debride a canal, micro-leakage/ bacterial contamination/exposure to endotoxins after endodontic therapy is performed, but before a final restoration is placed (all endodontic procedures should be followed by immediate restoration), (39,40) or due to failure and microleakage of the coronal restoration. It has been estimated that 25% of re-treatments involve the presence of a post. Fiber posts are atraumatically removed in a matter of a few minutes with available proprietary removal drill systems. (41-43)

No discussion of the restoration of a badly broken down endodontically-treated tooth would be complete without discussing the concept of the circumferential ferrule, which is defined as “a metal band or ring that encircles the tooth in order to provide retention and resistance form, as well as protect the tooth from fracture”. (44)

Most of the published articles, based on in vivo and in vitro data, suggest that a 2mm ferrule is best for improving resistance to fracture with significant decreases when the ferrule is 1mm or nonexistent. (45-47) However, it is not only the height of the remaining dentin that is critical for creating the ferrule, but just as important is the width of the remaining dentin and the number of walls. As shown in Figures 7 and 8, there is a drastic difference in outcomes when preparing a ferrule in a modestly flared canal versus a wide flare. As can be seen, when a wide flare exists, the preparation of a ferrule actually removes the dentinal lateral walls creating a stand-alone core

that essentially has no ferrule at all. It is important to note here that glass ionomer cements and resin modified glass ionomers lack the physical properties to function as a core material. (48,49) Jotkowitz et al. in their article on “Rethinking the Ferrule”, provides one of the best regression analyses and clinical guidelines in the literature, evaluating the effects of the height, number of walls remaining, thickness of the walls, and whether a mesial/distal or buccal/lingual wall is remaining in relationship to the functional stresses involved. (50) A simple example would be the difference of losing a lingual wall on an upper central – even if three walls remain – which can be catastrophic due to the torque placed on the lingual in function, as opposed to losing an interproximal wall which has little weakening effect when lingual stress is applied. Their conclusion is that no ferrule equals un-restorable. “Clinical protocols should feature well-defined inclusion criteria, including delineation of the number of residual coronal walls, for a clearer assessment of the influence of the remaining tooth structure on treatment outcomes”. (51)

As the number of remaining walls decrease, the fracture resistance decreases when no post is used, but the fracture resistance is increased significantly when fiber posts are placed – except when there is no wall left. (52) “The success rate for all posts decreases drastically in the absence a residual coronal wall.” (51)

The literal definitions of reinforcement from various sources includes: • A device designed to provide additional strength;

• To strengthen by adding extra support;

• To make stronger;

• To strengthen with some added piece, support or material;

• To make a structure stronger.

Much of the dental literature and texts from the 1970s to the early 1990s indicate that a post is placed when there is insufficient structure left to retain a core/crown, and that metal posts do not reinforce the root. (53-56) Retrospectively looking at research on endodontically-treated

teeth utilizing metal posts certainly support this finding. (57,58)

However, more recent research articles and publications are creating a body of work that fiber posts do indeed make the root more resistant to fracture and may strengthen the root. What follows is only a partial list with short summaries of some of the more recent relevant studies supporting the notion of reinforcement by using fiber posts:

D’Arcangelo et al. (59) studied the fracture resistance and deflection of teeth restored with a fiber post and prepared for veneers.

Seventy-five human maxillary central incisors with similar anatomic crowns were included: no preparation, veneer preparation, endodontic access filled with composite, endodontic access with composite and veneer preparation, and fiber post placement (RTD Endo Light Post) followed by veneer preparation. All specimens were thermo cycled and submitted to fracture strength tests by using a displacement measurement system. Preparation for veneers increased the deflection values of the specimens, but the fiber reinforced post restoration with veneer preparations did not show statistically significant differences from the intact unprepared incisor.

When investigating the fracture resistance and failure mode of premolars restored with composite resin and various prefabricated posts Hajizadeh et al. (1) utilized 60 extracted teeth with four subgroups: no cavity preparation, endodontics with an MOD and no post, endodontics with a DT Light Post (RTD) and MOD, and the last group with endodontics, Filpost (Filhol Dental, Gloucestershire, UK) and an MOD composite restoration. The teeth restored with the DT Light Post and composite were as strong as the control (the unprepared tooth) and stronger than those teeth restored with composite alone without a post, and those restored with a Titanium post and composite. In the DT Light Post group, 86% of the fractures were “restorable”, which was much higher than any of the other three groups. According to the authors, “There is growing

evidence that fiber posts provide the additional benefit of increased fracture resistance.”

The effect of placing fiber posts under zirconiaceramic crowns was studied by Salameh et al. (60) Ninety mandibular second molars were divided into three test groups representing various extents of coronal damage, endodonticallyaccessed and obturated with warm vertical condensation.

Half of the specimens were restored with composite, the other half with a translucent FRC post (Rely-X Fiber Post 3M/Espe) with a composite core. The insertion of the fiber post improved the support under the zirconia crowns, which resulted in higher fracture loads and favourable failure type compared to a composite core build-up. Maccari et al. (61) utilized thirty single rooted endodontically-treated teeth to evaluate the fracture resistance of different prefabricated esthetic posts. Included in the study were Aestheti Post (RTD), FibreKor Post (Jeneric Pentron, Wallingford, CT) and CosmoPost (a ceramic post system) (Ivoclar Vivadent, Schaan, Liechtenstein). They summarized that the mean fracture resistance of the glass fiber prefabricated esthetic posts proved a higher fracture resistance than the ceramic post which was less than one half of the fiber posts.

The fracture resistance and failure pattern of endodontically-treated maxillary incisors restored with composite resin, with and without fiber reinforced composite posts under different types of full coverage crowns, was studied by Salameh et al. (62) One hundred twenty maxillary incisors were endodontically-treated and divided into four groups of 30 each and further divided into two sub-groups of restoration with or without a fiber post (Postec Plus, Ivoclar Vivadent, Schaan, Liechtenstein). Restorations placed were PFM, Empress II, SR Adoro crowns and Cercon crowns with all preparations including a 2mm ferrule. Fracture tests showed that the type of crown was not a significant factor affecting the fracture resistance, but the presence of a post was. The authors state

that “although prosthodontic textbooks do not generally advocate the placement of fiber posts in endodontically-treated incisors, the results of this study indicate that the use of fiber posts in such teeth increases their resistance to fracture and improves the prognosis in case of fracture.”

In a study of 80 endodontically-treated maxillary premolars treated with or without fiber posts, and MOD cavity preparations restored with different types of crowns including porcelain fused to metal, lithium disilicate, fiber reinforced composite or zirconia crowns, Salemeh et al, (63) loaded the restorations until failure recording the maximum breaking loads. Under vertical loading conditions, the fracture loads of teeth restored with fiber posts were significantly greater than those without posts, and the fiber posts significantly contributed to the reinforcement and strengthening of pulpless teeth by supporting the remaining tooth structure against vertical compressive stresses.

There are many more studies showing the reinforcement of tooth structure with fiber posts.64-73 It is impossible to summarize them all, but it seems obvious that our concept of restoring endodontically-treated teeth is continually advancing as new products and bonding techniques evolve. Even when there are variations in the types of fiber posts used in the studies, and different cementation and adhesive protocols, there is compelling evidence that fiber posts can reinforce tooth structure.

To create balance in this overview of the literature, it must be said that there are of course some published scientific articles that do not show a reinforcing effect of fiber posts. (7,74,75)

In addition to the traditional definition of mechanical reinforcement: restoring a compromised tooth to a fracture strength equal to or greater than its original “untreated” fracture resistance, we clinicians perhaps should be more focused on the predictability of outcomes, particularly in worst-case scenarios. That is the contribution of the post versus no post, or composite only, to the remaining structures. The

most predominant conclusion emerging from the growing body of in vitro (76-79) (and clinical) data is that failures of fiber posts in situ are more likely to be described as “non catastrophic” or “repairable” which is usually not the case with high modulus posts.

Furthermore, recently published clinical trials correlate the success rate to the number of remaining dentin walls. (51,80,81) Variations in the literature on fiber posts are the results of: use of natural teeth or bovine teeth, in vivo versus in vitro results, the effect of the periodontal ligament in distributing some of the stresses, loading technique (vertical, horizontal or at an angle), the type and quality of the post, the recognition of the “secondary smear layer” and how it affects adhesion, the type of radicular dentin that is to be bonded, the adhesive used, the light carrying or transmission capability of the post, the type of composite used to cement the post, the amount of composite lateral to the post, the filler loading of the composite, and the amount of critical dentin that is removed to place the post.

Adhesive bonding in the root canal has its unique challenges due to dentinal structure in the canal (coronal dentin bonds better than apical dentin), the “secondary smear layer” of debris from gutta percha and sealer that compromises the ability of simplified systems to actually bond to the root surface (results in mainly frictional resistance), C and S Factor polymerization effects, curing to depth when using dual-cured composite (all dualcured composites have a higher polymerization percentage when exposed to sufficient light) resulting in better overall physical properties, and material incompatibilities.

Fiber post restoration techniques require a meticulous protocol and the clinician is urged to scour the literature, not only for the best fiber post available but also the best techniques for placement. Materials and techniques for fiber post restoration of endodontically-treated teeth are continuously evolving with the inevitable outcome of better clinical results for our patients.

Fiber

Figure 1 Especially in ovoid canals (which are the norm) post preparation needlessly remove dentin and result in weakening the remaining tooth structure, leaving lateral gutta percha which compromises bonding/cementation.

FIGURES

Figure 1 Especially in ovoid canals (which are the norm) post preparation can needlessly remove dentin and result in weakening the remaining tooth structure, while leaving lateral gutta percha which compromises bonding/cementation.

Figure 1 — Especially in ovoid canals (which are the norm) post preparation can needlessly remove dentin and result in weakening the remaining tooth structure, while leaving lateral gutta percha which compromises bonding/cementation.

3

Figure 3 — The taper of the Macro-Lock post allows respect for the dentin and ensures a more even and minimal amount of surrounding composite resin, thereby reducing polymerization contraction forces.

Figure 3 The taper of the Macro -Lock post allows a more even and minimal amount of surrounding composite polymerization contraction forces.

Figure 2 To seat the inserted parallel sided post into the tapered canal would more apical removal of vital dentinal structure needlessly weakening the root creating an apical stress point.

Figure 2 — require more apical removal of vital dentinal structure needlessly weakening the root and creating an apical stress point.

Figure 4 In irregular or ovoid canals the use of Fibercones RO has many clinical advantages increasing longevity.

Figure 4 — In irregular or ovoid canals the use of Fibercones lateral to the Macro-Lock X RO has many clinical advantages increasing longevity.

To seat the inserted parallel sided post into the tapered canal would require dentinal structure needlessly weakening the root and

Figure 5 — A clinical photograph showing the placement of Fibercones laterally to the main Macro-Lock Post which decreases composite volume, adds anti-rotational elements, and decreases microleakage.

Figure

The taper of the Macro-Lock post allows respect for the dentin and ensures a more even and minimal amount of surrounding composite resin, thereby reducing polymerization contraction forces.

Figure lateral to the Macro-Lock XRO has many clinical advantages

Fiber

Figure 6A The common esthetic failure when using of the tooth structure as well as the gingival collar.

Figure 6A — The common esthetic failure when using metallic posts with discolouration of the tooth structure as well as the gingival collar.

Figure 6B — The result of placing a light transmitting fiber post with a translucent ceramic.

Figure 6B The result of placing a light transmitting ceramic.

Figure 7 — The typical result of creating a full crown with a ferrule in a moderately tapered endodontic access opening.

Figure 7 The typical result of creating a full crown with a ferrule in a moderately tapered endodontic access opening.

Figure 8 — When preparing a ferrule on a tooth with a wide flare, the preparation removes all lateral dentin creating a stand-alone core which drastically decreases the clinical success rate.

Figure 8 When preparing a ferrule on a tooth with a wide removes all lateral dentin creating a stand-alone core which drastically clinical success rate.

AUTHORS

Dr. Len Boksman graduated as a DDS from the Faculty of Dentistry, University of Western Ontario in 1972. After 7 years in private practice, he joined the Faculty of Dentistry at Western as an assistant professor of operative dentistry, shortly thereafter attaining the tenured position of Associate Professor. He has authored more than 100 articles and several chapters in textbooks and was awarded the Ontario Dental Association Award of Merit in 2005. He has recently been appointed as adjunct professor in the University of Technology Dental School, Jamaica, where he donates his time. He can be contacted at lenpat28@gmail.com.

Dr. Gary Glassman graduated from the University of Toronto, Faculty of Dentistry in 1984 and was awarded the James B. Willmott Scholarship, the Mosby Scholarship and the George Hare Endodontic Scholarship for proficiency in Endodontics. A graduate of the Endodontology Program at Temple University in 1987, he received the Louis I. Grossman Study Club Award for academic and clinical proficiency in Endodontics. The author of numerous publications, Dr. Glassman lectures globally on endodontics, is on staff at the University of Toronto, Faculty of Dentistry in the graduate department of endodontics, and is Adjunct Professor of Dentistry and Director of Endodontic Programming for the University of Technology, Jamaica. Gary is a fellow of the Royal College of Dentists of Canada, and the endodontic editor for Oral Health dental journal. He maintains a private practice, Endodontic Specialists in Toronto, Ontario, Canada. He can be reached through his website www.rootcanals.ca.

Dr. Santos received his DDS (1986) and MSc in dental clinics (1999) from Federal University

of Bahia, and PhD in prosthodontics (2003) from University of São Paulo. Dr. Santos was appointed as assistant professor, Division of Restorative Dentistry at the University of Western Ontario Schulich School of Medicine and Dentistry in 2006 and in 2011 was appointed chair of the Division of Restorative. He has several publications in international journals and has trained and mentored graduate students in the area of biomaterials research throughout his career. He can be reached at via e-mail at gildo.santos@ schulich.uwo.ca.

Dr. Manfred Friedman graduated from the University of Witwatersrand and Johannesburg in 1971 and then obtained his BChD Honours at the University of Pretoria in 1980. He immigrated to Canada in 1987 where he took up a full-time position at the University of Western Ontario (UWO) and was appointed as director of dentistry at The Southwestern Regional Center for developmentally challenged adults from 1987 to 1994. Dr. Friedman was also the director of the undergrad endo program from 1997 to 2002. He currently has a full-time practice in London, ON, restricting his practice to endodontics, and is a major part-time adjunct professor at Schulich School of Medicine and Dentistry at UWO, where he directs the endodontic lab course as well as acts as clinical instructor.

Dr. Friedman has given numerous courses on endodontics since joining UWO, with particular interests in rotary instrumentation, endodontic materials, apex locators, and restoring the endodontically treated tooth. He can be reached at (519) 673-5293 or at friedmanm@rogers.com.

The authors would like to thank Mrs. Laura Delellis for her work creating the figures used in this article.

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56 Assif D, Gorfil C. Biomechanical considerations inrestoring endodontically treated teeth. J Prosthet Dent 1994;71:565-567.

57 Trope M, Maltz DO, Tronstad L. Resistance to fracture of restored endodontically treated teeth. Endod Dent Traumatol 1985;1:108-111.

58 Guzy GE, Nichols JI. In vitro comparison of intact endodontically treated teeth with and without endopost reinforcement. J Porsothet Dent 1979;42:39-44.

59 D’Arcangelo C, De Angelis FDe, Vadini M, Zazzeroni S, Ciampoli C, A’Amario M. In vitro fracture resistance and deflection of pulpless teeth restored with fiber posts and prepared for veneers. JOE July 2008;34(&):838841.

60 Salameh Z, Ounsi F, Aboushelib MN, Sadig W, Ferrari M. Fracture resistance and failure patterns of endodontically treated mandibular molars with and without glas fiber post in combination with a zirconiaceramic crown. Journal of Dentistry 2008;36(7):513-519.

61 Maccari PC, Conceicao EN, Nunes MF. Fracture resistance of endodontically treated teeth restored with three different prefabricated esthetic posts. J Esthet Resor Dent 2003;15:25-31.

62 Salameh Z, Sorrentino R, Ounsi HF, Sadig W, Atiyeh F, Ferrari M. The effect of different full coverage crown systems on fracture resistance and failure pattern of endodontically treated maxillary incisors restored with and without glass fiber posts.

63 Salameh Z, Sorrentino R, Ounsi HF, Goracci C, Tashkandi E, Tay FR, Ferrari M. Effect of different all-ceramic crown system on fracture resistance and failure pattern of endodontically treated maxillary premolars restored with and without glass fiber posts.

JOE July 2007;33(7):848-851.

64 Schmitter M, Huy C, Ohlmann B, Gabbert O, Gilde H, Rammelsberg P. Fracture resistance of upper and lower incisors restored with glass fiber reinforced posts. J Endod April 2006;32(4):328-30.

65 Carvalho CA, Valera MC, Oliveira LD, Camargo CHR. Structural resistance in immature teeth using root reinforcements in vitro Dent Traumatol June 2005;21(3):155- 159.

66 Rosentritt M, Sikora M, Behr M, Handel G. In vitro fracture resistance and marginal adaptation of metallic and tooth coloured post systems. J Oral Rehabil July 2004;31(7):675-81.

67 Goncalves LA, Vansan LP, Paulino SM, Neto MDS. Fracture resistance of weakened roots restored with a transilluminating post and adhesive restorative materials. J Prosthet Dent Nov 2006;96(5):339-344.

68 Naumann M, Preuss A, Frankenberger R. Reinforcement effect of adhesively luted fiber reinforced composite versus titanium posts. Dent Mater Feb 2007;23(2):138-144.

69 Hayashi M, Takahashi Y, Imazoto S, Shigeyuki E. Fracture resistance of pulpless teeth restored with post-cores and crowns. Dentr Mat 2006;22:477-485.

70 Hayashi M, Sugeta A, Takahashi Y, Imazato S, Ebisu S. Static and fatigue fracture resistance of pulpless teeth restored with post-cores. Demt Mat Sept 2008;24(9):1178- 1184.

71 Salameh Z, Ounsi HF, Aboushelib MN, Al-Hamidan R, Sadig W, Ferrari M. Effect of different onlay systems on fracture resistance and failure pattern of endodontically treated mandibular molars restored with and without glass fiber posts. Am J Dent 2010;23(2):81-86.

72 Ferrari M, Cagidiaco MC, Grandini M, De Sanctis M, Gorraci C. Post placement affects survival of endodontically treated premolars. J Dent Res 2007;86(8):729-734.

73 Nothdurft FP, Seidel E, Gebhart F, Naumann M, Motter PJ, Pospiech PR. The fracture behavior of premolar teeth with class II cavities restored by both direct composite restorations and endodontic post systems. Journal of Dentistry June 2008;36(6):444- 449.

74 Kreijci I, Duc O, Dietschi D, de Campos E.. Marginal adaptation, retention and fracture resistance of adhesive composite restorations on devitalized teeth with and without posts. Oper Dent 2003;28(2):127-35.

75 Abdul Salam SN, Banerjee A, Mannocci F, Pilecki P, Watson TF. Cyclic loading of endodontically treated teeth restored with glass fibre and titanium alloy posts: fracture resistance and failure modes. Eur J Prosthodont Restor Dent Sept 2006;14(3):98-104.

76 Cormier C, Burns D, Moon P. In vitro comparison of the fracture resistance and failure mode of fiber, ceramic, and conventional post systems at various stages of restoration. J Prosthodont 2001;10:26-36.

77 Fokkinga WA, Creugers NH, Kreulen CM. In vitro failure mode of fiber-reinforced post core systems: A systematic review. J Dent Res. Vol. 82 IADR Abrstact #2563, 2003

78 Le Bell-Ronnlof AM, Lassial LV, Kangasniemi I, Vallittuu PK. Load-bearing capacity of human incisor restored with various fiber-reinforced composite posts. Dent Mater. Jun 2001;27(6):e107-15 Epub 2011 Mar 27.

79 Cagadiaco MC, Goracci C, Garcia-Godoy F, Ferarri M. Clinical studies of fiber posts: a literature review. Int J Prosthodont. JulAug 2008;21(4):328-36.

80 Bitter K, Noetzel J, Stamm O, Vaudt J, Meyer-Lueckel H, Neumann K, Kielbassa A. Randomized clinical trial comparing the effects of post placement on failure rate of post-endondontic restorations: Preliminary results of a mean period of 32 months. J Endod 2009;35:1477-82.

81 Naumann M, Koelpin M, Beuer F, Meyer-Lueckel H. Ten-year survival evaluation or glass-fiber-supported postendodontic restoration: a prospective observational clinical study. J Endod Apr 2012;38(4):432-5 Epub 2012 Feb 16.

Accutron™ Digital Ultra™ Flowmeters

The Accutron Digital Ultra™ Flowmeter offers user-friendly, advanced technology and includes enhanced safety features. It allows clinicians to work in a digital environment with color-coded, fingertip controls, while displaying critical parameters both numerically and as electronic flow tubes. Its sealed flush surface makes it easy to disinfect or barrier-protect. The unit‘s design complements aseptic, contemporary operatory environments.

• Automatic compensation to easily adjust total flow or gas ratio while the other stays constant.

• Both digital and electronic flowtube displays for ease of use.

• Maximum nitrous oxide ratio at 70% for patient safety.

• Audible and visual alarms to notify of low oxygen.

• Oxygen fail-safe and flush for additional safety.

• Emergency oxygen resuscitation connector.

• Sealed flush surface makes it easy to disinfect or barrier protect.

There are two options for portable Digital Ultra solutions that can seamlessly move between operatories – the 4-cylinder stand package and the Newport™, which is fully enclosed.

Advanced Conscious Sedation Systems

Accutron™, a proud member of HuFriedyGroup, is a leading manufacturer of innovative nitrous oxide/oxygen sedation equipment and accessories. For over forty-five years, our focus has been to design and manufacture the highest quality sedation products that assist dental practitioners in relaxing their patients and making their dental visit a comfortable experience.

Accutron™ products are proudly made in the USA, in Phoenix, Arizona.

Accutron™ ClearView Nasal Masks

Accutron™ ClearView™ Nasal Masks feature a mask-in-mask design to minimize ambient nitrous oxide in the operatory. This design eliminates the need for a “scavenging hub” on the scavenging circuit in older designs such as the Accutron™ PIP+ Nasal Mask and others. The clear outer mask allows you to monitor patient breathing, as condensation appears when the patient is properly breathing through their nose. The colorful, soft inner mask design creates an improved facial seal.

Additional Features:

• Lower profile than original designs to expand clinical field of view

• Single-use minimizes cross-contamination; saves staff time

• Appealing colors and scents engage and relax patients

• Can be used with other brands of scavenging circuits

• 12 individually wrapped nasal masks/box

Not made with natural rubber latex.

For more information, contact Piro Trading International +1-209-667-7204 • caroline@pirotrading.com

Accutron is now a proud member of

trident View Gold

I-View Gold Intraoral sensor

Thanks to the advanced calibration tool, the I-View Gold captures high-definition images without any filters. Calibration files are used to remove any imperfections during acquisition, reducing noise and enhancing detail. As a result, the images captured by the I-View Gold require no further processing, ensuring reliable images, accurate diagnosis and time efficiency.

- DICOM compatibility

- Bridge feature for connecting to other dental management software.

- TWAIN option

- Multiuser connection

Etch, prime and bond in one step!

The trend in the development of adhesive systems is to improve adhesion while simplifying clinical manipulation steps. Along with that, the use of universal adhesives has been increasing and its performance has been reported to be clinically sufficient.

With BeautiBond Xtreme, SHOFU continues to evolve the latest generation of a true universal adhesive. By introducing a new type of Acid Resistant Silane coupling agent (ARS), a chemical composition with excellent stability has been designed to allow the surface treatment of a wide range of adherends with an easy-to-use system. BeautiBond Xtreme is a light-curing, self-etching all-in-one universal adhesive for bonding direct and indirect restorations. It has “inherited” the excellent properties of the former BeautiBond Universal bonding system, such as bond strength, low technique sensitivity, convenient application and simplified one-step application procedure.

The multi-talent where safe and reliable bonding is required

Thanks to the new silane bonding agent ARS, BeautiBond Xtreme bonds to enamel, dentine and various indirect restorative materials (composite, precious and non-precious alloys, glass-ceramics, alumina and zirconia). An additional primer is not required.

February 23-24-25, 2024

HAMMAMET - TUNISIA

Dr. Bassem maatar, PresiDent of the tunisian Dental synDicate stmDlP

Group photo from the meetinG of the ArAb DentAl feDerAtions hosteD by the tunisiAn DentAl AssociAtion

Picture in the exhiBition floor with Prof. naBiha Douki

l. to r. Drs. mouraD khaBthani, eman traBoulsi, Bassem maatar, tony DiB, mohameD kessentini, sinen Bejia

closing ceremony with tunisian traDitional clothing

BoarD memBers in traDitional tunisian clothing

grouP Photo of the tunisian Dental association BoarD memBers

Dr fAten benAmor receivinG her certificAte for the lecture on cbct AnD intrA orAl scAnners in implAntoloGy

Dr mAssimo frosecchi lecturinG on full Arch immeDiAte loADinG protocols

Dr. Bilel marawi lecturing on new technologies at the service of Dentistry

Dr. faten Benamor lecturing on cBct anD intraoral scanners in imPlantology

Prof. ronalD younes receiving the certificate for his lecture on Preserving alveolar riDge

Dr. naBiha Douki receiving the certificate for her lecture on white enamel lesions

Dr slim haffani anD mr. DaviD hamou receiving the certificates for their lecture on metismile face scanner anD augmenteD reality

Prof. carina mhanna receiving her certificate for her lecture on artistry in ceramic veneers

Prof. mohameD rayyan receiving his certificate for his lecture smart restorations following enDoDontics

l. to r. Drs. tony DiB, mouraD khaBtani, Bassem maatar, faDhila Zariat, mohameD kessentini

The 10th Lebanese International Dental Congress

25-26 & 27 April 2024,

Beirut

Arab University - Tripoli Campus

To

to R. Joseph

tony

touFic

pResiDent oF the chambeR oF commeRce in tRipoLi, ministeR mohameD moRtaDa, hani chaaRani, saLma

the Lebanese DentaL association, tRipoLi oFFeRing the pLaque oF appReciation to the ministeR oF cuLtuRe, mohameD moRtaDa. L. to R. steFany chahRouq, tony FRangieh, nazem haFFaR, h e mohameD moRtaDa, eLie DaouD

DR. Joseph hayeck, pResiDent oF the conFeRence committee

L.

hayeck,

FRangieh, nazem haFFaR,

Dabbousi-

FaouaL

inauguRation oF the exhibition FLooR with ministeR mohameD moRtaDa

photo FRom the exhibition FLooR

L. to R. DRs. tony FRangieh, kaRim kabbaRa, ministeR mohameD moRtaDa, hani chaaRani, pResiDent nazem haFFaR, maya haFFaR, nazih saLeh, ouLa Raii, Dean magueD Fahmy

photo FRom the exhibition FLooR

DR. ahmaD eLsayeD, LectuRe on FRee hanD aRtistRy backeD with 3D DigitaL technoLogy

DR hani ounsi LectuRe on cLeaning-DRiven instRumentation

ghassan bassit LectuRe compaRing tRaDitionaL anD DigitaL thinking in impLantoLogy

photo FRom the exhibition with the egyptian DentaL association DeLegation

L. to R. DRs eLie DaouD, kaRim kabbaRa, saLma FaouaL, tony FRangieh, RahiL Doueihy, maya zakaRia, nazih saLeh

DR

photo FRom the exhibition with the egyptian DentaL association DeLegation

DIGITAL INNOVATIONS

April 26 and 27, 2024 Antonine University, Baabda, Lebanon

L. to R. DRs. Amin Zoghbi, ZiAD sALAmeh, CARoLe YAReD, mARwAn DAAs, ReCtoR sAghbini, PieRRe KhouRY, mAYA nohRA, Jose ChiDiAC

Distinguish guests, I am thrilled to welcome each one of you to the Scientific Congress and Exhibition 2024, jointly organized by the Antonine University’s Department of Dental Laboratory Technology at the Faculty of Public Health, the Lebanese Society of Prosthodontics, and in partnership with the French Dental Association.

As we convene at this esteemed scientific congress focused on digital innovation in dentistry, it is my privilege to address the pivotal role of collaboration between dentists and dental laboratory technologists in advancing our field.

In the landscape of digital dentistry, where innovation is not just a choice but a necessity, the synergy between dental professionals and laboratory technologists is foundational. The seamless workflow between these two entities is paramount in harnessing the full potential of digital technologies to deliver optimal patient care and outcomes. This relationship is not merely transactional; it is founded on a shared commitment to patient well-being and a dedication to excellence in craftsmanship. As we embrace digital technology, it’s vital to remember that it should not replace human expertise, but rather complement and enhance it.

Furthermore, as we reflect on the evolution of our educational practices, it is imperative to acknowledge the transformative impact of technology on our curriculum. In 2010, through a collaboration with Amann Girrbach, one of the leading companies in Austria, we pioneered the integration of CAD/ CAM into our educational framework, transforming the way our students engage with digital dentistry.

As I conclude, and in alignment to our UA values related to excellence and beauty, I would like to emphasize the significance of merging tradition with modern techniques in dental laboratories, where excellence, human skills, technology, and AI converge to create prosthetic wonders and ensure bright, functional and beautiful smiles.

Long live Antonine University, and long live Lebanon.

Maya Nohra, Director of the Dental Laboratory Technology Department at the Antonine University

Révérends Pères Recteurs, Chers Présidents des Ordres, Doyens, Professeurs, Docteurs, Prothésistes, Étudiants et Amis.

Tout d’abord, permettezmoi d’exprimer ma sincère reconnaissance pour les membres du bureau de la société: Camille Haddad, Ghada Ayach, Rahif Tawil, Hani Tohme, Maria Reslan et Alain Abi Sleiman: Votre soutien et votre engagement sont des piliers essentiels de notre réussite collective.

Cet événement marque un moment important dans notre calendrier, où nous avons l’occasion de nous réunir, d’échanger nos connaissances et de renforcer les liens qui nous unissent.

Durant ces deux dernières années, la société a scellé des alliances stratégiques. Nous avons eu le privilège de devenir membre officiel du Global Scientific Dental Alliances à Dubaï depuis octobre 2022. Et le 28 juin 2023 le remarquable MOU avec La prestigieuse Université Antonine qui s’est engagée à promouvoir l’excellence, l’intégrité et le professionnalisme dans l’avancement du domaine de la prothèse dentaire.

Ces partenariats représentent une avancée significative dans notre quête d’excellence et offrant à nos membres l’accès à des ressources académiques de premier plan.

Ces alliances stratégiques témoignent de notre détermination à rester à la pointe de notre domaine d’activité.

Et voilà, cette vision est résumée par ce congrès joignant la LSP, l’Université Antonine et l’Association Dentaire Française. En reconnaissance de leur contribution, un trophée sera attribué à l’Association Dentaire Française, représentée par le Dr Marwan Daas, au Pr Ziad Salemeh, ambassadeur de la «Digital Dentistry Society», ainsi qu’au Pr Amin Zoghbi président de la section Liban et Moyen-Orient de la Société Pierre Fauchard, et qui est nommé membre d’honneur de notre société.

Dr. Pierre Khoury

President of the Lebanese Society of Prosthodontics

nohRA DiReCtoR of DentAL LAboRAtoRY teChnoLogY DePARtment At the Antonine univeRsitY

mARwAn DAAs RePResenting the ADf - AssoCiAtion DentAiRe fRAnçAise

to DR. mARwAn DAAs RePResenting the ADf fRom the ReCtoR of the Antonine univeRsitY

mAYA

L. to R. JuLien monteneRo, JeAnPieRRe CAsu, RoDnY AbDALLAh, feRAs DAhbouR, mohAmeD ZAhLAne

DR.

tRoPhY

PLAque to DR. ZiAD sALAmeh the DDs AmbAssADoR

L. to R. DRs Amin Zoghbi, PieRRe KhouRY, CAmiLLe hADDAD, ZiAD sALAmeh

RoDnY AbDALLAh, eLie sAbbAgh, JeAn-PieRRe CAsu, mAYA nohRA

Photos From the exhibition

IDEX - Istanbul 2024 Istanbul Dental Equipment and Materials Exhibition 8-11 May 2024 Istanbul Expo Center

Great interest in IDEX Istanbul, the unrivaled exhibition of the dental industry!

IDEX Istanbul, the 2nd largest gathering point of the dental sector, Istanbul Dental Equipment and Materials Exhibition, hosted 32,120 international visitors from 185 different countries between 8-11 May, 2024, reaching its own record-breaking trade volume. With over 300 million dollars in trade, the fair also surpassed 90,000 visitors.

IDEX Istanbul, one of the biggest gatherings in the world for dental sector, set a record by generating a trade volume of over 300 million dollars. Another record of the fair was in the number of visitors. Hosting visitors from 185 different countries, IDEX Istanbul welcomed 32,120 international visitors, totaling 93,900 professional buyers. With these figures, the fair once again broke its own record and became the most productive trade platform of the year.

The 19th edition of Istanbul Dental Equipment and Materials Exhibition, IDEX Istanbul, hosted over 1,000 buying groups from more than 130 countries, including Europe, Africa, the Balkans, Gulf Countries, the Commonwealth of Independent States, and Middle Eastern countries.

Another feature of IDEX Istanbul was the number of international exhibitors. At the fair held on May 2024 ,11-8, a total of 598 companies exhibited their products, including 166 international exhibitors from 48 different countries. With over 5,000 brands showcasing their latest technology products at IDEX Istanbul, the realization of visitor and trade records once again proved that the success of IDEX Istanbul is not a coincidence.

Symposiums and courses were met with intense interest from visitors. At the fair, symposiums and hands-on courses were organized where internationally renowned domestic and foreign academics discussed the past, present, and future of the sector. Innovations and developments in oral and dental health were practically addressed in symposium and course programs. Over the course of 4 days, more than 80 trainings were held in a 350 person symposium hall and 4 different course halls, where the world›s leading academics and experts provided information about innovations in the sector to industry professionals and students.

Countdown for IDEX Istanbul 2025 has begun!

IDEX Istanbul, which will take place with a special vision for its 20th year in 2025, will host the largest organization ever made for the dental sector. Organized by the association of the sector, Turkish Dental Businessmen Association (DİŞSİAD) subsidiary company DİŞSİAD Congress and Conference Limited Copmpany the IDEX Istanbul Dental Equipment and Materials Exhibition will once again bring together the global dental sector at the Istanbul Expo Center between 7-10 May, 2025

Belmont Booth

FKG Booth

meSA Booth

Centrix Booth

liBerty mediKAl Booth

nSK Booth

doCtor Smile Booth

mAJor Booth

SAudi dentAl SoCiety Booth

trident Booth

ultrAdent Booth

ShininG 3d Booth

VoCo Booth

Photo From the exhiBition

Photo From the exhiBition

BYBLOS Dental Association

May 11, 2024

Byblos, Lebanon

Dr. EliE rouphaEl, prEsiDEnt of thE ByBlos DEntal association

prof. ronalD younEs, prEsiDEnt of thE lEBanEsE DEntal association

plaquE of apprEciation to Dr. nazEm haffar, prEsiDEnt of thE lDa tripoli

of apprEciation to prof.

plaquE

GEorGEs aoun, DEan of thE DEntal school at thE lEBanEsE univErsity

roGEr rBEiz, lEcturE aBout DEalinG With calcifiED canals

Dr raWaD samarani shEDDinG liGht on DiGital tEchnoloGiEs in implant DEntistry

l. to r. Drs aDiB Kassis, roGEr rBEiz, roula younEs, EliE rouphaEl

l. to r. Drs. tony harB, ronalD younEs, EliE rouphaEl, antoinE choufani, Wisam sharrouf

l. to r. Drs. nazEm haffar, faDi aBillama, EliE rouphaEl, housam Jassar, Dany Bilan

l. to r. Drs. moufiD naWfal, tony DiB, charlEs saKr, EliE rouphaEl, martin BaKhos, nathaliE aBi Ghosn

l. to r. Drs. aBDulKaDEr Bsat, mohamED EiD Khalil, EliE rouphaEl, carina mhanna, tatiana zGhEiB

l. to r. Drs. richarD nassar, nazEm haffar, charlEs saKr, EliE rouphaEl, ronalD younEs, rEDa charafEDDinE, moufiD naWfal

LSP Opening Speech

8th Scientific Meeting

18 May 2024, Hilton Beirut Habtoor Grand

Ladies and Gentlemen, Distinguished Guests,

Esteemed Members of the Lebanese Society of Periodontology,

It is with immense pleasure that I stand before you today at the opening ceremony of the Lebanese Society of Periodontology. This event marks a significant milestone in our journey towards promoting periodontal health and advancing the field of periodontology in Lebanon.

As we gather here, it is essential to reflect on our achievements and the impactful events we have organized, particularly our celebration of Gum Health Day. This annual event has raised awareness about the importance of gum health within our professional community and the general public. Gum Health Day has provided a platform for us to educate people on preventing and treating periodontal diseases, thus contributing to improving public health.

Our society’s efforts have not gone unnoticed on the international stage. As an international member of the European Federation of Periodontology (EFP), we have benefited immensely from the resources and collaborative opportunities provided by this scientific organization. The EFP membership grants us access to cutting-edge research, continuing education programs, and a global network of professionals dedicated to excellence in periodontology. These privileges enable us to stay at the forefront of advancements in our field and apply the latest scientific findings to our practice in Lebanon. We now have a speaker and an ambassador among our members that will join Europerio 11 in Vienna next year on May 17-14, 2025.

Moreover, our society’s involvement in the Lebanese Dental Association’s activities and annual congress, the BIDM, has enhanced our professional development and positioned Lebanon as a key player in the international periodontal community. We take pride in our contributions and the recognition we have received for our dedication to advancing periodontal health.

Today, as we inaugurate this event, let us reaffirm our commitment to promoting periodontal health and excellence in clinical practice to elevate the standards of periodontal care in Lebanon.

I extend my heartfelt gratitude to our speakers, members, and partners who have made our achievements possible.

Thank you, and I wish you all an inspiring event.

Prof. Nada Naaman President of the Lebanese Society of Periodontology

DR. NaDim mokbeL, scieNtiFic cooRDiNatoR oF the LsP

DR. abDuLsaLam aL askaRy LectuRiNg about tReatiNg FaiLeD imPLaNts iN esthetic ZoNe

L. to R. DRs. NayeR aboeLsaaD, Fatmeh hamasNi, NaDa NaamaN, NaDim mokbeL, abDuLsaLam aL askaRy, aNDRea PiLLoNi

PRoF. RoNaLD youNes, PResiDeNt oF the LebaNese DeNtaL associatioN

L. to R. DRs. geoRgiNa eLghouL, geoRge aouN, RoNaLD youNes, NaDa NaamaN, NaDim mokbeL

L. to R. RawaD samaRaNi, abDuLsaLam aLaskaRy, NaDim abou JaouDeh, aLaiN RomaNos

ceRtiFicate oF aPPReciatioN to PRoF. FaDy hage DiRectoR oF the PeRio DePaRtmeNt at the Lu

DR. NayeR aboeLsaaD FRom the beiRut aRab uNiveRsity DePaRtmeNt oF PeRio with FeLLow PeRioDoNtists

L. to R. DRs. NaDim mokbeL, NaDa NaamaN, geoRge aouN, JeaNmaRie meghaRbaNeh, RoNaLD youNes, Fatme hamasNeh, mageD Fahmi, JosePh ghaFaRi, geoRgiNa eLghouL, RogeR mataR, gaby meNassa

DR. NayeR aboeLsaaD haNDiNg the ceRtiFicate to DR abDuLsaLam aL askaRy

Photos From the exhibition

J.M Megarbane received his DDS degree from St Joseph University Beirut-Lebanon in 1969.

He graduated in Periodontology from the University of Paris (France) in 1971 and from TUFTS University, Boston (USA) in 1973.

He was a visiting Professor in Periodontology at the University of Florida, USA. (1974-1978) and Professor and Chairman of the Department of Periodontology at the Lebanese University Beirut, Lebanon (1981-1993).

He is a Member of Pierre Fauchard Academy, French and American Society of Periodontology and numerous scientific societies since 1974.

He is “Founding Member” (1985) and “Board of Directors” (1992-1998) of the International Academy of Periodontology.

He is “Founding Member” (1996) and the Scientific Chairman of the Lebanese Society for Osseointegration.

He was President of the International College of Dentists (Middle East section) from 2008-2010.

He received in 2019 a certificate of Merit for 50 years graduation from St Joseph University-Beirut-Lebanon. He received in 2021 the award “Pioneer in Dentistry” from the American University-Beirut-Lebanon.

He received in 2023 the award of ‘’Greatest Appreciation’’ from the Lebanese University–Beirut-Lebanon at the occasion of its 40th year of foundation.

His C.V. includes 30 published papers in peer reviewed journals and more than 300 invited lectures and courses in the Middle East, Europe and USA.

He lectures in postgraduate programs in Lebanon and abroad.

Since 1974, Professor Megarbane is in limited private practice to Periodontics in Beirut-and founded in 2005 ‘’Masters Dental Clinic’’ where all specialties are present.

hoNoRiNg PRoFessoR JeaN maRie megaRbaNe

Honoring Professor Jean Marie MEGARBANE,

Establishment of TAKARA BELMONT MIDDLE EAST BRANCH in DUBAI

Takara Belmont known world widely as a manufacturer of dental equipment such as dental units, chairs and x-rays opened a new office in Dubai, UAE in May to strengthen its business development in the Middle East region.

Dubai is a hub for logistics, finance, and information in the Middle East, and also actively attracting global companies. By establishing a sales base in this location, Takara Belmont will strive to strengthen its sales and marketing capabilities in the dental market in the region and achieve the highest level of customer satisfaction in order to further expand its overseas business.

Outline of new office:

Name: TAKARA BELMONT MIDDLE EAST

Location: Dubai, United Arab Emirates

(Dubai Airport Free Zone)

Branch Manager: Takahiro Horiguchi

Email: belmont_me@takara-net.com

Opening Date: May 1, 2024

THE CORD FROM THE CAPSULE

• Thin cannula with flexible tip – easy and pinpoint application into the sulcus

• Viscosity Change – paste consistency varies during application and sulcus widening

• Good visibility – contrasty to the gingiva

• A clean product – quick and easy to spray off