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Dental News, Volume XXIII, Number II, 2016
3
ARTICLES 12.
National Oral Health Survey of Oral Health Status of Bahraini School Children Aged 6, 12 & 15 Year Old Dr. Azhar Ali Ahmad Naseeb
CONGRESSES 46.
EOS 2016 Egyptian Orthodontic Society February 11 - 13, 2016 Marriott Hotel, Cairo, Egypt
50.
LSE 2016 Lebanese Society of Endodontics March 18 - 19, 2016 Beirut, Lebanon
54. 24.
OIDC 2016 Oman Int’l Dental Conference March 31 - April 1, 2016 Muscat, Sultanate of Oman
Tooth Size Discrepancy Importance As a Diagnostic Tool for Orthodontic Treatment Planning: A Review Dr. Ahmad Hajar
60.
LDA TRIPOLI 2016
62.
LOS 2016 Lebanese Orthodontic Society
April 21 - 23 , 2016 University of Balamand, Lebanon
May 5-8, 2016 Beirut, Lebanon
66. 36.
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78.
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Dental News, Volume XXIII, Number I, 2016
Dental News, Volume XXIII, Number II, 2016
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w w w.dentalnews.com Volume XXIII, Number II, 2016 EDITORIAL TEAM Alfred Naaman, Nada Naaman, Jihad Fakhoury, Dona Raad, Antoine Saadé, Lina Chamseddine, Tarek Kotob, Mohammed Rifai, Bilal Koleilat, Mohammad H. Al-Jammaz COORDINATOR Suha Nader ART DEPARTMENT Marc Salloum SUBSCRIPTION Micheline Assaf, Nariman Nehmeh ADVERTISING Josiane Younes PHOTOGRAPHY Albert Saykali TRANSLATION Gisèle Wakim, Marielle Khoury DIRECTOR Tony Dib ISSN 1026-261X
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November 1-4, 2016 Alexandria, EGYPT Website: www.aidc2016.com
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34 22 12 Pedodontics
National Oral Health Survey of Oral Health Status of Bahraini School Children Aged 6, 12 & 15 Year Old Dr. Azhar Ali Ahmad Naseeb Consultant Dental Public Health Member, GCC Oral & Dental Health Committee anaseeb@health.gov.bh
Key words et al, 2006). Also a need for consistent and reguChildren, Dental caries, periodontal diseases, Fluo- lar measures of oral health in order to determine rosis, Epidemiology, Bahrain the need for a state programs and to design such preventive programs to produce the most benefit throughout conducting a wide broad study or a Introduction Despite the fact that dental health have been im- national survey. This report presents summarized proved tremendously over the last century but still results of the oral health of 6, 12 and 15 years old prevalence of dental caries in children remains a school children surveyed in the school year 2011significant clinical problem and it is still the single 12, the fourth national oral and dental health surmost common chronic disease of childhood, oc- vey of this age group. curring five to eight times as frequently as asthma, The survey reported here provides information on the second most common chronic disease in chil- the prevalence and severity of dental decay (caries), periodontal diseases, dental fluorosis and dren (AMCHP, 1999). Epidemiological studies done in Gulf Council erosion, traumatic injuries to teeth, oral mucosa Country (GCC) proved that dental caries preva- lesions and complete or partial denture in 6,12 lence among children ranged between 80-90% and 15 years-old children attending governmental as this becoming a priority for the GCC Ministries schools. Further reports will be produced including of Health. Since oral diseases include dental car- summary reports of face to face interview quesies and periodontal diseases, yet these diseases are tionnaire that 12 years children were subjected to. very expensive to treat as identified by U.S. Depart- Thus, aim of this survey is to study prevalence and ment of Health and Human Services in 2000 that: trends of oral and dental diseases among children “dental caries is painful, expensive to treat, and can aged 6, 12 and 15 year olds and provide informaharm nutrition and overall health (USDHHS, 2000) tion about risk factors that have effects on chilalso the same Watt, R. 2005 has stated that: dren’s oral health in order to offer the necessary “Since oral diseases include dental caries, dental data for strengthening dental public health proerosion, dental fluorosis, and periodontal diseases, grams in The Kingdom of Bahrain. but these are expensive to treat but at the same time they are largely preventable”(Watt, R., 2005), Method also it is important to monitor their occurrence in The survey was undertaken during the 2011-12 children to most effectively preventive efforts, also, school year. The sampling frame was children atit is important to understand the pattern of dental tending governmental schools who were aged 6, caries as one of most common disease in children. 12 and 15 years old at the time of the survey. Data Thus, that the limited public resources can be used was collected by trained and calibrated examiners most effectively so that they have the greatest ef- who were dentists employed by Ministry of Health fect in preventing the disease such as the establish- of Bahrain providing community dental services. ment of school based preventive programmes is The training and calibration of examiners was carattributed to the improvement of oral health in de- ried out using at the beginning of the month of veloped countries (Petersen, 2003 cited by Varnne October 2011; a two day training and calibration
Dental News, Volume XXIII, Number II, 2016
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14 Pedodontics for inter and intra-examiner reproducibility exercises (Eklund S, Moller IJ, LeClercq. World Health Organization, (1993)-WHO, (2013), was conducted to all examiners the dentists and their recorders who were dental hygienists to control epidemiological and clinical data in a constant manner. Interviewer, field organizers and supervisors have also attended the training workshops, all to be on the same page. Training involved an explanation of survey protocol, method of data collection, definition of terminology, and standardization of diagnostic criteria infection control procedures, using slides based on the Oral Health survey booklet provided by World Health Organization (WHO), Eklund S, Moller IJ, LeClercq MH. (1993)-WHO (2013). Thereafter, Kappa statistical test of both exercise (inter and intra) were done. Result of first and second findings was perfectly matched with each other by consistency level not below (85%-90%) according to WHO recommendations Eklund S, Moller IJ, LeClercq MH. (1993)-WHO (2013). Five skillful survey teams were available to execute the project in all five governorates in order to collect data in even manner. Each team were included all the following members of human resources: calibrated dentists and dental hygienist as an examiner and recorder respectively, another dental hygienist as an interviewer, field organizer and project manager as well as field supervisor who was a dental public health consultant. The examinations area for conducting examinations were planned and arranged for maximum efficiency and ease of operation by field organizer who contacted the schools and arranged with them the sport or activity hall as a survey sites filed with available of day light to assure light standardization in all schools. Survey sites were provided
Dental News, Volume XXIII, Number II, 2016
with following setup: examination table to let student’s participants to lay on a table, and the examiner sits behind the participant’s head, chair, one instruments table, interview table. Nevertheless, infection control procedures were highly strict in the survey kits hence to reduce the risk of cross infection to children. All dental team were using disposable masks and gloves and the wearing of protective glasses during children examination on progress. A sterilization team were responsible of sterilization of each day instruments and to assure providing the survey sites with sterilized supplies of instrument included in the examination set: mouth in the mirror, the CPITN periodontal probe, tweezers, and pair of gauzes, cotton rolls, plastic disposable cup and clinical sheets, one big tray for sterilized instruments and another small container for used instruments, protective tools: mask & pair of gloves, paper hand towel and others stationery that included identification cards, WHO Clinical examination Forms, interview forms, white sheet for recording participant name and identification number (A4), blue pen, pencil, sharpener, eraser and clips. A positive consent was obtained before the survey from the child’s parent or from someone with the competence to give consent on behalf of the child. Requests for consent for sampled children were sent to parents and followed by a second request where no response was made to the first. Clinical data was collected from each subject selected in the sample and recorded in World Health Organization (WHO) Assessment Form. First section of WHO Assessment Form will be responsible to collect data on general information from follows:
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16 Pedodontics While the second section of WHO Assessment Form will be responsible to collect data on clinical data from as follows: Clinical Data The following clinical data will be recorded at WHO form/2004:
Sampling methods and Sample Size According to Central Informatics Organization in The Kingdom of Bahrain data base in year 2012, The Kingdom of Bahrain is located centrally on the southern shores of the Arabian Gulf with total area of 769.77 sq. km and Manama is the capital city. Population of Bahrain estimated to be equal to 1,208,96 people (ww.cio.gov.bh/cio. eng, 2016). Bahrain population is mixed of Bahraini and nonBahraini residence with different socio-cultural context. Sampling method of this survey has been passed through two sampling methods phases: first sampling method was the cluster random sampling as these results from two stage process in which the population divided into clusters and subset of the clusters were randomly selected. Clusters are bases on the followings: governorates clusters: (Muharraq, Capital, Central, Northern, and Southern) and then geographic areas cluster that involved schools in each of the governorate which were selected and coded accordingly. The second phase of sampling was stratified random sampling; were population is divided into homogenous groups or strata and a simple random sample is drawn from each strata as the followings: age group (6, 12 & 15 years old), educational level (primary, intermediate and secondary), gender (male & female), nationality (Bahraini & non-Bahraini). The survey was conducted over six months between October 2011 and March 2012. To consider a sample frame of this study, schools is the convenient place to find all subjects of tarDental News, Volume XXIII, Number II, 2016
get sample at same instance during their education learning and school-working hour, thus, a strong cooperation with the Ministry of Education was articulated to obtain students lists. This took place during month of August to September 2011 at least to get their support before and during the survey execution and implementation phases. Because of resources limitation, time consuming, great massive effort of human resources required as well as the high cost that require in surveying all population; surveying sample of 2500 was selected with following inclusive criteria: Bahraini children, aged 6, 12 and 15 years old, spoke Arabic language without orthodontic appliances and free from any medical compromised or mental diseases from whole population of each age group was considered in sample size to pledge equitable of results, while exclusion criteria were considered those children not from age mentioned above, spoke other language than Arabic, have orthodontic appliance and were medically or mentally ill. The 12 years students also participated in answering face-to-face interview questionnaire about oral health practices and the use of dental health services. Both collected sociological and clinical data was entered and analyzed using SPSS 15.0 by presenting descriptive, mean of DMFT and periodontal disease, and percentages of all diseases in the study: dental caries, periodontal disease, dental fluorosis, erosion and traumatic injuries and trend of DMFT and periodontal disease by using pie graphs chart with secular trend as needed accordingly.
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18 Pedodontics
Results Of the total drawn of 2500 schoolchildren, a response rate of 2134 (85.4%) school children at age 6, 12 and 15 years old were clinically examined and included in the final analysis. Results had a small proportion of non-respondent that equal to 366 (14.6%). This because some of parents 4% have actively stated they did not want their children included in the survey and only 0.6% of children with consent declined to take part on the day. Absenteeism on the day of examination accounted for a loss of 4% of consented children, 6% the non-response to the request was the most common reason to reduce the sampled students despite two requests and schools actively seeking returned forms. Target sample of 2134 (85.4%) schoolchildren were clinically examined where, 896 (42%), 810 (38%) and 428 (20%) were at age 6, 12 and 15 years old respectively (Fig. 1) with 1140 (53%) female and 996 (47%) male students (Fig. 2).
Results had revealed also, that 260 (29%) out of 896 at 6 years old children (Fig.3) have got gingival bleeding. Trends of bleeding condition among 6 years old children plotted since year 2005 = 54% and in year 2012 showed bleeding condition among those children has decreased and to be = 29% (Fig.4).
29% 71%
Bleeding
Healthy
Fig. 3: % of 6 years old children with Bleeding condition
20% 42% 38% Fig. 4: Trends of bleeding condition among 6 Years old children Primary (6 yrs)
Secondary (15 yrs)
Intermediate (12 yrs)
Fig. 1: Target sample /Age
53%
47%
Female
Fig. 2: Target Sample /Gender
Dental News, Volume XXIII, Number II, 2016
Male
421 (52%) out of 810 at age 12 years old children (Fig. 5 & Fig. 6) and 207 (48.52%) out of 428 at 15 years old children have gingival bleeding (Fig. 7).
52%
Bleeding
48%
Healthy
Fig. 5: % of 12 years old children with Bleeding condition
20 Pedodontics 12%
88%
Caries
Healthy
Fig. 8: Prevalence of Dental Caries in 6 Years Old Fig. 6: Trends of bleeding condition among 12 Years old children
5
4.56 4
Periodontal pocket of 4-5 mm have been discovered in 141 (33%) and pocket > 6mm also discovered in 5 (1.23%) of 15 years old school children (Fig.7). Periodontal Status in this survey was measured by using a light weighted periodontal probe with a 0.5-mm ball tip was used, bearing a black band between 3.5 and 5.5 mm from the ball tip.
4.07
3
2
1 0 d
m
f
Fig. 7: Trends of Periodontal Diseases in Age 15 Years Old children
dmft
Fig. 9: dmft in 6 Years Old
Fig. 10: Trend of dmft in 6 years old children
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22 Pedodontics
CPI is an Indicator for: Three indicators of periodontal status are used for this assessment: absence of gingival bleeding, presence of gingival bleeding and Periodontal Pockets-subdivided into Shallow (4-5mm) and deep (6mm) or more Supra or subgingival calculus was not recorded in accordance to 5th Edition Oral Health Surveys Basic Method, 2013. Prevalence of dental caries in children aged 6 years old was equal to 88% (Fig. 8) and mean
dmft = 4.56 (Fig. 9) that compared with dmft resulted from survey conducted in year 2005; dmft = 4.66 (Fig.10).
30% 70%
Caries
Healthy
Fig. 11: Prevalence of Dental Caries in 12 Years Old 2.5
2.26 2.02
s, V is i t u 1 6, 0 2 C A EED br u ar y, e F 2 . - 4 . b ai D u G 12 N o. St a n d o . 7 Hall N
2 1.5 1 0.5 0 D
M
F
DMFT
Fig. 12: DMFT in 12 Years Old
beatingtherecords.
However in age 12 years old children the prevalence of dental caries was equal to 70% (Fig. 11) and mean DMFT = 2.26 (Fig. 12) while in year 2005 the DMFT = 2.3(Fig. 13).
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24 Orthodontics
Tooth Size Discrepancy Importance As a Diagnostic Tool for Orthodontic Treatment Planning: A Review Dr. Ahmad Hajar Faculty of dentistry, Beirut Arab University, Lebanon dr.ahmedhajar@gmail.com
Abstract The main goal in comprehensive orthodontic treatment is to obtain an optimal functional occlusion, overbite and overjet. Tooth size discrepancies of the maxillary and the mandibular arches are an important factor for achieving this goal. Inadequate relationships between the maxillary and the mandibular teeth can pose problems in achieving the ideal occlusion. Early treatment planning and proper diagnosis of tooth size discrepancy minimizes problems attained at finishing stage. Bolton’s ratios set an ideal relationship of maxillary tooth width to mandibular tooth width. This article shows the significance, validity as a diagnostic tool and the methods of measuring tooth size discrepancy. Key words Bolton’s ratio - tooth size discrepancy – malocclusion – overbite – overjet.
Introduction
This article was published in the IAJD Vol. 6 no. 2 (2015)
Orthodontic diagnosis and treatment planning poses several significant challenges for clinicians with respect to their ability to provide the most predictable results for the patient in an effective, efficient and safe manner. Similarly, orthodontists must address these challenges of assessing treatment results in an objective manner. Orthodontic treatment goal is to simply place the teeth in proper interdigitation with correct overjet and overbite 1. Reaching this goal is much more complicated than simply knowing it. Biological limitations make it nearly impossible to attain an ideal outcome without loss or gain of the tooth structure through extractions or composite build-ups. Inter-arch tooth size discrepancy is the most encountered limitation, which refers to the tooth size proportion of the maxillary teeth to that of man-
Dental News, Volume XXIII, Number II, 2016
dibular teeth. If the proportions of the maxillary to those of mandibular teeth are not equivalent, it becomes very difficult, if not impossible to align teeth in a correct position 1. The orthodontic “finishing” phase or detailing of occlusion requires complicated biomechanical forces to reach an ideal orthodontic treatment. Whenever the patient has significant tooth size discrepancy (TSD) between upper and lower arches, orthodontic alignment to attain an ideal occlusion may not be possible. For proper occlusion with normal overjet and overbite, the maxillary to mandibular teeth must be proportional in size 2. Widely varying opinions exist on the need for the documentation of TSD before starting orthodontic treatment, the frequency of occurrence and the amount of discrepancy that is clinically significant 3. G.V Black in 1902 4 was one of the earliest investigators that discussed the topic of the tooth size at the beginning of the twentieth century. A large number of human teeth were measured and tables recording their mean dimensions were constructed. These tables are considered until now as an important research reference to refer to. Neff 5 defined the “anterior coefficient” in an effort to simplify the determination of the intermaxillary tooth - size relationship. Lundström 6 developed the “anterior index” and determined that the tooth width had a great influence on the alignment of the arches, overbite and overjet. It can be useful for an orthodontist to determine if there is an inter-arch tooth size discrepancy (ITSD) before treatment begins. This allows the practitioner to develop the treatment plan in a way that will take ITSD into account during the treatment instead of trying to manage it at the end. Several methods have been used to determine ITSD.
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26 Orthodontics
Of these methods the one most commonly used is the Bolton analysis 1. The 1958 publication of Bolton’s seminal TSD study has long been the gold standard in orthodontics to clinically determine the TSD; Bolton with his analysis became the first person to develop a simple and clinically useful method for measuring TSD. By simplifying the method of measuring tooth size, Bolton aimed to facilitate the treatment planning and the determination of the functional and the esthetic outcomes of orthodontic cases 7. Bolton 8 recognized the need for a clinically applicable way to determine the influence of the tooth size on disharmonies in occlusion. In Bolton’s introduction, he pointed to Ballard 9 and Neff’s5 earlier studies as important work in the examination of TSD. Bolton selected 55 cases, drawn from ten different private practices in the Seattle, Washington area, with excellent occlusion. The mesiodistal dimensions of the teeth from the first molar to the contralateral first molar in the same arch were measured and the sum of the twelve maxillary teeth was totaled and compared to the sum of the twelve mandibular teeth. The same method was used to set up a ratio between the maxillary and the mandibular anterior teeth 8. Bolton concluded that these 2 ratios should be used as tools for orthodontic diagnosis, allowing the orthodontist to gain insight into aesthetic and functional outcomes of the given case needing to use a diagnostic setup 8. During the diagnostic phase of treatment, a quick analysis is ensured by the determination of the ratios and means for both the anterior and the overall dentition. By applying this method, the clinician could initially measure the mesiodistal tooth width of the upper and lower teeth and immediately recognize if a discrepancy exists by comparing the anterior and overall ratios to those published by Bolton. Also, it provides the relative size difference which may exist between the upper and the lower arches. Bolton also expanded the clinical application of his analysis. Bolton’s standard deviations from the original are used to determine the need for addition of tooth tissue by restorations or reduction of tooth tissue by interdental stripping.10
Dental News, Volume XXIII, Number II, 2016
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28 Orthodontics This review aims to: - Analyze the different methods for measuring the TSD and significance in the final finishing stage of orthodontic treatments. - Highlight on the prevalence of TSD in different populations. - Evaluate the TSD and its relationship with the gender, malocclusion and ethnicities. - Identify the applicability of TSD ratios as a diagnostic tool for treatment planning.
Significance of measuring TSD
to 30% of the overall population inherently possess a significant anterior TSD and yet demonstrate an excellent occlusion 3. One study suggested that in cases with thicker upper anterior teeth, proclined incisors, smaller than normal inter-incisal angles, the Bolton’s ratio may not be applicable 10. Another study carried on typodonts evaluated the effects of an artificially introduced TSD to typodonts with excellent occlusion. The teeth width was altered. The typodonts then were set together in the best occlusal fit possible. The study concluded that a satisfactory occlusion could be attained with a TSD up to twelve millimeters 18. Other studies have suggested overjet 10, overbite 8, tip of incisors 19, torque of incisors, interincisal angles 10,19, and finally the tooth thickness 10,20 as an influential factors in achieving excellent occlusion. Using the diagnostic setups, it has been shown that a decrease or an increase in arch length results from changes in the incisal angles 19. It’s important to mention that one study conducted by Rudolph 20 reported a strong correlation between upper incisal tooth thickness and anterior tooth size ratio. He suggested two formulas for anterior tooth size relations under the circumstances of an ideal anterior proclination.
TSD is an overlooked problem in retention 11. The correct coordination of arches is difficult to reach, without proper mesiodistal tooth size/ratio between mandibular and maxillary teeth 12. Bennett and McLaughlin 13 added a seventh key into Andrews six keys of normal occlusion which was the correct tooth size. In order to achieve a good occlusion with satisfactory intercuspation and interdigitation of teeth and a correct overjet and overbite, the maxillary and mandibular teeth must be proportional in size. Sperry et al. 14 found that the harmony in mesiodistal width of maxillary and mandibular teeth is one of the major factors in coordinating posterior intercuspation, overjet and overbite in centric occlusion. The tooth size must Methods of measuring TSD be in harmony with the arch size to allow proper Studies have focused on varying aspects of TSD inalignment 15. cluding methods of measurement, prevalence, gender, race, extractions and malocclusion type. Bolton8 9 developed a formula to calculate TSD between upreported in his study that 90% of the Ballard casts of 500 patients examined had a TSD. If max- per and lower teeth as following: illary anterior teeth are too large related with the opposing mandibular anterior teeth, clinical mani- Overall ratio = (Sum of mesiodistal widths of twelve festations vary from various problems as higher mandibular teeth) / (Sum of mesiodistal widths of overjet and deep overbite or a combination of twelve maxillary teeth) x100 both, crowded anterior segment or buccal segment out of proper occlusion. On the other side, Anterior ratio = (Sum of mesiodistal widths of six if mandibular anterior teeth are too large related mandibular teeth) / (Sum of mesiodistal widths of six to the opposing maxillary teeth, an end to end re- maxillary teeth) x 100 lationship, spacing in maxillary anterior segment, mandibular crowding in incisors and improper oc- In order to analyze Bolton’s ratios, several methods clusion of posterior teeth may result 10. are available for measuring tooth width, and these are continuing to develop with increasing advances Validity of Bolton’s analysis for TSD as di- in technology. If a method of measurement is to be widely used, it is important to be quick, easily appliagnostic tool Although Bolton’s analysis for TSD determination cable and reproducible. has been considered to be handy and easy to use, The traditional method of measurement used by its validity and accuracy have been discussed and Bolton 8 and Neff 5 was the needle point divider. The disputed 16,17. Many studies have reported that 20 needle point divider can be used intraorally or on Dental News, Volume XXIII, Number II, 2016
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30 Orthodontics study casts. The divider can be measured directly with a ruler or holes can be punched into graph paper and then measured. Another commonly used instrument is the caliper 21. There are several types of calipers that could be used to analyze Bolton’s ratio including Boley gauges, dial calipers or digital calipers. Shellhart et al. 21 suggested that Bolton’s analysis may be appropriate to be used as a screening tool to determine the possible range of discrepancy because of its ease and rapidity. Although, if the discrepancy range indicates two treatment alternatives, a diagnostic wax up is considered, even though it is more time consuming 21. Ho and Freer 22 stated that digital calipers are arguably the most popular and simplest type of caliper as a single value is displayed on the screen and could be integrated with computer software. This may reduce any calculation or transfer errors associated with manual methods. In addition, study casts now can be digitized or scanned into a computer so that images can be measured on screen. With the increase in popularity of digital models, several studies were conducted on the accuracy of measuring TSD of computerized models compared to those of plaster models. Tomassetti et al. 23 were first to compare computerized methods to manual measuring method. Three methods of computerized TSD measurements - Hamilton Arch Tooth System, QuickCeph, and OrthoCad - were compared to the gold standard of manual measurements with vernier calipers. No statistically significant error was found between any of these methods but clinically significant differences (>1.5 mm) were found for each method. Each of the digital measurement methods in the study was faster than the manual method. Further research found that measurements from digital models are not significantly different than those of plaster models. The digital models were accurate enough and significantly faster to measure, allowing the orthodontist to make the same diagnoses and treatment planning decisions that would have been made with plaster models 24,25. A commonly practiced method for measuring TSD is “eyeballing” the models and estimating the TSD. Proffit 26 suggests an easy way to estimate TSD by Dental News, Volume XXIII, Number II, 2016
comparing the maxillary laterals to those of mandibular laterals in width. If the maxillary laterals appear to have widths which are equal to or less than those of the mandibular laterals then a mandibular excess is likely present. He also stated that the maxillary second premolars should be equal or roughly equal in size. However, Othman and Harradine 27 found that visual estimation is a poor method of measuring TSD as orthodontists who used it missed picking out cases that didn’t have significant discrepancies, but still 30% of those cases were guessed incorrectly. The most accurate and reproducible results for studies measuring TSD were achieved with usage of vernier calipers 21,28. Vernier calipers digitally linked to computer programs provided additional accuracy as the error of data recording and transfer is eliminated 22. This is supported by Zilbermann et al. 29 who found that the measurements made up using digital calipers such as the HATS system, produced the most accurate and reproducible results. This is most probably because investigators can measure more accurately on plaster models as compared to digitized or scanned 3-dimensional models, with less risk of error by inaccurate data recording or analysis. These results suggest that measurements for future studies assessing TSD are best carried out by using digital calipers connected to computerized analysis software. Prevalence The prevalence of a TSD depends on the proportion of occlusions falling outside two standard deviations from Bolton’s mean ratios. The 4th edition of Proffit’s textbook sets the prevalence at 5% 26. However lots of studies reported a higher prevalence of TSD with a greater percentage of these patients having anterior TSD than an overall TSD. The table 1 provides a summary of the literature. Johe et al. 37 attributed the higher prevalence of TSD in a lot of studies compared to Bolton’s study due to the varying ethnic and genetic sample population. Almost all of the studies that examined the prevalence of TSD have concluded that the use of Bolton’s analysis prior to orthodontic treatment is recommended and essential in treatment planning, as anywhere from 13-30% of patients can have a clinically significant TSD.
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32 Orthodontics
TSD and malocclusion groups All studies that have focused on the prevalence of a Bolton’s discrepancy in a sample of orthodontic patients have looked up at different Angle’s malocclusions with varying results. Studies found up relative mandibular tooth size excess in Class III malocclusions 14, 31, 40 - 43, relative maxillary excess in Class II malocclusions 40, whilst other studies found no significant differences 12, 33, 37, 44. TSD and gender A lot of studies didn’t find any significant differences between TSD in males and females 31, 38, 40, 42, 45, 46 . Smith et al. 1 found that posterior and overall ratios were significantly larger in males than females, although the differences were small (0.9% for the posterior and 0.7% for the overall ratio). TSD and ethnic- racial differences Lavelle 47 compared mesio-distal crown diameters of the maxillary and the mandibular teeth in a total of 120 casts with excellent occlusion from three major racial groups (White, Black and Far-eastern). Percentage overbite was greater in Caucasoids than Mongoloids and that for Dental News, Volume XXIII, Number II, 2016
Negroids was intermediate. Lavelle found that Blacks had the highest overall and anterior TSD ratios while Whites had the lowest ratios, while people of Eastern Asia descent between the two groups. Smith et al. 1 support the evidence of racial variation with respect to tooth size; 60 study models, 30 males and 30 females from each racial group Black, Hispanic, and White were measured and anterior, posterior and overall ratios were compared. The authors found that the anterior ratio was similar to Bolton’s ratio, while the total ratio was different for all three groups. Paredes et al. 34 determined the Spanish population values and ratios. Bolton’s ratios were significantly different requiring specific standards for Spanish population. Researchers found also that Bolton’s anterior ratio was not applicable to a Japanese population, and that specific Japanese standards were required 35. Despite of all ethnic and racial differences reported in the literature, other studies coincided with the results of Bolton. Al-Tamimi and Hashim 45, established tooth-size ratios in a Saudi population and realized that Bolton’s prediction tables can be used. Also Bolton standards could be used for an Iranian- Azari population 48.
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34 Orthodontics Conclusion Tooth size discrepancy plays an important role in the development of an ideal occlusion with proper form, function and esthetics. Having the ability to predict such discrepancies before initiating treatment allows the orthodontist to adjust the treatment plan that provides the most efficient and effective way to help the patient. The usage of Bolton’s analysis for measuring TSD before starting an orthodontic treatment aids in the development of an orthodontic treatment plan and predicts the functional and esthetic outcomes of the case. Tooth size ratios may be influenced by other factors such as upper incisors thickness, anterior incisors inclination, overjet and overbite which should be further investigated.
References 1. Smith SS, Buschang PH, Watanabe E. Interarch tooth size relationships of 3 populations: “does Bolton’s analysis apply?” Am J of Orthod Dentofacial Orthop 2000;117(2):169-174. 2. Proffit WR. Contemporary Orthodontics,4th ed, St. Louis: Mosby, 2006:170-172. 3. Othman SA, Harradine NWT. Tooth-size discrepancy and Bolton’s ratios: a literature review. J Orthod 2006;33:45-51. 4. Black GV. Descriptive anatomy of the human teeth. 4th ed Philadelphia; SS White, 1902. 5. Neff CW. Tailored occlusion with the anterior coefficient. Am J Orthod 1949;35:309-313. 6. Lundström A. The importance of genetic and non-genetic factors in the facial skeleton studied in 100 pairs of twins. European Orthodontic Society Report Congress 1948;30:92-107. 7. Staley RN& Reske NT. Essentials of orthodontics: Diagnosis and treatment. 2011 (1st ed.), West Sussex, UK: Wiley-Blackwell. 8. BoltonWA. Disharmony in tooth size and its relation to the analysis and treatment of malocclusion. Angle Orthod 1958;28:11330. 9. Ballard M. Asymmetry in tooth size: A factor in the etiology, diagnosis and treatment of malocclusion. Angle Orthod 1944;14:67-71. 10. Bolton WA. The clinical application of a tooth-size analysis. Am J Orthod 1962;48:504-529. 11. Graber TM, Vanarsdall RL, Vig KWL. Orthodontics: Current Principles &Techniques, 4th ed. Philadelphia Elsevier Inc. 2005:1133. 12. Crosby DR, Alexander CG. The occurrence of tooth size discrepancies among different malocclusion groups. Am J Orthod Dentofacial Orthop 1989;95:457-461. 13. Bennett JC and McLaughlin RP. Orthodontic treatment mechanics and the preadjusted appliance, London, Wolfe Medical Publishing 1993. 14. Sperry T, Worms F, Isaacson R, Speidel T. Tooth-size discrepancy in mandibular prognathism. Am J Orthod 1977;72:183-190. 15. Moorrees CFA and Reed RB. Biometrics of crowding and spacing of the teeth in the mandible. Am J Phys Anthrop 1954;12:7788. 16. Freeman JE, Maskeroni AJ, Lorton L. Frequency of Bolton tooth-size discrepancies among orthodontic patients. Am J Orthod Dentofacial Orthop 1996;110:24-27. 17. Fields H. Orthodontic restorative treatment for relative mandibular anterior excess size problems. Am J Orthod 1981;79:176183. 18. Heusdens M, Dermaut L, Verbeek R. The effect of tooth size discrepancy on occlusion: an experimental study. Am J Orthod Dentofac Orthop 2000;117:184-91. 19. Tuverson D. Anterior occlusal relations. Am J Orthod 1980;78:361-93. 20. Rudolph DJ, Dominguez PD, Ahn K, Thinh T. The use of tooth thickness in predicting intermaxillary tooth-size discrepancies. Angle Dental News, Volume XXIII, Number II, 2016
Orthod 1998;68:133-8. 21. Shellhart WC, Lange DW, Kluemper GT, Hicks EP, Kaplan AL. Reliability of the Bolton tooth-size analysis when applied to crowded dentitions. Angle Orthod 1995;65(5):327-334. 22. Ho CT, Freer TJ. The graphical analysis of tooth width discrepancy. Aust Orthod J 1994;13:64-7. 23. Tomassetti JJ, Taloumis LJ, Denny JM, Fischer JR Jr. A comparison of 3 computerized Bolton tooth-size analyses with a commonly used method. Angle Orthod 2001;71(5):351-357. 24. Stevens DR, Flores-Mir C, Nebbe B, Raboud DW, Heo G, Major PW. Validity, reliability, and reproducibility of plaster vs digital study models: Comparison of peer assessment rating and Bolton analysis and their constituent measurements. Am J Orthod Dento facial Orthop 2006;129(6):794-803. 25. Leifert MF, Leifert MM, Efstratiadis SS, Cangialosi TJ. Comparison of space analysis evaluations with digital models and plaster dental casts. Am J Orthod Dentofacial Orthop 2009;136(1):16. e1-4; discussion16. 26. Proffit WR. Contemporary Orthodontics, St. Louis: MosbyYear Book; 2007. 27. Othman SA and Harradine NW. Tooth size discrepancy and Bolton’s ratios: The reproducibility and speed of two methods of measurements. J Orthod 2007;34(4):234-42. 28. Arkutu N. Bolton’s discrepancy-which way is best? Poster 3, British Orthodontic Conference 2004. 29. Zilberman O, Huggare JAV and Konstantinos AP. Evaluation of the validity of tooth size and arch width measurements using conventional and three- dimensional virtual orthodontic models. Angle Orthod 2003;73:301-306. 30. Santoro M, Ayoub ME, Pardi VA, Cangialosi TJ. Mesiodistal crown dimensions and tooth size discrepancy of the permanent dentition of Dominican Americans. Angle Orthod 2000;70:303-307. 31. Araujo E, Souki M. Bolton anterior tooth size discrepancies among different malocclusion groups. Angle Orthod
2003;73:307-313. 32. Bernabe E, Major PW, Flores-Mir C. Tooth-width ratio discrepancies in a sample of Peruvian adolescents. Am J Orthod Dentofacial Orthop 2004;125(3):361-365. 33. Uysal T, Sari Z. Intermaxillary tooth size discrepancy and mesiodistal crown dimensions for a Turkish population. Am J Orthod Dentofacial Orthop 2005;128:226-230. 34. Paredes V, Gandia JL, Cibrian R. Do Bolton’s ratios apply to a Spanish population? Am J Orthod Dentofacial Orthop 2006;129:428-430. 35. Endo T, Shundo I, Abe R, Ishida K, Yoshino S, Shimooka S. Applicability of Bolton’s tooth size ratios to a Japanese orthodontic population. Odontology 2007;95:57-60. 36. Barbara We˛drychowska-Szulc, Joanna Janiszewska-Olszowska, Piotr Stepien. Overall and anterior Bolton ratio in Class I, II, and III orthodontic patients. Eur J Orthod 2010;32:313–318. 37. Johe RS, Steinhart T, Sado N, Greenberg B, Jing S. Intermaxillary tooth-size discrepancies in different sexes, malocclusion groups, and ethnicities. Am J Orthod Dentofacial Orthop 2010;138(5): 599-607. 38.O’Mahony G, Millett DT, Barry MK, McIntyre GT, Cronin MS. Tooth size discrepancies in Irish orthodontic patients among different malocclusion groups. Angle Orthod 2011;81(1):130-133. 39. Naseh R, Padisar P, ZareNemati P, Moradi M, Shojaeefard B. Comparison of tooth size discrepancy in Cl II malocclusion patients with normal occlusions. J Dent Shiraz Univ Med Scien 2012;13(4):151-155. 40. Nie Q, Lin J. Comparison of intermaxillary tooth size discrepancies among different malocclusion groups. Am J Orthod Dentofacial Orthop. 1999;116:539-544. 41. Ta TA, Ling JYK, Hägg U. Tooth-size discrepancies among different occlusion groups of southern Chinese children. Am J Orthod Dentofacial Orthop 2001;120:556–558. 42. Alkofide E, Hashim H. Intermaxillary tooth size discrepancies among different malocclusion classes: a comparative study. J Clin Pediatr Dent 2002;26:383-387. 43. Fattahi HR, Pakshir HR, Hedayati Z. Comparison of tooth size discrepancies among different malocclusion groups. Eur J Orthod 2006;28:491-495. 44. Liano A, Quaremba G, Paduano S, Stanzione S. Prevalence of tooth size discrepancy among different malocclusion groups. Prog Orthod 2003;4:37–44. 45. Al-Tamimi T, Hashim HA. Bolton tooth-size ratio revisited. World J Orthod 2005;6:289-295. 46. Akyalcin S, Dogan S, Dincer B, Erdinc AM, Oncag G. Bolton tooth size discrepancies in skeletal class I individuals presenting with different dental angle classifications. Angle Orthod 2006;76(4):637-643. 47. Lavelle CLB. Maxillary and mandibular tooth size in different racial group and in different occlusal categories. Am J Orthod 1972;61:29–3. 48. Mirzakouchaki B, Shahrbaf S, Talebiyan R. Determining tooth size ratio in an Iranian-Azari population. J Contemp Dent Pract 2007;8:86-93.
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22 36 Prosthetic Dentistry
Is Prosthetic Surgery Always Useful for Complete Edentulous Persons? Dr. Jaouadi Jamila j.jaouadi@yahoo.fr
Clinic of dental medecine in Monastir,Tunisia.
Introduction When conceiving complete dentures, we may have to cope with different anatomic obstacles: • Under-cuts • Flubby ridges • Oversized tuberosities, Torus palatinus In the past, surgery was systematic to better facilitate prosthetic conception and integration. Today this should not be the first option, since it causes resorption but also it is unavoidable to repair or reline prosthetics after surgery.
1- Under-cuts They can be unloaded either on the primary or the secondary casting with plaster; which allows an ease of insertion during try in or denture delivery. When under-cuts embrace all the ridge even
2- Flubby ridges Most of these anatomical features are caused by prosthetic instability, so it seems reasonable to correct this etiology by correcting occlusion and treating soft tissues. tuberosities, it will be required to enregistrate them to be able to unload them, that’s why we did the border mold in this situation with silicone which make denture conception easier. Dental News, Volume XXIII, Number II, 2016
In order to do this we reline dentures and we establish occlusion with resine until flubby ridge resorbe, that is what we call: the tissue preparation what saves our patients from surgery.
38 Prosthetic Dentistry
3- Oversized tuberosities
Conclusion
Most of these damages are caused by prosthetic instability, here also we should correct and stabilize the occlusion and treat the soft tissues.
In many cases we can avoid surgery to our patients, in order to preserve their bone stock. Prosthetic solutions may be a good help for successful dentures.
References 1. Aïche H. Empreinte primaire à l’alginate en prothèse totale amovible. Cah Prothese 2000;109:69-72. 2. Bertrand C, Hüe O. Le réflexe nauséeux en prothèse. Cah Prothese 2002;117:57-66. 3. Chevaux JM, Aïche H. Empreinte primaire fonctionnelle mandibulaire en prothèse totale amovible. Cah Prothese 2000;109:69-76 4. Faber BL. Comparison
of an anatomic versus physiologic method
of posterior tooth placement for complete dentures.
1992;67:410-4
J Prosthet Dent
5. Hue O, Berteretche MV. Prothèse complète: Réalité clinique, solutions thérapeutiques. Paris: Quintessence International, 2004. 6. Klein P. Prothèse piézographique: prothèse atrique. Paris: John Libbey Eurotext, 1988. 7. Lejoyeux R. Les tale. Paris:1986
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10. Pompignoli M, Doukhan JV. Prothèse complète: clinique et laboratoire. Paris: CdP, 1994.
Light-curing nano-ceram composite • nano-reinforced ceramic particles • special resin matrix • significantly less free monomers • highly esthetic • universal for all cavity classes • comfortable handling, easy modellation • also available as a flowable version Dental Material PROMEDICA Dental News, Volume XXIII,GmbH Number II, 2016
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11. Rignon-Bret JM, Rignon-Bret C. Les empreintes mandibulaires chez l’édenté total. Actual Odontostomatol (Paris) 2001;214:189-209. 12. Rouvière H. Anatomie humaine tionnelle. Paris: Masson, 1974.
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22 26 40 Prosthetic Dentistry
Full-mouth Reconstruction with BruxZir and BruxZir Anterior John W. Farah, D.D.S. Enspire Dental, Ann Arbor. Michigan
Introduction BruxZir® Anterior is a highly esthetic zirconia ceramic designed to satisfy the esthetic and functional requirements of the anterior region of the mouth. BruxZir Anterior has an average flexural strength of 650 MPa with translucency and color similar to natural dentition. BruxZir Anterior requires less reduction than monolithic glass ceramic restorations and is kind to natural opposing dentition during occlusal and parafunctional activity. Indications include single-unit crowns and threeunit bridges with one pontic. Prep requirements are conservative - only 0.8 mm of reduction is required, although 1.25 mm is ideal. BruxZir Solid Zirconia with flexural strength of 1200 Mpa was used to restore posterior molars.
Case Presentation A forty-four year old male patient presented with worn upper and lower dentition due to years of bruxism, resulting in about 2 mm loss of vertical affecting his smile and other facial features (Figure 1a,b). The patient was concerned about the compromised esthetics and the long-term functionality of his teeth. Fig 1a
Figure 1b. Pre-op closed. Fig 1b
Figure 1b. Pre-op open. Dental News, Volume XXIII, Number II, 2016
Fig 2
Figure 2. Working model.
Preliminary PVS impressions, x-rays and photographs were taken of his teeth to help formulate a treatment plan. The models were poured and mounted on an articulator and the bite was opened by 2 mm to achieve an ideal tooth length. The patient did not want his teeth to look too long - he said, “I want my teeth to look natural and still fit my personality.” Once the stone models were mounted, a wax-up was done to simulate the final size, form and shape of the teeth (Figure 2).
Clinical Procedure Second Appointment The finished working models were shown to the patient (Figure 2). He liked the size and esthetics and gave his approval to proceed. The shade was discussed and agreed upon with the patient settling on the B1 Vita shade. To temporarily open the bite by 2 mm, 12 posterior teeth (including 1st molars, 2nd molars and 2nd pre-molars) were slightly roughened with a medium-grit football shaped diamond bur. The posterior teeth had three amalgam fillings, six composites and one PFM crown. The amalgams were replaced with composites.
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© Carestream Health, Inc. 2016. Dental News, Volume XXIII, Number II, 2016
All were etched with 37% phosphoric acid, rinsed, and bonded with Scotchbond Universal (3M) followed by the application of a composite (Camouflage, shade A2, Glidewell Laboratories). Enough composite was added to the teeth to achieve a 2 mm vertical opening. The composite was light cured, the occlusion was checked in centric and the composite was adjusted until a 2 mm vertical opening was achieved. Third Appointment Two weeks after establishing the new vertical, the patient reported no discomfort with his bite and he was scheduled to start with the treatment. The plan was to prepare a total of 16 teeth, including two upper and lower molars as well as two upper and lower bicuspids in the right and left quadrants. The patient was scheduled for a five-hour appointment. At that appointment the upper and lower right quadrants were anesthetized and the molars were prepared for restorations made from BruxZir Full Zirconia Crowns and Bridges (Glidewell Laboratories), while the bicuspids were prepared for BruxZir Anterior (Glidewell Laboratories) restorations. Upon completion of tooth preparations, temporaries were made at the newly established vertical using Luxatemp shade B1 (DMG) temporary material. The tissues were packed with a #1 cord where indicated and fullarch impressions were taken of both the upper and lower arches using Aquasil putty (DENTSPLY/Caulk) for the tray material and Aquasil XLV light-body material. A bite registration (Futar Fast, Kettenbach) was also taken of the prepared right quadrants at the pre-selected vertical opening. While the temporaries were being readied, the upper and lower left quadrants were anesthetized. All eight teeth were prepared for Bruxzir anterior and posterior crowns as described earlier for the right side. Full-arch upper and lower impressions were taken. The impressions were examined and found to be suitable to send to the laboratory. The right bite registration was used to obtain a left bite registration at the same vertical opening. The full-arch impressions taken at first for the right side were used as back up impressions in case any tooth preparation was not clearly defined. Several photographs were taken and study models were sent as well as specific directions to assist the lab in completing the preparations of the crowns to achieve a satisfactory outcome. Fourth appointment The patient did not experience any problems during the threeweek temporization period and was very pleased with the fit, comfort and esthetics of the temporaries. The molar crowns were fabricated by Glidewell Laboratories using BruxZir Full Zirconia Crowns and Bridges, while the bicuspids were fabricated with BruxZir Anterior. The esthetics of all restorations was excellent; one could not detect a difference between the molar and bicuspid crowns. The crowns were tried in for fit, shade and occlusion and received the approval of the patient for their cementation. The teeth and the internal surface of the crowns were treated with Scotchbond Universal (3M) bonding agent prior to applying RelyX Ultimate Adhesive Resin Cement (3M) in each crown. The four crowns were seated one quadrant at a time, the margins flash cured for not more than 1-2 seconds, the excess
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44 30 Prosthetic Dentistry cement removed from around each crown, and the teeth carefully flossed before final curing each crown. This procedure was repeated for all four quadrants. The occlusion was checked and selectively adjusted when needed. The need for adjustment was minimal. Once everything looked satisfactory, the patient was scheduled for the next appointment at which time the upper and lower anterior teeth would be prepared. Fifth appointment The upper anterior (#6-11) and lower anterior (#22-27) teeth were anesthetized and prepared for BruxZir Anterior crowns. Since the bite was open, almost no reduction was needed at the incisal edges. Circumferential tooth reduction was kept to a minimum because the BruxZir Anterior material has excellent strength and good translucency (Figure 3). Once the preparations were done, full-arch impressions were taken using Aquasil putty for tray material and Aquasil XLV light-body material (Figure 4). A bite registration was also taken to help in properly mounting the case. The impressions, bite registration, models and photographs of the prepared teeth were all sent to Glidewell Laboratories to assist in completing the case accurately. The front teeth were temporized using Luxatemp shade B1 (Figure 5). Sixth Appointment The patient was anesthetized, the temporary crowns removed and the BruxZir Anterior crowns fitted using Stabiliner (Crown Delta Corp) tryin silicone liner. The patient was pleased with the esthetics and requested cementation of the crowns. The crowns were cemented with Scotchbond Universal and RelyX Ultimate Adhesive Resin Cement (3M Oral Care). The cement was flash-cured, the excess removed, teeth flossed, and everything was postcured. The occlusion was checked and adjusted where needed. Final photographs were taken as shown in Figure 6.
Fig 3
Figure 3. Circumferential tooth reduction of maxillary and mandibular anterior teeeth. Please note final posterior restorations are seated. Fig 4
Figure 4. Impression of lower anterior preparations. Fig 5
Figure 5. Provisionals spanning from #6 to #11 and #22 to #27. Fig 6
Figure 6. Final anterior crowns at cementation. Fig 7
Summary The patient was pleased with the final outcome and the resulting esthetics. Three months after completing the case, the patient is doing very well, the tissues are healthy and he is very pleased with his winning smile (Figure 7). Dental News, Volume XXIII, Number II, 2016
Figure 7. Three months post-procedure.
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The 28th Scientific Meeting of The Egyptian Orthodontic Society
46
February 11 - 13, 2016 Marriott Hotel, Cairo, Egypt
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Prof. Abbas Zaher, President of the Egyptian Orthodontic Society
Drs. Abbas Zaher and Panagiotis Skoularikis exchanging trophies in opening reception
Picture from the opening ceremony
Drs. Paolo Manzo, Khaled Aboul Azm, Mauro Cozzani and Joseph Bou Serhal In the legendary Marriott Hotel and Omar Khayyam Casino in the heart of Cairo, at 9 am on February 11, 2016, Professor Abbas Zaher, President of the Egyptian Orthodontic Society greeted the attendees of the international congress and commenced the outstanding scientific program. The congress was honored with the participation of an esteemed slate of world-renowned speakers representing nine countries. A big thank you goes to Drs. Nasib Balut and Mauricio Gonzales Balut from Mexico, Drs. Juan Fernando Aristizabal and Carlos Villegas from Colombia, Drs. Puiu Nicolescu and Mihai Dorobantu from Romania, Drs. Mauro Cozani, Raffael Spena, Paolo Manzo and Turi Bassareli from Italy, Drs. Nejat Erverdi and Nazan KĂźcĂźkkeles from Turkey, Dr. Joseph Bou Serhal from Lebanon, and Dr. Dirk Bister from England. The Greek Orthodontic Society contributed with three speakers; Drs. Athanasios Athanasiou, Michael Kalavritinos and Apostolos Tsolakis. Celebrating this joint meeting, Dr. Panagiotis Skoularikis, Dental News, Volume XXIII, Number II, 2016
Drs. Ashraf Bedewi, Abbas Zaher, Panagiotis Skoularikis, Tarek Mahmoud, and Khaled Al Badr the President of the Greek Society addressed the attendees and invited them to take part in the second joint congress between the two societies, The Greek International Symposium, that will take place in Athens in April 15-17, 2016. In an attempt to encourage the next generation, the well-attended congress presented a platform for 10 junior Egyptian speakers to present their studies and showcase the research work currently conducted in different Egyptian Universities. This year, the Egyptian Orthodontic Society organized for the first time a competition for the best clinical case presentations and selected three winners who received a recognition from the society and rewarded valuable prizes sponsored by American Orthodontics Egypt. In addition, three winners for the best poster presentations received recognition from the society and rewards from Egypt-Ortho Company. We look forward to seeing everyone next year in our 29th Annual Scientific Meeting. Prof. Abbas Zaher, President of the Egyptian Orthodontic Society
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Dental News, Volume XXIII, Number II, 2016
Some of the congress speakers at the pyramids
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Egyptian night at the Marriott
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LSE 2016 50
11th international meeting for the Lebanese Society of Endodontology March 18 - 19, 2016 Hilton Beirut Habtoor Grand Sin El Fil, Beirut, Lebanon
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Picture of The Audience during the lecture
Dr. Edward Rizk, President of the Lebanese Society of Endodontics
Left to right; Drs. Adib Zakaria, Chadi Tawil, Carlos Khairallah, Edward Rizk, Fadl Khaled, Tony Saliba, Edgard Jabbour
Dear Colleagues, It is my pleasure to welcome you Endolovers to this 11th scientific fair of the Lebanese Society of Endodontology under the patronage of the President of the LDA, Pr. Carlos Khairallah. Pr. Maalouf and our teachers transmitted to us the desire of Endodontics and the challenge to always reach the best, as Napoleon Hill said ‘’the starting point of all achievements is desire” Following Pr. Maalouf’s steps, many Lebanese Endodontists having this desire, excelled all over the world in their inventions, research and presence in the international endodontic podiums. I think you have all heard about Reciproc, wave one gold, MMTA, CMA, RevoS 2, SP Pluggers… and the list is long. In All these inventions, there is a hand of an LSE Member; I will keep for you to guess each invention for which inventor. In summary, This makes me proud to be an LSE member and you should all be proud as well. The important factor of success is the Scientific program and this year we have 6 int’l Top Speakers from Italy, Pr. Dental News, Volume XXIII, Number II, 2016
Filipo Santarcangelo and Alberto Dagna, from Belgium Roland De Moor, France Dr. Guillaume Jouanny, Switzeralnd Dr. Klaus Neuhaus and from Lithuania Dr. Zivile…. Our speakers will talk about the new waves in Endo and how to apply it in the clinical practice. New rotary instruments, bioceramics, irrigation devices and laser as well as research studies. This will allow the participants to have different angles of vision to endodontics and will entice them to create a fruitful debate. Dear Colleagues since ’Perplexity is the beginning of knowledge.” As the Lebanese philosopher Khalil Gibran said, we invite you to attend the congress where different ideas sometimes even contradictory are exposed and to participate in the workshops in the hope that after this meeting you will have new possibilities of treatment and new horizons. And finally be sure that we in the Lebanese Society of Endodontology always aim for the moon and if we miss we would have at the least hit the stars. Dr Edward Rizk President of the Lebanese Society of Endodontics
Drs. Hareth AbdelSater, Carla Z. Moubarak, Filippo Santarcangelo, Ghada Bassil, Edward Rizk, Marc Kaloustian
Members of the LSE: Carla Mobarak, Tony Harb, Edward Rizk, Ziad Mjaes, Roula Abiad, Marc Habib, Marc Kaloustian
LSE 2016
Drs. Edward Rizk, F. Edmond Koyess
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Dr. Omar Bahgat, Dr. Alberto Dagna
Dental News, Volume XXIII, Number II, 2016
Dr. Guillaume Jouanny Lecturing on Bioceramics in Endodontics
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54
March 31 - April 1, 2016 Grand Hyatt Hotel, Muscat, Sultanate of Oman
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Photo from the opening ceremony
Dr. Husein Lawati president of Dental News, Volume XXIII, Number II, 2016 the Oman Dental Society
On behalf of the Conference organizing committee which consists of Oman Dental Society in cooperation with the Ministry of Health, the Armed Forces Medical Services, Royal Police Oman and the Royal Court and on behalf of myself, I have the pleasure to extend to you my warmest welcome to the 18th Oman International Dental Conference. In particular, I would like to welcome all the conference guests who came through from outside Oman to their second home, the Sultanate of Oman, wishing them happy stay and joyous time during their visit. The dental care has been representing, and it is still, an integral part of comprehensive medical care. The attention given to this profession by the Ministry of Health and the remaining governmental health institutions is a genuine interpretation of the government care for the dental profession. More than 450 participants are taking part in this conference as well as an array of professors and specialized dentists from various international universities and institutions. The conference is witnessing the participation of 54 lecturers from 16 countries. We have to bear in mind to develop and support human resources in the dental industry to guarantee the best high-profile health services for the society and to make sure that the dental personnel in the Sultanate is being kept updated with the rapidly growing dental advancements in the world. Finally, we would like to thank you for your generous patronage of this conference. We pray to Allah to endow us with success, bless this conference and guide us to serve our beloved country under the wise leadership of His Majesty Sultan Qabous bin Sai’d – may Allah protect and safeguard him. As early as the dawn of Oman’s renaissance, His Majesty has paid a special attention to developing human resources as an essential pillar to achieve the goals of glorious renaissance. Dr. Husein Lawati President of the Oman Dental Society
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*With twice-daily brushing References.. 1. Jeandot J et al. Clinc (French) 2007; 28: 379–384. 2. Nagata T et al. J Clin Periodontol 1994; 21(3): 217–221. 3. GSK data
on file. DOF Z2860473. 4. Leight RS et al. J Clin Dent 2008 19(4) 147-153. 5. Schemehorn BR et al. J Clin Dent 2011 22(1) 11-18. 6. Shellis RP et al. J Dent 2005 33(4) 313-324. 7. GSK data on file. DOF Z2860415. 8. GSK data on file. DOF Z2860435. Arenco Tower, Media City, Dubai, U.A.E. Tel: +971 4 3769555, Fax: +971 3928549 P.O.Box 23816. For full information about the product, please refer to the product pack. For reporting any adverse event/side effect related to GSK product, please contact us on contactus-me@gsk.com Prepared: December 2014, CHSAU/CHSENO/0034/14f. We value your feedback Saudi Arabia: 8008447012 All Gulf and Near East countries: +973 16500404
The Minster of Health Dr. Ahmad Al Saidi and Dr. Lawati taking a picture with the representatives of Kuwait, Saudi Arabia, Lebanon, UAE and Yemen
The minister of Health at the Saudi Dental Society booth
Dr. Ahmed Al Saidi Minister of Health cutting the ribbon of the exhibition
Inauguration of The Exhibition
Dental News, Volume XXIII, Number II, 2016
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58
Dr. Ehab Heikal Lecturing on Modern Dental Advertisement
Pr. Nour Habib Lecturing on Color in Posterior Composites
Pr. Louis Hardan Talking on Direct Composites
Pr. Atef Shaker explaining CAD/CAM
Pr. Richard Simonsen Discussing the issue of commerce versus care in Esthetic Dentistry
Dental News, Volume XXIII, Number II, 2016
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Pr. Crawford Bain lecturing on how to extend the life of restorations
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LDA TRIPOLI 2016 The 8th International Meeting of the Lebanese Dental Association - Tripoli, Lebanon
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60
April 21 - 23 , 2016 University of Balamand, Lebanon
Picture from the opening ceremony at the Balamand University
President Michel Suleiman addressing the audience
Dr. Adib Zakaria, president of the LDA-Tripoli
كلمة النقيب د� .أديب زكريا يف حفل افتتاح امل�ؤمتر احلياة �أمل يخفيه �أمل و�أمل يحققه عمل وعمل ينهيه �أجل وبعد ذلك يجزى كل امرء مبا فعل. فبعد خم�سون عاما على ت�أ�سي�س نقابتنا على يد املرحوم الدكتور فريد معو�ض وبعد خم�سة وع�رشون عاما على عقد �أول م�ؤمتر علمي يف عهد النقيب د .ب�سام كبارة حفظه اهلل ها نحن جمددا نعقد م�ؤمترنا العلمي الثامن بعنوان Golden Jubilee Catch the Updateيف �رصح جامع مميز لكل �أبناء الفيحاء وال�شمال وذلك برعاية كرمية لفخامة الرئي�س مي�شال �سليمان لإعطاء دفع معنوي لأبناء ال�شمال و�إثبات �أن طرابل�س هي مدينة حقا ا�ستحقت لقب مدينة العلم والعلماء. فالعلم نور واجلهل ظالم يحرق الأمم وال�شعوب ,فمن �سلك طريقا يلتم�س فيه علما �سلك طريقا من طرق اجلنة وهو �سالح لتحقيق النجاح وتطوير ح�ضارة الأمم ومن هذا املبد�أ انطلقنا كمجل�س نقابة يف عملنا لإقامة هذا امل�ؤمتر على �صعيد دويل جامع لكل اخت�صا�صات طب الأ�سنان لي�ضاف هذا احلدث يف �سجل عملنا الد�ؤوب الذي بد�أناها منذ �سنة ون�صف بحيث متكنا من حتقيق عدة اجنازات �أولها �رشاء دار جديد للنقابة و�إن�شاء مركز للتعليم امل�ستمر وت�أمني الطبابة للمتقاعدين بالتعاون مع ال�صندوق التعا�ضدي لأطباء الأ�سنان ف�صحيح �أن تلك الإجنازات كانت حلما بالن�سبة لعديد من الزمالء ب�سبب قلة املوارد التي جتبيها النقابة �إال �أن ت�صميمنا على خلق الإجنازات جعلنا نتجرد من التجاذبات ال�سيا�سية كانت �أم ال�شخ�صية فبع�ضنا كاحلرب وبع�ضنا كالورق فلوال �سواد بع�ضنا لكان البع�ض �أ�صم ولوال بيا�ض بع�ضنا لكان ال�سواد �أعمى .فمن هذا املبد�أ ا�ستطعنا �أن ن�ضع م�صلحة نقابتنا �أوال لكي نتابع م�سريتنا بنجاح و�إزالة العوائق من �أمامنا و�أهمها املعا�ش التقاعدي لطبيب الأ�سنان فبعد اجناز تعديل م�رشوع قانون العائدات اجلمركية ال FOBيف جلنة الإدارة والعدل والتي ا�ستطعنا �أن نرفع مردوده من � 1إىل %2ها هو امل�رشوع يقبع يف �أدراج جمل�س النواب ينتظر لينفك عقد هذا املجل�س وبت هذا امل�رشوع مبردوده الإيجابي على ال�صندوق التقاعدي� .أما العائق الثاين فهة البت يف م�رشوع قانون ال Credit Pointsوالذي يتم متابعته ب�شكل ج ّدي من قبل معايل الوزير �سمري اجل�رس م�شكورا لإحالته الحقا �إىل جمل�س النواب وبته لي�صبح �إلزاميا على جميع الزمالء وي�صبح الطبيب مطابقا للموا�صفات كثائر الدول املتح�رضة. ولذلك �إنني اليوم �أغتنمها منا�سبة لرفع ال�صوت عاليا �أمامكم مل�ساعدتنا على �إقرار تلك امل�شاريع وجعلها قوانني نافذة. �أما العائق الأخري فهو عمالة الأطباء الآتني من خارج احلدود والذين يعملون دون ح�سيب �أو رقيب فال �سلطة لنا عليهم وال متابعة لهن من قبل �أجهزة الدولة فباهلل عليكم من يتحمل امل�س�ؤولية يف ذلك فهذا �س�ؤال بر�سم جميع املعنيني �آملني �أن ال يخيب ظننا. و�أخريا �أ�شكر فخامتكم لرعاية هذا امل�ؤمتر راجيا من اهلل �سبحانه وتعاىل �أن يوفق قادة البالد يف ملء الفراغ الرئا�سي ,فجمهورية بال ر�أ�س كمركب دون قبطان .وال�شكر اجلزيل �أي�ضا �إىل رئي�س جامعة البلمند و�إدارتها و�إىل كل الأع�ضاء الذين �ساهموا يف التح�ضري لهذا امل�ؤمتر و�إىل ح�ضوركم الكرمي وال�سالم عليكم. Dental News, Volume XXIII, Number II, 2016
Dr. Adib Zakaria Surrounded by his guests at the opening ceremony
Dr. Rola Dib Khalaf, Dr. Fadi Karam, President Michel Suleiman, Dr. Adib Zakaria
Inauguration of the exhibition floor
LOS 2016 Today and Tomorrow’s Orthodontics Lebanese Orthodontic Society
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May 5-8, 2016 Mövenpick Hotel & Resort Beirut, Lebanon
More Pictures Available On www.facebook.com/dentalnews1
Photo from The Opening Ceremony at The Mövenpick Hotel, Beirut
Dr. Fadi Dahboul, president of the Lebanese Society of Orthodontics.
P. Salim Daccache, s.j. USJ rector
Dr. Maha Hoyek Abou Jaoude
Chers collègues, Après Djerba et Hammamet, Beyrouth est fière d’accueillir du 5 au 8 mai 2016, les troisièmes rencontres du Collège Inter-universitaire Francophone d’Orthodontie (CIFO) en collaboration avec la Société Française d’Orthopédie Dento-Faciale (SFODF), les Facultés de Médecine Dentaire de l’Université Saint-Joseph (USJ), de l’Université Libanaise (UL), de l’Université Arabe de Beyrouth (BAU) et du Département d’Orthodontie de l’Université Américaine de Beyrouth (AUB). Ces troisièmes rencontres du CIFO coïncident cette année avec le Jubilé d’Or de la Société Libanaise d’Orthodontie (LOS) qui a été fondée en 1965 et qui est considérée comme une des plus anciennes sociétés d’orthodontie du Moyen-Orient. La LOS s’est toujours efforcée de promouvoir l’orthodontie au Liban et dans la région depuis sa création à nos jours. Dental News, Volume XXIII, Number II, 2016
La LOS a aussi toujours aidé à propager l’orthodontie française. Ainsi en février 2002 déjà, une convention scientifique entre la SFODF et la LOS fut signée à Beyrouth, et en février 2005 le premier congrès des orthodontistes francophones fut tenu également à Beyrouth. Placées sous le thème “L’Orthodontie d’aujourd’hui et de demain”, les troisièmes rencontres du CIFO feront le point sur les nouvelles perspectives des concepts et des stratégies de traitement en orthodontie, avec la participation d’une élite de conférenciers français et francophones. Au nom de tous les membres de la LOS, je vous souhaite un excellent congrès et un agréable séjour au pays du Cèdre, bastion traditionnel de la francophonie au Moyen-Orient. Dr. Fadi Dahboul Président de la Société Libanaise d’Orthodontie
Left to right: Pr. Alain Bery president of the FFO, Pr. Olivier Sorel president of the SFODF and the Board members of the Lebanese Orthodontic Society
To Pr. Fouad Ayoub, Dean of the Lebanese University, Dental School
LOS 2016 Trophy Distribution
To Pr. Essam Osman, Dean of the Beirut Arab University, Dental School
Left to right DrsVolume . Alain ery, O Sorel, Adel BenAmir, Dental :News, XXIII,B Number II, livier 2016 Frej Jemmali, Fadi Dahboul, Joseph Ghoubril, Fadi Ghaith
To Pr. Nada Naaman, Dean of the Saint Joseph University, Dental School
To Pr. Adel Ben Amir president of the CIFO-College Interuniversitaire Francophone d’Orthodontie
Left to right: Dr. Cherif Masoud, Dr. Najib Khalaf, Dr. Sam Daher, Mrs. Emilie Leon
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CAD/CAM 2016 11th Edition of the CAD/CAM & Digital Dentistry Conference May 06 - 07, 2016 Jumeirah Beach Hotel Dubai, UAE
Dr. Aisha Sultan, President of the Conference
Dental News, Volume XXIII, Number II, 2016
More Pictures Available On www.facebook.com/dentalnews1
Planmeca Showing The Romexis Software
To Planmeca
To Coltene
To DentsplySirona
CAD/CAM 2016
Trophy Distribution
Carestream Demonstrating The CS 3600 Digital Scanner
To Henry Schein
T GSK
To Ivoclar Vivadent
Dental News, Volume XXIII, o Number II, 2016
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Dr. Jan Paulics, Denmark, Talking About Intraoral Scanning
Dr. Tif Qureshi, UK, Explaining Simple Orthodontics
Dr. Michael Dieter, Switzerland, Lecturing About Bonding
Conference Speakers
Dr. Mario Besek, Switzerland, Talking About Composite in CAD/CAM
Prof. Jihad Abdallah, Lebanon, Explaining Digital Radiography in Implants
Dr. Guillaume Jouanny, France, Showing Modern Endodontic Instrumentation
Assoc . Prof . JVolume oseph SNumber abbagh , Lebanon, Explaining Dental News, XXIII, II, 2016 the Golden Rules for Successful Digital Dentistry
Dr. Eduardo Mahn, Chile, Lecturing on Easier CAD/CAM Technology
Experts at ACFF Symposium Call for Collaboration and “Joining Up Existing Evidence” to Promote Successful Caries Prevention and Management The Alliance for a Cavity-Free Future (ACFF) held its first annual symposium at the 20th annual UAE International Dental Conference in Dubai (AEEDC) on 2 February 2016. The day-long session – titled “The Fight for a Cavity-Free Future: ‘Joining Up’ the Evidence to Make an Achievable Difference”– engaged key thought leaders in robust discussion to not only understand the existing body of evidence regarding the current approach to caries prevention and control, but to determine how to integrate that evidence and identify a clear path towards a cavity-free future for all. The symposium hosted a group of experts across key disciplines, including, nutrition, education and behavior change, cariology, public health, clinical practice, and caries management. “The annual AEEDC meeting brings together leading oral health professionals to address pioneering advancements in oral health research and technology,” said Professor Abdullah R. Al Shammery, Rector of the Riyadh Colleges of Dentistry and Pharmacy in Dubai and Co-Chair of the local North Africa and Middle East ACFF Chapter. “Today’s ACFF Global Symposium is a powerful example of the importance of global collaboration among oral health stakeholders to promote efforts and evidence that address the burden or oral disease on a global scale and, in consequence, drive meaningful change.”
A Need for Collaboration Symposium experts agreed that dental caries is a complex, multifactorial disease that cannot be prevented by the traditional focus on single factors in isolation. Very often, oral health efforts have worked in silos to address pressing issues around oral disease burden. The group suggested that organized collaboration and synergy that effectively “joins up” existing evidence between individual elements of the “Caries Puzzle,” can help fulfil the primary goal of the ACFF, a cavity-free future for all.
Key Takeaways:
Symposium experts discussed what specific factors needed to be part of the comprehensive approach and stressed the need for synergy to operationalize the existing evidence:
- Sugar: following the new World Health Organizations (WHO) guidance on reducing the amount of free sugars to prevent caries, obesity and diabetes. - Education and behavior change: enabling both patients and health professionals to do the right things at the right time to prevent and control caries. - Cariology: implementing the wealth of evidence about how to control caries, realizing that fluoride is important, but not sufficient, against high sugar challenges. - Public health: responding to the need for advocacy on caries and oral health issues, often neglected in public health policy and practice. - Clinical practice and management: recognizing the clinical evidence to support a preventive approach, as well as adopting a System to deliver caries classification and disease management in dental clinical practice, the International Caries Classification and Management System (ICCMS™). Importantly, experts overwhelmingly agreed that “Joining-up” these pieces of the “Caries Puzzle,” combined with suitable actions from other external stakeholders – including health professions, the public and patients – will allow us to achieve a cavity-free future more rapidly than separate strategies or individual group efforts.
Figure 1. “Caries Puzzle” Showing a collaborative relationship between multiple critical stakeholders to effectively shift the global burden of caries.
WWW.ALLIANCEFORACAVITYFREEFUTURE.ORG
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«Experience – the significant difference»
Training highlight in Berlin: the International Dental Conference 2016 the audience to join in and try out Dr. Lazik’s exercise suggestions for muscle relaxation. Friday finished with an evening event in the Wasserwerk Berlin, a building that is more than 100 years old and connects the traditional with the modern. During dinner there was time to catch up with one another and to exchange thoughts and ideas on a professional level. There were also some show acts: both the didgeridoo group Silberbodys and the solo violinist Bea, who played floating from the ceiling, provided musical entertainment in the old machine hall which was Workshops on Friday Tobias Grosse, Division Manager Implantology at Dentaurum beautifully illuminated in colors. Implants and Dr. Friedhelm Heinemann (Morsbach, Germany) welcomed the participants on Friday and opened the first four A bilingual marathon of scientific lectures on Saturday workshops. Saturday’s program offered eleven talks on implantology and interdisciplinary topics from the fields of science, research and practice. Tobias Grosse and Dr. Friedhelm Heinemann welcomed the international guests on the second day of the conference and guided them through the interesting program. The opening talk of the day was held jointly by Dr. Friedhelm Heinemann and Prof. Dr. Dipl.-Phys. Christoph Peter Bourauel from the University of Bonn on the subject of the immediate load capacity of tioLogic® implants. Dr. Sigmar Schnutenhaus (Hilzingen) spoke on the digital transformation in implant prosthetics and the opportunties this transformation presents. Anatomical and surgical considerations regarding the lateral jaw was the topic of a talk held by Dr. Joachim Hoffmann and Dr. Gudrun Stoya (both from the Friedrich Schiller University Jena, Germany). In a multimedia presentation they showed bone configurations in the mandibula, anatomical problem zones that can lead to difficulties during implant insertion, and topographical reference points to the neighDr. Christoph Bourauel (University of Bonn, Germany) and Dr. boring soft tissue on the floor of the mouth. Friedhelm Heinemann presented hands-on exercises using the new implant system CITO mini® on a plastic jaw and spoke on “Shorties – is this trend scientifically evident?” was the question asked the subject of the “Strategic increase of the number of abutments and answered by Dr. Torsten Mundt from the University of Greifswald, with standard and mini implants”. Dr. Sigmar Schnutenhaus (Hilz- Germany. He defined the term, spoke about the indications, gave a ingen, Germany) held a workshop on “Fixed restorations without comprehensive overview of literature on the subject and shared his augmentations” and gave the participants guidelines for use in own experiences and conclusions. He has reached the conclusion that their practice. “Tips and tricks concerning soft tissue – before, implants with a length of 10 mm or less no longer pose a problem if during and after implant placement” was the title of Dr. Daniel indications are taken into consideration. He gave the participants a set of clear recommendations. Prof. Dr. Werner Götz from the University Schulz’s (Henstedt-Ulzburg, Germany) presentation. Dr. Dieter Lazik, a research assistant at the institute for sports of Bonn spoke about the healing and degradation of bone substitutes therapy and prevention at the University of Potsdam, Germany, and gave an interim review after 10 years of research. invited the participants to join in with his workshop titled “The After lunch, Prof. Dr. Mohammed A. Al-Shahat from Mansoura Unicraniosacral system in dentistry”. He believes it is essential to take versity in Egypt spoke on minimally invasive implant insertion, followed a holisitic view of each patient. It didn’t take long for members of by Dr. Stefan Möller (Göttingen, Germany) on the subject of the cortiThree eventful conference days are now over for more than 300 participants from 19 countries: the International Dental Conference took place at the Meliã Hotel in Berlin from 22 to 24 April 2016. This year’s implants event highlight from Dentaurum Implants with 19 top-class speakers from home and abroad has left a lasting impression with its interesting lectures, practical workshops, an unforgettable evening event and perfect organization.
Dental News, Volume XXIII, Number II, 2016
cal microfixation of screw implants with osteosynthesis plates / satellite implants and the resulting increase in primary stability. The importance of emergency management in the dental practice became clear to the participants after listening to Dr. Peter Schablin (Bonn) talk on this subject. He spoke about symptoms and the necessary actions for emergencies in the dental practice, such as hyperventilation, and informed the participants on the necessary emergency equipment. Prof. Dr. Klaus K.-F. Roth (Hamburg University, Germany) reported on progress made in peri-implantitis treatment. In his résumé, he commented that there are few studies available on this subject. The risk of developing this disease can however be reduced by a system of regular recalls and by excellent oral hygiene. Prof. Dr. Dr. Kai-Olaf Henkel (Military Hospital, Hamburg) adressed the issue of complications in implantology. Using various case demonstrations, he clearly illustrated which complications may arise and which counteractive measures should be implemented. Dipl.-Paed. Herbert Prange (Mallorca) concluded the second conference day with the subject of dental intelligence and brain research. He spoke about dopamin pushing, its consequences and, in particular, the relation between the brain and patient consultation. With his humorous tips on optimum strategic consultation with patients, he brought the day to a wonderful conclusion. It had been a successful conference day with many interesting aspects.
man and international guests expressing how much they had enjoyed the practical workshops, the informative talks, the interesting social program and the overall excellent organization. The number of enquiries that came made it clear that there will soon be another implant event of this size from Dentaurum Implants.
Sunday: four workshops within an international context The workshops on Sunday were held in English only. The main subject for the speakers from Egypt and Turkey was the computer-guided insertion of implants using tioLogic® digital and implant prosthetics with AngleFix abutments. These workshops were headed by Dr. M. Akif Eskan (Istanbul, Turkey), Dr. Ali H. Özo lu (Adana, Turkey) and Prof. Ahmed Barakat (Cairo, Egypt). Dr. Joachim Hoffmann provided much food for thought in his talk on how to avoid complications in the dental practice. Dr. Daniel Schulz used illustrative case studies to show a number of variations for the management of soft tissue. As was the case on Friday, participants had here also the possibility to take part in all four workshops. As the third day drew to a close, voices could be heard from Ger-
More information: DENTAURUM Implants GmbH Centrum Dentale Communikation Turnstr. 31, 75228 Ispringen Tel.: +49-7231/803-470 / Fax: +49-7231/803-409 E-Mail: kurse@dentaurum.de Web: www.dentaurum-implants.com
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Ionolux® – Light-curing glass ionomer restorative material in VOCO application capsules Aesthetic restorations without bonding! Ionolux is a light-curing glass ionomer restorative material in VITA© shades A1, A2, A3, A3.5 and B1, which combines the advantages of glass ionomer materials with those of composites. The dentist can, for example, individually adjust the working time of Ionolux by using a polymerisation light. Application of Ionolux is quick, and the material can be modelled with ease without sticking to the instrument. It also adapts excellently to cavity walls. Ionolux not only makes conditioning of the dental hard tissue unnecessary, there is also no need to apply a final coat of varnish. Polymerisation times are short and practice-oriented, at 20 seconds per 2-mm layer. Ionolux is easy to polish, it is biocompatible and releases fluorides. Our proven Ionolux is now available in the new and particularly practical application capsule, distinguished by the fact that an activator is no longer required. The combined advantages of glass ionomer materials and composites, easy to use with Ionolux: place the filling, polymerise, finish, ready! website: www.voco.com
NEW PIEZOSURGERY® INSERTS FOR PERIODONTAL OSSEOUS SURGERY bone remodeling. The lanceolate-shaped insert (OP5A) is used for refining the bone contour. The precision and minimum invasiveness guaranteed by these piezoelectric instruments make this kit a wonderful addition to the surgical armamentarium for to both novice and expert surgeons. Optimal benefit is achieved in the most delicate phases of bone architecture remodeling during periodontal surgical procedures aimed at: Mectron has recently launched on the market 5 new Piezosurgery® inserts for ostectomy and osteoplasty procedures during periodontal osseous resective surgery, developed in collaboration with Professor Leonardo Trombelli and the University of Ferrara, Italy. The combination of inserts with specific shapes and dimensions allows to perform controlled bone contouring, minimizing the risk to excessively remove bone or damage teeth or other delicate anatomical structures. The spherical inserts (OT13 and OT14) facilitate bone surgery procedures in easily accessible areas, whereas the file-shaped inserts (OP8 and OP9) allow for effective interproximal and interradicular Dental News, Volume XXIII, Number II, 2016
- eliminating/reducing periodontal supraosseous pockets, improving the fit of the flap to the underlying bone profile - eliminating/reducing intraosseous pockets of mild severity, restoring a more physiological morphology to the supporting alveolar bone - crown lengthening, restoring the biological width in the most apical position. The inserts will be available separately as well as in a Kit with all five inserts dedicated to periodontal osseous resective surgery.
website: www.mectron.com
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G-CEM LinkForceTM from GC Dual-cure adhesive luting cement
Strength and aesthetics in one system for all indications, all substrates From inlays/onlays, overlays, veneers and tabletops to CAD/CAM prosthetics, the choice between different types of restorations has become wider. Add the introduction of new substrates such as zirconia, lithium disilicate and hybrid ceramics and it is no surprise that mastering all the cementation procedures for all indications is now a difficult challenge. G-CEM LinkForce from GC - the universal and powerful solution to all your adhesive cementation challenges. Secured adhesion in all situations with only one system with three base elements G-Premio BOND, bonding to ALL preparations with no compromises Bonds to teeth, metal abutments and composite core build-ups G-Multi Primer, ensures a stable adhesion to ALL restorations Stable chemical adhesion on all surfaces, even on precious metals G-CEM LinkForce, provides a strong link in ALL indications Universal without limitations in indications or substrate
Light-cure, dual-cure: the choice is yours High bond strength thanks to an efficient light-curing of the bonding Efficient self-cure mode Particularly useful when luting opaque or thick restorations Optimal light-curing of the resin cement Ideal for the luting of veneers Aesthetic & stable over time 4 shades to match all needs, accompanied by their corresponding try-in pastes Tooth–like fluorescence Color stability over time website: www.gceurope.com
3D generation_ Long-term success for your endodontic treatments
Dental News, Volume XXIII, Number II, 2016
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