TT June 2017

volume 10 issue 3 june 2017

issn 1757-4625

the

technologist the official journal of the dental technologists association

In this issue: An MOA technical walkthrough Cerezen – a splint alternative Virus and bacteria – Part 2 of infection control

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HOURS OF VERIFIED CPD PLUS 1 HOUR OF UNVERIFIED CPD IN THIS ISSUE!

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technologist in this issue Editor: Vikki Harper t: 01949 851 723 m: 07932 402 561 e: vikki@goodasmyword.com Advertising: Sue Adams t: 01452 886 366 e: sueadams@dta-uk.org

DTA administration: Sue Adams Chief Executive F13a Kestrel Court Waterwells Drive Waterwells Business Park Gloucester GL2 2AQ t: 01452 886 366 e: sueadams@dta-uk.org

news

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dta column

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hr facts: designed to fail

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CPD

business loans – what you need to know

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CPD

Tony Griffin Treasurer

Shofu vintage pro

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John Stacey Gerrard Starnes Marta Wisniewska Social media coordinator

Cerezen – A splint alternative

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CPD

CPD

Straumann roadshow

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the digital dental world: part three

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CPD

medium opening activator (MOA) technical walkthrough

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CPD

continuing professional development

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DTA Council: James Green President Delroy Reeves Deputy President

Editorial panel: James Green Tony Griffin

Design & production: Kavita Graphics t: 01843 583 084 e: dennis@kavitagraphics.co.uk

Published by: Stephen Hancocks w: www.stephenhancocks.com

infection control for the dental laboratory: part two

The Technologist is published by the Dental Technologists Association and is provided to members as part of a comprehensive membership package.

For details about how to join, please visit: www.dta-uk.org or call 01452 886 366

Find out the 11 reasons to join DTA by visiting: www.dta-uk.org the

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ISSN: 1757-4625 Views and opinions expressed in the publication are not necessarily those of the Dental Technologists Association.

Cost effective professional indemnity insurance for dental technicians and laboratories

Tel: 01634 662 916

2 june 2017

news&information

■

AMAZING EDUCATION SPECIFICALLY FOR TECHNICIANS AT THE ADI TEAM CONGRESS 2017

The ADI Team Congress 2017 has once again been a resounding success. With a wide scope and exceptional speakers, the three-day event was a great experience for all members of the dental team.

T

he Technicians’ Programme provided dental technicians with plenty of food for thought. With a full day of inspiring lectures from renowned speakers, including Ashley Byrne, Phil Reddington, Emma McCormack and Jonathan Bill, the programme delivered some exceptional ideas for delegates to implement in their own laboratories.

Attending technicians were also invited to attend the Congress’s Plenary Programme that featured a line-up of world-class lecturers from Daniel Alam to Dennis Tarnow, Stephen Chu and Ueli Grunder – all of whom were eager to provide delegates with the very latest in implant knowledge and techniques.

offer once they’d returned to work!

What’s more, with an extensive trade exhibition and a fantastic Congress Dinner at the National Maritime Museum, the ADI Team Congress 2017 was the very best way to celebrate the first 30 years of the ADI.

Technicians benefitted from this wide range of education and certainly could make good use of the information on

■ For information on the ADI and upcoming events, please visit www.adi.org.uk

■ BE AWARE OF THE NATIONAL MINIMUM AND LIVING WAGES (NMW/NLW)

The government has revealed the top excuses of employers for not paying the NMW and these include ‘only wanting to pay staff when there are customers to serve and believing it was acceptable to underpay workers until they had “proved” themselves’.

An awareness campaign has been launched to encourage workers to check their pay to ensure they are receiving at least the statutory minimum based on recent 1 April 2017 increases.

■ NLW for workers aged 25 and over (introduced and applies from 1 April 2016) £7.50 ■ the main rate for workers aged 21–24 £7.05 ■ the 18–20 rate £5.60 ■ the 16–17 rate for workers above school leaving age but under 18 £4.05 the

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■ the apprentice rate, for apprentices under 19 or 19 or over and in the first year of their apprenticeship £3.50 This will be the second increase in six months for the NMW rates and in the future new NMW and NLW rates will be reviewed every April. Common errors cited by HMRC include: ■ not paying the right rate, perhaps missing an employee’s birthday

■ making deductions from wages that reduce the employee’s pay below the NMW/NLW rate ■ top-ups to pay that do not qualify for NMW/NLW ■ failure to classify workers correctly, so treating them as interns, volunteers or self-employed ■ failure to include all the time a worker is working, for example, time spent shutting up shop or waiting to clear security The penalties imposed on employers that are in breach of the minimum wage legislation are 200% of arrears owed to workers. The maximum penalty is £20,000 per worker. The penalty is reduced by 50% if the unpaid wages and the penalty are paid within 14 days.

HMRC also names and shames employers who are penalised.

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thedtacolumn

DTS 2017

Articulate e-journal Are you receiving Articulate by email?

If not, let us know your current email address and we can add you to the mailing list. Alternatively you can view each issue on the website in the publications section.

Don’t miss out on at least 30 minutes of CPD available in every edition.

letterstotheeditor From: JD Marsden CPD Questions: Shade taking using the 5th generation Easyshade Comments: Great, very informative.

DTA Fellowships 2017 Congratulations to Sue Adams and Ashley Byrne who have been awarded a DTA Fellowship. More on this story in the August edition …

Dentaid A big thank you to DTA members who took part in the ‘Donate a £1’ to Dentaid campaign.

DTA President, James Green presents a cheque to John Elkins of Dentaid

Thankyou

From: P Conlon CPD Questions: The digital dental world Comments: Great CPD. Interesting to see the speed with which what seems the latest technology can be superseded as in the Easyshade V: something we should bear in mind when investing in equipment.

From: M Bawn CPD Questions: The use of removable appliances in place of fixed appliances Comments: More on acrylic and chromes please.

From: P Thwaites CPD Questions: The digital dental world Comments: The changing world of dental technology. It’s mind-blowing.

Andrea Johnson The DTA management team (Council) is sorry to see Andrea Johnson leave the team and wish her well for the future.

Keep in touch with DTA on Facebook and Twitter: @DentalTechnologistsAssociation @The_DTA the

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From: S Lucas CPD Questions: Infection control for the dental laboratory Comments: Very interesting and a timely reminder how to use infection control for the best in the lab.

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■ Designed to fail Standards for the Dental Team: Standard 7.3 Update and develop your professional knowledge and skills ■ Educational aim: – to get up to speed on the latest advice for achieving effective and positive performance reviews with your team ■ CPD outcomes: – to hear the criticisms of previous ‘best practice’ advice and why it doesn’t work – to be informed of ways and be better able to engender a positive working relationship amongst members of the team

Often referred to as staff appraisals or performance management, most employee review schemes fail to achieve their stated objectives of individual and business improvement. Richard Mander looks at the 5 main reasons why the average scheme is doomed to failure and what you can do to make yours more relevant and impactful.

1. It’s not all about the forms

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dread to think of the amount of time wasted by businesses and particularly HR ‘experts’ in designing the perfect appraisal form. In my experience, it doesn’t exist.

But in trying to design the ‘perfect’ system, the forms take over and get longer and inevitably more complicated.

Forget form design and focus on the quality of the conversation that takes place at review time. To do this it usually pays to emphasise the importance of regular, short, face-to-face, mini-review meetings.

A 10–15 minute, two-way conversation every 2 or three weeks, based simply on what’s been working well, less well and what you/they need to start doing differently is a great format.

Afterwards, share a set of bullet points of the main areas covered and use these as the start point for the next meeting.

often physically divorced from the ‘real’ work environment and not close enough to assess what really goes on or to have a valid view of what’s been achieved.

Inviting feedback from a broader range of people, including peers and even customers or clients, can provide a more balanced view of strengths and development needs.

This approach is sometimes referred to as 360 feedback but can fail due to overelaborate mechanisms for gathering views. A simple email asking for comments on what works well, less well and what could be changed is often all that is needed.

4. Imposing views When new review schemes get introduced, it’s normally done as a ‘top down’ exercise. Owners/managers tend to promote the scheme they used at their ‘last place’ and can be surprised when they meet with resistance or low take up for what they saw as the perfect solution.

2. Backward thinking

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All too often employee reviews are entirely backward-looking and tend to focus on the mistakes or the things that need to be improved. As well as reviewing past performance, it’s really important to discuss future aspirations and the type of support and training that your employees will need to progress their careers and develop their skills.

Try to agree a set of informal targets for the next review and invite the appraisee to decide what’s achievable. Most people like to be stretched at work and you may be surprised by what they think is achievable.

3. The manager doesn’t always know best The appraiser or manager’s view will often dominate when discussing an individual’s performance, as if they have some kind of second sight. But the line manager is the

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Online schemes are often hailed as the perfect solution for gaining buy-in but many lack the flexibility to allow them to be adapted to what your business really needs.

A more effective way of introducing any new procedure is to invite views and feedback from staff on a draft version, before incorporating the best of these into the final design.

5. Links to pay or grade Nothing that I have seen in the area of staff reviews is more likely to produce

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businessloans

■ Business loans –

What you need to know!

Standards for the Dental Team: Standard 7.3 Update and develop your professional knowledge and skills

questionable, overblown results than linking the review discussions to a rating or worse still a pay rise. This approach does have some merit but can only work if reviewers have the skills and courage to truly differentiate between the different levels of performance.

I would argue that you could only have a truly objective discussion about performance when carried out as a ‘neutral’ discussion with the output being commitment to a development plan.

Additional information: Sample forms and guidance notes for carrying out employee reviews to encourage employee development and improvements to your business performance can be found in the membership area of the DTA website.

Richard Mander Richard Mander is a freelance HR consultant with over 25 years’ experience in Strategic and Operational HR with companies including the Granada Group and Ecclesiastical Insurance. He specialises in providing support to smallto medium-sized companies who do not have their own in-house resource and aims to deliver cost-effective, pragmatic and practical solutions. If you would like to find out more about this topic or advice on other HR matters you can contact him at www.manderhr.com 07715 326 568.

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■ Educational aim: – to be aware of the various types of funding available to support business growth and stability ■ CPD outcome: – to understand the options available for financing your laboratory’s growth or stability and their advantages and relevance to different circumstances

Business funding is crucial to the survival and growth of any business.

Whether it be to fund the purchase of vital equipment or to assist a growth plan, such as new premises or taking on more staff, obtaining additional finance is an important decision that many business owners will have to wrestle with at some time in their business lives.

Here, we take a look at some of the options you have for funding, and what to look out for in deciding if it is right for you.

Business funding options 1. The bank a) Loan

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igh street banks will offer business loans to businesses and the interest rate they charge will depend on the relationship you have with the bank and the perceived risk following a computer credit check on you and the business. They will carry out a credit history check and normally request a full business plan and two-year cash flow forecast, both of which we have looked at in previous articles, to assess the viability of the purpose of the loan and your ability to repay it. If you have security to offer on the loan, such as equipment or premises, then this lowers the perceived risk taken by the bank and will increase the chance of you getting the

loan and hopefully reduce the interest rate they offer as well. b) Overdraft If your funding need is because of a short-term cash flow problem, then a better option might be an overdraft that offers a chance to obtain finance for a short period of time and for use when you need it most. There will be a set-up fee and ongoing charges as and when you dip into your overdraft. The charges are higher than that for a loan because it is more short term and flexible.

2. Start-up loan The start-up loan is a government-backed loan facility open to anyone in the first two years of a business. Loans can be from £500 to £25,000, at an interest rate of 6%, and repayment terms from 1 year to 5 years. They will also do a credit check to ensure lending viability and require sight of a full business plan and two-year cash flow forecast.

3. Poor credit history options Both high street banks and the government-backed start-up loan require you passing a credit check. Should your credit history not allow you to pass such a check, then another option could be the Fredericks Foundation, which is a charitable trust that specialises in lending to businesses that can’t get credit elsewhere. They will again request a business plan and cash flow forecast, and subject to you passing this part of the process, you will be asked to present your idea to a panel.

They will spe other ultimately

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decide whether your application is successful.

There may also be specific charitable organisations in your local area that may offer something similar.

4. Crowd funding Crowd funding has grown dramatically in popularity over the last few years. It is the practice of getting funding for a business by raising contributions from a number of people. This is primarily achieved via internet sites such as Kickstarter and the Funding Circle. Crowd funding can work in a number of ways. Some sites put the lender in front of possible contributors and get the lendee to offer incentives for contributors to pledge money towards the end target. This is not a loan but instead is given to the lendee as long as their incentives raise enough money to achieve the target. It is therefore up to you to offer decent incentives for the pledges of money you need and to have a business proposal that is attractive. Other sites get investors to give to projects for a certain return and offer the money to the lendee via a normal business loan but funded by many different individuals, called peer-topeer lending.

5. Hire purchase/lease When a business is looking to buy capital items, such as motor vehicles or equipment, there is an option to finance the purchase by taking out a lease or HP agreement. These are agreements to pay back a finance company for the cost of the asset over a period of time, subject to interest and charges. There are many different types of lease and ways of paying back the finance. It could be a the

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straight monthly amount or it could be a balloon agreement where you pay reduced monthly payments and then a larger sum at the end to actually buy the asset and make it yours. In both these examples the asset becomes your property at the end of the term. You could, however, do a straight monthly hire of the equipment where you pay to hire for the use of it but the intention is that the asset is never yours.

increasing value of the business.

Investments would normally be in return for a number of shares in the business that then dictate the proportion of any dividends voted that they would receive and the value of their shareholding could increase as the business grows.

Tax implications

Other options

If the business takes out a business loan then the interest element of the repayments would be available to set against any profits to reduce the amount of profit that would be subject to tax.

There are a few other options available depending on your location and age.

The Princes Trust will invest small amounts to get new businesses off the ground providing the entrepreneurs are aged 18 to 30 or above 55 years of age.

You may have local charities in your area that may offer financial assistance in certain circumstances, such as mental health issues, etc.

If you have gone down the overdraft route, then all interest and charges, including set-up and arrangement fees that the bank may impose on you, would be tax deductible.

With HP and lease arrangements, some or all of the interest on the agreement is tax deductible over the term of the contract. If it is a straight hire of equipment, then some or all of the full hire cost is tax deductible, but the asset never becomes yours, so you cannot claim the associated capital allowances on the value of the asset, whereas you can with the other two options.

Outside investors Other sources of business finance could involve bringing in investment from outside individuals, whether they be family members or professional investors.

It may be they are seeking an investment return by way of interest or dividend, as well as having an interest in the

Obtaining grants is very specific to the area you live in and it always worth checking out the local council website to see if they are offering any financial assistance for new businesses in the area or to help existing businesses to expand and grow.

Also check out www.grantfinder.com that regularly updates to have details of the majority of UK grants listed on its site.

As you can see, there are many options for obtaining business finance, and it is important to get the right advice to see which is the most appropriate option for you. Make sure you get the right advice from your accountant before taking the plunge!

About Peter Blake Peter Blake is a chartered accountant, business coach and master practitioner of NLP. He has his own practice based in Wiltshire, lectures on ďŹ nance and mentors new business start-ups for Gloucestershire Enterprise Ltd. For further details, contact Peter on 07912 343 265 or email peterblake@pbcoachingandtraining.com

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advertorial

■ Definitely improving aesthetic results: innovative PFM system reduced to the maximum!

Proven products have been redesigned for even more convenient handling and sophisticated shade matching – so why not rediscover PFM restorations?

VINTAGE PRO, launched at the IDS 2017, represents a fresh, new PFM porcelain generation, allowing dental technicians to easily, efficiently and aesthetically meet all challenges in the field of PFM restorations.

B

ased on SHOFU’s proven VINTAGE systems and more than 30 years of experience and expertise in dental porcelains, this optimised leucite-reinforced feldspathic porcelain helps users to achieve maximum aesthetics in a minimum of time. The excellent handling of a wellestablished PFM system has been systematically optimised, the aesthetic benefits have been further enhanced, and the porcelain basis has been combined with new materials – for even greater ease of use, higher safety and firing stability, and naturally opalescent shades on all classical PFM alloys!

VINTAGE PRO provides new perspectives for PFM restorations. The uncomplicated, light-transmitting and reflecting porcelains

of this system allow both professionals and beginners to create excellent aesthetic results using a time-saving technique. Thanks to their leucitereinforced crystalline structure, these porcelains feature exceptional brilliance with great depth and high colour and firing stability, making PFM restorations look as if they were all-ceramic – no matter if the frameworks are made of gold-containing, palladium-based or nonprecious alloys or CAD/CAM materials!

Excitingly classic, refreshingly new: brilliance with depth VINTAGE PRO stands for new, fresh aesthetics with precise opalescence and fluorescence, whose naturalness changes with varying light conditions. The reason: each porcelain material shows a characteristic shade effect, based on specifically matched light refraction properties. VINTAGE PRO is a leucitereinforced feldspathic porcelain system with a versatile, life-like shade range including standard shades, highly fluorescent margin and cervical shades, opalescent effect shades and supplementary bleach shades – all

accurately matched to the Vita Classical system. In addition, high quality paste stains are available for individualisation.

Another highlight: Newly developed Powder Opaque and ready-to-use Paste Opaque materials with great opacity and bond strength allow technicians to quickly and reliably mask metal frameworks and create an aesthetic base for porcelain build-up. Both Opaque types can easily be adjusted or modified and applied in any desired thickness.

Rediscover PFM – and improve aesthetic results!

VINTAGE PRO meets all requirements that a state-of-the-art PFM system has to meet. An optimised layering system, ideal stackability and sculptability, and high dimensional and firing stability at a temperature of approximately 900°C make this porcelain convenient and efficient to use in everyday work.

Reduced to the maximum, VINTAGE PRO porcelain is now available in 16 standard shades, 4 whitening shades and various light-dynamic auxiliary and effect shades.

The system also includes Paste and Powder Opaque materials ensuring the right base colour and high bond strengths. the

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alternativelsplint

■ Cerezen – A splint alternative

By Robert Jagger, BDS, MScD, FDSRCS and Alaa Daud, BDS, MSc Standards for the Dental Team: Standard 7.3 Update and develop your professional knowledge and skills ■ Educational aims: – to outline the design of the Cerezen device – to reflect on the benefits and patients’ feedback ■ CPD outcome: – to review the potential of the new Cerezen appliance for TMJ disorders

Introduction Temporomandibular disorders are very common. It has been shown that 25% of individuals experience a TMD at some point in their lives.2

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cclusal splints have been an important part of the management of TMDs for many patients. Soft splints are most commonly provided in general dental practice.

Alternatively harder splints such as the Michigan splint are sometimes used. Not all patients are able to tolerate a splint.

Splints interfere with speech and other oral functions, so wearing a splint in the daytime is difficult or not possible.

Prolonged use of splints can cause unwanted occlusal changes. An alternative treatment method, Cerezen®, has become available to treat the jaw pain and symptoms associated with teeth grinding and clenching that avoids many of the Fig. 1

The aim of this article is to describe this new treatment method and to highlight potential advantages and disadvantages of the devices.

Cerezen The Cerezen device comprises a pair of removable, custom-made, 3D printed hollow inserts that are placed within the ear canal (Fig.1).

The ear canal is located very close to the temporomandibular joint (TMJ) and the volume of the ear canal increases when the jaw is opened through movements such as chewing, smiling and speaking.

The Cerezen device uses this anatomical change to exert a very small amount of pressure on the walls of the ear canal when the jaw is in the closed position.

This encourages the patient to return to a tooth-apart position, minimising the tendency to clench the jaw and tense the surrounding muscles (Fig. 2). The inserts themselves are almost invisible. They have small tabs for easy insertion and removal.

The appliances are suitable for patients with TMD pain arising from either the TMJs or muscles of mastication. However patients with ear disorders, such as infection or developmental disorders, cannot use Cerezen appliances.

Making the appliances Devices are custom made to the shape of the ear canals. In order for the device to the

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Fig. 2

problems associated with occlusal splints.

The Cerezen device is made from E-Shell 300. This material is a liquid, photoreactive acrylate and has been used in hearing aid shells and otoplastics for the last 10 years. This material does not contain latex. The E-Shell 300 material is CE certified and has been approved for use by the Health Products Regulatory Authority and the European Notified Body.

be manufactured, an impression of the ear canals needs to be taken. This is performed by a trained audiologist. Before impressions are taken, the audiologist carries out an ear examination to ensure that there are no contraindications to treatment, such as ear infection.

Impressions are taken using silicone impression material.

At the fit appointment the clinician facilitates the device fitting, making sure the patient is able to insert and remove the devices. Instructions on cleaning and maintenance are provided.

As with dental appliances, there is a process of adaptation when the patient must adjust to the presence of the appliances.

Any problems relating to the fit of the appliance must be dealt with by the audiologist. Problems relating to TMD symptoms are dealt with by the dentist.

Discussion The clinical effectiveness and safety of the Cerezen device was established in a prospective, three-month, randomised, controlled clinical trial3 that included patients with TMD with myalgia, disc displacement with reduction, and/or arthralgia and who had a screening visual analog scale pain score of > 4 on a scale of 0 to 10. The Cerezen device produced

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a statistically significant reduction in pain within the first month of treatment, with further reduction observed through the duration of the study.

No unanticipated adverse effects or serious adverse events were reported during the study, and there were no reports of diminished hearing acuity in patients treated with the device.

Patients in the study reported very high satisfaction.

One hundred per cent of subjects in the Cerezen treatment group indicated excellent (71%) or good (29%) overall satisfaction with the device.

Cerezen appliances can therefore be extremely effective in controlling TMD symptoms. They have the particular benefit that they can be used in the daytime and, unlike occlusal splints, do not interfere with speech or other oral functions.

In conclusion, whilst further clinical studies will provide greater clarification of the benefits of Cerezen, in particular which type of patients should experience the greatest benefits, Cerezen has some significant advantages when compared with conventional splint treatments.

References 1. Macfarlane TV, Blinkhorn AS, Davies RM, Kincey J, Worthington HV. Oro-facial pain in the community: prevalence and associated impact. Community Dent Oral Epidemiol 2002; 30: 52–60.

2. Peck CC et al. Expanding the Taxonomy of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). J Oral Rehabil 2014; 41: 2–23.

3. Tavera AT, Montoya MC, Calderón EF, Gorodezky G, Wixtrom RN. Approaching temporomandibular disorders from a new direction: a randomized controlled clinical trial of the TMDes ear system. Cranio 2012; 30: 172–182.

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■ Infection control for the dental laboratory – Part two

By Andrea Johnson, BSc (Hons), LOTA, MDTA Standards for the Dental Team: Standard 7.3 Update and develop your professional knowledge and skills

pandemics in human history – there are beneficial species that are essential to our health.

■ Educational aim: – to be aware of how bacteria and viruses can impact us

Good bacteria

■ CPD outcomes: – to get a better understanding of bacteria and viruses – to understand how infection and cross contamination occur

Infection control is a huge concern for all of us who work in the healthcare industry and we must all be aware of the potential for cross infection in all aspects of our work and personal lives.

So, with that in mind, in our last article we looked at the main modes of infection transmission and cross infection, the chain of infection and laboratory infection control procedures. In this article we focus on bacteria and viruses, with the aim of highlighting how these can affect us inside and outside of work. The objective is to raise awareness of our own infection control procedures to enable us to find ways to break the chain of infection.

Thanks to very successful marketing campaigns, most of us are now well aware of the health benefits of good bacteria. Keeping our gut healthy is the surest way to happiness, we are told. As well as claims they improve our gut health, bacteria give yogurt its tangy flavour. They also give sourdough bread its distinctive taste. They make it possible for certain animals, such as cows, sheep and goats, to digest plants and for some plants, including soyabean, peas and alfalfa, to convert nitrogen into a more usable form.

Bad bacteria This is where the bad press starts and there’s no denying that bacteria cause many different types of disease, from sore throats, eye and ear infections and food poisoning to swelling of the brain and death. There are some common villains that cause problems and they are usually grouped according to their shape.

Bacilli – these are shaped like rods Salmonella and Escherichia coli (E. coli) are two of the most well known causes of food poisoning. E. coli lives in our large

Bacteria & viruses Bacteria Although bacteria are about as far away on the spectrum to humans as living things can be, they are essential to life – from we mere human beings to all existence on Earth. Research shows that bacteria existed some 3.5 billion years ago, making them one of the oldest living organisms. And although they have something of a bad reputation, specifically for causing human diseases that span everything from tooth decay to the Black Death – one of the most devastating

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infectioncontrol importance of good personal hygiene, such as regular hand washing, using tissues (and binning them after use, then washing your hands) and avoiding kissing when suffering from a virus.

In order to get some sort of perspective on the dangers that viruses pose in our everyday lives, and the scale of how many people they can affect, I have listed some examples of well-known viruses below: Ebola – had around a 90% kill rate, although now in 2016 it has dropped to around 60%. In 2014 it killed around 1,000 people in West Africa.

Rabies – Over the past 100 years rabies has declined significantly as a public health threat, and if bitten, treatment is available and effective. However, if not treated, it has a 100% kill rate. Still, the disease remains a great threat in other areas of the world. Approximately 55,000 people die of rabies every year in Africa and Asia, according to the WHO. intestines and doesn’t do us any harm until it gets into other parts of our bodies.

Drinking unclean water that includes traces of untreated sewage or eating food that has been washed in such water, as well as poor personal hygiene, including not washing our hands after going to the toilet, are the most common reasons people suffer from E. coli poisoning.

Cocci – these are like little spheres or balls Streptococci cause sore throats (you may have heard of ‘strep throat’) and Streptococcus pneumoniae causes the more serious lung infection, pneumonia, as well as sinusitis, meningitis, sepsis and peritonitis, among others.

One of the main reasons that bacteria are so effective – and devastating – is that they multiply amazingly quickly. Using a process called binary fission, they split in two making identical copies of themselves. This means their copies have the same structure, genetics and capabilities as the original cell. Consider this: if you have 1 bacterium at 9.00 am, the

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by noon you will have 512, by 4.00 pm you will have over 2 million and by 8.00 pm there will be nearly 9 billion!

Viruses Viruses are not true living organisms in the strictest sense of the word because without a host cell they can’t reproduce or synthesise proteins, generate or store energy, or carry out their life-sustaining functions. Broadly speaking, they are similar to parasites.

However it does get more complicated.

Some viruses can ‘live’ even without a host – they can hibernate until they find the right conditions in which to make copies of themselves. Because they can travel easily by air or touch, ideal conditions can be created quite simply.

Consider coughing and sneezing. If a person coughs into their hand, then touches a surface (door handle, keyboard or telephone) or another person, say by kissing or shaking hands, for example, their virus will be passed on. With sneezing, the virus is projected outwards becoming airborne, meaning it can be breathed in by another person. Hence the

HIV – Though the number of annual deaths related to human immunodeficiency virus (HIV) – has declined in recent years, an estimated 1.6 million people worldwide died of HIV and acquired immune deficiency syndrome (AIDS) related causes in 2012. To date an estimated 36 million people have died worldwide from the epidemic.

Influenza – The flu may not sound very scary, but it kills far more people every year than Ebola does. A highly contagious virus, influenza sickens far more people than it kills, with an estimated 3 million to 5 million people becoming seriously ill yearly from influenza viruses. Worldwide, the flu causes an estimated 250,000 to 500,000 deaths every year, according to the World Health Organization (WHO).

How a virus infects you Viruses are a continual part of our environment just waiting for a host cell to come along. As illustrated, they can enter our bodies through the nose, mouth or breaks in the skin. Once inside, they find a cell to infect.

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Conclusion Infection control is a lifestyle choice – not just part of your job! If in doubt, clean/disinfect/sterilise! Break the chain! as a baseline.

References

For example, cold and flu viruses will attack cells that line the respiratory or digestive tracts. The human immunodeficiency virus (HIV), which causes AIDS, attacks the T-cells of the immune system.

Regardless of the type of host cell, all viruses follow the same basic steps in what is known as the lytic cycle: 1) The virus cell attaches to a host cell.

2) The virus then releases its genetic instructions to the host cell, allowing the injected material to recruit the host cells enzymes. 3) The enzymes make parts for more new virus particles. 4) The new particles assemble the parts into new viruses. 5) The new particles break free from the host cell and the cycle begins once again.

Is that all?

As was stated in part one of this feature, we need to be aware of infection control in every aspect of our daily lives. After all, we could easily bring infectious agents into the lab/clinical environment as easily as we can take them home if we do not apply

appropriate infection control procedures into our daily routines. To give a perspective to this, I would like to conclude with something most people can relate to – the toilet seat comparison. It is commonly thought that the toilet seat is quite a large potential source of infection transmission, so we will use this as a baseline.

■ The average toilet seat has around 50 bacteria per square inch.

■ Usually there are about 200 times more faecal bacteria on the average chopping board than a toilet seat.

■ A kitchen sponge is 200,000 times dirtier.

■ A dishcloth is 20,000 dirtier.

■ The average desktop is 400 times dirtier.

■ Some people have more faecal bacteria in their reusable shopping bag than their underwear. (They tend to wash their underwear but not their bags!)

■ Sofa arms have on average 12 times the contamination of toilet seats.

■ Your mobile phone has around 25,000 bacteria per square inch!

1. British Dental Association, 2003 2. http://www.mylot.com/w/image/2053101.aspx accessed on 26/2/2012 at 16.00 3. http://faculty.ccc.edu/tr-infectioncontrol/chain.htm accessed on 26/2/2012 at 17.28 4. http://1300apprectice.com.au/wp-content/uploads/ 2012/01/Welder-Final.jpg accessed on 22.10 at 19.46 5. http://www.uow.edu.au/content/groups/public/ @web/@health/documents/mm/uowo25316.jpg accessed on 26/2/12 at 19.35 6. http://www.cdeworld.com/courses/4530 accessed on 27/2/12 at 19.32 7. http://lista-dentallab.com/images/pictures/ dental-main.jpg accessed on 22/2/12 at 19.31 8. http://www.keysignsuk.co.uk/imahes/products/ images/products/SIMPSONS-PPE-SAFETY-POSTER.jpg accessed on 27/2/12 at 21.27 9. http://masteryworksinc.com/wp-content/uploads/2011/ 04/broken-shains51.jpg accessed on 27/2/12 at 21.27 10. http://thesun.co.uk/sol/homepage/news/4060914/ Fake-dentist-sold-DIY-false-teeth.html accessed on 19/1/2012 at 9.00 11. Pritchard,C. (2012,November17). Is the toilet seat really the dirtiest place in the home? Retrieved September 8, 2014. From BBC News Magazine: http:// www.bbc.co.uk/news/magazine-203234304 – Overview of bacterial infections image: Häggström, Mikael, Medical gallery of Mikael Häggström 2014, Wikiversity Journal of Medicine 1 (2), DOI10.15347wjm2014.008. ISSN 20018762 [Public domain], via Wikimedia Commons – Overview of viral infections image: Häggström, Mikael, ‘Medical gallery of Mikael Häggström 2014’, Wikiversity Journal of Medicine 1 (2), DOI:10.15347/wjm/2014.008. ISSN 20018762 – All used images are in the public domain.

– Mainly Chapter 33 (Disease summaries), pp. 367–392 in Fisher, Bruce; Harvey, Richard P; Champe, Pamela C Lippincott’s Illustrated Reviews: Microbiology (Lippincott’s Illustrated Reviews Series), Hagerstwon, MD: Lippincott Williams & Wilkins, pp. 367–392, ISBN: 0-7817-8215-5.

– For common cold: National Institute of Allergy and Infectious Diseases (NIAID) > Common Cold. Last Updated 10 December 2007. Retrieved on 4 April 2009.

– For exclusion of CMV among the main viral STDs: Lucile Packard Children’s Hospital > Sexually Transmitted Diseases (STDs) Retrieved on 5 April 2009, Public Domain, https://commons.wikimedia.org/w/ index.php?curid=6416098.

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14 june 2017

straumannroadshow

■ Straumann juggernaut launches Straumann UK invites you to rock out this summer at one of the most instrumental roadshows UK dentistry has ever seen. They will have you jamming to the tune of digital success as they unveil a number of exciting developments to their digital solutions portfolio.

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or 10 days in July the ‘Straumann Juggernaut’ will play host to the Digital Performance tour, taking to the road and visiting seven locations across the UK. This highly anticipated rock fest will showcase to clinicians, technicians and CDTs the potential to amplify their career with the NEW synchronised digital workflow from Straumann® CARES® Digital Solutions.

This epic roadshow is a result of Straumann’s commitment to ensure clinicians, technicians and CDT have everything they need for every step of the treatment pathway. Audiences can expect to see exclusive performances from

headlines acts, such as Case Planning & Guided Surgery, Digital Impressions, Lab Scanners, In-Lab & Centralised Milling, 3D Printing and Scan & Shape.

Provides complete data visualisation to achieve real-time surgical and restorative case planning.

INTRA-ORAL SCANNING ROCK OUT TO DIGITAL …

The new and exciting Straumann® CARES® Digital Solutions offers the complete digital workflow to help achieve precision and efficiency, together with the peace of mind of Straumann’s quality, reliability and service. Combining interconnected software platforms, open and fully validated workflows, alongside a wide variety of materials on offer, Straumann® CARES® Digital Solutions is a true benchmark in digital dentistry.

CASE PLANNING & GUIDED SURGERY The workflow between coDiagnostiX™ and Straumann® CARES® Visual is completely seamless with DWOS Synergy™. Transfer coDiagnostiX™ implant planning to CARES® Visual and receive the restorative plan from the lab technician.

Designed for high performance, ease of use and optimal patient comfort, the extremely compact Straumann® CARES® IO Scanner and Straumann® CARES® IO Portable Scanner allow clinicians to quickly and easily create digital impression data that can be used to design and produce effective prosthodontic solutions.

3Shape TRIOS® Wireless Intraoral Scanners enhance patient experience, reduce chair-time and unlock the widest range of treatment opportunities. Backed by continuous software updates, upgradable hardware and add-on treatment modules, the 3Shape TRIOS® 3 range of intraoral scanners offers accurate, ultra-fast, powder-free scanning.

LAB SCANNERS Straumann® CARES® 3Series and 7Series Desktop Scanners effectively combine a proven and established scanning process with the latest computer technology in an elegant, functional design to accurately scan models and impressions. The scanners combine proven laser triangulation technology with three or five axes of freedom and are embedded with a powerful PC and several DWOS applications.

IN-HOUSE MILLING & 3D PRINTING Straumann offers the capability of milling custom dental prosthetics in-house via the flexible Straumann® CARES® Series Milling Units (C, D & M Series).

Additionally, the Straumann® CARES® P Series 3D Printer sets a new standard in 3D printing for labs, offering speed and reliability specially tailored to satisfy the highest demands in both the practice and laboratory.

OUTSOURCED PRODUCTION The Straumann® CARES® Centralised the

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UK digital tour Milling facility operates as an extension of the modern laboratory, with state-of-the art equipment and validated workflows.

There is a comprehensive range of products to choose from, including onestep restorations, customised abutments, screw-retained bridges and bars, copings, bridge frameworks as well as full contour crowns and bridges. Alongside this, Straumann offer a variety of materials, including multiple glass ceramics, zirconia available in numerous shades and translucencies, cobalt chrome, titanium and polymers.

By adding an all-encompassing digital dimension to their portfolio, Straumann have added a completely new vibe to their offering – they’re more than a dental implant company, they’re your digital solutions partner.

TOUR DATES Audiences will be driven wild by the great product deals, insightful presentations and hands-on demonstrations on offer at the Straumann Digital Performance Tour. Plus, with exclusive backstage access to the live music and entertainment on offer, and after-parties scheduled at selected locations, the Straumann Digital Performance Tour promises to be a mustattend event for any technician, CDT or clinician looking to enhance their digital offering in 2017 and beyond.

■ ■ ■ ■ ■ ■ ■

10–11 JULY LONDON 12 JULY EXETER 13–14 JULY COVENTRY 17–18 JULY MANCHESTER 19 JULY LEEDS 20 JULY NEWCASTLE 21 JULY EDINBURGH

■ Don’t miss the opportunity to see these fantastic innovations at the Straumann Digital Performance Tour.

FREE-to-attend places are limited – to book your place visit straumanndigital performance.co.uk or call 01293 651 230.

Guy’s and St Thomas’ NHS Foundation Trust

AN EXCITING OPPORTUNITY... ... has arisen to join the team in the removable laboratory at Guy’s Hospital as a band 5 dental technician. This is a permanent appointment. You will be expected to provide a broad range of work, however the majority it will be the construction of simple to complex removable prosthodontics appliances for clinical staff and postgraduate students. You should ideally be experienced in the production of simple implant-retained dentures and removable metal frameworks, ideally including attachments. You should be capable of constructing the full range of complete and partial dentures to a high standard. Knowledge of surgical appliances and stents would be an advantage but not necessary as full training would be given. You must have an appropriate dental technology qualification, such as a National Diploma. An advanced qualification in removable prosthodontics is desirable but not necessary as equivalent experience would be equally considered. The ideal candidate should be a great team player. For the right person it is a great opportunity to progress their career. You should have at least 3 years post qualification experience and you must be registered with the GDC.

For informal enquiries please contact: Martin Stevens on 02071 881 851 To apply please go to the Guy’s and St Thomas web site via the link below: http://jobs.gstt.nhs.uk/job/v692388 Closing date for applications is 30th of June 2017

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16 june 2017

dentaldigitalworld

■ The digital dental world: Part Three In an exclusive article, Ed Littlewood, marketing manager at Renishaw’s Medical and Dental Products Division, discusses the benefits of a digital workflow for dental manufacturers and laboratories.

Standards for the Dental Team: Standard 7.3 Update and develop your professional knowledge and skills

digital scan of the patient’s mouth.

Removing impressions from the process would not only mean that dental work is completed more quickly, but there would be no physical shipping of impressions with the potential for loss or delay while in transit.

■ Educational aim: – to gain an overview of digital workflow ■ CPD outcomes: – to get a better understanding of the benefits of digitalisation – to understand how CAD and digital printing can be effectively utilised to improve efficiencies

One of the most renowned myths about America’s first president, George Washington, is that his dentures were made from wood. In fact, Washington had several sets of full and partial dentures, all of which were constructed from human, cow and horse teeth, lead, copper and silver. Washington was elected President of the USA on 30 April 1789, and dentistry has advanced significantly since the 18th century, so much so that dental manufacturers are benefitting from digital technology in the design and production of dental pieces.

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ental laboratories are no strangers to digital manufacturing.

For more than a decade they have been scanning dental models and using specialised software to design crown and bridge restorations. Milling, a process by which material is removed from a workpiece, has traditionally been

the preferred means of production. Now alternative manufacturing methods, including a plethora of 3D printing technologies, are becoming more prevalent as the industry moves towards fully digital workflows.

Computer-aided design Computer-aided design (CAD) is the keystone of digital dentistry. This allows manufacturers to create more precise dental implants, bridges and structures with less manual input than if a traditional manufacturing process was to be used.

During the process, dentists take an impression of their patient’s teeth, which is then sent to the dental laboratory where the impression is scanned to create a digital copy of the mould. A physical model can then be manufactured using traditional milling techniques or using more contemporary methods such as 3D printing.

Using a digital file, rather than an actual impression, helps the lab minimise the risk of errors as digital files can be reviewed and revised before the final product is made. The majority of modern dental scanners create a digital file by using either fringe projection technology or laser scanning, to create an accurate reproduction of the impression. This allows for a more precise final result.

In the future, we can expect patient impressions to phase out completely and intraoral scanners (IOS) to become more commonly used in dentistry to create a

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3D printing During the 3D printing process, an advanced laser melting system builds up each framework in a series of successive layers. A high-powered laser beam is focused onto a bed of powdered metal and the selected areas consolidate into a thin solid layer. Successive layers of powder are then spread over the first, until every layer has been built. The solid frameworks are then taken from the machine and the product is dressed, grit blasted, and inspected as part of an ISO13485 medical devices quality management system.

The benefits of digitalisation Swift Dental Laboratory manufactures crowns and bridges, prosthetics and supportive chrome work, all of which are based on patient impressions taken at dental surgeries across the UK. Before working with Renishaw, Swift Dental Laboratory used lost-wax casting to create porcelain-fused-to-metal (PFM) frameworks.

As the laboratory’s volume of work increased, Swift Dental started to consider the potential of digital design and

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advanced manufacturing to speed up processes and increase efficiency.

We supplied Swift Dental Laboratory with one of our AM250 additive manufacturing systems, which uses a high-powered ytterbium fibre laser to fuse fine-grained metal powders together to create a final three-dimensional structure.

About Renishaw The AM250 is coupled with Renishaw’s DS30 blue light scanner, which creates a digital copy of a die stone model that is then used to create the framework. A file is then sent to the AM250 and the framework is produced from 40 micron layers of cobalt chrome powder. For a build of around 200 units, this takes between 8 to 12 hours, depending on the volume of the parts being produced.

Through our additive manufacturing technology, we have greatly improved the efficiency and accuracy of Swift Dental’s processes. Before introducing the AM250 and DS30, around two products in every ten would need a rework after the endcustomer’s first fitting – this has reduced significantly. The reduction in reworks is a particular benefit to dentists as it helps reduce the number of appointments needed for each customer, which has a significant effect on the revenue of the practice.

UK-based Renishaw is a world-leading engineering technologies company, supplying products used for applications as diverse as jet engine and wind turbine manufacture, through to dentistry and brain surgery. It has over 4,000 employees located in the 35 countries where it has wholly owned subsidiary operations.

For the year ended June 2016, Renishaw recorded sales of £436.6 million, of which 95% was due to exports. The company’s largest markets are China, the USA, Japan and Germany.

Throughout its c verifiore history, ed Renishaw has made a significant m commitment & e ateria quip ls to research men t and development, with historically between 14 and 18% of annual sales invested in R&D and engineering. The majority of this R&D and manufacturing of the company’s products is carried out in the UK. The company’s success has been recognised with numerous international awards, including eighteen Queen’s Awards recognising achievements in technology, export and innovation.

■ For more information about Renishaw, visit: www.renishaw.com ■ For more information about Swift Dental, visit: http://swiftdental.co.uk

Towards the end of his run as president, George Washington became so embarrassed about his dentures, which often clacked and creaked as he spoke, that he became a recluse. Fortunately, today’s dental industry has become more skilled and technologically advanced, meaning that there are always alternatives to poorly fitted and unsightly dentures like Washington’s.

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18 june 2017

medium opening activator (MOA) walkthrough

■ Medium opening activator (MOA) technical walkthrough

By Paul Mallett, BSc (Hons), FOTA, MIMPT, FDTA and Andrew Tinkler, CDT (Eng), LOTA, MPT, MDTA Standards for the Dental Team: Standard 7.3 Update and develop your professional knowledge and skills ■ Educational aim: – to outline the design of the MOA – medium opening activator, using cold cure acrylic resin ■ CPD outcome: – to give greater awareness of alternative techniques with regard to the design and fabrication of the MOA

Introduction The medium open activator made its first appearance on the world dental stage with the publication of Harry S Orton’s iconic atlas of clinical prescription and laboratory construction Functional appliances in orthodontic treatment.

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t the time of its publication this was one of the few publications to give in-depth information for both the orthodontist, and the technician who will ultimately make the appliances.

Important information about wire size position and function are included to better ensure that the technician makes an appliance that will treat the patient in the way intended. Whilst the atlas has many appliances to choose from, we have chosen what we think is one of most known appliances, the MOA. We are aware that readers of this article may have their own favourite construction

method for this appliance. The main materials choice when it comes to making this appliance is to choose heat cure or cold cure. In this article we have chosen to present a method of construction for an MOA using cold cure acrylic resin.

With regard to the wire components that are used in its design, there have been many deviations from the suggested configuration outlined in the atlas.

However this is sometimes driven by the subjectivity of each case as it is presented for construction. The important and overarching consideration is that the clinician and the technician appreciate and adhere to the principles by which this appliance functions to achieve an effective treatment. These can be termed the functional component objectives. We will outline these later in the article.

The upper and lower models are reverse articulated on a simple hinge articulator. This will give access to the palate and lingual aspects of the models for applying the acrylic at a later stage.

Model preparation – Remove all the anomalies from the model using an Ash 5 or similar.

Prepare the undercuts for the Adams clasps on the appropriate teeth.

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William R Proffit, DDS, PhD, stated that Harry S Orton OBE has contributed significantly to the ‘components approach’ to functional appliances in which specific appliance components are selected and incorporated to produce specific effects.

As such, great care must be used by the technician to not only ensure that the correct component parts are selected, but equally important that they are positioned in the correct place on the cast of the patient’s soft tissues and dentition. Failure to adhere to these rules could result in the appliance being ineffective or facilitating unwanted tooth movement.

How to contact the Authors Paul Mallett (Maxillofacial Laboratory Manager): University Hospitals of Morecambe Bay, NHS Foundation Trust, Maxillofacial Laboratory, Ashton Road, Lancaster, Lancs LA1 4RP. Tel: 01524 583 410. Email: Paul.Mallett@mbht.nhs.uk Andrew Tinkler (Senior Orthodontic/Maxillofacial Technologist): Andrew’s address and telephone number is the same as for Paul. Email: Andrew.Tinkler@mbht.nhs.uk Reference – Orton HS 1994. Functional appliances in orthodontic treatment, 2nd edn. London, Quintessence Publishing. the

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medium opening activator (MOA) walkthrough

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The undercut areas are highlighted.

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Functional component objectives must be observed when constructing and placing the wirework for this appliance.

The Adams clasps provide fixation of the appliance (holding it in the mouth). You may use a double Adams clasp 5–6 if you prefer and if the dentition allows.

We have used 0.7 mm hard StSt wire for my Adams clasps in this case. However we would recommend that you use a 0.8 mm wire if you are to use a double Adams clasp.

The occlusal rests 0.9 mm wire provides vertical restraint to the maxillary buccal teeth. These components will prevent unwanted eruption of these teeth during treatment.

S 3

The undercut areas are blocked out using plaster. Yellow stone has been used here for visual purposes.

The palatal wire 1.125 mm (use 1 mm wire in smaller arches); provides vertical restraint to the labial teeth canine to canine. This wire should be formed in an ideal as possible arch form. It should be positioned high up over and in contact with the cingulum of the central and lateral incisors. It should also be rested on the cingulum of the canine teeth.

The labial bow 0.9 mm wire: formed as an ideal arch, lying just above the interdental papilla (supragingivally). Medium-sized ‘U’ loops. The labial bow will provide sagittal restraint.

S 4

The wirework is fabricated as shown and waxed into position in the palate, as opposed to labially/buccally.

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20 june 2017

medium opening activator (MOA) walkthrough

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More plaster is used to cover the labial and buccal aspects of the model.

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The articulated and blocked out models.

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6

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The upper and lower models are placed onto the articulator and gently closed together.

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The upper and lower models are waxed out as shown.

Wax shuttering is applied to the model to prevent the cold cure acrylic from being over extended unnecessarily and to minimise the post curing finishing of the appliance. The shuttering should be formed as shown to enable the maxillary and mandibular base plates to be formed and built up using the salt and pepper technique simultaneously, either on or off the articulator. Please note that the shuttering should allow for build-up of the lower incisal capping at the same time as the rest of the lower baseplate.

Occlusal view of the upper model blocked out with plaster and waxed out labially.

The upper and lower models are soaked in cold water for 10 minutes then the excess water is blown off using compressed air. Cold cure acrylic is then applied to the lower lingual section of the model, as shown. Cold cure acrylic is also applied to the palate of the upper model.

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medium opening activator (MOA) walkthrough

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The acrylic is trimmed to shape, as shown.

Functional component objectives for 12 the acrylic baseplate: the acrylic baseplate should be kept clear of the mandibular buccal teeth. This is to allow the mandibular buccal teeth to erupt and enable overbite reduction.

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The lower incisal capping is an important component that is used to provide vertical restraint of the mandibular incisors. This will also prevent any unwanted incisal tipping from occurring. It is important not to over block out the lower incisors as this will lead to a baggy fit and the possibility of soreness and gingival stripping, due to mandibular movement possible within the capping. A more positive fit will enable the patient to more accurately position their jaw in relation to the appliance.

Absence of acrylic on the palatal aspect of the upper incisors will reduce the bulk of the appliance and will enable the patient to breathe through the mouth when required, although nasal breathing is to be encouraged as an ideal. The absence of the acrylic in this region allows the palatal wire to act in a way to minimise up-righting of the upper incisor teeth whilst at the same time providing vertical restraint.

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The appliance is then smoothed and polished in the usual way on a lathe. The finished appliance.

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22 june 2017

continuingprofessionaldevelopment Continuing Professional Development (CPD) Programme The Technologist is pleased to include a continuing professional development (CPD) programme for DTA members in accordance with the UK General Dental Council’s regulations and the FDI World Dental Federation’s guidelines for CPD programmes worldwide.

The UK General Dental Council regulations required that from 1 August 2008 all dental technicians must start documenting their CPD. They are required to complete and record a minimum of 150 hours of CPD every five-year cycle, a third of which should be verifiable CPD (50 hours). This should include verifiable CPD in the following core subjects: ■ medical emergencies (10 hours per cycle) ■ disinfection and decontamination (5 hours per cycle)

■ materials and equipment (5 hours per cycle) The questions in this issue of The Technologist will provide verifiable CPD for those entering the programme. Complete your answers for free online at www.dta-uk.org, or use the answer sheet overleaf (or a photocopy if this is preferred, so as not to remove the page). Return your answer sheet to the DTA Head Office address with your £5 payment (please note that your CPD won’t be processed without payment) before the 21 August 2017.

Online and paper responses must be received by the deadline. Dental technicians completing the programme will receive a certificate for the prescribed number of hours of verifiable CPD, together with the answers to the questions either online or by post according to the above guidelines.

Aims and outcomes In accordance with the General Dental Council’s guidance on providing verifiable CPD: ■ The aim of The Technologist CPD Programme is to provide articles and material of relevance to dental technicians and to test their understanding of the contents.

■ The anticipated outcomes are that dental technicians will be better informed about recent advances in dental technology and associated subjects and that they might apply their learning to their practice and ultimately to the care of patients.

Please use the space on the answer sheet or online to provide any feedback that you would like us to consider.

Infection control for the dental team Part two (Disinfection & decontamination CPD – 45 minutes) Q1 – Which of the following are characteristic of bacteria?

A – They are essential to life and life on the planet B – They are believed to have existed for as long as 3.5 billon years C – There are good and bad bacteria D – The common villains can be classified by shape and all of the above

Q2 – Bacilli are bacteria that: A – Are shaped like spheres or balls B – Are also known as salmonella and E. coli C – Are distributed via unwashed hands after visiting the toilet D – Are responsible for food poisoning and b & c

Q3 – Which of the following do not relate to streptococcus?

A – They are rod-shaped bacteria B – Sore throats, lung infections and pneumonia are associated with this bacteria C – Cocci bacterium also causes meningitis D – Binary fission is the means by which they multiply

Q4 – If you have one bacterium at 9.00 am how many cold bacterium do you have 12 hours later?

A – A million B – 7 trillion C – Nine billion D – Nine hundred million

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Q5 – Which of the following are characteristic of viruses?

A – They cannot carry out life-sustaining or reproductive functions without a living host cell and b B – They can survive without a host C – They are extremely dangerous having been responsible for the deaths of tens of millions of people and a, b & d D – They are spread very easily through touch, sneezing, coughing

Q6 – Identify the odd one out in the following about viruses: A – A virus will release its genetic instructions to the host cell and recruit the host cells enzymes B – They attach to and release genetic instructions to host cells and a&c C – They can enter us through breaks in the skin, the nose and the mouth D – The lytic cycle is a four-stage process of virus infestation and reproduction

Q7 – Breaking the chain means being aware. Which of the following is the worst source of bacteria?

A – The toilet seat B – A kitchen sponge C – Sofa arms D – The average desktop

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continuingprofessionaldevelopment The digital dental world: Part three (Materials & equipment CPD – one hour)

Cerezen – A splint alternative (Materials & equipment CPD – 30 mins)

Q1 – What were George Washington’s dentures made from?

Q1 – The number of individuals experiencing TMD at some point in their lives is:

A – Porcelain B – Wood C – Human, cow and horse teeth, lead, copper and silver D – Walrus ivory

Q2 – The Additive Manufacturing System described adds layers of material at about 0.04mm, which is ...

A – 5 microns B – 15 Microns C – 40 Microns D – 165 Microns

Q3 – What does CAD stand for?

A – Critically analysed design B – Computer analogue design C – Computer aided design D – Competent algorithmic design

Q4 – How do the majority of modern labs create a digital file?

A – In the plaster room B – In a creative software package C – From a virtual model D – Using fringe projection technology or laser scanning

Q5 – Which medical devices quality management system is cited?

A – ISO13485 B – ISO14684 C – ISO17864 D – ISO19321

A – 5% B – 15% C – 25% D – 35%

Q2 – Cerezen appliances work by: A – Closing the eustachian tube B – Creating a small vacuum C – Placing a small amount of pressure on the ear canal D – Reducing noise

Q3 – Cerezen appliances are made from: A – Silicone polymer B – Acrylate resin C – Latex rubber D – Vinyl resin

Q4 – Contraindications to Cerezen treatment include: A – High blood pressure B – Ear infection C – Diabetes D – None of the above

Q5 – In a clinical study the following percentage of subjects indicated excellent overall satisfaction with Cerezen treatment: A – 91% B – 71% C – 51% D – 31%

Q6 – What type of laser does the AM250 3D printer use?

A – Ruby B – Ytterbium fibre C – Carbon dioxide D – Semiconductor diode

Q7 – What type of scanner is Renishaw’s DS30?

A – White light B – Laser C – Contact D – Blue light

Q8 – What are indicated as benefits of moving to digital technology?

A – Improved efficiency B – Accuracy, and all answers C – Reduced reworking, and a) and d) only D – Minimises the risk of errors

Q9 – Before it went digital, how many of Swift Dental products needed reworking?

A – One in ten B – Four in ten C – Half D – Two in ten

Q10– What are the suggested advantages of using a digital scan of the patient’s mouth?

A – Increases work turn around and all answers B – No requirement for collection and c) and d) C – No delay or chance of loss and d) and b) only D – Removes the physical impression from the process

Designed to fail (Other specific cpd – 30 minutes) Q1 – The most effective employee review schemes rely heavily upon: A – Comprehensive forms B – An online system C – Regular, high quality, face-to-face conversations D – A two-hour, once-a-year meeting

Q2 – A good review will focus mainly on: A – Past performance B – Mistakes and missed targets C – Performance rating and salary expectations D – A balance between past performance and future targets and aspirations and the support required for achieving it

Q3 – The most objective view of performance comes from: A – The reviewer/manager B – The employee C – The customer/client/peers D – A blend of views including self, manager, peer, customer

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continuingprofessionaldevelopment Q4 – The most effective way to introduce a new appraisal system is to: A – Use a system that has worked for you before and then quickly implement it B – Consult all employees as early as possible and take their views and ideas into account in the final design before launch C – Make it online only D – Involve managers only in developing the new system

Q5 – Linking appraisal discussions to salary increases mainly leads to: A – A less effective appraisal B – A more effective appraisal C – Improved employee development D – Improved employee retention

MOA Walkthrough (Materials & equipment CPD – 45 mins) Q1 – Why are the models reverse articulated?

A – Gives access to the lingual and palatal aspects of the models when applying the acrylic B – There is no reason C – To enable the technician to fabricate the wirework D – To enable easier waxing out of the models

Q2 – What does the palatal wire do?

A – Used to strengthen the appliance B – Used to retract the incisors C – Provides vertical restraint to the labial teeth canine to canine D – Used to expand the upper arch

Q3 – Where should the palatal wire be positioned?

Business Loans (Other specific cpd – 30 minutes) Q1 – Funding Circle is an example of: A – High street bank B – Crowd funder C – Angel investor D – Charity

Q2 – If you have a business loan you can claim tax relief on: A – Loan repayments B – Loan advance C – Loan interest D – The amount outstanding

A – Following the line of the gingival margins B – Just palatal to the incisal tips of the centrals, laterals and canines C – High up over and in contact with the cingulum of the central and lateral incisors. It should also be rested on the cingulum of the canine teeth and in contact with the first premolar D – High up over and in contact with the cingulum of the central and lateral incisors. It should also be rested on the cingulum of the canine teeth

Q4 – Where should the labial bow lay?

A – Just above the interdental papilla (supragingivally) B – Labially & infragingivally C – Above the point of greatest bulbosity of the central incisors D – Fitted exactly to the surface details of the centrals, laterals and canines

Q3 – A bank overdraft is best for: A – Short-term cash flow problems B – Buying equipment C – Long-term cash flow issues D – Buying premises

Q4 – The government start-up loan scheme offers loans up to: A – £10,000 B – £15,000 C – £20,000 D – £25,000

Q5 – The start-up loan is available to: A – All businesses B – New start ups C – Any business in its first two years of trading D – Charities

Q5 – Why should the acrylic baseplate be kept clear of the mandibular buccal teeth?

A – To prevent mandibular buccal teeth from erupting B – To allow the mandibular buccal teeth to erupt, and enable overbite reduction C – To provide greater patient comfort during the wearing of the appliance D – To reduce the bulk of the appliance

Q6 – What does the lower incisal capping do?

A – Helps stimulate the obicularis oris muscle B – Encourages movement of the lower arch while the appliance is in situ C – Provides lower incisor tooth alignment D – It is an important component that is used to provide vertical restraint of the mandibular incisors. This will also prevent any unwanted incisal tipping from occurring

Q7 – What year was the Orton HS Functional Appliances in Orthodontic Treatment, 2nd Edition published?

A – 1994 B – 1990 C – 1993 D – 1995

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Simply fill in the multiple choice answer sheet on the inside back cover and complete the form ...

june 2017

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answer sheet the technologist june 2017 Please PRINT your details below: First Name*

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GDC no.*

Title

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DTA no.*

*Essential information. Certificates cannot be issued without all this information being complete.

Complete free online at <www.dta-uk.org>. First-time users will need to register; those already registered need only log in.

Or, either remove this page, or send a photocopy to: Dental Technologists Association, F13a Kestrel Court, Waterwells Business Park, Gloucester GL2 2AT. A £5 payment must be included with your CPD answer sheet – please do not forget!

Please note that you must achieve a score of 50% or more to receive a certificate.

Answer sheets must be returned before 21 August 2017 for CPD responses returned in the post and for online CPD users.

Answer sheets received after this date will be discarded.

Answers Please tick the answer for each question below Infection control for the dental team: Part two (Disinfection & decontamination CPD – 45 minutes) Question 1:

A

B

Question 2:

C

D

A

C

D

A

Question 6:

A

B

B

Question 3:

C

D

C

D

A

B

Question 5:

Question 4:

C

D

A

C

D

A

C

D

A

C

D

A

C

D

A

C

D

A

C

D

A

B

C

D

A

C

D

A

C

D

A

C

D

A

C

D

A

C

D

A

C

D

A

B

C

D

C

D

C

D

C

D

C

D

C

D

C

D

Question 7:

B

The digital dental world: Part three (Materials & equipment cpd – one hour) Question 1:

A

B

Question 2:

C

D

A

C

D

A

Question 6:

A

B

B

Question 3:

C

D

C

D

Question 7:

B

A

B

Question 8:

A

B

Question 5:

Question 4:

B

Question 10:

Question 9:

B

B

B

Cerezen – A splint alternative (Materials & equipment CPD – 30 mins) Question 1:

A

B

Question 2:

C

D

A

B

Question 3:

C

D

A

B

Question 5:

Question 4:

B

B

Designed to fail (Other specific cpd – 30 minutes) Question 1:

A

B

Question 2:

C

D

A

B

Question 3:

C

D

A

B

Question 5:

Question 4:

B

B

Business Loans (Other specific cpd – 30 minutes) Question 1:

A

B

Question 2:

C

D

A

B

Question 3:

C

D

A

B

Question 5:

Question 4:

B

B

MOA Walkthrough (Materials & equipment cpd – 45mins) Question 1:

A

B

Question 2:

C

D

A

C

D

A

Question 6:

A

B

B

Question 3:

C

D

C

D

A

B

Question 5:

Question 4:

B

B

Question 7:

B

Feedback We wish to monitor the quality and value to readers of The Technologist CPD Programme so as to be able to continually improve it. Please use this space to provide any feedback that you would like us to consider.

An important note for non-DTA members Non-DTA members will incur a £25 fee for undertaking CPD provided through this publication. Cheques made out to DTA should accompany your answer sheet. the

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