photo credit to Dr Victor Tallud DE C E MBE R 2 0 1 5 • D E N TA L A CCE S S • 1
Special Feature The Tuguegarao City Cagayan Dental Chapter “The City of Angels” Page 14 - 16
Editor in Chief Dr. Harris Co Publisher Dr. Armi B. Cabero Managing Director Mr. Medardo Chua
Contributing Editor Dr Jhing Chua-Sy
Pre-Finishing Orthodontic Check List: A Must!
Contributors Dr Aaron B. Mayordomo Dr Johanna Po Dr Joseph Lim Dr Vincent Gabriel S. Caagbay
“Start right - End well” Orthodontics By Dr Maridin Lacson Page 25
Circulation Executive Dr. Guenevere N. Uy - Tanchuanko
Scenes and Events 107th PDA CONVENTION “Professional Excellence for Global Competitiveness” Page 23 IDEM Singapore 2016 “The Business of Dentistry | Striving for Excellence” Page 35
DenTech China 2016 Page 36
Publication Manager Ms. Michelle M. Chua Advisory Board Members Dr. Claver O. Acero Jr. Dr. Maridin Munda-Lacson Dr. Ramonito R. Lee Dr. Darwin Lim Dr.Derek Mahony Prof. Alexander Mersel Dr. Antoinette Veluz Designers Mr. Christian Nipa (Web Design) Mr. Ace John Avila (Graphic Design)
Profiles Published By:
“Dental Box:The Smart Way to Dental Management” Page 20 - 21 “An interview with Dr Kelvin Chye” Page 22 - 23
Product Catalogue Exomed by Medesy Page 28 - 33
Dental Access is published 4 times in a year by ADJ Dental Access Publications. Its circulation reaches the three archipelagos of the Philippines mainly Luzon, Visayas and Mindanao. The collective efforts of our media and print platform will further extend in the Southeast Asia, Asia Pacific, and China. We are working close with other international organizations in order to build strong ties that will make Dental Access a resource of information and international talent with its pool of compotent an intelligent professionals. All material received by ADJ Dental Access Publications are understood to have full copyrights from the advertiser / contributor / author and will have full rights to publish both on website and on print. The advertiser / contributor / author shall then indemnify all against the claims or suits for libel, violation of right of privacy and copyright infringements. ADJ Dental Access Publications Rm 505 Admiralty Building 1101 Alabang - Zapote Road Muntinlupa City 1770 www.identalaccess.com Tel: 02-8937837
2 • D EN TAL AC C E S S • DEC EM BER 2015
DE C E MBE R 2 0 1 5 • D E N TA L A CCE S S • 3
THE FUTURE IS NOW lent of the value and profitability it provides to my clinic income. I was no longer a miser, for what I hold now tangibly is only half of what is at stake, and that is my future in the profession.
Dr Harris Co uring my days in college, when our professor would ask us to buy a dental product, they would always emphasize the usage of high quality materials over sub standard products. I remember their mantra, efficiency and durability is KEY to a successful practice. However, this advise normally fell on deaf ears to some who were reluctant to invest on these products.
On my end, I settled with a Japanese brand which was a far cry from other materials that swarmed our dental stores nearby. I figured, this would suffice to last me until I finish my clinical requirements. And so it did, until I bought a new set of instruments when I passed the board exams. These days I see myself doing Dentistry with a whole new perspective. Rummaging through my collective experience in the profession, I coined a new phrase, “Making Smart Investments Maketh a Career in Dentistry.” Now, I choose my purchases wisely. After careful consideration on the pros and cons of a product, I began to train myself how to discern a good brand over poor quality products. This enables me to foresee the value of my purchase along with its longevity and sustainability it would give me in 10 to 15 years. However, investment does not always equal price but it is the equiva-
ABOUT THE AUTHOR
The technology and protocol today is not quite what it was 15 years ago. Many things can happen in a span of 2 years where Dental Technology constantly evolves. Among other things, our scientists, physicists and researchers are the innovators of such technology thus producing a more efficient clinical tool / material for dental usage. If I compare our industry to the technology that is common to the masses, the possibility that my kids will get to type in a typewriter or play music using a cassette player is implausible due to the advent of newer technology (laptops, android phones, smart phones, itunes et.al). In the same manner where self cured resins and macro-filled light cured resins were the gold standard of aesthetic dentistry 10 - 15 years ago, the power of nanofilled technology have overcome its worth and has slowly become a thing of the past. It is quite possible that tomorrow a modified Zeptofil composite resin will be available with optimum strength, better bonding and cosmetic value that can surpass a ceramic or even a porcelain restoration. So just think how our industry with such a dynamic trend can change our culture and practice. People may have a different opinion of me over the investments I put in the clinic. To me I simply
live by the standards I created that is suitable both to my needs and my patients. From the very beginning of my career, I committed myself to provide a high standard of care and that entails a good working attitude akin to continuing education (attending seminars, conventions, etc.) And since my practice caters to a high demand in aesthetics, I taper to a dictum - “Patients will leave my clinic, beautified!” So, in order for me to provide that service, I keep myself and my clinic trendy and innovative. After all, a good business attitude coupled with proper management are the elements of success.
benchmark for continuing education by a media publication providing world class lectures starting with world renowned speaker / lecturer Dr. Markus Lenhard. This is a great opportunity to start the year right by making a commitment to our profession.
And with so much knowledge to be absorbed, how can one simply say they know it all?
Alongside our platform is the continued awareness on the MRA (Mutual Recognition Act) looming around the corner. In that sense, we should aspire to set our clinic protocols with world class standards that is parallel to first world countries. This is our window to the world where the cultivation of dental knowledge is no longer exorbitant. With today’s fast paced technology, obtaining a solid, unequivocal education is both a necessity and an investment.
Dentistry today has evolved over the past decades that it has affected not only our culture but our business practice as well. Gone are the days when dentists were only associated with poorly crafted iron tools peering though the gaping mouths of our patients. Thanks to the relentless research and development of these doctors, we are no longer considered Stone-Age. Now, we are modern, advanced and high tech.
In addition to our campaign, we are strongly promoting the 107th PDA Dental Convention this coming 28th of May 2016. Despite the non-occurrence of last 2015 PDA Elections that created mass hysteria in the dental community, our goal now is to elect a New President who will lead our members toward economic progress and social responsibility. This is our opportunity to make a difference - so let this moment come to pass with your vote.
Likewise with our publication, Dental Access will hold its ground as the center for advanced continuing education for dental professionals. In light of that, we will hold our First Dental Excellence Seminar on January 19 at the Grand Convention Center in Cebu City. We believe that our collaboration with Ivoclar Vivadent will be the new
We all have the power to make a difference. It is up to you if you will make that decision or not. Like the late President Nelson Mandela, Life changing circumstances is not a matter of chance, but a matter of choice! The defining moment is now. Occupare Momento (seize the moment). The future is Now!
Dr Harris Co is a graduate of Centro Escolar University in 1999 with an impressive number of achievements during his collegiate years. With his much promising career as a dentist, he became an Associate Member of the International Association for Orthodontics and is an active Member Tzu Chi International Medical Association, Philippine Prosthodontic Society, Philippine Academy of Esthetic Dentistry, and the Philippine Academy of Implant Dentistry. Currently he is the Editor in Chief of Dental Access Publications.
4 • D EN TAL TA L AC A C C E S S • DEC EM BER 2015
DENTAL LAW and ETHICS
THE ASEAN INTEGRATION AND WHAT IT MEANS TO PHILIPPINE DENTISTRY
but lesser developed member countries is addressed by the ASEAN integration. The other areas of collaboration includes “human resources development and capacity building; the recognition of professional qualifications; closer consultation on macroeconomic and financial policies; trade financing measures; enhanced infrastructure and communications connectivity; development of electronic transactions through e-ASEAN; integrating industries across the region to promote regional sourcing; and enhancing private sector involvement for the building of the AEC.”
Dr Jhing Chua - Sy
uring the 13th ASEAN Summit held in Singapore in 2007, the member countries - Brunei Darussalam, the Kingdom of Cambodia, the Republic of Indonesia, the Lao People’s Democratic Republic, Malaysia, the Union of Myanmar, the Republic of the Philippines, the Republic of Singapore, the Kingdom of Thailand and the Socialist Republic of Vietnam, adopted the ASEAN Economic Community (AEC) Blueprint which will “transform ASEAN into a single market and production base, a highly competitive economic region, a region of equitable economic development, and a region fully integrated into the global economy.” The AEC aims to make the ASEAN into a stable and prosperous region that would equitably develop its economies and reduce poverty and socio-economic gap among the member countries. The goal is to establish by the year 2020 the ASEAN Community; much like the European Union (EU) which was also preceded by their own European Economic Community (EEC) in 1958. The elements of the AEC are numerous but profound. The intention to make the ASEAN dynamic and competitive as well as help accelerate the integration of Cambodia, Laos, Myanmar and Vietnam which are ASEAN’s newer
ABOUT THE AUTHOR
Recognition of Professional Qualifications Movement of skilled professionals is the core of the Mutual Recognition Arrangement (MRA) on Dental Practitioners. The said agreement was signed in March 2009 with the objective of facilitating the “mobility of dental services professionals within ASEAN, enhance exchange of information and expertise on standards and qualifications, promote adoption of best practices for professional dental services and provide opportunities for capacity building and training of dental practitioners.” The Mutual Recognition Arrangement on Dental Practitioners (“http://www.asean.org/communities/asean-economiccommunity/item/asean-mutual-recognition-arrangement-on-dental-practitioners-2” http://www.asean.org/ communities/asean-economic-community/item/aseanmutual-recognition-arrangement-on-dental-practitioners-2) Under Article II, Definition of Terms; the following are described: 2.1 Dental Practitioner refers to a natural person who has completed the required professional dental training and conferred the professional dental qualification; and has been registered and/or licensed by the Professional Dental Regulatory Authority in the Country of Origin as being technically, ethically and legally qualified to undertake professional dental practice. 2.2 Specialist refers to a Dental Practitioner who has the dental specialist training and postgraduate qualification(s) that are recognized by the Country of Origin and has been registered and/or licensed as a specialist if such registra-
tion is applicable in the Country of Origin; 2.3 Foreign Dental Practitioner refers to a Dental Practitioner including Specialist who holds the nationality of an ASEAN Member State, registered to practice dentistry in the Country of Origin and applying to be registered/ licensed to practice dentistry in the Host Country. 2.4 Registration refers to registering and/or certifying and/ or licensing of the Dental Practitioner within a jurisdiction or may refer to the issuance of a certificate or license to a Dental Practitioner who has met or complied with specified requirements for registration to practice dentistry in the Country of Origin and/or Host Country. 2.5 Country of Origin refers to the ASEAN Member State where the Dental Practitioner has a current and valid registration to practice dentistry. 2.6 Host Country refers to the ASEAN Member State where a Foreign Dental Practitioner applies for registration to practice dentistry. 2.7 Professional Dental Regulatory Authority (hereinafter referred to as PDRA) refers to a body vested with the authority by the government in each ASEAN Member State to regulate and control Dental Practitioners and their practice of dentistry. PDRA in this context refers to the following: Member State PDRA Brunei Darussalam Brunei Medical Board; Cambodia Cambodian Dental Council and Ministry of Health; Indonesia Indonesian Medical Council and Ministry of Health; Lao PDR Ministry of Health; Malaysia Malaysian Dental Council; Myanmar Myanmar Dental Council Ministry of Health; Philippines Professional Regulation Commission, Board of Dentistry and Philippine Dental Association*; Singapore Singapore Dental Council and Dental Specialists Accreditation Board; Thailand Thailand Dental Council and Ministry of Public Health; Viet Nam Ministry of Health. (*caps mine for emphasis author) 2.8 Domestic Regulations include laws, by-laws, regulations, rules, orders, directives and policies relating to the practice of dentistry issued by the PDRA and/or relevant authorities. 2.9 Continuing Professional Development (hereinafter referred to as CPD) is the means by which members of the dental profession maintain, develop or improve their knowledge, skills and professional performance. (to be continued)
Dr Jhing Chua - Sy is an alumna of Centro Escolar University, Manila, Batch ‘87. In her early days as a dental student, she was the News Editor for The Scholar - a CEU University Publication. After passing the board exam, she pursued her post-graduate training at the UP-PGH Department of Hospital Dentistry in 1991. In addition to her line of achievements, she is a Former Legal Affairs Committee Secretary for the Philippine Dental Association in 1995-1997, a Former Comelec Secretary PDA in 1997-1998, a Former Executive Secretary for the National Dental Health Week in 1996 and Founding President and co-founder of Novaliches Dental Professionals, Inc. Today she continues her passion in writing as one of the contributing editors of Dental Access with her column Dental Law and Ethics. DE C ECMBE R R2 021051 5• •D EDNETA L A S SS • DE E MBE N TA L CCE A CCE S 5 • 5
LOCAL NEWS By Dr. Jhing B. Chua-Sy
DENTAL PROFESSIONALS SHOW SUPPORT FOR THE LUMADS
he Philippine Dental Association together with the Uni versity of the Philippines Beta Sigma and the Univer- sity of the Philippines Ladies Corp, conducted a dental mission called “Kalinga Sa Lumad” last October 30, 2015 at the grounds of the UP College of Human Kinetics, UP Diliman.
Lumads paying careful attention to the lectures given by QCDSI PP Dr. Nelson Magnaye in the visayan dialect. (courtesy of Dr. A. Aguiluz)
Dental volunteers from the Quezon City Dental Society, Inc. (QCDSI); Kapisanan ng mga Dentista sa Bulakan (Kadebu), dental graduates from the De Ocampo Dental College and the PDA led by Executive Director Dr. Maria Arlissa Aguiluz, provided the necessary dental treatments and lectures (in Visayan dialect) to our displaced brethren from Mindanao. Over a hundred tribesmen benefitted from the dental mission with the able support and assistance from Colgate Philippines, through Dr. Angel “Bong” David II, and ACS Unique care of Dr. Anne Camus, PDA Immediate Past President Dr. Corazon S. Flores and Dr. Rico Calingasan and Mr. Kokoy Aguiluz. (Wikipedia) “The LUMAD is a term for a group of indigenous peoples of the southern Philippines. It is a Cebuano term meaning “native” or “indigenous”, or a collective identity of the non-Islamized indigenous peoples of Mindanao.” They were forced to vacate their ancestral lands due to militarization of their communities. Their homes, On that account, they took to the streets of Manila to make their plight known to our citizenry as well as seek the intervention of the Philippine government to stop the plundering and militarization of their ancestral domains. The Lumads’ stay in Manila is part of the Manilakbayan2015, a campaign of the Lumads against attacks on their schools and communities. About 700 of them travelled from Mindanao to Manila. DA
A Lumad leader performs a sacred ritual called Panubadtubad infront of the Palma Hall of UP Diliman (photo credited to bulatlat.com)
6 • D EN TAL AC C E S S • DEC EM BER 2015
At its 107th Annual Convention
PDA SETS GENERAL ELECTIONS DRUG TRAFFICKER IN ON MAY 28, 2016 TARLAC TOWN IS A DENTIST
he Philippine Dental Association will hold it s National General Elections during its 107th Annual Convention at the SMX Mall of Asia Convention Center from May 25 to 30, 2016.
Led by Dr. Jesus Tumaneng appointed General Chairman of the 107th, the PDA is enjoining the general membership to vigorously participate in this annual affair and be a pro-active member of the association by casting their votes come election day. Only members in good standing including life members are allowed to vote at the time of the elections. The general elections, scheduled for May 28, 2016, Saturday, is mandated by the PDA’s Constitution and Bylaws. The organizing committee of the 107th hopes that every dental professional will uphold the constitutionality of the elections and its proceedings as well as expect that the decision of the PDA’s Commission on Elections (Comelec) regarding election-related issues, is upheld by the stakeholders consistent with its constitutional mandate. It is also widely expected that all interested candidates will be mindful of the qualifications of the respective positions they are gunning for to become an officer of the association for the Dental Administrative Year of 2016-2017. DA
prominent dentist in Paniqui, Tarlac was arrested along with his accomplices in a rented apartment in Barangay Patalan by police officers armed with a search warrant. Paniqui Police Chief Supt. Salvador Destura, Jr, identified the suspect as Dr. Epifanio Cabalu Castro, 54 years old. He was caught with 8 grams of shabu and other drug paraphernalia in his possession. Dr. Castro is listed as the “Number 1drug personality in the town, “according to Destura. Also arrested with Castro were Rufino Divina Fernandez, 49, of Barangay San Miguel, San Manuel town and Sarhani Rimpun Diko, 18, from Purok 4 Extension, Alabang, Muntinlupa City. The police also found in their possession a micro-weighing scale and empty plastic sachets apparently for packaging shabu. Castro admitted to selling shabu since he started using it in 1995. He identified Diko as his runner for a supplier identified only as Alex who is based in Metro Manila. Records showed that Castro already had a previous record of arrest for possession of illegal drugs sometime in 2012 and was released from jail only last year. DA
DE C E MBE R 2 0 1 5 • D E N TA L A CCE S S • 7
Dr Charlston Uy Receives an Honor from National Consumers Affairs Foundation
Dr Charlston Uy, a Tan Yan Kee Scholar and Alumnus of the University of the East College of Dentistry was awarded the 2015 Outstanding Young Professional Award by the National Consumer Affairs Foundation last November 18, 2015. Earlier in 2014, he was a recipient for the Dangal ng Bayan - Young Professional for Dental Medicine awarded by the same foundation. Dr Charlston excelled in his academic years and earned 6th Place in the National Dental Boards in 2008. The foundation is chaired by Dr Jonathan Nazareno Navea, a civic leader journalist who initiated and popularized major family and consumer related events in the Philippines and the AP region such as Mother’s Day, Father’s Day, Family Week, Grandparent’s Day, and Children’s month celebration since 1980. Dr Charlston Uy is the son of Dr Charles Martinez Uy and Mrs Lorna Escudero Uy. Both Dr Charles and his son, Dr Charlston are practicing in Tuguegarao City with a satellite clinic in Fairview, Quezon City.
8 • D EN TAL AC C E S S • DEC EM BER 2015
In the scientific world, there is no more stringent authority than the Cochrane Collaboration. The independent international network of scientists and physicians is consistently guided by principles of medicine which are supported by evidence. An exceptionally critical view is made of studies before their results are published in the Cochrane Review. In the current Cochrane Review, caries infiltration with Icon is taken into account – where it has been favorably assessed.
The infiltration treatment with Icon is effective.
One particularly noteworthy factor is that this innovative concept is thus supported by an independent and evidence-based assessment of clinical success, and only six years after its introduction.
The recent review article (drafted in accordance with the guidelines of the The authors summarize that caries infiltration is a suitable micro-invasive Cochrane association) assesses different micro-invasive treatment options treatment option whose clinical success rate is at least comparable to that for proximal lesions in permanent teeth and in milk teeth. of the long-established sealers. There is also an emerging trend that this kind of infiltration is more effective than sealing with resin. In addition to the sealing of fissures with resin-based sealants, glass ionomer cements and polyurethane patches for proximal areas, the infiltration Icon is able to function as a barrier and thus can effectively stabilize the lesion. treatment with DMG’s Icon was integrated for the first time.
BusinessUltradent Raises 341,036 lbs. of Food for Utah News Food Bank
Straumann Receives Prestigious Pierre Fauchard Academy Dental Trade and Industry Recognition Award Straumann is this year’s recipient of the prestigious Dental Trade and Industry Recognition Award presented by the Pierre Fauchard Academy (PFA). Presented annually since 1994, the Award honors an outstanding leader in the field for contributions to dentistry and the community. The 2015 Award was presented in Washington D.C. at the PFA Annual Awards luncheon concurrent with the American Dental Association Sessions in recognition of the company’s ‘service and merit to the profession and community, well above recognized standards’. PFA President, Dr. Karyn Stockwell cited Straumann for “outstanding contributions ensuring the highest standards of care for our patients. Straumann’s commitment to ongoing clinical research and contributing to communities through outreach to developing regions, ongoing commitment to Ectodermal Dysplasia patients, the Young Professional Award in Regenerative Dentistry and the Straumann AID charitable program
have exemplified the mission of the Pierre Fauchard Academy by providing excellence in research, public service, education and leadership development in oral healthcare worldwide.”
“It is a great encouragement to receive recognition for things that often go unseen and unnoticed”, said Marco Gadola, CEO of Straumann. “we share it with countless unseen dentists and colleagues whose selfless support is an essential part of our efforts to enhance patient care and to give smiles to the less privileged. We sincerely thank them and the Pierre Fauchard Academy”.
Ultradent Products, Inc. held its annual food drive this year, promoted with an “Ironman” theme, as the company aimed to raise as much food and money for the Utah Food Bank as possible within a three-day intensive push. Within those three days, Ultradent was able to raise $85,263, which translates to 341,036 lbs. of food that will help feed needy people and hungry families this holiday season and throughout the year. This annual food drive has become a cherished and much looked-forward to tradition for Ultradent employees and their families, who have each year, stretched to help give back to those around them less fortunate. Throughout its history with the Utah Food Bank, and victims of world tragedy, such as those affected by Typhoon Haiyan in 2013. Donations for Ultradent’s 2015 food drive were raised through numerous opportunity drawings, bake/pop-up boutique sales, several “Food Truck Friday” events, and a charitable golf tournament, all organized by company employees. Ultradentv presented a check for $85,263 to the CEO of the Utah Food Bank on Thursday, November 19, 2015 Dr. Fischer, Ultradent’s president and CEO, attributes his enthusiasm for the food drive to lessons he learned as a young boy. He says, “My grandfather taught me as a young boy that it is only with an open hand that one has the ability to receive.”
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Sirona Dental, Inc., the leading manufacturer of innovative dental technology, is hosting a superheroes-themed party at the House of Blues on Feb. 26, 2016, in Chicago during the 2016 Chicago Dental Society Midwinter Meeting. This party is a membership benefit of SIROWORLD, Sirona’s new event-based community. After saving the day, attendees are encouraged to emulate their favorite superheroes by dressing up in tights, capes and masks to celebrate into the night at Sirona’s Superheroes of Dentistry party. “Sirona is known for throwing incredible parties and this party will be no different,” said Sirona Dental, Inc. President Michael Augins. “At the CEREC 30th Anniversary Celebration in Las Vegas, Sirona hosted the Party Like a Rockstar event in which attendees arrived in their best rock star attire to a club filled with 10 foot laser robots and acrobats swinging from the ceiling! At the Superheroes of Dentistry event, we will have more surprises in store for our SIROWORLD community members as our Dental Superheroes party the night away at one of Chicago’s most famous venues, the House of Blues.” All SIROWORLD members are invited to join in on this epic night of superhero action. Membership into SIROWORLD includes access to parties like this; along with SIROWORLD’s educational events held at major U.S. trade shows like the Greater New York dental meeting and the CDA South meeting in Anaheim, California. The highlight of SIROWORLD membership is our inaugural SIROWORLD C elebration in Orlando, Florida where entertainment and education collide at digital dentistry’s premiere event.
During these educational events, members can speak to leading experts in the field of digital dentistry and compare stories with fellow members about the technologies that have helped integrate his/her practice into the digital age.
NOBEL BIOCARE WINS RULING ON ITC ISSUES OVER INTRADENT ON PATENT ONFRINGEMENT A Nobel Biocare patent relating to the NobelActive® line of dental implants was infringed upon by the Neodent® DriveCM™ implant, sold by Straumann® subsidiary Instradent® and manufactured by JJGC Indústria e Comércio de Materiais Dentários S/A, according to an Initial Determination from the United States (US) International Trade Commission The Notice of Initial Determination, issued on October 27, 2015, confirms that Nobel Biocare’s US Patent No. 8,764,443 is valid and also that Neodent’s DriveCM™ implant infringes that patent. The order also finds that the infringing DriveCM™ implant violates US trade law. The ITC will issue a Final Determination by February 29, 2016. The ITC’s determination stems from an investigation that began in October 2014 to determine whether the DriveCM™ implants violate Section 337 of the Tariff Act. The infringing DriveCM™ dental implants are Brazilian-made imports that have been sold throughout the US, and their original design has striking similarities to the patented design of the NobelActive® implant. After the ITC formally instituted this investigation, Instradent® discontinued sales of this implant design. The NobelActive® line has grown to become one of the world’s most popular dental implants, supported by Nobel Biocare’s commitment to research and development spending, extensive clinical studies, and training programs for clinicians. The US patent found to be infringed relates to technology for aiding the surgical installation and successful integration of the implants in a variety of patient bone types. The Initial Determination separately found that the DriveCM™ implant did not infringe any valid and enforceable claim of a second Nobel Biocare patent. Nobel Biocare intends to seek further review of that ruling.
10 • D E N T AL AC C E S S • DEC EM BER 2015
Epigenetics: THE FUTURE IS NOW (Part 2) Dr. Joseph Lim Genes are the key even in the development of our teeth. And in the future, a genetic profile of a patient will go a long way in providing “personalized” oral health care to each individual patient. Looking into the future, dentists will be able to build a genetic profile based on the knowledge on how genes play a key role in dental development and how this development responds to oral diseases. Future dentists will be able to look at how genes are being switched on and off in a patient’s body, according to new research. In a paper published in the Australian Dental Journal, researchers from the University of Adelaide’s School of Dentistry wrote about the current and future use of the field of Epigenetics as it relates to oral health. Epigenetics has much to offer in the future treatment and prevention of dental disease, said Associate Professor Toby Hughes, speaking on Dentist’s Day last March 6. In Epigenetics, scientists study heritable changes in gene activity that are not caused by changes in the DNA sequence, that are not necessarily heritable. “Our genetic code, or DNA, is like an orchestra – it contains all of the elements we need to function – but the epigenetic code is essentially the conductor, telling which instruments to play or stay silent, or how to respond at any given moment,” explained Associate Professor Hughes. “This is important because, in the case of oral health, epigenetic factors may help to orchestrate healthy and unhealthy states in our mouths. They respond to the current local environment, such as the type and level of our oral microbes, regulating which of our genes are active. This means we could use them to determine an individual’s state of health, or even influence how their genes behave. We can’t change the underlying genetic code, but we may be able to change when genes are switched on and off,” he explained.
Associate Professor Hughes is part of the team of researchers at the University of Adelaide that has been studying the underlying genetic and environmental influences on dental development and oral health, the university said in a press statement. Since the completion of the Human Genome Project in 2007, epigenetics has had an increasing role in biological and medical research, Associate Professor Hughes said. “Dentistry can also greatly benefit from new research in this area. It could open up a range of opportunities for diagnosis, treatment and prevention. “We know that our genome plays a key role in our dental development, and in a range of oral diseases; we know that the oral microbiota also play a key role in the state of our oral health; we now have the potential to develop an epigenetic profile of a patient, and use all three of these factors to provide a more personalized level of care.” He said other potential oral health targets for the study of epigenetics include the inflammation and immune responses that lead to periodontitis, or gum disease, which can cause tooth loss; and the development and progression of oral cancers. “What’s most exciting is the possibility of screening for many of these potential oral health problems from an early age so that we can prevent them or reduce their impact.” The full paper of the study can be found at the Australian Dental Journal’s website.
About the Author Dr. Joseph D. Lim, graduated cum laude from the University of the East, College of Dentistry where he later held the position of Associate Dean. He holds a Doctor of Education degree from National University where he is also its present Dean of the College of Dentistry. A diplomate in Oral Implantology, he is an honorary fellow of the Asian Oral Implant Academy and the Japan College of Oral Implantologists.
That Disease Called Cancer Dr Johanna Rosette Po - Major
As doctors, we oftentimes talk about cancer and are all too familiar with the clinical signs and symptoms that are often associated with this particular disease. However, as professionals who are greatly involved in the medical field, we should be quick to ask ourselves about how familiar we are with the disease. How extensive is our knowledge of this particular disease? In this series of articles, factors that influence the development of cancer will be discussed in the hope to further understand how and why this occurs. In this manner, we hope to be able to distinguish FACTS from MYTHS, especially in this age of the internet.
Loss of Control in the Cell Cycle The cell cycle is an important physiological event which helps in the development of the body’s tissues and organs. Under normal conditions, there are proteins, better known as genes, that aid in regulating the cell cycle so that the pace in which cell division occurs is kept at a normal rate. These genes, better known as tumor suppressors, help in interfering with the cell cycle, when necessary, through biochemical feed backs in order to prevent the cell from dividing at an uncontrollable rate. Medical researches dating back to the 1960s have shown the existence of genes such as p53, p21 and pRB, which all contribute to the maintenance of the cell cycle in order to keep cell division under control. Many other tumor suppressor genes have been discovered in later years all of which, in one way or another, help in controlling cell division by manipulating and intervening with biochemical signals involved in the cell cycle. If everything in the body is maintained at a normal physiological state, the cell cycle progresses but is stopped whenever biological signals send “messages” to certain tissues for cell division to end. However, when tumor suppressor genes undergo mutation, their roles are changed and they begin to suffer from loss of function. To put things simply, they lose their ability to interfere with the cell cycle and ultimately lose their capacity to suppress tumors from forming.
Because of this loss of function, the cell cycle continues without any brakes or stops and the cells continue to divide nonstop. When this happens, tumors are formed and continue to grow in size and change histologically in shape.
Cysts and Tumors Are Not Necessarily Cancerous There are two words that automatically cause panic amongst people: the words cyst and tumor. These nouns are usually made to be synonymous without much thought. However, it is important to consider that in order for a cyst or tumor to be considered cancerous, these pathological lesions must be able to exhibit an ability to invade tissue spaces located beyond their point of origin. These lesions must be able to exhibit the ability to metastasize, which means that they have the ability to spread to the point of causing danger to other tissues. This again is due to the fact that the cell cycle is deemed to be beyond control. Besides this, enzymes now interact with the extracellular matrix where these cancer cells are located, ultimately breaking down the matrix which allow the cancer cells to grow and go beyond their point of origin.
About the Author Dr Johanna Rosette Po - Major is a graduate of the University of the East College of Dentistry. In 2004, she received her doctorate degree in molecular biology from Hokkaido University, specializing in cancer research. She continues to hold practice in Manila and teaches part-time at the Cranio-Facial Foundation of the Philippines and the University of the East. DE C E MBE R 2 0 1 5 • D E N TA L A CCE S S • 11
COMPOUND FROM CHINESE MEDICINE BLOCKS BIOFIL FORMATION ON MEDICAL IMPLANT MATERIAL S. aureus commonly forms biofilms on medical implants, causing pneumonia, meningitis, endocarditis, osteomyelitis, and bloodstream and urinary tract infections. Biofilms, which are far tougher than bacteria not incorporated into biofilms, are resistant to antibiotics even when the individual bacteria composing the biofilm lack antibiotic resistance genes. Once biofilms become attached to the surfaces of medical devices, they are extremely difficult to expunge. PGG is “far more potent” than several other compounds found to inhibit biofilms, including IDA, NAC, and NPM, according to the report. Despite that potency, PGG did not kill S. aureus.
It is also non-toxic to human epithelial and fibroblast cells. PGG likely inhibits biofilm formation during the initial attachment stage, as the investigators found PGG to be effective only when it is added to a medium within an hour after seeding. Besides polystyrene and polycarbonates, PGG inhibited biofilm formation on silicon rubber, a material commonly used in catheters, and on glass coverslips. PGG is an active ingredient in plants that are commonly used in Chinese medicine to treat inflammation. It was one of 48 compounds purified form medicinal plants that the researchers screened for efficacy in inhibiting S. aureus biofilm formation. PGG was on sole compound from among them that did not kill the pathogens.
Story Source: Provided by American Society for Microbiology Photo credit: Stuart Miles
OVERWEIGHT LINKED TO HIGHER RISK OF GUM DISEASE Lead author of the article Charlene Krejci DDS, MSD recently stated that being overweight can affect many aspects of a person’s health. She further added that researchers suspect a link exists between obesity and gum disease. “Obese individuals’ bodies relentlessly produce cytokines, proteins with inflammatory properties. These cytokines may directly injure the gum tissues or reduce blood flow to the gum tissues, thus promoting the development of gum disease.” Half of the U.S. population age 30 and older are affected by gum disease — a chronic inflammatory infection that impacts the surrounding and supporting structures of the teeth. Gum disease itself produces its own set of cytokines, which further increases the level of these inflammatory proteins in the body’s bloodstream, helping to set off a chain reaction of other inflammatory diseases throughout the body. Research on the relationship between obesity and gum disease is still ongoing. “Whether one condition is a risk factor for another or whether one disease directly causes another has yet to be discovered,” says AGD Spokesperson Samer G. Shamoon, DDS, MAGD. “What we do know is that it’s important to visit a dentist at least twice a year so he or she can evaluate your risks for developing gum disease and offer preventive strategies.” The best way to minimize the risk of developing gum disease is to remove plaque through daily brushing, flossing, rinsing, and professional cleanings. “A dentist can design a personalized program of home oral care to meet each patient’s specific needs,” says Dr. Shamoon. Story Source: Academy of General Dentistry Photo credit: Clare Bloomfield
GUM DISEASE CAN AFFECT CHANCES OF PREGNANCY Periodontal (gum) disease is a chronic, infectious and inflammatory disease of the gums and supporting tissues. It is caused by the normal bacteria that exist in everyone’s mouths, which, if unchecked, can create inflammation around the tooth; the gum starts to pull away from the tooth, creating spaces (periodontal pockets) that become infected. The inflammation sets off a cascade of tissue-destructive events that can pass into the circulation. As a result, periodontal disease has been associated with heart disease, type 2 diabetes, respiratory and kidney disease, and problems in pregnancy such as miscarriage and premature birth. Around 10% of the population is believed to have severe periodontal disease. Regular brushing and flossing of teeth is the best way of preventing it. Prof Hart, who is Professor of Reproductive Medicine at the University of Western Australia (Perth, Australia) and Medical Director of Fertility Specialists of Western Australia, said: “Until now, there have been no published studies that investigate whether gum disease can affect a woman’s chance of conceiving, so this is the first report to suggest that gum disease might be one of several factors that could be modified to improve the chances of a pregnancy.” The researchers followed a group 3737 pregnant women, who were taking part in a Western Australian study called the SMILE study, and they analysed information on pregnancy planning and pregnancy outcomes for 3416 of them. They found that women with gum disease took an average of just over seven months to become pregnant — two months longer than the average of five months that it took women without gum disease to conceive. In addition, non-Caucasian women with gum disease were more likely to take over a year to become pregnant compared to those without gum disease: their increased risk of later conception was 13.9% compared to 6.2% for women without gum disease. Caucasian women with gum disease also tended to take longer to conceive than those who were disease-free but the difference Prof Hart said that the reason why pregnancies in non-Caucasian women were more affected by gum disease could be because these women appeared to have a higher level of inflammatory was not statistically significant (8.6% of Caucasian women with gum disease took over one year to conceive and 6.2% of women with gum disease). 12 • D E N T AL AC C E S S • DEC EM BER 2015
Information on time to conception was available for 1,956 women, and of, these, 146 women took longer than 12 months to conceive — an indicator of impaired fertility. They were more likely to be older, nonCaucasian, to smoke and to have a body mass index over 25 kg/m2. Out of the 3416 women, 1014 (26%) had periodontal disease. Prof Hart said: “Our data suggest that the presence of periodontal disease is a modifiable risk factor, which can increase a woman’s time to conception, particularly for non-Caucasians. It exerts a negative influence on fertility that is of the same order of magnitude as obesity. This study also confirms other, known negative influences upon time to conception for a woman; these include being over 35 years of age, being overweight or obese, and being a smoker. There was no correlation between the time it took to become pregnant and the socio-economic status of the woman. “All women about to plan for a family should be encouraged to see their general practitioner to ensure that they are as healthy as possible before trying to conceive and so that they can be given appropriate lifestyle advice with respect to weight loss, diet and assistance with stopping smoking and drinking, plus the commencement of folic acid supplements. Additionally, it now appears that all women should also be encouraged to see their dentist to have any gum disease treated before trying to conceive. It is easily treated, usually involving no more than four dental visits. “The SMILE study was one of the ted controlled trials performed in Western Australia. It showed conclusively that although treatment of periodontal disease does not prevent pre-term birth in any ethnic group, the treatment itself does not have any harmful effect on the mother or fetus during pregnancy.” Prof Hart said that the reason why pregnancies in non-Caucasian women were more affected by gum disease could be because these women appeared to have a higher level of inflammatory response to the condition. Story Source: Provided by European Society of Human Reproduction and Embryology (ESHRE).
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The City Angels Tuguegaro City Cagayan Dental Chapter By Dr Armi Cabero After hearing about the several awards the Tuguegarao City Cagayan Dental Chapter (TCDC) received in 2015, I was invited by my professor to begin my journey to Tuguegarao City to cover a story about the TCDC. On my way, I was accompanied by Dr Charleston Uy who graciously obliged to go with me and meet the 2015 Chapter President of Tuguegarao City Cagayan Dental Chapter (TCDC) Dr Alvin Callangan and his members. A one hour flight from Manila, I contemplated on what the doctors of TCDC have been doing to the community that earned them this recognition.
And because no water supply was available within their area, she had to do this sacrifice in order to supply the needs for her family. Immediately, they were silenced by her plight. Imagine the life of this person compared to those who are comfortably getting their water supply from their homes. How can one complain about partiality when this woman endures a life without comfort?
special feature tuguegarao
As we deplaned, we were greeted by the hospitality of Dr Uy’s mother where later in the afternoon, I was taken to the miraculous Our Lady of Piat Church. From there, I prayed for guidance and wisdom before I headed to our me eting place where I would interview the chapter President and his board members for a feature article at Dental Access. Reading through my notes, the TCDC won 3 regional awards in 2015 including the Best Dental Chapter in Region 2, Best Implementor “Ngiti Mo, Sagot Ko” Project, Region 2 and Presidential Merit Award which was awared to 2014 TCDC President Dr. Johnny Lou Yague during the awards ceremony held last July of 2015.
This inspired Dr Yague and his members to make concrete provisions for the said barangay, so in September 20, 2014 they awarded their 3rd artesian well to the community through the“Poso Mula sa Puso” program. Then in Nov 24 of that same year they donated another artesian well to the Barangay Masin Iraga along the mountainous portion of Solana where a total of 25 households benefited from the project. Though the roads were unpaved, they trekked the hilly climb and paved the way for another artesian well. Coupled with an oral health awareness program and tooth brush distribution, they believe they have served their community’s needs. “You get a feeling of inspiration when you see how your works can moved mountains in order to provide their basic needs. It’s a simple act of kindness that speaks volume to our advocacy. When you see how they deeply appreciate your contribution to the society, you will find yourself in a moment of true happiness. And that feeling is irreplaceable compared to receiving a gift,” the TCDC members explains. “Why do you engage in these activities?” I asked.
Meeting the TCDC for the first time, I was greeted by the beaming faces of all the members including the past presidents of the chapter. Contrary to what I expected, the members showed anticipation for my arrival while I was there to do a cover story about their activities and achievements. Slowly, as I eased into the room and was introduced to Drs Alvin Callangan, Ryan Pacquing, Johnny Lou Yague, the rest of the members showed a pronounced feeling towards my presence. I felt easy and welcomed by the whole group even before we started the interview. As I was chatting away with Dr Callangan, Dr Pacquing and Dr Yague, I realized how amazing their story was. These doctors all had the same philosophy in life and that is to impart Charity. To them, a single act of kindness creates an endless ripple that resonates from generation to generation. It all started with a hopeful dream of creating change in their community through the efforts of the whole chapter. From their daily routine of dental missions, they moved their projects slowly to social services and environmental programs that our country is facing today. This included programs that involved the children, the disabled, the elderly, the minority groups living in outskirts of Tuguegarao and most importantly the environment. As I looked at the photos and videos they presented, all past presidents including the incumbent president had each contributed to the success of every program the chapter initiated. From the looks of it, championing these programs were arduous tasks but I can see from the light in their eyes that the TCDC was serious with their advocacy. As a group, they all wanted to make a difference. As we moved to another table for the interview, one by one they narrated their unique stories about how community service has brought them together. During the term of Dr Johhny Yague in 2014, he and his colleagues were passing through a dirt road in Barangay Andarayan when they came across a 54 year old lady who was carrying two pails of water half a kilometer away from her home. Immediately, they got out of their vehicle and helped the poor old lady from carrying these pails. While relating her story to them, they found out that she had been carrying these pails of water to and from her home for the past 15 years. 14 14 •• D DEEN N TTAL AL AC ACC CEESSSS •• DEC DECEM EMBER BER 2015 2015
“We believe that we are our brother’s keeper.” Dr Ryan Pacquing replied. “When we started these projects, we all shared our inputs and collective theories on how we can change the system, if not the world. But through our team effort, we were all able to build a group that purposely serves our community members that is outside our professional group.” Dr Alvin Callangan added. “We all do our best to contribute and share our blessings to the less fortunate.” Says Dr Vic Tallud. “Although with respect to our beneficiaries, we involve them in our projects so that they too will take part in contributing to the success of our programs. We see that empowering these people with the knowledge on how to care for others and the environment will set a good example to their next of kin.” “We also have other social activities for the young children, the elderly and the community such as Lice Alis Program, Dental Caravan Para Kay Juan, Poso Mula Sa Puso, Oral Care Para sa Daycare, Projects for Special Kids, Pustiso Alay kay Lolo’t lola, Kapatid Kong Aeta, Aalagaan Kita, Anti-smoking campaign bearing the slogan we coined, Stop smoking now or regret in the future which received major league reviews from the community. And these are continuously promoted within Tuguegarao City and are recognized by the local government and non government agencies such as the Rotary International.” In 2014, Dr Johnny Lou Yague spearheaded a note-worthy project that focused on their advocacy towards the environment. With the increasing awareness on the effects of global warming, they proposed lateral projects in line with the environmental solutions such as proper sharp disposals, tree planting, proper waste management, international coastal clean up drive and the anti-smoking / belching campaign. And because the chapter firmly believes in their combined efforts, they maintained their position not only an advocacy for the environment, but as a catalyst for improvement. Championing a crucial role of ensuring the well-being of humanity this inspirational vision became the benchmark for other chapters to emulate.
SPECIAL FEATURE In an effort to help the Bessang’s Day Care Center in Allacapan, Cagayan, Dr Yague and his members proposed a project that will provide the children a proper school facility mainly by donating chairs and tables to the school. So, they started collecting plastic bottles from schools and restaurants for their project to be realized. However, the limited resources was not enough to provide them with the raw materials so they travelled all the way to Broadway Centrum in Manila to meet the representatives of the popular noon time show Eat bulaga and sought for their assistance. On that same day the management approved their proposal and scheduled the delivery of the empty plastic bottles that were to be recycled as chairs and tables. This project was so compelling that their Twinning partner, Batangas Dental Chapter donated 4 sacks of empty plastic bottles. “The sacrifice was all worth it knowing that many school children will surely benefit from this project.” Dr Yague affirms. And yet, their projects didn’t stop from there. From recycling, they managed to include projects that are dedicated to clean our oceans through their Clean Up Drive program where the garbage from coastlines, rivers and lakes are collected. In this crusade, The TCDC members together with the Cagayan Police Community Relations of Region II and Barangay officials of Centro I Tuguegarao City took part of this noble activity. Through their participation, sacks of litter was identified, weighed and recorded in a standardized data card. With hard work and perseverance, the TCDC’s efforts in this clean up drive inspired the community to help save the environment from hazardous pollutants. “Some people consider us in jest as a charity group because of the extra-curricular activities but to us, we are just doing our part in the society and the environment. Social responsibility is lacking these days and we would like to emphasize how a small effort can create positive changes coming from a small group like the TCDC.”
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SPECIAL FEATURE Leading a life with an Advocacy When I first heard about their missions, the Regalong Ngiti Program deployed by the TCDC was the project that stood out for me. Since 2010, the Regalong Ngiti Program initiated by Dr Agnes Villanueva has been a mainstay for the TCDC opening their doors to several indigents by helping them transform their lives dramatically overtime. “Dr Victor Tallud had been instrumental in the success of this project. Though we had limited funds, he was very supportive during my term.” says Dr Agnes Villanueva. In this project, many patients who received treatment were able to regain their lives like normal people. With the surgery on its way, these patients prepare for the future opportunities that were deprived in the past before their operation. Multiplied by the number of participants in this program including the physicians, dentists, nurses and other local goverment sect, they joined efforts and began this journey like one big family. “Our volunteers especially our dentists are really involved in this project. This is a lifechanging experience not only for our patients but for us, too. If you are responsible for that person’s transformation, from someone who was ridiculed by his or her classmates into a new person, it leaves you humbled for life.” Dr Maricel Judith Querol stated. “Their stories are heartfelt and it brings us to tears whenever they give testimonials before and after the surgery. I am proud of this project and I love our chapter for being involved in this walk of life.” Shares Dr Queenie Enrile, President Elect of TCDC. Starting with a handful of patients, now the Regalong Ngiti has been catering to 20- 26 patients based on their last dental mission. With 3 dental surgeons at bay, an anesthesiologist, nurses and a brigade of dentists from the TCDC, these volunteers made every undertaking successful. In a span of three days, from admission to surgery up to the time they discharge their patients, these doctors who organized this noble cause endured the mission like professionals. And just when you thought their duty is over, they included post operative recall with Speech therapy for patients to have a more effective communication skill. As if a parent to a child who only wants the best for their offspring, the TCDC surpassed the expectation of everyone by giving them their all to this project. “We think the area of responsibility does not end there because what we offer during and after the surgery is not the cosmetic gain alone. But how about their ability to speak like normal people? Our approach on this project (and to every program we do) is to target the problem holistically. So, we included a complete rehabilitation of the mouth and a speech therapist to help them communicate effectively.” Dr Mary Jane Chua - Punzalan expressed. “We totally agree. Because our goal is to help them regain and sustain their lives even after the operation. The surgery is just the beginning. When others see what we have contributed to these people, they also want to get involved and take part of this life-changing experience. ” Dr Ramon Punzalan added. What they all professed could not be more truer than words when the humanitarian services of the TCDC paid off a few years later. A non-government agency in the likes of Rotary International showed interest in their program and pledged their support to the chapter. Now on their 6th year, they will hold another dental mission in July 2016 that will solely dedicate ttheir efforts to patients who have a long-standing defect of facial disfigurement. Through this, it opened more opportunities for the local and non government agencies, including the law enforcers to heed and support their projects. These doctors who have shown compassion over indifference, charity over animosity, have set an example that there are still good people who can make a big difference. Like an answered prayer to a person’s misery, the Tuguegarao City Cagayan Dental Chapter showed a silver lining amidst adversaries. To me, this city is flocked by angels who are bearers of good news and fortune. Tuguegarao City is indeed lucky to have these angels dwelling in their city.
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UNIVERSITY CORNER A CLEFT REFLECTION
Dr Vincent Gabriel S. Caagbay
s a 7th-day Adventist one of our main goals is to serve God by helping those who are in need by offering our talents, time, and resources. When I graduated from the course Dentistry, I told myself that I would dedicate all that I have learned in achieving that goal. I’ve been actively joining numerous “dental missions” in which of course the only services we could give is a simple dental checkup and tooth extractions. It was August 2014 when Dr. Ramonito Lee, one of our professors from the College of Dentistry invited me and my classmate to join him on a “cleft mission.” I couldn’t resist; my eagerness to learn and develop new skills in the field of dentistry and bearing this passion of giving service to others made me accept the invitation without having second thoughts. I call myself fortunate for being able to witness and be part of it.
ABOUT THE AUTHOR 18 • D E N T AL AC C E S S • DEC EM BER 2015
Unlike in the usual dental missions that I join wherein a patient comes to you for a tooth extraction who could or could not be suffering from any symptoms, walks in for the treatment and walks out and live their same usual lives; a cleft lip/palate patient is different. Each of these patients has their own stories to tell. Most of them experienced different ways of emotional and psychological assault, bullying and humiliation, others were feared, and some were viewed as if they’re just partly human. Their experiences lead them to develop antisocial personalities and low selfesteem just because of how their condition made them appear. Most of them especially the young adults cover their faces and would barely make an eye contact or even show their faces to anyone. I could only imagine the pain and sadness of their families who could only watch their children be mistreated by others. It made me think, what if it was my child, and all I can do is sit and watch. Most of the families that these patients came are from a poor background. A cleft lip and palate operation costs a fortune that most if not all of them couldn’t afford. They never chose to be brought up in this world like that.
ers. Rarely could we see nowadays a group of humble professionals come together and just give it all back to God through helping others. It inspired me to have a vision that hopefully one day my church and university could conduct a program like this. The Tuguegarao dental chapter, these group of Doctors demonstrated the perfect example of how we should give back all the blessings we have to those in need, selfless and wholeheartedly. This is the reason why I’m in this field, to help the needy, to serve others, to change lives. All that we have and that we are, we owe it all to God. Our riches, our time, our hands, God gave them to us not just to pursue our own personal desires, but to give it all back to Him through helping others.
I mentioned that a patient in a usual dental mission comes in and comes out and lives the same life. But a patient who suffers from a cleft lip or palate comes in with troubled life yet brings with them a hope, a hope that once they go through the operation they could live a normal life just like anyone else. It may mean not so much for some of us, but for them it means a new life. I have seen the joy in their families’ eyes, the smile that gives a little glimpse of what they feel inside, and their heart felt “thank you doc” which is not enough to express their gratitude to all those who worked hard to make the operation possible. I was moved by the dedication and eagerness of the Tuguegarao dental chapter to make this mission possible each year. They serve with joy and excitement even if it takes a lot of personal sacrifice from each of them. Their camaraderie and bond to work as a team is exceptional; you could always feel a different kind of spirit and passion to serve and help oth-
Dr Vincent Gabriel Caagbay is an alumnus of the Adventist University of the Philippines in 2015. An aspiring oral surgeon, he the eldest among the four children of Mr and Mrs Raymond Caagbay.
WITNESSING A LIFE-CHANGING MISSION FOR CLEFT LIP AND PALATE Physical appearance or facial form is often used by people to judge an individual’s beauty, personality, intelligence, and skill. An individual born with a cleft lip or palate are often mocked by others, and they experience so much psychosocial problem. Lowered self-esteem and difficulties in social interaction have been noted in them.
Dr Aaron B. Mayordomo
ave you ever imagined how hard life is for a person with a physical deformity, a cleft lip or cleft palate for instance. Imagine if you were in their state of being, would you still have the confidence to blend with people? Would you have the courage to reach your dreams and ambitions? Would you still be able to reach your attainments or be as what you are right now?
ABOUT THE AUTHOR
A group of dentists in Tuguegarao city, Cagayan, have been conducting a yearly mission for five years now, to give hope for people with cleft lip and palate. We believe that it is God’s hands that work to guide the members of this group. Doctor Ramonito Lee and Doctor Charlston Uy served as an instrument for this mission, they both have a generous heart to offer their God-given knowledge and skills for this cleft lip/palate mission to be possible. We are thankful for our professor, Dr. Ramonito Lee (an attending faculty of AUP- College of Dentistry), for bringing us again with him for the second time to witness this life-changing cleft lip/palate mission. We have learned things that are more important than surgery itself. What we have learned are life lessons, values that we need to equip ourselves to become a good Christian dentists. We have seen the
importance of Respect, Humility, and Helpfulness, as shown by the members of the group. We are blessed to be with these patients, we somehow felt their emotional struggles and we understand how they feel, we learned a lot about life from them. For them, this operation could open new doors to reach their dreams and ambitions in life. No words could exactly describe how happy and thankful the patients and their parents are. The contributors of this mission are happy as well to see the patients wearing a smile on their faces after they have recovered from surgery. These moments are priceless, to see from the patients’ eyes the new hope that this mission has brought for them. We pray that this kind of mission would continue to work for the glory of the Lord. As a student of Adventist University of the Philippines College of Dentistry, our mission statement is to provide quality Christian education and training to future dentists by equipping them with the necessary skills, knowledge and attitudes that would spell excellent dental service to humankind. The experience that we had during the cleft lip and palate mission opened our eyes for a deeper meaning of our mission statement.
Dr Aaron B. Mayordomo was born in 1990 at Malolos City, Bulacan. A graduate of the Adventist University of the Philippines College of Dentistry he earned his degree in Doctor of Dental Medicine in March 2015. DE C E MBE R 2 0 1 5 • D E N TA L A CCE S S • 19
ON THE SPOTLIGHT
DENTAL BOX: The Smart Way To Dental Management
Philippines, a growing commerce for BPO’s and other leading industries has been “eyed” by several foreign investors including Smart Dentalbox Founder and CEO Mr Gerald Wegner as their headquarters for their newly developed dental software. Catering to dental clinics who wish to improve their work flow and efficiency, the Smart Dentalbox offers numerous opportunities for a systematic and effective clinic organization that simplifies protocols and improves business strategies. Mr Gerald Wegner plays a pivotal role in displaying new artifacts and systems in his newly developed Smart DentalBox. With his new creation, Dental Access profiles another innovator in the industry that is identified to be the next big thing in Dentistry.
Just in time way back in 2005, I attended an event from the Chamber of Commerce in Austria where they promoted Philippines as a country of investment. I found Phil ippines as a potential place to invest my skills and resources. In 2008, I established SOFTSHORE Global Solutions Inc., an IT outsourching company in the Philippines making projects for European clients. We focused developing in the web service technology and gained deeper experience. Two years ago, I visited a clinic for my dental treatment and I just had a conversation with the owner of the clinic. I was told that dental offices encounter challenges related to data management and protection. Recently, pure cloud-based dental solutions are on trend in the market. Most are really good and even sophisticated however it faced a long list of challenges like:
on the spotlight
1. Please tell us more about your background (experience) in software building and how your journey began when you developed to build this program I started with programming in the late 80’s using several computer technologies. I have worked in the company specializing Real-Time Processing Application and developed several projects for the government of Vienna and for Austrian and Italian Oil and Gas companies. Aside from work I shared my skills with several computer schools. After many years working in Austria, I was looking for a new challenge.
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1. Data security issues. Storing patient sensitive information in the cloud is a risk. Many incidents have been reported that patient’s information have been sold to organizations or companies for marketing/statistics. Also incidents of hijacking and data breaches happened even to known secured company sites. 2. Dependent to internet speed and connection. The performance of pure cloud-based dental software relies on the internet connection. We have to consider the possibility of slow or limited internet connection in the Philippines. With cloud, when the internet is slow your services are also slow; when the internet is down, cloud services are also down. 3. Cost. With pure cloud-based dental software, it requires monthly subscription fee, payment for each user and the storage plus good internet connection is also expensive. 4. No ownership of data. With cloud, you rely the safety of your data to a cloud service provider. If you stop the subscription fee, you have limited access or no access to your data at all. In other words, you are only renting the software.
“Because the way you manage your Dental Clinic reflects on the quality of your dental service.” 7. Unlimited number of users and records without extra cost 8. Two-way text messaging for easy communication with the patient 9. No subscription fee required. No need for dentist to rent software. It’s affordable even for small dental clinics and considered as a long time investment. 10. Excellent customer support. Since our developers and engineers live in Cebu Philippines, you can reach us and talk to us for technical concerns 11. Charting is very smart. It gives the right help and suggestion at anytime with fewer clicks required. It’s fast and easy just like the pen and paper you use.t
After extensive research (talk to more dentists and ask for their concerns and their requirements), we came up with an idea of developing Smart Dentalbox. Smart Dentalbox is a hybrid solution which eliminates the disadvantages of a cloud-based and clientserver based dental solution without losing its advantages. It is a With the many existing soft-wares created for dental – medcomplete dental solutions designed by European IT experts and 3. Philippine dentists for Philippine dentists to improve their man- ical records, how are you planning to introduce it to the market? agement hence their practice and worry less about data security I am aware there are good and sophisticated dental software in the and office systems. market but mostly it requires internet and data security is at risk. Also, dental clinics in the provincial areas can’t use cloud-based 2. What systems have you integrated in software because there is no internet available. I do believe our soyour software that makes yours competitive lution is the right software for Philippine dentists. I have consulted dentists, front desk officers and assistants and I got a feedback that and beyond from the existing soft-wares? Smart Dentalbox meets their requirements.
on the spotlight
Almost all of the soft-wares available in the market are mostly pure cloud-based soft-wares which require a good and stable internet connection. With Smart Dentalbox we combined the advantages of a cloud software and local server-based software. We integrated a hybrid solution in the form of a mini computer with embedded software. The mini computer can be easily connected to the local area network in the clinic, example a WIFI router. Smart Dentalbox performs a backup daily and automatically so you can choose where to save your backup.
4. Why do you think it’s essential to have this type of record keeping over paper? Or how can you encourage your future users to go paperless? (please indicate advantages and disadvantages) We are now in a fast-paced world. When you look around, everything is digital. With paperless solution, finding and accessing data is fast and easy, sharing or transmission of information is more convenient. No need for a big filing cabinet to store the information. With emails and SMS, communication with your patient is fast and less hassle. In our view, there is no disadvantage with paperless solution though there may still be documents required but With Smart Dentalbox you have (Advantages): its minimal (example, documents that requires signature or seal). 1. Exclusive and full access to data with full rights and owner5. Are there more features that you will incorporate soon in ship. Thus you have full control of who access your data and what your software to make it more competitive and interesting? (indata to share. novations in the future) 2. Software runs without depending on the internet connection however it may use net for keeping the system always up to We want to expand Smart Dentalbox to have more functions and date. features to integrate with. Soon we will be implementing the IC3. High performance according to speed and accessibility DAS, various customized requests by dentists for specific items 4. Because no internet required, the system is fast and relilike reports and statistics. Smart Dentalbox will also push nonable and it allows charting in real-time during dental treatment sensitive data in the cloud which can be retrieved anytime, any5. No installation of software required where (Example: Appointments – dentist can see and book new 6. Performs backup daily and automatically. From the backappointment, read-only reports like treatments, treatment plans ) up, data can be stored anytime DE DEC CEEMBE MBERR 22001155 •• DDEENNTA TALL AACCE CCESSSS •• 21 21
AN INTERVIEW WITH DR KELVIN CHYE
DEM Singapore, one of the most anticipated international exhibitions in the Asia Pacific will welcome its delegates and industry partners for an all-out innovation showcase gathering more than 550 exhibitors and visitors to witness a milestone of tradition right in the heart of Singapore. In our interview with one of the Key Speakers of IDEM, Dr Kelvin Chye shares his reflection and vision of IDEM Singapore with Dental Access.
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What can our delegates expect from the upcoming IDEM IN 2016? This year’s conference theme “Striving for Clinical Excellence” is built upon the common goal that all dental professionals recognize the importance of continuous learning and strive to achieve clinical excellence in order improve their patient’s oral health. With that in mind, the conference topics of discussion this year will provide a multi-faceted con-
Profiler tent on what it means to strive for clinical excellence, and it will feature multiple high-caliber and renowned speakers of the various dental disciplines across the globe. Our conference delegates and visitors can expect a larger exhibition space which would feature a wider variety of exhibitors and feature new exciting innovations in dentistry. In addition, the scientific conference will have a round-table summary on the first and last day. This is exciting as it is an open invitation to all IDEM visitors and delegates and it will be an interactive and stimulating session between the conference speakers and participants. Also, there will be a full day workshop focusing on digital dentistry and it covers all aspects such as laser technologies and CAD/CAM. Moreover, there will also be a full day forum dedicated only to new dentists. Please tell us more about the dentistry trends in Singapore and Asia in general? Firstly, the demographic shift in Asia has an impact on dentistry trends. Some countries in Asia, like Japan, Korea and Singapore are facing a silver tsunami in which the population is rapidly aging. Therefore more dentists are providing dental treatment and care that are catered towards the elderly. Geriatric dentistry is becoming more important as elderly health and dental-related diseases continue to rise. Next, the rising socio-economic status of many Asians means these consumers are demanding for higher quality services. Providing good dental services not only involves the treatment aspect, but it is a combination of a holistic dental-care delivery system, which includes things like provider functions, administrative functions and technical resources to cater towards patient care. For the past 10 years, how has the conference changed and evolved? The conference has definitely become larger in size and in scale. It has been attracting more foreign delegates and visitors to the exhibition and conference. Dental professionals
are increasingly using IDEM as a platform to keep themselves abreast of developments in the dental arena. During the workshops and conferences, there is a high level of interaction among dental professionals to share knowledge and best practices to their peers. To many of my dental friends and colleagues around the region, IDEM is one of the highly anticipated dental event that they all look forward to attending. How has IDEM Singapore helped position Singapore as a medical hub in Asia? IDEM Singapore has become the No.1 dental event in the Asia-Pacific region. It has been a great platform for everyone in the dental industry, professionals and exhibitors to congregate and be informed about the trends in the industry. The conference not only brings in international speakers and brands, but many local dental professionals are present to share and exchange their innovative ideas and expertise. As a result, IDEM has helped to profile Singapore as a country that is attracting a growing number of medical professionals, international companies and Singapore’s overall clinical excellence. Do you have a message for our delegates who will attend the IDEM Singapore 2016? Come and attend IDEM Singapore 2016 and get your mind engaged and stimulated through the exciting interactions with your fellow peers and the world-class speakers. Your attendance makes a difference as it will be beneficial to you, your future practice and patients. Dr Kelvin Chye is the official spokesperson of the Singapore Dental Association. IDEM Singapore and the Singapore Dental Association has worked closely on this joint effort to create an international hub committed to advancing dental innovations and knowledge shared by world experts and leading innovators in the dental industry. Continuing its tradition, IDEM Singapore 2016 will be another leading exhibition for global innovations in dental technology in the Asia Pacific.
The IDEM Singapore 2016 conference will be held from April 8th to 10th 2016 at the SUNTEC Singapore Convention and Exhibition Centre. Do join us at IDEM Singapore 2016, the gateway to the Asia Pacific's dental market, with a massive 18,000 sqm of exhibitions space, over 550 international exhibitors and many of the world’s experts in dental practice, education and research! Please visit the website www.idem-singapore.com for more information. Also, you may visit our social media sites; Facebook, LinkedIn and Youtube page. For more information on the upcoming event, please visit the website www.idem-singapore.com You may also send your inquiries to: Ms Cindy Tantarica: firstname.lastname@example.org (Registration) Ms Stephanie Sim: email@example.com (Sales) Ms Andrea Berghoff: firstname.lastname@example.org (Marketing)
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Pre-Finishing Orthodontic Check List: A MUST!‘ START RIGHT- END WELL’ Orthodontics DR MARIDIN C. MUNDA-LACSON,IBO,MSD Ed The clinical concept of ‘to begin with the end in mind’ has been a standard of treatment whenever we start a case in orthodontics. As the specialty matured, many orthodontic practitioner must keep a check ist of a pre-finishing orthodontic case that would be considered as the “end in mind”.
3. PLANE OF OCCLUSION
1. 2. 3. 4. 5.
A case report of A.S.C. ,9 y/o, male patient, his mother’s chief complaint was the unaesthetic protrusion of his upper anterior This article elaborates in detail on how to start and finish a Class teeth. Extra oral examination of the patient revealed a convex proII Division 1 case with the concept of “START RIGHT-END WELL” file with an incompetent lip posture. Intraoral examination maniprotocol. fested a Class II Division 1 malocclusion with proclination of the upper anterior teeth, mild crowding on the lower teeth and presThe International Board of Orthodontics (IBO) sets a standard on ence of posterior primary teeth on both arches. The upper and the following criteria that would zero-in on a clear presentation on lower arches are relatively narrow. how to finish an orthodontic case. He has an overjet of 7.4 mm and an overbite of 5.5 mm, curve 1. OVERBITE/OVERJET of Spee of 3.3mm and a midline discrepancy of 1.8mm maxillary • It is an acceptable standard for a finished case to achieve shift to the right. An arch length discrepancy of +1.5mm on the upan overbite (vertical overlap) and an overjet (horizontal overlap) of per and +1.7mm on the lower respectively. 1-3 mm The patient displayed a Stage 1 in the cervical vertebrae maturation (CVM) upon the start of treatment. A positive sign of an ortho2. CLASS I MOLAR/ CANINE RELATION pedic treatment modality. • Class I molar relation is considered ideal when the maxillary first molar mesial buccal cusp intimately intercuspates into the His cephalometric analysis revealed a maxillary prognathism with a normal mandible, Class II skeletal pattern, high vertical dimenbuccal grove of the lower first molar. • Class I canine relation is described as when the canine tip sion (hyperdivergent) and it’s dental relationship presented a profits intimately between the distal incisal edge of the lower canine clined upper incisor and within normal lower incisor. and the mesial surface of the buccal cusp of the lower first bicuspid. Treatment Objectives
• Measured from the second molars to canines with a flat instrument will be 0-2mm at its deepest point.
4. SECOND MOLAR IN OCCLUSION • The second molars must be considered acceptable when it is aligned and in complete occlusion.
5. MARGINAL RIDGES • Marginal ridges most specifically in both upper and lower 6 - 7 ,4 - 5 areas must be leveled.
6. ROTATIONS • It is considered acceptable when all teeth are aligned along the long axis and centered buccolingually. 24 • D E N T AL AC C E S S • DEC EM BER 2015
Improve facial profile Reduce overjet Improve skeletal relationship Achieve ideal overbite and overjet Achieve proper interdigitation
Treatment Modality and Progress High pull headgear was worn and patient was instructed to wear it full time. A 2x4 partial strap up was initiated, clinical experience suggests that moderate amounts of force against the maxillary teeth can impede the forward growth of the maxilla. After initial leveling with the use of an .016 Ni Ti and a wire progression to .016 SS and.016 x .022 SS. Class II elastic therapy was paramount to retract anterior teeth and inhibited the further protrusion of the maxilla.
Phase II treatment started as all permanent teeth erupted. Full bracketing and banding were done. As leveling and alignment were achieved, final interdigitation, finishing and detailing by elastic and wire therapy. Conclusion Comprehensive treatment is necessary to achieve the ultimate goal of an acceptable and board-finished case. One must be totally guided on the pre-finishing checklist as to the step-by-step guidelines on how to competently reached the orthodontic post treatment result. About the Author Dr Maridin Munda Lacson is a Diplomate of the International Board of Orthodontics in New York University and a Board Examiner for Orthodontics. She is an alumna of the UE College of Dentistry graduated with honors including the Most Distinguished Dental Clinician in 1992. Currently she is a faculty of the University of the UE College of Dentistry Post Graduate Orthodontic Department and NYU College of Dentistry, Department of Biological Science.
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About the Author
First Step Appliance Figure1.The EMA First Step appliance.
Dr Derek Mahony is a specialist orthodontist who has spoken to thousand of practitioners about the benefits of interceptive orthodontic treatment. He is also a contributing editor to the Journal of Clinical Pediatric Dentistry and the Internatinal Jounal of Orthodontics. Dr Mahony is a Fellow of the International College of Dentists and is cinsidered a pioneer, throughout the world, in a raising dentist’s awareness of the need for early interceptive orthodontic treatment. He has presented over 400 lectures on orthodontics topics in more 30 countries.
By Dr. Mahony and Terry White
Figure 2. The EMA First Step kit includes all materials and parts to construct the appliance including complete instructions.
Figure 3. Position the upper lugs between the canine and first bicuspid. Use the blue sticky wax included.
Figure 4. Using the included jig mark the position for the lower lugs.
Figure 5. Position the lower lugs using the blue sticky
Figure 6. Upper and lower models with lugs in place.
Figure 8. Trim with scissors.
Figure 8. Trim with scissors.
Figure 9. Attach elastic strap, right side.
Figure 10. Attach elastic strap, right side.
Figure 12. Airway obstructed.
Figure 13. Airway maintained with the EMA appliance
Figure 11. Changing the length of the elastic strap changes the amount of titration. A shorter strap increases advancement. 26 • D E N T AL AC C E S S • DEC EM BER 2015
Prefabricated Composite Veneers: Historical Perspectives, Indications and Clinical Application
“the prefabricated composite veneer is likely to establish itself as the modern and improved version for direct composite veneers...”
By Didier Dietschi, DMD, PhD and Dr Stephan Lampl
hile the “invention” of veneering anterior teeth by Dr Pincus1 was first presented in 1937, it became more popular in the mid-seven ties, using 3 different approaches: direct bonding using resin composites, prefabricated composite veneers and indirect, custom-made porcelain veneers.2-4 The pre-fabricated composite veneer (Mastique®, Caulk) was then explored about 35 years ago, using a methyl-methacrylate matrix and large glass fillers, such as used in resin com-posites3,4 but with limited success due to technological limitations and poor surface quali-ties.5 The breakthrough in porcelain veneering technique happened with the development of ceramic etching and true adhesive cementation as developed by Rochette (1975)6 and thereafter improved by Calamia and Simonsen (1983).7 From there, this technique underwent considerable suc-cess and development over the following years and continues today. The rapid loss of surface gloss and surface degradation of prefabricated resin veneers linked to some interfacial defects led the system to soon be abandoned and definitely replaced by porcelain veneers, which also had the advantage of an individual fabrication process. More recently, an innovative shade guide was used in the context of the “natural layering con-cept”,8 based on a 2-layer incremental technique mimicking the anatomy of natural teeth.9,10 The shade guide consists of enamel shells into which the dentin samples are inserted and then allow the prac-titioner to foresee the result produced by the combination of any selected dentin and enamel shades. When a proper match between the shade guide and contra-lateral or reference tooth is obtained, a predictable aesthetic result and restora-tion optical integration is ensured. Based on a technology comparable to the one used to produce the enamel shells of this shade guide, the concept of pre-fabricated composite veneers was recently revitalized, taking advantage of new technologies.11 The so-called Direct Venear® system (Edelweissden-tistry, Hoerbranz, Austria) was launched and is based on high pressure molding and heat curing processes, followed by laser surface vitrification. This enables the veneers to exhibit a hard and glossy surface, with slight texture to fit the majority of den-titions. The system is actually aimed at facilitating the aesthetic restoration of decayed or discoloured single and multiple anterior teeth (Figure 1).
Indications The aforementioned direct composite veneer system does not aim to replace systematically the wellestablished individualized porcelain veneer technique but rather offers an alternative to directly (or free hand) built up composite veneers which is a delicate and time consuming technique (Figures 2-4). Composite prefabricated veneers present an obvious potential in the following indications:
Figure 1. Section of an Edelweiss veneer showing the inorganic vitrified restoration surface, providing optimal surface gloss.
Figure 2. Preoperative view of a patient showing moderate to severe front tooth wear; despite the significant tissue destruction, a micro-invasive treatment approach was selected using prefabricated
Figure 3. Set of prefabricated composite veneers featuring a vitrified inorganic surface with high gloss.
Figure 4. Post-operative view showing the good aesthetic and functional integration of cemented restorations.
1. Single facial restorations: • large restorations/decay with loss of natural tooth buccal anatomy/colour; • non-vital, discoloured teeth; • traumatized, discoloured teeth (without endodontic treatment); • severe/extended tooth fracture; or • extended tooth dysplasia or hypoplasia. 2. Full smile facial rehabilitations: • moderate to severe discolourations (i.e. tetracycline staining and fluorosis); • generalized enamel hypoplasia/dysplasia (i.e: amelogenis imperfecta IIIA, ...); • large serial restorations/decays with loss of natural tooth buccal anatomy/colour; • attrition of incisal edges (after proper occlusal and functional management); • financial limitations; or • young patients with an immature gingival profile. In fact, the aforementioned indications cover the accepted application field of “classical” veneers, while other mere cosmetic indications are to be considered really controversial also with this technique. Based on the whole spectrum of restorative procedures (Table 1), such veneering technique lies also in the micro-invasive group, which makes it part of modern treatment strategies and a viable alternative to direct veneers.
Clinical protocol and treatment sequence The case preparation for prefabricated composite veneers does not differ from other functional and aesthetic treatments. Actually, as soon as initial therapy was completed and proper prophylaxis measures engaged, the treatment approach and sequence developed such as depicted in the following Chart 1. Apart from the need to individualize the cervical profile and possibly the proximal and incisal edges, the overall preparation and cementation procedures are for the most part very similar to those applied for indirect porcelain veneers, which keeps the learning curve for this technique to a minimum. Another advantage for both the patient and the dental team is of course the fact that no temporaries are needed. In regards to the internal surface treatment, these restorations are handled identically to composite inlays and onlays, which eliminate the need to acquire additional material or products, which is also of practical interest. Fatigue testing simulating about 4 years of clinical service12,13 have shown overall an excellent performance of the restorations, under simulated functional loading. Almost no defect was observed either before or after loading at both enamel and dentin margins. The most relevant demonstration of the satisfactory behaviour of tested prefabricated veneers was obtained with the evaluation of restoration internal adaptation. Actually, there was no defect found at the interface with enamel or in-between luting cement and the veneer, which confirms the excellent bond strength at either composite-enamel or compositecomposite interfaces.
Figure 5. View of the transition area, from enamel to dentin. The composite-composite interface is also visible and shows that this interface is stable and resisted perfectly to occlusal loading.
The concept for prefabricated composites veneers was introduced in dentistry about 35 years ago with rather limited success due to former technological limitations. As a result, this interesting treatment option was replaced by an increase in the porcelainveneering technique. This “old” idea has been recently revisited by taking advantage of modern technology via the introduction of surface laser vitrification, enabling for the first time the production of a resistant, inorganic glossy surface. However, this rejuvenated technique shall not replace conventional “custom-made” ceram-
ic veneers, but rather offers the clinician a one-visit, cost-effective alternative to directly (or free hand) built up composite veneers. This system may also allow us to fill in gaps within our treatment armamentarium with obvious and interesting application potential, such as the treatment of young patients with localized or generalized hypoplasia/dysplasia, discolouration and in general, when a long-term temporary and highly-aesthetic solution is needed. In conclusion, the prefabricated composite veneer is likely to establish itself as the modern and improved version for direct composite veneers.
References 1. Pincus CL.”Building mouth personality” A paper presented at: California State Dental Association; 1937:San Jose, California. 2. Faunce FR, Myers DR. Laminate veneer restoration of permanent incisors. JADA 1976;93:790-792. 3. Helpin LM, Fleming JE. Laboratory technique for the laminate veneer restoration. Pediatric Dentistry 1982;4:48-50. 4. Haas BR. Mastique veneers: a cosmetic and financial alternative in post-periodontal care. J N J Dent Assoc 1982;53:25-27. 5. Jensen O.E., Soltys, J.L. “Six month clinical evaluation of prefabricated veneer restorations after partial enamel removal.” J Oral Rehab. 1986;13: 49-55. 6. Rochette AL. A ceramic restoration bonded by etched enamel and resin for fractured incisors. J Prosthet Dent 1975;33: 287-293. 7. Calamia JR. Etched porcelain facial veneers: a new treatment modality based on scientific and clinical evidence. N Y J Dent 1983;53:255-259. 8. Patent No US2002/0064749 A1, May 30, 2002. 9. Dietschi D, Ardu S, Krejci I. A new shading concept based on natural tooth colour applied to direct composites restorations. Quintessence Int 2006;37:91-102 10. Dietschi D. Optimizing smile composition and esthetics with resin composites and other conservative procedures. Eur J Esthet Dent 2008;3:14-29. 11. Patent No A1124/2010 July 2, 2010 12. Krejci I, Reich T, Lutz F, Albertoni M. In-vitro Testverfahren zur Evaluation dentaler Restaurationssysteme. Schweiz Monatsschr Zahnmed 1990; 100: 953-959. 13. Krejci I, Heinzmann JL, Lutz F. Verschleiss von Schmelz, Amalgam und ihrer Schmelz-Antagonisten im computer gesteuerten Kausimulator. Schweiz Monatschr Zahmed 1990; 100: 1285-1291.
About the author Dr Didier Dietschi was licensed in 1984 and received his doctoral and Privat Docent degrees in 1988 and 2003, respectively, at the Unive sity of Geneva, Switzerland. He also received a PhD in 2003 at the University of ACTA, Netherlands. Following a 6-year period of full time teaching and research activity in Operative Dentistry and Periodontology, he started a part-time private practice in Geneva dedicated to aesthetic restorative dentistry. He now holds positions of adjunct Professor at CASE Western University (USA) and senior lecturer at the University of Geneva. Dr Dietschi has published more than 75 clinical and scientific papers and book chapters on adhesive and aesthetic restorations and co-authored the book “Adhesive Metal-free Restorations”, edited in 1987 by Quintessence and translated into 7 languages. Dr Dietschi lectures internationally on adhesive and aesthetic restorations.
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BY MICROCOPY Gazelle Nano Composite Polishers
BY MAGPIE TECH CORP. Scooba Ultrasonic Cleaner
BY BIOLASE Epic X Diode Laser
Anti-crumble silicon ensures durability. Gazelle does not crumble. No paste needed. Individually packaged and sterile.
The Scooba is an ultrasonic cleaner that features a large corrosion resistant stainless steel tank that is also easy to drain. Abundant airflow around internal electronic modules prevents the unit from overheating when the tank is heated.
The Epic X diode laser features cutting edge software, and a cordless foot pedal. It is capable of a full range of soft tissue procedures as well as laser-assisted whitening and pain relief therapy.
BY SUNI MEDICAL IMAGING, INC. SuniRay 2 Digital Intraoral Sensor SuniRay 2 achieves maximal image quality with superior diagnostic capabilities while maintaining the lowest radiation levels among all digital sensors.
BY DENMAT Perfectemp10 Temporary Crown & Bridge Material Perfectemp10 is a highly esthetic, strong, multifunctional acrylic composite material. It uses a two component system based on a multi-functional acrylic composite that is produced using no Bisphenol-A or Bisphenol-A precursors in the manufacturing process.
BY SHOFU BeautiSealant Pit and Fissure Sealant
BY SHOFU Beautifil Flow Plus Flowable Composite
BeautiSealant Pit and Fissure Sealant is a tooth colored, fluoride recharging, pit and fissure sealant with a self-etching primer that speeds treatment time by eliminating the need for phosphoric acid etching.
BEAUTIFIL Flow Plus, is a radiopaque, base, liner, and final restorative in one. Amazing tooth-like light diffusion and chameleon properties provide intuitive and highly aesthetic outcomes.
BY KERR RESTORATIVES Herculite Ultra Nanohybrid Dental Composite
BY A-DEC INC. A-dec 300 Traditional Dental Delivery System
Herculite Ultra Universal Nanohybrid Dental Composite has herculite gold standard technology and Chameleon quality.
The A-dec 300 delivery System can integrate a quad-volt intraoral light source and two ancillaries.
28 • D E N T AL AC C E S S • DEC EM BER 2015
BY PELTON & CRANE Helios 3000 LED Dental Operatory Light Helios 3000 LED Dental Operatory Light’s LED technology enables color mixing, A “No Cure” setting, and a crisp 3” x 6” light pattern that illuminates only where you need it to.
BY KERR RESTORATIVES SonicFill Sonic-Activated Bulk Fill Composite The SonicFill System comprises a handpiece that enables sonic activation of a specially formulated and conveniently delivered composite.
BY A-DEC INC. A-dec 511 Dental Chair Premium comfort for your patients with great ergonomic access that maintains great access and posture for you.
BY ALIGN TECHNOLOGY, INC. iTero Element
BY SHOFU Artistic Composite Kit
A fast and versatile digital impression system with a small footprint, the iTero Element offers features well suited to both general dental practices and orthodontic specialists.
The Artistic Composite Kit includes high quality Shofu diamonds, carbides and stones suited for finishing anterior composite restorations.
BY ARMANN GIRRBACH Ceramill CAD/CAM materials Amann Girrbach enables the processing of CAD/CAM materials with absolutely unique precision using a new cutter and diamond trimmer for all Ceramill Motion generations and a special milling and grinding strategy, which was specially developed for these instruments. (Alphadent)
BY ARMANN GIRRBACH Ceramill Zolid
BY DENTSPLY ENDO BUR Dentsply Endo Access Bur
BY DMG Icon
With Ceramill Zolid the dental specialist Amann Girrbach succeeded in providing high-grade zirconia with aesthetically convincing translucency for non-veneered, fully anatomical restorations and veneerable frameworks as well as ensuring long-term stability.
The special diamond coating reduces gouging with its tip matching round bur sizes for initial penetration while its diamond shaft flares the pulp chamber. The cutting surface of the Endo Access Bur is 10mm. The total length is 21mm.
Icon is used for the micro-invasive treatment of smooth surface and proximal caries lesions. In one patient visit, and with no drilling, Icon can arrest the progression of early enamel lesions (caries) and white spot caries-like lesions. (Metro DNC)
BY DURR Tornado 2 - Super SIlent
BY IVOCLAR The New Bluephase N
BY IVOCLAR The New IPS Classic V Powder Opaquer
For decades the Tornado Compressor Programme has stood for quality at an attractive price. Efficiency was again boosted in the new model and energy consumption efficiently reduced by approx. 15 %. red dot design award winner 2011.
With the sales launch of the new Bluephase N product family, Ivoclar Vivadent sets again high standards in the field of LED polymerization devices. Users can choose between three curing lights tailored to individual customer needs.
IPS Classic V Powder Opaquer is developed using a new production method. Users benefit from its great flexibility in application techniques as well as from a fast and efficient veneering process.
BY IVOCLAR IPS e.max Press Multi
BY IVOCLAR Adhese Universal
BY IVOCLAR SR Nexco
An innovative, new ingot now allows highly esthetic restorations showing a lifelike shade progression to be fabricated in a single press sequence.
A new single-component, light-cured universal adhesive for direct and indirect bonding procedures. It features compatibility with all etching techniques: self-etch, selective-enamel-etch and total-etch.
SR Nexco Flask is a new type of flask with the help of which light-curing veneering composites can be pressed on dental frameworks.
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BY IVOCLAR Variolink Esthetic The new luting composite Variolink Esthetic is an esthetic light- and dual-curing composite material for the permanent cementation of demanding ceramic and composite restorations.
BY MAILLEFUR Endo Z Bur The Endo-Z’s long tapered configuration allows easy access to the canal orifices and funnel shaping of the chamber walls. Its’ six specially designed tungsten carbide spiral blade cuts but lifts debris coronally along its flutes. The non-cutting tip helps prevent damage to the chamber floor or walls. Available in one size, in FG and RA versions.
BY PLANMECA Planmeca Romexis® 4.0 a completely renewed all-in-one software
Unident delivers cutting edge technology in a range of hygiene and disinfection products, offering unprecedented performance whilst meeting and exceeding the needs of today’s modern dental practice.
Planmeca Romexis® is the first dental software in the world to combine 2D and 3D imaging and the complete CAD/CAM workflow, while also providing extended connectivity with Planmeca dental equipment.
BY SIRONA T2 Turbines
ORTHOPHOS XG 3D can capture the patient’s whole jaw in a single span. The field of view is large enough to avoid the stitching of several 3D x-ray images and thus multiple exposure to radiation. Yet it is also small enough to be a time-saver in diagnosis.
The T2 Comfort class provides you with top quality technology for relaxed work. The titanium coated turbines lie comfortably in your hand ensure that control, boost and mini satisfy every requirement.
The lay:art system from Renfert comprises 8 different, high quality mixing trays and 8 individual premium line brushes, which the porcelain artists can choose from to suit their own individual style.
BY TRIHAWK Trihawk Talon Burs The Trihawk Talon Bur cuts horizontally and vertically, cuts amalgam, crowns and bridges faster. An independent study supported the performance, economy, and value of Tri Hawk’s bur, and it was the only single-use bur that rated 100 percent performance in an ADA review.
BY VITA IN-CREAM The new VITA DISCs
BY VITA AKZENT VITA AKZENT® Plus
The DISC product line for the partially yttriumstabilized zirconium dioxide material VITA In-Ceram YZ will be extended to include additional variations for dental CAD/ CAM processing. The new VITA In-Ceram YZ DISC Color and VITA YZ DISC HT will be launched.
The new VITA AKZENT Plus stains provide a complete, integrated system that is both extremely user-friendly and offers exceptional application reliability. Thanks to a broader range of indications, these new stains provide users in practice and laboratory environments with freedom and versatility during processing.
30 • D E N T AL AC C E S S • DEC EM BER 2015
BY RENFERT Renfert Layart
BY SIRONA Orthopos XG 3D
The kit is composed of titanium scalpel handle for microblades; Molt periosteal elevator and periosteal HP3; Titanium Curved Micro tweezers; Titanium curved micro scissors; Titanium Micro needle holder.
BY UNIDENT Unident Group Selection
BY MEDESY New Periodontal Micro-Surgery Kit
BY VITA VM VITA VMK Master VITA VMK Master, a new ceramic belonging to the VMK (VITA MetallKeramik = VITA metal ceramics) generation for veneering metal frameworks in the conventional CTE range.
BY AMD LASERS Picasso Lite
BY PERIOPTIX MicroLine Series TTL Loupes
BY VOCO Ionostar Molar
Indications of use include Soft Tissue Procedure; Gingival Troughing for Crown; Impressions; Gingivectomy & Gingivoplasty; Gingival Incision & Excision; Soft-Tissue Crown Lengthening
Weighing in from only 36 grams, these lighter, smaller optics can be worn all day with comfort and with less fatigue. Available in microTTLs on the Adidas Adivista frame or the classicallydesigned Ultralight titanium.
• Restorations of non occlusion-bearing class I cavities • Semi-permanent restorations of class I and II cavities • Restorations of cervical lesions, class V cavities, root caries • Restorations of class III cavities • Restoration of deciduous teeth • Base/liner •
BY DEXIS LLC DEXIS Platinum Digital Intraoral Sensor The DEXIS Platinum Sensor is a direct-USB digital X-ray solution with PureImage technology. Its sensor detects radiation where the image is automatically saved, dated, tooth numbered, and correctly oriented -no need to return to the keyboard. Its “One-Click Full-Mouth Series” reduces a FMX procedure to 5 minutes from start to finish.
BY SHOFU Veracia SA Denture Teeth
BY BISCO PRO-V®
Veracia SA Denture Teeth is a new Semi-anatomical aesthetic denture tooth composed of homogenous MF-H (microfilled hybrid) composite reinforced with layered glass. Enhancing Shofu’s Veracia SA is a revolutionary Posterior tooth delivery system called the “Q3 Pack” allowing the simultaneous setup of 4 individual posterior teeth at once thereby saving production time
BISCO’s provisional materials are designed to address the differing requirements for creating and placing provisional restorations. The system comes with PRO-V COAT®, a hydrogel separating agent which prevents the dentin surfaces from bacterial or temporary cement contamination and PRO-V FILL® providing strength and durability while creating an optimal marginal seal.
BY LED DENTAL VELscope® Vx The VELscope® Vx, the latest model release of VELscope technology that uses natural tissue fluorescence to discover abnormalities in the oral mucosa improving the way practitioners examine and screen tissue abnormalities by enhancing the visualization of pre-cancers, cancer and other disease processes.
BY W&H Synea Vision Reliable, ergonomic and outstanding quality handpiece, the premium instrument line in the Synea series. Innovative and long service life guarantee excellent treatment results for restoration and prosthetics.
BY MOUTHWATCH, LLC MouthWatch ExamTab 8 inch The MouthWatch 8 inch ExamTab is the perfect chairside dental imaging tablet designed to help you boost case acceptance, patient education and begin conversations about cosmetic imaging. Powered with Windows 8.1, the tablet can accommodate many other functions including patient entertainment, practice management, email and more.
BY LED DENTAL RAYSCAN Alpha – Expert
BY LED DENTAL EnvisionTEC 3D Printers
BY BISCO TheraCal™ LC
RAYSCAN Alpha - Expert is the world’s first imaging system to utilize a wireless remote control for patient positioning with unique benefits such as pulsed for reduced X-ray exposure, multiple panoramic scan modes, with scan time of a maximum of 14 seconds for panoramic, and minimum of 4.0 seconds for cephalometric.
EnvisionTEC printers integrate seamlessly with leading CAD software programs, allowing clinicians to go from design to a finished product in just a few clicks. With a smooth surface finish and Built-in ethernet interface, this innovation enables printing of orthodontic models, partials, surgical guides, & bite guards with complete efficiency.
TheraCal™ LC is a light-cured flowable resin that contains Calcium Silicates. A first of its class of internal flowable pulpal protectant materials known as Resin Modified Calcium Silicates (RMCS), TheraCal LC provides the sustained alkalinity
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BY VOCO Admira Fusion Flow
BY VOCO Provicol QM Plus
BY VOCO Remin Pro forte
Admira Fusion Flow is the world’s first purely ceramic-based universal restorative material.This unique “Pure Silicate Technology” brings a number of benefits including a high filler content, extremely low polymerisation shrinkage, low level of shrinkage stress with excellent biocompatibility and a very high colour stability.
Now with greater adhesion, the Provicol QM Plus is ideally suited to clinical situations requiring particularly high levels of adhesion. The eugenol-free material contains calcium hydroxide and is indicated for the temporary luting of provisional and definitive restorations (crowns, bridges, inlays and onlays), as well as for the temporary obturation of small, single-surface cavities.
Remin Pro forte is a protective dental care product with fluoride and hydroxy apatite that contains extracts of ginger (Zingiber officinale) and curcuma (Curcuma xanthorrhiza). Scientific studies have confirmed the antimicrobial potential of ginger particularly the curcuma extracts having an antibacterial effect against against streptococcus mutans and an anticariogenic effect.
BY BOTISS cerabone® cerabone® is derived from the mineral phase of bovine bone, which shows strong resemblance to the human bone with regard to chemical composition, porosity, and surface structure. The pronounced hydrophilicity of the cerabone® surface supports a fast uptake of blood or saline, thus improving handling.
BY BOTISS Jason® membrane Jason® membrane is a native collagen membrane obtained from porcine pericardium, developed and manufactured for dental tissue regeneration. The superior biomechanical and biologic properties of the natural pericardium are preserved during the patented production process that exhibits excellent handling characteristics like a remarkable tear resistance and very good surface adaptation.
BY BOTISS collacone® collacone® is a wet-stable and moldable cone made of natural collagen. As a completely resorbable and hemostatic wound coverage, it is intended for application in fresh extraction sockets in the daily clinical practice.
BY KERR ENDODONTICS Elements Diagnostic Unit Dental Pulp Tester Elements Diagnostic Unit Dental Pulp Tester provides the convenience and accuracy of a high quality pulp tester and apex locator in one system. The satellite display conveniently brings critical data into the field of vision for a faster more stable reading. 32 • D E N T AL AC C E S S • DEC EM BER 2015
BY BOTISS mucoderm® mucoderm® is a natural type I/III collagen matrix derived from porcine dermis that undergoes a multi-stage purification process, which removes all potential immunogens. mucoderm® promotes the revascularization and fast soft tissue integration and is a valid alternative to the patient’s own connective tissue.
BY BOTISS maxgraft®
maxgraft® is a sterile, high-safety allograft prouct, derived from human-donor bone, processed by Cells+Tissuebank Austria (C+TBA). C+TBA, a high-quality bone bank, is regulated, audited, and certified by the Austrian Ministry of Health and fulfills the highest EU safety standards.
BY STRAUMANN® Emdogain® Straumann® Emdogain® is a well-researched, easy-to-apply gel containing Enamel Matrix Derivative (30mg/ml) originating from unerupted porcine tooth buds. As a component of embryonic tissues it is designed to promote predictable regeneration of hard and soft tissues lost due to periodontal disease or trauma.
BY KERR ENDODONTICS Vitality Scanner 2006 Dental Pulp Tester
BY J. MORITA USA, INC Root ZX II Endodontic Apex Locator
Vitality Scanner 2006 Dental Pulp Tester ensures dependable and pain-free pulp testing. This outstanding diagnostic tool is automatically controlled and features large digital readouts. It’s the quick and easy solution for patientand practice-friendly pulp testing.
Root ZX II’s patented technology has been independently evaluated to be 96.2% accurate. The large color LCD display screen is easy to read and provides a clear, progressive display with high contrast and is lightweight with compact low speed handpiece option.
316 Roosevelt Avenue San Francisco Del Monte, Quezon City, Philippines Tel No: (632)374-1111 Fax No: (632) 372-0893
A.V.M. Ortho Inc. BY PAC-DENT INTERNATIONAL, INC. Rootpro Wireless Endo Motor And Apex Locator
BY DENTSPLY NUPRO White Gold Tooth Whitening System
The RootPro endodontic motor with Low-Speed Handpiece prepares root canals while displaying accurate measurements of the root canal. RootPro also accurately and precisely locates the position of the file inside a root canal, without requiring the user to set the machine to zero.
NUPRO White Gold is a dentist-prescribed, take-home system that has been designed to address your patient’s tooth whitening requirements. Dramatic tooth whitening results can be obtained in one-two weeks with the flexibility of either day or nighttime application.
Orthodontic and Dental Supplies, Recuerdo Townhouse Unite E 6623 E. Ramos Street Pio del Pilar, Makati City, Philippines Tel No: (632) 893-7696
Unit 717 Future Point Plaza 1 112 Panay Ave., Quezon City Philippines 1103 Tel No: (09228696657) ROCO IBE
Philippine College of Surgeons Bldg. Rm. 201 992 EDSA Quezon City, Philippines Tel No: (632) 926-4526 Fax No: (632) 927-1631
Metro DNC Inc.
3/F Chunics Bldg., 3368 Magsaysay Blvd. Sta. Mesa, Manila, Philippines 1016 Tel No: (02) 358-3257
Ordent Trading BY HU-FRIEDY Abou-Rass Angled Apical Plugger
BY HU-FRIEDY Retro Filling Plugger
The Abou-Rass Angled Apical Plugger is designed for easy access and visability of the apical foramina.
The Retro Filling Plugger is used to compact filling material during vertical condensation.
Unit 1206 City and Land Mega Plaza ADB Avenue cor Garnet Road Ortigas Center, Pasig City Telephone: ++632.994.8306 Fax: +632.570.9840 Email: email@example.com
FILGEN Business Solutions, Inc.
59 Vista Verde Ave. Executive Village Cainta, Rizal, Philippines 1900 Tel No: (632) 645-7977 Fax No: (632) 646-4968
Suite 1001 Dasma Corporate Center 321 Dasmarinas St. Binondo Manila, Philippines Tel No: (632) 244-5634 Fax No: 244-5639
BY SHOFU Core Shade GlasIonomer Core Build-Up Base Cement CoreShade GlasIonomer is formulated to provide a dependable, easily detectable, metal-free core build-up.
BY ANTHOGYR Ergoject Intralig Syringe Ergonomically designed, these technical syringes allow every kind of anaesthesia, especially intraligamental and intraseptal. A Progressive mechanism which makes the injection very quiet and smooth.
2230 Jose Abad Santos Avenue Tondo, Manila, Philippines Tel No: (632) 252-6171 Fax No: (632) 253-0124
Jandra Global Traders Corp
494 Halcon St., Mandaluyong City Telephone: +632.570.7392 Fax: +632.533.4207 Email: firstname.lastname@example.org
New Citizens Dental Supply
655 Paterno St., Quiapo, Manila 1008 Tel. No.: (632) 733-2977; 733-2982; 733-3769; 733-9504; 733-9529 Cel. No.: 0927-2927696; 0917-8129958 Email: email@example.com
BY 3M Adper Easy Bond Self-Etch Adhesive
BY PHILIPS ORAL HEALTHCARE Zoom Whitening Pen
Eliminating post-operative sensitivity is high on every dentist’s list. With Adper Easy Bond Self-Etch Adhesive the etching and penetration of resin monomers into the demineralized dentin and enamel are carried out simultaneously in one step, thus preserving the collagen structure.
Zoom Whitening Pen as a convenient way for your patients to keep their white smiles on-the-go! The easy-to-use, stylish pen applicator brushes a 5.25% hydrogen peroxide formula directly onto the tooth to touch-up between whitening treatments.
Suite 615 Don Santiago Building, 1344 Taft Avenue, Ermita, Manila, Philippines Tel No: (632) 5262911
R&R Newtech Dental Corp.
1207 Cityland Herrera Tower Rufino Street cor. Valero St., Salcedo Village, Makati City Tel No: (632) 753-2220 Fax No: (632) 753-2133 DE C E MBE R 2 0 1 5 • D E N TA L A CCE S S • 33
SCENES and EVENTS
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IDEM Singapore 2016 is the Leading Showcase in Asia Pacific for Global Innovations in Dental Technology.
IDEM Singapore 2016 is the leading showcase in Asia Pacific for global innovations in dental technology. IDEM Singapore 2016 is a key driver for clinical excellence and adoption of innovation in oral health and dental care throughout Asia-Pacific. With technology developing at such a rapid rate, it is imperative that all dental professionals update their knowledge and skills in order to provide the safest and most effevctive care for the public. Modern dentistry is also undoubtedly dependent on advanced technologies in ensuring that dental care and oral health isv easily accessible to consumers. As a result, dental professionals need to constantly upgrade, update and familiarise themselves with the technological advances in dental care. In recent years, devntal professionals in the Asia-Pacific region have been early adopters of emerging technologies in their laboratories, dental practices and dental teaching. To enable dental professionals, take advantage of the critical benefits of new digital technologies, IDEM Singapore 2016 has expanded its broad offering of education to include The Digital Dentistry Forum. The theme for the new forum is ‘A Primer in Digital Dentistry – Practice and Laboratory Development for Clinical Excellence’. This introductory full day forum, to be held on the 10th of April, is open to dentists and dental technicians and its goal is to help dentists and dental technicians to navigate their way to the adoption of digital dentistry through understanding the process of change and the development of new skills necessary to harness the tremendous benefits of areas such as CAD/CAM, 3-D printing, and CAT scans. The forum will feature internationally-recognised experts in private practice and dental laboratories, who will be addressing, not just the benefits of digital technologies, but how to adopt them and transition to the delivery of dental care in the digital world. Dr. Jonathan Ferencz, world-leading prosthodontist from York University College of Dentistry, and Mr. Lee Culp, CDT, Chief Technology Officer for MicroDental, Inc., and other renowned experts and authors will lead the forum. To further cement its aim in striving for clinical excellence and highlighting the importance of innovative technologies, IDEM Singapore 2016 will also provide visitors with the opportunity to view the latest dental technologies and innovative products during the exhibition. Visitors can expect 550 exhibitors and, among them, more than 20% of current exhibitors are focused in the field of digital dentistry, including Creatz3D, 3Shape, Dentsply Implants, Planmeca, Sirona and many others. DE C E MBE R 2 0 1 5 • D E N TA L A CCE S S • 35
SCENES and EVENTS
DenTech China is China’s leading professional event in the dental technology industry. Pioneering the event with its one of a kind inaugural event commencing in 1994, DenTech China has grom from experience for 20 years in organizing one of the most attended conference for dental professionals who seek for a continued accreditation education. This also paves the way for international buyers, traders, and distributors who are looking to source high-quality and cost efficient products and equipment produced in China throughout Asia. Some of the participating international market leaders are 3M, Henry Schein, A-Dec International Inc., Ultradent, Bricera Inc. And Proctor and Gamble. Dentech China 2016 provides an excellent showcase of USA dental product manufacturers who capitalize on the growth of the Chinese market. Joining the US Pavillion enables buyers to easily identify USA pavillion made products. Companies exhibiting in the USA pavillion can also benefit from a range of marketing and promotional support during the show, including media coverage, USA unilimited branding, interpretation and business matchmacking.
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The Tuguegarao City Cagayan Dental Chapter makes its debut right here at the front cover of Dental Access. Showcasing their feat of accompli...
Published on Nov 20, 2015
The Tuguegarao City Cagayan Dental Chapter makes its debut right here at the front cover of Dental Access. Showcasing their feat of accompli...