Dental Asia January/February 2021

www.dentalasia.net

JANUARY / FEBRUARY 2021

exocad releases exoplan 3.0 Galway The importance of magnification in implant dentistry The story of two centrals

Dentsply Sirona paves the way for the future of digital dentistry Photo courtesy of Dentsply Sirona

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CONTENTS

20

16

26

CONT TRENDS

DENTAL PROFILE

USER REPORT

16 exocad releases exoplan 3.0

26 Dentsply Sirona paves the way for

44 Preoperative digital planning

Galway

the future of digital dentistry

18 Grow your dental practice by reaching and retaining patients

UNDER THE SPOTLIGHT 20 Redefining the standards of dental care in the digital era 24 Virtual practice: The way forward

in implant dentistry

CLINICAL FEATURE

invasive multidisciplinary

35 Treatment of Class II Division

approach

I malocclusion with deep bite in mixed dentition requiring early interceptive orthodontic and expansion 40 Tooth whitening and sealing: An innovative concept for the retention of destaining results (Part A)

DENTAL ASIA JANUARY / FEBRUARY 2021

50 Smile makeover using minimally

30 The story of two centrals

treatment of arch development

2

48 The importance of magnification

CONTENTS

3

48

30

50

52

58

ENTS BEHIND THE SCENES

IN DEPTH WITH

REGULARS

52 Manufacturing thermoformed

56 Soaric: The exceptional gives the

4

First Words

6

Dental Updates

clear aligners and retainers on 3D Printed Models with the Form 3B and new Draft Resin

world its value 58 CS ScanFlow v1.0.3: Faster

62 Product Highlights

scanning with more secure and

72 Giving Back to Society

shareable data

74 Events Calendar

61 Evaluation of bioaerosol

76 Advertiser’s Index

dispersion generated by the use of ultrasound inserts in different powers and its comparison with high rotation turbine

JANUARY / FEBRUARY 2021 DENTAL ASIA

3

First Words

The pursuit for excellence continues No be er way to welcome the year 2021 than the availability of the COVID-19 vaccine. More than anything, this development reflected the global solidarity of figh ng this historic threat.

PABLO SINGAPORE Publisher

Publications Director

Jamie Tan jamietan@pabloasia.com

Senior Editor

Pang Yanrong yanrong@pabloasia.com

However, despite the progress, there is no me to be complacent in the dental industry. Guards are up, and innova on con nues.

Assistant Editor

For instance, Henning Mueller, group vice president Asia Pacific of Dentsply Sirona, reveals that the company had con nuously launched new products amid the crisis (p.26). In fact, he emphasised that digital processes are becoming even more important especially regarding the highest hygiene demands.

Pang Yanrong Senior Editor

Graphic Designer

Circulation Manager Addi onally, for Under The Spotlight, we have two orthodon sts from Singapore and Australia who have relied tremendously from digital technology during the peak of the global lockdown and as their prac ces reopened.

Dr Enrica Sham shares how she is redefining the dental care in this digital era (p.20), while Dr Theo Baisi explains why going digital is the best way forward (p.24). Both of them are encouraging their fellow prac oners to equip themselves with the latest prac ce concepts to prepare them with the challenges of the future.

On another note, Dr George Freedman, Dr Fay Goldstep, Dr Edward Lynch, and Dr Patrick Hardigan have shared an innova ve concept for reten on of destaining results (p.40).

Despite the pandemic, they managed to push through with this two-parts study (Part B will be published next issue) concluding the effec veness of one and two-step Supersmile Whitening Bolt.

William Pang williampang@pabloasia.com

Czarmaine Masigla czarmaine@pabloasia.com Liu Yu liuyu@pabloasia.com Shu Ai Ling circulation@pabloasia.com

PABLO BEIJING General Manager

Ellen Gao pablobeijing@163.com

PABLO SHANGHAI Senior Editor

Sharon Wu pabloshanghai@163.net

HEAD OFFICE PABLO PUBLISHING & EXHIBITION PTE LTD 3 Ang Mo Kio Street 62 #01-23 Link@AMK, Singapore 569139 Tel: (65) 62665512 Email: info@pabloasia.com Website: www.dentalasia.net

Company Registration No.: 200001473N Singapore MICA (P) No. 075/05/2019 Malaysia KDN: PPS1528/07/2013 (022978)

Also, Dr Anand Narverkar publishes “The story of two centrals” highligh ng the benefits of direct restora on with a step-by-step guide of how to restore central incisors with natural aesthe cs and surface lustre (p.30).

As we enter the hopefully “post-pandemic” era, may we con nue to be socially responsible and look a er one another. Perhaps, if there’s one thing that this crisis has taught us, it would be the reminder that in unity, there’s strength.

REGIONAL OFFICE (CHINA) PABLO BEIJING Tel: +86-10-6509-7728 Email: Pablobeijing@163.com

REGIONAL OFFICE (CHINA) PABLO SHANGHAI

LET’S CONNECT!

Tel: +86-21-52389737 Email: Pabloshanghai@163.net

@dentalasia

ADVISORY BOARD

Dr William Cheung

Dr Choo Teck Chuan

Dr Chung Kong Mun

Dr George Freedman

Dr Fay Goldstep

Dr Clarence Tam

Prof Nigel M. King

Dr Anand Narvekar

Dr Kevin Ng

Dr William O’Reilly

Dr Wong Li Beng

Dr Adrian U J Yap

Dr Christopher Ho

Dr How Kim Chuan

Dr Derek Mahony

Prof Alex Mersel

Digital Impression with Primescan The right choice for all your digital nee eds needs

dentsplysirona.com/primescan

Dental Updates Bluelight Analytics partners with 3M Oral Care to introduce Bluelight CheckUp Bluelight Analytics (Bluelight), a company

following the success of the CheckMARC

specialising in light measurement

service over the past five years.

technology, has partnered with 3M Oral Care to introduce Bluelight CheckUp to

“We are excited to work with Bluelight as we

help dentists improve the outcomes of their

share a common mission – to help dentists

restorative procedures.

improve the outcomes of their restorative dental procedures. By leveraging the

Dentists rely on restorative procedures for

advanced technology of Bluelight, we can

half of their income and yet, they often

continue to work together to help ensure

overlook the importance of light curing to

optimal health and quality of dental curing

the success of those procedures. Patient

light around the world,” said Andrew Milder,

care can be compromised, and a dentist’s

global portfolio leader at 3M Oral Care.

1

Burns, chief growth officer at Bluelight. ■

reputation and revenue can be put at risk in those crucial few seconds they rely on their

“For many years, 3M Oral Care has been

1

curing light.

recognised as a worldwide leader in light

2005-06 Survey of Dental Services Rendered.

curing technology and restorative dentistry.

1–181. American Dental Association (2013).

CheckUp offers a solution that supports

We are excited to deepen our relationship

Survey of fees. Retrieved from: http://www.

dentists in their quest for clinical excellence

with 3M Oral Care by partnering on the

toothnature.com /2013/07/survey-average-

by allowing the convenience of testing their

promotion of CheckUp. Together, we can

fee-charged-by-dentists.html ) Dental

curing lights in their office, on their own

ensure clinicians around the world have the

Revenue in the US (2013). Retrieved from:

schedule. This is the second partnership

tools they need to improve patient care and

http://www.statista.com/statistics/296642/

between Bluelight and 3M Oral Care,

perform restorations that last,” said Rob

revenue-dentists-in-the-us/)

American Dental Association. (2007).

Crest, Oral-B, and Blend-a-med unveil their first ever recyclable HDPE toothpaste tubes in North America and Europe Procter & Gamble Oral Care has unveiled

The solution to this is the High-Density

Albéa to start using its proprietary Greenleaf

its newest packaging innovation across its

Polyethylene (HDPE) tube, which provides

Generation 2 tube technology, which

leading toothpaste brands: Crest, Oral-B,

the same product protection as current

enables the tubes to be recycled wherever

and Blend-a-med.

tubes, and has been certified by North

collection schemes are active.

American and European recycling bodies This announcement increases the level of

to be compatible with existing recycling

recyclability of its toothpaste tubes, as part

technologies. These HDPE tubes can be

of the P&G Ambition 2030 commitments

recycled where collection programmes exist.

of achieving 100% recyclable or reusable packaging.

For introducing the right solution and making its toothpaste tubes more

The leading global oral care brands, Crest

sustainable, Procter & Gamble is in

and Oral-B, and the European brand Blend-

discussions with several HDPE tube suppliers

a-med, started the switch in January 2021,

and has already reached an agreement with

and will continue until full conversion, by

6

“P&G Oral Care started our sustainability journey many years back and continue to reduce our footprint. To drive a more circular supply chain, all of our production sites globally are qualified as sending zero manufacturing waste to landfill, and our sites across the United States, Canada, and Europe purchase 100% renewable electricity,” stated Steve Bishop, health care

2025.

chief executive officer of P&G. “There is

Toothpaste tubes are used by millions of

of the steps we are taking with our leading

consumers every day; however, its multi-

brands, Crest and Oral B in North America,

material construction poses a challenge

and Blend-a-med in Europe, to achieve

for recycling facilities around the globe.

recyclable tubes in the years ahead.” ■

DENTAL ASIA JANUARY / FEBRUARY 2021

much yet to be done; however, we are proud

Dental Updates

Keystone and Henkel to launch new 3D dental modelling resin As part of their ongoing collaboration for 3D printing applications in the dental industry, Keystone Industries (Keystone) and Henkel have

→ THE REVOLUTIONARY INVENTION IN BONE SURGERY PIEZOSURGERY® touch

developed KeyModel Ultra.

This next generation of 3D dental modelling resin offers a new level of accuracy, detail, and speed. KeyModel Ultra is formulated for rapid printing and fast post-curing. It is also designed to reduce peel forces, which increases print accuracy.

KeyModel Ultra does not require release agents for thermoforming aligners and other devices. Its flawless detail ensures that all thermoformed devices fit perfectly, and it can be carved without chipping to adjust the model when needed. KeyModel Ultra is available in ivory and light grey.

“The collaboration of the Henkel and Keystone teams created an opportunity to develop a model material with new innovative characteristics. Our KeyModel Ultra prints faster than other materials and offers a smoother finished surface,” explained Doug Statham, senior director of Digital Materials at Keystone. “As model printing for clear aligner is the number one application in dental, our

→ best cutting efficiency and maximum intraoperative control → perfect ergonomics → over 90 inserts specifically designed for a wide variety of clinical applications → more than 250 clinical and scientific studies

teams developed a material that offers an integrated release agent, making vacuum-formed aligners easier to remove than with other materials, hence, improving the workflow. In addition, Keystone and Henkel are supplying this material at reduced costs compared to other model material on the market, providing greater value to our end users.”

“We are excited in cooperation with Keystone to introduce KeyModel Ultra to the dental market,” said Ken Kisner, head of Innovation for 3D Printing at Henkel. “Henkel’s rapid innovation capabilities in collaboration with Keystone’s manufacturing and market know-how have again enabled another outstanding technology; delivering the next generation of modelling resins that provide speed, accuracy, and detail. This is the first of many new launches to come, where the longstanding know-how of Keystone in the dental space, coupled with our extensive material science know-how will continue to drive the transition to digital dentistry.” ■

→ www.mectron.com

JANUARY / FEBRUARY 2021 DENTAL ASIA

7

Dental Updates Carestream Dental introduces their latest software update: CS ScanFlow v1.0.3 Carestream Dental has introduced their

based Microsoft Azure. On top of it, this

third-party software as exocad or Blender for

latest scanner acquisition software update,

software eliminates the need to update the

dental with an articulator add-on.

CS ScanFlow v1.0.3.

CS Mesh Converter on all computers in the

CS ScanFlow v1.0.3 features anti-reflective

practice when a new version of CS ScanFlow

Now, users can also display the scan onscreen

is available.

in the same orientation as the patient’s mouth

mode that optimises scanning shiny or

with Smart Position mode for a more intuitive

reflective surfaces. Users can now start

CS ScanFlow v1.0.3 also enables optimal

scanning right away without the need for

treatment planning and the ideal appliance

additional step while still generating a high-

fit with its new bite capture capability.

quality rendering of reflective surfaces on the digital impression.

scanning experience.

Additionally, to help drive patient engagement right from the start of treatment, practices

Users can obtain up to five—instead of the

can even create an animated MP4 file of

previous three—bites to get an extensive

the digital impression after completing the

It also includes access to secure digital

view of the patient’s overall occlusion. All

acquisition.

impression file conversion tools via cloud-

five bites can be exported to a lab or used in “These improvements to CS ScanFlow are based on the requests of users whose valuable feedback makes the software more efficient and the scanning experience better,” said Ed Shellard, DMD, chief dental officer of Carestream Dental.

Other user-inspired new updates include scan preservation for refinement; an enhanced cutting tool, intuitive scanner identification and connection; and many others. ■

Award-winning clinical research shows the effectiveness of AI technology in improving radiographic analysis New clinical research shows that Denti.

diagnose problems promptly and improve

artificial intelligence tool has the potential

AI’s radiographic analysis can help dentists

their productivity.

to reduce provider fatigue and diagnostic

in catching undiagnosed or overlooked conditions and identifying pathologies.

8

errors. Her poster on the same research won The American Academy of Oral and

first prize for the best scientific poster at the

Maxillofacial Radiology (AAOMR) has

AAOMR annual session.

Denti.AI is a software company that

awarded the prestigious 2020 Albert G.

leverages on AI analysis of dental x-rays

Richards Graduate Student Research Award

“Our team at Denti.AI is committed to

to detect key abnormalities, past dental

to a graduate student from the University of

being at the forefront of implementing

treatments, and other relevant features to

North Carolina Adams School of Dentistry

artificial intelligence into clinical practices

who showed the artificial intelligence

through rigorous academic validation

software often accurately identified

and collaboration with leading academic

pathologies missed by board-certified dental

institutions,” said Dmitry Tuzoff, founder and

experts.

CEO of Denti.AI.

Dr Manal Hamdan conducted the study

This is the second academic award the

titled, “Detecting apical radiolucencies using

company’s product has received last year.

deep learning technology: A pilot study.” She

The University of Louisville awarded first

concluded that Denti.AI’s technology had

prize to a separate clinical study featuring

comparable or improved results, and the

Denti.AI’s technology. ■

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Dental Updates CeramTec Group acquires Dentalpoint AG The CeramTec Group has taken the next

future market for metal-free dentures and

“With the acquisition, we are not only

step in its transformation into a medtech

thus, expanding its portfolio for medical

consistently expanding our portfolio in

company and acquired the Swiss specialist

technology applications.

the medical segment, but also expanding

for ceramic dental implants, Dentalpoint AG.

our access to the dental market, product As one of the leading suppliers in the

development expertise, and manufacturing

The leading medical technology group is

field of metal-free, two-part ceramic

capacities in a rapidly growing market

expanding its range as a supplier in the field

implants, Dentalpoint makes a substantial

environment,” said Hadi Saleh, CEO of the

of high-performance ceramics. The high-

contribution to the further development

CeramTec Group.

quality, biocompatible ceramic components

of implantology and has an established,

for joint and dental implants from the

innovative product platform.

Adrian Hunn, CEO of Dentalpoint AG, added,

CeramTec Group help patients around the world to improve their lives.

“Through the integration into the CeramTec The transaction creates a leading global

Group, we expect new impulses for our existing

provider of solutions in the field of ceramic

business and the expansion of our international

With the takeover of the Swiss Dentalpoint

dental implants that combine the highest

presence. Dentalpoint will remain on the

AG (“Dentalpoint”) on 4 January 2021,

product quality in terms of compatibility and

market as a company with the established

CeramTec is investing in the rapidly growing

aesthetics.

Zeramex brand and continue to expand.” ■

Dentsply Sirona acquires Datum Dental, a leading provider of the innovative OSSIX® regenerative solutions portfolio Dentsply Sirona has announced that it has

safe and transformational solutions – that

acquired Datum Dental, Ltd. with its strong

simplify procedures and overcome major

OSSIX biomaterial portfolio.

deficiencies in existing biomaterial‐based

®

regenerative products,” said Itay Itzhaky, chief executive officer of Datum Dental.

The acquisition of Datum Dental, an Israelbased company known for its innovative dental regeneration products with the

“Datum Dental perfectly fits in our strategy

Since 2016, Dentsply Sirona has already

clinically superior proprietary technology

to deliver innovative and meaningful

been in distribution agreements with Datum

GLYMATRIX®, will open up significant

solutions for our customers. The biomaterial

Dental. Today, Dentsply Sirona is promoting

opportunities for Dentsply Sirona within its

sector is an important cornerstone of

the full OSSIX® portfolio (OSSIX® Plus,

Implants segment.

the future of dentistry. The acquisition is

OSSIX® Volumax, and OSSIX™ Bone) in the

another important step for us to deliver

U.S., Canada, Colombia, France, Belgium,

With a track record of simplifying and

on our purpose to empower dental

UK-Ireland, Nordics, Poland, Romania,

developing innovations for regenerative

professionals to provide patients with better

Turkey and Hong Kong.

procedures, the OSSIX portfolio will

dental care and make people smile,” said

support the vision to become one of the

Gene Dorff, group vice president Implants

Clinicians will benefit in the future from

leaders in the dental regeneration industry.

Product Group of Dentsply Sirona.

OSSIX® products’ being implemented in a

With innovative products driven by the

“We are pleased that the OSSIX family

Dentsply Sirona’s capacity to invest in the

GLYMATRIX® core technology, OSSIX®

is becoming part of the market leader

future development. The strong OSSIX®

bio-durable design will ensure long-term

in dental. Dentsply Sirona offers us

portfolio will be the foundation of the

predictable and superior results. The

opportunities to work on continued

Regenerative portfolio of Dentsply Sirona.

OSSIX dental regeneration products will

innovation with the strongest research and

The transaction is expected to close in

support and enhance the future of implant

development team (R&D) in the industry. Our

January 2021, following customary approval

dentistry and oral care.

R&D pipeline will continue to develop new,

requirements. ■

®

broad set of solutions and workflows and

®

10

DENTAL ASIA JANUARY / FEBRUARY 2021

®

Dental Updates Ivoclar Vivadent announces new chief marketing officer Bringing extensive experience in

GREATER CUSTOMER FOCUS

the start of 2019 – initially as co-CEO of

marketing and brand management for

Frank has been with the company since the

Kapanu, an Ivoclar Vivadent subsidiary.

global organisations, Patric Frank will

beginning of 2019, and his appointment

drive the continued expansion of the

as CMO of Ivoclar Vivadent from 1 January

Headquartered in Zurich, Switzerland,

dental specialists from Liechtenstein as

2021 underlines the importance of this task.

this start-up specialises in visual data

chief marketing officer (CMO), effective immediately.

In his new role as a member of Corporate Management, Frank will be responsible

One of the leading dental companies

for all global business units as well as for

worldwide, with a comprehensive portfolio

planning and implementation of their global

of products and systems for dentists and

marketing strategy.

dental technicians, Ivoclar Vivadent AG continues to focus on global expansion

Particularly, he will concentrate both on

and strengthening its presence in growing

further enhancing global awareness of the

markets.

brand and its positive image, as well as on

processing and machine learning for dental applications, developing solutions such as the smile visualisation app: IvoSmile.

In June 2019, he also took over leadership of the Global Brand and Marketing Communications sector at Ivoclar Vivadent, where his responsibilities included brand management, customer experience, digital

optimising customer focus.

communication, and scientific marketing.

Frank brings extensive experience in brand

regions in question, it also demands a

EXTENSIVE EXPERIENCE IN BRAND MANAGEMENT

comprehensive branding and marketing

In doing so, Frank has the advantage that

previously held various sales and marketing

strategy.

he has already been with the company since

roles at Salomon, Sonos, and Logitech. ■

Achieving this goal not only requires innovative products and services for the

management for global organisations. He

Henry Schein now offers full portfolio of 3D Printers from SprintRay Henry Schein, Inc. has reached an

now available through Henry Schein, cover

agreement with SprintRay that will reinforce

every step of the dental 3D printing process,

its effort to provide in-office 3D printing as

including:

an option for dental practices. Henry Schein

•

Pro95 Desktop 3D Printer – A user-

has announced that it is expanding its 3D

friendly desktop printer for the in-office

printing offerings through the distribution

manufacturing needs of the modern

agreement.

digital clinic; •

SprintRay, a technology company that builds

high-resolution workhorse printer

comprehensive 3D printing solutions for dental professionals, will now have Henry

•

Schein offer its full portfolio of 3D printers.

The move will bring in-office 3D printing as

Pro55 Desktop 3D Printer – An ultra-

•

•

3D Printing Materials Library – A

designed for restorative applications;

large selection of dental 3D printing

Pro Wash/Dry – A fully-automated,

materials, designed to get the most out

two-stage wash and dry system;

of SprintRay 3D printers

Pro Cure – A post-curing system

an option for dental practices to produce

that maximises print strength with

With the addition of SprintRay’s products,

orthodontic aligners, implant surgical

convection heating;

Henry Schein’s field sales consultants will

Dashboard 2.0 & Design Services – A

receive additional in-depth training on the

cloud-based dental appliance design

company’s 3D printing solutions portfolio,

platform that integrates with SprintRay

so they are fully equipped to help customers

3D printers; and

identify the right options for their practice. ■

guides, occlusal guards, digital dentures, indirect restorations, and more.

SprintRay’s Frictionless Workflow solutions,

•

JANUARY / FEBRUARY 2021 DENTAL ASIA

11

Dental Updates Colgate laboratory tests show toothpaste and mouthwash neutralise COVID-19 virus by 99.9% Laboratory studies show that toothpaste

(NJMS) Public Health Research Institute and

and director of the Centre for COVID-19

containing zinc or stannous and mouthwash

Regional Biosafety Laboratories.

Response and Pandemic Preparedness, who led the Rutgers NJMS study along with

formulas with cetylpyridinium chloride (CPC) neutralise the virus that causes COVID-19

The results suggest that some toothpaste

colleagues Drs Pradeep Kumar and Riccardo

by 99.9%.

and mouthwashes may help reduce the

Russo, said, “Given that saliva can contain

spread of SARS-CoV-2, the virus that causes

amounts of virus that are comparable to that

The studies are part of a Colgate research

COVID-19, by temporarily reducing the

found in the nose and throat, it seems likely

programme that includes clinical studies

amount of virus in the mouth.

that SARS-CoV-2 virus originating in the mouth contributes to disease transmission,

among infected people to assess the efficacy of oral care products in reducing the amount

“We’re at the early stages of our clinical

especially in persons with asymptomatic

of the virus in the mouth, potentially slowing

investigations, but our preliminary

COVID-19, who are not coughing. This

the transmission of the COVID-19 virus.

laboratory and clinical results are

suggests that reducing virus in the mouth

promising,” said Dr Maria Ryan, chief clinical

could help prevent transmission during the

In the laboratory studies – the first to

officer at Colgate. “While brushing and

time that oral care products are active.” ■

include toothpaste – Colgate Total and

rinsing are not a treatment or a way to fully

Meridol toothpaste neutralised 99.9% of the

protect an individual from infection, they

virus after two minutes of contact. Colgate

may help to reduce transmission and slow

Plax and Colgate Total mouthwashes were

the spread of the virus, supplementing the

similarly effective after 30 seconds.

benefit we get from wearing masks, social distancing, and frequent hand washing.”

The studies were conducted in partnership with Rutgers New Jersey Medical School’s

Dr David Alland, chief of Infectious Diseases

VDDI and Koelnmesse postpone IDS to September 2021 With the unchanged challenges, the

there would be improved health situation

The #B-SAFE4business concept that is based

COVID-19 pandemic is raising in Germany

and relaxation of the travel restrictions so

on the applicable Corona Protection Ordinance

and the anticipated continuation of

more international partners and customers

will also accompany IDS in September to offer

the extensive restriction of personal

can travel to Cologne, Germany.

the exhibitors and visitors the highest possible level of safety.

contacts by the government, states, and municipalities at the beginning of the new

The presently essential political decisions

year, the VDDI board, the Gesellschaft zur

taken by the Federal Government are also

“The Association of the German Dental Industry

Förderung der Dental-Industrie mbH (GFDI)

affecting trade fairs in Germany, including

and Koelnmesse have kept a close eye on the

(the commercial enterprise of the VDDI)

IDS. Thus, it will be staged in September

developments of the pandemic at all times and

and Koelnmesse have decided to postpone

with the new trade fair concept that was

have analysed the possible consequences on

the International Dental Show (IDS).

planned for March, which unites physical

the trade fair activities of all personnel involved.

and digital elements.

The trade fair that was originally planned

The health of our exhibitors, partners, and

to take place from 10 to 13 March, will now

visitors takes top priority for us here. After

be held from 22 to 25 September 2021.

assessing the current facts, we have had to

This is in response to the currently ongoing

refrain from staging IDS in March and are

COVID-19 policy, which may be extended in

postponing the always successful dental show

Germany into the new year.

to the autumn of next year,” explained Mark Stephen Pace, chairman of the VDDI and Oliver

12

By postponing the 39th edition of IDS to

Freser, chief operating officer of Koelnmesse

September, the organisers are hoping that

GmbH. ■

DENTAL ASIA JANUARY / FEBRUARY 2021

Dental Updates BIOLASE launches Waterlase Endo Academy BIOLASE, Inc., the global leader in dental lasers, completed its leadership council meeting of the Waterlase Endo Academy, forming an exclusive community of leading endodontists, dedicated to improving patient outcomes and profitability with

EASY TO USE EASY FOR ALL!

new technology.

The academy, open to all Waterlase endodontists, was created to foster peer-led learning, best practice sharing and optimal integration of Waterlase technology into clinical practice.

“The launch of Waterlase Endo Academy was a natural next step in our company journey, as we continue to pursue the mission of advancing dentistry,” said Todd Norbe, president and CEO of BIOLASE. Benefits for the members of the academy include ongoing mentorship from leading clinicians, didactic online meetings, and interactive case reviews by Waterlase experts along with in-person training experiences hosted by leading Waterlase Endo Academy clinicians, including Dr Charles Maupin, and on-demand access to clinical resources and webinars.

The Waterlase dental laser offers various benefits for endodontists, from faster procedures to new treatment options.

The Waterlase also provides greater access to lateral canals and the critical apical third improving efficiency and patient-reported outcomes. The unique radial firing tip allows for success in conservative endo treatment while the overall technology delivers more predictability, reduced patient discomfort and improved patient care.

soft-tissue surgery, crown and veneer removals, apicoectomies and more. ■

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The universal use of Waterlase also allows clinicians to perform

VITA – perfect match.

JANUARY / FEBRUARY 2021 DENTAL ASIA 3587E_LUMEX_Anzeige_250x95.indd 1

13

18.01.2021 11:57:39

Dental Updates DenMat launches ZEN CP+ DenMat Holdings, LLC (“DenMat”) has

professionals treat tooth sensitivity by

that penetrate the dentin tubules and

launched another new product in the oral

using what is already present in the tooth

rapidly release calcium and phosphate ions

hygiene category, ZEN CP+.

– calcium phosphate,” said David Casper,

for rapid mineralisation.

CEO of DenMat. “Our team recognised a This unique desensitising gel alleviates

need for a new product in this space, one

Minerals are formed deep into the dentin

tooth sensitivity and discomfort by

that treats patients in a safer, more effective

tubules and are unaffected by wear and

delivering nano-sized calcium phosphate

manner. University research data shows

acid. ZEN CP+ does not contain any milk-

minerals to the tooth surface, occluding and

ZEN CP+ to be a superior alternative to

derived proteins so it is safe for all patients

penetrating deep inside the dentinal tubules.

other desensitising products in its ability to

including those with milk-based allergies.

The patent-pending microsphere technology

occlude dentinal tubules.”

reacts with saliva to deliver mineral-forming calcium phosphate ions.

“This innovative new product helps dental

Designed for daily use, ZEN CP+ is available ZEN CP+ is formulated with CAPOSAL®

in 45g tubes and is simply brushed on to

microsphere technology, featuring small

the teeth as part of one’s daily oral care

particles consisting of calcium phosphate

regimen. ■

ADA announces the search for its new executive director The American Dental Association (ADA)

with Korn Ferry to conduct a robust search.

“I thank Dr O’Loughlin for her long-running

has announced that it has retained the

The ADA is seeking a leader with extensive

commitment to our great organisation

executive search firm, Korn Ferry, to lead

knowledge of the health care industry, the

and we are grateful she has given us more

the search for its next executive director.

The announcement comes after the current ADA Executive Director Kathleen O’Loughlin, DMD, MPH, announced her decision to retire

dental delivery system, governmental health related agencies, and/or the profession of dentistry, as well as association

than a year’s notice so we can conduct a robust search,” said Dr Daniel Klemmedson, DDS, MD, president, ADA. “As we look to the future, we are committed to finding

at the end of 2021 after 12 years of service.

management and non-profit financial,

The ADA Board of Trustees approved an

The position does not require candidates to

of dentistry and assist dentists in advancing

executive director search committee to work

be dentists.

the health of their patients.” ■

operational, and strategic planning skills.

the most qualified candidate to build on Dr O’Loughlin’s work to power the profession

FDI highlights the need to reduce the environmental impact of dentistry without compromising quality of care

14

FDI, as the principal representative body for

He commented, “Many countries are leading

and offices that are only beginning their

more than one million dentists worldwide,

the way in terms of green dentistry and

sustainability journey.”

is currently developing guidelines on how

many dentists are making sustainability a

to run an environmentally friendly, socially

high priority by using more environmentally-

FDI’s new infographic on sustainability in

responsible, and successful dental practice.

friendly dental supplies and equipment,

dentistry highlights the environmental impact

cleaning products, or making structural,

of dentistry as well as the ways in which these

Dr James Zenk, committee chair of FDI

energy efficient changes to their clinics. FDI

impacts can be reduced, for the health of the

Dental Practice and leader of FDI’s

can help by sharing these success stories

patient, the practitioner, and the practice.

Sustainability in Dentistry project, reinforces

to help build awareness in other countries

how important green dentistry is to FDI and

The Sustainability in Dentistry project aims to

believes the organisation’s commitment to

show how good oral health benefits not only

sustainability can help dentists achieve it in

to patients and dental practices, but also the

their daily work too.

environment. ■

DENTAL ASIA JANUARY / FEBRUARY 2021

Dental Updates Formlabs launches Permanent Crown Resin, further digitising restorative dentistry Formlabs, a leading 3D printing company,

Crown Resin, the company is one of the

An increase in adoption and accessibility

has expanded its dental material offerings

first 3D printing manufacturers to offer a

for dental 3D printing over the last five

with the launch of Permanent Crown Resin.

high-quality solution with a low upfront

years have opened the door to testing

equipment cost.

and validating cutting-edge indications.

Permanent Crown Resin, whose digital

Formlabs’ Permanent Crown Resin provides

workflow is developed in partnership with

Historically, 3D printing permanent

the material innovation needed to move restorative dentistry forward.

BEGO, is a tooth-coloured, ceramic-filled

restorations was out of reach due to a

resin for 3D printing permanent single

lack of appropriate dental materials in the

crowns, inlays, onlays, and veneers.

market that had the desired mechanical

“3D printing improves the patient

properties, accuracy, and fit compared to

experience and enables dental labs and

milled or conventional materials.

practices to provide patients with higher

The introduction of these new materials empowers dental offices and labs to further

quality, more reliable and affordable

digitise restorative dentistry and offer

solutions to traditional processes,”

patients 3D printed long-term restorations

said Georgio Haddad, dental strategic

such as fillings, crowns, bridges, and

partnerships lead at Formlabs. “We’re

implants.

committed to innovating our offerings to provide the dental industry with the tools

3D printing permanent crowns is a

needed to operate at the cutting edge of an

completely new application to the dental

increasingly digital workflow and provide

industry, and with Formlabs’ new Permanent

patients with high quality care.” ■

Medit announces Straumann Group as a distributor for its intraoral scanners Medit and Straumann have entered a

common goal of driving the adoption of

the adoption of digital dentistry through the

global distribution partnership for intraoral

digital dentistry.

partnership.”

This agreement leverages the existing

With the distribution agreement, the Medit

Guillaume Daniellot, CEO of the Straumann

partnership of the two companies for dental

i500 will be integrated in Straumann’s

Group, added, “A key strategic goal for

lab scanners.

prosthetic and clear aligner workflow

the Straumann Group is to create the

solutions, such as ClearCorrect. The alliance

leading ecosystem for aesthetic dentistry,

The distribution agreement includes Medit’s

will also include the workflow between

connecting all our digital solutions, services

highly popular intraoral scanner, the i500.

Medit’s open collaboration platform, Medit

and equipment with partners and third

The scanner delivers excellent performance

Link, and Straumann Group’s open software

parties, to provide seamless workflows for

for a wide range of applications.

platforms for surgical planning, CAD/CAM

dentists and optimal treatment outcomes for

prosthetics, and treatment services.

patients. Intraoral scanners have a pivotal

scanners effective as of 1 January 2021.

role in this and with Medit, we will be able

Straumann Group is a global leader in tooth replacement and orthodontic solutions

GB (Gyu Bum) Ko, CEO of Medit, said, “We

to include a very large segment of dentists

that develops, manufactures, and supplies

are pleased and proud to announce the

for whom affordability has been a major

innovative global brands for replacement,

partnership with the Straumann Group, a

hurdle.” ■

corrective, and digital dentistry.

world-renowned corporation in the dental industry. Medit’s i500 intraoral scanner

With Medit’s strong presence as an open

has been highly appraised for its superb

system provider, and Straumann Group’s

quality and excellent performance in dental

large digital ecosystem, the partnership

applications. We are truly excited to get a

is based on powerful synergies and the

step closer to attaining our vision of driving

JANUARY / FEBRUARY 2021 DENTAL ASIA

15

Trends

exocad releases exoplan 3.0 Galway Latest release offers edentulous case planning and design of respective surgical guides exocad GmbH (exocad), an Align

digital workflow: from virtual prosthesis-

Surgical and fixation guides can

oriented implant planning with exoplan

exoplan 3.0 Galway, the latest version of its

be freely designed or based on a

and designing surgical guides with Guide

implant planning software. The new release

prosthesis scan

Creator, to planning and producing the

New tools to speed up the entire

implant-supported, temporary, and final

planning process

restorations with DentalCAD.

Technology, Inc. company, has released

supports planning of edentulous cases,

•

placement, and fixation guide

•

including design of surgical guides.

•

Improved implant selection dialogue

“We are excited to announce the release

•

Automatic panoramic curve detection

“As the world’s premier OEM supplier

of exoplan 3.0 Galway and enthused about

•

More implant libraries, now with

of dental CAD software, we provide the

the new possibilities it presents for guided

over 500 implant systems and over

symbiosis of prosthetic and implant

surgery,” said Tillmann Steinbrecher, CEO

8,500 implants from more than 80

planning,” added Steinbrecher. “Users can

of exocad. “exoplan 3.0 Galway will provide

manufacturers

achieve predictable results in a cost and

Virtual tooth extraction on optical

time-efficient manner which can lead to

scans

increased customer satisfaction.” DA

dental practices and laboratories with

•

a digital workflow that offers maximum flexibility and builds on exocad’s mission to make CAD design as easy as using an app

•

Possibility to easily mark sinus cavity and check if implants are intruding

EU and other select markets. exocad names

on a cell phone.”

All exocad solutions are based on the same

its releases after current EU “European

exoplan 3.0 Galway is a powerful, open, and

technical platform with an open architecture,

Capitals of Culture” and selected the Irish

efficient software package for virtual implant

ensuring the seamless functionality of the

city of Galway for this release.

planning. Customised surgical guides can be designed using the Guide Creator software module, and then produced on site - in a laboratory, dental practice, or an external production centre. The software comes in a new, modern user interface, inspired by the Google Material Design system.

With more than 40 new features, as well as enhancements to over 60 existing functionalities, the Galway release represents a major expansion of capabilities in guided surgery and improved integration with DentalCAD, exocad’s dental CAD software.

Key highlights of exoplan 3.0 Galway include: •

Planning of edentulous cases and design of the respective surgical guides, including necessary tools, such as dual scan protocol, anchor pin

16

exoplan 3.0 Galway is now available in the

DENTAL ASIA JANUARY / FEBRUARY 2021

#whaims aims.wh.com

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Trends

Grow your dental practice by reaching and retaining patients

By Dr Pedram Pakzad

F

or potential patients to be aware

group or groups and giving them

healthcare services. I once placed an ad on

of what we can do, we must first

information

the front cover of a magazine distributed

present ourselves. If I want to

in the town where my office is located,

reach patients, I need to let them

THE TOOLS

informing patients about digital methods

find me, and there are different

Upon collecting my thoughts, I need tools to

when placing dental implants.

ways of achieving this.

The first step in the process is to find the

put them into practice. There are traditional and digital tools for marketing, among which

Social Media: With the most popular

the most effective, I believe, are as followed:

networking sites being Facebook,

answers to a number of questions:

Instagram, LinkedIn, Twitter, Pinterest, and

•

What services do I mostly provide?

Public relations: Conferences, congresses,

YouTube, all that needs to be done is to

•

Do I want to brand my business or

and symposia create good networking

combine them with professional content

myself?

opportunities. Being actively involved in

creation.

•

What kind of image should my brand

such events, particularly as an executive

evoke in people’s minds?

member or speaker, can increase

Website: A website is your primary online

How much time can I invest in

the chances of fruitful channels of

identity, presenting your brand. Depending

marketing?

communication. Being quite interested

on what you want to illustrate as your brand,

How much money can I invest in

in scientific work, I personally have

you can design and create content on your

marketing?

contributed as an executive member

website. Search engine optimisation (SEO)

and have also delivered lectures at many

helps to ensure you appear near the top in

national and international events.

online searches.

These events have improved my public

Content: Creating professional content is

speaking, leadership qualities and

the cornerstone of your online presence.

management skills while helping me in many

From experience, I can say that preparing

I have set a number of short and long-term

theoretical and practical scientific matters.

appropriate content is the most challenging

goals for my marketing strategies, whether

Additionally, taking part in such events has

part of digital marketing. No matter

they be direct or indirect, targeting people

paved the way for more positive and smooth

whether you are more active on Facebook,

who need our services either at the present

networking.

Instagram, LinkedIn, Twitter, Pinterest,

• •

Finding answers to these questions clarifies what I want to do, helping me establish systematic marketing policies.

MARKETING STRATEGIES

time or in the future.

YouTube, or your website, you need to Referrals: For a business with no previous

generate content to share. Images, videos,

To be successful in the long run, these

marketing plan, referrals, whether they

infographics, written stories and articles

policies should be formulated by taking the

be from friends, relatives, and people you

about new skills, treatments and equipment,

benefits of patients into account. Bearing

know or from your professional network

and such materials are usually the major

the points mentioned above, I, first, followed

of colleagues, enable us to survive at the

content you benefit from on the web.

the steps below to run systematic marketing:

beginning. Especially if you are a specialist,

•

Needs assessment - what patients need

you need a network of referrals from and to

Self-assessment - the needs to which I

colleagues.

•

can respond • •

18

Reviews: These reflect patients’ opinions of us and our services. You should definitely be available on Maps, Google Maps, Yelp,

Broadcasting - different tools to tell

Magazines: An ad in a health-related

or similar navigation programmes. When

people about the services I provide

magazine can find its way to a group of

searching, people always have an eye on the

Targeting - defining a specific target

people who are looking for particular

average ratings and reviews. Thus, it seems

DENTAL ASIA JANUARY / FEBRUARY 2021

Trends advisable to encourage your patients to

I benefit my patients. When patients

Fresh air, relaxing music, soothing

rate you online where 4+ ratings can attract

•

come to me with a chief complaint,

colours, flowers, and welcoming smiles

patients into your office.

I evaluate their situation holistically,

are all small enhancing assets that

giving them the best treatment plans

to some extent mitigate the stressful

If managed smartly, these tools, in addition

based on their status. Then, given

image patients have of a dental office.

to the ones related to retaining patients, can

different options available, we pick the

I also keep stress-creating appliances

be used to complement and support each

most appropriate, having consulted

such as syringes, forceps, scalpels,

other.

the patient about the timing, costs,

and so on all hidden from view in order

morbidities, or anything along the lines

to minimise patients’ stress. Overall, I

By way of example, holding a congress

associated with the treatment plans.

make every potential effort to improve

lecture presents me with networking

So: Benefit your patients, build your

the patient experience in my office.

opportunities and more to the point, any

practice.

So: Create a lively environment, give

photos and videos taken on-site can be used as content to add value to my social media

your patients a positive experience.

•

I love my patients. We all want to provide our patients with a treatment

CONCLUSION

that, in the end, they are happy with.

Marketing strategies, branding, and policies

Apart from that, continuous learning

For that to happen, we need to know

to retain patients produce the most desired

means we can present our new skills with

our patients and their expectations. We

result when combined. It is true that

the result that patients who seek these

are more than just a treatment provider

bringing patients to the office is important,

particular services come to us, allowing us

for our patients. In fact, they want

but so is our reputation as well as retaining

to incorporate them into our daily practice.

us to listen to them carefully before

patients in our circle of clients.

This is an efficient improvement in our

beginning any treatment.

platforms.

expertise and the services we provide.

One strategic recommendation is always to We also ought to reduce the unpleasant

RETAINING PATIENTS

set aside a portion of your time and budget

side of the experience patients often go

for marketing, bringing added value while

So far, I have talked about ways to reach

through during their dental treatment.

helping your business to grow continuously

patients. However, when patients set foot in

I try to minimise my patients' pain

and letting your patients receive better

our office, our job is just beginning and we

throughout, starting with a gentle and

services. DA

have to show them they have come to the

smooth anaesthetic injection.

right place.

So: Develop an emotional bond, know

This article was originally published on the

your patients and their expectations.

ITI website: www.iti.org

In addition to being an expert in our job, we are expected to create a cool and calm

•

I explain 'Whys' to my patients.

environment for our patients, both physically

Patients tend to trust us more when

and psychologically. In my own practice, I

they know the reasons why we are

follow a number of principles:

carrying out a particular treatment.

Dr Pedram Pakzad

Sometimes, I might even show them

is a dentist and

the rationale behind the chosen

an international

treatment, using textbooks and papers.

speaker in the field of

I also warn them about the possible

implant dentistry. He

discomforts they may experience. When

Fig. 1: “Acquiring” skills can be boosted by “Presenting” them to be put into practice (“Doing”).

In a cycle, we feel the need to enhance what we do by learning more (“Acquiring”) as the cycle is set to continue.

About the Author

predominantly works

informed in advance, patients realize

on short implants, dental implants

that this is a part of the procedure.

biomechanics, and computer-assisted

However, if not warned, patients are

surgery for placing dental implants.

likely to feel uneasy, leading to a

Currently, he is working as a dentist in his

possible loss of some of their trust.

private office, is a board member of the

So: Clarify 'whys', build trust.

Iran Dental Association and he is both an ITI Speaker and ITI Fellow.

•

I keep the office environment

http://ppakzad.com/#ABOUT

pleasingly cool, calm, and relaxing.

JANUARY / FEBRUARY 2021 DENTAL ASIA

19

Under the Spotlight

Redefining the standards of dental care in the digital era

E

Dr Enrica Sham, Orthodontist and Clinical Director of TLC Dental Centre

ight years ago, Dr Enrica Sham,

ahead and committed themselves fully to the

She expounded, “It touches my heart

orthodontist and clinical director

process.

witnessing my patients in different phases of

of TLC Dental Centre, took a leap

their lives. Some of my younger patients are

of faith and left her post at the

Dr Sham, shared, “As life and business

now grown-up and still coming back to the

government hospital to start her

partners, we find ways to support each

clinic for their reviews.”

own practice.

other. He mainly handles the business operations while I take charge of the

As their practice grew, the TLC Dental

With her passion for orthodontics and to

household. We share similar visions in

Centre’s family got bigger as well.

help her patients achieve their best smile

running the practice and in our free time, we

possible, Dr Sham braved her way through

discuss clinic issues.

the challenges of setting up a practice, going

“Our team members are young and dynamic, each of them has different personalities,

digital, and equipping herself with the latest

It is also nice that we are doing different

strengths, and desires. I try my best to

practice techniques.

but complementary disciplines. I restrict my

understand them as an individual, spend time

practice to orthodontics while my husband is

to talk to them individually, and care for them

Today, she and her husband run a dental

a general dentist so we are able to offer our

like family.

clinic committed to providing nothing short

patients more holistic treatment options.”

of excellent dental service… delivered with tender, loving care.

HUMBLE BEGINNINGS

We try to find a role suitable for each person In less than a year, the clinic operations

to allow them to display their strength.

picked up – by placing their focus on what is

It is important to let our team members

best for their patients.

understand our treatment philosophy, and

The freedom to equip their clinics with the

provide them with the necessary training in

latest dental materials and technology

“Treating all our patients with TLC is our

terms of dental assisting, product, and service

fuelled Dr Sham and her husband, Dr Kevin

treatment philosophy. We spend time

training,” shared Dr Sham.

Co, to start their practice – The TLC Dental

understanding and acknowledging their

Centre.

fears and concerns, before recommending

THE RIGHT PARTNERSHIP

possible treatment options for them.

To Dr Sham, orthodontics is the perfect

However, this decision is not a walk in a park.

combination of art and science.

Treating each person who walks through

Apart from the initial start-up costs of setting

our door with respect and genuine care is

She said, “This is a discipline that

up a new clinic, they also had to consider

something my team and I strive to do every

requires appreciation of beauty, and using

the fact that they will be having a common

day,” explained Dr Sham.

mathematics and physics concepts to create

source of income, which might be an issue as they were expecting a second child.

the perfect smile for each patient.”

Dr Sham also takes pride that she and her patients go beyond the usual doctor-patient

20

Dr Sham has always been a meticulous person

But with their patient’s best interest at heart

relationship as they become like friends and

and finds the need for quick thinking and

and faith in their partnership, they pushed

family to her.

problem-solving skills in her field exciting.

DENTAL ASIA JANUARY / FEBRUARY 2021

Under the Spotlight

It was no surprise that she signed up for

When asked why she chose to partner with

mandibular modification features. They

the first edition of “Future Elite Programme”

Align, she answered, “I will only recommend

introduced Invisalign First clear aligners

from Align to better herself in terms of clear

something to my patients after studying the

targeting interceptive treatment for young

aligner therapy.

product and understand its strength and

children as well.

weakness. Invisalign is one aligner brand The “Future Elite Programme” introduces

that stands out from the rest because of its

Most recently, they announced G8 with

orthodontists to technology with focus

long track record and dedication to R&D.”

SmartForce Aligner Activation, so the

on planning and developing strategies for

innovation continues.”

the treatment of various kind of complex

She admitted that like many others, she

orthodontic cases.

was sceptical about the product in the

CULTIVATING THE DIGITAL CULTURE

beginning.

Running a dental clinic with the latest

The programme ran for a year with an

technologies has always been Dr Sham’s

Invisalign treatment expert orthodontist

But, seeing the end results of complex

who flew into Singapore to conduct the

Invisalign treatment cases gave her the

course. The course consists of lectures,

confidence to try it herself.

clinical sharing by the presenter as well as case discussion among participants.

vision.

She shared, “I started my practice in 2013 with electronic patient records, CBCT,

She explained, “Over the years of practicing

intraoral camera, and soft tissue laser right

Invisalign treatment, I have gained valuable

away. Soon enough, I upgraded to digital

In fact, their course instructor, Dr Tony Weir

experience and am now able to treat a

workflow. I acquired scanners and set up my

from Australia, gave Dr Sham a different,

variety of complex orthodontic cases

own digital CADCAM lab.”

fresher perspective.

confidently just like braces.

“He opened my mind to how aligner

Invisalign clear aligners in the initial years

invested in the CEREC system for improved

orthodontics is fast becoming a treatment

are often seen as an orthodontic tool for

efficiency and accuracy of crown and bridge

modality in mainstream orthodontics and

treatment of only mild to moderate cases.

work.

In terms of restorative dentistry, they

how I must embrace it in my practice.

However, Invisalign technology has

They also acquired iTero scanner to fully

Digital orthodontics is not far future

improved tremendously over the past six

transform Dr Sham’s orthodontic practice

anymore, the future is now and we need

years with the new SmartTrack material,

into digital.

to do it today so that we are ready for the

followed by G5, G6, G7 solutions for

future.”

deep bite and extraction cases, and then

However, to optimise all these technologies,

JANUARY / FEBRUARY 2021 DENTAL ASIA

21

Under the Spotlight

further training is required not just for Dr

With all the information collected, the

Dr Sham has proven the worth of her

Sham but their entire team too.

consultants recommended a list of key

decision of investing on the latest

interventions for us to work on.”

technology.

first start out using digital technology in my

However, before these interventions, they

She shared, “When COVID-19 hit the world

orthodontic practice is changing my team’s

had a discussion with their team members

unexpectedly, we saw a sudden drop in the

mindset.

to engage them in the process and ensure

number of patients in the clinic as everyone

that they are on board.

is scared, given that one of the modes of

She shared, “The biggest challenge when we

My orthodontic team members are comfortable and confident performing

The action plan includes optimisation of

traditional procedures. Asking them to learn

the digital workflow, assigning individual

a new product/skill takes extra effort for

staff specific role in the workflow, providing

them, hence, they feel that it is extra work and refuse to change.”

Dr Sham also admitted that they experienced a lot of inertia in going digital and there was no clear digital workflow.

However, Dr Sham had the privilege to pilot the new product of Align called ADAPT programme.

She explained, “I was very privileged to be selected as one of the only two dental clinics in Asia (the other being a medium-sized practice in Japan) for this project.

ADAPT stands for Align Digital and Practice Transformation, it is a holistic, highly personalised consulting service built on Align’s industry expertise, using data analysis and workflow observation to develop strategies that will help to transform our practice.

The ADAPT team’s business consultants came to the clinic to observe our workflow and interaction with patients, interviewed all

them with the necessary sales and product training, and various internal and external marketing efforts.

“Digital transformation is as much about culture change as it is about technology,” noted Dr Sham.

She continued, “Before we went through the ADAPT programme, our digital tools were something that we use to facilitate our treatment records when necessary.

We are simply using digital tools but our team is stuck in an analogue culture.

After the digital transformation, our digital tools have now become an integral part of our workflow, from records taking, to treatment plan presentation, and patient treatment progress monitoring.”

In fact, after finishing their six-month programme, they have seen continuous and tremendous growth in the practice leading Dr Sham to achieve a Platinum Elite status from Align.

Subsequently, Singapore has gone through a two-month period of circuit breaker and dental clinics are only allowed to perform emergency dental procedures, and orthodontic treatment has to be deferred during this period of time.

Thankfully, I have been monitoring my Invisalign treatment patients remotely using Dental Monitoring since late 2019.”

Dental Monitoring is an AI-based patient remote monitoring system providing detailed analysis of teeth movement and aligner fit. Practitioners can also use this to track patient’s oral hygiene.

“During the period of clinic closure, my patients continue to perform video scan of their teeth and aligner using the Dental Monitoring app on their phones. This allowed me to monitor their progress and to communicate instructions without the patient coming to my clinic.

Having all their dental records in digital form also made it easy to send digital scans of teeth for retainer fabrication when patients lost their set,” she added.

our staff and some patients who are willing

She shared, “Considering that we are a

to give their feedback to find out more about

small dental practice and I’m the only

Dr Sham noted that all of this will not

our clinic operations.

person practising orthodontics working a

be possible if they did not adopt digital

four-day work week, I’m really proud of this

dentistry early.

They scrutinised every detail, including chair

achievement.”

In five to 10 years, she hopes to see TLC

time by procedure, individual staff ’s job

22

transmission is through aerosols.

scope, financial reports, billing systems and

FUTURE PROOFING THE PRACTICE

Dental Centre grow from a small dental

instalment plans as well as evaluated our

With the ever-changing demands of the field

practice to a medium-sized service oriented

marketing strategy.

coupled with the pandemic situation,

dental centre.

DENTAL ASIA JANUARY / FEBRUARY 2021

Under the Spotlight

NOWHERE TO GO BUT UP

local and international dental conferences

why she is so passionate about encouraging

Although Dr Sham relies on technology to

is still what Dr Sham considers her greatest

practitioners to do so too.

make her practice as efficient as possible,

achievement in her career.

she acknowledges that human touch is still irreplaceable.

She said, “Making real human interaction with our patients, making them feel welcome, calming their fears, all these can’t be achieved by technology.”

In fact, she strongly believes that while having good dexterity and clinical skills are paramount for a dentist or orthodontist, having a listening ear is what she considers the most important trait.

Thanks to her mother who is a nurse, Dr Sham understood at a young age what it’s like to be empathetic towards patients.

Dr Sham emphasised that transforming She shared that if she’s not a dentist,

a practice is not a one person’s job. With

she could imagine herself as a piano or

the right resources and support as well

mathematics teacher, two of her other passions in life, as she finds fulfilment in sharing her knowledge and passing on her skills.

Dr Sham gets her daily inspiration to better herself from her two kids.

“I love my job and transforming my patients’ life by giving them their ideal smile.

However, what is life if it is just about work?

In my list of priorities, my family comes first.

I also want to invest in my own health.

as discipline to go through the process, nothing is impossible.

She said, “I’m sure most of us know the benefits of digital practice but don’t really see the need for change in our current system, or are worried about the financial burden that comes with acquiring new equipment and the difficulty in learning new techniques.

I was there once. However, our patients’ mindset is changing. They are more educated and many are aware of these new technologies and are asking for these

She advised, “Listen to your patients,

Therefore, I work a four-day work week, so

understand their needs and fears. Don’t just

that I have three days to spend quality time

listen to the words that come out from their

with my children and family, as well as to

With the changes in the world, there is no

mouth, listen to their heart.”

enjoy my other hobbies,” she shared.

better time to transform your practice than

And even with the success of her

Going digital allows Dr Sham to spend

me, take that first step and you will never

practice, teaching the new generation of

more time away from the clinic while still

look back. I wish everyone success in their

orthodontists and being invited to lecture in

keeping in touch with her patients. That’s

own digital transformation journey.” DA

services.

now. If I can do it, you can do it too. Trust

JANUARY / FEBRUARY 2021 DENTAL ASIA

23

Under the Spotlight

Virtual practice: The way forward

D

r Theo Baisi, one of the leading

In 2003, with the advent of Invisalign and

convenience of smartphones to connect

orthodontists in Sydney,

SureSmile, he began his digital journey.

patients and doctors to provide virtual

Australia, has always been

consultations.

fascinated with computers

“With these clear aligner technologies, we

and digital technology. After

were able to prescribe the exact positions

As Dr Baisi is a strong advocate for digital

practicing for over three decades, his

of the teeth, when and where we wanted

technology, he utilises this software as the

openness to adapt to the advances and

them to be. So, if nothing was broken and

algorithms are not only detailed but accurate

innovations has made his practice what it is

the aligners were fitting, we could see

too.

today: future ready.

our patients less and less. The six-week intervals became 12. The only problem was,

“I even receive weekly reports on how active

Like all orthodontists, Dr Baisi started

what would we do if something was going

the wire is. That means the patients could come

out using metal brackets, molar bands,

wrong,” he commented.

in sooner if needed or later. If you add this to

and looping arch-wires to the point of developing callouses on his fingers.

a system like SureSmile where you can have He said that if they had a way of monitoring

custom NiTi wires bent, clinicians eliminate the

their patients outside of the clinic, then

need for direct bonding and become even more

He shared, “Orthodontic practice in the

theoretically speaking, patients can visit

efficient,” he said.

1980s required excellent manual skills along

only when needed.

with knowledge and persistence to achieve

Now, even though he spends a lot more of

optimal outcomes. Like a stonemason,

And that’s how Dental Monitoring became a

his time in front of a computer, the clinical

orthodontics was a craft, as well as a

relevant tool to his practice today.

outcomes of his treatment are better than ever

scientific pursuit.

before.

STAYING ONE STEP AHEAD

24

But recently, orthodontics essentially

Dental Monitoring (DM) is an AI-powered

He added, “This also significantly reduced the

became a reactive treatment process. We do

software which allows dental professionals

stress on the staff, especially now that we also

something to patient’s teeth, see what has

to follow and assess patients’ treatment

do remote and virtual appointments for routine

happened after four to six weeks, then do

remotely. Through DM’s SmileMate,

aligners, as well as phase 1 expansion and for

something else, until we are happy.”

advanced AI is combined with the

observation and retention patients.”

DENTAL ASIA JANUARY / FEBRUARY 2021

Under the Spotlight

Dental Monitoring made it possible to free up unnecessary appointments, hence, increasing their overall practice efficiency.

WALKING THE TALK Most of the time, technological advancements AD_VIP_PA_001_01_pr_H_AS_en

are designed for practitioners to provide better care. But what is it like to be on the receiving end?

Dr Baisi and his team also wondered the same thing. But to their surprise, the patients were eager to be on board.

He admitted, “At first, we thought that patients would think that they were not wanted in the clinic and therefore, why should they pay us

“I have been treating a patient in

side of things and unbiased orthodontic

money.

Queensland with missing lower teeth. He

clinical and scientific research.

required extraction of deciduous teeth and What has transpired, however, is that they

over 12mm of extraction space to close with

The 12 years it takes to specialise,

are embracing the digital interaction with the

aligners. Although the treatment has taken

combined with the cost, may outweigh

practice. They are confident that they can reach

over 18 months, I have only physically seen

the ability to maintain an income from

out to us with less interference in their own

him twice after we started but have been

orthodontics alone and require combining

lives.”

able to direct the removal of the deciduous

this with general dentistry,” he explained.

teeth and follow through. Just recently, he During the lockdown, they had nearly 500 active

was able to have a scan done which was

DM patients and they were already in a great

forwarded to me to work on,” he said.

position to monitor and reassure them that they are well-taken care of. Patients were using the

FUTURE AND BEYOND

SmileMate to communicate and stay in touch

Dr Baisi himself is astonished by how

with them.

orthodontics has progressed over the years.

And, with Dental Monitoring, the possibilities

In fact, Dr Baisi noted that the pandemic

are endless.

situation has caused a drastic change in how they operate.

However, when asked about his thoughts on the future of the profession, he honestly

He said, “If we now combine the fact that we are

shared his reservations.

65% aligners and we remote monitor as much as we can, the 100+ patients per day have reduced

“I am somewhat worried that the digital and

nearly 40%, and staff has reduced nearly 30%.

AI advances we are seeing today, which have been amazing, are seen as a substitute for

But for dental professionals who are interested in incorporating Dental Monitoring to their practice, Dr Baisi’s advice is: commit to the process.

“It is not like asking the representative for a special introductory deal and then going back to the team and saying, ‘Look what I’ve just signed up for!’

First, you need to decide as a team what do you want to achieve by using DM’s Virtual Practice and then design the systems around this to make it work.

Numbers of appointments per patient are

our specialist knowledge and patients are

Decide to commit the next 10 or 20 patients

reducing, only anecdotal at this stage, but at

suffering for it.

to the process to work out the system and communication then evaluate,” he advised.

least 10% fewer appointments per patient across the board.”

In addition, Dental Monitoring had been

But I am hopeful that this will change in the mid-term as overall knowledge increases

Dr Baisi strongly believe that a well-planned

throughout.

digital workflow is the key to success. He is certain that going digital is the way forward

particularly useful for a patient staying in a different state.

Long term, I am concerned for the academic

and there is no turning back. DA

JANUARY / FEBRUARY 2021 DENTAL ASIA

25

Dental Profile

Dentsply Sirona paves the way for the future of digital dentistry

D

ue to the inevitable economic

employees and customers is the secret to

downturn brought about by the

Dentsply Sirona’s success in handling the

pandemic, it is unsurprising

challenges of COVID-19.

to hear disheartening stories about companies struggling to

stay afloat.

As the pioneer of digital dentistry, they maximised the potential of technology to ensure that their team members stay

Although COVID-19 has unarguably left

motivated with high morale especially during

a negative impact on most businesses,

the peak of the virus spread.

Dentsply Sirona, the pioneer in digital dentistry, has demonstrated resilience and

Mueller, shared, “We’ve utilised a variety of

emerged unscathed.

digital channels, including our intranet (DS

In fact, the company hasn’t stopped

Henning Mueller, Group Vice President Asia Pacific at Dentsply Sirona

Community), videos, town hall live stream

protocols to safeguard the well-being of

broadcasts to employees in all regions.

their team. They have enabled work-fromhome set up for employees who can perform

launching new products amid the crisis.

We have also hosted regular live chats

their job remotely and restricted all cross-

With their future-oriented vision, Henning

with the management team to encourage

border international travel and non-essential

Mueller, group vice president of Asia Pacific,

dialogue and address employees’ questions

domestic travel.

shared how the company is managing the

from nearly every corner of the world.

As for supporting their customers, Dentsply

challenges of the pandemic while continuing to deliver innovative solutions and support

We even have a vibrant series of podcasts

Sirona has rapidly shifted their programmes

dental professionals.

that also help keep us engaged and

from in-person to online learning.

connected.”

To their surprise, the market responded

DEFYING THE HISTORIC THREAT Prioritising the health and safety of their

26 DENTAL ASIA JANUARY / FEBRUARY 2021

More importantly, they implemented

positively. More than 800,000 dental

Dental Profile

professionals, including more than 712,000

He added that one of the many first

and numerous product presentations. The

dentists, attended clinical education course

highlights included a new online training

multiple possibilities for interaction gave

in the first half of the year 2020 and over

programme that was developed and

the “visitors” the feeling of being part of the

93 percent of those courses were offered

implemented in China when the COVID-19

event.

virtually.

outbreak began in January 2020; then the

“No one else in the industry comes close

first live online course took place just on 9th

Mueller, continued, “The Dentsply Sirona

February.

Dental Solutions Week in Korea in June, as well as the Total Solutions Week in

to the breadth and depth of our offering.

Dentists took advantage of the opportunity

In less than three weeks, 46 courses were

Singapore from October to November, were

to learn about routine dental procedures

set up, which were viewed by a six-digit

both special events for dental professionals.

including endodontics, restorative dentistry,

number of dental professionals.

We also equipped major hospitals and their

orthodontics, and implant dentistry,” shared At the beginning of April, a webinar series

dental departments with our products this

was launched in Australia.

year, for example in Korea and Thailand.”

socio-economic circumstances of the APAC

As part of that, Dentsply Sirona developed

The company accelerated these activities so

region, Dentsply Sirona had to curate special

the “Endo Hacks” together with Dr Omar

they can operate more efficiently and remain

strategies to accommodate the market

Ikram – a format for general information

the ideal partner to their customers.

demands.

about dentine preservation during root

Mueller.

However, with the unique geographic and

canal treatment. More than 1,700 dental

On top of it, Dentsply Sirona has successfully

“In the APAC region, we were hit with the

professionals from all over the world took

held the inaugural virtual edition of Dentsply

COVID-19 pandemic before anyone else in

part.

Sirona World.

the world.

In the middle of March, the Dentsply

And having dental professionals from 25

Numerous digital formats, such as online

Sirona Taiwan Team arranged a virtual

countries participate demonstrated the

training, digital congresses, and trade fairs,

trade fair. The two-day event included live

solidarity of the dental community to live up

as well as internal training and meetings,

broadcasts with interactive elements, a

to their responsibility of ensuring healthy

were set up,” noted Mueller.

webinar on aesthetic anterior restorations,

smiles for their patients.

JANUARY / FEBRUARY 2021 DENTAL ASIA

27

Dental Profile

He concluded, “Our customers know that we are there for them – as a partner, and through our employees, as someone they can turn to at any time with their thoughts, concerns, and questions.

Of course, our technical and customer service teams are always available and ready to help.”

PAVING WAY FOR DIGITAL DENTISTRY Mueller shared that the pandemic showed the world that digital dentistry is the way forward – not only for them as a company, but also within the dental practices.

“Digital processes are becoming even more important, especially regarding the highest hygiene demands. Our CEREC system can make an important contribution here, allowing for single-visit dentistry and

Mueller, shared, “Our engineers have

the system. With these components, the

therefore fewer contacts.

continued to research and develop

system becomes a setup for an entirely new

CEREC in close cooperation with Prof

chairside experience.

Thanks to versatile hygiene options, dentists

Dr Dr Moermann, other scientists, and

can count on optimal infection control at all

enthusiastic early adopters.

He added, “We are leading the way by developing complete end-to-end solutions

times,” he said.

Initially, we were focused on the fabrication

with cutting-edge digital technology in

CEREC’s market launch in 1985 marked the

of inlays and single crowns, but today, we

nearly all areas of dentistry. We believe the

beginning of digitalisation in dentistry and,

are talking about an enormous variety of

future is digital.”

like many innovations from Dentsply Sirona,

indications, including implant dentistry and

changed the profession fundamentally.

orthodontics.”

To date, CEREC has brought several

With CEREC Primescan, their state-of-

on developing new solutions along with their

important advances to dentistry that

the-art intraoral scanner, high accuracy in

passionate team members, they were still

are now considered standard. It set the

digital impressions can be achieved.

able to continue launching new products

CONTINUING INNOVATIONS Thanks to Dentsply Sirona’s long-term focus

despite the pandemic.

digital example and paved the way for the digitisation of dentistry in all specialties.

Additionally, with the latest CEREC software, artificial intelligence is utilised to support

Mueller, shared, “We have an extensive

With CEREC, Dentsply Sirona recognised

the production of restorations. It features a

pipeline that includes products such as

the importance of CAD/CAM technology for

high level of automation and intuitive touch

Astra Tech Implant EV, Surefil one, and

modern dental treatment and made it widely

functionality.

Palodent 360, just to name a few.”

available to the dental practice.

The software is also used to control CEREC

The product launches for the new flagship

The company has always demonstrated a

Primemill, their new grinding and milling

imaging unit Axeos, and new Xios AE sensor,

real pioneering spirit and truly persevered

unit that can produce restorations quickly

were all held virtually.

– in the 1980s, scepticism and reservations

and precisely.

With Axeos, Dentsply Sirona is introducing

prevailed, but by the 1990s, digital

28

technology became a hot commodity and

The CEREC SpeedFire, the sintering

a new and versatile 2D/3D top-of-the-line

began to be sought after.

furnace for chairside treatment, completes

dental X-ray solution.

DENTAL ASIA JANUARY / FEBRUARY 2021

Dental Profile

Axeos is designed to meet all the

Dentsply Sirona also sees great potential

that some aspects of it would be translated

requirements of modern imaging in dental

in materials that can be digitally processed

into their future events.

practices: clinical confidence, smart

and treated with regard to the longevity and

connectivity with integrated solutions and

compatibility for patients.

the benefits of hybrid events for the future.

treatment planning, and an exceptional user and patient experience.

Mueller, concluded, “We certainly believe in

From their point of view, the process chain is almost complete with regard to the devices;

That said, we’re all excited for the prospect

With its Field of View of up to Ø 17x13cm,

hence, they see further developments rather

of coming together in person in Las Vegas

Axeos covers a wide range of dental

than completely new developments.

in 2021 and we’ve learned a lot from the experience of organising DS World 2020 as

indications. It is ideal for different treatment areas, including specialised 3D imaging

“I mentioned our latest innovation in imaging,

a virtual event.”

needs such as digital orthodontics.

Axeos, which will facilitate practice expansion for our customers. It can be used for

EMERGING STRONGER THAN EVER

“We know from our users that they have

SureSmile services, our clear aligner solution,

With their innovative and creative approach

demonstrating excellent integration of our

in handling the COVID-19 situation, Dentsply

products,” he noted.

Sirona has further strengthened their

been waiting for such a device. They can use it to answer almost any clinical question.

Thanks to simple patient positioning and short X-ray times, the dentist receives the requested image quickly and reliably,” he explained.

The innovative X-ray unit embodies Dentsply Sirona’s claim to use technological progress to make the work of dentists and clinicians easier, faster, and above all, safer.

Outstanding image quality, connectivity, and ease of use ensure that users can offer their patients state-of-the-art dentistry for a healthy, beautiful smile.

GLIMPSE OF THE FUTURE In the post-pandemic (hopefully) era, the industry can expect nothing less from Dentsply Sirona. Expanding their research on the use of artificial intelligence (AI) is just one of the highlights they have in store.

Mueller, explained, “AI technology is already being used in Primescan in which intraoral impressions from different points in time can be compared and used in patient monitoring.

foothold in the industry.

With SureSmile, they are ramping up their manufacturing footprint to meet the expected

Mueller, said, “As individuals, our employees

demands.

are putting their heart and soul into supporting the practitioners. And, as a

Another aspect of innovation is the efficient

company, Dentsply Sirona is here for the

utilisation of the diagnostic capabilities of

dental profession.

their devices.

We demonstrate this through our wellFor instance, modern intraoral scanners such

thought-out product solutions as well as

as Primescan generate a lot of data. Dentsply

training programmes focused on infection

Sirona aims to make all these data usable for

prevention or practice management.”

even better diagnostics, therapy planning, and implementation.

He noted that while the company continues to be mindful of the global pandemic, he

He added, “Digital dentistry should create

believes that the dental industry has shown

real added value for the dentist as well as

amazing resilience.

their patients. This technology helps facilitate thoughtful communication with the patient by

When asked what is his message to dental

helping them to visualise the treatment and

professionals, he said, “We would like to

create realistic expectations. This allows them

assure you: What you do matters. You make

to decide in an informed and enlightened

a positive difference in the health of your

way leading to a more positive treatment

communities.

experience.”

Teeth don’t heal themselves so there is an Dentsply Sirona also sees growth potential for

inherent need for oral healthcare. Dentistry

implant dentistry and integrated workflows by

is an essential component of overall well-

bridging the gaps between implant dentistry,

being and health.

imaging, and CAD/CAM, as well as connected This can help determine a possible loss

software for smart procedures.

of hard tooth substance, changes to the

We will continue to work closely with you, our customers, to better understand

gingiva and tooth movements—research

Additionally, with the success of their virtual

your needs and ensure that our solutions,

continues here as well.”

events, the dental community can anticipate

training, and support are aligned.” DA

JANUARY / FEBRUARY 2021 DENTAL ASIA

29

Clinical Feature

The story of two centrals

By Dr Anand Narvekar

INTRODUCTION

As a treatment option, direct restoration with

The following clinical case highlights the

The proportion and symmetry of central

resin composites has the following benefits:

story of two maxillary central incisors where

incisors are paramount to facial beauty

•

Helps preserve natural tooth structure

one tooth was endodontically treated while

and individual characteristics of a smile.

•

Provides more control over the final

the other had Class III decay on mesial and

aesthetic outcomes

Hence, optimal restoration of central incisors (aesthetics and function) without compromising the natural tooth structure

•

More affordable compared with indirect restorations

remains a challenge in routine clinical practice.

When restoring maxillary central incisors, special attention should be given to the

distal surfaces.

A simplified restorative protocol was adopted to overcome the challenges and achieve the desired aesthetic outcome (Fig. 1).

In treatment planning, we, as clinicians,

key elements determining the success of

often make a crucial decision: choosing

final restoration: accurate shade match,

between direct and indirect restoration

anatomical form, establishing contact,

CASE DESCRIPTION

especially for an endodontically-treated

curvature of the smile line, and meeting

A 24-year-old female patient visited

maxillary central incisor.

patient’s expectations.

the clinic with a complaint of black

Fig. 2: Caries lesion on tooth 11 (mesial) and prominent caries lesion on tooth 21 extending to the palatal with loss of mesial contact

Fig. 1: Before and after

30

DENTAL ASIA JANUARY / FEBRUARY 2021

Fig. 3: Caries lesions on tooth 11 (mesial and distal) and tooth 21 (palatal view, mirror reflected)

Fig. 4: Illustration of the direct restoration plan and layering technique with Beautifil range of bioactive composites (Beautifil Injectable X, Beautifil II LS and Beautifil II Enamel)

Clinical Feature

discolouration on the upper front tooth with

TREATMENT PROCEDURE

Phase 2: Restoration of teeth 11 and 21

no signs of associated pain.

Phase 1: Root canal treatment on tooth 21

The patient was recalled after three days

Clinical examination revealed caries lesions on mesial and distal surface of tooth 11 and a prominent caries lesion on tooth 21, involving a larger palatal surface with loss of mesial contact area resulting in diastema (Figs. 2,3).

Tooth 21 tested negative to vitality test

Caries removal and access opening on tooth 21 was followed by cleaning and shaping of the canal. Calcium hydroxide paste was inserted until the apex to facilitate the healing of the periapical infection.

Fifteen days later, the patient was recalled for review on tooth 21 and the calcium

of tooth 11 and accomplish the final restoration of tooth 21.

Rubber dam isolation with floss knots were placed to obtain eective isolation and avoid contamination of gingival crevicular fluid.

Following through with the direct restoration

with no pain on percussion. Its periapical

hydroxide paste was removed. After

radiograph revealed a periapical lesion and

confirming that the canal is dry, obturation

using Beautifil range of bioactive composites

angulated radiographs showed a radiolucent

was done with lateral and vertical

(Beautifil Injectable X, Beautifil II LS and

lesion approximately 5mm by 5mm in size.

condensation to ensure a 3D seal.

Beautifil II Enamel) (Fig. 4).

Fig. 5: Complete caries removal from teeth 21 and 11 (palatal view, mirror reflected)

Fig. 8: Packable composite Beautifil II LS shade A2O was placed on the palatal side of tooth 21, leaving some space for final composite layer

Fig. 9: Maxillary labial view after placing body shades from the palatal Fig. 6: The 2mm-3mm bevel on teeth 11 and 21, for blending of the final composite restoration (palatal and labial view)

Fig. 7: Beautifil Injectable X shade A2O (opaque body shade) injected and shaped on palatal surface of tooth 21, a small quantity applied on the mesial cavity of tooth 11

32

to restore the mesial and distal cavities

DENTAL ASIA JANUARY / FEBRUARY 2021

Fig. 10: Bioclear Class III anterior mesial matrix was placed and Beautifil Injectable X shade A2 injected to form a cervical heap and secure the matrix

plan, layering technique was performed

Fig. 11: Beautifil Injectable X shade A2 and Beautifil II LS shade A2 packable composite were placed using the snowplough technique

Fig. 12: The mesial matrices were removed to place the final layer of Beautifil II Enamel shade LVT and shaped on the mesial surface of both teeth

Fig. 13: Bioclear anterior matrix was placed on the distal of tooth 11 and the shallow cavity was restored from the palatal side with a single shade of Beautifil Injectable X A2

Clinical Feature

RESTORATION PROCESS OF TEETH 11 AND 21

FL Bond II) was used for the adhesive

of tooth 21, a packable composite, Beautifil

procedure.

II LS shade A2O, was placed; leaving enough space for final composite layer when

After complete caries removal on mesial and distal surfaces of tooth 11, a 2mm-3mm

After priming and bonding, an injectable

restoring the contact area from the labial

bevel was created on the buccal and palatal

high-strength bioactive direct restorative,

aspect (Figs. 8,9).

side of tooth 11 and 21 using diamond

Beautifil Injectable X shade A2O (opaque

points.

body shade), was injected and shaped on

Restoration of tooth 11 consisted of two

the palatal surface of tooth 21 (Fig. 7).

cavities on mesial and distal surfaces. Small quantity of Beautifil Injectable X shade

This was done to achieve perfect blending of Tip: Selecting an opaque body shade for

A2O was injected on the deeper mesial

the palatal surface helps to block the light

cavity which required layering. The distal

Palatal aspect

transmission through the labial surface of

shallow cavity was restored with a single

The gutta-percha in the orifice of the

the tooth to add depth of colour. It also

shade using Beautifil Injectable X shade A2

endodontically-treated tooth 21 was

masks the discolouration caused by a non-

(Universal body shade).

smoothened and cleaned to ensure

vital root canal treated tooth that tends to

an optimal seal. Selective etching was

occur over time.

the final composite restorations (Figs. 5,6).

To restore the central incisors eďŹƒciently and

performed with 35% phosphoric acid, and the sixth-generation bonding system (Shofu

For the build-up of the palatal contact area

achieve an aesthetic diastema closure at the

Fig. 18: Maxillary buccal view of the final restoration

Fig. 14: The restorations after contouring with fine diamond bur and Super-Snap purple disk

Fig. 15: The restorations after pre-polishing and removal of surface scratches with OneGloss

Fig. 16: Direct Dia diamond polishing paste used with SuperSnap bu disk to achieve the final high-gloss with enamel-like lustre

Labial aspect

Fig. 19: Retracted maxillary palatal view (mirror reflected) showing natural aesthetics, contour, and contact

Fig. 17: Before treatment, after cavity preparation, and final restoration (reflected palatal views)

Fig. 20: Close-up showcasing the restored central incisors with natural aesthetics and surface lustre

JANUARY / FEBRUARY 2021 DENTAL ASIA

33

Clinical Feature

To achieve highly aesthetic restoration, it is crucial to understand the properties of materials used and the interplay of shades especially when using incremental layering technique.

Bioactive composites were used in this case for their additional advantage of minimising caries risk with no compromise on the aesthetics and function.

The new generation of injectable composites, Beautifil Injectable X, and low shrinkage packable composite, Beautifil II LS, packed using incremental layering technique with Bioclear matrices result to

Fig. 21: Creative angle of the final restorations

restorations with good contact, contour, and

same time, the Bioclear Class III anterior

shape the material where you need it; saving

mesial matrix was placed and Beautifil

chair time and increasing patient comfort.

Following a stringent finishing and polishing

Injectable X shade A2 was injected in the cervical area. Then, it was light-cured to

Finishing and polishing protocol

protocol is vital in achieving the enamel-

create the cervical heap and stabilise the

After removing the rubber dam, anatomical

like lustre and increases the longevity of

matrix (Fig. 10).

contouring and gross finishing was done with

restorations (Figs. 18-21). DA

Tip: Beautifil Injectable X is an ideal material to form a cervical heap, securing the matrix perfectly and facilitating easy placement of the composite materials.

After placing a wedge, Beautifil Injectable X shade A2 and Beautifil II LS shade A2 packable composite were placed inside the matrix using the snowplough technique (Fig. 11).

The mesial matrices were removed to place a final thin layer of Beautifil II Enamel shade LVT (Low Value Translucency) and shaped on the mesial surface of both teeth (Fig. 12).

After achieving the anatomical form and final light cure, the Bioclear anterior matrix was placed on the distal surface of tooth 11. The

a tapered fissure fine diamond (red band) and the Super-Snap purple disk (Fig. 14).

Surface texture and high points were checked with 40-micron articulating paper and smoothened with a Dura Green stone.

Pre-polishing and removal of surface scratches from the finishing process was achieved with OneGloss two-in-one impregnated silicone polisher (Fig. 15).

Super-polishing, Direct Dia diamond polishing paste with Super-Snap bu disk was used to achieve a high gloss and replicate the enamel-like lustre on the restorations (Fig. 16).

CONCLUSION

About the Author Dr Anand Narvekar, graduated in 1996 from Pune, India, has immersed himself in the field of dentistry with a special focus on aesthetic dentistry. His special interest lies in treating complex fullmouth rehabilitation and smile design cases. His keen eye for aesthetics extends beyond dentistry. He is a globally acclaimed photographer with his photographs published in industry-wide publications. He is a fellow, advocator, and trainer for MiCD (Minimally Invasive

The two central incisors restored in the

Cosmetic Dentistry) Global Academy,

above clinical case consisted of three cavities

a key opinion leader for a number of

that varied in size, shape, and depth: post

companies, and conducts workshops

endo build-up on tooth 21, deep Class III

for articulators, photography, and direct

Tip: The use of Beautifil Injectable X

mesial cavity and shallow distal cavity on

resin restorations.

composites helps to conveniently inject and

tooth 11 (Fig. 17).

distal shallow cavity was restored from the palatal side using a single shade of Beautifil Injectable X A2 (Fig. 13).

34

natural aesthetics.

DENTAL ASIA JANUARY / FEBRUARY 2021

Clinical Feature

Treatment of Class II Division I malocclusion with deep bite in mixed dentition requiring early interceptive orthodontic treatment of arch development and expansion

By Dr How Kim Chuan, Dr Kevin Ng and Dr Manjusri Lim CASE DESCRIPTION

•

Upper dental midline deviation to the right by 1mm and lower dental midline deviation to the right by 3mm

The male patient was 12 years old at the time of the first presentation and appeared to have delayed dental development. His

•

parents were concerned about his protruding upper incisors.

•

Class I permanent molar relationship on both sides OPG shown incipient developing crowding on 13, 23, 33, 43, 17, 18, 27, 28, 37, 38, 47, and 48

CLINICAL PRESENTATION The patient was presented with Class II Division I malocclusion in mid-mixed dentition, moderate deep bite with increased overjet. He appeared to have an increased height in the middle facial one-third, convex profile, and lips that are incompetent at rest. Gummy smile can also be seen along with a backward and downward jaw rotation with early signs of vertical maxillary excess. There was a deviation of the upper dental midline towards the right and procumbent lips due

•

Lateral cephalometric analysis showed retrognathic mandible with slight maxillary prognathism

•

Skeletal Class I tending to Class II relationship

•

Slightly high mandibular plane angle

•

LAFH% lesser than the ideal percentage; indicates a discrepancy in the facial proportion

•

Approximately 90 degrees interincisal angles, with acute nasolabial angle and shallow labiomental fold

to proclined incisors.

TREATMENT GOALS

CLINICAL FINDINGS •

Mixed dentition stage with Class II Division I incisor relationship

•

Late dental development as multiple deciduous teeth such as 53, 54, 55, 63, 64, 65, 73, 74, 75, and 85 are still present at his age

•

Control vertical maxillary growth by arch development

•

Reverse vertical maxillary excess and facial growth

•

Arch development and expansion to allow sufficient space for permanent dentition to erupt in an ideal position

•

Complete deep bite to palatal mucosa

•

Stimulate mandibular growth

•

Increased anterior overjet of 8mm

•

Reduce overbite

•

Bimaxillary proclination

•

Correct Class II incisor relationship

•

Gummy smile

•

Correct gummy smile

Fig. 1

Fig. 5

Fig. 2

Fig. 3

Fig. 6

Fig. 4

Fig. 7

JANUARY / FEBRUARY 2021 DENTAL ASIA

35

Clinical Feature

Fig. 8

Fig. 9

Fig. 10

Figs. 1-8: Intra and extra oral images before treatment Fig. 9: Panoramic radiograph before treatment Fig. 10: Cephalometric radiograph before treatment

Fig. 11

Fig. 12

Fig. 13

Fig. 14

Fig. 15

Figs. 11-15: Initial ClinCheck treatment plan

TREATMENT APPROACH

The aligner wear change at 14 days rationale is because tooth

The patient was recommended treatment with the Invisalign

exfoliation of permanent teeth and jaw growth is a slow but steady

System (clear aligner therapy) as it can align teeth and allow arch

process. The aligners are intended to provide a low but steady force

development and expansion for maxillary and mandibular growth to

to modify growth directions with a velocity consistent to the bodily

a greater extent than other orthodontic systems.

growth rate. His progress was reviewed at eight-week intervals.

Phase 1 – Pre-eruptive phase

Phase 2 – Eruption phase

The first phase of treatment involved vertical maxillary control. Both

We believe that low extrusive force is conducive to stimulate

upper and lower arches were expanded by 30% to gain space for

deciduous teeth exfoliation simultaneous to permanent spontaneous

permanent dentition eruption to prevent crowding. Intrusion on

tooth eruption. Low expansion force with root control stimulates

upper anterior was prescribed to reverse vertical maxillary excess

transverse growth. It broadens the arch form to create space for

and reduce gummy smile. Extrusion of 4mm on lower posterior

incipient crowding relief. During the active growth phase, this is

teeth would reduce deep overbite and facilitate the spontaneous

effective in avoiding extraction by stimulating facial growth. Hence,

eruption of permanent succedaneous dentition. Pontics were used

the second phase of treatment focused on further arch expansion

to replace missing teeth and to maintain space. Class 2 elastic was

and development to achieve an ideal A-P relationship and to gain

used to stimulate mandibular growth through soft tissue stretching

space for permanent canines to erupt in position. Mesialisation

of condylar. It also provides reciprocal anchorage to restrain forward

on the lower arch was done to achieve Class I molar and incisor

maxillary growth. Immediate correction of upper anterior overjet was

relationship and encourage mandibular growth. A further 20%

applied.

expansion was prescribed on both upper and lower arch. The space gained was utilised to fully reduce overjet. A total of 26 upper and

For skeletal and teeth relationship analysis, diagnostic orthodontic

lower active aligners were used. The patient was instructed to wear

photographic and radiographic records (panoramic radiograph,

the aligners and continue to wear Class II elastics. His progress was

lateral cephalogram and PA skull) were collected for the patient.

reviewed at eight-week intervals.

Polyvinyl siloxane (PVS) impressions were taken for the development

36

of the ClinCheck treatment plan. A total of 27 upper and lower

Phase 3 – Comprehensive phase

aligners were determined to be required for the initial treatment

The final phase of treatment aimed to further improve the occlusion

phase. The patient was instructed to wear the aligners for 22 hours

and smile arc. Intrusion on the upper arch by 3mm progressively was

daily, change it every 14 days, and to wear Class II elastics.

indicated as the patient did not like his gummy smile. The intrusion

DENTAL ASIA JANUARY / FEBRUARY 2021

Clinical Feature was approached from incisor to molars to facilitate lower jaw closure

teeth 17, 16, 27, 26, 37, 36, 47, and 46

to occlusion by auto-forward jaw rotation. Distalisation on the upper

•

Conventional rectangular vertical attachment on tooth 23

arch was done to achieve ideal Class I molar and incisor relationship.

•

Optimised root control attachments on teeth 15, 14, 25, 24,

was instructed to wear the aligners and his progress was reviewed at

•

Optimised rotation attachment on teeth 13, 43, and 45

eight-week intervals.

•

Optimised multiplane attachment on tooth 12

•

Optimised attachment on teeth 35, 34, and 44

A total of 27 upper and lower active aligners were used. The patient

22, 33

TREATMENT DETAILS Active treatment time

RETENTION

•

Phase 1: 11 months

Vivera retainers are currently worn by the patient for both the upper

•

Phase 2: 12 months

and lower dentitions. He has been instructed to use the retainers

•

Phase 3: 8 months

permanently at night.

Aligners used •

Phase 1: 27 upper and 27 lower aligners

TREATMENT OUTCOME

•

Phase 2: 26 upper and 26 lower aligners

After treatment, all permanent dentition has erupted in an ideal

•

Phase 3: 27 upper and 27 lower aligners

position and orthodontic treatment was completed without extractions of premolars. Through arch development and expansion,

ATTACHMENTS

permanent premolars and canines were allowed to erupt into a

Phase 1

maintained space. The bimaxillary proclination was subsequently

•

Conventional rectangular horizontal attachment (3mm) on

corrected and marked improvement in procumbent facial profile was

teeth 16, 26, 36, 46 and 54, and (4mm) on 55, 65, 75, and 85

seen. Lips are competent at rest. With arch expansion transversely

• •

Conventional rectangular vertical attachment (3mm) on tooth

on the upper arch and intrusion on the upper anterior teeth, vertical

63

maxillary growth was reversed and controlled. Vertical dimension

Optimised deep bite extrusion attachment on teeth 64 and 74

was increased by lower posterior extrusion. Jaw position has also improved by auto-jaw rotation (forward and upward). These

Phase 2

movement has allowed mandible to grow three-dimensionally,

•

Conventional rectangular horizontal attachment (4mm) on

promoting mandibular growth during the growth phase. This can

teeth 16, 15, 14, 24, 25, 26, 36, 35, 34, 45, and 46

be seen on the patient’s facial profile, where he has an equal frontal

Optimised rotation attachment on tooth 44

facial third with improvement on chin prominence during treatment.

•

Phase 3

A Class I incisor canine and molar relationship with maximum

•

intercuspation was achieved by mesialisation of the mandible and

Conventional rectangular horizontal attachments (4mm) on

Fig. 16

Fig. 20

Fig. 17

Fig. 18

Fig. 21

Fig. 19

Fig. 22

JANUARY / FEBRUARY 2021 DENTAL ASIA

37

Clinical Feature

Fig. 23

Fig. 24

Fig. 25

Figs. 16-23: Intra and extra oral images after treatment Fig. 24: Panoramic radiograph after treatment Fig. 25: Cephalometric radiograph after treatment

Fig. 26

Fig. 27

Fig. 28

Fig. 29

Fig. 30 Figs. 26-30: Final ClinCheck treatment plan

appearance and this is a growth precursor indicator of vertical maxillary excess (VME) and increased lower anterior face height •

VME would cause downward and backward jaw rotation, which most likely results in severe Class II with retrognathic mandible

•

Patient with VME tends to have narrow arch mandible, early detection could relieve crowding issues and avoid extraction to gain space

•

Arch development with expansion is ideal for a patient within the growing phase

Fig. 31

Fig. 32

•

Figs. 31-32: Ortho analysis (before and after)

distalisation of the maxilla. Deep bite and increased overjet were

crowns in mixed dentition •

tooth loss and achieve treatment goals

facial midline. A U-shape arch shape on both upper and lower •

Deep bite extrusive attachment and horizontal extrusive attachment were used on deciduous dentition to allow early

patient’s gummy smile. A nice smile arc with a posterior curve of

exfoliation

spee was achieved. He was happy with his current smile arc and the improvement of his gummy smile as well.

Although tooth movement on deciduous dentition may result in accelerated root resorption, it was necessary to allow early

resolved. The upper and lower dental midlines coincided with the arches was seen. There was a remarkable improvement in the

The use of the maximum number of horizontal and vertical attachments are able to improve retention on short clinical

•

Long horizontal attachments were used for extrusion movement on posteriors to increase vertical dimensions

CLINICAL TIPS •

38

Increased posterior alveolar height result in reverse smile arc

DENTAL ASIA JANUARY / FEBRUARY 2021

•

The use of Optimised Root Control Attachment on erupted premolars and canines ensure bodily tooth movement and root

Clinical Feature •

parallelism during space closure and alignment

system on the expected outcome (Table 1). Basically, the longer the

Facial aesthetics are a key concern for patients when they seek

hours the patient can wear daily, the better the results.

treatment for protrusive lips

IMPACT ON CLINICAL PRACTICE This case demonstrates that the Invisalign System is effective in complex orthodontic cases requiring early interceptive orthodontic.

The system allows arch expansion and development without the patient needing to wear additional removable appliances or undergo surgery. Simultaneously, the patient’s deciduous teeth are allowed to exfoliate naturally with the help of Invisalign extrusive attachments placed on them. The use of pontics to maintain space for the eruption of permanent dentition is also possible. Besides, this case provides evidence that with proper treatment planning, the Invisalign System can stimulate mandibular growth and allow auto-forward jaw rotation for the patient to achieve optimum growth within the

CONCLUSION This case involved treatment of Class II Division I with deep bite in mid-mixed dentition. The patient presented with procumbent facial profile, bimaxillary proclination, retrognathic mandible, increased middle facial one-third and a deviated upper dental midline. The treatment plan aimed to control vertical maxillary excess and stimulate mandibular growth in multiple planes. This case has demonstrated that through arch development and expansion, permanent dentition was allowed to erupt in an ideal position. The Class II malocclusion, deep bite, dental midline and gummy smile were corrected. Through this case, the Invisalign System demonstrates its ability to perform interceptive orthodontic treatment during mixed dentition. A nice

growing phase. It also provides evidence for the efficacious use

smile arc and facial profile were achieved without extractions – the

of Invisalign in correcting deep bite and midline shift. Face driven

treatment plan that the patient hoped for. DA

orthodontic philosophy should be a key focus of contemporary orthodontics, particularly in the case of correcting bimaxillary

About the Authors

protrusion and gummy smile.

Dr How Kim Chuan graduated from the

This case also proves that there is a misconception regarding

National University of Singapore in 1991. He

starting orthodontic treatment once all permanent teeth have

went on to specialise in orthodontics at the

erupted. In fact, it is best to start early to prevent severe

University of London Eastman Dental Institute

malocclusion happening in the future. A practitioner should be

and obtained his MSc in orthodontics in 1995.

able to identify the problems and foresee potential orthodontic issues when the patient is young, particularly between eight to 10 years old, and if possible, start interceptive orthodontic treatment immediately when the patient is still in the growing phase.

The case provides evidence for the use of the Invisalign System for patients who wish to undergo treatment with an “invisible” aligner system and reluctant to use a conventional fixed appliance system

He later obtained his MOrth RCS from the Royal College of Surgeons of England as well as Edinburgh in 1996. Dr How is currently the chief consultant at the Imperial Dental Specialist Centre. He is also a speaker for the Invisalign System and has conducted multiple certification courses and study clubs in South East Asia and India. Presently, he is also an examiner for MOrth RCS Edinburgh.

and removable appliances. We hope to increase the use of the

Dr Kevin Ng is a visiting professor at the

Invisalign System through demonstrating that good results can be

Ghongzhou Medical University and Hon.

obtained with shorter or comparable treatment time to conventional

Clinical professor at the University of Hong

fixed appliance system. We have developed an aligner changing

Kong (2017-2019). His post-graduate

protocol which enables patients to vary their aligner changing

qualifications include Membership of the

frequency based on the achievable wearing hours with a grading Grade

Wearing hours

Recommended wearing days

A

22 to 24

7

B

20 to 22

10

C

18 to 20

12

D

16 to 18

14

F

Less than 16

Bound to have off tracks

Table 1: Aligner changing protocol used by Imperial Dental Specialist Centre showing the recommended wearing days per aligner based on the patient’s wearing hours and the expected outcome

Faculty of Dental Surgery (MFDS) of The Royal College of Surgeons of Edinburgh. He runs a private practice in Hong Kong.

Dr Manjusri Lim obtained her Bachelor of Dental Surgery degree from the University of Adelaide, Australia. She has interest in clear aligner therapy and Dr How is one of her mentors in Orthodontics. Dr Lim is currently working in Singapore.

JANUARY / FEBRUARY 2021 DENTAL ASIA

39

Clinical Feature

Tooth whitening and sealing: An innovative concept for the retention of destaining results (Part A)

By Dr George Freedman, Dr Fay Goldstep, Dr Edward Lynch, and Dr Patrick Hardigan

This two-part article evaluates the eectiveness of One-step and Two-step Supersmile Whitening Bolt in terms of the retention of tooth whiteness and smoothness after application.

T

wo studies were undertaken to evaluate the retention

SUBJECTS

of tooth whiteness, both objective and subjective, and

Thirty healthy subjects (15 males and 15 females) were entered into

the perceived smoothness of the treated tooth surfaces

the study, in which all of them completed. There was no exclusion on

with a single application of an innovative product

the basis of baseline tooth colouration. Fifteen individuals from each

that incorporates both a tooth whitening gel and a

group were used in the analysis.

whitening sealant.

The average age for the placebo group was 53.8 (SD = 18.7), and

Another objective was to determine the perceived (subjective)

the treatment group was 57.7 (SD = 13.9). Females comprised 40%

retention of whiteness and smoothness over the course of the 24

of the placebo group and 60% of the treatment group.

hours following application as compared to matching placebos.

WHITENING AND SEALING PRODUCT ASSIGNMENT The first study was a two-day, parallel, blind, two cell clinical trial of

Individuals were assigned randomly to the test and control groups,

Two-step Supersmile Whitening Bolt (Fig. 1). The results of this trial

alternating with the order of entry into study. Individuals who were

are reported in Part A.

completing the clinical study concurrently were assigned to the same group.

Subsequently, One-step Supersmile Whitening Bolt (Fig. 2), an analogous, but more convenient product was developed by the

OBJECTIVE MEASUREMENT OF TOOTH COLOUR

manufacturer, Robell Research Inc. (New York, NY).

Tooth colour was measured both by objective and subjective measurements. For objective measurements, the tooth colour of

The scheduled introduction of the more user-friendly One-step

the eight anterior maxillary teeth was measured in a standardised

Supersmile Whitening Bolt design coincided with the COVID-19

manner.

pandemic; therefore, it was not possible to perform a similar clinical trial for the product.

Variability was eliminated with the Vita EasyShade Compact (Vident, Brea, California) intraoral dental spectrophotometer shade-matching

Instead, a laboratory evaluation (Precedent Research Inc., Fort

device1,2,3,4. It consists of a light source; a wand to direct the source

Wayne IN) of extrinsic stain inhibition comparing both the One-step and Two-step Supersmile Whitening Bolt formula to an untreated negative control was done. The results of this evaluation are reported in Part B.

OBJECTIVE The objective of this two-day parallel, blind, two cell clinical trial was to determine the retention of tooth whiteness, both objective and subjective, and the perceived smoothness of the treated tooth surfaces with a single application of Two-step Supersmile Whitening Bolt as compared to matching placebos.

Another objective was to determine the perceived (subjective) retention of whiteness and smoothness over the course of the 24 hours following product application as compared to matching placebos.

40 DENTAL ASIA JANUARY / FEBRUARY 2021

Fig. 1: Two-step Supersmile Whitening Bolt Fig. 2: One-step Supersmile Whitening Bolt Fig. 3: Vita Classic shades and corresponding scores

Clinical Feature sequence, to the eight maxillary anterior teeth.

4.

Then, the Post Application objective and subjective tooth colour

5.

And the subjective Post Application smoothness was determined.

6.

The subject was asked to consume chromogenic (tooth-staining)

shades were obtained,

foods and beverages for a period of up to 15 minutes, beginning no less than three minutes after Step 5.

7.

Then, the Post Staining objective and subjective tooth colour shades were obtained,

Fig. 4: Variable analogue scale (VAS)

light to an object and in turn receive the reflected light from the

8.

And the subjective Post Staining smoothness was determined.

9.

Within 24 hours, the investigators asked about the retention of tooth whiteness and smoothness after the application of Step 1

object; and a spectrometer to determine the received light intensity

and Step 2.

as a function of wavelength.

The EasyShade Compact’s CPU analyses the spectrophotometer data, determining a shade match to Vita Classic or 3D systems, and displays the results on a touch screen.

For each subject, the shades of the eight maxillary anterior teeth were each measured separately: in the middle third and at the

OBJECTIVE RESULTS The results of this study show that the single application of the Two-step Supersmile Whitening Bolt resulted in a very significant improvement of teeth colour over the control during the application step – a significant average of 2.2 shades as compared to the Placebo whitening the teeth 0.0 shades.

mesio-distal centre of the tooth. These measurements were taken at

The shade of each tooth was scored by reading the EasyShade Compact screen and recording the Vita Classic shade reference code. The Vita Classic shade reference code was assigned a score as indicated in Fig. 3. The overall change in shade per patient was then obtained by averaging the scores as previously described1,2.

Analysis of means (t-test) was employed to compare the mean Vita

Baseline

varying from dark to light with the mid-point (5.5) being average.

CLINICAL PROCEDURE 1.

After obtaining the Baseline objective and subjective tooth colour shades,

2.

The subjective Baseline smoothness was determined.

3.

The subjects were then provided with the Two-step Supersmile Whitening Bolt or the Placebo to use according to the manufacturer’s instructions. These instructions included the supervised application of the test and placebo materials, in

Post Appl. Post Stain

15

15

15

15

15

30

30

30

42.5

73.5

68.3

41.3

39.6

55.3

41.9

56.6

Median

48

49

80

74

38

35

55

41

51

SD

21.3

21.4

27.9

22.1

17.8

18.3

25.1

19.3

28.9

Min

10

9

25

31

19

21

10

9

21

Max

75

74

119

116

84

85

116

84

119

Table 4. Objective comparisons between and within groups with a Bonferroni adjustment Difference Placebo

Lower 95% CI Upper 95% CI

P-Value

Baseline

vs Post Application

-0.1

-4.2

3.9

0.998

Baseline

vs

Post Stain

-31.1

-35.2

-27.1

<.0001

Post Application

vs

Post Stain

-35.1

-26.9

-31.0 Difference

<.0001

Lower 95% CI Upper 95% CI

P-Value

Baseline

vs Post Application

26.9

22.9

31.0

<.0001

Baseline

vs

Post Stain

28.7

24.6

32.7

<.0001

Post Application

vs

Post Stain

1.7

-2.3

5.8

Difference

0.682

Lower 95% CI Upper 95% CI

P-Value

Baseline

Placebo

vs

Treatment

-25.9

-41.4

-10.3

Post-Application

Placebo

vs

Treatment

1.2

-14.3

16.7

0.880

Post Stain

Placebo

vs

Treatment

33.9

18.4

49.5

<0.001

0.002

80

Average Objective Score

and smoothness of their teeth on a Variable Analogue Scale (VAS)

Baseline

15

lightest; and “10” the roughest and “1” the smoothest) (Fig. 4).

The subjects were then allowed to rank the self-perceived colour

Overall

Post Appl. Post Stain

42.4

Treatment

printed 10 gradation shade guide (“10” the darkest, and “1” the

Baseline

N

staining.

For subjective measurements, the subjects were provided with a

Post Appl. Post Stain

Mean

EasyShade Compact scores at Baseline, Post application and Post

SUBJECTIVE MEASUREMENT OF TOOTH COLOUR AND SMOOTHNESS

Treatment

Placebo

the Baseline, Post Application, and the Post Staining stages.

60 Group Placebo

40

Treatment 20

0 Baseline

Post Application Time

Post Stain

Fig. 5: Objective Measure Descriptive Statistics After one application, the Two-step Supersmile Whitening Bolt test group shows a significant average of 2.2 shades of whitening, while the Control group exhibits 0.0 shades. After staining, the Two-step Supersmile Whitening Bolt test group shows a further, but negligible, continued average of 0.1 shades of whitening, while the control group exhibits a significant 2.6 shades of staining

JANUARY / FEBRUARY 2021 DENTAL ASIA

41

Clinical Feature

Table 7. Smoothness Measure Descriptive Statistics

Table 5. Color Measure Descriptive Statistics Treatment

Placebo Baseline

Post Appl. Post Stain

Baseline

Post Appl. Post Stain

Baseline

Treatment

Placebo

Overall

Post Appl. Post Stain

Baseline

Post Appl. Post Stain

Baseline

Overall Baseline

Post Appl. Post Stain

Post Appl. Post Stain

N

15

15

15

15

15

15

30

30

30

N

15

15

15

15

15

15

30

30

30

Mean

4.6

4.4

5.7

5.1

3.3

3.1

4.9

3.9

4.4

Mean

2.7

2.7

3.2

3.7

2.1

2.1

3.2

2.4

2.6

Median

5

6

5

3

3

5

4

4

Median

3

3

3

4

2

SD

1.2

1.2

1.4

1.2

1.1

1

1.3

1.3

1.8

SD

1.1

1.2

1.1

1.2

0.9

Min

2

2

3

3

2

2

2

2

2

Min

1

1

2

1

1

1

1

1

1

Max

7

6

8

8

6

5

8

6

8

Max

5

5

5

5

4

3

5

5

5

5

Placebo

Treatment

Lower 95% CI Upper 95% CI

vs Post Application

0.2

-0.0

0.4

0.255

Baseline

vs

Post Stain

-1.1

-1.4

-0.9

<.0001

Post Application

vs

Post Stain

-1.6

-1.1

<.0001

-1.3

Lower 95% CI Upper 95% CI

2

3

1.1

1.1

vs Post Application

1.8

1.6

2.0

<.0001

Baseline

vs

Post Stain

2.1

1.8

2.3

<.0001

Post Application

vs

Post Stain

0.3

0.0

0.5

0.093

Lower 95% CI Upper 95% CI

Lower 95% CI Upper 95% CI

P-Value

Baseline

vs Post Application

0.1

-0.2

0.4

0.904

Baseline

vs

Post Stain

-0.5

-0.8

-0.2

0.011

Post Application

vs

Post Stain

-0.8

-0.2

Placebo

-0.5 Difference

P-Value

Baseline

Difference

Difference

P-Value

Baseline

Difference

3 1.2

Table 7. Smoothness comparisons between and within groups with a Bonferroni adjustment

Table 6. Color comparisons between and within groups with Bonferroni adjustment Difference

2 0.8

Lower 95% CI Upper 95% CI

0.003 P-Value

Baseline

vs Post Application

1.5

1.2

1.8

<.0001

Baseline

vs

Post Stain

1.6

1.3

1.9

<.0001

Post Application

vs

Post Stain

0.1

-0.2

0.4

Treatment

Difference

P-Value

Lower 95% CI Upper 95% CI

0.904 P-Value

Baseline

Placebo

vs

Treatment

-0.5

-1.4

0.3

0.231

Baseline

Placebo

vs

Treatment

-0.9

-1.7

-0.2

0.022

Post-Application

Placebo

vs

Treatment

1.1

0.2

1.9

0.020

Post-Application

Placebo

vs

Treatment

0.5

-0.2

1.3

0.178

Post Stain

Placebo

vs

Treatment

2.7

1.8

3.5

<0.001

Post Stain

Placebo

vs

Treatment

1.1

0.4

1.9

0.006

10.0

Average Color Score

Average Smoothness Score

5 4 Group

3

Placebo 2

Treatment

1

7.5

Group Placebo

5.0

Treatment

2.5 0.0

0 Baseline

Post Application

Baseline

Post Stain

Post Stain

Time

Time

Fig. 6: Subjective Measure Descriptive Statistics - Colour The Two-step Supersmile Whitening Bolt group self-perceived a significant 1.8 steps whitening between Baseline and Post Application while the Placebo group self-perceived a change of 0.2 steps. Between Post Application and Post Staining, the Two-step Supersmile Whitening Bolt group self-perceived a further, but not significant, 0.2 step whitening, while the Placebo group self-perceived a significant change of 1.3 steps of tooth darkening.

Post Application

Fig. 7: Subjective Measure Descriptive Statistics - Smoothness The Two-step Supersmile Whitening Bolt group self-perceived a significant 1.5 step increase in smoothness between Baseline and Post Application while the Placebo group self-perceived a change of 0.1 steps. Between Post Application and Post Staining, the Two-step Supersmile Whitening Bolt group self-perceived a further, but not significant, 0.1 step smoothing, while the Placebo group self-perceived a non-significant change of 0.5 steps of tooth roughening

DISCUSSION Furthermore, the single application of Two-step Supersmile Whitening Bolt resulted in a very significant maintenance of teeth colour over the control during the staining step – the Two-step Whitening Bolt exhibited a further whitening of 0.15 shades (negligible) as compared to the teeth in the Placebo group darkening a significant average of 2.6 shades with the chromogenic diet.

SUBJECTIVE RESULTS Subjects were asked to self-score their tooth colouration and smoothness according to a 10-step VAS printed guide. While quite variable in results, these methods are extensively used in oral health clinical trials to gauge subjects’ self-perceptions (Figs. 6-7).

Subjects’ self-perceived colour improvement did not always correspond with the magnitude of the objective colour change. They tend to underestimate the baseline colouration, to interpret the application colouration changes well, and to recognise the staining effect.

The results of this clinical trial show that the retention of tooth whiteness, both objective and subjective, and the perceived smoothness of the treated tooth surfaces with a single application of Two-step Supersmile Whitening Bolt as compared to matching placebos were significant, as demonstrated by the data.

CONCLUSIONS 1.

42

100% of Two-step Supersmile Whitening Bolt subjects improved

Within 24 hours, the investigators asked about the retention of tooth

their tooth whiteness upon application with an average of 2.2

whiteness and smoothness after the application of Step 1 and Step 2

shades of whitening as assessed by a standardised intraoral

(Figs. 8-9).

dental spectrophotometer shade-matching device.

DENTAL ASIA JANUARY / FEBRUARY 2021

Clinical Feature

Table 1. Color duration 1 Placebo Treatment

2

11(73.3) 0(0.0)

4(26.7) 3(20.0)

3

4

5

6

7

8

0(0.0) 4(26.7)

0(0.0) 3(20.0)

0(0.0) 1(6.7)

0(0.0) 3(20.0)

0(0.0) 0(0.0)

0(0.0) 1(6.7)

About the Authors

Using a Fisher’s Exact test we found a difference between the placebo and treatment groups for color duration (p<0.01)

Dr George Freedman is a founder and

Fig. 8: Subjective Measure Descriptive Statistics – Colour within 24 hours The Two-step Supersmile Whitening Bolt group self-perceived a significant whitening for between 0-24 hours after Post Application while the Placebo group self-perceived a change of mostly 0 whitening and minimal whitening for up to two hours

past-president, AACD, co-founder, CAED and IADFE, Diplomate and Chair, American Board of Aesthetic Dentistry. He is adjunct professor of Dental Medicine, Western University, Pomona CA and professor and programme director, BPP University, London, UK, MClinDent

Table 2. Smoothness duration

Placebo Treatment

N

M

Med

SD

Min

Max

15 15

1.8 15.3

1 18

1.1 5.5

1 6

4 24

Using a Wilcoxon non-parametric test we found a difference between the placebo and treatment groups for color duration (p<0.001)

Fig. 9: Subjective Measure Descriptive Statistics – Smoothness within 24 hours The Two-step Supersmile Whitening Bolt group self-perceived a significant increase in tooth smoothness surface for up to 24 hours after Post Application while the Placebo group self-perceived a non-significant change of smoothness for up to four hours

2.

After staining, the Two-step Supersmile Whitening Bolt showed an average of 0.1 shades of whitening, while the control group exhibited 2.6 shades of staining, as assessed by an objective standardised intraoral dental spectrophotometer shadematching device.

3.

After using the Two-step Supersmile Whitening Bolt once, 80% of participants improved three or more shades as assessed by an objective standardised intraoral dental spectrophotometer shade-matching device.

4.

In an objective assessment by a standardised intraoral dental spectrophotometer shade-matching device, 100% of Twostep Supersmile Whitening Bolt subjects improved their tooth whiteness after one application.

5.

In an assessment of a subjective survey after using the Supersmile Whitening Bolt once, 80% of participants improved three or more shades.

6.

Supersmile Whitening Bolt subjects perceived significant improvement in their tooth whiteness and smoothness for up to 24 hours. DA

REFERENCES 1.

Freedman G, Nathoo S, Goldstep, F: Eliminating Dental Stains, Dental Tribune America June 25–July 1 2007 2:21 16–19

2.

Freedman G, Nathoo S, Goldstep, F: Eliminating Dental Stains with Whitening Chewing Gum, Cosmetic Tribune US Edition– January 2009 2:1 4–5

3.

Goldstep F, Freedman G, Nathoo S: Clinical Evaluation of a Self-Applied Tooth Whitening Activator. IADR Abstract 149 – Tampa FL March 2012

4.

Programme in Restorative and Cosmetic Dentistry. Author/ co-author of 14 textbooks and more than 900 dental articles, Dr Freedman practices in Richmond Hill, Ontario.

Dr Fay Goldstep lectures extensively on Proactive/Minimal Intervention Dentistry, Soft-Tissue Lasers and Bioactive Dental Materials. She has published more than a hundred articles and contributed chapters to four textbooks, serves on numerous editorial boards: Oral Health Journal, Dental Tribune US Edition, Dental Asia and REALITY, and has been a Leader in Continuing Education (Dentistry Today) since 2002.

Consultant to a number of dental companies, she practices in Richmond Hill, Ontario.

Professor Edward Lynch, peer-elected “Most Influential Person in UK Dentistry 2010”, is professor, Restorative Dentistry and Gerodontology, Queen’s University Belfast, and Consultant, Restorative Dentistry, Royal Hospitals. Author of more than 500 publications, he is a specialist in Endodontics, Prosthodontics and Restorative Dentistry. A “wet gloved” academic, Prof Lynch is an ADA Consultant, BDA spokesperson, and chairman, European Experts Group on Tooth Whitening.

His research team has received 10 IADR first prize honours.

Dr Patrick Hardigan is associate dean of Academic Affairs, Health Professions Division, and Executive Dean of Research, Dr Kiran C. Patel College of Allopathic Medicine. Dr Hardigan is statistician and research advisor, International Health Initiatives, and founder NSU’s Statistical Consulting Center.

Past-president, Association for Behavioral Sciences and Medical Education, he is statistical advisor, The Internet

Goldstep F, Freedman G, Nathoo S: Clinical Effect of Dentifrice/Activator

Journal of Allied Health Sciences and Practice and the

on Teeth Whiteness & Gingival Health. IADR Abstract 149 – Tampa FL

American Journal of Dentistry.

March 2012

JANUARY / FEBRUARY 2021 DENTAL ASIA

43

User Report

Preoperative digital planning

By Dr Florin Cofar and Dr Eric van Dooren

Digital planning and preparation provide a high level of reliability in implant-prosthetic procedures. Preliminary virtual simulation of the surgical intervention can provide confidence and certainty to carry out the actual surgery with peace of mind.

E

very workflow begins with an

information gathered, we obtain a “digital

Designing the prosthetic restoration forms

information gathering exercise.

clone”.

the first stage of the implant planning

If a digital workflow is followed,

sequence. In the present case, the shape

the information consists of data

These amalgamated data sets enable us to

that can be processed by the

plan all steps in a virtual treatment suite; as

software. Our prosthetics team employs

if we were working on a clone of the patient.

a photo-video protocol to examine the

Here is an example of an implant prosthetic

aesthetic-functional relationship between

single-tooth restoration.

the smile, dental situation, and face of the patient.

CREATING A DIGITAL CLONE The process begins by obtaining a high-

of the existing tooth should be maintained.

If an analogue workflow is followed, the premise for the implant is extraction of the tooth.

This scenario also forms the first step in the digital procedure described here, however, the tooth is “only” extracted virtually. We

In addition to conventional photographic

quality portrait photograph, a DVT, and an

documentation and video sequences, we

STL file (Figs. 1–3). In the case presented

use digital volume tomography (DVT) and

here, tooth 12 can no longer be preserved

future alveolar cavity (emergence profile)

intraoral scans in the assessment of implant

and needed to be replaced with an implant

and generate an optimised emergence

prosthetics cases. By merging all the

prosthetic restoration.

profile.

can extract the tooth digitally to design the

Fig. 1: Portrait image prior to the intervention

Fig. 2: DVT data set in the software programme

Fig. 3: Surface scan of the preoperative situation

Fig. 4: Virtual extraction of the tooth in need of treatment

44 DENTAL ASIA JANUARY / FEBRUARY 2021

User Report

Fig. 5: Designing the drill template

Fig. 6: Digitally designed alveolar cavity with scan body

Fig. 7: Printed drill template (Mguide, MIS)

Fig. 8: Immediate temporary restoration

reflects the position and proportions of the

For the next step, we simulate the surgical

designing the drill template (navigated

original tooth. A copy of the scanned file is

procedure on the screen. The implant is

implant insertion) and (2) fabricating a

again used as a working file on which the

inserted digitally and a template of the

temporary restoration or abutment prior to

virtual tooth extraction is performed.

procedure is exported.

files are used while the original data sets

This allows us to go back to the original

The conditions of the alveolar bone can be

remain untouched.

data and compare it with the working file.

assessed to determine the bone’s fitness

We define the ideal implant placement

for the planned procedure. If necessary, the

Several methods can be employed to

position and design the peri-implant soft

alveolar bone may be adjusted, for instance

perform the virtual tooth extraction. In

tissue contours on the screen to provide an

by planning a bone transplant. Alternatively,

our opinion, the most effective approach is

adequate emergence profile (Fig. 4).

a compromise may be made to opt for a

An alveolar model is required for (1)

the surgical intervention. Only copied data

cemented restoration or a change in the

using the “Provisional Pontic” CAD process and to design the alveolar cavity to have an

We then prepare a drill template for safe

optimum shape.

transfer of the implant position to the

design instead.

oral cavity. Even though most dentists are

We take all the major decisions at the virtual

Always work on two levels when executing

familiar with this procedure, we will briefly

implant insertion stage. The details can

this step: The working scan represents the

address the fundamentals.

then be transferred to the clinical situation by means of the drill template. The position

first level, and the original scan with the tooth represents the second level in this

Three data sets are required for preparing

of the implant is established with the help

scenario.

a drill template: (1) a scan showing the

of the wax-up (3mm to 4mm deeper).

digitally extracted tooth, (2) a data file of

The implant angle and position should be

IMPLANT PROSTHETIC PLANNING

the DVT, and (3) a scan showing the CAD

selected so that the available bone structure

The implant crown is designed (virtual wax-

design of the tooth being treated; in the

can be used to optimum effect, without

up). In the present case, the tooth being

present case, this means the original scan

deviating too much from the specifications

replaced serves as the template. The crown

with the existing tooth.

of the prosthetic restoration.

JANUARY / FEBRUARY 2021 DENTAL ASIA

45

User Report

In this case, the aim is to provide a screw-

3mm to 4mm. The optimum length of the Ti

SURGICAL PHASE

retained restoration. We are still using our

base is, therefore, 1.5mm.

All items required for the surgical intervention have been prepared and are

“digital clone” to plan these steps. Once the preparatory steps have been completed, the

The temporary restoration is placed on a Ti

drill template is printed (Fig. 5). In addition,

base with free rotation to prevent potential

the STL file of the implant model including

problems caused by the implant index

the optimised alveolar cavity design and digital scan body (Fig. 6) are prepared to design the temporary restoration.

DESIGNING THE TEMPORARY RESTORATION The virtual implant model (Fig. 6) is imported into the construction software to design the abutment or temporary restoration. The crown-abutment interface should be placed in an optimum position in

position.

now ready for use. This includes the printed drill template (Fig. 7) and the temporary implant restoration (Fig. 8). Tooth 12 is now extracted atraumatically in the “real world” (Fig. 9).

Whether a screw-retained or cemented restoration is chosen is at the discretion of the dentist. We tend to prefer screwretained restorations. However, the ultimate decision about which restoration to use can only be made at the point when the surgical intervention is planned.

Immediately, the fit of the drill template is checked in the oral cavity and the implant is inserted according to the drill protocol (Fig. 10). This is followed by the augmentative measures, which was planned in advance and finally, the temporary crown is screwed on (Figs. 11–12).

the previously prepared alveolar cavity.

Whether the prosthetic restoration is made

The Ti base has been defined at the time

at the discretion of the dentist. Hybrid

weeks, the temporary restoration is removed

when the implant depth was determined

restorations are normally preferred in

and the design is copied. This is the first

during the implant planning step. In the

aesthetically demanding situations and one-

time in the entire procedure that the actual

present case, the implant has a depth of

piece restorations in the posterior region.

scan body is used (Fig. 13).

Fig. 9: Atraumatic tooth extraction

Fig. 10: Implant insertion (NP implant, MIS) with drill template

Fig. 11: Drill template and implant after insertion

in one piece or as a hybrid crown is also

Fig. 12: Temporary restoration after the surgical intervention

46 DENTAL ASIA JANUARY / FEBRUARY 2021

PROSTHETIC RESTORATION After a healing phase of at least eight

Fig. 13: Clinical situation with scan body

User Report

Fig. 14: Implant prosthetic restoration

Fig. 15: Close-up of the final situation

of materials is available for the final

intervention on a “digital clone” and

restoration. We normally use hybrid

preparing any auxiliary and therapeutic

restorations for the restoration of single

devices ahead of the actual surgical

implants.

procedure. If this approach is used, suboptimal implant placement — both

Here, the restoration consists of a

prosthetically and surgically — can be

monolithic zirconium oxide abutment

detected and corrected in advance.

(Zenostar) and a monolithic multi-shaded all-ceramic crown (IPS e.max ZirCAD MT

In addition, necessary augmentative

Multi). The restoration is characterised with

measures are already evident at the planning

stains and completed without any shape

stage and can be prepared accordingly. This

modifications (Figs. 14–16).

way, “surprises” during the intervention on the patient can be avoided as far as

BEING PREPARED

possible. This brings a high level of reliability

Errors can be avoided by planning the

and certainty to the treatment process. DA

Fig. 16: Portrait image after completion of the restoration

About the Authors The scanned body assists in recording the position of the implant. This position corresponds to the originally planned position and also reflects the implant index position. This method ensures the accuracy of the restoration procedure.

Dr Florin Cofar received his degree in dentistry from the University of Victor Babes in Timisoara, Romania in 2007. He is active in aesthetic interdisciplinary dentistry and works closely with other respected dentists. Besides speaking internationally on dental aesthetics; digital dentistry; and smile design, Dr Cofar is also known for his dental videography work.

The transgingival areas have already been formed at the time of the temporary restoration. In the present case, the thickness of the gingival tissue should increase. For the final restoration, a Ti base of the same length for the temporary restoration is used.

Dr Eric van Dooren attended the Katholieke University in Leuven, Belgium, where he received his degree in dentistry in 1982. After graduation, he opened a private practice in Antwerp, Belgium, specialising in periodontics, fixed prosthodontics, and implants.

Currently, Dr van Dooren is a visiting professor at the University of Liege in Belgium and University of Marseille in Provence, southern France. He is an active member of the European Academy of Esthetic Dentistry (EAED).

This time, however, the base features an anti-rotation lock. A large selection

JANUARY / FEBRUARY 2021 DENTAL ASIA

47

User Report

The importance of magnification in implant dentistry

By Dr Marcelo Oliveira

conditions, the human eye can be deceptive

Implant dentistry requires specific motor

WHAT IS EYESTRAIN AND HOW CAN IT LIMIT YOUR PRACTICE?

skills with an intense and focused vision for

Eyestrain is a common condition that occurs

to clinical errors that could have been

several hours consecutively.

when your eyes get tired from intense use.

foreseen when using magnifying loupes.

However, the conditions and obstacles that

In the oral cavity, operating sites are usually

Struggling to see into the patient’s mouth

we usually encounter in the oral cavity can

small and poorly illuminated. Under these

with indirect vision can also cause:

HOW RELIABLE ARE YOUR EYES?

add a considerable burden to our vision and

when seeing fine important details leading

•

Sore neck, shoulders, or back from poor posture

limit our ability to perform at our best. This is one of the main reasons why loupes are

•

Burning or itching eyes

the standard of care in dentistry.

•

Blurred or double vision

•

Headaches

During the 30 years of my career as an oral

•

Increased sensitivity to light

surgeon, I have noticed that at times all I

•

Difficulty concentrating

needed was a little rest to fully recover my

•

Feeling that you cannot keep your eyes open

vision and restore my posture.

•

General increased fatigue

Over the years, that need for rest intervals became more frequent and longer. That’s

Eyestrain can be unpleasant and disruptive

when dental magnifying loupes helped me

to our ability to focus and perform at our

tremendously to become more efficient

best. The symptoms of eye strain may lead

in my daily routine. I improved both my

to physical fatigue, decreased productivity,

posture and vision, optimising my chair

increased numbers of work errors, and

time.

anxiety.

48 DENTAL ASIA JANUARY / FEBRUARY 2021

User Report

HOW TO MINIMISE RISK AND EXPOSURE?

THE MOST RELEVANT PRODUCTS IN IMPLANT DENTISTRY

shadows that may impede the field of view.

Increased magnification and improved

EyeZoom™ Variable magnification loupes:

With Orascoptic’s release of TruColor™, 90

illumination of the operating field have many

The first and only three-in-one variable

CRI (colour rendering index) illumination

benefits for the operator and directly reduces

magnification loupes, EyeZoom™ offers

is available for the first time across

eye fatigue.

magnification levels ranging from 3x-5x.

Orascoptic’s range of loupe-mounted

An enlarged view of the operating site using

Developed for dental professionals who

choosing the right restoration colour for

proper vision enhancement tools will make

need a lower magnification during surgery

the patient. With TruColor™, users instantly

your practice more precise, efficient, and

but quickly need to upgrade their view of

upgrade their vision with light that reveals

enjoyable.

the restorative procedure will never miss an

more accurate colour without diminishing

incorrect margin again.

brightness. DA

headlights and delivers more natural light

Direct light positioned in front of you into your operating field will maximise illumination

This patent-pending technology provides

while minimising reflective glare from the

edge-to-edge clarity and high-definition

mirror and reducing shade in your field of

resolution.

About the Author

view.

With an ideal symmetry between style and The ability to work with a high level of

performance, the lightweight magnesium

accuracy and improved control reduces

bezel leaves a lightweight feel and an

treatment time and operator fatigue.

aesthetically pleasing design.

Reducing the working time to execute implant

TruColor™: Having proper illumination

procedures results in increased patient case

during procedures and examinations is

acceptance and profitability for your practice.

crucial to ensuring that critical details are

DENTAL MAGNIFICATION AND ILLUMINATION: A BREAKDOWN OF

Dr Marcelo F Oliveira Director, Clinical Advisor North America

not overlooked by the naked eye. While

Source: Nobel Biocare blog; originally published

magnification may enhance the viewing

on the Orascoptic blog, 31 August 2020. Ref: ORA-

field; proper lighting will work to eliminate

MKG-0270). Photo Courtesy of Orascoptic.

JANUARY / FEBRUARY 2021 DENTAL ASIA

49

User Report

Smile makeover using minimally invasive multidisciplinary approach

By Dr Nadeem Younis ASSESSMENT

appliance to expand the arch followed by a conventional fixed

In this case, a female patient in her late 30s came to the practice to

appliance to align the anterior labial segment. The orthodontic

address her following concerns: moderate upper anterior crowding,

treatment took approximately 12 months (Figs. 2-3).

a discoloured upper left central incisor, and defective composite restorations in the upper central incisors (Fig. 1).

Once the anterior crowding had been remedied using conventional

Unhappy with the overall aesthetics of her smile, the patient was keen to undergo a smile makeover using a minimally invasive treatment approach.

To help ensure the patient make an informed decision, several treatment options were discussed including orthodontics, tooth whitening, composite resin restorations, and ceramic veneers.

After consultation, the patient chose the conservative option of composite restoration, following comprehensive orthodontics and tooth whitening.

fixed appliances, tooth whitening was carried out on the upper left incisor using the inside/outside technique to correct the internal discolouration.

For this, an Essix retainer was used with 16% carbide peroxide gel with instructions given to wear the tray at all times for three to five days while changing the whitening gel twice a day (Figs. 4-5).

After five days of whitening, the access cavity of the upper left central incisor was sealed. Then, the patient was instructed to wear the tray at night-time only while using whitening gel to whiten the rest of the upper arch (Figs. 6-7).

By opting for the less intrusive – and also more cost effective – process of alignment, bleaching, and bonding, all of the patient’s

When the satisfactory shade was obtained, there was a pause in

concerns were addressed safely and effectively.

treatment for three weeks prior to restoring the central incisors with direct composite resin restorations. This will allow the oxygen to

ALIGNMENT AND BLEACHING

dissipate from the teeth, which would otherwise have interfered with

The upper anterior crowding was resolved by using a removable

the bonding process.

Fig. 1: Patient’s pre-op occlusion

Fig. 4: Prep for inside/outside whitening

50 DENTAL ASIA JANUARY / FEBRUARY 2021

Fig. 2: Pre-op smile

Fig. 5: Essix retainer used for whitening

Fig. 3: Pre-op intraoral view

Fig. 6: Inside/outside whitening post-op

User Report

Fig. 7: Upper arch whitening post-op

Fig. 8: Preparation of upper central incisors for composite resins

Fig. 10: Polished composites upper centrals

Fig. 9: Composite build up

Fig. 11: Post treatment

Fig. 12: Final smile

RESTORATION

are now proportionate resulting in a more aesthetically pleasing

For the third phase of the treatment process, the aim was to improve

smile. As such, the patient is extremely delighted with the treatment

the shape of the central incisors as well as replace the defective

outcome, which she says has “exceeded her expectations” (Fig. 12).DA

Class III composite restorations.

About the Author

This was achieved with a single shade composite, which is both effective and convenient for restorations of this nature.

Dr Nadeem Younis qualified in 1993 from the In this instance, BRILLIANT EverGlow shade A1/B1 from COLTENE

University of Sheffield and has since been in

was chosen, as the universal composite works well as a single shade

general practice in Burnley, England. He also

composite and it doesn’t run or stick to instruments. Hence, it allows

works as a specialty doctor in orthodontics

for easy modelling of the composite resin.

at Burnley General Hospital. He has a special interest in aesthetic dentistry and orthodontics.

BRILLIANT EverGlow also features a Duo Shade system, which allows the composite to blend in well with the adjacent tooth structure

He has completed courses in orthodontics, restorative dentistry

making the restoration look virtually invisible (Figs. 8-10).

and cosmetic dentistry. His commitment to postgraduate education led to the award of the Diploma in General Dental Practice from

A white opaque tint from the MIRIS 2 range, also by COLTENE, was

the Royal College of Surgeons of England in 1996 and the Diploma

used to mask discolouration on the cervical area of the upper left

in Postgraduate Dental Studies from the University of Bristol in

central incisor.

2007. In 2016, he was awarded an MSc from Bristol University after completing a two-year research project.

Free hand incremental build up technique was utilised to restore the central incisors with direct composite resins. To finish, the

Dr Younis is the founder of the Northwest Dental Academy and has

restorations were polished using a fine diamond followed by alumina

been involved in research in Primary Dental Care being an active

impregnated silicone points and fine Sof Lex discs.

member of the East Lancashire Research and Development group.

He is currently the president of the British Academy of Aesthetic

REVIEW

Dentistry (BAAD).

As the BRILLIANT EverGlow polishes to a very high lustre and is incredibly durable thanks to its submicron particle filler particle size

He has lectured extensively and published articles on aesthetic

(Fig. 11), I am pleased with the result of the restoration.

dentistry and has been running hands-on courses for over 20 years for general dental practitioners.

As for the orthodontic aspect of the treatment, both central incisors

JANUARY / FEBRUARY 2021 DENTAL ASIA

51

Behind the Scenes

Manufacturing thermoformed clear aligners and retainers on 3D Printed Models with the Form 3B and new Draft Resin

P

By Dr Elisa Praderi roducing clear aligners and

1. SCAN

planning and design, contact the software

retainers is a valuable service

The orthodontic CAD software requires a

manufacturer.

that requires little initial

digital impression file to create clear aligner

investment from practices and

models. Capture the digital impression

2.1. Import

labs alike. Treatment planning

either directly, using an intraoral scanner

Import the scan data into the software.

for these appliances is done using CAD

(Fig. 1), or indirectly, using a desktop

software, then each sub-step of the

optical scanner to scan a polyvinyl siloxane

2.2. Build the model base

treatment is fabricated by a 3D printing

(PVS) impression or stone model. Unless

Depending on the quality of the data, the

model, and thermoforming over these

working inside a complete scan and CAD

scans may need to be trimmed slightly

models.

system, export the scan as an open STL

below the gingival margin. By doing so,

format file.

it can help minimise the model size and

Formlabs’ new Draft Resin is their fastest

reduce print time.

printing material, capable of printing a

2. DESIGN

dental model in under 20 minutes. This

After capturing the digital impression,

Next, build a horseshoe arch base for the

highly accurate resin prints with a smooth

import the scan files into orthodontic CAD

model. As clear aligners are usually cut

surface finish, making Draft Resin the

software and design teeth movement for

to the gingival margin of the patient’s

ideal material for aligner and retainer

the desired clinical outcome (Fig. 2). Make

dentition, it is recommended to extend the

production. The 200 micron setting can be

sure to select orthodontic CAD software

base below the lowest point on the gingival

used for fastest print speeds and same day

that offers open STL file export to ensure

margin by about 2mm.

appliances, or alternatively the 100 micron

compatibility with Formlabs PreForm

settings can be used for more detailed

software.

models.

52

Note: Keeping the height of the base close to minimum will help reduce print times and

The exact procedures in treatment planning

material use. Formlabs recommends keeping

This application guide details the clear

and design vary by software package, but

the base 2mm below the lowest gingival

aligner and retainer workflow using a Form

generally, follow the workflow described

margin. If a taller base is preferred, avoid

3B 3D printer, from start to finish.

below. For detailed advice on treatment

extending the base to more than 8mm-

Fig. 1: Capture digital impression (intraoral scanning)

Fig. 2: Import scan files into orthodontic CAD software and design teeth movement

Fig. 3: Design orthodontic treatment

Fig. 4: Chamfer the model base

Fig. 5: Emboss identification tags

Fig. 6: Hollow model feature

DENTAL ASIA JANUARY / FEBRUARY 2021

Behind the Scenes

Fig. 7: Set-up the printer

Fig. 10: Vertical printing

Fig. 8: Configure print settings

Fig. 11: Orient parts for printing without supports

Fig. 9: Horizontal printing

Fig. 12: Generate supports

Fig. 13: Ensure that there are no supports touching tooth surfaces or the gingiva

10mm from the gingival margin, to keep

These steps are optional and depend on the

is only available in certain orthodontic CAD

the total model height below 19mm. This

workflow and desired print orientation.

software. If hollowing a part, ensure that wall thickness is at least 2mm-3mm thick

will ensure that the larger model size does not stretch the thermoforming material to a

2.4.1. Chamfer the model base

(Fig. 6). Formlabs recommends printing solid

point of being too thin.

Chamfering the model base makes removing

models to reduce post-processing difficulty.

parts significantly easier. This can be done 2.3. Design orthodontic treatment

easily at the rear of the model with a plane

2.5. Export models

To design the orthodontic treatment, first

cut tool (Fig. 4).

Export models for each treatment step in STL or OBJ file format.

section the teeth in the software, separating individual teeth from the complete model

A chamfer angle of 30°-45° is

(Fig. 3). Then, move each tooth to the final

recommended, with a chamfer height of

3. PRINT

position. Subdivide the treatment plan into

2mm-3mm to allow space for a part removal

3.1. Import model files into PreForm

individual models with each stage moving

tool to be easily inserted.

Open PreForm and import the generated STL or OBJ file(s).

the patient’s teeth by slight amounts. The number of generated aligners depends on

2.4.2. Emboss identification tags on the

the complexity of the case.

model

3.2. Configure print settings

Embossing identifying information on

In the ‘Print Setup’ menu in PreForm,

Warning! Orthodontic treatment design

printed models can be significantly helpful

choose the printer to be used based on its

should be done by licensed orthodontists

for high-volume aligner production. A

name, a unique combination of two words

only. Orthodontic CAD software can simulate

treatment stage number, ID number, and/

(Fig. 8). Select “Model” or “Grey” from the

tooth movements that are not realistic or

or patient name can be embossed anywhere

Material menu, and 0.1mm for the layer

feasible.

below the gingival margin except on the

thickness.

base of the model (Fig. 5).

Note: An analysis on accuracy in printed

2.4. Model sculpting (optional) For each model from the treatment plan,

To ensure optimal printability, place the

orthodontic models showed that 0.05mm

sculpting can:

embossed information on the vertical wall of

print layer thicknesses yielded only marginal

the extended base.

differences in accuracy and precision, while

•

doubling the print time. Printing orthodontic

Improve printability

•

Streamline part removal

Note: Hollow vs Solid Models

•

Add workflow-specific features, such as

Hollowing the model can improve print time

recommended, to reduce print times while

identification tags

and reduce unit cost, although this feature

still ensuring clinically acceptable accuracy.

models at 0.1mm thicknesses is strongly

JANUARY / FEBRUARY 2021 DENTAL ASIA

53

Behind the Scenes 3.3a. Orient parts for printing without

significantly easier and more consistent, but

shaking and rotating it several times. Insert

supports

requires additional print time for the base and

a resin tank, the Dental Model or Grey Resin

Horizontal printing (Fig. 9): Faster print

support pillars.

cartridge, and a build platform into the printer.

Vertical printing (Fig. 10): Slower print

3.3b.1. Orient the models

Note: Using Standard Resin Tanks vs. Resin

times, more parts per build

Orient the model with the occlusion facing

Tank LT

up and away from the build platform.

For the highest accuracy and precision, Resin

Note: Formlabs recommends printing

Orienting models at a 15° angle or greater is

Tank LT is recommended for printing dental

horizontal models to maximise accuracy and

recommended. Lower angles improve print

models. Testing of Grey and Dental Model

precision, but many Formlabs users also

times. Higher angles allow for a higher density

on Resin Tank LT revealed no degradation of

have success vertically printing orthodontic

of models to be printed in the same build.

accuracy or precision over the tank’s lifetime.

times, fewer parts per build

models.

If using the standard resin tanks, laser 3.3b.2. Generate supports

exposure forms white, clouded marks on the

If printing parts directly on the build

Generate supports using PreForm’s auto-

surface of the resin tank’s silicone layer. This

platform, the models must have a flat

generation feature (Fig. 12), then inspect the

clouding eventually becomes extreme enough

surface. The slicing tool on the right-hand

model to ensure that there are no supports

to affect accuracy. To avoid fit issues due to

side can be used to double check correct

touching tooth surfaces or the gingiva (Fig.

tank clouding, switch to a new standard resin

snapping of the part to the platform.

13). For improved print consistency, a point

tank after 50 consecutive prints, or with every

size of 0.7mm for supports is recommended.

second cartridge of resin, whichever comes

To orient the base of the part directly to the

earlier.

build platform, select the base of the model

Remove any stray supports in Supports >

in Orientation > Select Face (Fig. 11).

Edit, or orient the model with a less steep

3.5. Print

angle.

Click the orange “Print” button in PreForm,

3.3b. Orient parts for printing with

54

then upload the job to the printer. Once the

supports

3.4. Prepare the printer and resin

print is uploaded, press the button on the

Printing with supports makes part removal

Thoroughly agitate the resin cartridge by

printer to start the print.

Fig. 14: Wash parts

Fig. 15: Remove parts

Fig. 16: Post-cure model

Fig. 17: Use a dental thermoformer machine on the printed model to form the clear aligner

Fig 18: Initial cut below the gingival margin

Fig. 19: Deburr edges

DENTAL ASIA JANUARY / FEBRUARY 2021

Behind the Scenes away from surfaces. Inspect parts closely to

6.2. Deburr

ensure all uncured resin has been removed.

Smooth edges and remove burrs by cutting

Repeat wash if necessary. If compressed air

closely along the margin using a rotary tool

sources are not available, simply leave the

with a carbide bur attachment (Fig. 19).

parts to air dry before inspection.

Thicker attachments can help to efficiently cut closer to the gingival margin.

4.4. Remove supports if needed

Fig. 20: Smoothen edges

Use the flush cutters included in the

6.3. Polish

Formlabs Finish Kit to carefully cut the

Use a polishing wheel to smoothen all edges

supports at the points where they attach

of the aligner (Fig. 20).

to the part. Use caution when cutting the supports, as the material may be brittle.

ACCURACY STUDY

Supports can also be removed using other

An in-depth accuracy study showed

4.1. Wash parts

specialised appliances, such as cutting disks

that the dentition of orthodontic models

Place the build platform, with the models

or round cutting instruments like carbide

printed on the Form 3B were dimensionally

still attached, in a Form Wash filled with

burs.

accurate within ±100 microns over 85%

4. PREPARE

isopropyl alcohol (IPA), 90% or higher

of surfaces, providing a precise clinical fit.

(Fig. 14). Alternatively, remove the models

4.5. Post-cure the models (optional)

This was found to be similar across both

from the build plate and place them in the

Expose dental models to light and heat for

Dental Model Resin and Grey Resin, both at

included basket for washing. Set Form

optimal mechanical properties, accuracy,

0.05mm and 0.1mm layer thicknesses. DA

Wash for 10 minutes to clean the parts and

and precision (Fig. 16). When using Form

remove excess resin from the models.

Cure, place the printed models inside Form Cure and post-cure for 30 minutes at 60 °C.

Warning! Hollow models printed directly on the build platform will trap liquid resin in the

5. THERMOFORM

hollow regions underneath the model. Hollow

From this step, the process is identical

models must be removed from the build

to the traditional workflow for creating

platform prior to rinsing.

clear aligners and retainers. Use a dental

About the Author Dr Elisa Praderi is a trained dentist who graduated from the Universidad Católica

thermoformer machine on the printed Note: Using the Standard Finish Kit

model to form the clear aligner, using the

Formlabs recommends using Form Wash for

recommended settings for the thermoformer

optimal resin removal and surface finish. If

and material being used (Fig. 17).

using the Finish Kit, remove parts first from the build platform with the part removal tool.

Warning! Depending on the aligner material

Rinse the parts in two buckets of isopropyl

being used, if the model base is too tall,

alcohol (IPA), 96% or higher for an initial

the resultant aligner walls will be too thin.

bath for 10 minutes, and a second bath for

Ensure that the models generated are

five minutes.

short enough for the recommendations provided by the manufacturer. Generally,

4.2. Remove parts

the recommendation is to keep model height

Next, remove parts from the build platform

below 19mm.

(Fig. 15). For chamfered models, insert the included putty knife into the chamfer with a

6. FINISH

firm force, then twist the knife gently from

6.1. Initial cut

side to side. Otherwise, grasp the base of

Make an initial cut below the gingival margin

a molar using the included pair of flush

using a rotary tool with a diamond disc

cutters, applying the same twisting motion.

attachment, then remove the aligner (Fig. 18). To prevent fusion of the aligner and

4.3. Air or blow-dry

the model, avoid using a hot knife when

Use a compressed air hose to blow IPA

removing the aligner from the model.

del Uruguay in 2017.

She conducted a research study in the area of aesthetic dentistry which she presented in the 96 th General Session and Exhibition of the International Association for Dental Research as a Unilever Hatton Award Competitor. She has worked at the University’s emergency service and in private dental practice for the last three years.

Dr Praderi has always been interested in dental materials, clinical workflows, and technology integration in the daily practice. These components were the triggers that made her pursue a professional career in 3D printing and join Formlabs in 2019 as the clinical protocols and KOL manager.

JANUARY / FEBRUARY 2021 DENTAL ASIA

55

In Depth With

Soaric: The exceptional gives the world its value

W

ith Soaric, Morita is

irrespective of whether child, adult, or

Synchronised backrest adjustment: The

now offering unique

person with restricted mobility.

new Soaric synchronised mechanism with the combined movement of backrest

possibilities that will provide users with

Super-sensitive height adjustment: The

and seat guarantees optimum sitting and

valuable support for

patented kinematics of the patient’s chair

lying comfort during patient positioning.

their everyday dental practice and future challenges.

The modern and timeless design of Soaric, evident right down to the finest detail, underlines competence and professionalism.

It creates an atmosphere of trust and safety with the treatment unit’s harmonious expression of form. After all, the more relaxed the patient, the more pleasant the treatment.

THE INTERPLAY OF TECHNOLOGY, ERGONOMICS, AND DESIGN The interplay of technology, ergonomics,

provide gentle, precision height adjustment.

Neither starting nor stopping is noticeable.

The patient is lying in a comfortable and relaxed position. Depending on requirements, users can choose between a high- or a low-speed mode.

Ergonomic headrest: Both the extension and the angle of the ergonomically-formed headrest can be adjusted easily at the push of a button. During this procedure, the kinematics track the patient’s natural neck movement and ensure that the head is resting in a safe position.

patient’s spine and prevents any stretching or compression in the back area.

EASY MOUNTING AND DISMOUNTING OF THE CHAIR Soaric is equipped with a foldaway foot section and armrest to make mounting and dismounting the chair easy. It is particularly suitable for older patients and those of limited mobility. It also allows for intensive patient consultation.

This model, with its comfortable Soaric synchro-mechanism, also supports the patient’s spine. With a seat height of only

and design places the patient at the centre

56

This provides anatomical support for the

of attention. Sophisticated kinematics and

Variable backrest height: The fully

380mm in its lowest position and a foot

highly varied range of adjustment options

extendable backrest guarantees an

section that can be folded away by 90°, this

enable users to adjust the patient’s chair

individual adjustment to all patient body

treatment unit offers patients the easiest

according to the body size of their patient,

sizes.

possible access. Nevertheless, operating

DENTAL ASIA JANUARY / FEBRUARY 2021

In Depth With

height adjustment is still possible up to

mode or with fourfold enlargement. If the

requirements of hygiene directives while

800mm, ensuring that users have optimum

treatment unit has been integrated into

making the process of treatment preparation

ergonomic working conditions.

the network, users can display the data

so much easier.

from their practice’s PCs on the Soaric

MINIMUM FOOTPRINT WITH MAXIMUM MOVEMENT AREA

monitor in so-called “PC mode”. The data

The flexibility of the operator’s and

the operator panel, the foot control, or a

Irrespective of what configuration the

assistant’s element makes Soaric ideal for

connected mouse.

practitioners are used to for their foot

can be processed using the Trackpoint on

treatment by individuals and particularly

FOOT CONTROL: ALL-ROUNDER WITH CONTROL COMFORT

control, the Soaric‘s cabled foot control

IMPLEMENTED IN AN INTELLIGENT WAY

with safe transmission enables them to take

are ideally located within easy reach and can be passed easily between practitioners

Experience safe dental prostheses using

configure the foot control buttons to suit

according to the situation during four or six

guided implantology, thanks to Soaric’s

their individual needs too.

hand treatment.

“Implant mode”.

Maximum legroom: The slim design of the

Soaric’s integrated implantology motor

programme the foot control and store their

backrest provides the practitioners and their

supports a wide range of indications,

settings. In this way, they can operate the

assistants with optimum legroom and access

from implantology to oral surgery, and

patient’s chair, instruments, and OP light to

to the patient, ensuring relaxed, safe, and

endodontics. As soon as it is switched on,

suit their specific treatment methods.

precise treatment in all treatment positions.

Soaric runs through the entire treatment

suitable for working in a team. Instruments

over their old habits and settings. They can

Using the LC touch display, users can

Innovative instrument holders: The

navigation interface. The individual stages

OP LIGHT: OPTIMUM LIGHTING FOR PRECISE TREATMENT

instrument holders with horizontal

are displayed on the screen.

The OP light LunaVue LD excels with its

sequence, step-by-step, using its intuitive

adjustment ensure that users can intuitively

large field of light and an even, shadow-free

remove and replace the instruments safely.

The star feature: users can save the

illumination of the working area. The high

The patented hose strain relief minimises

treatment sequences for as many as seven

light intensity of 30,000 Lux at a colour

strain on hand and finger muscles and helps

dental prostheses manufacturers using the

temperature of 4,200 Kelvin generates a

guarantee precise and non-tiring treatment.

control panel.

natural light.

Precise focusing: The slow-speed mode of

Powerful implantology motor: The MX-i, the

Motion detectors on the underside of the OP

the patient’s chair allows millimetre-precise

most powerful implantology motor made

light enable users to switch the light on and

focusing of the treatment area. This is

by Bien-Air, has an impressively low weight

off without contact – this can also be done

particularly important if users are working

(119g) and an equally impressive range of

using the foot control or the operator panel.

with a microscope.

speeds – 100rpm to 40,000rpm, making

USER-FRIENDLY NAVIGATION

indications. Throughout the entire treatment

ASSISTANT’S ELEMENT: SPACESAVING, MULTI-POSITIONING

Soaric makes it convenient for users to use

process, it is highly convenient to use and

The telescope extension with a height-

the operator panel. With the non-reflecting

offers maximum safety at all speed ranges.

adjustable swivel arm can always be moved

it the ideal flexible tool for many different

LC touch display, users can call up all

into the ideal position, for solo or team

functions on the treatment unit at the push

The LED lighting, adjustable up to 38,000

of a button, carry out the individual settings

lux, ensures a clear view of the treatment

and store them to memory. This applies

field. It scores in terms of hygiene too. Its

The sleek design even allows positioning

to the settings of the patient’s chair, the

hermetically sealed surface makes it easy to

between assistant and patient. The patient’s

instruments, foot control programming,

sterilise for the next task.

chair, OP light, suction, cuspidor rinsing, and

and automated cleaning and maintenance

treatment.

tumbler filling functions are all controlled Peristaltic pump: With a feed rate of 30-

from the operator panel. The saliva and

150ml/min, the peristaltic pump guarantees

spray mist ejector have an additional slide

The LC touch screen display can be

the ideal saline supply during treatment.

control so that the instruments can be

transmitted to the monitor in full-screen

The insertion mechanism satisfies the

controlled simply and easily by the users. DA

processes.

JANUARY / FEBRUARY 2021 DENTAL ASIA

57

In Depth With

CS ScanFlow v1.0.3: Faster scanning with more secure and shareable data Carestream Dental’s most recent scanner acquisition software update, CS ScanFlow v1.0.3, continues to deliver an enhanced scanning experience with new benefits that reduce steps in the scanning process, protect data, make working with third parties easier, and even encourage patients to share their virtual smiles on social media.

CS ScanFlow v1.0.3 includes the following

2.

Web-enabled digital impression

Helps ensure optimal treatment

conversion

planning and ideal appliance

improve their scanning experience:

•

Provides users with anytime,

fit, thanks to new bite capture

1.

anywhere access to secure digital

capability, which lets users obtain

Anti-reflective mode (CS 3700 only)

impression file conversion tools via

extensive views of the patient’s

•

cloud-based Microsoft Azure

Provides users with a new dedicated scanning mode that is optimised for

•

•

•

Eliminates the need to update the

the scanning of shiny and reflective

CS Mesh Converter on all computers

surfaces

in the practice when a new version

Generates a higher quality

of CS ScanFlow is available

rendering of shiny and reflective

•

overall occlusion •

Enables the user to capture five additional bites and allows export of the corresponding files

•

Enables all positions to be

Secures digital impressions as

registered, including maximum

surfaces on digital impressions such

the scanned datasets can only be

intercuspation, centric relation,

as metal, full ceramic (bracket and

exchanged with third parties who

left and right canine and anterior

crowns), and resins (dentures)

have logged in and provided their

Saves time by allowing users to

credentials

scan the surface without the use of additional powder, liquid, or microetching to dull the surface

58

•

features requested by the end-users to

guidance •

Allows for the use of bite acquisitions in third party software,

3.

Extra bite capture capability is

such as exocad or Blender for

extended from three to five

Dental with articulator add-on

Fig. 1: Anti-reflective mode

Fig. 2: Extra bite capture capability

Fig. 3: Smart Position mode

Fig. 4: Video creation and transfer

Fig. 5: Scan preservation

Fig. 6: Enhanced cutting tool

DENTAL ASIA JANUARY / FEBRUARY 2021

In Depth With

Fig. 7: Toggle to measurement and transparency tools

4.

Fig. 8: View the Occlusal map

Displays the scan in the same

treatment planning and restorative

by their model and serial number,

orientation as the patient’s mouth with

or appliance fabrication by allowing

helping users identify the device

Smart Position mode

users to preserve surfaces of the

that is in current use

•

Provides users with a more natural,

scan that would have been cleaned

intuitive scanning experience by

by the soft tissue removal algorithm

allowing them to display the digital impression on the screen in the same

Simultaneous use of Measurement,

Enhanced cutting tool

•

Simplifies and enhances the process

Streamlines and simplifies

by which users review and check

Previously, the arch was displayed

the process by which digital

their digital impressions by allowing

in the orientation in which the user

impressions are adjusted and

simultaneous use of Measurement,

performed the scan; this update

modified

Occlusal map, and Transparency

•

allows user to choose their preferred •

9.

Occlusal map, and Transparency tools 7.

orientation as the mouth •

Eliminates the need to activate

tools to check and control the digital

scanning experience

both the cutting and rotation tools

impression prior to sending it to

Helps user to better track the

multiple times when different angles

the lab

tip position and follow the scan

and views of the digital impression

•

progression

are needed to perform a precise cut

10. Preference to automatically save the

Users can cut several areas from

quadrant snapshot

Digital impression scene video creation

the scan and keep the cutting tool

•

and transfer

activated while rotating the digital

quadrant snapshot feature with

impression

dental practice management

Users can toggle between the

software, creating a more user-

format which can easily be shared

rotation feature to the cutting

friendly and intuitive usage of the

with their patients and referrals via

feature simply by pressing CTRL on

snapshots in patient reports*

email

the keyboard

• 5.

Fig. 9: Quadrant snapchat feature

•

Enables users to create an animated video of the digital impression in MP4

•

•

Provides the referring doctor with a 3D view of the case that can be

•

•

Enhanced integration of the

An automated pdf report is generated and can be mailed to

8.

Intuitive scanner identification and

viewed from any web-enabled device

connection

Helps drive patient engagement

•

referral •

With activation in Preferences in the

Provides optimum interoperability,

CS ScanFlow, quadrant snapshots

right from the start of treatment

giving users the flexibility to utilise

can automatically be stored in

by allowing them to keep a copy of

multiple scanners on the same

the patient’s CS Imaging folder

their scan and even share on social

computer

in JPEG format together with the

The CS ScanFlow user interface

digital impression upon exiting the

allows users to easily switch from

acquisition software DA

media that can also help promote the

•

practice

one device to another on the same 6.

Scan preservation for refinement •

The Keep Selected Area tool

*Availability limited to dental practice

When launching CS ScanFlow,

management software with CS Imaging and

ensures that the digital impression

intraoral scanners used on the same

CS Orthodontic and OMS imaging integration

includes all required information for

computer can be easily identified

capability

60 DENTAL ASIA JANUARY / FEBRUARY 2021

•

computer

In Depth With

Evaluation of bioaerosol dispersion generated by the use of ultrasound inserts in different powers and its comparison with high rotation turbine

T

By Prof Dr Alexandre Capelli his study evaluates the

250

dispersion of bioaerosols generated by ultrasound

200

with and without LowSpray technology (Helse®) in different

ultrasonic powers.

150

100

METHODOLOGY

50

For the evaluation of bioaerosol dispersion in the study model proposed, the microbial

0 50 cm

contamination index methodology was used (adapted from Pasquarella, Savino 2000;

(50%) Acteon H3

100 cm (50%) Low Spray

150 cm (30%) Acteon H3

(30%) Low Spray

Fig 2. UFC count/cm2 ultrasound inserts (power 50% and 30%). Mean distances of 50cm, 100cm and 150cm

Viani et al., 2020).

Microbiological tests were carried out using the high-speed turbine as well as the LowSpray (Helse®) and Acteon H3

(Setalec®) inserts in two different ultrasonic

reduced the dispersion of bioaerosol

powers (30% and 50%).

compared to the high-speed.

After the one-minute activation of

Regarding the tested inserts, the Low Spray

peripherals (ultrasound and high speed), the Petri dishes were opened for 15 minutes. After which, the plates were closed and placed in the greenhouse of the microbiology.

average, 99.5% (at 50% power) and 99.9% (at 30% power) dispersion of bioaerosols compared to the Acteon H3 insert (Setalec®).

After 48 hours, the Colony Forming Units A

model (Helse®) reduced significantly, on

(UFC/cm2) were counted (Fig. 2). The tests

Thus, Low Spray insert (Helse®) used

were carried out in triplicate.

at 30% power can be an alternative for better control and biosafety of the dental

CONCLUSION

environment during the use of ultrasound in

In this in-vitro study, ultrasound inserts

dental care. DA

About the Author Prof Dr Alexandre Capelli graduated as a dentist in 1992. His passion B

for education led him to pursue and achieve his MSc and PhD degrees in Endodontics at the University of São Paulo (USP), Brazil.

In 2006, Dr Capelli was asked by a European manufacturing company to develop a line of NiTi rotary instruments based on his innovative technique and approach to Endodontics. This partnership resulted in Dr Capelli’s first patent, the CPdrill Endodontic Bur.

C Fig 1. Detail of the insert with Low Spray technology (Helse®) (A); Acteon H3 insert (Setalec®) (B); and the high-speed turbine (C). Both activated for one minute

While pursuing his PhD, Dr Capelli was invited to be part of a business incubator project focused on technology. Here, he received an extensive amount of training in entrepreneurship. This was the catalyst for the birth of Helse Ultrasonic.

JANUARY / FEBRUARY 2021 DENTAL ASIA

61

Product Highlights VOCO

Optimise composite and nano-ORMOCER applications with VOCO Caps Warmer

VOCO, a dental solutions company, has

The VOCO Caps Warmer has three different

introduced the VOCO Caps Warmer, a

temperature settings: 98°F (37°C), 130°F

preheating device for composite and nano-

(54°C) and 155°F (68°C). Each temperature

ORMOCER restorative unit dose capsules.

setting can be selected to achieve a different viscosity depending on the material being

The VOCO Caps Warmer can easily warm

warmed, resulting in increased adaptation,

one unit-dose capsule while it is loaded in a

and simplifying application.

VOCO Caps dispenser, and simultaneously warm four extra caps and two instruments,

The VOCO Caps Warmer is optimised for

giving the device a total of seven warming

VOCO restorative capsules, allowing for

bays.

the perfect fit and enabling the best heat transfer while also ensuring that all capsules

The VOCO Caps Warmer assists in making

and instruments are warmed uniformly.

composite and nano-ORMOCER restorative materials easier to extrude and manipulate,

Warming VOCO composites will not decrease

particularly if stored in a dry environment.

or modify their physical properties. The the imperfections, micro-etch pattern or

VOCO Caps Warmer simply changes the way

Additionally, warmer, more viscous

small fissures within the prep. Warming

in which the material functions temporarily,

material will have a softer consistency,

an instrument will make the sculpting of a

allowing for diversity in handling during

allowing the material to better adapt to

composite easier and more precise.

placement. ■

W&H

Unique W&H solution for the Zygoma application

When it comes to high-risk patients, difficult

The W&H SZ-75 is the world’s first 20:1

compliance, extreme bone resorption and

handpiece with contra-angle handpiece

complex bone augmentations are often

chucking system and was specially

stretched to their limits. For upper jaw

developed for the Zygoma application.

interventions, one possible alternative is the use of Zygoma implants.

Not only is it a genuine innovation on the market but, above all, it ensures ultra-safe

The new 20:1 Zygoma handpiece for implant

use whilst providing high concentricity

site preparation and implant insertion was

accuracy. In addition, the handpiece can

developed by W&H in cooperation with

also be used with standard implant burs and

leading Zygoma specialists.

can be applied universally in surgery. interventions easier in the area of the

EASY ACCESS TO THE TREATMENT SITE

zygomatic bone. The ergonomic angulation

EFFICIENT SPRAY COOLING

of the handpiece enables optimal access to

This handpiece removes the need for

Zygoma implants are inserted into the

the treatment site. Thus, allowing users to

manual cooling by the dental assistant

zygomatic bone at an angle. It is crucial that

work for extended periods without fatigue.

as the external spray channel ensures

the implant is positioned exactly in line with the specified angle.

The new W&H SZ-75 handpiece makes

62

DENTAL ASIA JANUARY / FEBRUARY 2021

the treatment site is cooled. The spray is

ULTRA-SAFE USE

expelled close to the instrument’s area of

Conventional surgical handpieces do not

activity and cools the operating site with the

offer adequate fixation for Zygoma burs.

utmost efficiency. ■

Product Highlights Zebris for Ceramill®: Trouble-free restorations at the touch of a button – 100% digital

Amann Girrbach

Zebris for Ceramill can be used as a

the articulator, allows Zebris for Ceramill to

Overall, the result is a simple, safe workflow

digital facebow, but offers numerous

be integrated into the daily workflow and

that can be used profitably in everyday

other functions in addition. Thus, the JMA

reduces manual post-processing of the

work. ■

Optic system forms the basis for virtually any indication – from single restorations to scanning model-free with an intraoral scanner as well as large-span restorations

restoration.

Zebris for Ceramill allows for precise

or splints.

recording of the individual jaw situation.

The automatic data transfer to the Ceramill

enable more accurate dentures, hence,

System and the resulting direct transfer into

simplifying collaboration with the laboratory.

Additionally, the digitised functional data

Combine hygiene and function with Arti-Fol metallic Complete ®

Bausch

Bausch, a dental company specialising in

The unique combination of a high-tech metal

The Arti-Fol metallic Complete BK 328 also

occlusion test materials, has introduced

foil (Shimstock foil 12μ) and a two-sided

precisely marks moist occlusal surfaces.

Arti-Fol metallic Complete BK 328 which

colour coating with micro-fine ground colour

combines the proven Arti-Fol metallic

pigments enables clear visible marking of all

Thus, it is universally applicable for all

film black/red with a new and hygienic

occlusal contact points.

cardboard holder.

materials such as metal, ceramics, plastics including composites, and natural teeth.

The material enables efficient grinding in,

Due to its special shape, Arti-Fol metallic

even with occlusal splints (bruxism).

Complete can be used individually on the left or right side or together for the entire

The centric and eccentric are clearly

dental arch.

indicated on the bite aid and can be shown One package contains 100 holders, 10 of

consecutively with only one foil because of

which are hygienically sealed.

the two different colours. ■

Enhance safety in root canal preparation with endo-reamer 152Z BUSCH has introduced the endo-reamer

drilling through the pulpal wall.

152Z which is designed to prevent the

BUSCH

CE mark for medical products on their packaging. ■

piercing of pulpal wall inadvertently when

The BUSCH endo reamer with FG shank is

reaming cavities and root canals with

easily identified by the gold-coloured neck

standards instruments (via falsa).

and shank.

As part of the range of endodontic

Taking into account the manufacturers’

instruments from BUSCH, endo-reamer 152Z

instructions, the instrument can be

has a smooth, round tip which optimally

disinfected, cleaned and sterilised by all

supports safe working/reaming. The

conventional means and methods. Carbide

non-cutting smooth tip reduces the risk of

instruments with FG shank feature the

JANUARY / FEBRUARY 2021 DENTAL ASIA

63

Product Highlights Mectron

Advancing prophylaxis with Mectron Mectron has launched their new ultrasound

Perio P3 gives the clinician an optimal

to-reach areas, characterised by deep

inserts specially designed for gentle and

intraoperative control and a secure feeling

periodontal pockets such as furcations,

effective removal of supra- and subgingival

while working interproximally, supra- and

root surfaces, and concavities, thereby

biofilm as well as for safe periodontal

subgingivally.

preserving epithelial tissue and promotes new attachment formation.

debridement.

With its Soft Mode function which reduces

PERIO P3: THE FULL SCOPE MAINTENANCE INSERT

the amplitude of the ultrasound oscillations and allows the insert to move gently and

for mechanical biofilm disruption, bacteria

Perio P3 is indicated for the removal

efficiently, it is highly recommended for

dispersion, and periodontal pockets

of supra- and subgingival biofilm. Its

sensitive patients for a more pleasant and

detoxification.

slim shape allows easy access in deep

comfortable treatment.

Additionally, the cavitation effect allows

The inserts in detail:

periodontal pockets and interproximal

P15: Recommended for the debridement of

Thanks to its remarkable linear movement,

PERIO ANATOMIC INSERTS P15, P16R, P16L FOR FULL MOUTH PERIODONTAL TREATMENT

it is minimally invasive for the soft tissues

Perio anatomic inserts P15, P16R, P16L

curettes n° 1-2, 3-4, 5-6, 7-8

and root cementum. Hence, it is ideal for

are indicated for periodontal debridement.

preserving the epithelium.

The inserts guarantee maximum efficacy

P16R – P16L: Recommended for supra-

without risk of injury to the soft tissues and

and subgingival interproximal spaces and

spaces in all the quadrants.

It is best utilised for interproximal and

periodontal ligament.

deep periodontal pockets. Easy access to canine and anterior teeth. Replaces manual

an efficient root planing on molars and premolars. Replace manual curettes n° 11-

subgingival cleaning. It effectively removes extrinsic stains too.

Its shape allows optimal access to hard-

12, 13-14, 15-16, 17-18 ■

Perio P3 for interproximal and subgingival cleaning

P15: Universal curette for supra- and subgingival treatment

P16R – P16L: Right (P16R) and left (P16L) angled periodontal curettes for subgingival concrement and biofilm removal from furcations and deep pockets

64 DENTAL ASIA JANUARY / FEBRUARY 2021

Product Highlights Dentsply Sirona

Axeos™: Dentsply Sirona’s top-ofthe-line dental x-ray solution with a large field of view

→ THE EVOLUTION OF PROPHYLAXIS COMBI touch

Axeos, the newest top-of-theline, versatile 2D/3D imaging solution by Dentsply Sirona, offers a comfortable experience for patients and dentists and at

→ AIR-POLISHING AND ULTRASOUND IN ONE UNIT

the same time a growth engine for practices across various workflows.

From a focused Field of View (Ø5 x 5.5 cm) for endodontic cases up to a large FoV (Ø17 x 13 cm) that covers complete dentition, including both temporomandibular joints (TMJ), Axeos offers a broad range of treatments.

→ easy switch from supra to subgingival air-polishing by a simple click → subgingival perio air-polishing tip – flexible, soft and anatomically adjustable to the periodontal pocket → more than 40 inserts for scaling, perio, endo and prosthetics → SOFT MODE: the ultra-gentle scaling for sensitive patients

As dental practices adapt even more to safety protocols and adjust workflow practices, Dentsply Sirona continues to pursue innovative solutions. Axeos is designed to not only address a wide range of diagnostic needs and grow with the practice, but also to reduce the need for physical contact to ensure patient and staff safety.

Axeos offers three core benefits for any practice: clinical confidence, smart connectivity with integrated solutions and treatment planning, and an exceptional user and patient experience. Additionally, the new unit enables practice expansion and improved clinical outcomes through industry-leading education and training.

Offering a range of fields of view (FoV), it is ideal for different treatment areas, including specialised 3D imaging needs such as digital orthodontics. The unit offers outstanding imaging quality with intelligent low-dose, a higher level of patient and user comfort using the Patient Positioning & Image Assistant (PIA) and smart height adjustment – a feature in which the unit height for the individual patient can be set even before they enter the X-ray room. The comfortable wheelchair accessibility enables direct and uncomplicated positioning of wheelchair patients in the unit.

Axeos comes with the modern and highly intuitive award winning Sidexis 4 imaging software that supports an accurate and precise diagnosis. Aligning with practice needs, Axeos seamlessly integrates with multiple treatment planning software, like SICAT® Implant, SICAT® Air, SICAT® Function and SICAT® Endo or can be

→ www.mectron.com

used for SureSmile services, supporting the individual workflow and making in-office procedural expansion possible now or at any time in the future. ■

JANUARY / FEBRUARY 2021 DENTAL ASIA

65

Product Highlights Rapid Shape

Fully automate 3D printing of clear aligner dental models with the RS inline system

Rapid Shape, a leading manufacturer of

Up to five printers can be controlled

Additionally, Rapid Shape has also broken

professional and industrial 3D printers, has

simultaneously in one production line. One

new ground in post-processing. The RS

released the RS inline system to 3D print

printer prints on average 300 models per

clean-C centrifuge, which is implemented

fully automated clear aligner dental models

eight-hour shift, so within 24 hours in a

in the RS inline, considerably simplifies the

in high volume.

complete line, more than 4,000 models are

post-processing of printed parts. After the

produced. The printer automatically ejects

printing process, the dental models are

The RS inline reduces the production

the printed models and starts the next print

transported via a conveyor directly into

cost of models significantly thanks to its

in less than two minutes.

the centrifuge, where they are spun at high

automation, open material system, and

speeds.

innovative cleaning process to regain

RS inline is not only a powerful, resin-based

material. The system comprises many

additive manufacturing system featuring

All machine entities are seamlessly

processing steps that make everyday life in

DLP force-feedback technology, but also

connected and server controlled by the

dental model production considerably easier.

impresses with its small footprint.

RSPC application.

RS inline shows the best productivity per

RSPC decides which printer has the free

unit area which makes it increasingly

capacity and puts it into the job queue

attractive for dental laboratories and

automatically. Every single model is

production facilities. Due to its flexible

traced with all production parameters

design, it can be adapted to customer

including material batch to ensure MDR.

Renfert

requirements and the machine setup can be

This guarantees efficient production with

expanded at any time.

maximum capacity utilisation at all times. ■

The first diamond polishing paste specifically for hybrid materials

Hybrid materials are being used increasingly

preliminary work and polishing needs to be

up, effectively extending the life of the

in the CAD/CAM production of indirect

performed to achieve a satisfactory degree

restorations.

restorations. However, the many benefits

of gloss.

of this combination of ceramics and

Renfert Polish hybrid materials is an efficient

composites are offset by one major

Renfert has the answer in the form of a

polishing solution for modern hybrid

drawback: poor polishability.

specific extraoral diamond polishing paste

materials, true to the motto, “Because it’s

for the high-gloss polishing of hybrid

simply better”. The specifically adapted

materials: Renfert Polish hybrid materials.

abrasion properties provide a fast polishing

The ceramic-polymer combination delivers a high load-bearing capacity with improved

result and a high degree of gloss combined

abrasion behaviour, while at the same time

Renfert Polish hybrid materials is a specific

making restorations less brittle and easier

diamond polishing paste. It was developed

to process. When it comes to polishing,

precisely to meet the requirement of hybrid

however, conventional polishing agents

materials with well-matched diamond

reach their limits due these two materials’

particles ensuring the best possible

different needs.

polishing results.

This is also made worse by the unequal

Cleaning is easy and gentle on the material,

material ratio – the high ceramic and low

thanks to low smearing. The optimal

composite contents. This is why much more

surface treatment reduces plaque build-

66 DENTAL ASIA JANUARY / FEBRUARY 2021

with a low level of consumption. ■

THE 5+ DREAMTEAM

UNIVERSAL SUBMICRON HYBRID COMPOSIT

ONE COMPONENT LIGHT CURED UNIVERSAL ADHESIVE

BRILLIANT EverGlow®

ONE COAT 7 UNIVERSAL

Enduring gloss – made brilliant

Always the right choice

´ Exceptional polishability and long-lasting brilliance

´ Universal bonding to dentin, enamel, ceramics, zirconia, metals and composite

´ Aesthetic single-shade restorations ´ Versatile shade system with three translucency levels ´ Excellent sculptability and smooth consistency ´ Good wettability with minimal stickiness to the instrument

´ Excellent and reliable bond strength no matter which etching technique used ´ Great marginal sealing for long term stability ´ User-friendly handling

004725 05.19

´ Antibacterial (Proliferation test for antimicrobial activity with S.epidermidis by QualityLabs, Germany)

www.coltene.com | Info.ap@coltene.com

Product Highlights Straumann

Rediscover white with the Straumann® SNOW Ceramic Implant System

The Straumann® SNOW Ceramic Implant

needs of patients with high aesthetics

concerns with metal devices and metal

System is the only 100% ceramic (metal-

expectations as well as those having

allergies.

and plastic-free) implant on the market.

Wide range of implant diameters to adapt Straumann and Z-Systems, a Swiss-based

to patient specific anatomy and surgical

international leader in ceramic dental

techniques: Implant available in diameters

implant systems with over 60,000 implants

Ø3.6mm, Ø4.0mm, and Ø5.0mm. Suitable

placed since 2004, has joined forces to offer

for submerged healing, augmentation and

a versatile and reliable system that dentists

simultaneous sinus lift.

can trust for their aesthetic cases.

Full prosthetic flexibility: Wide range of straight One hundred percent ceramic system

and angled abutments to accommodate the

(metal- and plastic-free): To address the

unique needs of patient and clinical situation. ■

VITA

VITA VIONIC VIGO®: Beauty and intelligence for digital dentures At the push of a button, the VITA VIONIC

shape with pronounced interdental margins

VIONIC BOND to fix the teeth instantly in the

VIGO smart tooth unleashes the full

automatically ensures a natural papilla

alveoli.

efficiency potential of digital denture

design resulting in pink and white harmony.

production, with results just as beautiful as

The perfect fit leaves no room for rotations

analogue solutions.

MORE USER-FRIENDLINESS FOR INCREASED CAPACITY

The VITA VIONIC SOLUTIONS material

Time-consuming wax removal and

system is now even more powerful. With its

sandblasting are no longer necessary. After

The intelligent beauty of VITA VIONIC VIGO

three-dimensional layer, light-dynamics, and

taking the ready-to-use teeth from the

brings digital full dentures to a whole new

natural texture, the denture tooth is making

blister pack individually, the pre-conditioned

dimension of economic and highly aesthetic

a huge impact on day-to-day work.

adhesive surfaces are moistened with VITA

solutions. ■

The VITA tooth library automatically provides the correct positioning for the teeth with four setup concepts and up to 600 functional set ups for all skeletal classes.

NOT ONLY BEAUTIFUL, BUT ALSO SMART With VITA VIONIC VIGO, fabrication time is reduced by up to five hours. With its basally and cervically pre-reduced tooth dimensions, the denture tooth fits precisely into milled or printed alveoli. Its dynamic

68 DENTAL ASIA JANUARY / FEBRUARY 2021

and gaps. Ready after just 20 minutes in the pressure pot; no need for reworking.

Product Highlights Geistlich

Treat simple to complex bone defects with Geistlich biomaterials Successful regeneration of bony defects

The defect-oriented Geistlich concept

requires stabilisation of the augmentation in

combines the proven Geistlich products

with stabilising umbrella screws for

the defect area.

Bio-Oss® and Bio-Gide® with three different

defects with a missing bone wall

treatment and stabilisation methods: By shielding against acting mechanical

•

•

•

Stabilised Bone Regeneration (SBR)

Customised Bone Regeneration (CBR®)

Guided Bone Regeneration (GBR) with

with the Yxoss® 3D titanium mesh

forces, dislocations of the bone substitute

membrane fixation using titanium pins

for complex defects with vertical and

material used can be prevented as well as

for smaller defects

horizontal characteristics

guarantee undisturbed bone healing.

The concept offers practitioners Depending on the location, size, and

comprehensive treatment options for

geometry of the defect, different treatment

optimal patient care. ■

options are available.

NSK

NLZ: The compact makes a big change Now in a more compact size, with higher

the motor have now been integrated. This

safety and flexibility for different installation

new, more efficient configuration makes

styles, NSK’s all new “NLZ” can help any

maximum use of the limited space and is

user of air-driven handpieces convert to

lighter and more powerful than before.

electric and enjoy the full benefits of this smart system.

Less heat: NLZ employs a simple nonlayered coil instead of a standard layered

the water flow supplied from the rear of the

The unique technology of “NLZ” employs

coil. The coils are as compact as possible,

motor. The NLZ uses a simple straight pipe

an all-new micromotor system and expands

shortening the pathway for heat generating

design instead of a crank, reducing the risk

the possibilities of dental treatment.

current. As a result, it generates less heat

of water clogging in the rear section of the

This original concept from the leading

without reducing the output power.

motor.

handpiece manufacturer provides cuttingedge features applicable to a wide-range

Simplified pipe configuration: Conventional

Contaminants are stopped by a microfilter:

of endodontic treatments with enhanced

products include several pipes, which crank

There is a water filter with 0.3mm diameter

comfort and safety.

mesh fitted within the tubing connector at the back of the main unit to catch debris

TECHNOLOGY AND FUNCTION

and foreign particles and prevent clogging.

Powerful: The conventional magnet rotor has been replaced with an improved version.

Endo torque calibration function (NLZ

More powerful rotation is achieved in the

E Only): Performing the “Contra-Check

same amount of space by reducing weak

Function” also enables torque calibration.

magnetic areas.

This function measures the no-load current values and corrects the torque accordingly,

Efficient: In this unique technology, the

resulting in greatly enhanced safety in

water and air lines that used to bypass

endodontic treatment. ■

JANUARY / FEBRUARY 2021 DENTAL ASIA

69

Product Highlights 3M

Achieve aesthetically polished restoration with the Sof-Lex™ Diamond Polishing System

Proper finishing of restorations is desirable

The 3M ESPE Sof-Lex Pre-Polishing Spiral

not only for aesthetic considerations but

(beige) is indicated to smooth the surface of

also for oral health. The primary goal of

restorations. The 3M ESPE Sof-Lex Diamond

finishing is to obtain a restoration which has

Polishing Spiral (pink) is indicated for final

ideal contour, occlusion, healthy embrasure

high-gloss polishing.

forms, and surface smoothness.

Spirals can be used to polish surfaces of:

Finishing and polishing procedures remove the air-inhibited layer, contour and shape the

Polishing System is a two-step, multi-use

restoration, create surface characterisation

polishing system. The spirals use the same

and produce surfaces with high gloss. Tight

mandrel as 3M™ ESPE™ Sof-Lex™ Finishing

margins should blend aesthetically into the

and Polishing Discs. The spirals are made

tooth’s natural contours. Healthy embrasure

with either aluminium oxide or diamond

forms and smooth surfaces are less likely to

particles impregnated in a thermoplastic

trap food debris and collect plaque.

Direct: •

Composite restorations

•

Resin-modified glass ionomers

•

Bisacrylic temporary materials

Indirect: •

Composite

elastomer.

•

3M™ ESPE™ Lava™ Ultimate CAD/CAM

Several factors can affect the final finish

The universal shape allows for usage on all

•

of a restoration: the resin matrix and fillers

Restorative Precious and semi-precious metal

tooth surfaces and reduces the need for

Both wheels are used with a slow-speed

within the restorative material, finishing

different shaped tools. It adapts to all tooth

handpiece operating within 15,000rpm–

instruments, and preparation design.

surfaces, works from any angle, effective

20,000rpm. Adding water is recommended

for anterior and posterior restorations, and

during use and will create a more ideal

helps create natural gloss in two steps.

surface quicker than without water. ■

The 3M™ ESPE™ Sof-Lex™ Diamond

COLTENE SciCan

OPTIM® 1: One wipe. One-step. One minute.

COLTENE SciCan has launched OPTIM 1, a

with each OPTIM 1 Wipe than they could

or statements; it is everything health care

one-step cleaner disinfectant with a one-

with competitors’ disinfectant products1.

workers have come to expect from OPTIM,

minute broad-spectrum contact time. With

Just like the other OPTIM disinfectant

just faster and more efficient.

OPTIM 1, there is no need to compromise

product lines, OPTIM 1 does not require

between safety and efficacy.

any GHS hazard pictograms, signal words

*OPTIM 1 has demonstrated effectiveness against viruses similar to the COVID-19 on

With a one-minute contact time, OPTIM 1 is

hard, non-porous surfaces and non-invasive

one of the fastest and most effective cleaner

medical devices. Therefore, this product

and disinfectants. It is on the “Health

can be used against COVID-19, only when

Canada - List of Disinfectants to Use Against

used in accordance with the directions for

COVID-19” and can deactivate the virus in

use against Poliovirus on hard, non-porous

just one minute*.

surfaces, and non-invasive medical devices.

Powered by a patented hydrogen peroxide-

1

based formula, OPTIM 1 is also safe and

Antonia Molinari. Environmental Surface

gentle for staff, patients, and surfaces. In

Wetness Test: Comparison of Disinfectant

addition, users can disinfect a larger area

Wipes. Ann Arbor: Dental Advisor, 2015. ■

70 DENTAL ASIA JANUARY / FEBRUARY 2021

John A. Molinari, Ph.D., Peri Nelson, B.S.,

Giving Back to Society The beginning of Smiles for All Movement Millions of Americans have lost their health

(3) non-profit that provides dental care to

BeeSure, Care Harbor, Sinclair, Midwest

coverage, including dental care due to the

underserved populations in Illinois, United

Dental, Aseptico, AM-Touch, Sunset

COVID-19 pandemic. With nowhere else to

States.

Technologies, Practicon, DryShield, SISU)

turn to, more people have been seeking free

are giving back even as they are affected by

and low-cost dental clinics for dental care.

Since Dr Lam’s office reopened this year

These clinics serve as a safety net for the

after the initial shutdown, they have been

most vulnerable populations, but have been

fighting to stay open.

struggling to meet the growing demand with their limited resources.

the changing economy.

Since the inception of the pandemic, these companies have donated $2.9 million in

The Smiles for All Movement was born in

cash, products, and services.

the wake of COVID-19 to help those lacking “We’re living day by day unsure when we

access to necessary dental care. This year,

By using their resources to help others, the

will run out of supplies. The only other

17 dental companies (Forward Science,

companies supporting the Smiles for All

non-profit dental clinic in our area is fully

OrthoGum, Dr Kevin M Kenny Foundation,

movement are promoting a mission of giving

booked out for a year and not taking any

Tokuyama, PureLife, hyperbiotics, byte,

back when it is most needed. As more dental

patients. People have nowhere else to go,

companies join the movement, more non-

so parents have been calling and begging

profits will have the resources necessary

us to see their kids. The need is higher than

to tackle this healthcare crisis, potentially

ever, but we cannot get the supplies that we

changing the lives of the billions of people

need with our small budget,” said Dr Loretta

around the world that struggle to access

Lam, a dentist at Well Child Centre, a 501(c)

dental care. DA

vhf dental supports food banks with Christmas donation vhf dental, a milling machine and tool

contribution, as it is especially important

were not previously dependent on external

manufacturer company, has donated to the

to show solidarity,” said Ria Brandenberger,

assistance.

work of the food banks in Germany, which

member of the board at vhf, about the

save around 265,000 tons of food per year,

company’s commitment.

which in turn is given to more than 1.6 million people.

These are people who have lost their jobs or part-time jobs due to the pandemic, or self-

In 2020, the charity organisation is facing

employed people whose livelihood is at stake

special challenges. This is because the

due to a drop in orders. In its poverty report

“Showing social responsibility is part of our

COVID-related lockdowns in spring and

2020, a German welfare association even

self-image. We would like to support the

November led to fewer food donations at

speaks of a poverty rate at a record high.

volunteer work of the food banks with our

the food banks in many places. A decrease

For this reason, vhf camfacture AG makes

in active volunteers and more expenses for

a solidarity contribution and financially

protective measures was also noted.

supported the Tafeln Deutschland with its annual Christmas donation.

The food banks in Germany needed

72

DENTAL ASIA JANUARY / FEBRUARY 2021

additional support to cope with the

The charity organisation not only helps

increased workload and the associated

to curb the waste of edible food but also

costs. At the same time, the charity

support people in need. Since the association

organisation is seeing a new need for help

is Germany’s largest food saver, it also

and a worsening of poverty and social

makes an important contribution to climate

inequality in Germany. People are currently

protection by limiting the otherwise huge

asking for support from the food banks who

waste of resources. DA

Giving Back to Society GSK Consumer Healthcare partners with Direct Relief to donate one million USD to support frontline healthcare workers GlaxoSmithKline (GSK) has donated one

gloves, and tens of thousands of protective

million USD to Direct Relief on behalf

suits and other items to help safeguard

of consumers who have purchased its

health workers.

consumer healthcare products since the onset of the COVID-19 pandemic.

“Direct Relief is deeply grateful for the leadership and commitment reflected by

According to the COVID Tracking Project,

GSK’s action today, which is both keenly

hospitalisations have more than doubled in

needed and will be put to immediate use,”

less than two months. GSK recognises that

said Thomas Tighe, CEO and president of

with cases rising rapidly, there is a critical

“We are so proud to partner with Direct

Direct Relief. “This is a perfect example of

need to continuously support health care

Relief to support the amazing work they are

what’s needed as we all face this historic

workers.

doing to ensure health professionals have

threat to the health of people everywhere.”

the essential items that they need as the The monetary donation will be used to

COVID-19 pandemic continues,” said Lisa

Globally, GSK is closely monitoring the

purchase personal protective equipment

Paley, general manager, US and Puerto Rico

COVID-19 pandemic and supporting

(PPE) and essential medical items for United

for GSK Consumer Healthcare.

efforts to tackle the virus. The company is

States (US) health workers on the front line dealing with this unrelenting crisis.

collaborating with companies and research Direct Relief is coordinating with public

groups across the world working on

health authorities, non-profit organisations,

promising COVID-19 vaccine candidates

Since the outbreak, GSK has been providing

and businesses to provide personal

through the use of its innovative vaccine

its scientific expertise to support the global

protective equipment and essential medical

adjuvant technology. It is also supporting

response to COVID-19 and ensuring its

items to health workers responding to

screening and research into potential

global supply chain continues to deliver

COVID-19. Since January, Direct Relief has

medicines for COVID-19, as well as

vital medicines and consumer healthcare

delivered more than 46 million N95 and

providing expertise and financial support to

products to the people who depend on them.

surgical masks, more than eight million

relief organisations. DA

New ADA podcast aims to educate on oral health In December 2020, the Australian Dental

with only 48% of Australian adults attending

topics such as oral health and pregnancy,

Association (ADA) has released the first

for a dental check-up in the last 12

infant oral health care and advice for visiting

episodes of the organisation’s new oral

months, people are no-doubt sourcing their

the dentist with an anxious child.

health education podcast called Watch Your

information elsewhere.

Mouth.

Episodes will discuss a range of subjects Watch Your Mouth – a revisit to the 2018

providing advice on topics that the public

The podcast aims to provide an alternate

Dental Health Week campaign tagline, is

both want and need to know. DA

form of oral health education to the

available at both Apple Podcasts and Spotify.

Australian public that is easy to consume

Episodes are released fortnightly and include

on-the-go such as during the daily

a short questions and answers between an

commute.

interview host and dental professional.

Although it is recommended that individuals

The first series of episodes were based on

see a dentist for their oral health advice,

infant/early childhood oral health, including

JANUARY / FEBRUARY 2021 DENTAL ASIA

73

2021 EVENTS CALENDAR JANUARY 22 – 24

22 – 25

HK IDEAS 2021 - Hong Kong International Dental Expo and Symposium

http://www.wcise.com/en

26 – 28

Venue: Hong Kong Convention and Exhibition Centre

Dental Salon 2021: The 49th Moscow International Dental Forum and Exhibition

https://www.hkideas.org

Moscow, Russia

Wan Chai, Hong Kong

Venue: Crocus Expo

FEBRUARY 25 – 27

156th Chicago Midwinter Meeting (Virtual) https://www.cds.org/

26 – 27

https://en.dental-expo.com/dental-salon-en

MAY 6–8

Dental Community 2021 Brescia, Italy

Venue: Tour & Taxis

Venue: University of Brescia - Faculty of Engineering

https://www.dentex.be/en

MARCH

10 – 13

http://www.dentalsouthchina.com/?_l=en

28th MDA SCATE 2021- The Digital Edition

20 – 22

https://www.expodental.it/en

Famdent Pune 2021 Pune, India

28 – 29

Auckland, New Zealand

https://www.famdent.com/famdent-pune

Venue: ASB Showgrounds https://dentalexpo.co.nz

38 International Conference on Dental and Oral Care (Webinar) th

28 – 30

BDIA Dental Showcase On Demand (Virtual)

Dental World Conference

https://www.famdent.com/mumbai-show

JUNE 4–6

Venue: Village Hotel Changi

14th Asian Congress on Oral and Maxillofacial Surgery

https://magnusconferences.com/dental

Singapore, Singapore

Singapore, Singapore

Venue: Marina Bay Sands Convention Centre

APRIL 14 – 16

Famdent Mumbai 2021 Mumbai, India Venue: Bombay Exhibition Centre

https://www.dentalshowcase.com

29 – 31

Dental Expo 2021

Venue: Auto Cluster Exhibition Centre

https://dentistry.conferenceseries.com

22 – 26

Expodental Meeting 2021 Rimimi, Italy

https://mda.org.my/home/scate2021/

23 – 24

Dental South China 2021 Guangzhou, China

Kuala Lumpur, Malaysia

6–7

Dentex 2021 - The Dental Trade Fair Brussels, Belgium

https://www.dentalcommunity.it

5–9

Dental Show West China Chengdu, China

www.acoms2020.sg

4–6

Chongqing, China

Seoul Inxternational Dental Exhibition & Scientific Congress (SIDEX) 2021

Venue: Chongqing International Convention and Exhibition Center

Seoul, South Korea

http://www.dentalshow.com.cn/nf/

Venue: COEX

South Dental Forum and Show 2021

https://eng.sidex.or.kr

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DENTAL ASIA JANUARY / FEBRUARY 2021

2021 EVENTS CALENDAR 9 – 12

26th Sino-Dental® 2021 Beijing, China

5–7

Ho Chi Min City, Vietnam

Venue: China National Convention Center

Venue: Saigon Exhibition and Convention Centre

http://www.sinodent.com.cn/en/f

10 – 13

28th IAPD Virtual Congress https://iapdworld.org

14 – 15

http://hcm.medipharmexpo.com/en

12 – 14

Venue: Chennai Trade Centre www.ifea2020india.com

London, United Kingdom

17 – 18

21 – 22

Dental Days 2021

https://tandfagligedage.dk

26 – 28

Dubai World Dental Meeting (DWDM) 2021 Dubai, UAE

https://dentistry.bioleagues.com/

SEPTEMBER 4–5

Venue: Hitex Exhibition Centre, Hitec City

https://aeedc.com/dubai-world-dental-meeting/

AEEDC 2021 - The 25th edition of the UAE International Dental Conference & Arab Dental Exhibition

https://www.famdent.com/famdent-hyderabad

10 – 12

Venue: Jakarta Convention Center https://indonesiadentalexpo.com

Venue: The Dubai International Convention and Exhibition https://aeedc.com/

17 – 19

Petaling Jaya, Malaysia

Association of Orthodontists (Singapore) Congress (AOSC) 2021 – Digital Edition

22 – 25

http://www.ids-cologne.de

https://www.aoscongress.com/

The 2021 IADR/AADR/CADR General Session (Hybrid) Boston, MA, United States

IDS 2021 - 39th International Dental Show (Biennial Meeting) Cologne, Germany

Singapore

21 – 24

5th Malaysia International Dental Show (MIDS) http://mids.com.my/100-about-us

JULY 2 – 11

The Premier Dental Exhibition & Conference for Indonesian Market Jakarta, Indonesia

Dubai, UAE Centre

Famdent Hyperabad 2021 Hyperabad, India

Venue: Novotel Hotel

29 June – 1 July

3rd International Conference on Dentistry & Oral Health Chennai, India

Copenhagen, Denmark Venue: Bella Center

IFEA 202ONE - 12th World Endodontic Congress Chennai, India

27th World Congress on Dentistry and Oral Health https://dentistrycongress.dentistryconferences.com

Vietnam Medi-Pharm Expo 2021

23 – 25

ICOI World Congress 2021 - 38th Edition Sydney, Australia https://www.icoi.org/events

Venue: Hynes Convention Center https://www.iadr.org/2021iags

AUGUST 5–7

IndoHealthcare Expo 2021 Jakarta, Indonesia

With the evolving COVID-19 situation, kindly check with organisers for updates on the related events. Please refer to the local airports’ websites for the latest travel advisories too.

Venue: JIExpo Kemayoran https://indohealthcareexpo.com

JANUARY / FEBRUARY 2021 DENTAL ASIA

75

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COMPANY 3Shape A/S

PAGE IBC

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SHOFU

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71

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Align Technology

Dentsply Sirona

9 7, 65

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76

DENTAL ASIA JANUARY / FEBRUARY 2021

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