The Dental Technician Magazine July 2022

VO L 7 5 N O. 7 I J U LY 2 0 2 2 I B Y S U B S C R I P T I O N

THE DIGITAL PATIENT ZIRKONZHAN PAGE 18-19

Combination dentures: an indication-specific material mix in the digital workflow VITA

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PAGES 14-17

THIS MONTH... l

EVENTS: ADI TEAM CONGRESS P. 6

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BUSINESS: YOUR FINANCES AND GROWING A FAMILY I BY RICHARD LISHMAN P. 8-9

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INSIGHT: ENSURE YOUR TEAM IS ‘WELL-LED’ I BY NICKI ROWLAND P. 20-22

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CONTENTS

JULY 2022 Editor: Matt Everatt F.O.T.A. E: editor@dentaltechnician.org.uk

Welcome Welcome from the editor

Designer: Sharon (Bazzie) Larder E: inthedoghousedesign@gmail.com

Events

Advertising Manager: Chris Trowbridge E: sales@dentaltechnician.org.uk T: 07399 403602

ADI Team Congress

EDITORIAL ADVISORY BOARD Andrea Johnson Ashley Byrne Sharaz Mir Sir Paul Beresford

PUBLISHED BY THE DENTAL TECHNICIAN MAGAZINE, PO BOX 2279, PULBOROUGH, RH20 9BR. T: 01372 897463 The Dental Technician Magazine is an independent publication and is not associated with any professional body or commercial establishment other than the publishers. Views expressed in this journal are not necessarily those of the editor, publisher or the editorial advisory board. Unsolicited manuscripts and photographs are welcome, though no liability can be accepted for any loss or damage, howsoever caused.

No part of this publication may be reproduced in any form without the express permission of the editor or the publisher.

Your finances and growing a family. By Richard Lishman

8-9

DTS 2022 Stand out sessions at DTS 2022

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Digital Technology Combination dentures: an indication-specific material mix in the digital workflow - VITA The Digital patient - Zirkonzhan

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Dental Technology Zirkonzahn Multi Blank Holder - 7 crowns, 7 colours, 7 patients Zirkonzahn - The “all in-house” culture trilogy Part 1

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Insight Executive Leadership Series – Ensure your Team is ‘Well-led’. By Nicki Rowland

20-22

Dental News Increasing our Standard Operating Procedures (SOP) through evidence based research.

By Andy Barrs 22-23

Advertorial Funding your professional dreams the easy way. By Richard Porter, WestWon

The Dental Technician, Select Publisher Services Ltd, PO Box 6337, Bournemouth BH1 9EH

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BAR HEADER WELCOME

From the

Editor I can’t help but feel a sense of calm for the first time in a while. There has been a lot of talk about increasing prices and many labs no longer offering NHS type priced work.

In my capacity of a lab owner, in one of our labs we have significantly increased prices in some areas. The net result being we have almost done as much turnover in a month with 15-20% less cases.

Matt Everatt F.O.T.A

l

Welcome to your July edition of The Dental Technician Magazine.

I was very surprised to learn that this month I have been the Editor for 2 years! What a very crazy 2 years it has been for us all.

I don’t want to dwell on some have the stuff that has gone, however I would like to say some thank you’s. Firstly, to you, the readers. From time to time I get to hear feedback from you and I’ve only heard good things so far! I have tried to introduce some new features and keep the content fresh and original. My favourite little feature has to be ‘5 Things I Cannot Work Without’.

I have also loved the leadership articles produced by several authors including our regular writer, Nicki Rowland.

I would like to thank the Editorial Board, Ashley Byrne and Andrea Johnson have been particularly legendary in providing us with some fantastic pieces each and every month. A special thank you to Bazzie Larder who manages to pull all of our content together, inevitably at the last minute every month and to Chris Trowbridge for the daily chasing of writers, editorial pieces and for encouraging our advertisers to support the magazine.

Without the incredible support of the advertisers the magazine would not be where it is.

4 JULY 2022.indd 4

I recently responded to a Facebook post in a group, a Practice Manager asking for NHS lab Recommendations. There had been a few comments about it being difficult to find labs accepting NHS work and someone had mentioned sending cases overseas. It spurred me to post a comment in a Dentists Group on Facebook. It quickly attracted over 100 likes and some very supportive comments from dentists saying they choose to support local labs and don’t send cases overseas. I hope the message I was aiming to send in the post has struck a chord with some of those dentists that quibble over a few £’s for their work. Those that are trying to save A £ here or there are looking in the wrong places to try and increase their profit margin. I do hope this is a turning point for us as labs in regards to stopping this price ‘race to the bottom’.

Recruitment still seems to be an issue, something I don’t think we will resolve immediately and perhaps things will get worse before they get better. Wearing my hat in my teaching role, I have seen around 30 students this year who will progress on to their next year. Most of them do not want to seek out a career as a Dental Technician, many using the course as a stop gap or filler before they progress onto further studies. I am a huge advocate of Dental Technology and I want it to be a fantastic career and professional choice for the younger generations. We have to do our bit to help make it an attractive

choice for students leaving school. I noticed Andrea Johnson was at an NHS Careers event in Doncaster this week. She had a table full of interesting work in the hope to get people interested and excited about becoming a Dental Technician. This is something we all need to do a bit of.

Well done and thank you Andrea!

I am still on the look out for more people to join our Editorial Board, there are some areas we need people who can bring in some good technical pieces and news from their area in the profession. If you think you could bring something to the magazine, please do get in touch with me via email; editor@dentaltechnician.org.uk For now, I hope you enjoy this months edition and that you have a fantastic July. To those of you who have children doing GCSE’s and A-Levels, I wish you and them all the best and hope they are able to progress onto their next stage in life.

All the best for now, see you in August.

Matt

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TECHNICIANS INSIGHT EVENTS

ADI Team Congress draws packed crowd for Technicians’ Programme

T

he ADI Team Congress 2022 presented an exceptional Technicians’ Programme, which drew a full crowd for every single session. Topics included everything from full arch restorative options to digital versus analogue workflows, zirconia methods and 3D printing.

Delegate Mat Beable from Studio 3 Dental Laboratory Ltd, commented: “I have attended the ADI Team Congress a few times in the past. I came again this year for CPD and to hear new ideas – it’s always good to meet colleagues and see what they’re doing. I always come away with something useful and I think it’s one of the best events in the field.

“I was very happy with the range of topics covered in the Technicians’ Programme and there were some very good speakers in the Plenary programme too – you learn things even in sessions not directly related to your work, but it’s good to have that knowledge.

I also had a look around the trade and it was great to see everyone there too.”

The next ADI Team Congress will be held in May 2023 – save the dates to make sure you don’t miss out!

The ADI Team Congress 2023 will be held on 4-6 May at the Birmingham ICC. Visit the website for details in due course.

ADI members get significantly discounted rates for all ADI events. www.adi.org.uk

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BUSINESS

YOUR FINANCES AND GROWING A FAMILY From Student to a Qualified Experienced Dental Technician (Part 5 of 10)

8 JULY 2022.indd 8

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BUSINESS

I

n the last editorial of the series, our character, Bridget Crown, took the plunge and bought her first home. Now, time has moved on, she’s met and married the man she wants to spend the rest of her life with, and she’s also added to her family, giving birth to a baby girl.

in this scenario, if she or her partner claims, the other will be left without cover as the policy will have fulfilled its purpose. Plus, it’s always worth remembering that policies are highly dependent on any pre-existing medical conditions, and some will deny applicants if they have certain health concerns.

But how have these changes impacted her financial situation and what are some good things for Bridget to consider now that her family has grown?

Life Insurance matters too

Pooled resources

By Richard T Lishman Managing Director of the 4dentists Group of companies Richard Lishman, awardwinning Founder of The IFA’s – a specialist firm of Independent Financial Advisers that provides guidance and advice for some of the wealthiest individuals in the UK and around the globe, heads this series of editorials for lab technicians.

As Dame Helen Mirren once said, “it can’t be a great marriage without being a partnership.”

From a financial point of view, a marriage can bring a certain number of benefits, especially as couples can pool their resources, split bills and tend to have more capital to fall back on.

However, with these benefits should also come some extra considerations. Raising a child is not a cheap business, and modern day estimates of how much it costs to support a child financially from birth up to the age of 18 suggest that this figure could be at least £160,000 – potentially even more if we include the rising costs of food prices, petrol and other expenses that are likely to continue to balloon over the next few years. i As such, in order to feel secure in her financial future, Bridget should explore ways to protect her income as much as possible:

Critical Illness Insurance

Should the worst happen and either Bridget or her husband become seriously ill, Critical Illness Insurance is a fantastic way to provide a safety net for the family in the future.

Typically, these policies pay out a single taxfree lump sum in the event someone being diagnosed with a serious illness or condition.

The conditions covered by these policies will vary, but typically life-changing illnesses such as cancer, Parkinson’s disease and stroke will be included in the policy.

Of course, to get the most security out of this option, Bridget should choose a policy that covers as many ailments as possible, though that will of course impact the price of what she will pay. In general, individuals thinking about Critical Illness insurance should choose a policy that would result in a sum that would cover their mortgage, any outstanding debts (student loans) and living expenses. This way, if it does come to the point where the policy is used, Bridget and her family will have the financial support they need.

There are also joint policies available for couples, but Bridget should remember that

In a similar vein, Bridget and her husband should definitely start talking about Life Insurance and what this could mean for them in the future. Like Critical Illness Cover, Life Assurance policies can often be a good safety net, especially as any lump sum pay-out or series of payments is likely to be enough to cover things such as the mortgage they owe on property or to provide income for the family members left behind.

Some Life Assurance policies can be combined with Critical Illness Cover, giving more comprehensive protection that covers more circumstances. As ever with insurance policies, there are multiple different types of life assurance on the market, so it’s vital that she gains financial advice from a trusted team of financial advisers in order to find a policy that best reflects her individual needs.

When there’s a will, there’s a way

If Bridget has been particularly organised, she may have already drawn up a last will and testament. Having her family will likely have changed her priorities of where she wants any money to be left, meaning that she should probably repeat this process – or go through it if she hasn’t already. This way, she can rest assured that her money is going where she wants it to in the event of her death should she have any particular requests.

Ultimately, while marrying and starting a family is an exciting adventure, it’s also a significant financial change in your life and brings with it a number of new aspects to think about. Seeking expert financial advice/ guidance is the most beneficial way to navigate this next stage, especially as experts will be able to identify the policies that will best protect you and your family moving forward.

For more information, please call 0845 345 5060 or 0754 336 8478 or visit www.theifas.com REFERENCE i Child Poverty Action Group. Cost of a Child.

Link: https://cpag.org.uk/policy-and-campaigns/ cost-child#:~:text=The%20Cost%20of%20a%20 Child%20in%202019&text=The%20latest%20 report%20in%20our,up%205.5%25%20since%20 2012). [Last accessed May 22].

NEXT ISSUE : BRIDGET BUYS HER OWN DENTAL LABORATORY… www.dentaltechnician.org.uk JULY 2022.indd 9

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DTS 2022

Stand out sessions

at DTS 2022 l

There were several stand out sessions at this year’s Dental Technology Showcase (DTS), with delegates thrilled to have had the opportunity to hear from an array of world-class speakers.

Speaking about Davide Acetto’s lecture in the DTS Lecture Theatre, Daniel Cascella, CDT at Tauris Dental Prosthetics, said: “Davide’s session was very informative for the future. There has been a good range of speakers and subjects and we have visited several stands – we’re interested in 3D printing for dentures. I would recommend DTS to others.”

About Dr Gulshan Murgai’s session, which covered “Vita – Chairside and lab digital dentistry solutions”, Lisa Perchal, ceramist at Evolution Dental Studio, commented: “This was very informative, introducing new materials in the CAD world of digital dentistry.”

But a brief snapshot of the sessions available at DTS 2022, this gives you a good idea of the calibre of the event.

If you missed out, be sure to get the 2023 dates in the diary early!

The Dental Technology Showcase (DTS) 2023 will be held on Friday 12th and Saturday 13th May, Birmingham NEC, co-located with British Dental Conference & Dentistry Show.

For more information, visit www.the-dts.co.uk, or email dts@closerstillmedia.com 10 JULY 2022.indd 10

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DIGITAL TECHNOLOGY

Combination dentures: an indication-specific material mix in the digital workflow

By Arbnor Saraci, Lukas Wichnalek and Norbert Wichnalek

D Arbnor Saraci

Lukas Wichnalek

igitization now provides completely new material options for dentists and labs that are metal-free and offer the right choice for every indication. Where restorations used to be made with wax-ups, they are now increasingly designed on a computer. A digital laboratory is full of grinding, milling and printing noises. Where metal frameworks used to be veneered, feldspar ceramics, glass ceramics, zirconia, high-performance polymers and hybrid materials are now used.

Less and less pouring is done. The following case study demonstrates the interaction that is already possible today in a commercial laboratory between digital diagnostics, design software, hardware and CAD/CAM materials. Using a virtual patient as a basis, a combined fixed and removable prosthetic piece is created from completely different material components that are predestined for the respective area of application.

Initial situation with split, carious anterior upper jaw teeth

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A 58-year-old patient came to the practice because he had been dissatisfied with the functional and aesthetic condition of his upper jaw for quite some time. With the exception of tooth 14, all the premolars and molars in the posterior region had been lost over time.

Anterior teeth 11 and 21 showed fractures in the incisal region. Secondary caries had been diagnosed in teeth 21 and 23. The patient had several desires for the new restoration: The situation should be functionally stabilized and age-appropriate aesthetically in the front tooth area. The restoration should be as metal-free as possible, and due to time constraints, should be carried out in as few sessions as possible.

An implantation was out of the question for the patient because of difficult anatomical conditions that involved very little bone availability in some places, and would entail complex surgical procedures. After a detailed consultation, he decided on a combined fixed and removable denture. This was to be manufactured in a digital workflow in order to be able to choose the right mix of materials and reduce the treatment time to a minimum, despite the prosthetic complexity.

Zirconia The remaining teeth in the upper jaw were to be supported with splinted crowns from 11 to 14 and 21 to 23, with integrated extra-coronal attachments in distal direction. The goal was to restore the aesthetics and to ensure sufficient stability for anchoring the removable dentures.

The multichromatic and super-translucent zirconia VITA YZ ST was chosen, which offers a natural-looking and stable framework for partially veneered restorations. The zirconia material is suitable for bridges with up to 14

Norbert Wichnalek

14

CASE STUDY:

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DIGITAL TECHNOLOGY

units in the anterior and posterior region, and it offers a consistently high strength of 1200 MPa, in addition to aesthetic advantages. The super-translucent blanks have to be dry milled in order to obtain optimal light-optical properties.

The two frameworks were to be constructed with only a slight vestibular reduction in order to make a patient-friendly, minimal surface finishing with the low-fusing, leucite-reinforced glass-ceramic VITA LUMEX AC (both materials VITA Zahnfabrik, Bad Säckingen, Germany).

The functional areas consistently remained purely monolithic for sustained clinical longterm stability. The zirconia system VITA YZ offers precise shade fidelity to the VITA shade standards. In this case, the tooth shade of the natural teeth was determined to be A3 using the VITA classical A1-D4 shade guide, and the multichromatic blank VITA YZ ST A3 was selected as true-to-shade. The determined basic tooth shade is reproduced reliably by the selected blank, while the integrated shade gradient already monolithically ensures a natural appearance. After the individualization with veneering ceramic, the final characterization and glazing was to be carried out with the VITA AKZENT Plus stain system.

High-performance polymer PEEK The framework of the removable partial denture was to be made from a high-performance polymer blank from the PEEK family, as the patient wanted the restoration to be as metal-free as possible. Due to its low weight, the material offers high wearing comfort and is chemically inert, which means that the highest possible biocompatibility can be expected. The low flexural modulus could be an advantage in compensating for chewing forces.

However, in our experience, a number of factors must also be considered with such a framework construction. The usual metal construction cannot simply be copied when high-performance polymers are used. In order to achieve the minimum layer thicknesses of 0.6 to 0.7 mm, almost three times more space is required than for metal. The patient must also be informed that constructions made of PEEK or PEKK, like all others made of acrylic and high-performance polymers, tend to absorb more or less water, which can result in an unpleasant odor. Plaque susceptibility must also be considered. In the course of clinical use with countless chewing processes, even the smoothest PEEK surface develops micro-retentive grooves over the long term, which subsequently promotes plaque accumulation. Each new highgloss polish is in turn associated with a certain loss of substance. In this case, a large part of the PEEK surface was in the palate area, which is subject to constant natural cleaning through tongue activity. Nevertheless, the patient was also informed about this fact with regard to his own oral hygiene at home. In this case, the freedom from metal and the wearing comfort outweighed these disadvantages in the patient's personal decision-making process.

FROM TOP ROW (LEFT TO RIGHT): Except for one premolar in the first quadrant, the complete support zone was missing in the maxillary posterior region; The intraoral situation in the habitual terminal occlusion with damaged teeth 11 and 21; Status following full crown preparation of all teeth in the upper jaw; Prepared stumps and opposing dentition were scanned intraorally and integrated into the facial scan; The initial situation matched with the facial scan was used as the starting point for the construction of the crown blocks; In collaboration with the patient, a virtual mock-up was created; Based on the virtual mock-up, both splinted crown units could be constructed; The splinted crown units constructed with extra-coronal attachments in the occlusal view; In the vestibular part of the crowns, non-functioning windows were integrated for individualization; The support zone in the posterior tooth area could also be constructed based on the information from the facial scan; Both splinted crown units with extra-coronal attachments made of the zirconia VITA YZ ST Multicolor; The denture base with matching attachment matrices was constructed out of a high-performance polymer of the PEEK family.

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DIGITAL TECHNOLOGY

Precisely fitting recesses for the TK1 friction element were planned in the construction of the framework in order to be able to continuously adjust a sufficient hold on the extra-coronal attachment of the splinted crown units, and to provide a handling that was as patient-friendly as possible. An integrated bar was to be constructed in the posterior region in order to ensure a secure fit of the splinted posterior region in the future. A lifelike finish with the flowable and light-curing veneering composite VITA VM LC flow was planned for the denture saddles. The gingival anatomy was not to be reproduced in an exaggerated manner, and stippling was to be consistently avoided in order to prevent accumulations and deposits, and to ensure a pleasant feeling in the mouth.

Composite The long-term provisional and multichromatic CAD/CAM composite VITA CAD-Temp was selected for the posterior region, analogous to the prefabricated teeth. The material consists of the Microfiller Reinforced Polymer Matrix (MRP) from which the VITA prefabricated teeth are also made. This is a high-molecular and highly cross-linked acrylate polymer with polymerized micro-fillers, which is responsible for the outstanding abrasion resistance of VITA prefabricated teeth. The missing premolars and molars were to be splinted and constructed on the lumen side to match the denture saddles and milled out of a blank. The incorporation of central cylindrical zirconia inlays was planned in the first molars inside the crown. They were to function as central stops over the long-term clinical course. The vertical height was to be stabilized, if necessary, and functional freedom was to be provided in the composite material for eccentric abrasive processes at the same time.

The virtual patient For a virtual work basis, several digital data sets had to be created and combined with each other. A facial scan (Face Hunter, Zirkonzahn, Gais, South Tyrol, Italy), an intraoral scan before and after the preparation and in habitual occlusion (Medit i500, MEDIT, Seoul, South Korea), was carried out. By virtually defining the reference points from the face scan and the habitual occlusion, the two splinted crown units with extra-coronal attachments and the missing support zones could be constructed. An individual tray was designed and additively manufactured for the overall construction in order to mould the tooth stumps in the upper jaw.

Analog control option For controlled assembly and harmonious individualization of the prosthetic material components manufactured with CAD/CAM support, an analog control option was to be created on the basis of the virtual data. Models were created on the basis of impressions in the upper and lower jaw and digitized in the Medit T710 laboratory scanner (MEDIT, Seoul, South Korea). In the CAD software, the virtual models could be articulated in relation

16 JULY 2022.indd 16

to the skull, based on the information from the face scan. The upper and lower jaw models were additively manufactured with integrated support pins for patient-appropriate centric positioning. Using the digital workflow, the die impressions of the upper jaw were subtractively transferred to the PlanePositioner (Zirkonzahn, Gais, South Tyrol, Italy). This made it possible to centrically articulate the upper jaw and then to articulate the lower jaw as well, with the help of the integrated model support pins. The virtual articulation was now also physically present.

FROM TOP ROW (LEFT TO RIGHT): The saddle region of the base was designed as struts together with suitably splinted posterior crowns made of composite; The overall denture construction made of zirconia, the high-performance polymer PEEK and composite; The denture base made of PEEK and the posterior teeth made of VITA-MRP composite (VITA CADTemp) before being combined; The completed partial denture with integrated attachment matrices; The finished combination denture prior to the final placement; A natural esthetic was achieved with only minimal surface finishing; The finished combination denture in the occlusal view; Matrix and patrix fit precisely into one another, thanks to the CAD/CAMsupported production; The saddle portions were subtly individualized, while care was taken with flat surfaces; The integrated combination denture in its habitual terminal occlusion; Shade effect, morphology and texture of the anterior maxillary region harmonized with the incisors in the lower jaw.

Clinical try-in After the two splinted crown units with extra-coronal attachments made of multilayered VITA YZ ST A3 were fabricated with CAD/CAM support, they were tried in

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DIGITAL TECHNOLOGY

clinically. In order to compensate for the divergences between the mechanical-static model situation and the biodynamic patient situation, the saddle portions and the tooth morphology were printed as a monoblock to match the extra-coronal attachments.

These custom-fit bite templates were used for subsequent registration on the patient, which was then transferred to the virtual and analog articulator for completion.

Plasma conditioning and fixation Based on the patient-appropriate new articulation, the framework of the partial denture was constructed from the highperformance polymer PEEK, and the posterior teeth were constructed from the CAD/CAM composite VITA CAD-Temp as a crown block. Both were then subtractively manufactured and finished in the digital workflow. After the two saddles had been made with a gum-colored cold-curing polymer resin, the crown lumen and the denture base were conditioned on the adhesive surfaces with low-pressure plasma (DENTAPLAS PC, Diener Plasma, Ebhausen, Germany). Both denture components were then adhesively bonded to one another using the toothcolored VITA VM CC cold-curing polymer resin. After the final individualization of the

denture saddle with VITA VM LC flow, the combination denture was completely cleaned with plasma, welded in, sent to the practice and integrated there.

Tailored combination of materials Today, the digital workflow makes it possible to find the right material for every indication and every patient request.

In this case, it was possible to create a tailor-made combination denture from three different CAD/CAM materials on a digital diagnostic working basis. The crown blocks made of zirconia in the front provide stability for the overall construction, and offer basic aesthetics with the integrated shade gradient. The framework of the partial denture made of PEEK was light, offered the greatest possible freedom from metal and was comfortable to wear. The composite crown blocks in the posterior region had the proven material properties of prefabricated teeth. Veneering and staining systems appropriate to the material are available for the minimal individualizations that enable efficient and individual surface finishing. The patient was completely satisfied with the quick result, the reduced treatment time and the aesthetic result.

The patient was absolutely satisfied with the function and aesthetics of his new restoration

DENTAL TECHNOLOGY

Zirkonzahn Multi Blank Holder 7 crowns, 7 colours, 7 patients l

The new Multi Blank Holder 4x1 and 7x1 Teleskoper are special holders for processing small material blanks (size 1) in different colours and heights. The Multi Blank Holder is particularly advantageous: it permits milling up to seven single crowns in hardly used colours. In this way, it is possible to produce crowns for seven different patients all at once.

Specifically for these supports, small material blanks (size 1) in the heights of 16 mm and 22 mm have been conceived and they are available in all type of Prettau® Dispersive® zirconia. Thanks to the smaller blank shape, it is no longer necessary to keep a large inventory of little-used tooth shades, ensuring significant cost savings.

diameter of 95 mm. In combination with the 2-Blank-Plate and the 4-Blank-Plate it can also be used in the M4 Wet Heavy Metal milling unit. The Multi Blank Holder 7x1 Teleskoper was specifically developed for the Teleskoper Orbit ⌀ 125 mm of the M2 milling unit comfort line.

MORE INFORMATION AT: www.zirkonzahn.com

The Multi Blank Holder 4x1 can be used in all milling units with an orbit

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DIGITAL TECHNOLOGY

Real jaw movements and face morphing on the digital patient: production of functional restorations in only two chairside appointments Example of a full-digital workflow based on the production of a demo mock-up.

The tools for patient diagnostics as well as the design automations used allow for a precise functionalisation of the prosthetics in the digital world, providing patients with customised restorations in only two chairside appointments.

T

he latest technologies and software innovations in terms of patient data acquisition permit the production of functionalised and aesthetic restorations in considerably shorter times. Through a demo case of a mock-up, this article describes a workflow based on Zirkonzahn’s patient diagnostics tools and design automations allowing for the manufacture of precise, individual dental prostheses in only two chairside appointments. A comparison between the produced demo mock-up and the natural teeth is also displayed, to show the mockup’s high level of customisation and natural effect achieved with the workflow.

First chairside appointment During the first appointment with the patient, the practitioner records the patient’s data and oral situation by taking 2D pictures of the face as well as digital impressions through the intraoral scanner.

After the visit, the dentist sends the recorded data to the dental technician, who creates a virtual patient folder in the archive software, saving and storing all patient information for future usage. Based on the 2D pictures and intraoral scans, the dental technician designs a first set-up by means of the Smile Creator module included in the Zirkonzahn.Modellier software, in order to create a preview of the potential new smile.

With the Smile Creator, the dental technician can design the tooth setup based on the natural teeth of the patient, or use the virtual libraries of natural tooth sets available in the software. In addition, the dental technician can apply different tooth sizes, display the teeth in a realistic dentine colour, as well as integrate different reference lines into the 2D pictures for

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TOP: Impression-taking with the intraoral scanner BOTTOM: Registration of patient data into the archive software

better tooth alignment (e.g. the smile line).

The completed setup can then be exported as a 2D or 3D file and saved in the software for future designs.

Second chairside appointment During the second appointment, the dentist and the dental technician show the digital smile

preview to the patient. If the patient is satisfied with the aesthetic result, the dentist continues the treatment according to the restoration type.

This demo case for the creation of a mockup shows the workflow generally used for treating complex cases on implants. In such situations, the dentist employs the following patient diagnostics tools:

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DIGITAL TECHNOLOGY

• The PlaneSystem® (MDT Udo Plaster), which records the patient’s occlusal plane and oral situation in Natural Head Position • The Plane Analyser II, which detects the patient’s real mandibular movements for a detailed and customised functionalisation of the prosthetics • The Face Hunter 3D facial scanner, for a photorealistic digitalisation of the patient’s face Such technologies permit the 1:1 reproduction of the patient physiognomy and oral situation into the virtual world with no loss of precious information. In this way, the techno-clinical team can continue the workflow with no need for further chairside appointments to perform functional and aesthetic checks. This is possible thanks to the integration of the recorded information into the Zirkonzahn.Modifier design software. By means of a specific software function (“Real Movement”), the dental technician can display with accuracy all mandibular movements recorded with the Plane Analyser II (opening, closing, protrusion, retrusion and laterotrusive movements), achieving an optimal functionalisation of the design. Subsequently, with another automation (“Face Morphing”) the functional movements can be associated with the patient physiognomy in order to simulate several facial expressions (e.g. smiling) and evaluate the restoration in terms of aesthetics. Movements can also be imported into the virtual articulator, which is adjusted automatically in relation to the case, for a possible switch to the analogue workflow with milled or printed models.

At this point, the dental technician sends the dentist a PDF file including all information concerning the design as well as the software-generated functional movements. After the dentist’s final approval, the dental technician proceeds with the manufacture of the prosthetics.

Delivery to the patient The patient goes to the dental practice to receive the restoration. No functional or aesthetic changes need to be applied, since all checks were performed on the digital patient by means of the Real Movement and Face Morphing functions.

For more information: W: www.zirkonzahn.com T: +39 0474 066 660 E: info@zirkonzahn.com TOP ROW: Creation of a first set-up displaying tooth size, colour and shape 2ND ROW (L): Capture of the oral situation with the PlaneSystem® 2ND ROW (R): Capture of the mandibular movements with the Plane Analyser II 3RD ROW (L): Photo-realistic 3D digitisation of the patient’s face with the Face Hunter facial scanner 3RD ROW (R): Matching of all data, for a 3D virtual reproduction of the patient’s oral situation and physiognomy 4TH ROW (L): 3D display and analysis of jaw movements recorded with the Plane Analyser II (“Real Movement”) 4TH ROW (R): Simulation of facial expressions (“Face Morphing”) 5TH ROW: Natural smile vs smile with the mock-up.

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INSIGHT

Executive Leadership Series PART 6

ENSURE YOUR TEAM IS ‘WELL-LED’

By Nicki Rowland

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INSIGHT

In June’s edition, Nicki Rowland explored ‘The Ostrich Effect’ and why it is so important to be a visible leader. In this article, she explores the difficulties that many laboratories are currently facing with regards to leadership and how to overcome the obstacles to being well-led.

WELL-LED – WHAT DOES IT MEAN?

The world of dentistry is governed by strict compliance. The Care Quality Commission (CQC) expect dental practices to have solid leadership, effective management systems and sound governance. Whilst laboratories are not currently visited by the CQC, there is a huge amount of value to be taken by implementing the ‘Well-led’ part of their model. What business is not going to grow and thrive on a foundation of visionary leadership, a culture of openness and candour and a collaborative approach to achieving success?

CULTIVATE AN OPEN AND SAFE ENVIRONMENT

Encouraging and cultivating a culture that supports personal growth within the business development model will result in multiple levels of success within your practice. Much like a good gardener who closely attends to their crop for maximum production, a laboratory that clearly cares about the personal development of its individual team members will have a more engaged workforce. This links directly to employee productivity and a greater financial yield over time.

PLANT THE GROWTH MINDSET SEED

As human beings, we need to feel appreciated, understood and valued at work.

This is integral to a healthy culture. Much like a plant needs water to survive, humans have an inherent desire to feel needed. If one of your team feels that they are not appreciated or that their opinions do not matter, they are far more likely to leave your business. In an environment where team members are afraid to share their thoughts out of the fear of reprisals, personal growth is stunted. It is just like putting a plant in the dark. Deprive an entity of essential nutrients and the environment is not favourable for growth. Therefore, it is up to us as leaders to plant a seed, water it daily and place it in the sun to nurture a growth mindset in our laboratories.

Supporting feedback is a great way to start honest and transparent conversations. This should not be a finger pointing exercise but an opportunity to encourage, listen and give credit where credit it is due. In a very busy laboratory, listening is more important than ever and there are many benefits to doing so:1. Builds trust and respect - Using active listening* skills demonstrates to the other person that you care. In a similar way, a struggling plant will prosper when given a stake or trellis for support.

2. Encourages openness – Just like a flower that feels the warmth of the sun, team members will ‘open up’ and ‘blossom’ when they know they are being heard.

3. Generates understanding - When implementing active listening, you can read the other person and truly understand what they need to thrive. Similarly, you may watch a YouTube video intently to understand how to treat your lawn when it looks a little yellow around the edges.

4. Avoids miscommunication - Using active listening skills reduces the chance of misunderstanding what the other person needs. It would be very easy to kill your grass if you mistook the word ‘feed’ for ‘weed’.

5. Boosts morale – It is easy to assume what someone is thinking and feeling.

However, if we go the extra mile and give people time and listen to them closely, they will feel energised and motivated. Likewise, when house plants appear a bit ‘sad’, a boost of plant food in their water is sure to pick them up. * Definition: Active listening is a skill that allows an individual to engage with the speaker more effectively by paying special attention to the conversation. It allows the person to draw information that is not being explicitly disclosed by observing and asking questions adequately - The Accounting Dictionary

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CULTIVATING YOUR CULTURE

The CQC have found a demonstrable link between how well-led a dental practice is and the safe delivery of its care to patients.

In other words, if leadership is lacking, then other aspects within the business are likely to be missing too. So, how can we improve our cultures? Unfortunately, culture is not an element that is easily monitored. Luckily, it can be assessed in other ways.

By implanting a systematic approach to leadership, management and governance in your laboratory, trust and cohesion can be nurtured within your team. Openness, transparency and candour can then be encouraged too. So, what can we do as leaders to enable this to happen? The answer is not conclusive but by taking a few simple steps, you can make a significant change to your culture and tick all the boxes within your business:1. Purpose and business planning – agree your purpose as a team and generate a clear vision of what your laboratory wishes to achieve. Your business objectives should be SMART (Specific, Measurable, Achievable, Relevant/Realisitic and Timeframed) and openly shared with your team. Monitoring progress and auditing results is essential to the ultimate success of your business 2. Performance management and appraisals - every team member should have a clear understanding of their roles and responsibilities and should be accountable for their performance. Everyone should receive an annual appraisal and appropriate training should be delivered to fill any skills, knowledge and attitude gaps and encourage personal growth 3. Leadership – effective leadership in your laboratory should be reflected in your purpose, values and consistent approach to management. Openness, transparency and honesty are key to nourishing trusting relationships with your team members

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INSIGHT

4. Feedback – seek feedback from both clients and staff so that their views and experiences continuously drive improvements in your service delivery 5. Quality assurance – this is a process whereby you are planning activities and reviewing, monitoring and evaluating outcomes. If any discrepancies or areas for improvement are highlighted within risk assessments, audits and surveys, a plan of action should be implemented within an appropriate timeframe to ensure sustainability of a high-quality service and a safe working environment.

PRACTICE GROWTH

There is no doubt about it that a well-led framework drives business growth. By building a culture where trust, respect and commitment thrive, accountability and results will be sustained. In my experience, a unified team with a shared focus and great leadership are like the roots of a large tree (your laboratory). When hit by strong winds, the tree will take a battering and lose twigs and branches. However, the roots will firmly anchor the tree in the ground. When the storm passes, your business may be a little weather beaten but your team will be ready

ABOUT NICKI ROWLAND Nicki has lived and breathed practice management since opening Perfect 32 Dental Practice in East Yorkshire in 2005.

For over 10 years, Nicki nurtured her team to achieve exemplary standards in both clinical and customer service-based areas of work and as a result the practice won countless awards. These include The National Training Awards for Yorkshire and Humber in 2010, as well as being a national finalist in the SME category. to pick up the pieces, revitalise the tree and allow it to flourish in the years to come.

In 2011, Perfect 32 won The Training Business of the Year Award at the local Chambers of Commerce Awards and Nicki herself was awarded Practice Manager of the Year by the UK’s Association of Dental Administrators and Managers (ADAM) in 2012. In 2014, Nicki set up her own business, Practices Made Perfect.

Nicki has also recently co-founded The Exceptional Leadership and she was placed in Dentistry’s Top 50 most influential people list in 2021.

A Word from Nicki

day.” My belief is that time is the most precious thing that you can give to anyone. A little drop of attention every day will revitalise your team during times of stress and adversity.

In the words of author, Cristen Rodgers, “We are all gardeners, planting seeds of intention and watering them with attention in every moment of every

If you need any help, advice or consultancy, contact me at either nicki@ela.team or info@pmp-consulting.co.uk

DENTAL NEWS

INCREASING OUR STANDARD OPERATING PROCEDURES (SOP) THROUGH EVIDENCE BASED RESEARCH

By Andy Barrs I Clinical Dental Technician

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When I was president of the BACDT, I often wondered why they appeared to get criticised for their apparent lack of effort in trying to increase direct access for CDTs. Yes, some CDTs might argue that our current SOP, set out by the GDC is unworkable and restricts patient’s choices, others would argue it’s not perfect but for them it works just fine.

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So what is the real answer and should our SOP be expanded to include direct access?

look at how they could do this and evidence based research would be invaluable.

With regard to BACDT, and in their defence, If the majority of the membership were happy with the SOP, then that is not going to be an area the association would pursue. If, however the majority wanted direct access then the association would

I’ve written several articles with regards to CDTs and the subject of direct access and partial dentures over the years and although I’m not surprised that many CDTs want to increase their SOP, having a moan on Facebook about not being able

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DENTAL NEWS

to get a prescription signed is going to achieve nothing.

The question I keep asking myself is, if we were to pursue direct access further, have CDTs really thought it through and what would that extra responsibility mean? Could it be argued, and this is my own very simplified view, that CDTs who don’t want direct access have any excellent working relationship with one or more dentists, receiving lots of referrals, and for them the current SOP works just fine, whereas CDTs who want direct access don’t have that same professional relationship?

Would FTP cases against CDTs increase, decrease or stay constant if we had direct access. Again, it could be argued that many FTP cases bought against CDTs are for working outside scope of practice. So if our SOP surely was increased, maybe the amount of FTP would decrease.

Alternatively, another point of view could be that that number of FTP cases would increase drastically because things could be missed because a CDT just wanted to make a denture quickly. Who knows. The question we really have to ask ourselves is ‘would patients really be getting the best dental care if they weren’t being checked by a Dentist before starting their denture treatment?’

The GDC’s main criteria is for patient protection and with the current regulations, I personally think the patient gets that protection. I’ve attended many meetings at the GDC over the years and a lot of their decision making is based on evidence based research. So, if CDTs do want to achieve direct access, surely having the relevant education in place but also backed up with some very strong evidence based research would help.

If CDTs were granted direct access tomorrow what percentage of patients could we treat - in other words how many patients in the CDTs opinion would be dentally fit and would need no

treatment at all before starting denture treatment. Obviously there will always be the odd patient who does not want to see a dentist. And if not treated by a CDT are we just pushing them to see a dental technician who will make them a denture illegally.

At the end of the day if you’ve got to send a patient back to a dentist for some treatment, then why not get a prescription/ oral health certificate at the same time?

Bearing all these factors in mind, I thought the best way to get some more accurate answers for myself and see if I could present a strong case for direct access would be for me to carry out some research of my own and see whether I could make a strong evidence based argument.

I kept a log of 100 patients (which makes it much easier for my simple brain to work out percentages). l Were they a new or existing patient to my clinic? l Did the patient come to me via a referral from a dentist? l Was

the patient partially dentate?

l Was

the patient edentulous?

l And out of those patients that needed a new partial denture how many needed no treatment at all from a dentist?

Here are my findings: l 37

patients were F/F cases - 37%

l 63 patients were for either a Partial or a full only or a partial and partial or partial and full l 63%

Of the 37 % - the F/F cases, 18 were new patients and 19 were existing patients so almost 50/50.

l Of the 63 % - the partial denture cases, 18 were referred by Dentists, 23 new cases came directly to my Clinic l 22 were existing patients coming back for a new denture.

So only 45 % of the patients who came to my clinic without a referral for a new denture, we’re partially dentate.

I also wanted to also see what percentage of those 45 patients wouldn’t need any treatment at all (after seeing a dentist) before I could start making them a new partial denture.

There were only 4 patients. So approximately 10% of my partial denture patients and only 4% of the overall patients coming in to see me for new dentures who didn’t need to see a dentist.

Personally, I’m very happy with our current SOP, and these percentages of patients in my opinion for me don’t warrant the additional cost, stress and responsibility of increasing my SOP. I’ve also seen patients who in my opinion where dentally fit only to discover that after seeing the dentist needed a small filling or a tooth extracted because I would have missed that decay. (I totally understand that might not be the case with the relevant training).

If every CDT carried out their own research and their findings and percentages were far higher than mine, then this would definitely make for a very strong evidence based argument to present to the GDC. Our current way of working is not perfect I agree, just ask any patient who is partially dentate in hospital who has had their denture lost.

But in the majority of cases it does work.

Remember, if CDTs want to change their SOP, then a strong association and some evidence based research can only help.

About The Author Andy qualified as a Dental Technician in 1985 and started his private prosthetics laboratory in 1988. He later qualified as a CDT in 2002 from George Brown and with Royal college of surgeons in 2007.

Previously a member of CDTA, then BACDT, serving 4 years as president of the BACDT.

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ADVERTORIAL

FUNDING YOUR PROFESSIONAL DREAMS THE EASY WAY Have you got your eye on new work benches, a top-of-the-line 3D printer or even industrial milling equipment but are worried about how to fund your professional dreams? Well, you need look no further, writes Richard Porter.

l

These are uniquely challenging times – there’s no getting away from it – but for those of us in dentistry, it is not all gloom and doom.

Whilst, of course, Covid-19 in itself was unexpected, an unanticipated outcome of the work from home culture is the ‘Zoom boom’ desire for cosmetic dentistry. This, naturally, requires technical work to be completed and so dental labs are in high demand.

You may now be wondering, how can you meet that kind of demand should new equipment or any other kind of large investment be prudent, without affecting your cash flow or your stress levels?

The good news is that we have the answer in the form of equipment finance and business loans. For example, to date, award-winning dental finance broker, WestWon, has supported dental lab professionals with over £3.2m of finance in 2022, which certainly means we are one of the leading dedicated finance brokers servicing your sector.

Don’t just take my word for it – here is what lab owner, Phil Reddington, who wanted a new milling unit, had to say about working with WestWon: ‘Richard organised everything, provided the necessary funding to purchase the new milling equipment and organised our funding within 24 hours. It has been one of the simplest and easiest processes I have ever experienced.’

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A dedicated service

So, what are the options for dental labs looking to make a significant purchase?

One possible solution is equipment finance or a capital loan, both of which offer several benefits in addition to maintaining cash flow, for example: ● Alternative lines of funding - you do not need to use up a bank facility, e.g. overdrafts. ● VAT consideration - on VAT funded agreements, the VAT is included in the rental, not in a lump sum.

● Pay

for the equipment as you use it - companies pay employees over time as they work, so why pay all the cost for equipment in advance? ● The latest equipment - always have the latest dental technology at your disposal by implementing a recycling strategy, whereby you replace equipment at the end of the lease term, e.g. IT. ● As demand grows for your services, you can invest in the equipment to align with the demand, and having a fixed monthly repayment ensures you have a clear return on investment.

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ADVERTORIAL

● Tax

planning - using a lease rental agreement enables you to claim 100% of your rental if you are a sole trader, in a partnership entity or, as a Limited company, a Hire Purchase will enable you to claim the super tax deductions of 130%. (The super deduction tax opportunity runs until 31 March 2023; after that date, there is a planned corporation tax rise.)

In addition, we support dental labs with sale and lease back, also known as equipment refinancing. In a nutshell, this is where a dental lab may have made a purchase in the last three months and now wishes to reimburse the business and put the equipment on a finance agreement. It is a fast and effective way to improve your cash flow, as well as enabling the reimbursed cash to go towards other areas in your business.

Doing good beyond the business

Our aim is to plant 100,000 trees within The WestWon Woodland and remove 7,500 tonnes of CO2 from the atmosphere over the next five years.

Step this way to achieve your goals

At WestWon, we do what we can to ensure each client is able to take full advantage of all tax breaks and bring savings to the business, alongside an easy and simple application process.

Working with our partners, we support the dental labs throughout the UK.

ABOUT RICHARD PORTER Richard is the Divisional Director for the Dental Sector, within award-winning WestWon and has over 25 years’ experience within the Sector, supporting clients and partners in their quest for business growth by providing expert and timely finance services.

If you would like to know more about how WestWon can help support your lab’s growth, simply visit https://www.westwon.dental/ alternatively call 01494 611 456 or email richard.porter@westwon.co.uk

With all of us becoming increasingly aware of the environmental risk to both the planet and future generations, many dental labs are embracing corporate social responsibility.

Branch out and plant a tree in the WestWon Woodland

We know how important that is and so we have arranged it so that you can also do good through your leasing choices.

Our new initiative, in association with Ecologi UK, means that when you proceed with a lease agreement with us, we will plant a tree for every month of the lease term in the WestWon Woodland.

It’s as simple as that. We don’t need anything from you, and you will receive a certificate of planting as well as a link to our very own WestWon forest, where you can see your trees being brought to life.

This simple and quick process is just another way of how undertaking an agreement via WestWon, not only benefits you, but in this case also helps support environmental and climate efforts.

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ECPD

FREE VERIFIABLE ECPD

As before if you wish to submit your ECPD online it will be free of charge. Once our web designers give it the all clear there will be a small charge.

This will be less than the CPD submitted by post. This offer is open to our subscribers only.

To go directly to the ECPD page please go to https://dentaltechnician.org.uk/dental-technician-cpd.

You will normally have one month from the date you receive your magazine before being able to submit your ECPD either online or by post.

If you have any issues with the ECPD please email us cpd@dentaltechnician.org.uk

0.5HRS VERIFIABLE ECPD LEARNING AIM The questions are designed to help dental professionals keep up to date with best practice by reading articles in the present journal covering Clinical, Technical, Business, Personal development and related topics, and checking that this information has been retained and understood.

LEARNING OBJECTIVES n To understand XXXXXXXXXXXXXXXXXX

VERIFIABLE ECPD - JULY 2022 1. Your details First Name: .............................................. Last Name: ........................................................Title:................

Address:.............................................................................................................................................................. ................................................................................................................................................................................ ............................................................................................................ Postcode:...............................................

Telephone: ......................................................Email: .................................................. GDC No:..................

LEARNING OUTCOME By completing the Quiz successfully you will have confirmed your ability to understand, retain and reinforce your knowledge related in the chosen articles.

CORRECT ANSWERS FROM THE JUNE 2022 DT EDITION:

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Q1.

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2. Your answers. Tick the boxes you consider correct. It may be more than one.

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3. Evaluation: Tell us how we are doing with your ECPD Service. All comments welcome.

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As of April 2016 issue ECPD will carry a charge of £10.00 per month.

Or an annual fee of £99.00 if paid in advance.

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You can submit your answers in the following ways:

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B

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1. Via email: cpd@dentaltechnician.org.uk 2. By post to: The Dental Technician Magazine, PO Box 2279, Pulborough, RH20 9BR

Q12.

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Payment by cheque to: The Dental Technician Magazine Limited. Natwest Sort Code 516135 A/C No 79790852 You are required to answer at least 50% correctly for a pass. If you score below 50% you will need to re-submit your answers.

Answers will be published in the next issue of The Dental Technician. Certificates will be issued within 60 days of receipt of correct submission.

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ECPD

VERIFIABLE ECPD AS YOU NEED IT VIA THE DENTAL TECHNICIAN

VERIFIABLE ECPD FOR THE WHOLE DENTAL TEAM

Payment by cheque to: The Dental Technician Magazine Limited. NatWest Sort Code 516135 A/C No 79790852

REAL JAW MOVEMENTS AND FACE MORPHING ON THE DIGITAL PATIENT: PRODUCTION OF FUNCTIONAL RESTORATIONS IN ONLY TWO CHAIRSIDE APPOINTMENTS BY ZIRKONZAHN Q1. The latest technologies and software innovations in terms of XXX data acquisition permit the pro-duction of functionalised and aesthetic restorations in considerably shorter times?

A - Patient B - Product C - Audience D - Materials Q2. Zirkonzahn’s patient diagnostics tools and design automations allows for the manufacture of pre-cise, individual dental prostheses in only XXX chairside appointments?

A-1 B-2 C-3 D-4 Q3. During the first appointment with the patient, the practitioner records the patient’s data and oral situation by taking XXX pictures of the face?

A - Digital B - Analogue C - 2D D - 3D Q4. Following on from Q3: as well as XXX through the intraoral scanner?

A - Digital impressions B - 2D Images C - 3D Images D - Surface structure Q5. Based on the 2D pictures and intraoral scans, the dental technician designs a first set-up by means of the Smile Creator module included in the Zirkonzahn.Modellier software, in order to create a XXX of the potential new smile?

A - Sample B - Preview C - Photo D - Model

Q6. With the Smile Creator, the dental technician can design the tooth setup based on the XXX of the patient?

A - Size B - Opacity C - Jaw Size D - Natural teeth Q7. The dental technician can apply different tooth sizes, display the teeth in a realistic dentine colour, as well as integrate different reference lines into the 2D pictures for better XXX? A - Tooth alignment B - Teeth straightening C - Tooth impressions D - Tooth scans Q8. During the second appointment, the dentist and the dental technician show the digital smile preview to the patient. If the patient is satisfied with the aesthetic result, the dentist continues the treatment ac-cording to the XXX? A - Impression B - Scan C - Restoration type D - Brief

Q11. By means of a specific software function (“Real Movement”), the dental technician can display with accuracy all XXX movements recorded with the PlaneAnalyser II? A - Maxillary B - Arches C - Mesial D - Mandibular Q12. The dental technician sends the dentist a XXX including all information concerning the design as well as the software-generated functional movements?

A - PDF File B - Photo C - Scan D - Impression

Q9. The patient diagnostic technologies permit the 1:1 reproduction of the patient XXX and oral situation into the virtual world with no loss of precious information?

A - Physiognomy B - Portrait C - Smile D - Tooth opacity

YOU CAN SUBMIT YOUR ANSWERS IN THE FOLLOWING WAYS: VIA EMAIL: cpd@dentaltechnician.org.uk OR BY POST TO: The Dental Technician Magazine, PO Box 2279, Pulborough, RH20 9BR. You are required to answer at least 50% correctly for a pass. If you score below 50% you will need to re-submit your answers.

Answers will be published in the next issue of The Dental Technician magazine. Certificates will be issued within 60 days of receipt of correct submission.

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Q10. The XXX team can continue the workflow with no need for further chair side appointments to per-form functional and aesthetic checks.?

A - Odontotechnic B - Techno - clinical C- Digital dental D - CAD/CAM

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TECHNICIANS INSIGHT

5 THINGS

I CANNOT WORK WITHOUT!

By Chelsea Morley I Co-owner TetraCAM Milling Services Co-owner GHOST Dental

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entistry is always changing.

Big deal, no secret there right?

Yes, we are all aware that the digital era has become a part of pretty much every aspect of our everyday roles as Dental Technicians. What’s your point? I can hear you think… I’m just explaining in advance why my ‘5 things I cannot work without’ article is probably a little bit different from the ones of my predecessors’ list. As the owner of a fully digital milling centre dedicated to serving dental technicians, there’s no Lecron in sight.

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Here we go…

SOFTWARE

No surprise there then. Software is without a doubt the most used utensils in my kit as a digital Dental Technician. Personally, 3shape is my tool of choice. This is possibly because I was first trained using it, but after a few years’ experience with the alternatives namely ExoCAD, Dental Wings and InLab from Sirona, I always find myself returning to 3shape. My number one contact for support in this area has always been Alex

Mensikov, he’s a legend. After the design stage, nesting STL files into the material blanks is next. The software used on our milling machines is Millbox from Sum3D. The easy navigation of both these software systems makes them my personal favourites and our working life much easier.

DIGITAL FILING SYSTEM

Milling centres receive a mammoth amount of STL files each month! An organised filing system is vital for us. We don’t use any fancy software to do this, just the good old file button on Windows 11 is used to create a system.

It’s cheap and cheerful… but it works. We organise by the client laboratory name, the date the orders were sent, then material choice.

All our STLs are coded to protect the patient confidentiality and are disposed of safely. The filing system makes the files accessible to us almost instantly in the case of a query, repeat orders and for invoicing purposes.

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TECHNICIANS INSIGHT

‘THE MAGIC BOARD’

This is my personal favourite member of this list. In our Office, we have what is known as the ‘Magic Board’. Each month we use this board to write the goals for the month ahead, a sort of wish-list, if you like. These goals are not always monetary targets, these sometimes are as simple as ‘receive a glowing google review’ or ‘maintain all current clients through great customer service’. Once the goals are decided, there they stay - for the whole team to see. When the goals are met, they are ticked off- the whole team gets to see. I find this not only encourages team motivation, but also provides a communal sense of achievement when we hit those targets collectively. We call it the Magic Board, because everything we write on it, tends to happen When we hit a biggie, we celebrate in style.

SOCIAL MEDIA

The use of social media in Dentistry has exploded! The number of Dental Professionals using social media for a multitude of reasons is massive. The uses include communication, show casing work, discussing treatment plan options, networking, team building and advertising. Many dental students are using social media platforms to vlog their journey through university and grow a following, which can turn into a readymade audience once qualified. Perfect to build an online portfolio and in turn advertise work. My personal platform of choice is, I cannot stress this enough…

INSTAGRAM. A huge 80% of the new enquiries about placing orders to both of my companies comes through Instagram.

We have no need for pricey exhibitions or paid advertisements. Social media is completely free and accessible to the whole planet.

Before I go… I like to be different, so I’m going to throw one more in…

COMMUNITY SPIRIT

Since the start of my journey through Dental Technology, from being a university student to setting up dental companies two years ago, I have noticed the unbelievable community spirit in the world of Dental Technology.

We are a weird and wonderful bunch and it is very true, we all know each other, or are a ‘friend of a friend’.

I feel so privileged to have had occasions where Dental Technicians have sent messages of support, praise or have approached us

for advice. During my student days, various Laboratories allowed me to shadow and ask my never-ending questions, no matter how busy their workload. There are people who I talk to regularly online who I have never met in person, who offer advice and constructive criticism.

People who were strangers, are now friends.

Laboratory owners who have advised me how to run a business, to milling centre owners who have offered backup on the rough days, I just wanted to use this little opportunity to tell you that you have all influenced this journey in one way or another, through Dental Technology so far. You know who you are!

If you don’t know, get to know.

WHATSAPP

Obviously, communication is key in our job. The single most effective form of communication for Dental Technicians, in my opinion is Whatsapp. We all know the frustration of a missing shade from the prescription, then spending 20 minutes on the phone asking the receptionist to find out for you. You can use it to set up chat groups with key people for immediate answers to burning questions, without the wait. Your client can answer you between patient visits, or whilst their creations are firing. It works well for us when our clients want to inform us of a deadline or requesting a rapid turnaround. Zero time wasted. Oh, most importantly Whataspp is encrypted, so we can have complete confidence in keeping the patients’ confidentiality promise.

If you would like to participate in our ‘5 Things I Cannot Work Without’ feature please email: editor@dentaltechnician.org.uk www.dentaltechnician.org.uk

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DENTAL TECHNOLOGY

THE “ALL INHOUSE” CULTURE TRILOGY Part I

A TOUR THROUGH SOME OF ZIRKONZAHN’S PRODUCTION CENTRES, ALL LOCATED WITHIN THE VICINITY OF THE HEADQUARTERS IN THE ITALIAN ALPS

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DENTAL TECHNOLOGY

W

hen it comes to deciding how to plan their production, companies first need to determine: in-house or outsourcing?

This is an important choice, which has to be made with consideration of the biggest impacts on the company’s vision and goals. In this magazine edition, we focus on the first of a three-part “tour” of Zirkonzahn’s production sites in the Aurina Valley (South Tyrol, Italy). The dental technical company exemplifies the “all in-house” culture, owning five production sites located within the vicinity of the company’s headquarters, where all their milling units, furnaces, scanners, implant prosthetic components, dental materials, burs and tools are produced.

Together with the production centre in Gais, Molaris I & II and Caninus, Premolaris is one of the firm’s production sites. Built in 2021, it is dedicated to the assembly of milling units, furnaces, scanners as well as machine testing and customisation. The production facility reflects the company's philosophy in the clear values of accuracy, cleanliness and order – prerequisites to a precise work, which perfectly combine in the firm’s design concept of product modularity. Founded and run by dental technicians (Enrico and Julian Steger, MDT), the company understands the needs of laboratories and aims to design complex technologies to be as transparent and comprehensive as possible, based on welldefined interfaces, to guarantee the greatest freedom of choice and processing. This

means that not only can the users benefit from a high level of customisation according to their necessities, but they can also avoid any waiting for service or loaner machines, saving valuable time.

Machine components production takes place in Molaris I & II. In Premolaris, milling units, scanners and furnaces are assembled, calibrated and fine-tuned at individual stations according to standardised production processes. A new

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machine must pass through numerous quality stations before it reaches the final inspection and each employee is responsible for a specific assembly step, becoming an expert in what he or she does. For example, this is the place where spindles and orbits are assembled into the milling units with all hardware and software components: precision tests and measurements are carried out on each spindle before they are mounted in the machines and all data obtained is recorded and registered. Machine assembly is a very complex procedure and employees have to comply with strict checklists, which serve to coordinate the different working steps and ensure safety. An area of Premolaris is also dedicated to laser marking. Here, machines are marked with their names, and products that can be customised – such as Zirkonzahn Shade Guides – are laser-marked with the name of the clinic or the laboratory. A selection of glass cases, which the clients can choose from to personalise their equipment, is also available in this area. Premolaris is also the place where the first milling, scanning or sintering processes are performed on the new machines: only after the execution of the final checks and tests is the equipment ready to leave the production site, moving on to the on-site logistic department. … To be continued in the next issue.

OPPOSITE PAGE: Testing the new, in-house developed electronics of the new Zirkonofen Turbo BELOW: The production site of Premolaris.

ABOVE: The new Zirkonofen Turbo. The first sintering process is performed at Premolaris.

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Advertise your business in the Dental Technician Magazine 01372 897462 sales@dentaltechnician.org.uk

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Zirkonzahn Worldwide – South Tyrol (Italy) – T +39 0474 066 680 – info@zirkonzahn.com – www.zirkonzahn.com

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www.dentaltechnician.org.uk 06/07/2022 20:36

MARKETPLACE

CREATECH MEDICAL EXPAND YOUR TEAM AND CAPABILITIES WITH EASE w Being able to cater for fluctuations in demand for your services is of huge benefit to your business. It also ensures that you can consistency meet your clients’ expectations.

Createch Medical - a Straumann Group brand - provides a direct-to-lab milling service that offers an extension to your services as and when you need it. You can have confidence that the highest quality standards are upheld and the full range of dental framework solutions are fabricated with unapparelled precision. Every product comes with the Createch Excellence warranty card for total peace of mind.

Plus, the highly experienced team offers premium service and support to ensure optimised collaboration with everyone they work with.

Find out more about how you could expand your team and capabilities with Createch Medical online today!

Register for your account with Createch Medical at http://www.createchmedical.com/en/file-sending/login-registro/ For more information on the Createch Medical direct-to-lab milling service from the Straumann Group, visit https://www.straumann. com/gb/en/dental-professionals/products-and-solutions/implant-borne-prosthetics/products/createch-medical.html

MEDENTIKA® PROSTHETICS PERFECTED w Engineered with German precision, the Medentika portfolio provides dental technicians and dentists with all the solutions they need to deliver exceptional services to patients.

affords optimal flexibility for good aesthetics even in challenging cases or those in the anterior zone. It enables screw access to be positioned by up to 25 degrees from the axis, plus it can be customised by chimney height.

Products include the Medentika ASC (Angulated Screw Channel) abutment, which

The multi-platform system series offers further versatility for professionals looking

to treat complex scenarios, all of which are compatible with all major implant systems on the market for convenience too.

To find out more about Medentika – a Straumann Group brand – and how it can help you deliver perfect prosthetics for patients, visit the website today.

For more information about MEDENTiKA® solutions, please visit https://www.straumann.com/medentika/us/en/dentistry.html

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MARKETPLACE

ZIRKONZAHN FRESCO CERAMICS – NEW CERAMICS FOR VENEERING GINGIVAL AND VESTIBULAR TOOTH AREAS w With the new ceramic pastes Fresco Gingiva and Fresco Enamel, monolithic and slightly reduced zirconia structures can be quickly and easily veneered in the gingival and vestibular tooth regions. Especially in the gingival region, a characterisation with stains is no longer necessary, since a natural gingiva reproduction can be achieved by purely applying the ceramic pastes.

Compared to conventional ceramics, Fresco pastes remain moist for a longer time and can be modelled for several hours. The consistency of the pastes can be further personalised by adding the two mixing liquids Fresco Liquid and Fresco Gel, depending on the preferred working method. Due to their high primary density, the pastes exhibit very low shrinkage.

This means that one Fresco firing cycle is sufficient to finish the tooth shape and the gingiva after the first firing. With this firing process, zirconia structures of different sizes can be fired simultaneously. No parameters such as holding time and/or temperature need to be changed: heating and cooling rates are the only ones to be adapted, since they are

Complete restoration on titanium bars made with Prettau® 3 Dispersive® zirconia, layered with Fresco Gingiva and Fresco Enamel.

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this means that with a very simple but efficient firing process stable results can be achieved.

If a correction firing has to be carried out, this can be done with the same parameters –

For more information: www.zirkonzahn.com

KEMDENT AN IDEAL WAX SOLUTION w Kemdent is the proud provider of a wide ranges of lab materials, products and other essentials for businesses across the UK. We are committed to delivering solutions of the highest quality, combining this with exceptional customer service and easily accessible support.

Callum MacKay from Advanced Denture Company comments on the Anutex Modelling Wax that he uses from Kemdent: “Anutex Modelling Wax is a great product with ideal material properties. It carves easily and is simple to manipulate for an easy workflow.”

To discover this and the many other products available to help your lab operate efficiently every day, contact the friendly Kemdent team today!

For more information about Kemdent Anutex Modelling Wax, or any other market-leading solutions available, please visit www.kemdent.co.uk or call 01793 770 256.

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