The Dental Technician Magazine October 2018

VO L 7 1 N O. 1 0 I O C TO B E R 2 0 1 8 I B Y S U B S C R I P T I O N

STRAUMANN CHARITY BIKE RIDE RAISES £55,000.00 FOR MOUTH CANCER

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VERIFIABLE CPD FOR THE WHOLE DENTAL TEAM

www.dentaltechnician.org.uk w w w.d e n t a l t e c h n i c i a n .o r g .u k

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DENTAL TECHNICIANS: DANGEROUS ROLE OF WW2: PART FIVE

BY TONY LANDON PAGE 24 & 26

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DENTAL NEWS THE FIRST DENTAL PROFESSIONALS CONFERENCE PAGE 12-14

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BY UR R S A EC UB C O S SE OL MM CR E LE EN IPT PA A D IO G GU IN N E E G 3

CASE STUDY: REHABILITATING THE EDENTULOUS MAXILLA

BY MEHMET AKIF ESKAN D.D.S, PHD PAGE 10-11

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Inside this month

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State of the Art in Freehand Composite Layering ■

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Efficient and easy reproduction of all tooth shades, based on the VITA* Classical shade system Excellent polishability and surface density Amazingly natural aesthetics and opalescence

Basic Colours Shade

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A3

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A4

rootA

B1

B2

B3

B4

C1

C2

C3

C4

D2

D3

D4

W2

W3

UNIVERSAL OPAQUE CERVICAL OPAQUE DENTIN BODY INCISAL

Effect and Gum Colours

Whitening Colours Shade

UNIVERSAL OPAQUE

W0

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UNIVERSAL OPAQUE

TRANSLUCENT

INCISAL CONCENTRATE W

GUM COLOR GUM-L

GUM-D

GUM-Or

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GUM-LP

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GUM-P

GUM-T

Supplied by

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www.dentaltechnician.org.uk www.shofu.co.uk

* VITA is a registered trademark of VITA Zahnfabrik, Bad Säckingen, Germany.

BODY INCISAL

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CONTENTS OCTOBER 2018

Editor - Larry Browne FBIDST. FDTA, ITI Fellow, LCGI, RDT. E: editor@dentaltechnician.org.uk T: 01372 897461 Designer - Sharon (Bazzie) Larder E: inthedoghousedesign@gmail.com Advertising Manager - Chris Trowbridge E: sales@dentaltechnician.org.uk T: 07399 403602 Editorial advisory board K. Young, RDT (Chairman) L. Barnett, RDT P. Broughton, LBIDST, RDT L. Grice-Roberts, MBE V. S. J. Jones, LCGI, LOTA, MIMPT P. Wilks, RDT, LCGI, LBIDST Sally Wood, LBIDST Published by The Dental Technician Limited, PO Box 430, Leatherhead , KT22 2HT. T: 01372 897463

Welcome Thoughts from the Editor

Marketing Marketing Simplified by Jan Clarke

By Mehmet Akif Eskan D.D.S, PhD

10 - 11

Dental News The first Dental Professionals Conference Straumann Charity Bike Ride raises ÂŁ55,000.00 for Mouth Cancer Dental Tribune News Dental Technicians: Dangerous role of WW2: Part Five by Tony Landon Help The Confident Dentist

12 - 14 16 -17 22 - 23 24 & 26 25

Insight Dental opinion from Sir Paul Beresford, BDS. MP Looking back with John Windibank FOA

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Case Study

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.

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

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19 20 - 21

Company News Kemdent /VITA /Acteon Group

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CPD 18 28 - 29

Education Clinical Dental Technician Study Day

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Classifieds

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There is a major change in CPD coming soon. The Dental Technician Magazine is a must read. Tell your colleagues to subscribe and if they do so we will extend your subscription for 3 months.

The only condition is that they have not subscribed to the magazine for more than 12 months. Just ask them to call the Subscriptions Hotline. With four colleagues registered that means your subscription would be extended for a year free of charge.

At only ÂŁ39.95 per year, for UK residents, this must be the cheapest way of keeping up to date. Help your colleagues to keep up to date as well. Ask them to call the subscriptions Hotline on 01202 586 848 now.

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THOUGHTS FROM THE EDITOR

WELCOME to your magazine WHAT ARE YOU WAITING FOR? THE TOOTH FAIRY! (ITS ONLY A FAIRY TALE)

l The Digital Revolution has now become everyday and very much part of our thinking and consideration when it comes to dental restorations. There are of course some who refuse to even consider its use or are hoping it might go away. I am afraid there is so little chance of digital techniques disappearing from our everyday lives and mainly because, unless it is pointed out, you don’t even notice it. Think of the everyday things like shopping. How do they locate your desired purchase in their stock room? Digital programmes! How do they check, if your item is out of stock, when they can get a replacement?

Digital systems. It is very much part of all the manufacturing processes in a modern economy and it is only a matter of time until it reigns supreme. Our exposure to the whole computerised processing method includes, of course, the CADCAM process but more and more, we are utilising 3D printing techniques and this does seem to offer the ultimate in reproducing a replacement or indeed and improved alternative.

In medicine 3DPrinting and virtual design is being used to train undergraduate students in all aspects of the function and measurement of organs and healthy expectations. It is also being used to confirm diagnosis and potential successful treatments without having to complete without confirmation.

The specialists are now utilising the Virtual capacity to test theories and potential treatment options without involving the patient in any risk.

While we know from our dental experience that there may be shortcomings in relying only on a virtual teaching model, it offers a great

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deal of security to be able to test outcomes accurately, before committing the patient to unseen risks and potential harm. What is remarkable is the potential increase in dental technology needs in the coming years. If you have been reading these pages in earlier issues you will see the world wide agreement on the predictable continuing increase in edentulous cases and the measurable demand it will place on the present cohort of laboratory staff and the clinical demands of these more demanding patients.

The truth is we will not be able to deal with the quantity, which has been predicted in the future years, unless we understand the need to invest in equipment and training which will need to be on going. At a growth rate of 4-6% per year, which has been predicted it won’t take long for the penny to drop.

We don't have enough trained technicians. We are not spending enough on training and we will be woefully undermanned to deal with the work demand. The Clinicians will have an equal problem dealing with the patients, often in situations they do not fully understand.

Clearly the lack of undergraduate training on the historic systems and methods leaves them vulnerable and more reliant on their technical support. This is far from the time to think of quitting your technical dental career but much more a time to get involved and learn as much

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as you can about the changing techniques and together with your traditional skills and knowhow you can be a real boost to the coming generations of clinical operators.

Laboratory owners who wish to continue to be successful in this future world will need to be aware of their need to train and enhance the knowledge of their youngest and their established technicians. You may say it is not your job to spend money on such a process but if you don't invest in your own future staff what chance have you of competing in the trained world. Some of you, I know already have in place your own programmes because you understand the importance of staying on top of theoretical and technical advancement. Those of you who don't!! Sorry it will be your fault if you find yourself slipping down the market because of the inability to change.

The first step is to remain involved in keeping up to date. Read your journals, attend local dental meetings and encourage your younger technicians and trainees to do the same. Don't just attend technicians meetings but get along to local BDA groups or join organisations like the ADI where clinical speakers can be listened to. If your into implants join your nearest ITI study group where you will also meet local clinicians.

More and more our roles in restorative dentistry, is becoming so similar that your voice as a technical expert is needed more than ever before. This need will continue to grow and your importance within the clinical situation will very much be part of your potential future career.

Dentistry will require your expertise as a technician so make sure you keep up to date or choose to do like too many of your technical colleagues and just sit and moan in your darkened playroom, your Laboratory.

Larry Browne, Editor

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MARKETING SIMPLIFIED JAN CLARKE BDS FDSRCPS MARKETING

l Jan qualified as a dentist in 1988 and worked in the hospital service and then general practice. She was a practice owner for 17 years and worked as an Advisor with Denplan. Jan now works helping dental businesses with their marketing and business strategy and heads up the Social Media Academy at Rose & Co.

Web: www.roseand.co Email: jan@roseand.co Facebook: Jan ClarkeTaplin Twitter: @JanetLClarke Instagram: janlclarkeacademy LinkedIn: Jan Clarke BDS FDSRCPS

SOCIAL MEDIA MARKETING FOR 2019

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probably lost some of you when you saw the title! Social Media Marketing?

Facebook? Twitter? “Not for me” I hear you say. Maybe some of you already use these channels but feel it is a waste of time?

By considering the age range of the client you are wanting to reach you can decide where you would like your social media activity to be.

I’VE BEEN USING FACEBOOK BUT I’M NOT GETTING ANY RESULTS There is no doubt that, like any form of marketing, social media marketing requires work and commitment. Yes I think it’s great but it’s not magic! It can’t turn one poorly put together post into hundreds of new clients.

Let me explain why you should think again and consider heading into 2019 with a new Social Media Marketing strategy and plan.

WHY SOCIAL MEDIA? • Most business owners will agree that word of mouth is a great source of referrals to their business. It attracts more of the same type of client you have been dealing with and, trusting, that these are good clients, your business thrives. Social media marketing is the modern day version of word of mouth marketing. By clients commenting or “liking” your posts you become visible to their friends giving you a social proof.

• It is simple to get involved with. If you know nothing about social media you can access free online courses and most channels have their own “how to” sections.

• It is relatively inexpensive – getting started costs nothing. You may want to get help to start in the form of a paid training and mentoring programme but once started there is no cost to post.

• It is a great way to increase the “marketing touches” of your brand and build awareness of your business.

• As you build confidence you can start to utilise the advertising possibilities on each channel. These allow small businesses to reach a targeted audience like no other form of advertising has done before. When used intelligently this can give returns that have not been possible in the past with traditional marketing.

• Quite simply, this is where your potential new clients could be “hanging out” and you need to have visibility there.

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EVERYONE SAYS FACEBOOK IS DEAD! There’s no doubt Facebook has had its own challenges in the past year or so but it is still the largest used social media channel and is still growing. How long this will continue no one knows, we still recommend this channel as the first port of call. My advice would be to familiarise yourself with Facebook, learn as much as you can from all the free resources available.

Facebook changes all the time so it is important to stay there, keep learning and keep growing.

MY SON/DAUGHTER DOESN’T USE FACEBOOK ANYMORE This is true of the younger generations, they may have started with Facebook, but as soon as their Mum and Dad turned up there they turned away! We find many of the younger dentists are active on Instagram and we also advise having activity there. Facebook owns Instagram so there is quite a good link between the channels. You can post to one and it’s duplicated to the other, helping save on time and content but also their advertising campaigns are linked which is a real boost.

Instagram could work very well for a dental laboratory with great images of work being created, work completed and with collaboration from your clients, some clinical images.

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The mistakes I see with businesses and their social media activity are: • No consistency, occasional posts just don’t work, you want and need regular posts so any visitor to your page sees a vibrant, exciting business with lots of activity.

• No persistency, after a couple of good posts nothing much happens and there are massive gaps between activity.

• Poor content with poor images or no images and too much shared content. Yes it’s fine to share others’ content occasionally but the lion’s share of your posts should be unique, fresh content from your own business.

WHAT CONTENT SHOULD I POST? Everyone wants to post that certain unique post that goes “viral” so you will have to think long and hard for that one! It’s definitely worth trying for something a bit different but in the absence of this there are a variety of posts that work well. The more personal to your business you can be the better and don’t be disheartened if a beautiful image of some great work receives little praise but when you post a pic of you receptionist’s dog visiting the business reach goes through the roof!

Social media is exactly that “social” and people generally like to see content about your team so consider posting more fun content p8 between your more informative posts.

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MARKETING

POST SUGGESTIONS • Information about certain techniques • What’s new in the work of dental laboratories • Images of work in progress and completed • Images of your team busy working on specific projects • Reviews received • Testimonials received • Images of completed work from dentists • Images of team night out or team building day • A who’s who of your team As you progress in the word of social media you will start to see what works for your business and you will find your own unique style and voice. Remember there is no “right” way to do social media.

Obviously you have to be mindful of the GDC guidelines (available at their website) but other than that just do what works for you. Yes, keep an eye on the competition, but don’t be too focused on it. A good guide to if you’re getting it right, apart from your statistics, is if someone copies you! I often find with my clients this happens. Be flattered, it is unlikely they will continue as they will lack in two areas – consistency and persistency.

CONSIDER HOW WE FIND OUT INFORMATION IN THE PRESENT DAY In the “good old days” when we wanted to find out something we would go to the library, research products in Which guides and so

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on. Now it is all at the click of a keyboard, including how to learn to just about do anything. My children use YouTube all the time and I have started to use it for anything from dog training to recipes and learning to do my daughter’s hair!

Moving into 2019, with this in mind, I would encourage you to start posting videos.

Post them first into Facebook, for maximum reach, but then post them to your own YouTube channel and start to build a library.

You can post simple posts helping dentists with some of the problems you may see with impressions and guidance as to how to avoid the common pitfalls. Or perhaps, a video showing the stages in crown construction?

Once you start videos it will be laborious and time consuming but once you do more and more the easier they will become. Videos are a game changer for social media and I would highly recommend you try them out.

WHEN SHOULD I EXPECT RESULTS? Building an audience on any social media channel takes time, there are no short cuts.

With great content, posts and persistent and consistent posting though, you will get there. Let as many people know about your channels as possible, that includes all your current clients and ensure your website has the links to the channels and even a feed of your content.

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By being diligent and spending time you will reap the rewards. Ensure your messaging systems are switched on for your channels and that you respond quickly to any queries. Equally ensure your team know what is going on so if someone calls your business regarding some offer or promotion you have, they will know how to respond immediately. Your marketing needs to be “joined up” and thought through.

WHEN CAN I CONSIDER FB ADS? Facebook advertising is a super resource and many use it without any real activity on their own account. I think you are ready for an advertising campaign once you can go to your page and feel happy there is a vibrant mix of posts, it looks great, all the service sections are completed and as you scroll down the page you can get a real feel for your business.

WHAT NOW, MOVING FORWARD? With 2019 just around the corner, embrace social media, learn as much as you can and start to set up your channels.

Video has to have a strong influence in 2019 too, so start filming and spreading the word about your business.

As ever I am here to help with any of these issues so do email or connect online with me, I look forward to meeting some of you in cyberspace!

CASE STUDY: BY MEHMET AKIF ESKAN D.D.S, PHD

CASE STUDY

REHABILITATING THE EDENTULOUS MAXILLA WITH IMMEDIATE LOADED BLT IMPLANTS

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his case report shows how a hopeless maxillary dentition can be restored with an immediately loaded functional prosthesis in a patient with poor bone quality and demanding aesthetic and functional requirements.

Straumann® Bone Level Tapered (BLT) implants and Straumann® Screw-Retained Abutments (SRAs) provide the necessary implants and prosthetics to support this Straumann® Pro Arch solution.

INITIAL SITUATION A 42-year-old male patient in good physical health presented at our clinic with the chief complaint of loose teeth and poor aesthetics (Fig. 1). He reported that he was a former smoker and did not take any medication.

His oral hygiene was poor, with a plaque score of 90% and bleeding on probing of 86%. Following the clinical and radiographic examination, it was determined that his remaining upper teeth and teeth 31, 41, 44 and 47 had a hopeless prognosis (Figs. 2, 3). Furthermore, CBCT analysis revealed a rounded and dome-like lesion in the left maxillary sinus (Fig. 4). After a consultation with an ENT specialist, this was diagnosed as a retention cyst of the maxillary sinus, which can regress spontaneously and disappear in 17 to 38 per. cent. of cases [1].

FIG.1 FIG.2

FIG.3 FIG.4

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FIG.5

FIG.6 FIG.8

FIG.7

FIG.9 FIG.11

FIG.10

TREATMENT PLANNING The treatment for the upper jaw included the extraction of hopeless teeth. Furthermore, since the patient had never previously tolerated a removable prosthesis, he requested a fixed restoration to restore his dentition during the treatment period. In order to meet the patient’s expectations and shorten the treatment time, the insertion of a screw-retained provisional prosthesis immediately following the extractions and implant placement were planned. Four implants (Straumann® BLT, Ø 4.1 mm, Roxolid, SLActive® implants), with tilting of the two posterior implants, were planned for placement. As the goal was to load the implants immediately, it was critical for primary stability to be established for immediate functioning with the planned fixed prosthesis.

SURGICAL PROCEDURE Surgery was carried out under local anesthesia.

All upper teeth were extracted, and a full thickness flap was reflected to enable all the granulation tissue to be completely removed

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(Fig. 5). A clear acrylic surgical guide was made to help us visualize whether at least 8mm of interocclusal space was available (Fig. 6). A small window to the sinus was opened with a round bur to locate the anterior sinus wall (Fig. 7).

Where necessary, countersinking was done to secure both buccal and lingual cortical bone contact at the implant collar in the thin bone crest. The posterior implants were placed with about 45°-30° of inclination, and 30° angulated SRAs were placed on the posterior implants to correct the angulation for immediate prosthetic rehabilitation (Fig. 8). Following placement of the SRAs, a provisional full-arch acrylic prosthesis using temporary titanium copings was delivered on the day of surgery. The provisional prosthesis was screwed into the patient’s mouth, and the esthetics and occlusion were checked (Figs. 9-11). The patient was instructed to maintain oral hygiene with chlorhexidine 0.2% mouthwash twice a day for the first week postsurgery, followed by a water flosser (Waterpik®).

The patient was also instructed to maintain a soft diet for 6 weeks post-operatively.

FIG.13

CASE STUDY

FIG.14

FIG.12

PROSTHETIC PROCEDURE After four months of the healing, the provisional prosthesis was removed (Fig. 12). The implants and peri-implant soft tissues showed good stability and no signs of mucositis or peri-implantitis after clinical and radiographic examination. Opentray impression posts for screw-retained abutments were attached to all implants, and were splinted using pattern resin and wires to avoid any unpredictable distortion (Figs. 13, 14). An open-tray impression was taken using a dimensionally stable polyether siloxane material (Fig. 15). Furthermore, a plaster model was cast, and the provisional prosthesis was seated on the model to check the adequacy of the impression. As the patient was happy with the esthetics of the provisional prosthesis, it was scanned for construction of the CAD/CAM framework (Figs. 16, 17). Following all try-ins, including metal and porcelain options, the prosthesis was delivered (Figs. 18, 19).

TREATMENT OUTCOME The short edentulous span in the lower anterior region was restored with an implant-supported fixed bridge, and the 44 gap restored with a single implantsupported crown. This new implant design allows immediate implant placement and functional loading. The final x-ray showed the prosthesis precisely fitted on the SRAs (Fig. 20). At 31 months after loading, the implant survival and success rate was 100% with no mechanical or biological complications. The overall functional and esthetic outcome of the treatment was judged to be excellent by the patient and the clinician (Fig. 21).

To find out more about Straumann’s dental implant range, contact Straumann on 01293 651230 or visit http://therevu. co.uk/category/implant-solutions/ Facebook: Straumann UK Twitter: @StraumannUK Instagram: @Straumann_UK REFERENCE [1]. Wang, J.H., Y.J. Jang, and B.J. Lee, Natural course of retention cysts of the maxillary sinus: long-term follow-up results. Laryngoscope, 2007.

117(2): p. 341-4.

FIG.16

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FIG.20

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MEHMET AKIF ESKAN D.D.S, PHD l Diplomat of the American Board of Periodontology. Adjunct-Faculty, Department of Periodontics NOVA South Eastern University College of Dental Medicine, Fort Lauderdale, Florida/USA. l Private

Practice in Istanbul.

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DENTAL NEWS

THE

FIRST

DENTAL PROFESSIONALS

CONFERENCE

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riday 14th and Saturday 15th of September saw the first meeting of the DPC (Dental Professionals Conference). Organised by Andrea Johnson (pictured left) from the OTA and supported by the DTA and the British Society of Dental Nurses and Future Labs. Andrea and many like-minded DCP’s are trying to bring some cohesion to the dental support team and will continue to invite others to the future meetings which are scheduled for each year.

CDT’s, perhaps we can tempt the Maxillo-Facial Techs to join us and maybe the Dental Hygienists and Therapists could be tempted. The two-day conference at The Park Plaza Hotel Nottingham featured speakers for all the areas of interest for the associated dental support team.

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Friday began with workshops which covered a good deal of those areas we are all required to be aware of with Lesley Sharpe presented a hands on workshop on Medical Emergencies and basic life support.

Lesley formerly a dental Nurse has gone on to qualify in other associated areas such as Radiography, Dental Sedation, and has qualified to support Oral Surgery, Orthodontics, Cancer MDT, Theatres and other nurse led clinics all of which has greatly increased her knowledge and clearly without reducing her enthusiasm for what she does.

Stuart Marlow.

Who many of you will know from the Many Schottlander courses he organises and participates in was showing his skill on the subject of /gingival Staining and characterisation. A timely and useful, hands on opportunity to achieve a measurable improvement in Prosthetic Aesthetics and naturalness. Stuart certainly demonstrated his expertise and made the visit worthwhile for the many Technicians who attended. The Enigma tooth range is now complimented with the Enigma Gingival Composite rage and offers a truly controllable way to produce these advanced aesthetic dentures.

James Green is the very able dental Laboratory manager of the Great Ormond Street Hospital for Children NHS Foundation Trust, Mid Essex Hospital Services NHS Trust and the North London Cleft Centre which is a superregional network for patients with cleft lip and palate problems. James was demonstrating his technique for making hard occlusal wafers for use in Othognathic Surgery Procedures. The patient has been assessed for the surgical procedure which may need the separation of the teeth and alveolus of one or both jaws the occlusal wafer is the location point for the final desired repositioned stuctures. Traditionally these hard records are made from PMMA materials but the risk of free monomer and allergenic reaction and the real risk of shrinkage distortion has lead to a really practical change to a Light Cured Urethane Acrylate.

This material also has a huge advantage in that it allows a long working and modelling phase and gives the Technician freedom to manipulate accurately the jaw sections on his articulator. James is an experienced confident speaker and his demonstration, Including his light box extension (via a black Cloth)! was very much appreciated. The material certainly seemed very manageable in the hands of the expert. ucontinued on page 14

DENTAL NEWS

Lesley came very well equipped with life sized adult and children teaching dummies.

She stressed the importance of good chest compression techniques and outlined the increased life recovery potential by knowing what you are doing in thes emergency situations. As DCP’s we are required to maintain our readiness and be equipped to deal with such situations. A useful and essential, support workshop.

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DENTAL NEWS

A very Topical area of interest to technicians was covered by The Digital Workflow Presented by Mark Barry, Richard Buckle and Jinesh Patel.

Mark Barry is the Managing Director of the ESM Digital Solutions who are the UK and Irelands leading provider of 3Shape scanning hardware and software for both clinics and Laboratories. Mark is a qualified Mechanical engineer with a MPhil. His masters was based on his work investigating Abutment Implant interfaces on taper-lock designed dental implants.

For some time he took on a teaching role at the Dublin Institute of Technology teaching production systems, maintenance and precision measurement to engineering undergraduates. With such talent ESM have a real capacity to deliver meaningful training for those investing in the 3Shape dental systems.

Richard Buckle has been in sales, marketing, product management and consultancy for 30 years. Richard joined Techceram in 2014 with the brief to find and introduce new Digital technologies. His interest has been in 3D printers and resins and as a consequence Techceram now supply several of the top 3D printers combining best price with performance ratio.

Jinesh Patel is representative of the new generation of Dental Technicians with a BSc in forensic chemistry and a BTec in dental tehnology.

With his own Laboratory in London, (HM London Orthodontic Laboratory. Established in 2011) Jinesh has a real love of the advantages offered by the Digital processes. It has helped his to streamline his workflow and make production quality control better. He like many of his technical colleagues is looking to continue to further improve and use the Digital processes as his preferred method.

Between them the team demonstrated the step by step of intraoral scanning the electronic transfer of the data and the design and production of the appliances. Mark Barry used the 3Shape Trios scanner, taking full arch scans and demonstrating the importing/ design editing in the 3Shape CAD and

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Jinesh will demonstrate how to nest /slice the horseshoes and set up a print run on the Structo OrthoForm 3D Printer. It was a very impressive demonstration and made the whole process look remarkably easy.

The alternative Workshop was Ashton Sheerkhan and Desmond Solomon speaking on Sleep Apnoea control devices which have grown importance and use over the past 10 years.

Ashton Sheerkhan has worked for Monarch Dental for 30 years , having joined just after leaving college. His early interest was in the Cobalt Chrome frameworks. In recent years he has been busy running the Thermoforming Department and growing his interest in the clinical and technical solutions to Sleep Apnoea. Working closely with his clinical colleagues at UCLH and The Eastman. He attends clinics at the ENT Dept. of Eastman’s Dental Hospital London, twice a month where he adds his technical know how to the problem of finding the best solution to the patients Apnoea problem.

Desmond Solomon is a very well qualified Dental Technician and Lecturer. After qualifying in Kingston Area Health Authority he joved on to Kingsyon Hospital where he found an interest in Orthodontics and gained his advanced City and Guilds in orthodontics. He worked abroad for some years and returned home to take up the job of Senior Technician at the Mayday Hospital where he set up a new Orthodontic laboratory while at the same time studying for his advanced City and Guilds Crown and Bridge qualification. He moved from Mayday to become Chief Technician at St. Marys Hospital, Roehampton and continued his studies to complete his advanced Maxillofacial City and Guilds Qualification.

He spent some 20 years as Senior Orthodontic Technician at Whipps Cross Hospital doing Orthodontic, Orthognatic, and Maxillofacial work. He was also interested and involved in teaching on courses and continued to be involved in helping to develop various solutions to any different patients needs. Including the rarely seen Cobalt Chrome Anti-Snore Devices. He then spent a few years teaching in Malaysia and running a workshop in sleep apnoea

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devises. After early retirement in 2015 Desmond returned to take a post as lecturer in orthodontics at the newly established Southgate College.

These two very well qualified technicians would explain the diagnosis and treatment of Sleep Apnoea and clearly demonstrate the impression and bite record requirements for constructing the devices. And describe how to maintain and adjust Mandible Advancement devices. Lots ot learn and lots to use in your daily life. A great workshop.

The day went on with Caitlin Wroath covering intraoral scanning and comparing it with the conventional impression methods, particularly for difficult patients.

Caitlin is at present involved at the Cardiff Metropolitan University studying for her Masters of Research. The subject of her study and her presentation is a patient centred comparison between modern digital methods and conventional impression techniques.

Particularly with patients who are unusually difficult to manage and who may be suffering from dysphagia or other disabilities. Caitlin will be looking at the situation of using scanning in community dentistry.

Many of the supporting companies had their goods and services on display with a good opportunity to discuss whatever might be of interest to the visiting dental professionals.

As you would appreciate there was a good deal of discourse around the modern digital options with Planmica, Createch. Future Labs(Blueprint Dental). Shottlander with their wonderful selection of teeth, and the Gum stain composite kit which proved very popular. For the first conference I do think the organising committee should be very pleased with the outcome and the response from the profession.

The show went on with speakers on various subjects including Orthognatic surgery, Record keeping, Human factors in dentistry and a good deal around inpornt issues such as TMD and Appliance therapy and infection control in the manufacturing process of Dental Devices.

Kate Clemson who is a greatly qualified speaker raised the topic of homelessness and social inequalities. Looking critically at the way our society deals with such problems and focused on the opportunities available to help with voluntary involvement. Kate is the deputy service organiser for Crisis at Christmas Dental Services.

DENTAL NEWS

STRAUMANN CHARITY BIKE RIDE IN ITALY RAISES ÂŁ55,000.00 FOR MOUTH CANCER

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his is the fourth Straumann Charity Bike Ride in support of The Mouth Cancer Foundation and in some ways certainly the most memorable, full of interest and incident. The ambitious course of 500 miles in five days from Lake Garda via Siena and Florence to Rome certainly set some challenges with the Dolomites as one of the principle obstacles along the way. We began our journey from the very lovely town of Trento set in the south Tyrol at the north end of Lake Garda, after flying into Verona. The route, had been mapped out, as is the norm by Just Pedal, who also accompanied and assisted the riders.

Just Pedal are very professional and were on hand to assist with any problems with the bikes, such as punctures, rather frequent, and with a daily surgery of repairs and adjustments. Remarkably they manage to keep almost everybody going throughout the 500 miles. Despite one rider requiring new wheels on day three and several others, requiring gear and chain replacements and

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Group 1 - in time for a quick dip

adjustments throughout. These thoroughly professional riders, generally set the pace for each of the five groups. The groups were set up to cater for the variety of talents which included very skilled and fast riders through to some beginners. Trying to maintain a single peloton of the number and variation in ability

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was not an easy task. Made up of Dentists, Technicians, Hygienists and other dental professional with a group from Straumann Germany joining the ride for the first time.

The ages cover everything from early twenties through to mid fifties an all sorts of body types. Steve Booth, the CEO of Straumann UK took up his usual role of participating and leading the evening after dinner update and creating some interesting roles for some of the riders to enjoy through the ride. He continues to maintain a pace in one of the faster groups and thoroughly enjoys the involvement.

Make no mistake these are remarkably fit individuals with many of them riding regularly and a high percentage involved with cross country running and iron man competitions.

Groups one, two and three can and do travel and maintain a really good pace throughout.

The nature of the dental professionals makes them competitive and there is certainly clear rivalry within these three groups. Group four is quite a large group with a good mixture of keen amateurs who may be intermittent

DENTAL NEWS

in their training regimes but always up to complete the “Straumann Ride” for which they practice and take part in Sportiefs of around a hundred miles on regular occasions.

Fitting it into their busy work schedules. Some run their own surgeries and laboratories and others working for their various companies, usually involved in dentistry, The first day was looked forward to with a mixture of concern and anticipation. The introduction suggested it would be a warm up day without too much hard work but it proved to be a good indication of what was to come. Coffee and lunch stops had been arranged along the way with food and drinks to sustain the efforts. This was the first of the rides to be arranged in Italy and the riders did not know what the Italian drivers reaction would be. Unfortunately it was not good with lots of horn blowing and driving too close to the riders. They soon learned they could not maintain a long group and so they were split up into fours, two abreast . Our first serious problem came from a bus driver who was obviously not happy sharing his route with a peloton of cyclists. After much horn blowing and moving in close he got ahead of the cyclists but then had to stop to pick up and drop passengers. After that stop he caught up and began to really close down the group ending with a contact against one of the Just Pedal riders who was shunted into Paul Baker , who came off really badly and was unconscious for 15 to 20 minutes. You can imagine that a few people were very upset and in fact the bus driver was lucky not to have been set on, a remarkably irresponsible action, which incensed all the riders. Ambulances were called and Paul was airlifted, by Helicopter, to hospital where he remained for two days under observation. Luckily, despite being very badly bruised and with a greatly swollen face he returned to us before flying home. The bus driver was questioned and we await the eventual outcome.

The second day started again with a reasonable lead in but at about 3.30 pm.

The riders came onto an 18% hill which challenged, even the most able and left the less fit riders in real agony.

They eventually all finished and had the rest of the evening to compare notes and put mattes to rights. Day three was expected to continue with more of the same and so it proved.

Another rider, Stephen Bates was hit by a car driving on the wrong side of the road. He was badly grazed and was taken to hospital and kept in overnight. Thank goodness he returned walking but with his expensive bike smashed into five pieces. He was very

What´s the hold up?

Steve Booth and some of the quicker riders

Stephen Baker - cheerful but confined in hospital

Group 4 take a break

lucky he was not more seriously hurt. We await the outcome of that second incident.

Thank goodness Stephen’s injuries thought quite severe are not long lasting. The ride continued with more and more reporting that the climbs were proving difficult. Right through to the last day and the finish at Rome Airport with a last climb up to the finish.

Last day - last finish in the dark

They were all glad to finish with one or two dashing back to the U.K for marathons and at least one going on to Sardinia for a Cycle ride!!!

A tough bunch who obviously muct have streak of Masochism. Or do they call it good old British pluck?

Cheering them home in the dark

THOSE OF YOU WHO COULD NOT GET INVOLVED PERHAPS YOU WOULD DONATE TO THE MOUTH CANCER FOUNDATION OR SEND TO THE STRAUMANN BIKE RIDE FUND TO TRY AND RAISE THE TOTAL AMOUNT FURTHER FOR A GREAT CAUSE.

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17

DENTEAM

2019

NEW DENTAL TEAM CPD EVENT

CPD

21ST AND 22ND JUNE 2019. SANDY PARK, EXETER

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DenTeam 2019 is a new regional event for the south-west that promises: "Top-quality CPD plus an exhibition in a superb, easily-accessible venue with great food and a friendly atmosphere – offering extremely good value for delegates." Taking place at the Sandy Park Conference Centre on the outskirts of Exeter on 21st and 22nd June 2019, organisers say: “DenTeam is about team members learning together.”

The event organiser, Teamwork Professionals Ltd, states that the event will have three concurrent streams covering a broad spectrum of CPD for all members of the dental team, plus a range of smaller seminars and workshops.

Topics confirmed so far include ‘human factors’ – the science of how everything we do affects people around us; psychological well-being in the dental practice; updates on periodontology and implantology; how to take better

impressions; oral cancer; safeguarding; and a business stream that takes team members through various milestones and stages of their career – such as buying their first house, setting up a practice, and much more.

Dr Roger Matthews, the former chief dental officer at Denplan, will deliver the keynote address on both days, looking at what is coming in dentistry over the next five years. The full programme will be published in January when the delegate rates will be announced.

The compact exhibition will feature a central hub and networking area where free refreshments will be available all day; with a hot or cold lunch included for all delegates.

For more information, and to register your interest in attending, exhibiting or sponsoring the event, visit

www.denteamcpd.com

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DENTAL OPINION FROM SIR PAUL BERESFORD, BDS. MP

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t was big news in the national press.

Well it was trumpeted on page 6. All the clever headline writers had a field day.

Sample the Daily Telegraph - “Growth in life expectancy stops dead in its tracks”.

The Times is less dramatic - “Britain falls to the bottom for improving life expectancy”.

As one would expect the articles were written to generate the worst. The papers looked at average life expectancy at 79.2 years for men and 82.9 for women in the UK. The articles then expanded to look at gloomy statistics of areas where life expectancy was lower and that amongst those aged 90-94 now there are only, twice as many women as men. Perhaps there is hope for us males. Also, longevity amongst the elderly was still rising.

All this set me thinking about longevity, the changes in dentistry and dental demands.

Have you noticed that we are getting more CPD programs on dealing with worn teeth?

Worn at least in part because we are keeping our teeth longer and using them to eat, worry (bruxism), smile or snarl longer.

I come from 3 generations of dentists. My grandfather learnt his dentistry as an apprentice in Auckland, New Zealand. I just remember him. Apparently, he made great dentures and this was in the days when brides sometimes had all their teeth out and “lovely white teeth” (dentures) as a wedding present to set them off on their married life! But if tales from my Grandfather are correct he was best known for his amazing gold fillings. I guess they were cast.

I have seen pictures of those glistening smiles with large gold anterior restorations.

dentures and moving on to these new plastic dentures with porcelain denture teeth.

Post WWII dental health changed dramatically, at least in New Zealand Australia, Canada, USA, the UK and much of Europe.

Child dental health became important. For example, New Zealand introduced Child Dental Nurses who gave dental care to virtually all primary school children. Sugar as a cause of caries was recognised and the dangers of sweets taught. Then of course the fantastic benefits of fluoride in toothpaste and even more effectively in municipal water supplies was introduced in more enlightened countries. Incidentally England is backward here.

Dentistry has evolved enormously as the changes, in dental health, has bought hugely changed demands. I recently treated a young lady who had tripped and fallen on the London hard pavements. She snapped her slightly protrusive upper right central just missing the pulp. I saw her after her patched face had returned to normality. If she had seen my grandfather, he would have made her suggested a beautiful gold restoration and in those times it would not have looked out of place.

INSIGHT

LIFE EXPECTANCY AND DENTISTRY She took a deep breath and said as you must repair my protrusive tooth let’s make it look better than before the fall. Thanks to modern dentistry she now has a beautiful porcelain veneer set in line and matching the other central. She would rather not have fallen but her smile looks better now than before the fall.

Longevity combined with better dental health is bringing bigger demands and more treatment problems. Anti-fluoridation campaigners have said if fluoridation works you dentists are doing yourselves out of a job.

They could not be more wrong. Dentistry is and will continue to change as we all keep our teeth. The materials and techniques are better.

Our results are better but the demands for perfection are greater. We are setting ourselves better standards - I hope! I and most of us, increasingly are using loups and microscopes.

Not just for endodontics but microsurgery saving teeth and restorative dentistry.

Longevity is great but we as dental professionals must keep up. The Telegraph headline is wrong. Life expectancy is not stopped dead in its tracks. It has only paused - be ready.

My Father obtained his dental degree at Otago University during WWII as did his brother who later indulged in this new dental treatment as an orthodontic consultant at the London. My Mother graduated at the same university dental school as a technician initially with vulcanite

SIR PAUL BERESFORD. BDS. MP. Dual UK/NZ nationality. New Zealand born, bred and educated, with post graduate education in UK. Worked as an NHS and private dentist

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in East and South West London. Private dentist in the West End of London then and currently in a very part time capacity in South West London. l Councillor including Leader of Wandsworth Council moving to the

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House of Commons.

A Minister in the John Major Government, MP for the then Croydon Central, then elected as MP for Mole Valley as a result of the boundary changes for the 1997 election.

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19

LOOKING BACK JOHN WINDIBANK FOA INSIGHT

MEMORIES OF AN OLD CODGER 17 MORE AND MORE EDUCATION

F

or thousands of years, advanced and settled societies all over the world become obsessed with qualifications.

Young people are the ones who had to spend their time remembering text they will never use again to get a foot on the ladder of employment and finding a niche in their society. So that’s where our society is today with people spending a quarter or more of their lives to become qualified to do even the everyday work.

Health Service Technicians working in the nineteen seventies and eighties knew that they had to keep pace with the educational requirements of the NHS to receive a good return for their efforts. Hospital Dental Technicians had seen their pay slip backwards against other groups and those of us that met at Central Council meetings knew that education was the platform for the professions progression.

The Technician Education Council (TEC) was created in 1973 by Margaret Thatcher then Secretary of State for Education, to unify and replace existing technician qualifications including City and Guilds. By 1979 talks started with City and Guilds on the introduction of Dental Technicians TEC qualification and of course we all wanted to be part of the process.

A meeting was arranged to take evidence and I remember a room packed with professor’s consultant’s academics civil servants and a few technicians. Bert Aldridge(OTA), Brian Conroy(IMFT) a few other technicians, Les Ward from Manchester Poly and Dr Huggett representing Society of University Dental Instructors were some I remember being present.

The TEC had a structure of certificate and diploma courses in a time frame of two to four years and the technicians present couldn’t envisage a period of less than four years for the tuition and training for a dental technician’s qualification. This however did not fit with the TEC’s format which required a viable technician at certificate level. The discussions went back and forth and after a half hour of this I suggested that until the units were written we had no idea what structure would be needed to fit into a TEC course. This was

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CENTRAL COUNCIL MEETING CC1988 LEFT TO RIGHT: Bob Winchurch (Wolverhampton), Lesley Hall (Guys London) the second lady to serve on the council, Rod Jackson (Reading), C Cowling (Hampshire), Harry Thompson (Slough), Mike Cook (Swansea), Peter Butler (Northampton), Ian Dorning (North Wales), Rod Snape (Peterborough)

met with a continued mantra about structure and this went on for about two hours. The meeting was finally brought to an end when a professor proposed we go away and look at what units were required, this was answered by the chairman with grateful thanks for such a wonderful intervention from such an eminent professor, absolutely sycophantically toe curling praise. Well I learned something from the meeting and that was, if you wanted to be listened to you had to have a status within the group, Dr Robin Huggett was listened to when he spoke, but the rest of us technicians were pretty well ignored unless we agreed with the professors.

The colleges went away and came up with structures and proposals which they hoped would please TEC. Ideas and disagreements as to the direction of our education filled the pages of the dental press and every group had an opinion.

Working parties were organised to look at Diploma level units and I was with the one concerned with Orthodontics. The group as I remember included Bert Aldridge, Les Ward and a couple of others whose names I can’t recall and at the end I was asked to draw all our conclusions together and submit them

to the Dental Technology higher awards sub group appointed by TEC. The TEC group had 8 members included Brian Conroy (Later CBE representing Maxillo Facial), myself (Orthodontic) Mr Black (Crown and Bridge), Les Ward (Manchester John Dalton College), TEC representatives and Mr Smith, a Crown and Bridge Prosthetic Consultant from Kings College Hospital, London. Mr Smith had a keen interest in Dental Technician’s education and I attended his tutorials at the South London College when I was qualifying. His mantra was to change the basis of our training to be based around Crown and Bridge, as this was the growing requirements for the profession. The technician presenting the Crown and bridge units had his work picked over and on one spectacular moment, a TEC Committee member asked Mr Smith what the technicians did? as the dentists made the devices. A shocked silent hiatus ensued and Mr Smith explained that these very clever technicians actually made the devices he fitted.

Brian Conroy presented arguments for Maxillo Facial Technology, he did not present a working structure but his arguments seemed

based around the timescale. An impasse ensued and I suggested to Brian that he present a unit structure to back up his case and being Brian that’s what he did and then some.

Brian Conroy attended the next meeting with a pile of at least 20 units and plonked them in front of the startled TEC panel. Mr Smith argued with Brian that all these units weren’t relevant and Brian retorted that his Consultants thought they were and he was getting quite a lot of support from the panel.

While I was involved, the IMFT were very critical of the efforts to form courses for Maxillo Facial Technicians and they eventually ran their own, but Brian later reported that some maxillo facial units were used in the London diploma submissions.

Les Ward took the submissions back to Manchester and his lecturers wrote the units which formed part of their TEC diploma submissions. It was the colleges that worked their way through the criticism and advice to bring the courses into a viable format for

•

I first met Les Ward in 1976, when the OTA had their third conference at the John Dalton Faculty of Technology and I was tasked with producing the program and table displays for the event. Les was a great man to work with, he was organised, constructive and positive and we were all pretty pleased with our conference.

The John Dalton Faculty was part of the Manchester Polytechnic when in 1992 it became the Manchester Metropolitan University and because of funding changes, Manchester developed degree courses for Dental Technicians.

Other centres such as Sheffield followed with degree courses and they needed to ask for financial support from the profession to achieve this. Everywhere people were seizing and creating possibilities, the profession at its best.

Hopes and aspirations were about to be achieved and for Hospital Technicians, this education evolution ensured their position as a profession within the service and as the voices of the past had wanted, we had a status accepted by the establishment.

REFERENCE:

•

Senior Chief Technician at West Hill Hospital, Dartford, Kent.

Represents OTA at CCHADT & Regional Delegate

PASSED POSTS:

• • • • • •

• • • • • • • •

Member of the first steering committee that founded the OTA. Founder Member of the CCHADT Member of the Whitley Council and Committees for 15 years.

Dental Technology Representative on the National Health Service Training Advisory Board Member of the City and Guilds Dental Advisory Board Member BTEC Dental Technology Higher Awards Advisory Board Member DTETAB Representing MSF Teacher of Orthodontics at Maidstone & Medway Technical College.

Vice Chairman OTA Chairman CCHADT Education Officer Minutes Secretary First Treasurer Member of SLC Dental Advisory Committee

HONOURS:

• •

Fellow of the OTA AE Dennison Award for services to Dental Technology

CC papers - WEB - BBC.

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21

INSIGHT

It was my turn next, and the unit structure outline I presented went through almost on the nod. I remember them peering at my submissions with hardly a question and my conclusion was, that not many in the room knew anything at all about orthodontic technology.

JOHN WINDIBANK FOTA

the profession and TEC.

DENTAL NEWS

INDIVIDUALIZED CAD/ CAM-PRODUCED TITANIUM SCAFFOLDS FOR ALVEOLAR BONE AUGMENTATION

BY DR. MARCUS SEILER, ET AL.

REPRODUCED FROM DENTAL TRIBUNE INTERNATIONAL. JULY 2, 2018

C

omputer-aided design/computeraided manufacturing (CAD/ CAM) technologies may improve application of titanium scaffolds, onlay techniques and guided bone regeneration. In this study, the clinical outcome of DICOM-based individualized CAD/CAM-produced titanium scaffolds (iCTSs) was analyzed in grafted defects, particularly with regard to relation of dehiscence to demographic and surgeryrelated factors.

Materials and methods: In 100 patients, 115 defects of the alveolar crest were reconstructed with an iCTS covered with a native bilayer collagen membrane or left uncovered. The volume was mostly

22

grafted with a mixture of autogenous bone and deproteinized bovine bone mineral. The healing process was documented. Office records were analyzed for association of dehiscence with demographic and surgical parameters.

Results: Uneventful healing was observed in 82 defects. Infection of the surgical area was documented in 11 cases, 10 were resolved by medication. One defect had to be regrafted. Dehiscence was reported in 26 defects. Premature removal of exposed iCTSs was not necessary. All of the cases showed sufficiently grafted volume for implant placement with presurgical 3-D planning. The grafted volume in the defects with dehiscence did not differ from that in sites without

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dehiscence. Statistical analysis revealed no significant association of dehiscence with demographic or surgical parameters, but a tendency to higher prevalence of dehiscence with mesiodistal width of the defect.

Conclusion: Combination of an iCTS with guided bone regeneration offers a reliable grafting technique with low sensitivity to dehiscence. Dehiscence did not correlate with demographic or surgical factors. In addition, it did not affect the final outcome, as implant insertion was possible simultaneously or staged in all of the cases..

The full article was published in the 1/2018 issue of the Journal of Oral Science and Rehabilitation.

DENTAL NEWS

NEW COATING PREVENTS BACTERIAL GROWTH ON DENTAL APPLIANCES BACK TO NEWS ASIA PACIFIC BY DENTAL TRIBUNE INTERNATIONAL MAY 30, 2018

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SEOUL, South Korea: According to the American Association of Orthodontists , more than five million people seek orthodontic treatments each year in the US and Canada alone. Therapy includes fixed orthodontic appliances and aligners, whose materials are prone to bacterial contamination. However, researchers from Yonsei and Kyung Hee universities in Seoul have now reported that they have developed a film that reduces bacterial growth on dental appliances.

Bacteria frequently build up on clear aligners or retainers, which also suffer from poor abrasion resistance. The researchers set out to develop a simple and affordable coating to combat this issue. They drew inspiration from super-hydrophilic antibacterial coatings on other medical devices in order to see if they could develop something similar for plastic appliances in the oral environment.

The researchers layered films on a polymer sheet modified with glycol (PETG). This layered film created a super-hydrophilic surface that prevented bacteria from adhering, resulting in a 75 per cent reduction in bacterial growth between coated PETG and the bare material. The coated plastic was also stronger and more durable, even when tested with artificial saliva and various acidic solutions.

The study, titled “A polysaccharide-based antibacterial coating with improved durability for clear overlay appliances”, was published online in ACS Applied Materials and Interfaces on 4 May 2018 ahead of inclusion in an issue.

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DENTAL TECHNICIANS INSIGHT

DANGEROUS ROLE IN WW2 PART FIVE

BY TONY LANDON

The U.S. First Army in France from June 1944 onwards reported that the endless construction, reconstruction, and repair of dental prostheses is the main dental problem that we have had to contend with.

Difficulties in providing adequate prosthetic care at all their world-wide overseas bases resulted mainly from the fact that demands for dental appliances greatly exceeded all pre-planning calculations by the American Command authorities.

12 WEEK INTENSIVE COURSE TO BE A DENTAL TECHNICIAN American medical army authorities trained up, during the early WW2 period, batches of dental technicians on an intensive 12-week course designed to prepare trainees to serve either in a dental laboratory as a prosthetic technician or in a dental clinic as a chair assistant. At most of the American dental training centres, the first 8 weeks of the course were devoted to the fundamentals and mechanics of basic dental laboratory procedures. Trainees in both sub-specialties attended classes in dental and oral anatomy, prosthetic materials and metallurgy, tooth carving, full and partial dentures, and various aspects of tooth repair. During the final month of the program, trainees were split into two groups for on-the-job training. Those chosen to become laboratory technicians worked in laboratories and attended extra classes in dental prosthetics.

REASONS WHY SO MANY DENTURES WERE BEING FABRICATED It was reported that the United States of America forces during WW2 had nearly 500,000 servicemen overseas wearing one or two dentures per soldier. The U.S. Army prosthetic treatment requirements for overseas combat theatre bases, though not as pronounced as in the large military camps receiving inductees in to the United States Armed Services, were far more than for noncombat personnel living under relatively stable U.S. mainland base camp conditions.

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In contrast with the total of 13,140 dentures constructed in France during the First World War, 845,000 prosthetic cases were completed for military personnel outside the United States in the 4 years from 1942 through 1945. An additional 20,000 appliances were constructed for civilians and prisoners of war by American based dental laboratories.

The following prosthetic operations of various types were completed per 1000 military personnel overseas during the 3-year period 1943-45. (Fig.1) U.S. army reports for 1944 placed the proportion of overseas personnel wearing dentures at about 10 per. cent. (Tony Landon believes this percentage is low for 1944) In every combat area the U.S. dental laboratories were pushed to the limit of their capacity. The Dental Division reported that 7.2 prosthetic operations were completed per 1000 military personnel overseas in the single month of August 1944. The Fifth Army in Italy found that 9 soldiers per 1,000 required prosthetic treatment every month.

The unexpected, inordinate requirements for prosthetic treatment in conflict areas such as North West Africa and Europe was attributed to a number of factors. When United States of America became embroiled in WW2 a lot of their signing up servicemen were not fully medically fit before their embarkation onto troop ships. These soldiers still had essential dental care to be completed. A lot of them needed dentures to replace their diseased, broken teeth that had been removed.

Treatments started in the United States were not always laboratory completed before the European Theatre of Operations ETO departure of the troops needing dentures.

In theory, dentures on being completely fabricated at base camps where the soldiers had been trained for ETO war were then sent on to the soldiers’ ongoing training or offensive operational bases. Only to find in a lot of cases particular servicemen had been reassigned to other camps or to forward positions. Many dentures were lost in shipment or ended up at other designated North West African, or European U.S. military camps.

IMMEDIATE DENTURES It is interesting to note that immediate dentures that are still prescribed here in Britain 2018 and still taught as an effective way for patients to accept dentures didn’t fully work out with North American troops during WW2. In the rush to have U.S. troops ready for the pre-planned offensives across North West Africa and Europe the prosthetic appliances that were finished before the edentulous soldiers embarked were thought to have been placed too soon after extraction of their fractured or carious teeth.

FIG.1

YEAR

FULL DENTURES

PARTIAL DENTURES

REPAIRS TOTAL

1943

10.0

28.1

19.9

58.0

1944

12.3

37.9

29.4

79.6

1945

9.2

40.3

33.6

83.1

37.2

29.6

77.4

Yearly 10.5 average

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p26

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The Confident Dentist team invites you to spend just 2 minutes of your time answering their survey on how you communicate with your team and patients. To show their appreciation, all respondents will be entered into a free prize draw to win over £1,500 worth of communication training, on Dr Barry Oulton’s Influencing Smiles two-day course, plus dinner with him and the team.

We all know that great communication is key to the growth and success of your practice. This survey is our chance to hear from you on any specific challenges you have in dealing with both your patients and team, to ensure that all our future communications and courses are tailored and perfectly placed to support you.

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Why choose BioHPP®?

By Colin Wilson CDT, Active Dental Laboratory Two years ago, I moved away from constructing screw retained bridges in titanium and acrylic to using BioHPP® with acrylic. I researched the benefits of BioHPP® before committing to this change.

• • • • • • • •

Its shock absorbing properties protects implants, spreading the load throughout the framework.

Its torsional flexibility, resembling natural bone makes it ideal.

Strong resistance to fracture.

Perfectly suited for veneering - achieves a higher bond strength than that of metal ceramic.

Ease of processing via the for2press, creating minimal waste.

The only material with a perfect balance between elasticity and rigidity, low weight and fracture strength as well as physiology and resistance to plaque.

Biocompatible – as a class 2a medical device it complies with all relevant DIN standards and is non-cytotoxic.

Metal free – no ion exchange, preventing reaction in the mouth or metal taste.

These benefits along with the great customer service, invaluable product knowledge, advice and support provided by bredent UK Ltd convinced me to make the change. For more information on BioHPP visit www.bredent.co.uk/biohpp

Case pictured: All-on-4 BioHPP® bridge using Nobel multi-unit implant system.

Materials used: • BioHPP pink pressed using for2press • Bond achieved using visio.link & Combo.lign • Composite gingiva layered with crea.lign flow & paste • Polished using Acrypol Paste and Abraso Star Glaze

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DENTAL NEWS

HELP THE CONFIDENT DENTIST

ucontinued from page 24

INSIGHT

The U.S. dental surgeon of the European theatre went on to report in 1943, ten per. cent. of the country’s servicemen who had received immediate prosthetic treatment before their impending troop transport shipment were unable to wear their appliances on arrival at their British further training camps. Was it that these ten per.cent. of U.S. troops were finding an excuse to have a protracted delay to facing or taking on the inevitable horrors of modern warfare?

The lack of sufficient prosthetic laboratory facilities with forward fighting units during the early attacking stages of WW2 battlefields across North West Africa, Mediterranean islands and Normandy beaches led to thought there had been a perceived carelessness when U.S. combat troops handled their own oral appliances. The wilful destruction or loss of a soldier’s individual dental appliance could lead to an excuse to be temporarily withdrawn from a combat area.

The U.S. Fifth Army reported how quickly prosthetic needs appeared with newly arrived divisions the 85th, 88th, and 91st even though these divisions' troops embarked for overseas duty when all their dental requirements had been fulfilled at their U.S. base camps. Also reported was the significant rate that new dentures and denture repairs were required within the1st Armoured, 34th, 36th, and 45th veteran divisions.

The soldiers’ field rations were not that inspiring and one wonders if it was their plentiful hard tack biscuits that broke many a denture! For example the Royal Ulster Rifles whom endured continuous fighting from D Day onwards across the Normandy countryside, had to cook their compo rations of their fourteen day pack in biscuit tins filled with earth which had been soaked in petrol or on small Coleman stoves. Their meals were monotonously made up of hard tack biscuits, tins of bully beef, Maconochie’s pies, (they were meat and vegetables mixed together which was claimed could be eaten hot or cold), steak and kidney puddings, tins of unspecified soup and plum pudding. Most importantly of all, the ever-ready brew up, tea premixed with powdered milk and sugar.

Oatmeal blocks that could be crumbled in hot water to make porridge were also readily supplied with tins of over salted and glutinous bacon with powdered egg. C ration cans were wrapped with stuck on paper labels, which soon fell off thus making it a pure guessing game what was not so eagerly being cooked up. U.S. soldiers faced the ongoing monotony of their tinned provisions and the Allied Australian forces in particular disliked the C rations, finding the canned food bland, overly soft in texture, and unappealing.

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In 1943, and this is a year before D Day the U.S. Army ration board reviewing medical examinations of soldiers after long-term exposure to tinned C rations recommended that canned food should be restricted to a maximum of five continuous days of consummation in the absence of supplementation with other rations Divisional records show that diarrhoea or constipation had reached such a critical situation as the weeks of fighting progressed so slowly across the Normandy countryside that many U.S. and Allied soldiers took to bartering as often as possible with their C or K canned rations for the very limited fresh produce the starving locals were willing to trade.

MUDDLED THINKING ON HOW TO EFFECTIVELY SUPPLY DENTAL LABORATORY FACILITIES The U.S. Army had an identification system of chests for their medical supplies, equipment and materials, necessary in their centres of military operation. To save costs the dental Field Chests 61 and 62 were removed from the medical battalions and small combat zone hospitals. This left the divisions with no prosthetic service, which drastically reduced the facilities that the U.S. armies expected.

The situations resulting from the drastic reduction in prosthetic denture replacement capacity with forward units soon led to these combat areas taking independent and unofficial actions to restore at least part of the lost dental facilities and return combatants to their frontlines as soon as practically possible.

Most offensive zones went further due to the anticipated arrival of approved dental laboratory truck set-ups by improvising models of their own for instantaneous usage. Dental Field Chests 61 and 62 became widely available again.

Portable dental laboratories were restored to the medical battalions with divisions.

Though three prosthetic mobile laboratories, with appropriate team personnel, had been added to an auxiliary surgical group who were to serve an army of ten divisions. With three evacuation hospitals and one field hospital, they still suffered a net loss of eleven field dental laboratory facilities. These mobile laboratories of the auxiliary surgical group had been expected to function with more efficiency than the previous range of equipment and assorted materials packed into the Field Chests 61 and 62. But the specialised dental trucks were not available until well into 1944, a year after the Field Chests 61 and 62 were withdrawn from being further supplied.

Further complications arose due to edentulous servicemen waiting

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unduly in a base camp for their dentures to be repaired or replaced by whatever dental laboratory facilities were available in. The withdrawn edentulous combat servicemen were taking up the very limited hospital beds and messing facilities that were primary for wounded soldiers.

During the spring months of 1943, a total of 250 prosthetic patients occupied beds in general hospitals of the Mediterranean U.S. Base Section. The dental surgeon of the U.S. North West African theatre reported, “At present there are thirty-five patients occupying beds in the 21st General Hospital, awaiting denture prostheses as their medical treatment.

The 7th Station Hospital is constantly being asked by organisations within a radius of 80 miles to hospitalise soldiers that just need full or partial denture work”.

The withdrawal evacuation of edentulous servicemen from combat areas did result in loss of the expected compliment of fighting patrols. The dental surgeon of the North West African theatre stated that one of his biggest problems was to prevent withdrawing servicemen from combat areas, just for prosthetic treatment involving replacement dentures or repairs of their appliances. When hospitals were becoming overrun with mutilated wounded soldiers during particular stages of a localised battle any combatants not requiring immediate medical care to save life were sent to the rear rapidly to make room for the seriously injured infantry.

It was expected edentulous soldiers would be returned to fight with replacement teeth, pretty sharpish!

It had been duly noted and reported that under these circumstances of evacuating edentulous combatants the fantastic lengths individuals might wangle! One soldier who required a repair to his denture during the Sicilian offensive, eventually had himself shipped back to North West Africa. He then hitched rides along the occupied zones whilst managing to be passed on through four hospitals with such speed that he was never seen by an actual dentist or dental team member.

It was envisaged that the mobile dental laboratories would at short notice move forward with fighting units as they engaged the enemy from area to area. The primary role of the dental technicians working in these mobile dental laboratories was to have the fighting servicemen with their denture fixed or replaced back up to engage with the enemy at their forward position as soon as possible.

Dwindling of U.S. troop numbers at critical times, through loss of dentures or fractured dentures wasn’t envisaged by the planners of the offensives they had set for the U.S. Army.

To be continued...

KEMDENT: NEW AUTUMN OFFERS AVAILABLE NOW w New Autumn offers are available on Kemdent’s popular products. From October, Dental Technicians can take advantage up to 50% discount on PumiceSafe Universal Cleaner or PlasterSafe – Plaster Solvent.

PumiceSafe Universal Cleaner is a multi purpose, alcohol free, ready to use solution that neutralises unpleasant smells from your Pumice tray, producing micro-organism free slurry with a fresh minty fragrance. It can be used as a bench surface cleaner plus it is ideal for pre-soaking lathe brushes to reduce the risk of burning the acrylic during polishing. This alcohol free cleaner has an emollient content so it will not irritate a technician’s hands.

PlasterSafe is a plaster solvent and tray cleaner. It is a ready to use, alcohol free solution that aids the safe removal of dental

long as it is required. The plaster dissolves and the trays can be rinsed quickly and efficiently in clean water.

Designed with the technician in mind, these products save valuable time, plus keep your laboratory clean and fresh with minimal effort.

Plus Kemdent’s popular Christmas hamper promotion is back for November 2018!

plaster and stone from the fitted surface of dentures and the hard to reach areas.

This water based solution has no harmful chemicals. It is easy to use, just remove any excess plaster or alginate, then immerse your trays in PlasterSafe. This can either be done rapidly in an Ultrasonic bath or soaked for as

Get a free hamper brimming with festive treats, the more you spend in November the bigger and more luxurious the hamper!

To find out more about PumiceSafe and PlasterSafe or how you can get your free Kemdent Christmas hamper call Jodie on 01793 770256. Email sales@kemdent.co.uk or visit our website www.kemdent.co.uk

VITA EVEN CLOSER TO YOU: YOUR TRUSTED PARTNER IN THE UK w VITA has been the reliable partner of technicians and dentists around the globe for over 90 years, providing both materials and technology. VITA’s aspiration is to inspire and support professionals to be able to deliver the most esthetic, functional and long-lasting restorations with an efficient protocol to their patients. To accomplish this mission, VITA provides precise communication means between the dental lab and practice, based on an accurate digital and visual tooth shade determination.

With its high quality, metal-free restoration materials and reliable equipment for shade reproduction, VITA enables technicians and dentists to achieve clinical and economic success. Get in touch with

your ‘perfect match’ on Facebook or get more detailed information from our representatives and on www.vita-zahnfabrik.com VITA Specialist Mrs. Nilou Sotouhi

Mobile: +44 7725 8710 71 Email: n.sotouhi@vita-zahnfabrik.com Order Department & Customer Service Mrs. Nicole Vogt Tel: +49 7761 562-281 Email: n.vogt@vita-zahnfabrik.com

ACTEON GROUP ACQUIRES PRODONT HOLLIGER w At the heart of France and a region known worldwide for its metal and in particular its blades and knives, Prodont Holliger manufactures reliable, leading-edge tools that are designed by dentist for dentists and technicians for technicians.

Carried by a passionate team of skilled engineers, their unique competence knows no bounds and rigor and precision are key words in every aspect of R&D, production and delivery.

Explore the wide range of dental laboratory products from handheld instruments and discs for working with all types of materials, to the new Protorch 4, one of the most reliable and constant burners on the market, with a precise and adjustable flame and automatic piezo ignition.

For more information, a product catalogue or demonstration, call Acteon UK on 01480 477307 or email info.uk@acteongroup.com

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COMPANY NEWS

THE DENTAL TECHNICIAN MARKETPLACE

FREE VERIFIABLE CPD As before if you wish to submit your CPD 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 CPD 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 CPD either online or by post.

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

4 Hours Verifiable CPD in this issue 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 REVIEW: n Strength of Zirconia n Implant planning n Customised Special trays n Business of Management

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 September DT Edition:

CPD

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VERIFIABLE CPD - OCTOBER 2018 1. Your details First Name: .............................................. Last Name: ........................................................Title:................

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

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

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

Question 1

Question 2

Question 3

Question 4

Question 5

Question 6

Question 7

Question 8

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A

A

A

A

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B

B

B

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C

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D

D

D

D

D

D

D

Question 9

Question 10 Question 11

Question 12

Question 13

Question 14

Question 15

Question 16

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B.

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A.

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Q7.

C.

Q8.

D.

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

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

Q9.

C.

You can submit your answers in the following ways:

Q10.

B.

Q11.

D.

1.

2.

Q12.

C.

Q13.

C.

Q14.

A.

Q15.

C.

Q16

B.

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

......................................................................................................................................................

Via email: cpd@dentaltechnician.org.uk By post to: THE DENTAL TECHNICIAN, PO BOX 430, LEATHERHEAD KT22 2HT

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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VERIFIABLE CPD AS YOU NEED IT VIA THE DENTAL TECHNICIAN RE REHABILITATING THE EDENTULOUS MAXILLA Q1. What is the reason for the loss of teeth?

A. Patient wanted a new smiLe B. Unmanageable Oral hygiene and advanced

Perio breakdown C. Patient wanted to try Implants D. Too many sweets Q2.

A B. C. D.

What was present in the Sinus?

Bone Graft An Ulcer A Retentive Cyst A Tumour

Q9.

A. B. C. D.

How Many miles were covered?

705 miles 500. Miles 550 Miles 650Miles

Q10. Where did they Start?

A. Lake Garda B. Lake Constance C. Verona D. Florence MEMOIRS OF AN OLD CODGER Q11. By whom was the TEC (Technicians Education

Council ) Created?

A. The City and Guilds B. The Goldsmiths Union C. Margaret Thatcher D. The NUT

Q3.

A. B. C. D.

How long did the Surgeon wait for healing?

Three Months Six Weeks Full 6 Months Not at all

Q4.

A. B. C. D.

How Long did the patient wear the Provisional?

5 Months 4 Months 6 Weeks 6 Months

Q5.

A.

B. C. D.

What was used to help negate the potential for distortion of the impression?

Open tray impression copings splinted with wire and pattern resin PMMA Plastics They were linked directly to the tray A bar linking the copings

Q6 A. B.

C. D.

What was used to manufacture the prosthesis?

Cast Gold Framework with Acrylic A CADCAM metal structure from the scanned provisional for bonding porcelain All Zirconium Bridge A removable Denture

Q7. At what angle were the posterior implants placed?

A. 25-35Degrees B. 45 Degrees C. 30-45Degrees D. 15-20Degrees STRAUMANN CHARITY BIKE RIDE Q8. What charity was the bike ride supporting?

A. The arthritic cyclist association B. The Polio Society C. The campaign for destitute Dentists D. The Mouth Cancer Foundation

DENTAL TECHNICIANS IN WW 11 Q. 12. How many American troops were estimated to be

wearing Dentures?

A. 230,000 B. 370,000 C. 500,000 D. 600,000 Q13. What percentage of U.S. troops wore partial or full

dentures between 1943 and 1945?

A. 28.1% B. 37.9% C. 40.3% D. 37.2% MARKETING Q14 What is the focus of this months article?

A. Magazine advertising B. Mailshorts C. Exhibitions.

D. Social Media Q15.

A. B. C. D.

What do you need for success?

Lots of constant change Consistency and quality Job of the month Discounts on line

PAGE 22.: CADCAM SCAFFOLDS Q16. What do the letters iCTSs Signify?

A. Individual castings for Treatment after surgery B. Independent Castings from Technicians specialists C. Individualied CADCAM Produced Titanium Scaffolds D. Individual computer treated sections

You can submit your answers in the following ways: 1. Via email: cpd@dentaltechnician.org.uk 2. By post to: THE DENTAL TECHNICIAN LIMITED, PO BOX 430, LEATHERHEAD KT22 2HT 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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CPD

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EDUCATION

Date: Wed 28th Nov 2018 Venue: LonDEC, 150 Stamford St, London, SE1 9NH Time: 9.15-17.00 Course Cost: £20 Verifiable CPD hours: 6.5

CLINICAL DENTAL TECHNICIAN STUDY DAY

HEALTH EDUCATION ENGL AND LONDON AND SOUTH EAST Present the study day for Clinical Dental Technicians (CDTs) This study day will provide delegates with a broad appreciation and an update in knowledge covering 5 key topics relevant to CDTs: • Oral cancer detection • Radiography • Infection control • Safeguarding vulnerable adults • Managing medical emergencies

By the end of the course delegates will: • Detect cancer and pre-cancerous lesions • Read radiographs and understand imaging issues • Maintain infection control standards in line with HTM 01-05 • Detect signs of abuse and recall how the MCA impacts on role • Treat a patient experiencing a medical emergencies GDC DEVELOPMENT OUTCOMES A, C and D

This study day is available to book via www.ewisdom-london.nhs.uk COURSE ID 8077

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