Dental News December 2016 + Yearbook 2017

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Oral rehabilitation with conventional complete dentures on a patient with Bardet–Biedl syndrome: A case report

Dr. J. Jaouadi, Dr. J.Safa, Dr. F. Achraf, Dr. K.Chebbi, Dr. K. Masmoudi, Dr. A. Hana, Pr. A. Ben Rahma

Molar-Incisor-Hypomineralisation (MIH) in Lebanon: A preliminary clinical observation

Dr. Mary Antoun, Dr. Paul Nahas, Dr. Assaad Nasr, Dr. Hicham Mansour

Managing of diastema case by orthodontic, surgical and prosthodontic therapies

Dr. Mohammed Sarraj

Wear behaviour and surface roughness of Polymer infiltrated ceramic material Compared to pressable glass ceramic

Dr. E. Elhomiamy, Dr. Y. Aboushady, Dr. B. El Malakh

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BIDM 2016

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November 1 - 4, 2016

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INTERNATIONAL CALENDAR

SDS 2017 - The 28th Saudi Dental Society Meeting

EOS 2017 - The 29th Egyptian Orthodontic Society Annual Scientific Meeting

January 10 - 12, 2017 at the International Convention & Exhibition Center, Riyadh, KSA Website: www.sds.org.sa

January 20 - 23, 2017 at the Mariott Hotel Cairo, EGYPT Website: www.edsic-eg.com

February 4 - 5 , 2017 at the Royal Thalassa Monastir, TUNISIA Email: atorecd@yahoo.fr

February 7 - 9, 2017 at the Dubai International Convention & Exhibition Center, Dubai, UAE Website: www.aeedc.com

IAPD 2017 - The 1st Emirates Pediatric Dentistry Club Conference

March 1 - 3, 2017 at the Taj Hotel, Dubai, UAE Website: www.epdc.com

March 21 - 25, 2017 Cologne, GERMANY Website: www.english.ids-cologne.de

May 5 - 6, 2017 at the Intercontinental Hotel, Festival City Dubai, UAE Website: www.cappmea.com

May 10 - 13, 2017 at the Lebanese Univesity Campus, Hadath, LEBANON Website: www.ul.edu.lb

May 18 - 20, 2017 Rimini, ITALY Website: www.expodental.it FDI 2017 - Annual World Dental Congress

August 29 - September 1, 2017 Madrid, SPAIN Website: www.fdiworldental.org

September 13 - 15, 2017 at the Intercontinental City Stars, Cairo, EGYPT Website: www.edsic-eg.com

Oral rehabilitation with conventional complete dentures on a patient with Bardet–Biedl syndrome: A case report

Dr. J. Jamila

Associate professor

j.jaouadi@yahoo.fr

Dr. J. Safa Resident

Dr. F. Achraf Resident

Dr. K.Chebbi Assistant

Dr. K. Masmoudi

Associate professor

Dr. A.Hana Resident

Pr. A. Ben Rahma

Head of the department of complete dentures

Keywords

Bardet-Biedel syndrome; oral health; complete dentures.

Abstract

Bardet-Biedel is a very rare syndrom ; its diagnosis needs the collaboration of multidisciplinary intervenants. We aimed to report a patient with this pathology not only to restore oral functions but also helps practitioners to offer better solutions to overcome difficulties in such situations. The patient was diagnosed with BBS since the age of 10 years. According to family background, parents were related and had 5 children, three of which non syndromic.

Introduction

Bardet-Biedl syndrome (BBS) is a rare, autosomal recessive disorder characterized by cardinal features including rod-cone dystrophy of the retina (sometimes called retinitis pigmentosa) 9, 10, 13

For the diagnosis, 4 primary or 3 primary and 2 secondary criteria are required. The diagnosis is mainly clinical and currently the genes responsible for cilia biogenesis and function are being investigated. Only few cases of BBS have been reported from India 1, 2, 11, 16

The etiology is still unknown, but it is described in the literature as 35% to 48% of parental consanguinity in patients with this syndrome. Patients also present buccodental anomalies such as malocclusion, anterior crowding, micrognathia, deep palate, hypodontia, small tooth roots, enamel hypoplasia, and microdontia. Because of the oral manifestations, dentists must get acquainted with this syndrome 2, 3, 14 In the literature, a few studies reported facial

features on patients with this syndrome. According to them, BBS patients display a long philtrum, thin upper lip, small mouth, brachycephaly, macrocephaly, large ears, palpebral fissures, bitemporal narrowing, and front baldness in male patients 1, 13, 16

Case report

A 53-year-old male patient consulted our department requesting new dentures conception; his complaints are mainly about aesthetic appearance and instability of his dentures, so he wanted to beneficiate of a new conception that would allow him a better faculty of chewing. (fig 1 A, B, C)

Clinic of dental medecine in Monastir,Tunisia

Fig 1

A B

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The general medical examination revealed a reduction of the eyesight; infertility through a detailed questioning of the patient; who adds that his sister is also suffering from the same syndrome and she is not married; then when we asked him if it is possible to bring her at an appointment; since she is a complete- denture- wearer also, he said that she is blind and it’s more difficult for her to get around 3, 5, 14, 17

The patient was diagnosed with BBS since the age of 10 years. According to family background, parents were related and had 5 children, three of which non syndromic.

The particularity of this syndrome in relation with oral rehabilitation is that the patient suffers from recurrent odontogenic cysts and its surgical resection is not only recurrent but also it causes bone resorption which is further added to physiological one where it’s centrifugal in the maxilla and centripetal in the mandible.

Intra-oral examination shows a reduced size of both mandible and maxillary arch (figure 2 .a.b) and alveolar bone height with knife-edge shape, which may complicate the denture construction and its biomechanical behavior during function.

The examination of old dentures shows a notable decrease of the occlusal vertical dimension (O.V.D); lack of retention and stability; what explains his aesthetic grievances (fig.3 a.b)

So it seems logic that the decision is to resume a new prosthetic conception instead of rebasing or relining old ones, in any case it’s not the indication.

The technique to idealize new complete dentures followed the same steps that are recommended as usual: A preliminary impression was made using stock edentulous tray (Schranemakers), then the final impression was taken with a custom tray fabricated with autopolymerized acrylic resin with border-moulded impression compound followed by a regular impression.

Master casts were mounted on a semi adjustable articulator with a common arbitrary ear-face-bow instrument, using condylar guidance of 30°, Bennett angle of 15°.

Occlusal vertical dimension was established using the physiological rest positions associated with phonetic and esthetic techniques. (Fig.4a.b.c.d)

Centric occlusion was established according to dynamic records based on unforced movements of the jaws in the terminal hinge position performed by the patients and manually guided.

The artificial teeth were arranged in wax. The patient and his wife accepted the arrangement of teeth which have the particularity to be done in cross-over in the right side to remedy to the resorption between maxilla and mandible.

(Fig 5 A, B)

The dentures were waxed, processed, finished, and polished.

Fig 2

Fig 3

Fig 4

Fig 5

The patient and his wife were recommended about its use, cleaning procedures, and the importance of followup, especially if there were some complaints or any discomfort.

To complete necessary adjustments, follow-up appointments were scheduled the next day and one week later. Future follow-up was also planned to evaluate progress in speech and esthetics.

The problem is that pain still present in the area of the cyst in the left side of the mandibular arch; relining will probably be the best alternative to reduce this pain.

Discussion

Based on the ocular findings and systemic manifestations, the following differential diagnoses were considered: Weiss syndrome, Biemond II syndrome, Laurence Moon syndrome, Alstrom syndrome and Bardet- Biedl syndrome 15, 18

Alstrom syndrome is characterized by tapetoretinal degeneration, obesity, preaxial polydactyly, diabetes mellitus, and neurogenic deafness. The patient had only one (obesity) of these manifestations. His blood glucose was normal and he had no symp

toms of diabetes. Neither did he have neurogenic deafness 6, 8

The other findings seen in this patient (hypogenitalism, and learning disability) are not manifestations of Alstrom syndrome. Biemond II syndrome is characterized by ocular defects (more specifically iris coloboma), learning disability, polydactyly, obesity, and hypogenitalism 19, 20

Although the patient had three of the main characteristics, retinal dystrophy is not a characteristic of this syndrome 5, 8

Obesity, genital dystrophy, nerve deafness, and short stature characterize Weiss syndrome, which were all seen in the patient. But the patient had retinal dystrophy, which is not characteristic of this syndrome.

Laurence Moon syndrome is characterized by retinitis pigmentosa or rod cone dystrophy, mental deficiency, hypogenitalism, and spastic paraparesis. The patient, however, had no spastic paraparesis and patients with Laurence Moon syndrome do not show polydactyly and obesity 7, 8, 12

Similar to Laurence Moon syndrome, Bardet-Biedl

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syndrome is characterized by retinitis pigmentosa, obesity, postaxial polydactyly, learning disabilities, hypogenitalism, and in some cases, renal dysfunction. With 4 of the 6 characteristics present in this patient, he was diagnosed to have Bardet-Biedl syndrome.

Secondary features are speech disorder/delay, strabismus, cataracts, astigmatism.

Decreased visual acuity can result from macular involvement of the disease 4, 7, 8

As there is no specific curative therapy available for this syndrome. The patient was managed symptomatically and a new complete denture was managed.

The patient was seen for some complaints at twice a time: First for aesthetic ones where some corrections were done; then for difficulties of chewing since prosthetic teeth were arranged on a cross way; so we decided to resume a new lower complete denture to find a better arrangement for occlusion and better stability of the complete dentures .

Conclusion

Hypogonadism as another major criterion of the syndrome may be seen with delayed onset of puberty in both genders, hypogenitalism in males and genital anomalies in females. Gonadal dysfunction is seen more often in male patients than female patients. Small penis size and decreased testis volume are often seen in male patients and in female patients; there is often a delay in the onset of the menstrual cycle 4, 9

An effective multidisciplinary approach is required to manage this pleiotropic situation. There is no definitive treatment method for BBS. Complications related to BBS should be treated symptomatically. There should be an awareness of complications for which BBS has laid the base and patients should be followed up in this respect 9, 10, 11

References

1. Yildirim mÖ, Çelik C, TezYürek m BardeT-Biedl SYndrome aSSoCiaTed WiTh BraChial amYoTrophY and CereBral and CereBellar aTrophY: a CaSe reporT. TurkiSh J phYS med rehaBil 2011;57(2);345-7.

2. Varma C, BhaT rY, BhaTT S. BardeT-Biedl SYndrome in TWo SiSTerS: a rare inCidenCe. J pediaTr GeneT 2013;2(1):49-51.

3. raJoor uG, Gundikeri Sk, Sindhur JC, dhananJaYa m. BardeT Biedl SYndrome-a rare CaSe reporT from norTh arnaTaka

mediCa innoVaTiCa 2013;1(2):118-20.

4. ferreira do amaral Co, loGar Gde a, pariSi aG, TakahaShi k, STraioTo fG. General and STomaToloGiC aSpeCTS of BardeT-Biedl SYndrome. J CraniofaC SurG 2014;25(6):e575-8.

5. lo kT, remulla J, SanTiaGo ap manifeSTaTionS of BardeT-Biedl SYndrome philip J of ophThalmol 2004;29(2):94-8.

6. haque m, alam mf, BeGum S, rahman Sa BardeT-Biedl SYndrome. BanGaBandhu Sheikh muJ B mediCal uniVerS TY J 2016;9(2):119-22.

7. GhoSh Tn, de S, paTi S, kumar p, Chaki B. BardeT Biedl SYndrome. J nepal paediaTr SoC 2013;33(2):129-31.

8. Sahin C, huddam B, akBaBa G, TunCa h, koCa e, leVenT m TWo BroTherS WiTh BardeT-Biedl SYndrome preSenTinG WiTh ChroniC renal failure CaSe rep nephrol 2015;2015:764973.

9. TiWari k, meena S, GoYal S. BardeT Biedl SYndrome: a rare oCCurrenCe inT J ConTemp pediaTr 2016;3:1480-2.

10. m’hamdi o, redin C, SToeTzel C eT al CliniCal and GeneTiC CharaCTerizaTion of BardeT-Biedl SYndrome in TuniSia: defininG a STraTeGY for moleCular diaGnoSiS Clin GeneT 2014;85:172-7.

11. fieGGen k, milliGan C, henderSon B, eSTerhuizen ai BardeT Biedl SYndrome in SouTh afriCa: a SinGle founder muTaTion S afr med J 2016;10:S72-4.

12. haque m, alam mf, BeGum S, rahman Sa BardeT-Biedl SYndrome. BSmmu J 2016;9:119-22.

13. aJmal m, khan mi, neVelinG k eT al exome SequenCinG idenTifieS a noVel and a reCurrenT BBS1 muTaTion in pakiSTani familieS WiTh BardeT-Biedl SYndrome mol ViS 2013;19:644-53.

14. halaC u, herzoG d BardeT-Biedl SYndrome, Crohn diSeaSe, primarY SCleroSinG CholanGiTiS, and auToanTiBodY poSiTiVe ThYroidiTiS: a CaSe reporT and a reVieW of a CohorT of BBS paTienTS CaSe rep med 2012;2012:209827.

15. aGhaa z, iqBalB z, azama m eT al a noVel homozYGouS 10 nuCleoTide deleTion in BBS10 CauSeS BardeT–Biedl SYndrome in a pakiSTani familY. Gene 2013;519:177-81.

16. CaSTro-SánChez S, álVarez-SaTTa m, CorTón m, Guillén e, aYuSo C, ValVerde d explorinG GenoTYpe-phenoTYpe relaTionShipS in BardeT-Biedl SYndrome familieS. J med GeneT 2015;52:503-13.

17. CardenaS-rodriGuez m, oSBorn dp, iriGoín f eT al CharaCTerizaTion of CCdC28B reVealS iTS role in CilioGeneSiS and proVideS inSiGhT To underSTand iTS modifier effeCT on BardeT-Biedl SYndrome hum GeneT 2013;132:91-105.

18. Chennen k, SCerBo mJ, dollfuS h, poCh o, marion V. BardeT-Biedl SYndrome: Cilia and oBeSiTY - from GeneS To inTeGraTiVe approaCheS med SC 2014;30:1034-9.

19. SChaefer e, lauer J, durand m eT al meSoaxial polYdaCTYlY iS a maJor feaTure in BardeT-Biedl SYndrome paTienTS W Th lzTfl1 (BBS17) muTaTionS. Clin GeneT 2014;85:4768.

20. zaCChia m, eSpoSiTo G, CarmoSino m eT al knoCkdoWn of The BBS10 Gene produCT affeCTS apiCal TarGeTinG of aqp2 in renal CellS: a poSSiBle explanaTion for The polYuria aSSoCiaTed WiTh BardeT-Biedl SYndrome. J GeneT SYndr Gene Ther 2014;5:1-10.

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Oral Pathology

Molar-Incisor-Hypomineralisation (MIH) in Lebanon: A preliminary clinical observation

Dr. Mary Antoun, BDS, DU Oral Biol., Department of Esthetic and Restorative Dentistry

Dr. Paul Nahas, BDS, CES Oral Biol., CES Removable Prostho., CES Fixed Prostho., Cert. Immunopathol.,

Dr. Assaad Nasr, BDS, DESS Restorative Dent., Department of Esthetic and Restorative Dentistry

Dr. Hicham Mansour, BDS, DESS Endo., Department of Esthetic and Restorative Dentistry

Abstract

Hypomineralization of Incisors and Molars, known as MIH, is an enamel qualitative defect of systemic origin. Although studies were carried out in various countries, none of them was reported on the Lebanese population. The purpose of this preliminary clinical observation is to increase awareness of this disease within Lebanese and Arab dental communities, and to encourage dentists towards its early diagnosis and contemporary treatments (such as amelioration of oral hygiene, re-mineralization with fluoride, application of calcium and bio-available phosphate, and fissure sealant up to partial or total coverage in case of severe damage of tooth hard tissue).

Introduction

MIH is a particular anomaly structure that has been described for the first time in the early 70s in Sweden 4. MIH 23,24,25 was defined by Weerheijm (2001) as"hypomineralisation of systemic origin of 1 to 4 permanent first molars, frequently associated with affected incisors".

dental pain in childhood and for the psychological impact caused by the obvious aesthetic consequences on incisors 8

The structure abnormality may cause extensive tissue damage in absence of diagnosis and early care16. Although no difference was reported in the prevalence between male and female genders17, the wide variation in prevalence (2.4% to 40.2%) is due to the difference in recording methods, indicators used, and different age or population investigated. In some countries, caries levels may mask the true prevalence of MIH 17. In order to establish easy comparison between different prevalence studies, the European Academy of Paediatric Dentistry (EAPD) defined criteria for diagnosing MIH, based on clinical observation of dried and cleaned dental tissue 4

MIH treatment requires a genuine strategy to deal with several problems related to hypomineralization: hypersensitivity, rapid development of caries, difficulties during analgesia, and recurring failure of restorations leading to more limited child cooperation 16

Lebanese University, School of Dentistry

Republished with permission of the Lebanese Dental Association

In the literature, MIH is also referred as "cheese molar" (Weerheijm et al., 2001), "idiopathic enamel hypomineralisation" (Fearne, Anderson, and Davis, 2004 - Koch et al., 1987), "non fluoride hypomineralisation in permanent first molars" (Leppaniemi, Lukinmaa, and Alaluusua, 2001), and "hypomineralised permanent first molars" (Jälevik and Norén, 2000).

MIH is a disease with uncertain etiology20. Unlike hypoplasia, which is a quantitative defect of enamel, MIH is characterized by a qualitative defect of systemic origin8; it affects one or more first permanent molars that are frequently associated with an affected incisor 15. MIH is responsible for severe

The majority of publications deal with the diagnosis and epidemiology of this disease; yet, few articles have discussed the protocol of action. The main objective of the treatment is to define a long term follow-up prophylaxis and an adapted restorative therapy for these patients 11

Prevalence (Table 1)

Many studies were conducted in various countries to highlight MIH prevalence in their populations. In 2010, Jälevik reviewed several well-documented studies assessing MIH prevalence. This review showed a very wide variation in the disease prevalence, worldwide: it ranged between 2.4% and 40.2%.

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Oral Pathology

In European countries, it varies between 3.6% and 25%, and in East Asia, a single study reported a prevalence of MIH in Hong Kong to be around 2.8% in a sample of 2,635 children, with 12 years as a mean age (Cho, Ki, and Chu - 2008).

An Iraqi study (Ghanim, Morgan, Marino, Bailey, and Manton - 2011) showed a prevalence of 18.6% while a Jordanian one reported a prevalence of 17.6% in Jordanian children aged between 7 and 9 years (Zawaideh, Al-Jundi, and Al-Jaljoli - 2011). More studies have also shown an increase in the prevalence of MIH over time: in Germany, it increased from 9.7 % in 1999 to 14.3 % in 200312. In Lebanon, no studies have been reported yet to determine its prevalence. Our limited clinical observations have shown variable severity between patients and between different teeth, within the same mouth.

Etiology

TMIH is a multifactorial disease. Ameloblasts are very sensitive to lack of oxygen during their maturation phase. Hence, a premature infant may run the risk of sustaining amelogenesis process due to the lack of oxygen 11

There are also environmental pollutants (“digoxin”) and contaminants that induce toxic effects and

that are involved in the development and growth of embryo. Tooth would probably be an excellent model for the study of toxic effects because odontogenesis is very sensitive to environmental changes and may be at the origin of MIH20. A lack in vitamin D, calcium, a phosphocalcic metabolism disorder, many childhood diseases (mumps, German measles = rubella, bronchitis, asthma...), chronic renal failure, chronic digestive infection, malabsorption, and malnutrition can cause the appearance of MIH 20,22

In addition, there may be a positive correlation between high fever and the development of MIH 11

Differential diagnosis

MIH can be confused with many other dental diseases and it is essential to properly make our observation in order to correctly diagnose 11

Diagnostic criteria 24 of MIH, set by the European Academy of Pediatric Dentistry -EAPD- (2003), are the following:

1- Presence of demarcated opacity

2- Post-eruptive enamel breakdown

3- Atypical restoration

4- Extraction of molar due to MIH

5- Delayed eruption of a molar or incisor.

Table 1: Prevalence of MIH in several countries.

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Oral Pathology

Differential diagnosis of MIH is made with the following dental pathologies:

1. Amelogenesis imperfecta

Is a hereditary quantitative defect of enamel affecting all teeth (temporary and permanent dentitions). It is sometimes associated with a qualitative defect. This condition is characterized by impairment of enamel, which modifies the shape and volume of teeth. Early attrition leads to the following consequences: incisors and canines lose their edges, while molars lose their cusps 20

According to Weerheijm (2004), amelogenesis imperfecta differs from MIH by:

• Diffuse and symmetrical opacities;

• Higher number of affected teeth;

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• Possible radiographic pre-eruptive detection through taurodontism* (for certain forms of amelogenesis imperfecta) 3,20

2. Dentinogenesis imperfecta

Is a hereditary pathology of dentin, not enamel, which constitutes the main difference with the MIH. It affects temporary and permanent teeth. All teeth are opalescent, ranging from blue to brown. Teeth often have constriction marking the corono-radicular junction, and radiographically, roots are thin, with an obliteration of pulp chamber. Teeth are relatively resistant to decay 5,19,20

* Taurodontism = a developmental anomaly characterized by a vertical enlargement of pulp chamber and a shortening of roots (taurodontism is mostly observed in human molars).

3. Regional odontodysplasia 20

It is a non-hereditary anomaly of dental hard tissue characterized clinically by radioopacites affecting dentitions of maxilla and mandible. Radiographically, the contrast of enamel and dentine is decreased (less radiopaque than normallly). Histologically, areas of hypocalcification are combined with irregular direction of enamel prisms, as well as fibrotic dentin 7

4. Hypoplastic enamel

This condition is common and comes in the form of macroscopic defects reaching a more or less extended surface of the tooth. It affects both dentitions, with higher frequency in permanent teeth. In case of general disorder, hypoplastic enamel symmetrically affects with hypoplasia all teeth of the same group.

Hypoplastic enamel differs from the MIH by:

- regular edges;

- symmetrical dental damage

- at least two teeth are affected

- possibly affects both dentitions.

5. Dental fluorosis ("mottled enamel")

Chronic fluoride poisoning (dental fluorosis), reflects the effect of excessive ingestion during the first years of life.

Fluorosis differs from the MIH by:

- White flecks, or yellow, or brown spots or areas, scattered irregularly on the surface of the tooth

- the resistance of teeth against caries process (initial stages).

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6. Turner's hypoplasia

Turner's Hypoplasia presents with a thin enamel on permanent teeth. In extreme cases, enamel is almost absent. Turner's tooth can be observed on incisors, canines, and premolars. Enamel's hypoplasia is the main feature, with sometimes a yellow deposit on cementum. It is thought to be caused by congenital syphilis, hypocalcemia, vitamin D deficiency, pre-term birth, and nutritional deficiencies.

7. Other non-hereditary or acquired disorders to be differentiated from MIH, include accidental trauma: due to accidental trauma that occurrs during temporary dentition, teeth deformation generally appears at the level of incisors, showing a deficit of mineralization and non-symmetrical but well-defined boundaries. Teeth could be opaque, or even strongly marked by hypoplasia 11,20

Therapy

A six step approach 25 to MIH management is suggested:

1- risk identificarion,

2- early diagnosis,

3- remineralization and desensitization,

4- prevention of caries and post-eruption breakdown, 5- restorations and extractions,

6- maintenance.

Severity of MIH lesions varies from one patient to another, and even in the same patient, from one tooth to another. Time, intensity, and duration of the disorder are responsible for the location and the severity of the disease 15

Diagnosis should be done as early as possible because of the fragility of tooth hard tissues. This allows a rapid establishment of therapy before the evolution of decay 16 Depending on the severity of hypomineralisation, different treatments may be implemented.

A- In case of minor damage, various treatments can delay the progression of the disease:

a. dietary precautions: food questionnaire allows to intercept harmful habits (nibbling, acids, sugars) and provide appropriate recommendations20;

b. good oral hygiene: in case of uncontrolled plaque acculmulation, new recommendations for oral hygiene should be established regarding the technique and the frequency of teeth brushing 16;

c. re-mineralization by brushing with a fluoride gel (~ 1%)6 or by an application of gel or fluorinated varnish in dental office 21,22;

(a, b and c are considered to be general recommendations).

d. application of calcium and bio-available phosphate that interacts with fluoride ions to create amorphous calcium-phosphate (CPPACP) on the surface of teeth, which releases calcium ions, fluorine, and phosphate for the re-mineralization creating more acido-resistant fluorapatites. The efficacy of this product remains uncertain and it should be confirmed by a wider panel of studies 20. CPP-ACP exists in different forms: topical cream for teeth with the tricalcium phosphate (3M ESPE, St. Paul, MN, USA), tooth mousse® (GC, Tokyo, Japan), and sugar free chewing gum (Recaldent®) 12. Studies from Bologna-Italy, published in March 2011, showed that calcium and phosphate casein improves mineralization, shape, and porosity of MIH affected teeth 1,4,8;

e. fissure sealing: using high viscosity glass ionomer (GC Fuji Triage® of Alsip, IL, USA, = a high -Fluoride- releasing glass ionomer, and, Riva Protect®, SDI, Southern Dental Industries of Australia = a glass ionomer fissure and tooth protector) can effectively seal the fissures and pits. In addition to its natural adhesion to dental tissues, it has a re-mineralizing action. On hypo-mineralized molars, the use of adhesive system promotes the retention of a resin for fissure sealant 20

B- In case of moderate damage, hypo-mineralized tooth can be restored by taking into account the following factors:

• challenges of analgesia;

• reduction of child anxiety;

• determination of the quantity of affected enamel that will be cut and the borders of future restoration.

To manage analgesia difficulties, dentists should not hesitate to use loco-regional analgesia, especially for mandibular molars in anxious and difficult children.

Tooth restoration involves placing:

a. amalgam (unsuitable for MIH) 16,20

b. glass ionomer cement (GIC) 11,16:

GIC is interesting for dentinal alternatives or for transitional restorations (natural adhesion to enamel and dentin, leaching of fluorine). Addition of resin improves resistance to wear and fracture. GIC is not indicated for occlusal surfaces of hypo-mineralized molars 20

Fillings of great extent, carried out with GIC, should be often replaced in a second phase with composite materials 14

c. composite resin:

Composite resins are the material of choice for hypo-mineralized teeth, especially when preparation borders are supra-gingival, located on healthy or slightly porous enamel, and when restoration is affecting only one to two sides of the affected tooth. In all cases, etching time must be reduced and placing rubber dam is essential. Among adhesive systems, self-etching systems are recommended 16,20

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Oral Pathology

Cases of MIH in Lebanon

Case 1: Moderate hypo-mineralization

Fig.1a. Spot of hypo-mineralization at cusp level of a mandibular molar (tooth 36).

Fig.1b. Spot of hypo-mineralization at cusp level of a Maxillary molar (tooth 16).

Fig.6a: Occlusal view of the right mandibular molar with x-ray (tooth 46).

Fig.2. Spots of hypo-mineralization on maxillary and mandibular incisors (teeth 21 and 41).

Case 2: Restorable severe Hypo-mineralization with decay

Fig.6b: Occlusal view of the left mandibular molar with x-ray (tooth 36).

Fig.4. Buccal view of a mandibular molar (tooth 46).

Fig.6c: Occlusal view of the left maxillary molar (tooth 26).

Fig.6d: Occlusal view of the right maxillary molar with arrested decay (tooth 16).

Fig.7: Severe MIH of the incisors with plaque and decay.

Fig.5: Occlusal view of a maxillary molar with an open pulp chamber (tooth 26).

Fig.3. Old composite restorations on central incisors.

Oral Pathology

C- In case of severe hypo-mineralization, advanced treatment is required with the pedodontic preformed caps (PPC) 11,16, or inlays/onlays and prosthetic rehabilitation for the final extraction of affected tooth 16. These extractions must be done before the age of 8-10 years, always in collaboration with the pediatric dentist: they allow a proper repositioning of the unaffected second permanent molar. The choice of therapy, however, depends not only on the extent of hypo-mineralization of incisors and molars, but also on Angle's Class and space available 14. Severely affected molars can receive endodontic treatment, instead of extraction 18

Figure 1a displays a moderate MIH of a mandibular molar (tooth 36); while Figure 1b exhibits a moderate MIH of a maxillary molar (tooth 16); both were treated with resin composite while keeping the slightly hypo-mineralized cusp untouched. A follow-up with fluorinated gel, combined with patient's good motivation for dental hygiene, can delay the progression of the disease. Similar treatment can be achieved for hypo-mineralized incisors (displayed in figure 2). Composite restorations can preserve healthy hard tissue for long time and reduce the psychological impact of MIH unaesthetic brown spots on anterior incisors (Figure 3).

Figures 4 and 5 display mandibular and maxillary molars with severe hypo-mineralization involvement (endodontic therapy, followed by a crown restoration, are needed).

Figures 6a-b-c and d exhibit unrestorable first molars of a 12-year old patient, indicating the amount of tooth damage and the rapidity of the disease, while incisors can still be conserved using composite restorations (in figure 7).

Conclusion

Early recognition of MIH is essential since damage of dental hard tissues can be fast. Impairment should be anticipated with the appropriate treatment. Patients in Lebanon aren’t safeguarded against MIH and dentists should be aware and ready to implement a diagnosis and a treatment in order to stop disease progression and limit hard tissue's damage.

Our paper is only a preliminary clinical observation. We have no comparison group: consequently, we cannot draw conclusions about MIH and its pathophysiology. However, cohort studies and randomized controlled trials (RCTs) on MIH are warranted in order to further elucidate various aspects of this dental disease.

References

1. anGelillo if, romano f, forTunaTo l, monTanaro d preValenCe of denTal CarieS and enamel defeCTS in Children liVinG in areaS WiTh differenT WaTer fluoride ConCenTraTionS CommuniTY denT healTh 1990;7:229-236.

2. arroW p preValenCe of deVelopmenTal enamel defeCTS of The firST permanenT molarS amonG SChool Children in WeSTern auSTralia auST denT J. 2008;53:250-259.

3. BeSloT a., VilleTTe f priSe en CharGe préCoCe de l’améloGenèSe imparfaiTe l’informaTion denTaire 2010:4-2;12-19.

4. BimBoire J. la première molaire permanenTe immaTure : miSe à Jour deS ConnaiSSanCeS aCTuelleS, uniVerSiTé Bordeaux SeGalen 2013.

5. Cameron a., Widmer r denTal anomalieS handBook of pediaTriC denTiSTrY parkinSon m., TaYlora., lainG a., Third ediTion edinBurGh, london, neW York, 2008.

6. fTeiTa d, ali a, alaluuSua S. molar-inCiSor hYpomineralizaTion (mih) in a Group of SChool-aGed Children in BenGhazi, liBYa eur arCh paediaTr denT 2006;7:92-95.

7. Gündüz k, zenGin z, Celenk p, ozden B, kurT m, Gunhan o reGional odonTodYSplaSia of The deCiduouS and permanenT TeeTh aSSoCiaTed WiTh erupTion diSorderS: a CaSe reporT med oral paTol oral Cir BuCal 2008;13:e563-566.

8. héBerT S. l’hYpominéraliSaTion deS molaireS eT deS inCiSiVeS 12eS JournéeS de SanTé denTaire puBlique du quéBeC, STJean-Sur-riChelieu, 14 Juin 2013.

9. JaSulaiTYTe l, Veerkamp JS, WeerheiJm kl molar inCiSor hYpomineralizaTion: reVieW and preValenCe daTa from The STudY of primarY SChool Children in kaunaS/liThuania eur arCh paediaTr denT 2007;8:87-94.

10. JaSulaiTYTe l, WeerheiJm kl, Veerkamp JS. preValenCe of molar-inCiSor-hYpomineraliSaTion amonG Children parTiCipaTinG in The duTCh naTional epidemioloGiCal SurVeY (2003). eur arCh paediaTr denT 2008;9:218-223.

11. kellerhoff n m., luSSi a l’hYpominélariSaTion deS molaireS-inCiSiVeS menS SuiSSe odonToSTomaTol 2004;114:250-253.

12. kukleVa mp, peTroVa SG, kondeVa Vk, nihTYanoVa Ti molar inCiSor hYpomineraliSaTion in 7-To-14-Year old Children in ploVdiV, BulGaria-an epidemioloGiC STudY folia med (ploVdiV) 2008;50:71-75.

13. kuSku oo, CaGlar e, Sandalli n The preValenCe and aeTioloGY of molar-inCiSor hYpomineraliSaTion in a Group of Children in iSTanBul eur J paediaTr denT 2008;9:139-144.

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Managing of diastema case by orthodontic, surgical and prosthodontic therapies

Dr. Mohammed Sarraj Sarraj2013@hotmail.com

Abstract

Dentistry consists of many disciplines, and in some cases, dentist should be familiar with good expertise that includes all disciplines.

Female 20 years old complains of diastema between the upper central incisors. Abnormal anatomical shape of the frenum and the incisors. That is summoned orthodontic, surgical and prosthodontic therapies.

Key-words diastema, orthodontic, surgery, prosthodontic.

Introduction

Many patients present with a variety of problems such as missing teeth, drifting, crowding, malocclusion, and extrusion that require the intervention of several dental disciplines.

As dental professionals, we can never assume what the patient will accept or reject as the appropriate esthetic treatment or goal.

The wise dentist develops a group of fellow practitioners of different specialties who can review the diagnostic work-up of a patient whenever there is a question of potential issues that may compromise the final esthetic result.

Only the patient can determine how much time, money, and effort that he or she is willing to invest, as well as what is a personally esthetic result. 1

One of the most challenging tasks of modern restorative dentistry is resolving the dilemma of spaces between anterior teeth. To some, an anterior diastema is desirable, whereas others attempt to hide it with habits such as lip or tongue posturing. 2

Treatment planning to correct a diastema may include orthodontics, restorative dentistry, or a combination of several therapies. Like most esthetic

problems, the treatment of a diastema requires careful analysis and occasional consultation with specialists.

Diagnostic casts, radiographs, and photographs or digital imaging are necessary to thoroughly evaluate a diastema. Anterior spaces should not be closed without first recognizing and treating the underlying cause(s). 3

The etiology of diastema may be attributed to hereditary and developmental factors. 4,5 Although hereditary determinants play a major role in causing diastemas, there is nothing that can be done to prevent them. Most of the other causes of diastema formation are preventable.

Anatomic factors such as those seen in atypical frenum positions may also contribute to diastema formation.6

The presence of the frenum muscle fibers on the alveolar ridge influences the direction of tooth eruption and maintains separation of the adjacent teeth after eruption.

Although teeth can be moved together orthodontically in the presence of a frenum, once the active appliance is removed, the teeth tend to separate, reforming the diastema unless permanent retention is provided.

An adequate border of attached gingiva is essential to successful orthodontic movement.

Surgical removal or repositioning of the undesirable frenum attachment (and the creation of a stable area of attached gingiva in its place) prior to orthodontic repositioning reduces frenum-related diastema relapse. 7,8

Other developmental causes of diastemas are obvious, such as the loss of a permanent tooth, or a more subtle cause, such as periodontal disease. 9

Case History

A 20-year-old female presented with a large maxillary diastema between the small central incisors. The atypical frenum protruded. The frenum muscle fibers were sat on the alveolar ridge. The patient’s chief complaint was that the presence of a space between her incisors. (Fig. 1, 2, 3)

Although the presence of a diastema is self-evident, these spaces must not be closed without first addressing the underlying cause. the dentist should include the patient in the treatment planning process by presenting appropriate treatment alternatives, prognoses, and fees. 10 In this case, the treatment is orthodontics, surgical and prosthodontic therapies.

The one step, orthodontic, brackets and rubber were sat to move the central incisors the middle to create enough space for esthetic result (fig. 4, 5). 11

The two step, surgical (fig 6), Excision of the labial frenum is easy within the reach of the general practitioner, and may be performed with various techniques. The method usually employed is that of excision using two hemostats. In this case, the procedure used is as follows. After local anesthesia, the lip is pulled upwards, and the frenum is grasped using two curved hemostats, which are positioned at the superior and inferior margins.

The lip is then further retracted and a thin scalpel blade incises the tissue found behind the hemostat, first behind the lower hemostat and then behind the upper hemostat. The frenum is hypertrophic and there is a large space between the central incisors, the tissues found between and behind the central incisors are also removed. Interrupted sutures are placed along the lateral margins of the wound in a linear direction, after the mucosa of the wound margins is undermined using scissors. 12

The third step, prosthodontic, after orthodontic and surgical therapy, any needed restorative treatment to achieve the final esthetic result may be performed. Diastema due to periodontal or anatomy problems cannot be corrected predictably with restorations alone, Splinting or some other method of stabilization would have to be included in the treatment plan. 13

Fig 1

Fig 2

Fig 3

Fig 4

Fig 5

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As patient acceptance of ideal treatment is the ultimate objective for the dentist in this phase, it is often necessary to allow the patient to visualize and judge the end result. For simple diastema closures involving restorations, the chairside application of tooth-colored wax or unbonded composite resin to the patient’s proximal tooth surfaces should provide a good indication of the result.

For complex cases that involve several teeth or combination therapies (orthodontics and restorations), a diagnostic wax-up and computer imaging may be required to enable the patient to appreciate the anticipated result of extensive treatment.

When multiple disciplines are involved, such as orthodontics, surgery, and restorative dentistry, a case presentation conference (or teleconference) with all involved clinicians and the patient may facilitate acceptance of complex treatment plans. 14

Pre- and postoperative photographs or digital images can provide many benefits. Photographs of the results of treatment on other patients can be used to help current patients envision the possibilities associated with their own treatment and inspire confidence in the dentist’s abilities. Photographs document the procedure and can be used to improve the chances for reimbursement from insurance carriers in certain cases.

A duplicate set of pre- and posttreatment images given to a patient following treatment helps to prevent “buyer’s remorse” and allows him or her to serve as a marketing advocate for the office when the dramatic before and after photos are displayed to family and friends. However, it is sound practice to use computer imaging of both close-up and full-face before and after images for best patient and doctor visualization (fig. 6). 2

The four incisors after preparation, a full ceramic bridge is choosed, to be sure the diastema will not relapse. (fig 7-8-9)

Fig 6

Fig 7

Fig 8

Fig 9

Conclusion

In this case, we must study the etiology of the diastema to be able to solve it. We excised the frenum using traditional surgery, then we started simple orthodontics. The orthodontic solution alone is not enough, because the form of the central incisors is atypical, consequently, the final esthetic result does not satisfy the patient and there may be relapse. We have to use prosthetic solution, ideally veneers, because they are the most conservative regarding the hard tissues. Instead we used full crown ceramic bridge prosthetics for retention and esthetics too.

References

1. GoldSTein re, Van B. haYWood, eSTheTiCS in denTiSTrY, 2nd ed 2002.

2. GoldSTein re. ChanGe You Smile. 3rd edn. ChiCaGo: quinTeSSenCe, 1997.

3. GoldSTein re eSTheTiCS in denTiSTrY. 1ST edn philadelphia: JB lippinCoTT, 1976.

4. huanG WJ, CreaTh CJ. The midline diaSTema: a reVieW

of iTS eTioloGY and TreaTmenT, [reVieW]. pediaTr denT 1995

5. oeSTerle lJ, ShellharT We maxillarY diaSTemaS: a look aT The CauSeS. J am denT aSSoC 1999.

6. leonard mS. The maxillarY frenum and SurGiCal TreaTmenT. Gen denT 1998.

7. Goodman nr. TreaTmenT of diaSTema: noT alWaYS freneCTomY denT SurV 1975.

8. miller pd Jr. The freneCTomY ComBined WiTh a laTerallY poSiTioned pediCal GrafT funCTional and eSTheTiC ConSideraTionS. J periodonT 1985.

9. ToWfiGhi pp, BrunSVold ma, SToreY aT, eT al paTholoGiC miGraTion of anTerior TeeTh in paTienTS WiTh moderaTe To SeVere periodonTiTiS. J periodonT 1997.

10. popoViCh f, ThompSon GW. maxillarY diaSTemaS: a look aT The CauSeS. J am denT aSSoC 1999.

11. GarBer ThomaS m. VanarSdall roBerT l. ViG kaTherine W.l orThodonTiCS: CurrenT prinCipleS & TeChniqueS 4Th, 2005.

12. fraGiSkoS d fraGiSkoS, oral SurGerY, 2007.

13. aTTia Y. midline diaSTemaS: CloSure and STaBiliTY anGle orThod 1993.

14. neWiTTer da prediCTaBle diaSTema reduCTion WiTh filled reSin: diaGnoSTiC Wax- up. J proSTheT denT 1986.

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Prosthetic

Wear behaviour and surface roughness of Polymer infiltrated ceramic material Compared to pressable glass ceramic

Dr. E. Elhomiamy

Bachelor in dentistry, BDS, Faculty of Dentistry, University of Alexandria.

Dr. Y. Aboushady

Professor of fixed prosthodontics, BDS, MSc, PhD, Conservative Dentistry Department, Faculty of Dentistry, University of Alexandria.

Dr. B. El Malakh

Professor of dental materials, BDS, MSc, PhD, Dental Biomaterial Department, Faculty of Dentistry, University of Alexandria.

Keywords: CAD/CAM, Two-body wear, Tooth brushing wear, Surface Roughness

Introduction

With the increase demand of esthetic materials, all ceramic restoration appeared and replaced old ceramo-metal restorations. The all ceramic restorations appear to mimic the natural dentition appearance as they lack metal core, they presented with good properties as biocompatibility, color stability and durability 1 Wide ranges of all ceramic materials with various chemical, mechanical and physical characteristics were developed. Dental restorative materials should have good mechanical properties and wear resistance to withstand masticatory process and with low abrasive nature to opposing dentition 1. Several aspects during selection of restorative materials should be considered, among which are the wear behaviour and abrasive nature to natural enamel 2 Ideally, restoration materials should have wear resistance similar to that of enamel. The normal vertical loss of enamel from physiological wear was estimated to be approximately 20–38 μm per annum 3

Wear is a complex cumulative process of multi factorial etiology, that characterized by progressive loss of material from its surface. Wear alters the anatomy of occlusal surface and affect the occlusal harmony and masticatory function 4,5

Pressable glass ceramic systems have gained their popularity due to their ease of fabrication, good mechanical properties, and relative kindness to natural dentition. The dimensional stability of pressed porcelain has made these ceramic materials excellent restorations. With the development of CAD/CAM technology new ceramic and composite materials were introduced that can be incorporated in all

ceramic restoration fabrications 6

Ceramic materials introduced tend to be more rigid and brittle and with potential hazard of excessive wear to opposing dentition. On the other hand the composite materials exhibit low mechanical properties and poor wear resistance but with low abrasive nature. Composite crowns showed preservation of occlusal anatomic form of 26.5% only versus 96% for ceramic crowns7 A recent analysis mentions excess wear and loosening as the major clinical weaknesses of composite crowns 8, notwithstanding recent structural improvements, of resin-based materials may also be an issue if used for large restoration and multiple restorations in a quadrant 9

Subsequently the developments of esthetic dental restorative materials have switched to more polymer based resin materials. New generation of restorative material was developed in the benefit of gaining both strength and color stability of dental ceramic and low abrasive nature of composite. These materials are known as hybrid dental ceramics, polymer infiltrated ceramic material is one of these hybrid materials10

One of the most recently introduced fully sintered CAD/CAM block, the Vita Enamic material, is a polymer infiltrated ceramic form of feldspathic ceramic 86 wt% and polymer 14 wt%. Vita Enamic polymer infiltrated ceramic material is manufactured by first infiltrating a porous feldspathic ceramic base structure with a monomer mixture of new cross linked polymethacrylate polymer material and then cured under high pressure and temperature. Vita Enamic is single visit monolithic restoration and surface shading and glazing is performed using special Polymerizable (light curing) stain and glaze kit. It is used as a single tooth restoration in the anterior or posterior zone 11

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The study was conducted to evaluate two-body wear and surface roughness measurement between the contact area on sliced block of polymer infiltrated CAD/CAM ceramic material and pressable lithium disilicate based glass ceramic materials on enamel cusp antagonist.

Materials and methods

Two types of ceramic materials were included in this study, esthetic CAD /CAM block Polymer infiltrated ceramic material (Vita Enamic) and pressable glass ceramic (IPS e.max press). Natural enamel (antagonist enamel cusp) was used as antagonist.

Specimen preparation

Sixteen freshly extracted caries free permanent upper first molars were collected from various general public hospitals intended for diabetic patient treatment.

The extracted teeth were ultrasonically cleaned to remove any calculus and soft tissue remnant and then polished with nonfluoridated polishing paste and stored in saline solution. The antagonist enamel cusp specimens (n=16) were prepared from the mesio-palatal cusp of upper maxillary first molar using high speed handpiece and long carbide fissure bur under water coolant 12. The antagonist enamel cusps were made into block using custom made copper mold and chemical cured acrylic resin (Self-cure acrylic resin, Vertex Dental Co., B.V., Netherland) showing approximately 3 mm of the enamel cusp (Fig. 1).

The enamel antagonist cusp block was then stored in saline solution which was changed every 2 days to prevent dehydration of the enamel specimens.

Eight specimens of IPS e.max press (IPS e.max press, Ivoclar Vivadent, Schaan, Liechtenstein, Germany) ingot shade A2 was heat pressed in press furnace (Programmat EP 600) following the manufacturer recommendations.

The IPS e.max press was made into slice of (14 × 12 × 2 mm thickness) using Special copper mold. The specimen’s surfaces were cleaned with blast of Al2O3 at 1 bar pressure followed by steam of air jet. Finishing was accomplished with glass ceramic finishing and polishing kit (Dialite LD finishing & polishing kit, Brasseler, USA). The surface intended for wear test was finished to obtain smooth surfaces according to manufacture instruction and then glazed according to manufacturer instructions.

Fig. 1: Tooth antagonist cusp specimen illustration diagram.

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Eight test specimens of Vita Enamic (Vita Enamic, Vita Zhanfabrick, Bad Säckingen, Germany) were prepared from size 14 block (18 mm × 14 mm × 12 mm) using saw microtome (Micracut 150, precision cutter, Metkon instrument Inc., Bursa, Turkey). Precision cutting instrument diamond coated cutting disc (Diamond Coated Wavering Blade No 11-4276, Buehler) was used to cut off the block into a slice with size of (14 mm × 12 mm ×2 mm thickness). The location of cuts was controlled using travelling stage and a horizontally displaced digital micrometer 13. The surface intended for wear test was finished with Vita Enamic polishing and finishing kit technical, then it was etched with 5% hydrofluoric acid gel for 60 seconds. The surface was carefully cleaned under running water to remove all acid remnants and air dried. Vita Enamic glaze was applied with fine brush evenly all over the surface and light cured for 60 sec with Elipar LED curing unit (Elipar TM S10 led curing unite, 3M ESPE, St. Paul, MN, USA).

Wear testing procedures

Two-body wear for ceramic samples and their

antagonist enamel cusp was conducted using special custom made tooth brushing wear machine (Dental Biomaterial department, Alexandria University).

The custom made tooth brushing machine formed of two articulating parts; movable upper parts and fixed lower part. The antagonist enamel cusp blocks were fixed in the upper movable articulating bars while the ceramic samples were fixed in the lower fixed part using special plastic holder. Contact point geometry was established between the movable antagonist cusp specimens and fixed flat ceramic specimens as shown in (Fig. 2). Artificial saliva was used as a lubricating medium 14

Wear test parameters

Two-body wear was conducted to total of sixteen ceramic specimens (n=8 per material) antagonized by sixteen antagonist enamel cusp specimens.

The wear test cycle strokes were to be a total of (60,000 cycles) with frequency of 60 cycle/ min and reciprocating displacement distance of 4-5 mm. A static load of 2 kg (20 N) was used.

Table 1: Mean &standard deviation (SD) values and results for comparison in the weight loss between the two ceramic groups and natural teeth antagonist.

Quantitative and qualitative analysis of two-body wear

Quantitative analysis of two-body surface wear ofceramic specimens and their antagonist enamel cuspspecimens was subjected to weight loss assessment andsurface roughness (Ra) change 15 The samples were weighted before and after the wear test using sensitive electronic balance (Analytical Balance, Scaltec SPB 31, Scaltec instruments GmbH, Robert-Bosch-Breite, 1037079 Göttingen, Germany). Wear in a test sample was defined as the weight loss of specimens to have occurred by subtracting initial

weight from the final weight measurements. Surface roughness (Ra) change was calculated using white light interference microscope (Interference Microscope, ZYGO Maxim-GP 200, ZYGO Lot GmbH, Boston, Middlefield, CT, USA). The occluding surface for each specimen was scanned and the surface roughness was measured before and after the wear test.

Qualitative analysis of wear patterns, the selected specimens were examined under backscattering scanning electron microscope (SEM) (Jeol JSM 5300, Stoneridge, 122 Pleasanton, CA, USA). Each sample was scanned under two different

Fig. 2: Antagonist enamel cusp occluding flat ceramic specimen.

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level magnification, overall view of the wear scar with (X500) magnification and magnified view with (X2000) magnification to give detail analysis of the wear scar.

Statistical analysis

The data sets were analyzed with statistical software (IBM SPSS Version 20, IBM Germany).

Descriptive statistics with mean, standard deviation and 95% confidence intervals for all tests and groups were computed. For the twobody wear results, statistical differences between the tested materials as well as the corresponding antagonists regarding (mean weight loss weight loss percent, mean surface roughness change and surface roughness percent change) were assessed with Mann-Whitney (U) test.

Mean value weight change: (weight before wear test) – (weight after wear test).

(Percent weight loss) = (WI-WF)/WI X 100

Where; WI = initial weight before wear test in (mg)

WF = final weight after wear test in (mg)

Mean value change in surface roughness (Ra): (Ra after wear test) – (Ra value before wear test).

Surface roughness percent change = (RaF - RaI)/ RaI X 100 Where RaI = initial surface roughness value before wear test in (μg)

RaF = final surface roughness value after wear test in (μg)

Results

Quantitative analysis

Regarding weight loss: There was statistically significant difference between the two ceramic groups. The higher weight loss occurred in the IPS e.max press samples with mean value of (6.2 ± 1.6 mg) and total percent change of (0.71%

± 0.25), while the Vita Enamic samples revealed lower mean weight loss with value of (1.5 ± 0.07 mg) and total percent change of (0.24 % ± 0.11) as shown in (Table 1).

There was statistically significant difference in the enamel cusp antagonist samples. The higher weight loss occurred in the enamel cusp antagonist opposed by IPS e.max press group with a mean value of (10.2 ± 2.8 mg) and total percent of (0.88% ± 0.27). While it was lower in the enamel cusp antagonist samples opposed by the Vita Enamic group with mean weight loss value of (1.7 ± 0.6 mg) and weight percent loss of (0.16% ± 0.05) as shown in (Table 1) & (fig. 3)

Regarding surface roughness: Surface texture analysis of test specimens revealed that there was statistically significant difference between the two ceramic groups, the higher surface roughness change occurred in the IPS e.max press samples with mean value of (0.15 ± 0.10 μm) and total percent change of (82.6% ± 37.1). While Vita Enamic samples revealed lower mean surface roughness change value of (0.06 ± 0.03μm) and total percent change of (48.7% ± 23.9) as shown in (Table 2).

There was statistically significant difference in the enamel cusp antagonist samples with the higher surface roughness change occurred in the enamel cusp antagonist opposed by IPS e.max press group with mean change value of (0.18 ± 0.11 μg) and total percent change value of (189%±147). While it was lower in the enamel cusp antagonist samples opposed by Vita Enamic group with mean surface roughness change value of (0.06 ± 0.08 μg) and surface roughness percent change of (78% ±108) as shown in (Table 2) & (fig. 4).

Table 2: Mean &standard deviation (SD) values and results for Mann Whitney test, for comparison in surface roughness change between the two ceramic groups and natural teeth antagonist.

Fig. 3: Bar chart represents the mean weight loss percent in the two ceramic systems and natural teeth antagonist.

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Qualitative analysis

The results of the qualitative SEM analysis are presented in (Fig. 5, 6) showing image pairs of contact areas on ceramic specimen and corresponding enamel cusp. SEM analysis of Vita Enamic samples revealed narrow, shallow and smooth wear scar as shown in (Fig. 5), with high magnification the wear surface revealed multiple small surface cracks and chipping off the ceramic surface.

Antagonist enamel revealed smooth and small area of wear scar with small surface cracks accompanying with the formation of pit-like structure defects. SEM observation of IPS e.max press samples revealed wider and deeper wear scar. The wear scar revealed multiple surface irregularities corresponding to area of abrasion (Fig. 6).

On high magnification the surface presented with needle shape crystals and fragment of antagonist teeth.

Antagonist enamel show large wear scar area with multiple surface cracks, rough furrows and enamel flakes. High magnification imaging of enamel surface revealed the formation of multiple small cracks and peeling-off the enamel surface.

Discussion

Tooth wear is a complex process that involves many variables, such as age, para-fuctional habits, neuromuscular force, thickness and hardness of enamel, properties of saliva, masticatory pattern and nature of restorative materials 16. The study of dental wear become common through the biomaterials literatures due to wide variety of dental restorative materials introduced 17 Laboratory wear testing procedure (in-vitro) may have limitations in reflecting the intraoral condition. It can’t perfectly simulate the intraoral masticatory movement; they can only simulate simple movement such as grinding and clenching 18. The obtained results are helpful in comparing materials under controlled condition, as well as useful in prediction of their clinical performance 19. Wide variety of in-vitro wear test parameters revealed in the publications concerning the applied force, numbers of

Fig. 4: Bar chart represents the mean surface roughness percent change in the two ceramic systems and natural teeth antagonist.

Fig. 5: SEM images of Vita Enamic and tooth antagonist, a & b represents overall view of wear pattern, c & d represents magnified view.

Fig. 6: SEM images of IPS e.max press and tooth antagonist, a & b represents overall view of wear pattern, c & d represents magnified view.

Helping you

cycles, design and frequency suggested that there is no agreement between studies. Difficulty in standardization and the impact of methodological or operator own modifications could make direct comparisons between studies almost impossible 20. In this study we followed the regime for wear testing at a rate of 60 cycle/ min for total of (60,000 cycles) under a load of (20 N) in reciprocating distance of (4-6 mm) which represents (120 days) as described by lmai et al 21. The load of 20 N used in this study applied on a small sample, that simulates a tooth

cuspid determines high tension values over the restoration according to Coppedê et al. 2013 22 and Faria et al 23

The tooth sample of mesio-palatal cusp of upper first maxillary molar was used in this study as recommended by (Kerjici et al) (24). Many authors recommend flat planes of enamel prepared from labial surface or mesial or distal surface of the tooth 25. The cuspal enamel was to be found much stronger than the enamel found on the side of a tooth and is stronger under compression. Consequently using cusp specimens was more clinically relevant as agreed by (Al-Hiyasat et al) 26

In this study under the two-body wear condition, it was revealed that there was statistically significant difference (P< 0.05) between the two ceramic groups. The IPS e.max Press showed higher wear loss and surface roughness change in comparison to Vita Enamic. There was statistically significant difference between the enamel cusp antagonists groups with the higher wear loss and surface roughness change in the enamel antagonist cusp opposed by IPS e.max press; in contrast Vita Enamic resulted in lower wear loss of enamel antagonist cusp. The test results were in agreement with Mormann et al, Hientze et al, Kim et al and Peng et al. 13, 27-29 Vita Enamic, wear behaviour and surface roughness results obtained in this study are in agreement with Mormann et al 13. They studied the two-body wear and tooth and roughness measurement of different kind of dental ceramic and composite materials including Vita Enamic. Their results revealed that Vita Enamic showed lower wear loss than most tested materials except for zirconia based ceramic, also they reported that Vita Enamic resulted in lower wear loss to the antagonist enamel cusp.

Mormann et al 13, also reported that the wear behavior of vita Enamic was similar to natural enamel, under SEM imaging of the contact area representing as a sharp line with minimal cracks and pitting defects giving criteria of fatigue wear which was confirmed by the present study. This may be attributed due to that Vita Enamic is interpenetrating phase composite with combination of ceramic (feldspathic) and acrylated base resin polymer. Vita Enamic is damage tolerant, the reaction of Vita Enamic

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to repetitive impact of the antagonist may be influenced by its modulus of elasticity and flexural strength which showed some degree of elastic deformation under load as reported by Coldea et al 30

The IPS e.max press, wear behaviour and surface roughness results obtained in this study were in accordance with Hientze et al 27. They reported that IPS e.max press showed lower wear loss and in comparison to Empress and Design, however they also reported that IPS e.max press showed higher friction coefficient. Kim et al 28 found that the IPS e.max press showed lower wear loss in comparison to other glass ceramic except for zirconia based ceramic. Hientze, Kim and Peng et al., reported that SEM images of IPS e.max press showed surface roughness with lateral surface cracks and delamination of ceramic surface representing abrasive wear as observed in this study.

The test results were in disagreement with Peris et al 31 and Albashaireh et al 32, they reported that the wear loss of IPS e.max press was lower to zirconia based ceramic. They also added that IPS e.max press caused lower wear loss to antagonist enamel cusp. The wear behaviour observed by Albashaireh et al 32 of the IPS e.max press showed fragment loss with superficial and deep surface cracks giving sign of fatigue wear which could be contributed due to they used zirconia ball as antagonist.

The publication is controversial about glazing and polishing on the wear behaviour of ceramic materials. In this study all ceramic samples surfaces were finished with glaze layer according to manufacturer instruction. Ling Wang et al 14 and Albashaireh et al 32, reported that the wear behavior of polished IPS e.max press has been lower to that of glazed one.

The glaze material will often be removed early during wear cycle leaving underlying rough surface. This could be attributed to that the micro structure of IPS e.max press glass ceramic is not completely free of porosities and/or pores. Surface porosities may cause primarily by volume changes associated with thermal differences during processing and from human errors during the preparation procedure and fabrication stages

33. procedure and fabrication stages 33. The inner properties of ceramic affect the wear rate once the effect of surface roughness disappeared with wear progression 34, Vita Enamic presented with low friction coefficient due to the presence of polymer interpenetrating phase which birding the ceramic phase surface causing surface crack deflections as reported by Alvaro Della et al 35 Ling Wang et al 14 reported that the frictional coefficient of polished IPS e.max press glass ceramic was higher than polished zirconia based ceramic when antagonized natural enamel. In contrast Peng et al 29 reported that the highest frictional coefficient was reported in the highly polished IPS e.max press samples, which could be attributed to the use of Al2O3 ceramic ball as antagonist. The hardness of IPS e.max press was reported to be higher than Vita Enamic 35-37 However in this study the wear loss of IPS e.max press was higher than Vita Enamic.

This could be contributed to that Surface hardness IPS e.max press glass ceramic has been reported to be affected by repeating loading especially in wet condition as reported by Wang et al, Belli et al and Won Suck et al 34, 38, 39 Corrosion mechanism of glass matrix occurred by the diffusion of positive water ions into glass matrix, which caused ploughing of surface molecule from the ceramic surface and reducing surface hardness. On the other hand Vita Enamic is polymer based ceramic fear of influence of water adsorption through the polymer layer and interfacial salinized polymer feldspar interface which could alter the mechanical properties. Ruse and Sadoun 2014 40, reported that the mechanical properties of Vita Enamic after aging process was merely affected.

Conclusions

Within the limitations of this in-vitro study, the following conclusions can be drawn:

1. Vita Enamic showed a lower wear loss and causes less wear damage on opposing enamel than IPS e.max Press.

2. The surface roughness change of Vita Enamic was much lower than IPS e.max Press and all ceramic material show lower surface roughness change than opposing enamel.

Restorative Dentistry

References

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8. kellY, J.r , 2011. arTiCle analYSiS and eValuaTion: CompuTer-aided deSiGned/CompuTer-aSSiSTed manufaCTured (Cad/ Cam) all- CeramiC CroWnS appear To perform BeTTer Than all-CompoSiTe reSin CroWnS folloWinG The firST 3 YearS of plaCemenT. Journal of eVidenCe-BaSed denTal praCTiCe 11, 203–205.

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10. kellY r CompuTer-aided deSiGned/CompuTer-aSSiSTed manufaCTured (Cad/Cam) all-CeramiC CroWnS appear To perform BeTTer Than all CompoSiTe reSin CroWnS folloWinG The firST 3 YearS of plaCemenT. J of eVidenCe BaSed denTal praCTiCe 2011; 11(4): 203-205.

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14. lin WanG a., YihonG liu a., WenJie Si B., hailan fenG a., YonGqinG Tao a., zhizuo maC friCTion and Wear BehaViorS of denTal CeramiCS aGainST naTural TooTh enamel. J of The european CeramiC SoCieTY 2012; 32: 2599–2606.

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16. elmaria a , GoldeSTien e an eValuaTion of Wear When enamel iS oppoSed BY VariouS CeramiC maTerialS and Gold. J. of proSTh denT. 2006; 96: 345-53.

17. SulonG m and aziz r a. Wear of maTerialS uSed in denTiSTrY: a reVieW of The liTeraTure. J of proSTh denT.1990; 63: 342-349.

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19. Yip k., SmaleS r and kaidoniS J. differenTial Wear of TeeTh and reSToraTiVe maTerialS: CliniCal impliCaTionS inT J proSThodonT. 2004; 17: 350-356.

20. al-hiYaSaT a.S., SanderS S.W. inVeSTiGaTion of human Wear aGainST four denTal CeramiC and Gold J of denTiSTrY. 1998;26: 487-499. elhomiamY eT al. Wear and SurfaCe rouGhneSS of

polYmer infilTraTed CeramiC 71 alexandria denTal Journal (2015) Vol.40 paGeS:65-71

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22. Coppede a r., faria, a.C.l., maTToS, m.G.C., rodriGueS, r.C.S., ShiBli, J.a., riBeiro, r f., 2013. meChaniCal CompariSon of experimenTal ConiCal-head aBuTmenT SCreWS WiTh aBuTmenT SCreW WiTh ConVenTional flaT-head aBuTmenT SCreWS for exTernal-hex and inTernal Tri-Channel implanT ConneCTionS: an in ViTro eValuaTion of looSeninG Torque inT J oral maxillofaC implanTS. 2013; 28(6): 321-9.

23. faria a. C., oliVeria a a., GomeS e a., rodriGeS r. C., riBeiro r f. Wear reSiSTanCe of preSSaBle loW fuSinG CeramiC oppoSed BY denTal alloYS. J of meCh. BehaV of Biom maTerialS 2014; 32: 40-51.

24. kreJCi i., alBerT p., and luTz f. The influenCe of anTaGoniST STandardizaTion on Wear. J of denT reS 1999; 78(2): 713-719.

25. anuSaViCe k.J. SCienCe of denTal maTerialS, 11Th ed phillipS, W.B. SaunderS, ST

26. al-hiYaSaT a.S., SanderS S.W. inVeSTiGaTion of human Wear aGainST four denTal CeramiC and Gold J of denTiSTrY 1998;26: 487-499.

27. heinTze S.d. CorVallei a Wear of CeramiC and anTaGoniST a SYSTemiC eValuaTion influenCe faCTor in ViTro denTal maTerial, 2008; 260: 1256-1261.

28. kim m J., oh S. h., kim J. h eT al. Wear eValuaTion of human enamel oppoSinG differenT Y-Tzp denTal CeramiCS and oTher porCelainS. J of denTiSTrY. 2012; 40: 979-88.

29. penG z., aBd elrahman m e zhanG Y., Yin l. Wear BehaVior of preSSaBle liThium diSiliCaTe GlaSS CeramiC. J of BiomediCal maTerialS reSearCh: applied BiomaTerialS. 2015; 40; 1032-40.

30. andrea Coldea, miChel SWain and norBerT f meChaniCal proprieTieS of polYmer infilTraTed CeramiC neTWork maTerial. J of denT maTer. 2013; 29: 419-26.

31. preiS V., hannel S., kolBeCk C. eT al. Wear performanCe of denTal maTerialS: a CompariSon of SuBSTruCTure CeramiCS, VeneerinG CeramiCS, and non- preCiouS alloYS. J of adVanCed BiomaTerialS. 2011; 12; B432-B439.

32. alBaShaireh z. TWo-BodY Wear of differenT CeramiC maTerialS oppoSed To zirConia CeramiC. J of proSTh denT. 2010; 104 (2): 105-13

33. Won-SuCk o h., ralph delonG a., and kenneTh J. faCTorS affeCTinG enamel and CeramiC Wear: a liTeraTure reVieW. J of proSTh denT. 2002; 48 (4): 451-59.

34. meTzelr k.T., WoddY r d in inVeSTiGaTion of The Wear of human enamel BY denTal porCelain. J. of proSTh denT., 1999; 81: 356-64.

35. alVaro della Bona, pedro h., Corrazzo. Y.u. CharaCTerizaTion of polYmer infilTraTed CeramiC neTWork maTerial. J of denT maTer. 2014; 30 (5): 564-569.

36. monmaTurapoJ n., laWiTa p and ThepSuWan W. CharaCTerizaTion and properTieS of liThium diSiliCaTe GlaSS CeramiCS in The Sio2-li2o-k2o-al2o3 SYSTem for denTal appliCaTionS adVanCeS in maTerialS SCienCe and enGineerinG. 2013; 1-11.

37. Conrad h. J., SeonG W. J. and peSun, i. J. CurrenT CeramiC maTerialS and SYSTemS WiTh CliniCal reCommendaTionS: a SYSTemaTiC reVieW. J proSTh denT 2007; 98: 389-404.

38. WanG r r., lu C. l., WanG G., zhanG d. S. influenCe of CYCliC loadinG on The fraCTure TouGhneSS and load BearinG CapaCiTieS of all CeramiC CroWnS inT. Ja of oral SCienCe. 2013; 6: 99-104.

39. Belli r., Genzier e., muSChWeCk a., peTSChelT a., lohBaue u meChaniCal faTiGue deGradaTion of CeramiCS VerSuS reSin CompoSiTeS for denTal reSToraTionS denTal maTerial J. 2014: 30 (4): 424-432.

40. ThornTon i., ruSe n d. CharaCTerizaTion of nanoCeramiC reSin CompoSiTe and liThium diSiliCaTe BloCkS for Cad/Cam. J denT reS. 2014; 93: 898-902.

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Precise and more conservative surgery with blue wavelength lasers

Dr. Carlos Sfeir

carlos.sfeir@orange.fr

Dental diode lasers have already proved their worth in many dental treatments, compared to conventional treatment methods. With the development of blue laser light with a wavelength of 445 nm, lasers now cover an even greater range of treatments than ever before.

The French dental practitioner Dr. Carlos Sfeir reports on his experience with the blue wavelength.

Lasers have been used in dentistry since the 1990s. It has now become an established treatment method, which is certainly due in part to its large range of indications. Whether for surgery, treatment of the peri-implantis or even for medical bleaching –exciting progress in treatment and diagnostics has been achieved due to the ongoing development of dental lasers.

With their diverse spectrum of applications, diode lasers in particular have been widely adopted over the years.

At my practice in Sillé le Guillaume in France, I have been working for 10 years with lasers, so that I now cannot imagine everyday work in my practice without them. From my point of view, it is a real all-rounder that offers both me and my patients many treatment advantages: Quite apart from the time savings, what impresses me about dental lasers is the usually scar-free wound healing and greater bacterial reduction, which, in turn, mean less postoperative pain for my patients. In my experience, the use of lasers can significantly optimize treatment results and thus increase patient satisfaction.

High absorption due to blue wavelength I had the pleasure of being a participant in the SI-

ROLaser Blue customer trial organized by Dentsply Sirona and I have been working with it since summer 2015. This enables us to consistently offer optimum treatment to our patients.

SIROLaser Blue is the first dental laser worldwide that integrates several laser diodes for three wavelengths: In addition to an infrared (970 nm) and red (660 nm) diodes, it also has a blue (445 nm) diode. It can therefore be used in all areas of soft tissue treatment and for soft laser treatment.

The SIROLaser Blue is suitable for a total of more than 20 indications and at the same time is easy and convenient to operate. The performance of the blue diode, whose light energy is particularly well absorbed by hemoglobin- and pigment-containing cells and tissue, is especially impressive from my point of view.

The high energy input results in rapid coagulation while not penetrating too far into the tissue. This reduces the risk of inadvertent damage to deeper tissue layers. Especially in surgical applications, the use of the laser is therefore practically indispensable for me.

Precise and more conservative incisions

The very high absorption rate of the blue diode in hemoglobin results in minimal bleeding and thus cleaner and more conservative incisions. Due to the simultaneously lower absorption of the 445 nm diode in water, correspondingly less heat is generated in the adjacent tissue.

In addition, the blue wavelength makes it possible for the first time to perform incisions in non-contact mode. This not only avoids activation of the fiber tip but means that there is no need to remove tissue residues from the fibers during treatment.

Restorative Dentistry

Case report

Excision of a tongue frenulum

The following case report clearly demonstrates how the SIROLaser comes into its own in surgical applications. My 9-year old patient suffered from a shortened tongue frenulum (Fig. 1), which resulted in speech difficulties. The use of lasers is to be recommended especially in the treatment of a thick frenulum due to the lack of bleeding and easy healing. We therefore decided to perform a frenectomy with the SIROLaser Blue.

We were able to remove the tongue frenulum in a matter of minutes with the blue laser light. The brown color on the upper part of the tongue correspondents to the coagulation (Fig. 2). The advantages of surgery with the laser compared with excision with a scalpel were obvious, as such a frenectomy usually tends to bleed profusely. I was able to perform the cut without bleeding and no sutures were required. This also obviated the need for postoperative removal of the sutures. The young patient suffered only minimal pain during the laser surgery.

Even on the next day, it was apparent how rapidly and inflammation-free the wound was healing (Fig. 3). Ten days after treatment, the smooth healing process is clearly evident (Fig. 4).

During the entire healing process, the patient was encouraged to continuously train the tongue with suitable exercises. One month after laser treatment, the wound was completely healed without scaring and the patient’s tongue was fully mobilized (Fig. 5 & 6).

Summary

The SIROLaser Blue is an all-rounder which, with its three wavelengths, is a truly versatile solution. The cut created by the blue laser light is extremely precise and enables a rapid, neat incision with only minimal bleeding. Especially for soft tissue treatment, I could not imagine life without it. It is not just me as the user, but also my patients who benefit from the laser.

Fig. 1: Initial situation.

Fig. 2: Situation directly after laser treatment.

Fig. 3: Situation on day 1 after laser treatment.

Fig. 4: Situation on day 10 after laser treatment.

Fig. 5: Photo of completely healed and scar-free treatment site, one month after laser treatment.

Fig. 6: The mobility of the tongue is not restricted.

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dr. norbert gutneCht leCturing about the latest advanCes in lasers

dr georges hajj talKing about new teChniques in imPlant dentistry

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-r: drs. luCa dalloCa, Charles goodaCre, hitaF nasseh, tony daher, georgina ghoul, robert moKbel

Pr. Carina mhanna, President oF the sCientiFiC Committee

inauguration oF the exhibition Floor

mP Fady Karam, Pr. essam osman, Pr. nada naaman roger ZarZour animating the oPening Ceremony

Trophy Distribution From the Lebanese Dental Association to

dr. Fadia dib, President oF the syrian dental assoCiation

Pr. tareK abbas, President oF the egyPtian dental assoCiation

dr. sami maneh President oF the Kuwait dental assoCiation

dr. ibrahim ghannam, President oF the Palestinian dental assoCiation

dr. Kamal bin mansour President oF the moroCCan dental syndiCate

dr. husein lawati, President oF the omani dental soCiety

mr. hamadi gtat From index dubai

dr ahmad Farid shehab, viCe-dean Future university Cairo

Trophy Distribution From the Lebanese Dental Association to

dr.

Exhibition Floor

ibrahim tarawneh, President oF the jordan dental assoCiation

dr yasser el gundi, President oF the egyPtian dental syndiCate

dr. Khaled tanaZeFti, President oF the tunisian dental syndiCate

dr. ahmad riZg, President oF the sudanese dental assoCiation

leFt to right drs: tareK abbas, Christian maKari, moushira salahuddin, Fadia dib, rahil douaihy, Carlos Khairallah, alain saKr, hala abboud, majid amin

drs: ronald younes, Carlos Khairallah, nada naaman, edy Chaar, Christian maKary, tony dib

dr. marCo martignoni and mr. daniel nobs

dr mohammed Fayad, dr brigitte douaihy

dr roula dib KhalaF, mrs josiane dib, dr. najib KhalaF

1-4, 2016

It is with the greatest pleasure that I welcome you to the 20th Alexandria International Dental Congress in Alexandria, Egypt from 1 – 4 November 2016. Under the theme “40 years and more”, the Scientific Committee has planned an excellent scientific program for general dentists and specialists covering all major topics in dentistry. The Congress features highly respected speakers who will share, discuss and debate significant new developments and scientific advancements that will impact the future of dentistry.

There will also be an exhibition of the latest and most up-to-date dental instruments and sophisticated equipment.

A visit to the exhibition will broaden one’s knowledge in realizing the importance of the immeasurable assistance from the high-tech equipment in one’s clinical practice.

Aside from the excellent scientific program, the Opening Ceremony and Gala Dinner will give participants a chance to network among colleagues while enjoying the cuisine, culture, and warm hospitality at which Alexandria has to offer.

With warmest regards,

Prof. Dr. Tarek Mahmoud Aly

President of the Congress Dean, Faculty of Dentistry

Alexandria University

November

Radisson Blu Hotel, Alexandria - Egypt

ProF. tareK mahmoud aly, President oF the Congress

ProF. aly sharaF, general seCretary oF the Congress

Photo From the oPening Ceremony

CA® CLEAR ALIGNER

Seminar

Level I - Beginner course with Dr. Pablo Echarri, DDS from Barcelona: “The therapeutic possibilities of the CA® System and the state of the art of CA® technique“

Date

Saturday, 11 February 2017

Time

from 9:00 am – 6:00 pm

Venue

Deira Ballroom Salon A

JW Marriott Hotel Dubai

Abu Baker Al Siddique Road, Hamarain Centre – Deira, Dubai – U.A.E

SCHEU-DENTAL GmbH

Dubai Office www.scheu-dental.com

phone +971 50 6255046 a.hbous@scheu-dental.com

Photo oF the members oF the organiZing Committee

ProF. tareK mahmoud, and dr rida Farhat, the mayor oF alexandria

leFt to right; drs. nadia aZiZ, hoda abdellatiF, Fahed al shehry, nagy elPrinCe

Photo oF the deans oF the dental sChools during the meeting under the PresidenCy oF ProF. tareK mahmoud

exhibition Floor

drs eZZat, ProF abbas Zaher, dr ahmed moneim, dr. marwa ghanem

drs joe massad, Ziad noujeim, tony daher

November 4 - 5, 2016

Over the last seven years DFCIC has played a key role in underpinning the scientific understanding of aesthetic dentistry. This is still very important today and the conference program addresses how to achieve effective results. To meet the goal, the DFCIC 2016 Committee has selected a multitude of scientific sessions, panels, and problem-based cases that will provide both intensive learning through hands-on experiences and practitioners from diverse disciplines. Recent findings with clinical implications, practical tips and tricks, marketing, and emerging technologies will be covered through interactive sessions and live demonstrations, alongside essential knowledge revision and update sessions.

The conference included:

- 5th AAID Global Conference.

- Dental Hygienist Seminar.

- Hands-on courses in various multidisciplinary topics (1-7 Nov 2016).

- Presentations from over 55 world-class speakers who showcase presentations in Aesthetic in Prosthodontic Dentistry, Orthodontic, Periodontology, Implantology, Pediatric Dentistry and Dental Laboratories.

- Attendance of over 2,500 dental professional.

Jumeirah Beach Hotel - Dubai, UAE

dr. FranK lamar reCeiving the CertiFiCate From dr mounir silwadi For his leCture on digital imPlant ProsthetiCs

Photo From the leCture room

dr roberto turrini talKing

ProF. angelo Putignano exPosing simPlexity in dentistry

dr. natalie wong From the ameriCan assoCiation oF imPlant dentistry

dr. morten worsoe ComParing dsd with wax uP

dr. shanKer iyer exPlaining ComPuter navigated imPlant surgeries

dr. walter devoto leCturing on suCCessFul direCt restorations

jean van lieroP leCturing on

Coltene booth

PlanmeCa booth

gsK booth

gum booth

dentsPly sirona booth

l-r drs tony dib, angelo Putignano, walter devoto, ajay juneja

Kavo Kerr booth

dr eduardo mahn at the ConClusion oF his worKshoP with his students

PhiliPs booth

Colgate booth

dr. aisha sultan with the omani delegates

Photo From the oPening Ceremony

KDA 2016

exhibition Floor

dr. ali alobeidy, minister oF health, Cutting the ribbon oF the CommerCial exhibition

exhibition Floor KDA 2016

dr ali alobeidy at the aeedC booth with the Chairman dr abdulsalam al madani (leFt)

dr. ali alobeidy at the saudi dental soCiety booth

dr husain allawati, President omani dental soCiety

dr Carlos Khairallah President lebanese dental assoCiation

dr yasser al gundi, President egyPtian dental syndiCate

dr dominiKi ChatZoPoulou, From queen mary university

KDA 2016

dr. mansour assiri, dean riyadh dental College

dr. ibrahim taKi, troPhy distribution to

dr. ibrahim ghannam, President Palestinian dental assoCiation

dr. abdel salam al-madani, index holding

dr. aisha sultan, President emirates dental soCiety

dr. tareK abbas, egyPtian dental assoCiation

KDA 2016

troPhy distribution to

dr. mohammed darwish, President qatar dental soCiety

dr. ahmad riZg, President sudan dental assoCiation

arwa al-sayed, saudi dental soCiety

dr. rabih omari, rePresenting lebanese dental assoCiation - triPoli dr. mashari al-oteibi, saudi dental soCiety

dr. Fahad alshehri, President oF the saudi dental soCiety

Celebrating the oman national day

dr. ibrahim tarawneh, President oF the jordanian dental assoCiation

dr mostaFa weld ibrahim From moritania

dr. ahmed Farid shehab From egyPt dr saud aleneZi, Kuwait

dr. raed aljubeh, President Palestine dental assoCiation, jerusalem

Marrakech 2017

26-29 2017 Palais des congrès

Octobre Marrakech Mansour Eddahbi

EXPODENTAL MEETING The Dental Future, Now

18-20 May 2017, Rimini - Italy

Six months to go until the opening of Expodental Meeting 2017! UNIDI – the Italian Dental Industries Association – that promotes and organizes the exhibition, is ready to introduce all the news of the next edition.

In 2016 Expodental Meeting confirmed its role as most relevant international trade-show for the dental sector in Italy – the one dental Event set up over 45 years ago by the Italian industry. In fact, Expodental Meeting is the showcase of the Italian dental industry, which has confirmed its position in the forefront of international markets on the strength of products that are appreciated throughout the world for the reliability of their components, their avant-garde technological solutions and pleasing design.

The exhibition and the comprehensive cultural and scientific program has attracted a huge number of dental professionals and buyers (16.000 visitors from 72 Countries), which created an increasing number of business opportunities and returns for the 244 Exhibitors; the beautiful location of Rimini Fiera turned out to be perfectly appropriate to welcome both national and international visitors.

For 2017 the offer for exhibitors and visitors will be even more complete and appealing: not only a trade-show, but a comprehensive experience where producers, distributors, agents, professionals, press and university from all over the world will have the opportunity to meet, with a special consideration for education and updating.

In addition to the broad exhibition, there will be a comprehensive cultural and scientific program for dentists, dental technicians and maxillo-facial surgeons, in partnership with the most important dental associations. Furthermore, there will be training opportunities for dental hygienists and dental assistants. A panel of internationally renowed lecturers will hold their courses in the training rooms of Rimini Fiera from 18 to 20 May 2017. However, what will really make the difference at the upcoming edition is the new pavilion called EXPO3D: an entire area, totally dedicated to the digital workflow from dental practice to dental

lab. The exposure of digital products and the intense scientific programme focused on digital technologies aim at a broader disclosure and knowledge of digital dentistry, in order to promote professional growth within the dental sector.

Besides the display of materials, equipment and machineries used within the digital workflow, a rich scientific program will take place, entirely focused on digital technologies, including events by professional associations, scientific lectures by academic experts such us the Digital Group of S. Raffaele Institute and the Eastman Institute for Oral Health University of Rochester, and workshops by the Exhibiting Companies.

At last, our scientific partner together with UNIDI, will set up a theoretical journey through videos and infographics explaining the complete digital workflow ion dentistry: starting from the image acquisition - through CBCT, Intraoral Scanner, Dental laboratory scanner - all the way through the use of CAD/CAM software to the final manufacturing phase (Milling, Prototyping, Additive Printing).

Finally, in 2017 the cooperation with ICE/ITA (Italian Trade Agency) will be even more intense, in order to make Expodental Meeting more and more international. In fact, last year the international participation has increased by 72%, with 563 new foreign visitors from 71 Countries and a large delegation with more than 60 buyers; next year no less than 100 delegates will meet the Italian companies in Rimini.

Besides, with its immense offer of beautiful landscapes, restaurants serving the best in local cuisine, culture, shopping, wellbeing and entertainment, Rimini is the place where business meets leisure, making your stay a truly unforgettable experience.

See you next year in Rimini from 18th to 20th May!

Eleonora Cocola - Press Office UNIDI – Italian Dental Industries Association

Composan bio-esthetic & Composan bio-esthetic flow

With Composan bio-esthetic and Composan bio-esthetic flow the German manufacturer PROMEDICA offers two restorative materials which convince by high biocompatibility, great physical properties and high aesthetics.

The innovative composition of three-dimensionally linked inorganic glass-like components, organic co-polymers and special nanoceram filler particles ensure high biocompatibility and superior physical properties.

Moreover, Composan bio-esthetic (flow) convinces dentists and patients by excellent aesthetic result: Natural translucency, very high colour stability, perfect colour adaptation and an excellent polishability allow tooth restorations which are not only durable, but also naturally beautiful.

The availability of the packable Composan bio-esthetic and its flowable version Composan bio-esthetic flow allows to choose the right nano-ceram composite version for every indication/ purpose.

The flow-on-demand material convinces by optimal flowability and thixotropic properties, as well as by excellent wetting properties. Moreover, it is extremely abrasion resistant and stress breaking. Due to a high strength it is even suitable for posterior regions which are exposed to masticatory loading.

website: www.promedica.de

G-CEM LinkForceTM from GC

Dual-cure adhesive luting cement

Strength and aesthetics in one system for all indications, all substrates

From inlays/onlays, overlays, veneers and tabletops to CAD/CAM prosthetics, the choice between different types of restorations has become wider. Add the introduction of new substrates such as zirconia, lithium disilicate and hybrid ceramics and it is no surprise that mastering all the cementation procedures for all indications is now a difficult challenge.

G-CEM LinkForce from GC - the universal and powerful solution to all your adhesive cementation challenges

Secured adhesion in all situations with only one system with three base elements

G-Premio BOND, bonding to ALL preparations with no compromises bonds to teeth, metal abutments and composite core build-ups, stable adhesion to ALL restorations, and stable chemical adhesion on all surfaces, even on precious metals.

G-CEM LinkForce, provides a strong link in ALL indications; Universal without limitations in indications or substrate.

Light-cure, dual-cure: the choice is yours

High bond strength thanks to an efficient light-curing of the bonding

Efficient self-cure mode: Particularly useful when luting opaque or thick restorations

Optimal light-curing of the resin cement: Ideal for the luting of veneers

Aesthetic & stable over time

4 shades to match all needs, accompanied by their corresponding try-in pastes; Tooth–like fluorescence, Color stability over time

website: www.gceurope.com

Dentsply Sirona Laser Days: International exchange on modern laser dentistry

Dental lasers enhance comfort and versatility in dental treatment. At this year’s third annual “Laser Days,” Dentsply Sirona again offered 52 international laser users and scientists from 21 countries an ideal platform for exchanging ideas and experiences. Besides offering various experiences with the SIROLaser Blue, the two-day event also focused on new application capabilities of the 445 nm wavelength laser.

Bensheim/Salzburg, October 1, 2016

Dental diode lasers are highly rated due to largely scar-free wound healing and a greater reduction in microbial load. With the development of SIROLaser Blue, users can now choose between three diodes: blue, red and infrared, with which more than 20 indications can be treated. Particularly the blue wavelength at 445 nm offers a number of treatment advantages, such as working in non-contact mode for surgical procedures.

Participants of the Dentsply Sirona Laser Days were given a detailed presentation of the experiences of blue diode users to date, and how the wavelength will be used more effectively still in the future.

A total of 52 experts from 21 countries were in attendance from September, 29 to October 1 at the Hotel Bachmair at Lake Tegernsee, in Germa-

ny. Here they had the opportunity to listen to numerous presentations and take part in workshops focusing on the various treatment options with dental lasers. Participants also enjoyed personal contact with each other: Particularly the Bavarian-themed evening meal on the second day and the generally relaxed atmosphere of the event made were highly conducive to networking and further strengthening the international laser dentistry community.

“We aim to offer all those interested the most complete insight possible into the latest research issues in connection with laser dentistry. This is why, on the Friday, we invited attendees to the come to the 25th annual congress of the German Society of Laser Dentistry”, explained Jan Siefert, Group Vice President Instruments at Dentsply Sirona.

A number of highly respected experts from all over the world spoke on subjects inspired by the theme: “From the roots to new horizons”. Dr. Carlo Francesco Sambri used his workshop to introduce participants to the practical use of the multiple wavelengths of the SIROLaser Blue. Besides the clinical indications, he also addressed the use of laser to preparing to take impressions with CEREC.

Maximum treatment versatility with the blue wavelength Attendees at the Laser Days event also enjoyed an extensive program of activities with a clinical focus on the Saturday – the emphasis here was on the use of the blue diode with 445 nm in practices.

In addition to the latest study results on the general use of the blue diode (Prof. Dr. Andreas Braun, Marburg), Dr. Günther Baptist Heymann and others presented results specifically related to wound healing following gingival treatment with the blue laser light: Thanks to the higher rate of absorption of the blue diode in soft tissue, the laser beam does not penetrate so far into the tissue which, in turn, reduces the risk of unintentional injuries. This results in precise, atraumatic surgical interventions, which were also discussed in other expert talks.

Dr. Ivan Katalinic (Zagreb, Croatia) demonstrated how the laser can be successfully used for implantology using clinical examples. The program of the 3rd International Dentsply Sirona Laser Days was rounded off with a workshop at which participants discussed the future of laser dentistry.

In the future, too, interested dentists will be able to find out more about the very latest laser dentistry trends via the Dentsply Sirona Laser platform. The integrated laser forum also provides plenty of opportunities to engage in direct discussion with other colleagues who are also keen laser users: http://www.sirona. com/en/sirolaser

International College of Dentists - Middle East Section

1966-2016: Golden Jubilee

The International College of Dentists, Middle East Section, held its Annual Convocation in Beirut, Lebanon on December 3, 2016, at the Riviera Beach Hotel.

The Section celebrated its golden jubilee as Autonomous Middle East Section, registered in 1966 at the Ministry on Interior in Beirut, Lebanon.

The celebration day consisted of the following activities:

1- A Full day Continuing Education Program

2- The Zahi Khalaf Merit Award

3- An Induction ceremony

4- The Honoring of Life Fellows

5- A Gala dinner

1. The Scientific day had as a central theme The Management of Complex Cases in Dentistry. After the word of welcome by President Tawil, guest speaker Gil Alcoforado, ICD Regent of Portugal addressed the orthodontic approach in the treatment of complex periodontal cases.

He was followed by Fellows Nabil Barakat and Nadim Aboujaoude who presented a multidisciplinary approach in treating complex cases. Fellow Jean Marie Megarbane defined complex cases and discussed modes of treating such cases.

Fellow Jihad Abdallah presented a 12 years follow up of a complex case. Roy Sabri combined orthodontics and implants in solving complex cases.

Edmond Koyess applied new treatment modalities in traumatized immature permanent teeth. Mosleh el Harbi described an approach in treating the cleft lip and palate cases at an early age after birth to facilitate surgical treatments at a later stage.

Elia Sfeir and Samia Aboujaoude related the retention to the permanent second molar as a clinical sign of ectodermal dysplasia cases. Joseph Sabbagh dealt with the complexity of the composite restorations, and Ziad Salameh closed the scientific day with the Zirconia restauration from simple to complex.

2. The Zahi Khalaf Merit Award was presented by Past President Zahi Khalaf and Regent Philip Souhaid to the distinguished students from the Lebanese, St Joseph and Arab Universities.

Amani Ali from Beirut Arab University receiving the Zahi Khalf Merit Award

Mario Haddad from St Joseph University receiving the Zahi Khalf Merit Award

Christophe Zoughaib receiving the Zahi Khalf Merit Award

Seated from Left: Regent D2 Nasser Al Hamlan, President Elect Yousef Talic, President Georges Tawil, Regent Portugal Gil Algoforado, Vice President Nadim Aboujaoude and Regent D1 Philip Souhaid. Standing the new Fellows from left first row: Shallen Verma, Gerard Tabourian, Anthony Macari, Alain Romanos, Carlos Khoury, Walid Nehme, Fouad Ayoub, Fadl Khaled, Ramzi Haddad, Joseph Hobeiche, Maha Hoayek and Nada Afeiche. Far back: Mosleh Al Harbi and Mohamad Ezzedine.

3. The Induction Ceremony: fourteen new fellows were invited to join the College. From District 1: Nada Afeiche, Fouad Ayoub, Mohamad Ezzedine, Ramzi Haddad, Joseph Hobeiche, Maha Hoyeck, Fadl Khaled, Carlos Khoury, Anthony Macari, Walid Nehme, Alain Romanos, Gerard Tabourian Jr. From District 2 Mosleh Al Harbi and Shallen Verma.

4. Honoring Fellows: during the Gala Dinner that was held at the end of the Induction Ceremony Fellows May Saikali and Mardiros Nigolian were conferred the title of Life Fellowship.

From left: President Georges Tawil, Regent Philip Souhaid, May Saikali, Mardiros Nigolian, Deputy Registrar Joseph Sabbagh, Treasurer Bassel Doughan and Regent Portugal Gil Alcoforado.

5. The Gala Dinner was the coronation of the Full day at the close of the 50th anniversary celebration of the ICD Middle East Section.

www.dentalnews.com

EVENTS CALENDAR 2017

EGYPT

Egyptian Orthodontic Society

January 20 - 23

Egyptian Dental Syndicate International Congress September 13 - 15

GERMANY

37th International Dental Show March 21 - 25

ITALY

EXPODENTAL 2017 Dental Congress May 18 - 20

LEBANON

27th Beirut International Dental Meeting September 21 - 24

Lebanese University Dental Meeting May 10 - 13

MOROCCO

Moroccan Dental Meeting October 26 - 29

SAUDI ARABIA

Saudi Dental Society Meeting

January 10 - 12

SPAIN

FDI Annual World Dental Congress August 29 - September 1

TUNISIA

ATORECD 2017 February 4 - 5

UNITED ARAB EMIRATES

21st AEEDC February 7 - 9

12th CAD/CAM May 5 - 6

1st Emirates Pediatric Dentistry Club Conference March 1 - 3

A New Definition for Oral Health

In its vision 2020, the FDI proposed a new definition that is neither static nor universal, it is influenced by the sociocultural environment.

Oral health is multi-faceted and includes the ability to speak, smile, smell, taste, touch, chew, swallow and convey a range of emotions through facial expressions with confidence and without pain, discomfort and disease.

Further attributes related to the definition state that oral health:

- Is a fundamental component of health and physical and mental well-being. It is influenced by the values and attitudes of individuals and communities;

- Reflects the physiological, social and psychological attributes that are essential to the quality of life;

- Is influenced by the individual’s changing experiences, perceptions, expectations and ability to adapt to circumstances.

Reference: Federation Dentaire Internationale

Dental News is opening its different platforms to the professionals in order to share their experiences and to speak about their patient‘s concerns and demands.

What we are witnessing, is the changing pattern of the practice which is moved mainly by three players: patient demand influenced by social pressure, the industry who is introducing new products and technologies, masters teaching the profession to satisfy the demands.

Luckily this is a dynamic profession geared toward a better oral health with more patient satisfaction.

Dr. Tony Dib tony.dib@dentalnews.com

« Dental News is opening its different platforms to the professionals in order to share their experiences »

Company name: A-dec

Country of origin: United States of America Website: www.a-dec.com

“A-dec began with a simple idea: make the best better.” -Ken Austin, Founder & Co-owner A-dec.

A-dec is the world’s leading manufacturer of dental chairs, delivery systems, and dental lights including the award-winning A-dec LED light.

Mission: Provide a quality environment where people work together for the betterment of dentistry worldwide.

MENA DISTRIBUTORS

BAHRAIN

GULF PHARMACY

P.O. Box 2576, Building 390, Road 3009, Block 330, New Zinj, Manama 330 Phone: +973 17 239399 office@gctbahrain.com

EGYPT

HIGH TECHNOLOGY COMPANY

17 Omer Bin El Khattab Street Sheraton, P.O. Box 106, Heliopolis Area, Rawda Sheraton, Cairo, 11799

Phone: +201222183362 htc_eg@hightechnologyeg.com

IRAQ

TAMER LEVANT

Italian City, Villa 570, Nawroz PostP.O. Box 50 Erbil

Phone: +964 7501 440 400 levant@tamerholding.com

KENYA

DENTMED (K) LTD

3rd Floor, Darshan Towers, Woodvale Grove, Westlands, P.O. Box 43873, Nairobi, 00100

Phone: +254.20.4445307 infinity@iconnect.co.ke

Description: A-dec’s long list of milestones includes some of the industry’s most revolutionary dental equipment. It’s no wonder. A-dec co-founders Ken and Joan Austin never strayed from a single-focused purpose: make the best better. Whether it’s advancing ergonomics, elevating infection control or integrating delivery system technologies, the results have added comfort, efficiency, and reliability to the world of dental care since 1964.

KUWAIT

ADVANCED TECHNOLOGY COMPANY

P.O. Box 44558, Hawally, 32060 Phone: +965 571 1760 +22247444 info@atc.com.kw

LEBANON

DROGUERIE TAMER S.A.L.

Tamer - Sim Building, Midan Street Dekwaneh, P.O. Box 11-41 Phone: +961 1 694 000 dental@tamerholding.com

OMAN

BAHWAN HEALTHCARE CENTRE LLC

P.O. Box 169, PC 100, Ruwi Way 2716 Bldg 996, CBD Area, Muscat Phone: +968 246 59778 equipment@suhailbahwangroup.com

QATAR

AL DANAH MEDICAL COMPANY, W.L.L. Gate No.4, Naser Bin Khaled Complex Salwa Road, P.O. Box 14485 Doha Phone: +974 4469 1122 info@aldanahmedical.com

SAUDI ARABIA

ABDULREHMAN ALGOSAIBI G.T.C. Head Office Algosaibi Building, King Abdulaziz Avenue, P.O. Box 215, Riyadh, 11411 Phone: +966 1 479 3000 dental@aralgosaibico.com

UNITED ARAB EMIRATES

GULF & WORLD TRADERS L.L.C. P.O. Box 5527, Deira, Dubai Phone: +971 4 282 1717 gwtdental@gwtuae.com

YEMEN

MOHAMMED A. SHAMLAN & SONS GROUP Street No. 5, Haddaa Assakaniah Zone P.O. Box 1138 (Tahreer), Sana’a Phone: +967 1472 533 massg@yemen.net.ye

Made to perform. The pinnacle of ergonomic engineering.

In collaboration with dental teams, A-dec has designed the new A-dec 500 stools to encourage proper posture and positioning all day long.

The new feature-rich stools provide pressure relief support via a dynamic seat assembly that enables good blood flow to the legs, while setting up the lower lumbar for a proper, healthy torso posture. Both the doctor’s and assistant’s stools feature a dynamic seat designed on a suspension frame, which flexes and conforms to the body’s every move. The middle layer of the seat structure is engineered with four individual performance zones for tailored comfort and support.

Introducing the New A-dec 300. Evolved.

The A-dec 300 offers a complete solution with the ability to specifically configure for each practice. The new update builds on the current designs by adding features such as virtual pivot to the chair for enhanced patient comfort, and a third delivery system configuration option that precisely fits the needs of the dental team.

Built as a modular unit, dentists begin with the chair, and pick and choose the features they want: from delivery system styles and touchpads, to foot controls, lights and monitors. The result is an individualized solution that fits the needs of the dentist, as well as their budget.

Company name: BEYOND® International Inc.

Country of origin: United States of America Website: www.beyonddent.com

Since founding in 2003, BEYOND® has grown rapidly into a global leader in professional tooth whitening systems and related consumables with more than 35,000 chair-side professional teeth whitening systems in place worldwide. Dentists and hygienists in more than 90 countries are giving beautiful, white smiles to their patients while building profits for their practices. BEYOND® products are developed and marketed worldwide by BEYOND® International Inc., a U.S. corporation based in Houston, Texas.

MENA DISTRIBUTORS

BAHRAIN

GULF PHARMACY & GENERAL STORE

Bldg No. 2038, Road 4156, Block 341, Juffair

Phone: + 973 17239399 office@gctbahrain.com

IRAN

DONYA KALAYE SINA

No. 9, Vernuse Ave, Keshavarz Blv, Tehran

Phone: +98 21 88998250 behzadi@dks-me.com

IRAQ

RAMI AUDAY YOUSIF Medicine bureau Near MOH Bab Almuadam, Baghdad Phone: +9647706275313 rami_moon_light@yahoo.com

JORDAN

OSAMA FADEL AL-DEEN LUTFI EST. Al-Jebeha, Al-Baladia St. 57

Amman

Phone: +962 6 5333115 expodent@orange.jo

KUWAIT

SAFWAN TRADING & CONTRACTING COMPANY (K.S.C.)

Ali Abdul Wahab Building, Old Shuwaikh, Street No. 6, Block No. 152, Safat Phone: +965 22276888 awagih@safwantrading.com

OMAN

AL BAITTAR INTERNATIONAL Mascat, Oman 011 968 9531 5525

SAUDI ARABIA

MEDICAL VISION EST.

Riyadh Showroom: 220 Dabab St. Phone: +966 (11)4640049

Jeddah Showroom: Khalid Ibn AlWaleed St., AlWaleed Comm Center Phone: +966(12)6140657

AlKhobar Showroom: King AbdulAziz St. Phone: +966 (13) 8940630

Southern Area Office Phone: +966 542076465

UNITED ARAB EMIRATES

WASHASH INTERNATIONAL Office Z 10, SAIF Zone, Sharjah Phone: +971 65529186 info@washash-intl.com

EUROPE

BEYOND DENTAL & HEALTH EUROPE SP. UL. Obwodowa 1 66-008 Swidnica/Zielona Gora Poland europe@beyonddent.com

LATIN AMERICA

TOTAL MEDICAL & DENTAL SUPPLIES 10760 HW 123rd St Medley, FL 33178 info@tmdsupplies.com

BEYOND® Max5 Treatment kits

Formulated to work with ANY whitening system

• Maximum strength whitening gel

Proprietary formula improves oral health while whitening

• Contains special ingredients to reduce the risk of sensitivity

• Clinically proven results

• Designed with a broader light activation spectrum for use with any light accelerated whitening system

*LED light systems may require additional treatment cycles for best results.

OSMO Teeth Whitening Pen

Home-Maintenance Whitening Pen

• Specially formulated 6% Hydrogen Peroxide gel designed for excellent results

• Each pen contains 30 days of applications

• Guaranteed to deliver shiny, white results with NO sensitivity

OSMO Five-Patient Professional Teeth Whitening Kit

Specially formulated 6% Hydrogen Peroxide

• Specially formulated 6% Hydrogen Peroxide gel designed for excellent accelerated results

• Includes easy to use Home-Maintenance Whitening Pen

• Guaranteed to deliver shiny, white results with NO sensitivity

BEYOND® SOLO Whitening Kit

Single Treatment Kit for Common Stains

• Economical Single Patient Whitening kit

• Advanced formula 35% whitening gel

• Reduced sensitivity

BEYOND® Corewhite

Take-home tray whitening available through the dental office

• 30 minutes a day for 14 days – no messy overnight whitening

• Visibly whiter in five days

• Gentle hydrogen peroxide formula minimizes risk of sensitivity

• EVA material included for a comfortable customized tray

• Two flavors to choose from: Mint and Orange

BEYOND® Blast

Pre-Treatment Extra-Strength Whitening Paste

• Manual-mix whitening paste

• Formulated to reduce the appearance of difficult and severe stains

• Effective pre-treatment whitening boost for tetracycline and fluoride stains

• For use with any BEYOND™ Whitening Kit

BEYOND® II Complete with tray

Comprehensive 30-minute Treatment & Maintenance Kit

• Comprehensive kit for patient follow-up whitening

• Advanced formula whitening gels

• Includes patient preparation materials

BEYOND® II Complete

Effective Treatment for Severe Cases Such as Tetracycline

• Formulated to effectively reduce the appearance of tetracycline and severe stains

• Advanced formula whitening gel

• Includes patient preparation materials

• Extra-strength pre-treatment whitening paste and post-treatment fluoride for improved oral health

Company name: BIEN-AIR DENTAL SA

Country of origin: Switzerland Website: www.bienair.com

Founded in 1959 in Bienne, Switzerland Bien-Air evolved from a family-run company to a global organization employing over 350 people. Thanks to its heritage in research, high precision and practical ingenuity, the company develops, designs, and manufactures all of its products locally. They are then distributed via a network of 8 subsidiaries across Europe, North America and Asia, together with competent representatives worldwide. More than 120 technicians provide fast and efficient after sales service.

Bien-Air Dental SA Headquarters, Bienne - Switzerland

MENA DISTRIBUTORS

BAHRAIN

GULF MARKETS INTERNATIONAL

Alfanar Building, Estiqlal Highway P.O. Box 5854, East Riffa

Phone: +973 1 749 0040 shahid@gulfmarketsintl.com

M. Shahid Nawaz

IRAN

HOSSEIN SHOJAEE DENTAL SUPPLY CO. 33 North Saba Ave, P.O. Box 15815 Tehran Phone: +98 21 6646 7007 hossein@shojaeedental.com

IRAQ

AL-NASEEM SCIENTIFIC BUREAU

Al-Mansoor Hay Dragh

Block 603, str. n.17, bldg. n.11

Baghdad Phone: +964 1 542 8125 dental@naseem-baghdad.com

Dr. Abdul Jabbar Hassan

JORDAN

AL-GHAD MEDICAL SUPPLIES EST. AL Fayyad Building No. 169, Wasfi Altel Street P.O. Box 954318 11954 Amman Phone: + 962 6 552 6358 ihassan@nets.com.jo

KUWAIT

AL-BADER SCIENTIFIC P.O. Box 24119 13102 Safat Phone: +965 22 461 116 janetd93@hotmail.com

LEBANON

KITCO

Saydeh Center, Sarba Highway P.O. Box 1876, 3rd Floor - Philips Bldg

Jounieh Phone: +961 9 640 321 kitco@inco.com.lb

SAUDI ARABIA

CARE AND PLANNING FOR HOSPITALS CO. LTD Office #4, 2nd floor, 911 Bldg, King Fahd Road / P.O. Box 55306 11534 Riyadh Phone: +966 11 416 9558 r.almassi@care-hdh.com

UNITED ARAB EMIRATES

AL-HAYAT PHARMACEUTICALS

Al Wahda Street, P.O. Box 4483

Sharjah Phone: +971 6 559 2481 mueen.abueida@alhayatuae.com

QATAR

NAGASHI MEDICAL SUPPLIES 13 Airport Street,Alhilal False Doha

Phone: +974 4458 1735

Info@nagashimedical.com nagashi@nagashimedical.com

TORNADO Quietly Powerful

Thanks to a series of proprietary technologies, the Tornado delivers an outstanding power output of 30 watts, the best in the industry today. It helps alleviate the number 1 dentist concern, lack of time. Operating at an unparalleled 55-decibel sound level, the Tornado skillfully combines performance with user and patient comfort. In this respect, it is no coincidence that Bien-Air chose the Tornado to premiere such features as a new spray/ illumination system and an improved bur-locking mechanism. To guarantee superior durability, the Tornado is fitted with custom-designed ceramic ball bearings capable of handling the highest speed and heaviest loads.

EVO.15 Designed for today’s challenges

The all-new contra-angle EVO.15 is one a kind, simultaneously raising performance standards and revolutionizing patient safety. This promising handpiece combines Swiss precision with an unparalleled level of durability and ergonomics. The most advanced engineering techniques, skilled company know-how, and up to 3 years of warranty put in your hands the quality and reliability our competitors have been trying to match for almost 60 years.

Company name: BISCO, INC.

Country of origin: United States of America Website: www.bisco.com

BISCO, a global leader in aesthetic dentistry continues to develop innovative products for contemporary dentistry. At BISCO “Adhesion is our passion” and we dedicate our lives to understanding and improving the bond. We understand the importance of the supporting layer of the restoration. Whether you are working with implants, zirconium, ceramics/lithium disilicate, or porcelain fused to metal we focus on dentistry from the bottom up so your patients can enjoy top down esthetics.

MENA DISTRIBUTORS

BISCO proudly manufactures its materials in the United States and markets its products through highly trained, focused distributors outside the United States. At BISCO, we understand that product quality, consistency and freshness are of great importance. BISCO Dental Products are available worldwide with award winning brand names such as ALL-BOND UNIVERSAL®, AELITE™, DUO-LINK UNIVERSAL™, eCEMENT®, TheraCal LC® and Z-PRIME™ Plus.

EGYPT

ALEX DENT

31 El Rashidi St., Kasr EL Ainy Shaheen Medical Mall

Cairo

Phone: +202-23634731 heshamelsheikh79@yahoo.com

JORDAN

BASAMAT MEDICAL SUPPLIES (BASAMAT PHARMADENT)

Jabal Al-Hussein, Al-Razi Street, Building No. 125, Amman Phone: +962 6 5605395 zqwaider@basamat.com

KUWAIT

ALPHA MEDICAL

IRAN

DONYAYE KALAYE SINA CO. #1, No.9 Vernous St. Keshavarz Blvd.

Tehran 1415953131

Phone: +98 21 88998248 farazbehzadi@gmail.com

LEBANON

DENTAL MEDICAL SUPPLIES – DMS

Sed el Bouchreih, Imad el Hachem Center 2nd floor, Beirut

Phone: +961 1 253107 dms@dms-leb.com

Shareq, Ahmed Al Jaber St. Dasman Complex, Block 1 9th Floor, Office 22 P.O Box. 11275 Code: 35153, Dasmah

Kuwait Phone: +965 2 2478611 georgesaba@alphamedicale.com

IRAQ

MZK DENTAL PRODUCTS

Al-Mansour Street

Baghdad Phone: +1-248-423-4644 info@mzkdental.com

QATAR

ACCROS TRADING COMPANY

Building No. 83, Zone 37, St. 232

Ahmed Bin Ali St., C-Ring Road Bin Omran

Doha

Phone: +974 4 4816511 info@accros.org

SAUDI ARABIA

AL-TURKI MEDICAL GROUP LTD.

AMG Building, Al-Buhtari Street, Al Zahra District

Riyadh 11412

Phone: +966 1 4766828 m.elsamra@alturki.med.sa

TURKEY

PASA DENTAL

Millet Cad. Karagul Is Merkezi No.102 - Findikzade

Istanbul 34270 Phone: +90 212 531 29 71 hkara@pasadental.com.tr

UNITED ARAB EMIRATES

AL THANAYA PHARMACEUTICALS Al Quoz 3 - The Curve Building Ground Floor - Store G21

Dubai

Phone: +971 4 3465001 luz@althanayadubai.com

ALL-BOND UNIVERSAL® Light-Cured Dental Adhesive

BISCO’s ALL-BOND UNIVERSAL allows you to standardize clinical protocols for effective delivery of adhesion. ALL-BOND UNIVERSAL is a light-cured, single-component dental bonding agent that combines etching, priming, and bonding in a single bottle. It simplifies restorative procedures by adapting to self-, total-, and selective-etch techniques and due to the low film thickness, ALL-BOND UNIVERSAL is easily spread thin allowing for easy cementation to tight-fitting crowns. ALL-BOND UNIVERSAL is compatible with all light-, self-, and dual-cured resin composites and cements for all direct and indirect bonding procedures. Other single-bottle adhesives may need more than 1 bottle for indirect restorations, but with ALL-BOND UNIVERSAL, no additional activator is required providing you a significant cost savings and guaranteed clinical effectiveness!

TheraCal LC® Resin-Modified Calcium Silicate Pulp Protectant/Liner

TheraCal LC is dentistry’s first radiopaque, light-curable flowable composite containing “apatite stimulating” calcium silicates to protect and stimulate pulpal and dentin repair.1,2 It is the ideal replacement to calcium hydroxide, glass ionomer-based or, RMGI materials due to its excellent handling, ease of placement, and its ability to promote healing.1 TheraCal LC performs as a barrier and protectant of the dental pulpal complex.

With high physical properties3 and low solubility1,4 immediately following light-cure, TheraCal LC is ideally suited for all deep cavity preparations. Ease of placement is facilitated by a 20 second light-cure and ability to be syringed directly onto the preparation and pulp without pre-mixing or the need for any additional activators. The proprietary hydrophilic resin formulation creates a stable and durable liner. Following placement of TheraCal LC the final restorative may be placed immediately, a significant clinical advantage.

1. ADA definitions for direct and indirect pulp capping at http://www.ada.org/en/publications/cdt/ glossary- of-dental-clinical-and-administrative-ter

2. Apatite-forming Ability of TheraCal Pulp-Capping Material, M.G. GANDOLFI, F. SIBONI, P. TADDEI, E. MODENA, and C. PRATI J Dent Res 90 (Spec Iss A):abstract number 2520, 2011 (www.dentalresearch.org)

3. Cantekin K. Bond strength of different restorative materials to light-curable mineral trioxide aggregate. J Clin Pediatr Dent. 2015 Winter;39(2):143-8.

4. Gandolfi MG, Siboni F, Prati C. Chemical–physical properties of TheraCal, a novel light-curable MTA-like material for pulp capping. International Endodontic Journal. 2012 Jun;45(6):571-9.

Company name: COLTÈNE/WHALEDENT AG

Country of origin: Switzerland Website: www.coltene.com

COLTENE operates production facilities in Switzerland, Germany, Hungary, Brazil and the USA, as well as a worldwide sales network with its own representatives and distribution partners. Dentists and dental technicians worldwide rely on COLTENE products, both for conventional, as well as implant-based treatment and dental reconstruction.

MENA DISTRIBUTORS

BAHRAIN

YOUSUF MAHMOOD HUSAIN COMPANY

58, Tijjar Road

Phone: +973 17276176 thomas@ymh.com.bh

ALGERIA

SARL THE ABOU SAMRA BROTHERS

Cite abdouni n° 24 dar el beida 24 16100 Alger arcco.algeria@yahoo.fr

EGYPT

GLOBE

El Obour Buildings,Orouba Av. 11 Heliopolis - Cairo info@globeegypt.com

IRAN

APADANA TAK

NO.45, Ghods Ave, Keshavarz Blvd. Teheran Phone: +98 21 88965650 apadantak@gmail.com

IRAQ

HIMAT CO. LTD.

Int. Medical Advamced Technologies Al. Jawhara Trading Centre No. 45 Al-Mansour, 14th Ramadan St. 10013 Baghdad

Phone: +964 1 5434324 main@himat.net

JORDAN

HIMED CO. LTD. Al-Madina Al-Munawara st. Faisaly Trading Bl. No. 295, Amman Phone: +962 65665481 al.hayderi@himedco.com

KUWAIT

AL-SAYAFE MEDICAL & PHARM. SUPPLIES

Jaber Mubarak Street, Sharq 22052 Salmiya alsayafe@alsayafemedical.com

LEBANON

DROGUERIE TAMER SAL Midan Street - G.Tamer Holding Bldg. Beirut - Dakwaneh Phone: +961 1 694000 dental@tamerholding.com

MOROCCO

LE MEDICO DENTAIRE S.A. 22, Rue Ahmed al Maqri, Racine 20050 Casablanca Phone: +212 22364482 medent1@menara.com

OMAN

BAHWAN HEALTHCARE CENTRE LLC. PO Box 169 Muscat Phone: +968 24701557 sandeepkunder@subhailbahwangroup.com

QATAR

Q-CARE

Al Jelaiat St., No. 37, Bin Omran

Doha Phone: +974 4469888 medical@alibinali.com

SAUDI ARABIA

ASNAN EST. FOR MEDICAL SERVICES

Riyadh

Phone: +966 2 4621613 asnanest@gmail.com

TUNISIA

SOCIÉTÉ PROMOSCIENCES

Matérial et Produits Dentaires

Z.I. Charguia - Rue No 7 2035 TUNIS CARTHAGE

Phone: +216 1 782 500 promosiences@planet.tn

UAE

CITY PHARMACY CO.

Hamdan Street

Al Otaiba Bldg., 9th Floor

Abu Dhabi

Phone: +971 2 6323016 cityphrm@emirates.net.ae

YEMEN

SAMA DENT IMPORT

Al-Dairi Al Gharbi after the old University 20th Crossroad Sana’a samadent222@gmail.com

BRILLIANT Crios

High performance – made brilliant

The reinforced composite bloc for CAD/CAM restorations shows excellent toughness as well as abrasion resistance and provides a pleasant bite feeling due to tooth-like behavior.

BRILLIANT EverGlow®

Universal Submicron Hybrid Composite

BRILLIANT EverGlow represents the latest, most advanced composite line of COLTENE. Developed to provide an ideal mixture of long-lasting aesthetics, handling convenience and mechanical strength, it is a true all-round material. It fully meets highest requirements for high aesthetic anterior and posterior restorations.

Company name: DenMat

Country of origin: United States of America Website: www.denmat.com

Since 1974, DenMat has been a leader in high-quality dental products for dental professionals in more than 60 countries around the world. DenMat makes and assembles most of its products at its world headquarters on the Central Coast of California. DenMat offers three main product categories: Consumables, Small Equipment, and a full-service Dental Laboratory. DenMat’s consumables include the brands known and trusted: Geristore®, Core Paste®, Tenure®, Ultra-Bond®, Infinity®, Splash®, Precision®, Perfectemp®, and LumiBrite®. DenMat’s small equipment includes a broad suite of products, including NV™, , and SOL™ soft-tissue diode lasers, Rotadent® PeriOptix™ magnification loupes and lights, Flashlite™ curing lights, Velscope® Vx-the world’s top choice for oral lesion screening, and a full line of high-quality hand instruments. DenMat is the home of the world’s #1 patient-requested thin veneer, Lumineers®

MENA DISTRIBUTORS

Visit our website Link to find local distributors https://denmat.secure.force.com/denmatmain/Global_Presence For all Inquiries please contact us international@denmat.com

Now better than ever and backed by Thinnovation®: DenMat’s fresh multi-disciplinary approach to anterior esthetics using the latest generation of Lumineers, all hand-finished by skilled lab artisans in California. DenMat also features Snap-On Smile®, the ultimate provisional appliance.

Each of DenMat’s more than 400 employees is focused on assuring that you—our dental customers—love our products and love your customer experience.

We’re building one of the world’s great dental companies—one happy dentist at a time!

PeriOptix®

DenMat’s magnification and illumination division, is excited to announce that its products have been selected for use by astronauts aboard the International Space Station. The PeriOptix Panoramic loupes launched on a commercial re-supply mission for NASA, flown aboard SpaceX’s DRAGON spacecraft on their ninth re-supply flight, which successfully launched out of Cape Canaveral early in the morning of July 18.

The flip-up loupes, historically used by dental and medical professionals, will be used for various scientific experiments and tasks aboard the space station. These specific loupes were chosen because they are lightweight and can be shared among crew members over the next few years. PeriOptix has been developing and manufacturing top-of-the-line, innovative loupes and headlight systems since 1999. This most recent selection by the ISS team is another exciting achievement in a long list of accomplishments and another testament to the quality and reliability of PeriOptix loupes.

“ After several years of successful clinical results, the SOL laser became an essential tool in my practice, it is the less invasive procedure for depigmentation, resulting with less bleeding, reduced infection, swelling and scarring as well as a fast healing process and increased patient satisfaction regarding aesthetics. SOL Laser is easy to use and consistently produces desired and efficient results! “

“There is no overrating to say I couldn’t achieve such an esthetic satisfying result without SOL laser, it is extremely precise, predictable and painless. SOL made cosmetic dentistry with no limits. Thanks to superb hemostasis even in intensive vascularization of the lip.”

Dr. Ramy Tamzouk – D.D.S., M.S

Fixed prosthodontist , LASER in dentistry Specialist

Dr. Habib F Zarifeh – Head of Dental division of Clemenceau Medical Center affiliated with Johns Hopkins International

Company name: DÜRR DENTAL AG

Country of origin: Germany Website: www.duerr.de

DÜRR DENTAL represents progress and innovation in dental medicine. The headquarters of the independent family business are in Bietigheim-Bissingen, Germany.

The business group with a turnover of more than 200 Mio. Euro, employs more than 1,000 people worldwide. Many standards in dental medicine originated from Dürr Dental developments such as oil-free dental compressed air or hygienic spray-mist suction. Dürr Dental com pressed air and suction systems have made the company one of the global market leaders in dental medicine.

MENA DISTRIBUTORS

DÜRR DENTAL MIDDLE EAST

PO Box 87355. Al Ain

UNITED ARAB EMIRATES

Phone: +971 50 550 8412

Fax: +971 3 7675615 koll.m@duerr.de

Duo Tandem Compressor with a 50-liter tank, two aggregates and electronic control

Compressor Quattro P 20

Optimally suited for continuous operation of milling and grinding machines.

Com pressors from Dürr Dental reliably supply oil-free, dry and hygienic compressed air. Today’s highly efficient membrane drying unit is one of many examples of Dürr Dental’s uncompromising spirit of innovation. This invention has become a technical standard that has had no peer for years. Milling and grinding machines have particularly high demands towards compressors to supply them with reliable and constant compressed air. Milling machines don’t stop during operation therefore a constant supply of oil-free and dry compressed air is guaranteed. The duty cycle of compressor units running a milling machine goes far beyond their duty cycle for normal dental operations. Dürr Dental’s fully developed technology meets all such demands and is designed for continuous operation. High-quality system parts ensure high precision and quiet running. Compressors not only run quieter, but also last longer.

In the areas of compressed air, suction, imaging, dental care and hygiene, this innovative leader provides many system solutions. Dürr Dental sets the benchmark with its developments and has the right choice of products for all requirements. To achieve the best possible quality our manufacturing is done almost exclusively in Germany. Our greatest advances have been in digital diagnostics: high quality intraoral images with VistaCam as well as high quality digital radiographs with VistaScan imaging plate system.

VistaCam iX HD: Multi head camera system with HD resolution and stepless autofocus

The well thought-out solutions from Dürr Dental also include the VistaCam iX HD multihead camera system. The autofocus enables the Cam interchangeable head of the VistaCam iX HD to cover the entire range from macro and normal intraoral recordings up to the extraoral recording. The Proof interchangeable head allows the dentist to make visible caries and plaque on occlusal and smooth surfaces whereas the Proxi interchangeable head supports the diagnosis of interproximal caries without X-ray radiation, and all this in HD resolution.

VistaVox S – 3D and 2D X-ray images with exceptional image quality

With its jaw-shaped Ø 100 x 85 mm, the Field of View of the volume tomograph has been designed to ensure the capture of the complete mouth area, including the rear molars. The anatomically adapted volume covers a diagnostic area for which conventional 3D technology would otherwise require an expensive unit with a volume of 130 mm in diameter. The highly-sensitive CsI sensor contributes to a reduction of the radiation exposure, achieved via a small-scale sensor geometry and simple kinematics. As with all products from the Vista System, the VistaVox S is extremely easy to use: for example through the faceto-face positioning of the patient. Supplemented by the 17 panoramic programmes in the tried-and-tested S-pan technology, this provides dental practices with excellent imaging diagnostics in both the 2D and 3D areas.

Company name: FKG DENTAIRE SA

Country of origin: Switzerland Website: www.fkg.ch

Founded in Switzerland in 1931, FKG Dentaire SA gained a new momentum in 1994, the year Jean-Claude Rouiller took over the reins of the company. He propelled FKG to the forefront in the development, manufacturing and distribution of dental products destined for general

MENA DISTRIBUTORS

ALGERIA

MDI MAGHREB DENTAL INDUSTRY

Lot 24 - Zone de Depot El Kerma, BP 354 Zerbani, Daira De Senia, DZ 31106 Oran

Phone: +213 56163 18 16 contact@mdi-dentaire.com

BAHRAIN

UNIVERSAL MEDICAL EQUIPMENT

Flat # 16, Building # 261

Block # 319, Road # 1908, Manama Phone: + 973 17310118 dr.ali.ume@gmail.com

EGYPT

EIO EGYPTIAN IMPORT OFFICE

12 Eleskander Elakbar St., Elazarita, Alexandria Phone: +20 3486 8733 eio@eio-medical.com

ONE DENTAL SOLUTION

32 Dokki Street, 12311 Giza Phone: +20 100 131 0202 info@onedentalsolution.com

IRAN

MEHR-E TABAN MED.

Apt. 54, No. 14, Taban Complex, Tehran Phone: +98 21 8879 0983 info@mehrtaban.com

IRAQ

HIMAT CO. LTD.

IRAQ Al-Mansour,14th Ramadan Street

Al-Jawhara Trading Center, no.45, Baghdad Phone: +964 55434342 marketing@himat.net

JORDAN

KHOURY DENTAL CO.

UMM Mutawe AL-Aslamiyah St., AL Jandwawil Seer, P.O. Box 306

AMMAN, JO-11118

Phone: +962 6582 7015 khoury_dental@khds.jo

KUWAIT

ULTRAMED GEN TRADING CO.

Mazaya Tower 2, 7th floor, Khalid Ebn Al Waleed St, Sharq

Kuwait city KW-22488

Phone: +965 2221 6950 info@ultramed-kw.com

practitioners, endodontists and laboratories. The FKG strategy is centered on innovative high-precision products and the creation of machines designed specifically for the dental field. Its aim is to offer solutions that meet the most demanding needs of end users.

KYRGYSTAN

ALATA LTD

Shota Rustaveli Street 44/42 Bishkek KG-720044

Phone: +996 7 7022 2631 rustam@alata.kg

LEBANON

DROGUERIE TAMER S.A.L.

Tamer Building, Midan Street, Beirut

Phone: +961 1 694000 dental@tamerholding.com

LIBYA

ELRA JA PHARMACEUTICAL AND MEDICAL EQUIPMENT TRADING CO. LTD.

Maarakat Sidy Ellafy St. Elsselmany Eigharby, Benghazi

Phone: +218 91 376 4896 elraja_dent_c@yahoo.com

MOROCCO

ABC DENTAIRE

Hay My Abdellah, Rue 246, N°25-27 Casablanca

Phone: +212 5 2287 2987 abcslaoui@gmail.com

DENTAL EXPRESS 23 Avenue Sidi Boukhari, Tanger Phone: +212 6 6343 9088 dentalexpress@gmail.com

OMAN

SALA MEDICAL COMPLEX

Al-Ali House Mezzanine Floor Suite 110, Behind Philips Showroom, Al-Khuwair, AL-ELM Street, PO Box 780 P.C.

Al Hamriyah, OM-131 Phone: +968 2445 8159 salamedical@yahoo.com

PAKISTAN

WESTERN SCIENTIFIC TRADERS Western Scientific Traders Jail road Lahore 69-C Phone: +92 321 456 76 66 kalimbaig@westerngroup.com.pk

PALESTINE

RIAM DENT

Um Al Sharayet Main Street, Ramallah

Phone: +22 9590 51/2/4 dental@riam-group.com

QATAR

DOHA MEDICAL

Office No. 4, 1st Floor, Area No. 52 Luqta

Al Rayyan Al Qaddem, Doha

Phone: +974 4471 1856 info@dohamedical.com

SAUDI ARABIA

COMMERCIAL & MAINTENANCE CO. FOR TECHNICAL EQUIPMENT

Mecca Highway, Bldg# 316, 2nd Floor, Olaya District, P. O Box 88552

Riyadh Phone: +966 11 463 33 61 info@comate.com

SYRIA

OUZOUN TRADING CENTER

Al Habbal Bldg. Al Telyani Ave., Omar Al Mokhtar St, Damascus Phone: +963 11 4430545 abdallaouzoun@ouzoun.com

TUNISIA

NE W MED EQUIPMENTS

Immeuble petit palais RDC N, 34 Avenue Habib Bourguiba ARYANAH (Tunis) TN-2080

Phone: +216 7171 0328 hatem.newmed@hotmail.fr

TURKEY

LIDER DIS

Fevzi Cakmak sokak No: 11/5

Kızılay ANKARA Phone: +90 31 2231 6485 lider@liderdis.com.tr

UNITED ARAB EMIRATES

DUBAI MEDICAL EQUIPMENT

Dar-Al-Khaleej Building Block A, New Al-Khan St. Sharjah Phone: +971 6 5308055 dt_uae@emirates.net.ae

Providing ease of use, resistance to cyclic fatigue, swiftness and effectiveness, the new XP endo® Shaper is the amazing single file system developed by FKG Dentaire SA.

The XP endo® range of instruments is designed to facilitate the clinicians’ practice, while maximising endodontic treatment quality and safety. The XP endo® Shaper provides the general dentists, as well as the specialists, with a very innovative endodontic file.

This broad spectrum instrument is indicated for the shaping of the vast majority of root canals:

• Manufactured using the patented MaxWire® alloy, the XP endo® Shaper features extreme flexibility and remarkable fatigue strength, compared to competitive instruments of the same final size. It has the capacity to expand and the ability to progress with agility within the canal, with a reduced risk of torsional fatigue. From its initial .01 taper, the XP endo® Shaper can expand to achieve a minimum .04 taper.

• Equipped with the Booster Tip (BT), offering 6 cutting edges, the XP endo® Shaper starts shaping at ISO diameter 15 and then increases its working scope to achieve ISO diameter 30. The BT tip maintains the instrument centered and avoids ledging or straightening of the root canal.

Thanks to its small core diameter, its cutting efficiency and the stream generated in the irrigation fluid, large amount of dentine

micro debris are evacuated efficiently. This prevents the risk of debris compaction into canal irregularities, as well as it limits the risk of extrusion beyond the apex. Used after preparing a glide path to minimum ISO 15/.02, it allows reaching a final canal preparation of at least ISO 30/.04. These technical advantages combined with high speed continuous rotation and minimum torque, minimise the stresses exerted onto the canal walls and prevent the risk of micro cracks. The XP endo® Shaper has a gentle, non aggressive action and promotes conservative procedures. With this new instrument, FKG Dentaire supports general dentists and endodontists to perform the root canal shaping simply, quickly, safely and with just one instrument. Available in 21, 25 and 31 mm lengths, the XP endo® Shaper are packed in sterile blister of 6 instruments.

Made with a highly flexible NiTi-based alloy, the XP-endo Finisher follows the contours of the canal with an improved reach of 6mm in diameter—or 100-fold that of a standard instrument of the same size.

A unique FKG alloy, the MaxWire (Martensite-Austenite electropolish-fleX), gives the instrument unparalleled flexibility so it can remove debris from those hard-to-reach areas, while limiting the impact on the dentine. The instrument also features a strong resis tance to instrument fatigue, thanks to its zero-taper design, and is simple enough for dentists to quickly learn to use.

The XP-endo Finisher

• Clean inner canal walls of all root canal morphologies, especially:

- irregular canals, large canals

- C-shaped canals, oval canals

- isthmuses, furcation canals

• Clean root canal pathology:

- internal root resorptions

• Finish the apical part, cleaning apical constrictions and foramens, especially:

- open apex of immature roots

- wide apex in periapical lesions

• Improve irrigants benefits

The XP-endo Finisher R

• Remove residual obturation material:

- elimination of Gutta Percha and sealer on canal walls in retreatment cases

- scraping of the exposed dentin walls to remove bacteria and biofilm

• Improve irrigants benefits:

- creation of turbulences of sodium hypo chlorite and EDTA or any other irrigants

• Remove blockages allowing obturation of accessory canals

Company name: MICRO-MEGA® Country of origin: France Website: www.micro-mega.com

MICRO-MEGA®, a hundred-year-old French company, possesses know-how that is recognized worldwide in the fields of the design, manufacture and sale of dental surgical instruments (root canal instruments, obturation, hand instruments and instrument hygiene).

MICRO-MEGA®’s expertise in the design and construction of its own production machinery has helped to achieve a predominant position in the dental instrument world.

MENA DISTRIBUTORS

SARL ODONTOMEDICA

Cite 05 juillet 62 bt15 n141 25000 Constantine ALGER

ALGERIA

Phone: +213 31 66 70 21 odontomedicadz@yahoo.fr

CIGALAH GULF MEDICAL

Building 670, Raod 919, Block 309, Salmaniya Manama

BAHRAIN

Phone: +973 172 32 170 hany@cgmed.com

NATIONAL TRADING COMPANY

NTC

54 Ramses Street - Roxy - Heliopolis Cairo

EGYPT

Phone: +202 24 51 31 91 sales@ntc-egypt.com

DAVAN TAK TEB

2307 Valieasr Ave, Tehran1516745131

Tehran

IRAN

Phone: +98 21 88 88 36 45 davantak@gmail.com

MEDI TRADING FZCO – FIA GROUP

Kurdistan- Erbil Branch

IRAQ

Phone: +964 75 04 28 45 03 dent090913@iraqimedco.com

DENTAMED

Complex No 75, Al Buhtori St 75, Amman 11118, Jordanie

JORDAN

Phone : +962 64 64 22 15 dentamed@go.com.jo

SAFWAN TRADING & CONTRACTING CO

Ali Abdul Wahab Building, Old Shuwaikh, Street 6, Block 152

P.O.Box: 20704 Safat 13068

KUWAIT

Phone : +22276888 Ext:223 abehary@safwantrading.com

Over the years, MICRO-MEGA® has become a leader and undisputed specialist in endodontics

Its mission is to innovate in this field, setting the standards for general dental practitioners throughout the world and offering the dental market a unique range of technical and scientific expertise

DENTALTECH SARL

Brasilia street, Hikmeh building, first basement, Baabda

LEBANON

Phone: +961 5950707 +961 5955854 info@dentaltechsarl.com

MOBADALA DENTAL & MEDICAL SUPPLIER

Ben Ashour Street P.O.Box 84296

Tripoli

LIBYA

Phone: +218 21 36 20 765 ly99@live.com

AMED

47 Rue de Bruxelles Casablanca

MOROCCO

Phone: +212 22 82 31 34 assistance@menara.ma

AL MAZROUI MEDICAL & CHEMICAL SUPPLIES PO Box 1259, PC 112, Ruwi

Muscat

OMAN

Phone: +968 24 59 56 70 ashar@almaz.net.ae

CEDARS DENTAL CENTER

Bldg 65, Street 850, Wadi al Sail, PO Box 47684

Doha

QATAR

Phone: +974 44 86 40 88 ramzi@cedars-dental.com

JEDDAH DENTAL SUPPLY

Alnazer Building, Palestine Road, Behind Haifa mall

Jeddah

SAUDI ARABIA

Phone: +966 2 66 92 462 khjds@hotmail.com

CIGALAH TRADING EST.

Sharafyia District, Ali Reda Tower, Madinah Road

P.O. Box 19435 Jeddah 21435

Jeddah

SAUDI ARABIA

Phone: +966 12 6148 282 awaly@cigalah.com.sa

MOLAR FOR IMPORT & EXPORT

Africa Road, Amarat Street No. 19, P.O.Box 15093 Postal code 12217

Khartoum

SUDAN

Phone: +249 120 97 00 00 alaa@molar.sd

CHATTA DENTAL SUPPLIES

Al Fardoss Str. Ibn Zeidoun Building, 1st FloorPO Box 4588

Damascus

SYRIA

Phone: +963 11 224 17 17 chatta@scs-net.org

INTER MEDICAL SERVICE

7 bis Rue De Cologne, Tunis

TUNISIA

Phone: +216 71 800 488 commercial@ims.com.tn

GUNEY DIS Umraniye, Istanbul

TURKEY

Phone: +90 216 466 83 83 arzu.karaul@guneydis.com

CITY PHARMACY

Hamdan Street, Abu Dhabi

UNITED ARAB EMIRATES

Phone: +971 2 67 32 954 cityphrm@emirates.net.ae

NOOR DENT FOR IMPORT MEDICAL EQUIPMENT

Hadda St. next to Al- Ghrasi building Sana`a YEMEN

Phone: +967 1 208827 noordent@gmail.com

Your new generation heat-treated flaring instrument

The first important step of the root canal preparation after completion of the access cavity consists in the enlargement of the root canal entrances to reduce the risk of shaping instrument fracture.

One Flare is a new flaring instrument for multiple use delivered sterile. It is the first instrument of the product range to benefit of heat treatment which provides the file with more flexibility, increased resistance to fatigue and a golden color.

These characteristics make the endodontic treatment safer and allow for a better progression of files in the root canal.

Benefits

• Heat-treated : more flexibility and increased fatigue resistance

• Sterile and for multiple use

• Elimination of coronal interferences

MICRO-MEGA proposes a brand new solution of rotary files which simplifies all the steps of the canal shaping:

• Access cavity with One Flare

• Glide path with One G

• Root canal shaping with Revo-S™ (SC1,SC2 and SU)

The benefits for you :

Saves time and money:

• No sterilization before the first use

• Easier management for your assistant

Hygiene:

• Infection risk control

• Compliance with the hygiene chain

Company name: NSK NAKANISHI INC.

Country of origin: Japan Website: www.nsk-dental.com

“Providing durable and elegant, yet competitively priced product” has been NSK’s philosophy since it was established in 1930. Specialized in super high-speed rotary cutting technology, NSK delivers a variety of high quality and extremely cost efficient products to the dentistry. NSK focuses on satisfying diverse customers’ requirements through timely product development backed up with unparalleled production engineering and innovative technology.

NSK is a top brand committed to serving the needs of dental practitioners, technicians and hygienists. NSK’s continued development offers innovative design and unrivalled quality as well as outstanding value and performance all of which is supported by NSK’s global sales network and first-class after-sales service.

MENA DISTRIBUTORS

MAGHREB DENTAL INDUSTRY-MDI

Es-Sénia-Oran

ALGERIA

Phone: +213 41 335890 contact@mdi-dentaire.com

SAFWAN EGYPT

Giza

EGYPT

Phone: +20 2 33022792 / 33042740 info@safwanegypt.com

DOUSTKAM CO. INC

Tehran

IRAN

Phone: +98 21 77527140 doustkamco@gmail.com

TAMER LEVANT

Erbil

IRAQ

Phone: +964 750 1 440 400 diaa.khreish@tamerholding.com

HIMAT CO. LTD.

Baghdad

IRAQ

Phone: +964 790 1317209 marketing@himat.net

SALBASHIAN TRADING CO.

Amman

JORDAN

Phone: +962 6 4645845 yeran.s@salbashiangroup.com

AL-SAYAFE MEDICAL & PHARMA SUPPLIES COMPANY W.L.L

Sharq

KUWAIT

Phone: +965 22 454924 alsayafe@alsayafemedical.com

DROGUERIE TAMER S.A.L.

Beirut

LEBANON

Phone: +961 1 694000 dental@tamerholding.com

AL MGD CO.

Tripoli

LIBYA

Phone: +218 21 3610154 mgdent@gawab.com

ASSISTANCE MÉDICALE ET DENTAIRE

Casablanca

MOROCCO

Phone: +212 (0) 522 822498 ihssan.b@amed.ma

MEDICAL & PHARMACEUTICAL SERVICES CO. (PHARMADENT)

Muscat

OMAN

Phone: +968 24567561

BASHIR SHAKIB ALJABRI & CO.

Jeddah / Phone: +966 12 6700430 / +966 50 203 0433

Riyadh / Phone: +966 11 4747750

SAUDI ARABIA bashirco@bashirco.com.sa

SALLOUM DENTAL CO.

Damascus

SYRIA

Phone: +963 11 2248772 / 2210974 psalloum@scs-net.org

PROMOSCIENCES

Tunis TUNISIA Phone: +216 71 772 500 promosciences@planet.tn

LIDER DIS

Ankara

TURKEY Phone: +90 312 2316485 nskturkey@liderdis.com.tr

CITY PHARMACY

Abu Dhabi

UNITED ARAB EMIRATES

Phone: +971 2 6732954

cityphrm@emirates.net.ae

YEMEN STORES FOR DRUGS & MEDICAL SUPPLIES

Sana’a

YEMEN

Phone: +967 1 444622 w.aghbari@yemenstores.com

Air Turbines Evolve to Become More Powerful

Based on the philosophy of consistently delivering products that exceed all expectations, Ti-Max Z Turbines supported by non-compromising NSK product design and ultra-high precision processing technology, provide a new level of comfort to both clinicians and patients like never before.

With one of the most powerful air turbines, our technological innovation will revolutionize dental practice.

Company name: Dentsply Sirona Website: www.dentsplysirona.com

Dentsply Sirona is the world’s largest manufacturer of professional dental products and technologies, with a 130-year history of innovation and service to the dental industry and patients worldwide. Dentsply Sirona develops, manufactures, and markets a comprehensive solutions offering including dental and oral health products as well as other consumable medical devices under a strong portfolio of world class brands.

As The Dental Solutions Company ™, Dentsply Sirona’s products provide innovative, high-quality and effective solutions to advance patient care and deliver better, safer and faster dentistry. With a sales presence in more than 120 countries, patients and practitioners virtually everywhere in the world rely on Dentsply Sirona.

MENA DISTRIBUTORS

Consumables Equipment Implants

ALGERIA

MDI DENTAIRE

Phone: +213 661200828 contact@mdi-dentaire.com

GROUPE DENTAIRE ALGERIEN

Phone: +213 23 85 01 78 spa_gda@yahoo.fr

NEGOSANTE

Phone: +213 2124 6624 benyahi.negosante@yahoo.fr

BAHRAIN

GULF PHARMACY & GENERAL

Phone: +973 17 239 386 orders@gctbahrain.com

CIGALAH GULF MEDICAL

Phone: +973 172 32 170 Maha@cgmed.com hany@cgmed.com

MEDICAL & PHARMACEUTICAL SERVICES W.L.L

Phone: + 973 1771 5785 bashirco@batelco.com.bh

OMAR SAEED AL-AMOUNDI SONS CO.

LLC

Phone: 009662 652 3394 Info@amoudico-sa.com

EGYPT

MIDDLE EAST DENTAL SUPPLIES

Phone: +202 24513870 +202 24513874 eid.kabrita@gmail.com

MIDDLE EAST INT’L TRADING CO.

Phone: +202 224 19054 +202 224 19296 saadeldin@meit.com.eg

PROCARE

Phone: +202 226 98 910 +202 226 86 137 info@procareeg.com

ALKAN MEDICAL

Phone: +202 012 23668475 mhamdy.alkan@eim-eg.com

DELTA MEDICAL SUPPLIES

Phone: (20) (40) (3402246) deltamedegypt@hotmail.com

INTERNATIONAL BIOMEDICAL GROUP wessam.ali@ibgmed.com shaimaa.mustafa@ibgmed.com daliaf@internetegypt.com

MEDI-TECH TRADING S.A.E

Phone: +2 0100 1020000 +2 0100 855 9962 hatem@meditech-eg.com g.elgendy@meditech-eg.com

PAN TRADE & DEVELOPMENT CO.

Phone: 00202 27055527 mars_pan@live.com

IRAN

DARMAN YAB SALAMAT POUYA CO. Phone: +98 (21) 87175239 h_harandi@darmanyab.com

IRAQ

TAMER LEVANT LTD

Phone: +964 7501 440400 levant@tamerholding.com

AL-INDIMAJ

Phone: +964 (0) 790 5730065 mohammed.maan@alindimaj.com

MEDI TRADING FZCO

Phone: +964-7504284503 dent090913@iraqimedco.com

JORDAN

IBN-RUSHD DRUG STORE

Phone: +962 6 552 6162 tareq@irds.jo

NABIH NABULSI DRUGSTORES

Phone: +962 6560 0102 nabulsi@go.com.jo

MODERN TECHNOLOGY COMPANY FOR MEDICAL EQUPMENTS

Phone: +962 6 551 8170 mtmeq@tedata.net.jo

KUWAIT

ALGHANIM HE ALTH CARE GEN. TRAD. CO. W.L.L Phone: +965 222 10050 noor.boresly@alghanimhc.com

YIACO MEDICAL CO. W.L.L Phone: +965 223 0600 dental@yiacokuwait.com

CENTRAL CIRCLE COMPANY

Phone: (+965) 50814100 lijini.orders@centralcircleco.com Feras.refaiyeh@centralcircleco.com

AL BADER TRADING Phone: +965 224 61116 emad_badran@hotmail.com

MEDICALS INTERNATIONAL, SAL Phone: +965 222 50228 wbarake@medicalsintl.com

ceram.x® SphereTEC™ is Dentsply Sirona’s latest universal composite that combines excellent handling comfort with natural aesthetics. This is made possible with the new proprietary SphereTEC filler technology which means that dentists no longer have to compromise between supreme aesthetics and outstanding handling characteristics such as adaptation, slump resistance and sculptability. SphereTEC is cutting edge spherical filler technology which is proprietary to Dentsply Sirona and stands for the process of manufacturing of well-defined spherical superstructures. A SphereTEC filler is comprised of sub-mircon barium glass particles which are held together with a pre-polymerised resin. The SphereTEC filler technology results in high slump resistance and ideal sculptability, and a non-sticky formula.

The X-Smart™ Plus is a simple and easy to use endo motor of choice for General Dental Practitioners performing root canal treatments with the reciprocating, single file technique or traditional continuous rotation file systems. It enables the practitioner to fully focus on the patient and the treatment due to its simplicity of use. It has everything you like about X-SMART with a PLUS. The motor operates in both continuous rotation and reciprocating motion. It features excellent visibility and access due to the miniature contra angle. There is no need for a foot pedal: the On/Off button is located on the motor hand piece. It is pre-programmed for different file systems, including WaveOne GOLD, ProTaper NEXT, ProTaper GOLD and ProGlider, helping you to choose your preferred system at a single glance. Interface is very user friendly with « click and go » navigation and button controls dedicated to each function. The unit is compact, portable and can be battery operated.

CEREC Zirconia

Valued material can now be used chairside

CEREC now provides a completely new process to dental practices: by combining the new CEREC SpeedFire furnace and CEREC Zirconia material, dentists can now deliver full contour crowns and small bridges made of the full-strength high-quality zirconium oxide while the patient waits. The material is milled in an enlarged form and then densely sintered to its final size in the new sintering furnace CEREC SpeedFire. The over-sized milling facilitates a new level of milling accuracy leading to superb, precisely fitting restorations. The sintering process takes just 10-15 minutes for crowns and 25 minutes for bridges. The sub-sequent glaze firing gives the restoration a high gloss finish. CEREC milling/grinding units now provide wet and dry milling. Dry milling reduces the processing time for zirconia and, combined with the world’s fastest sintering cycles, enables the chairside procedure.

MENA DISTRIBUTORS

LEBANON

DENTALTECH SARL

Phone: +961 5 950 707

+961 5 950 808 info@dentaltechsarl.com

PHARMACOL SAL

Phone: +961 4 525 278 +961 4 524 247 carole.manhal@pharmacol.com.lb

TOFF DENTAL-DIV. OF TOFF GROUP

Phone: +961 1 814 358 fadi.balhawan@hotmail.com

RICHA DENTAL STORE

Phone: +961 5 45 25 55 richdentlebanon@gmail.com

MEDICALS INTERNATIONAL SARL

Phone: +9614 530 630 wbarake@medicalsintl.com

LIBYA

AL NABAA COMPANY FOR DENTAL & MEDICAL SUPPLIES

Phone: +218 912183116

+218 916627191 g.m@alnabaa.ly/ abdo_enj@hotmail.com

AL-NAQQA FOR DENTAL & MEDICAL

Phone: +218 91 2134843

+218 92 6530337 al_naqqa@yahoo.com

AL REYADA AL-ARABIA FOR IMPORTATION OF EQUIPMENT & MEDICAL SUPPLIER

Phone: +218 619082076

+218 925880267 ellsufi@yahoo.com

MEDICAL WORLD COMPANY

Phone: +218 21 360 3540 medicalworld@hotmail.com

AL BASMA DENTAL CENTRE Phone: +21 82 1361 5043 basma_center@hotmail.com

MAURITANIA

ESPACE DENTAIRE

Phone: +222 42 00 42 42 +222 45 25 12 34 espacedentaire.mr@gmail.com

MOROCCO

ACADEMY DENTAL Phone: +212 522 862671 imadelfassi@yahoo.com

LA MEDICO DENTAIRE Phone: +212 522 364482 medent1.medico@gmail.com

NS DENTAL Phone: +212 522 951238 youssef-mrini@hotmail.com

ASSISTANCE MEDICALE ET DENTAIRE

S.A.R.L Phone: +212 5 22 82 31 34 ihssan.b@amed.ma

CEQUIDENT

Phone: +212 5 2231 6777 caquident@menara.ma

IDENTITE MEDICALE S.A.R.L. Phone: +212 5 22 208 564 idmedicale@yahoo.fr

SOUTHEMA DENTAIRE

Phone: +212 2232 0606 f.moustain@sothema.ma

UGIN DENTAIRE

Phone: +33 476 84 4545

DENTAL UP

Phone: +212 522 36 0488 dentalup1@gmail.com

OMAN

BAHWAN HEALTHCARE

Phone: +968 2479 3750, Ext 421 erp@suhailbahwangroup.com

MUSCAT PHARMACY & STORES LLC Phone: +968 2481 4501 mphq@mpmct.com

SALA MEDICAL COMPLEX LLC Phone: +968 2448 5159 salamedical@yahoo.com

PAKISTAN

DENTSCO INTERNATIONAL

Phone: + 92 21 34134871 + 92 333 3232720 nauman.dardent@gmail.com

MR DENTAL SUPPLY Phone: + 92-42-35775689 dentalpk2@yahoo.com

TOTAL TECHNOLOGIES LTD Phone: +92 (0) 42 3595 7281 – 3 office@totalgroup.com.pk

INTEGO Ambidextrous: Elegant turn for greater flexibility

INTEGO Ambidextrous is the new treatment center from Dentsply Sirona Treatment Centers that creates optimum working conditions for both right- and left-handed users. The intelligent pivoting mechanism makes the INTEGO Ambidextrous into a masterpiece of flexibility. With a few easy actions, Intego Ambidextrous can be converted from a right-hand to left-hand unit or back again. This flexibility has many advantages and opens up new possibilities: for example, in large practices with several users it means that everyone can use the same unit, whichever hand is dominant. It is estimated that around five percent of all dentists worldwide are left-handed. The treatment center is equipped with a special pivoting mechanism for this conversion: a switch on the water unit is actuated, which then travels to the other side of the chair. The entire process only takes around 15 seconds.

QATAR GERMINMED

Phone: +974 442 72148 abdallahsh@germinmed.com.qa

MASAR MEDICAL

Phone: +974 4436 4371 masar@masarqatar.com.qa

ALI BIN ALI MEDICAL

Phone: +974 4 4863457 Saif.Bukri@alibinali.com

NASSER TRADING & CONTRACTING

Phone: +974 466 5409 ntc@qatar.net.qa

BLUESKY MEDICAL & DENTAL SOLUTIONS

Phone: +974 44113699 info@blueskydent.com

AL AJAJI TRADING COMPANY

Phone: +966-011-4162229 Tareq.Anees@drsulaimanalhabib.com ate.purchaser@gmail.com

IBRAHIM MOHAMED AL MANA CO. Phone: +966 11 279 1150 almana.abdullah@googlemail.com

MEDICAL PALACE CORPORATION Phone: +966 5566607511 malimowafy@gmail.com

MELAT TRADING Phone: +966 1293 4044 dr.Algufari@melatdental.com

INTEGO New treatment center from Sirona Quality “made in Germany” at an attractive price

SENEGAL

DELTA MEDICAL Phone: +221 822 3037 delta@deltamedical.sn

SAUDI ARABIA

ABDULREHMAN AL GOSAIBI GTC

Phone: +966 11 479 3000 dental@aralgosaibico.com

ASNAN EST.

Phone: +966 11 491 6327 asnan@asnan.net.sa

BASHIR SHAKIB ALJABRI & CO LTD

Phone: +966 12 670 0430 bashirco@bashirco.com.sa

Sirona, global market and technology leader in the dental industry, has introduced a new treatment center: INTEGO offers top quality and flexible configuration options at an attractive price. The new treatment center comes in two versions: INTEGO and INTEGO pro with extended functionality. Each model can be supplied as a hanging hoses model (TS) or with whip arms (CS) in a wide range of shades. Both versions are based on a chair concept which takes the four dimensions of ergonomics into account – intuitive sitting, comfortable positioning, optimum visibility and integrated workflows – and thus ensures that practitioners achieve ideal results.

CIGALAH TRADING EST.

Phone: + 966 12 614 8281 ssherif@cigalah.com.sa

MEDICAL VISION EST.

Phone: +966 11 405 7275 medical_vision@alsanie.com.sa

HORIZONS DENTAIRES Phone: +221 821 0577 nabilgazal@arc.sn

TUNISIA

CHEDENT Phone: +216 718 07270 chedent-app@planet.tn

DEX Phone: +216 733 47939 dex@planet.tn

NEW MED Phone: +216 98332670 hatem.newmed@hotmail.fr

M.S.I EQUIPMENTS MEDICO-DENTAIRES Phone: +216 73 449 400 msi.bouzgarrou@topnet.tn

DISTRI-MED Phone: +216 71 334 812 distri-med@planet.tn

UNITED ARAB EMIRATES AL-HAYAT PHARMACEUTICALS Phone: +971 655 92481 service@alhayatuae.com

GULF MEDICAL COMMERCIAL AGENCY Phone: +971 653 31169 gmca@emirates.net.ae

PRIME MEDICAL SUPPLIES EST Phone: +971 2666 6037 sijy@primemedicalsupplied.ae

MODERN PHARMACEUTICAL CO. Phone: +971 4 3834262 coleen@mpchealthcare.com (Governmental Sector)

NEW AL-FARWANIYA TRADING Phone: +972 6775 447 farwania@emirates.net.ae

SIRONA DENTAL SYSTEMS TRADING LLC Phone: +971 4375 2355 amro.adel@sirona.com (Private Sector)

YEMEN

AL ASBAHI TRADING

Phone: +967 121 3214/404277 asbdentrd@yemen.net.ye

Company name: ULTRADENT

Country of origin: Germany Website: www.ultradent.de

Expertise from Bavaria.

Ultradent has been based in the Munich area since 1924. Countless innovative product ideas, the company‘s own patents and utility models signify a competitive edge in terms of technology and demonstrate their exclusive nature.

“Made in Germany”

ULTRADENT develops and produces its modern treatment units and equipment at its own factory in Brunnthal/Germany near Munich. It is precisely this German spirit of invention that brought the family company success: ULTRADENT has evolved to become one of the most important suppliers of modern treatment units for dental practices in all areas of dentistry and today is one of the leading companies in the field of dental treatment units.

MENA DISTRIBUTORS

BAHRAIN

AL TURKI MEDICAL (MIDDLE EAST) AME

Flat no 11th, Alwedha BLDG, Sheikh Dulaj AVE Qudaibiah street

Manama

Phone: +973 17712850 +973 17742494 ame@alturki.med.sa

EGYPT

ZAIDENT DENTAL SUPPLY

08 El-tahrir St, Dokki-giza

Hotline: +201222225076

Phone: +20237601582

zaident@link.net zaident2@yahoo.com

IRAQ

PULSE FOR MEDICAL EQUIPMENT L.L.C

100 metry street

Serbste 32-Park Avenue Hotel Juhaynah

Erbil

Phone: +964 7504166744

Cellphone: +971 505811379

Products for dentists in Germany, Europe and the world. The wishes and requirements of dentists, orthodontists, surgeons and their patients from various countries form the basis for the day-to-day work of the family company. This is demonstrated by user-oriented design, low-maintenance components and strict quality management.

ALDAWA SCIENTIFIC FOR MEDICAL APPLIANCES

Bartilla, George Kako Apt, 2.nd Floor, No: 209 Mosul

Phone: +9647503273990 +9647701663456

JORDAN

BASAMAT MEDICAL & DENTAL SUPPLIES

P.O. Box 141375 Amman

Phone: +962 65605395 sales@basamat.com

KUWAIT

HASSAN OPTICS COMPANY

Kuwait city , Fahd Al Salem Street

P.O. Box: 1139, Safat 13012, Kuwait

Phone: +965 1 806080 / Ext: 443

Cellphone: +965 94067505 audio.marketing@hassans.com

LEBANON

PHARAMCOL

Aboud Center, 3rd floor, Rabieh Main Road, Meten Beirut

Phone: +961 4524247 +961 4525278 carole.manhal@pharmacol1.com

SAUDI ARABIA

TAFAROD MEDICAL CO

Deutsche Gulf Finance Building, 3rd Floor King Abdullah Road Riyadh 11323

P.O. Box 285703

Phone: +96612032294

Fax: +96612032295

UNITED ARAB EMIRATES SMS MEDICAL SUPPLIES (SMS)

Dubai Phone: +971 48873050

Sales@sms-medent.com Nour@sms-medent.com

U 1303 (T/C).

The new heart of your practice.

The U 1303 from ULTRADENT makes it easy for you to include dental medical convenience with German top standards in your surgery. It is comprehensive and uncompromising for both your patients as well as for you. It is ideal for the widest range of dentistry

Its compact design and highest technical quality provide convincing advantages due to its advanced functionality and reliable efficiency. Its first-class specifications offer the perfect ergonomic support for each of your movements and rounds of our U 1303.

It is available in two versions, for your choice and preference.

U 6000 S. The new premium standard.

This premium treatment unit is impressive due to not only its spectacular new design entirely in white, but also the revolutionary vision U multimedia system.

With the U 6000 S, ULTRADENT is setting new standards. The elegant combination of technology and convenience help you to reach new goals. There is a full-touch display available for you and your dental assistants.

The latest W&H convincing technology with ImplantMed and the Primea Advanced Air-System is now optionally available.

Experience ULTRADENT’s top-of-the-range unit in your dental practice. Your team and patients will be impressed too. applications.

Indulge in perfection.

U 1303 C

U 1303 T

Company name: W&H Dentalwerk Bürmoos GmbH

Country of origin: Austria Website: www.wh.com

W&H - People Have Priority

The family company W&H Dentalwerk, based in Bürmoos near Salzburg, Austria, the only Austrian manufacturer of dental precision instruments and devices, is one of the leading providers of dental devices in the world. Innovative product and service solutions, a modern corporate structure, a strong focus on research and development, as well as social responsibility – this is what makes W&H Dentalwerk a successful local and global player.

MENA DISTRIBUTORS

PROMODENTA S.A.R.L.

21, Rue Boumenir Mouloud 26000 Médéa Algier

ALGERIA

Phone: +213 25596270 promodenta@gmail.com

GULF COOPERATION FOR TECHNOLOGY

Bldg No: 2038, Road: 4156, Block 341, Juffair, P.O. Box 2576, Manama BAHRAIN

Phone: +973 17239399 roshan@gctbahrain.com

IMECO

4, Mohamed Moussa St., Azarita Alexandria EGYPT

Phone: +20 3 4871264 imeco_eg@yahoo.com

1, Mathaf El Manial St., El manial Cairo EGYPT

Phone: +20 2 25328679 imeco_eg@yahoo.com

APADANA TAK

45, Ghods Ave, Keshavarz Blvd. Tehran

IRAN

Phone: +98 2188965650 apadana@apadanatak.com

ISSAM BUREAU GROUP

Karada - Q. 905 St. 15 No 45/1 Baghdad

IRAQ

Phone: +964 7712345201 issam@issambg.com

ARAB MEDICAL & SCIENTIFIC ALLIANCE (A.M.S.A.)

Khalil Salem Street - P.O. Box 2509 Tela’ Al-Ali , 11953 Amman

JORDAN

Phone: +962 65528009 Munther.shadfan@amsa.com.jo

With around 1,000 employees worldwide (600 of whom work in the Austrian headquarters in Bürmoos), W&H exports its products to more than 110 countries. The family company operates two production sites in Bürmoos (Austria), one in Brusaporto (Italy) and 18 subsidiaries in Europe, Asia and North America.

ADVANCED TECHNOLOGY COMPANY

Salem Al Mubarak Str., Salmiya, Cnr. Bahrain Str. - Block 62a, opp. Laila Tower, P.O. Box 44558 32060 Hawally

KUWAIT

Phone: +965 22247240 akar@atc.com.kw

MEDETECH S.A.R.L.

Gecco Bldg., 6th Floor, Blvd. Jdeideh, Sin-El-Fil, P.O. Box 90-946

Jdeidet El Metn

LEBANON

Phone: +961 1875401 medek@inco.com.lb

ALBYAN ALMOTAGADED FOR IMPORTING OF EQUIPMENTS & MEDICAL SUPPLIES

Equipments & Medical Supplies

P.O. Box 8252, Mohamed Fkini Street Tripoli

LIBYA

Phone: +218 925088549 albyan_almotagaded@live.com

MEDICODENTAIRE S.A.R.L. 22, Rue Ahmed Almaqri Racine 20050 Casablanca

MOROCCO

Phone: +212 22393433 medent1.medico@gmail.com

BAHWAN HEALTHCARE CENTRE LLC

Al Rawaq Building, Second Floor, Office 207 Building no 7, Street No. 38 Al Qurum, Muscat OMAN

Phone: +968 24650767 madhurbomb@suhailbahwangroup.com

ACCROS TRADING COMPANY

P.O.Box 23006 - Doha QATAR

Phone: +974 4816511 info@accros.org

AL-TURKI MEDICAL GROUP LTD. (A.M.G.)

Al-Turki Bldg. 46, Al-Bohtory St. off Al-Ahsa St., Al-Zahra District, P.O. Box 4952 Riyadh 11412

SAUDI ARABIA

Phone: +966 5014766828 m.abuadas@alturki.med.sa

OUZOUN TRADING CENTER

Al-Telyani Av., Omar Al-Moukhtar, St. Alhabal Building, Damascus SYRIA

Phone: +963 114430548 a.uzun@scs-net.org

DISTRI-MED

24 Av. de Madrid 1000 Tunis TUNISIA Phone: +216 71334812 distri-med@planet.tn

PRIME MEDICAL SUPPLIES EST. P.O. Box 44633, Abu Dhabi UNITED ARAB EMIRATES Phone: +971 26666037 vpshukla@hotmail.com

AL-ZOMALA’A DENTAL CO. Taiz St. Opposite to Nasser workshop P.O.Box 15210

Sana’a YEMEN Phone: +967 1422787 zomla2004@yemen.net.ye

The new Synea Vision turbine with 5x ring LED+ shows that W&H is the technological leader in the LED sector for dental instruments. Dentists benefit from a completely shadow-free view of the treatment field for the first time.

Synea Vision turbine with 5x ring LED+ The new dimension in shadow-free preparation

Complete elimination of shadows during preparation has long been the unfulfilled dream of many a dentist. In 2014, W&H achieved a technological masterpiece: five high-intensity, pinhead-sized LEDs are integrated in a ring shape into the small head of the new Synea Vision TK-98 L turbine. Dentists benefit from the 100% shadow-free illumination of the preparation site for the first time and patients benefit from improved treatment safety with the new sterilizable 5x ring LED+. The preparation site is not only illuminated from mesial but also from buccal, distal and lingual/palatal at the same time with the new light design. Full light intensity is guaranteed even in the most difficult situations.

Synea Vision turbine meets highest demands

An integrated 5x spray with its five outlet nozzles ensures perfect cooling and cleaning of the treatment site. The innovative W&H turbine with its special, scratch-resistant surface coating is particularly robust and maintains the quality of the instrument. A unique ergonomic design and a small instrument head contribute to comfortable and fatigue-free work.

The Synea Vision TK-98 L turbine with 5x ring LED+ is the result of intensive research and development. The close cooperation with internationally renowned users during development of the product give the innovative turbine the best possible support in practice routine.

The 5x ring LED+ of the Synea Vision turbine lets you see more. Five high-intensity LEDs in the small instrument head provide complete light intensity even in the most difficult situations.

The superiority of the W&H LED concept: Compared with the competing instrument (left), the Synea Vision turbine with 5x ring LED+ (right) offers a 100% shadow-free view of the preparation site.

Company name: 3SHAPE A/S Country of origin: Denmark Website: www.3shape.com

3Shape creates 3D scanning and CAD/CAM software solutions. Award-winning technology that enables dental and hearing professionals to treat more people, more effectively and with improved care. A privately-owned company, 3Shape has over 500 employees with a product-development force of more than 225 professionals. Offices and service centers located in the Americas, Asia and Europe serve customers in more than 100 countries. Company headquarters are in Copenhagen, Denmark.

MENA DISTRIBUTORS

Please contact 3shape for distribution partner.

3SHAPE A/S

Holmens Kanal 7, 1060 Copenhagen

DENMARK

Phone: +45 70272620

Fax: +45 7027621 info@3shape.com

3Shape TRIOS® 3 digital impression solution

3Shape TRIOS® 3 is a three-in-one digital impression solution featuring an intraoral scanner, integrated intraoral camera and automated shade measurement together in one device.3Shape TRIOS 3 is available in a pen grip design, handle grip and chair mount version.

3Shape dental lab scanners

3Shape delivers a full range of dental lab scanners. From the industry’s most powerful, D2000 all-in-one scanner with simultaneous two-model scanning, to the entry-level D500. All 3Shape lab scanners are ISO-documented accurate and provide industry-leading speed.

Dental System™ brings together 3D scanning, CAD modeling, the widest range of indications, restorative component libraries and 3rd party device integrations, all driven by clear intuitive workflows and seamless digital communications in an easy-to-use software solution for dental professionals.

Automated material changer for enhanced efficiency • Dry milling of zirconium oxide, acrylic resin, wax

• Wet-grinding capabilities for IPS e.max® CAD for Zenotec • The IPS e.matrix multiholder maximizes productivity and flexibility

Zenostar® Telio® CAD for Zenotec