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Hypnosis Applied to Dental Practice: A review
54. Minimally Invasive
Emna Hidoussi Sakly, Wiem Ben Amor Jemmali, Neila Zokkar Benzarti, Faten Ben Abdallah Ben Amor
Surgery in 2020
July 28th, 2020 19:00 Beirut/Riyadh Time Speaker: Prof. Alain Romanos Panelists: Dr. Arwa Alsayed, Dr. Emad Salloum, Dr. Muna Abbadi, Dr. Bassam Rabie, Dr. Luis Bessa
5 Ways 3D Printing Has Revolutionized The Dental Industry Olivia Hooper
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May 20 - 22, 2021 Rimini, ITALY www.expodental.it
Expodental Meeting: the event from 20 to 22 May 2021 in Rimini “Following one of the darkest periods in the history of recent years, at the end of lockdown which paralysed every activity and caused us to postpone our event, for everyone’s well-being and safety first to September and then November, we were convinced that Expodental Meeting 2020 could have represented, even if in a revised form, a crucial moment for the entire industry to relaunch”, the organisers stated.
DENTAL NEWS IS A QUARTERLY MAGAZINE DISTRIBUTED MAINLY IN THE MIDDLE EAST & NORTH AFRICA IN COLLABORATION WITH THE COUNCIL OF DENTAL SOCIETIES FOR THE GCC.
“Today, in the light of recent circumstances, a succession of government decrees, the current media campaign we must acknowledge that our event cannot take
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place”, President of UNIDI Gianfranco Berrutti declared. The decision comes from
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infected people which imposes the strict respect of social distancing measures and
the impossibility of Expodental to guarantee the best event possible in respect of the exhibitors, the visitors, and the sector players. There are different elements to consider. First, the latest increase in the number of border controls. Furthermore, it is currently necessary to take into consideration the renewed sentiment of uncertainty gripping everyone to various extents, a situation which also calls for strict travelling rules for staff and collaborators. Today, the situation globally is too unstable to plan events in the short term since strict measures to safeguard everyone’s health could suddenly be implemented.
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These considerations, obviously, echo the serious economic crisis that has forced all companies and professionals, both from the dental industry and all other sectors, to adjust and set up new budgets for different and cautious objectives. Work is underway for the next edition of Expodental Meeting. The event is pushed back a few months and will take place from 20 to 22 May 2021. It will feature a new exhibit area and a scientific and cultural programme even more packed with events to mark the Year Zero for our future.
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Hypnosis Applied to Dental Practice: A review Abstract
Emna Hidoussi Sakly, University Of Monastir, Faculty of Dental medicine, Research Laboratory of Oral Health and Rehabilitation, LR12ES11, Monastir, 5000, Tunisia
Wiem Ben Amor Jemmali, University Of Monastir, Faculty of Dental medicine, Research Laboratory of Oral Health and Rehabilitation, LR12ES11, Monastir, 5000, Tunisia
Neila Zokkar Benzarti, University Of Monastir, Faculty of Dental medicine, Research Laboratory of Oral Health and Rehabilitation, LR12ES11, Monastir, 5000, Tunisia
Modern technological advances in dental professions have managed to solve problems that have existed for centuries. Yet, there is a variety of psychological and psychosomatic disorders that still challenge us because of our inefficacy to cure patients exhibiting symptoms of these disorders. Although pain management field has seen significant advance, many people nowadays keep avoiding seeing a dentist out of fear or anxiety. Clinical hypnosis
seems to bring advantages to dentistry for it helps neutralize indefensible nervousness and phobia in patients. Dentists who make use of hypnosis are more able to relieve their anxious patients’ pain and fear. This article provides an insight into the advantages of hypnosis as a therapy, and explores its applications in dentistry. Keywords:
Introduction Hypnosis is stereotypically thought of as a method of manipulation and that’s because of the myths that built misconceptions and erroneous mental representations around it 1. In fact, the main aim of hypnotherapy is not to manipulate the patient, but to give them the tools they require to take back control of their behaviors, feelings and emotions. “Hypnosis” is originally a Greek word that means “sleep”. It represents a naturally modified conscious state. The individual gets into a hypnotic state called trance, which is not artificially induced and is different from the usual awareness state 2. The observation of neurophysiological changes assert this altered consciousness, which differentiates it from states of meditation or relaxation. Although in a hypnotic state the subject is highly attentive to suggestion, they maintain concentration and keep the potential to make their own decisions at any time.
Faten Ben Abdallah Ben Amor, University Of Monastir, Faculty of Dental medicine, Research Laboratory of Oral Health and Rehabilitation, LR12ES11, Monastir, 5000, Tunisia email@example.com
Dentists who use hypnosis regularly in their clinical practices appreciate a variety of significant advantages. There are many and varied applications of clinical hypnosis in dental clinical practice. Dental applications of hypnosis include relaxation, relief from fears and anxieties, reduction in both the perception and severity of pain during procedures, control of bleeding and salivation (both for increasing and decreasing flow, as needed), control of bruxism (tooth grinding), finger-sucking, and other habits, and promotion of behavioral modifications associated with optimization of oral health 3, 4. September 2020
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Amongst a lot of options for behaviour management and modifications, hypnotics is one of the oldest and noninvasive way to control dental anxiety in children, adult as well as in geriatric patients and hence get a better treatment result and a good compliance and satisfaction of the patient.
How does it work? It’s thought that hypnosis provides direct access to a person’s subconscious mind 5. In essence, it is the subconscious which is mainly responsible for a lot of what we do and how we feel. Science has agreed that hypnosis involves being in a trance state, experiencing relaxation at the same time as heightening the mind’s imagination. In this state, where the subconscious is released, we observe an alteration in the composition of neural oscillations especially in Prefrontal Cortex and Right occipital EEG channels 6. The mind is extremely susceptible to the hypnotherapist’s suggestions, which push the subjects’ focus to their inner world to influence their perception, feelings, thinking and behaviour. But to be of effect, suggestions must be acceptable to the subject.
Hypnosis applied to dental practice: A review
Hypnosis in children and adolescents is possible, but, much harder to administer than in the adults. It is also true that not everybody is susceptible to hypnosis, as it is apparent that this phenomenon has also some association with genetics and brain structure 9. Hypnotic suggestion is used in the management of paediatric patients as well. This involves the techniques of distraction, reframing and imagery suggestions. It is effective with kids aged 8–12 years, but even a four-yearold child can show responsiveness 1. Furthermore, the operative use of hypnosis includes analgesia during surgery. It has been largely superseded by pharmaceutical sedation and general anaesthetics. When using hypnosis for analgesia, the patient must reach deep hypnosis, which takes time, and have an environment free from distractions and interruptions 10.
Use of hypnosis in the dental practice Hypnosis can bring considerable relief to anxious patients and make it easier for the dentist to do their job but it is particularly implemented in order to help patients relax. As relaxation raises the pain threshold, requirement for local anaesthesia is reduced. And even if it is necessary, it is better tolerated. Therefore, the use of hypnosis as a general relaxation strategy is certainly possible and there are reports in the literature of its use in both adults and children 7, 8. Moreover, clinical benefits can be derived from hypnosis such as the control of dentophobia, abnormally active gag reflex, trigeminal neuralgia pain, benign chronic orofacial pain, temporomandibular joint dysfunction (TMD), adaptation to dentures, behaviour modification, like thumb sucking, bruxism. Additionally, hypnosis can control salivary flow and bleeding. Xerostomia and haemostasis can be produced through hypnotic suggestions, such as visualizing being in a desert on a hot day and noticing how dry the mouth becomes because of lack of water. Mental imagery of the ligation of a bleeding vessel can be used to decrease bleeding after soft tissue surgery.
Figure 1: Hypnotist with a patient during endodontic treatment. Hypnosis can be used instead of conventional anaesthetics to relieve the perception of pain in patients.
Current methods of hypnosis A distinction arises between a deep type of hypnosis and a light one and both have different applications. Deep hypnosis takes long so it is not apt for regular dental practice; however, it is required for analgesia and behaviour modification. On the other hand, the ‘light’ state is easier and faster to attain and is used in hypnodontia on a daily basis; for instance, to relax a nervous patient in a matter of minutes 9. Dentists have to use positive suggestions managing patients. Words or actions that inspire trust in the dentist will relieve the patient’s anxiety and fear. Informal hypnotic September 2020
methods include the use of utterances like “you will feel quite comfortable” or “you will like the results” and this can be a powerful technique of patient management. Suggestions can be categorized into two broad types: direct and indirect 11.
Hypnosis applied to dental practice: A review
References 1. Nicola A. Hypnosis in modern dentistry: Challenging misconceptions. Faculty Dental Journal 2015; 6 (4): 172-175.
Direct suggestion involves straightforward statements that are clearly understood by the hypnotic subject. An example would be: “don’t move your head because you won’t be able to before finishing.” Indirect suggestion uses indirectness in addressing the subject in a form of covert hypnotic statements. That is to say the subject is hypnotized without their knowledge.
2. Irina H, Barbara C, Andra C. Using Ericksonian Hypnosis Tech-
The above-mentioned example would be said during a conversation in this way: “well, you might not be able to move your head before finishing.”
4. Kroger, WS. Clinical and experimental hypnosis in medicine, den-
niques at Patients with Dental Problems. Procedia-Social and behavioral Sciences 2013; 84: 356-360. 3. Lance MR. Introducing clinical hypnosis to dentists: Special Challenges and Strategies. American Journal of Clinical Hypnosis 2019; 61: 276-289.
tistry, and psychology. Philadelphia, PA: Kluwer/Lippincott Williams & Wilkins. 2018 5. Lil N. The role of hypnotherapy in dental practice. Dental nursing 2013; 6 (4): 218-220. 6. Asma M. Review of clinical hypnosis in dentistry. Mod Res Dent 2017; 1(4): 59-60. 7. Patel B, Potter C, Mellor AC. The use of hypnosis in dentistry: A review. Dent Update 2000; 27: 198-202 8. Ramirez Carrasco A, Butron tellez Giron C, Sanchez Aramss O, Perdant Perez M. Effectiveness of hypnosis in combination with conventional techniques of behaviour management in anxiety/pain reduction during dental anesthetic infiltration. Pain research and management 2017; 1:1-5. 9. Singh et al. Hypnosis “A lost Art” in Dentistry A review. Rama Univ J Dent Sci 2017; 4(1):15-18.
10. Mark PJ. The neurophysiology of pain perception and hypnotic analgesia: implications for clinical practice. American Journal of clin-
Hypnosis has many uses within the dental field, ranging from simple relaxation of the anxious patient to complete analgesia for surgery. Clinical hypnosis can be an incredibly valuable tool in dentistry.
ical hypnosis 2008; 51(2): 123-148. 11. Yapko MD. Essentials of Hypnosis. New York: Brunner/Mazel Inc., 1995.
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5 Ways 3D Printing Has Revolutionized The Dental Industry 3D printing is a rapidly growing technology in numerous fields, especially in dental laboratories, all due to the new software, 3D scanners, additive technologies and postprocessing methods that increased efficiency and cost savings, to faster production speeds and improved quality to benefit not only doctors but also patients, to make their experience pleasing through the drop of the price, and save time, which is one of the little advantages that this technology brought with it to this industry.
Here are 5 ways in which 3D printing transformed the dental industry;
1. Improved Dental Product Quality technician. Achieving consistent and highquality dental products with so many potential sources of error are incredibly difficult and expensive. However, now with 3D printers, even delicate structures can easily be created as the component is built up layer-by-layer and the process is controlled by a software program.
When it comes to manufacturing dentures, 3D printing brings with it a whole host of points of interest. One of the greatest advantages is the improved qualities. Before, With traditional manual workflows, the quality of the finished products is highly dependent on the skills of a given
Compared to a plaster model, a 3D-model is a more stable, durable and precise alternative. The lines and edges on a 3D-model stay sharp without the dental technician having to worry about wearing them down. Compared to a milled model, a 3D-printed model has a more complex structure with a higher level of detail. Digital technologies simplify workflows, reduce the room for error, and the amount of labor required, resulting in time and cost savings on both the labâ&#x20AC;&#x2122;s and practiceâ&#x20AC;&#x2122;s side. September 2020
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Digital Dentistry 5 Ways 3D Printing Has Revolutionized The Dental Industry
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2. Dental Services are Faster and More Accurate With digital dentistry, the room for error is reduced and the automation reduces labor, resulting in time and cost savings for labs and practices all around the world, while Manual model-making is time-consuming while 3D printing allows for multiple appliances to be printed at once since the digital copy is received in minutes because it is sent electronically. The technician can start working as soon as the copy of the scanning arrives. Also, it provides a clean workplace for the technician, without having to deal with plaster or inhale grinding dust. Accuracy is also improved since 3D printers convert digital images into physical objects by printing 16-micronthick layers one on top of the other. Increased production capacity and more accurate end results benefit both dentists and patients.
3. Better Patient Experience As in all industries, clients always consider the important factor in any business, and the dental industry is no different, especially with the presentation of the new 3D printing technology in the industry. As a result, dental 3D printers create models of their patient’s problem areas in preparation for surgery, in order to help prepare themselves for an upcoming surgery reducing anxiety and increasing patient acceptance.
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In addition, Processes are generally faster as digital elements remove redundant steps, making the patient’s visit quicker and easier, besides that, the products themselves can be more aesthetically pleasing and treatments more accurate and less invasive, all of this help to make the client experience way pleasant than it was before, which the patient had to come over a month regularly, and results won’t even be as expected, as a result, the patient end up not happy or satisfied with the outcome.
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Saving money is one of the biggest advantages that a 3D printer brought to the dental industry for both patients and doctors, in another word, it’s truly a win-win because the cost of running a dental laboratory can reach $100,000 per year. Compare this to the one-time cost of
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5 Ways 3D Printing Has Revolutionized The Dental Industry
about $20,000 for a top-model 3D printer, which includes a starting supply of materials. Ongoing materials factor into the lifetime cost, but it’s far lower than running a dental lab. In addition to that, employing skilled staff to produce dental implants presents a considerable ongoing investment. In all, depending on the volume of work. However, Dental professionals aren’t the only ones saving time and money from dental 3D printers. The lower costs of materials and labor mean reduced prices for their patients as well, And with the increased accuracy and speed of dental 3D printers, the amount of return visits needed by patients is significantly reduced. It is estimated that the overall price of dental care could go down by 80 percent depending on what is needed. In addition, the accuracy level of the work is much higher meaning happier patients.
5. Work in House Dentists are able to bring the work of dental labs in-house. They are extremely user-friendly, which means no more paying for dental lab labor. Instead, the dentists themselves are usually able to operate the printers, in order to quickly and easily produce crowns, molds, models, bridges, and anything else that would otherwise be produced by lab technicians. However, Most dental practices don’t know the importance of them, which leads them to spend over $100,000 a year on lab work alone, due to material and labor costs. As for dentists who outsource their lab work, shipping and labor costs coupled with long wait times add up to astronomical amounts of money spent in the long run, which doesn’t benefit neither dentists nor patients because the amount of time and money those labs cost that’s why 3D printers are more and more used as they allow the dentist to work directly by himself. While most industrial 3D printers have prices upwards of $20,000-100,000+ dollars, dental professionals are able to get professional desktop 3D printers for about $6,000 and under, without sacrificing printing speeds, or imaging accuracy. The medical industry believes that this technology can create a revolution if directed properly. It allows groundbreaking innovations that can lead medical science to scale exponentially. These are just some examples of the wider scope of changes that digital dentistry and 3D printing processes are bringing to the dental industry. There’s no doubt that it’s definitely the future of the dental industry, it offers many opportunities and a lot of new exciting ways to make life easier for patients, dentists, and dental technicians.
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Reciproc Blue: The new generation of reciprocation The use of mechanical instruments in reciprocation with unequal forward and reverse rotation was introduced in 2008 1. Reciproc® series of instruments (VDW GmbH, Munich, Germany) were designed specifically for this type of motion 2. Canal preparation is done in the majority of the canals with only one Reciproc instrument without any prior hand filing and without the creation of a glide path 3. Reciproc® blue (VDW GmbH, Munich, Germany), a thermally treated nickel-
titanium instrument, is an improved version of the original Reciproc® 4. It has an increased resistance to cyclic fatigue and a greater flexibility 5. The present article describes the use of Reciproc® blue instruments for the canal preparation without any prior instrumentation and without a glide path. Only one instrument is needed to enlarge the majority of the canals to an adequate size and taper regardless of the size of the canal, the degree of canal curvature or canal calcification.
The Reciproc® blue system includes 3 instruments, similar to the original Reciproc® series, the Reciproc® blue 25, Reciproc® blue 40 and Reciproc® blue 50, matching paper points, matching gutta-percha cones, and matching gutta-percha obturators (GuttaFusion®) (Fig. 1a-d). The Reciproc® blue instruments have an S-shaped cross-section (Fig. 2). The three instruments have a regressive taper starting at 3 mm from the tip. The Reciproc® blue 25 has a diameter of 0.25 mm at the tip and an 8% (0.08 mm/mm) taper over the first 3 mm from the tip. The Reciproc® blue 40 has a diameter of 0.40 mm at the tip and a 6% (0.06 mm/mm) taper over the first 3 mm from the tip. The Reciproc® blue 50 has a diameter of 0.50 mm at the tip and a 5% (0.05 mm/mm) taper over the first 3 mm from the tip. Fig. 1
D September 2020
The instruments are used in conjunction with a motor (Fig. 3a, b) at 10 cycles of reciprocation per second. The motor is programmed with the angles of reciprocation and speed for the three instruments. The values of the forward and reverse rotations are different.
Reciproc Blue: The new generation of reciprocation
When the instrument rotates in the cutting direction (forward rotation) it will advance in the canal and engage dentine to cut it. When it rotates in the opposite direction, the reverse rotation (smaller than the forward rotation) the instrument will be immediately disengaged. The end result, related to the forward and reverse rotations, is an advancement of the instrument in the canal. The angles set on the reciprocating motor are specific to the Reciproc blue instruments. They were determined using the torsional properties of the instruments. Fig. 3A
Technique The technique is simple. In the majority of the canals, only one ReciprocÂŽ blue instrument is used in reciprocation to complete the canal preparation without the need for initial canal negotiation with small hand files or creating a glide path.
Recently, a reciprocating contra-angle has been introduced (Fig. 3c) 6. It has been shown to be as safe as the reciprocating endodontic motor 7. In addition, it offers a significant cost advantage. The contra-angle can be attached to either the air-driven or electrical micromotor of the dental unit.
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Reciproc Blue: The new generation of reciprocation
The use of drills or orifice openers is not required prior to starting the canal preparation with the ReciprocÂŽ blue instrument.
The selection of the appropriate Reciproc® blue instrument is based on an adequate radiograph (Fig. 4). If the canal is partially or completely invisible on the radiograph, the canal is considered narrow and the Reciproc® blue 25 is selected (Fig. 5a, b).
In the other cases, where the radiograph shows the canal clearly from the access cavity to the apex, the canal is considered as relatively large (Fig. 6a-c). A size 30 hand instrument is inserted passively to the working length (verified with an apex locator) with a gentle watch winding movement but without a filing action.
If the file reaches the working length, the canal is considered large; the Reciproc® blue 50 is selected for the canal preparation. If the size 30 hand file does not reach the working length passively, a size 20 hand file is inserted passively in the canal. If it reaches the working length, then the canal is considered medium in size and an Reciproc® blue 40 instrument is used for the canal preparation. If the hand file 20 does not reach the working length passively, the Reciproc® blue 25 is selected. Before commencing preparation, the length of the root canal is estimated with the help of an adequately exposed and angulated pre-operative radiograph. The silicone stopper on the instrument is set at two thirds of that length. Reciproc® blue is introduced in the canal with a slow in-and-out pecking motion without pulling the instrument completely out of the canal.
The amplitude of the in- and out- movements (pecks) should not exceed 3-4 mm. With this flexible instrument, only very light pressure should be applied. The instrument will advance easily in the canal in an apical direction and should not be forced forward. After 3 pecks, or if resistance is encountered before the 3 pecks are completed, the instrument is pulled out of the canal to clean the flutes. A #10 hand file is used to check patency to two thirds of the estimated length. The canal is copiously irrigated. The Reciproc® blue instrument is then re-used in the same manner until it reaches the two thirds of the estimated length.
Reciproc Blue: The new generation of reciprocation
Courtesy of Dr. Gustavo De-Deus
The canal is irrigated and a #10 file is used to determine the working length with the aid of an apex locator and a radiograph. After that Reciproc® blue is used as described until it reaches the working length. As soon as the working length is reached, the instrument is withdrawn from the canal to avoid an unnecessary over-enlargement. The Reciproc® blue instrument can also be used with a brushing motion against the walls of wide canals. With continuous rotation it is necessary to create a glide path in order to minimize instrument binding and the risk of fracture (8, 9). Glide path is usually created with engine-driven instruments which presented a fracture rate as high as 26% 10, 11 (Fig. 7). Binding is less likely to occur when an instrument is used in reciprocation with unequal forward and reverse angles and with the limited in- and out- movements as described earlier 12.
However, just as with any continuous rotary system, it is possible to use the Reciproc® blue instruments after creating a glide path with a new reciprocating instrument, the R-Pilot® (VDW GmbH, Munich, Germany) (Fig. 8) specifically designed for this purpose. The instrument is used with the same reciprocating motor/contra-angle and at the same settings. The reciprocating glide path R-Pilot® performed better than rotary glide path instruments in regard to cyclic fatigue resistance 16 and centring ability 17. A glide path should be created with the R-Pilot® prior to using the Reciproc® blue in some canals, or for example when the Reciproc® blue instrument stops advancing in the canal or if advancement becomes difficult. Fig. 8
Therefore, a glide path is not required in the majority of the canals when instruments are used in this manner. It has been shown the incidence of fracture of Reciproc blue® instruments used without a glide path is very low 13,14 in comparison to rotary instruments 15.
In these canals, apical pressure should not be exerted on the Reciproc® blue file. September 2020
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The instrument should be removed from the canal and the canal should be irrigated. Patency is established to the working length with a #8 file and the R-Pilot® instrument is used to create a glide path to the working length. The Reciproc® blue instrument can then be used safely to the working length. The R-Pilot® instrument is used with the same reciprocating motor and settings, with a light and short pecking motion similar to the use of Reciproc® blue. A glide path can also be created with the R-Pilot to reduce the stresses on the Reciproc® blue instruments for example in canals with difficult access or canals presenting with a curvature in their coronal third (Fig. 9a, b).
Reciproc Blue: The new generation of reciprocation
If an increased apical enlargement is required, a larger Reciproc® blue instrument, or a nickel-titanium hand or rotary instrument can be used. The access to the orifices of some canals such as the mesio-buccal orifice of a mandibular second molar may be difficult. Due to the thermal treatment of the Reciproc® blue files, it is safe to gently pre-curve their tip in order to make the access to these orifices easier.
Summary In summary, the use of instruments in reciprocation with unequal forward and reverse rotations and with a limited pecking motion has been shown to be very safe with a fracture rate ranging from 0 to 0.2% 13, 14, 18 compared to continuous rotation with a fracture rate ranging from 0.7 to 20% 15. The majority of the canals can be shaped with only one Reciproc blue instrument without any prior instrumentation and without a glide path 13, 14, 18. In contrast to canal preparation with rotary instruments, initial canal negotiation with small hand files sizes 06-15, a challenging step in narrow canals associated with a high incidence of procedural errors 19, 20 (Fig. 10 a-c), is not required in most canals prior to the use of Reciproc blue instruments.
Courtesy of Dr. Evaldo Rodrigues
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Endodontics Reciproc Blue: The new generation of reciprocation
Courtesy of Dr. Evaldo Rodrigues
Courtesy of Dr. Evaldo Rodrigues
These instruments have an increased flexibility and fatigue resistance, and are very safe for the preparation of severely curved canals 21, 22 (Fig. 11 a-c, 12 a-c)
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Reciproc Blue: The new generation of reciprocation
Courtesy of Dr. Thodoris Mandas
Courtesy of Dr. Thodoris Mandas
Courtesy of Dr. Thodoris Mandas
Reciproc Blue: The new generation of reciprocation
References 1. Canal preparation using only one Ni-Ti rotary instrument: prelim-
13. Performance of Reciproc Blue R25 Instruments in Shaping the
inary observations. Yared G. Int Endod J 2008 Apr;41(4):339-44.
Canal Space without Glide Path. De-Deus G, Cardoso ML, Belladonna FG, Cavalcante DM, Simões-Carvalho M, Souza EM, Lopes RT,
Silva EJNL. J Endod. 2019 Feb;45(2):194-198
3. The ability of the Reciproc R25 instrument to reach the full root
14. Mechanical properties and metallurgical features of new and ex
canal working length without a glide path. De-Deus G, Arruda TE,
vivo used Reciproc Blue and Reciproc. Generali L, Puddu P, Borghi
Souza EM, Neves A, Magalhães K, Thuanne E, Fidel RA. Int Endod J
A, Brancolini S, Lusvarghi L, Bolelli G, Consolo U, Pedullà E. Int En-
dod J. 2020 Feb;53(2):250-264.
15. Fracture of nickel titanium rotary instrument during root canal treatment and re-treatment: a 5-year retrospective study. Alfouzan
5. Blue Thermomechanical Treatment Optimizes Fatigue Resis-
K, Jamleh A. Int Endod J. 2018 Feb;51(2):157-163.
tance and Flexibility of the Reciproc Files. De-Deus G, Silva EJ, Vieira VT, Belladonna FG, Elias CN, Plotino G, Grande NM. J Endod 2017
16. Cyclic fatigue resistance of R-Pilot, WaveOne Gold Glider, and
ProGlider glide path instruments. Keskin C, İnan U, Demiral M, Keleş A. Clin Oral Investig. 2018 Dec;22(9):3007-3012.
17. Microcomputed Assessment of Transportation, Centering Ratio, Canal Area, and Volume Increase after Single-file Rotary and Recip-
7. The impact of using a pneumatic contra-angle device on the lifes-
rocating Glide Path Instrumentation in Curved Root Canals: A Lab-
pan of M-Wire- and Blue-treated instruments. Silva EJNL, Vieira
oratory Study. Aydın ZU, Keskin NB, Özyürek T, Geneci F, Ocak M,
VTL, Gabina TTG, Antunes HDS, Lopes HP, De-Deus G. Clin Oral
Çelik HH. J Endod. 2019 Jun;45(6):791-796.
Investig. 2019 Feb;23(2):617-621 18. Comparison of the ability of Reciproc and Reciproc Blue instru8. In vitro study of the torsional properties of new and used ProFile
ments to reach the full working length with or without glide path
nickel titanium rotary files. Yared G. J Endod 2004 Jun;30(6):410-2.
preparation. Adıguzel M, Tufenkci P. Restor Dent Endod. 2018 Nov 1;43(4):e41
9. In vitro assessment of torque and force generated by novel ProTaper Next Instruments during simulated canal preparation. Pereira
19. Ledge formation: review of a great challenge in endodontics. Ja-
ES, Singh R, Arias A, Peters OA. J Endod 2013 Dec;39(12):1615-9.
farzadeh H, Abbott PV. J Endod. 2007 Oct;33(10):1155-62.
10. Scouting Ability of 4 Pathfinding Instruments in Moderately
20. Instrument fracture in root canals - where, why, when and what?
Curved Molar Canals. De-Deus G, Belladonna FG, Souza EM, et al. J
A study from a student clinic. Ungerechts C, Bårdsen A, Fristad I. Int
Endod. 2016 Oct;42(10):1540-4.
Endod J. 2014 Feb;47(2):183-90.
11. Comparative evaluation of the effectiveness and fracture rate of
21. Shaping ability of reciprocating single-file systems in severely
three pathfinding nickel-titanium rotary instruments, Mtwo, OneG,
curved canals: WaveOne and Reciproc versus WaveOne Gold and
and ProGlider, in mechanically negotiating moderately curved mo-
Reciproc blue. Bürklein S, Flüch S, Schäfer E. Odontology. 2019
lar canals to the full working length. Neelam U Jaiswal, Shivkumar P
Mantri, Bonny Paul, et al. J Cons Dent May-Jun 2019;22(3):260-265. 22. Changes in Geometry and Transportation of Root Canals with 12. Elastic limits in torsion of reciprocating nickel-titanium instru-
Severe Curvature Prepared by Different Heat-treated Nickel-tita-
ments. Ha JH, Kim SR, Versluis A, Cheung GS, Kim JW, Kim HC. J
nium Instruments: A Micro-computed Tomographic Study. Filizola
Endod. 2015 May;41(5):715-9.
de Oliveira DJ, Leoni GB, da Silva Goulart R, Sousa-Neto MD, Silva Sousa YTC, Silva RG. J Endod. 2019 Jun;45(6):768-773.
Digital endo assistance fully automated CanalProTM Jeni Endo Motor navigates through treatment Autonomous driving, operations using a robot arm, computer-aided design (or CAD for short) - there is hardly an area in which humans can now not be assisted by an electronic co-pilot. The more complex the application, the more useful the support via algorithms. Endodontic treatment is no exception and also requires the utmost precision and reliability. Endo specialists therefore increasingly rely on the fully automatic navigation of the latest endo motors.
the variable file movements at millisecond intervals by constantly regulating rotational movement, speed, torque and file stress. The endo motor adapts to the individual root canal anatomy and guides the preparation step by step. Integrated length measurement is available at the same time. The outstanding comfort and level of safety that Jeni delivers during preparation, is unmatchable.Jeni recognises the risk of a potential fatigue fracture of the file and informs the dentist with an acoustic signal that a file change is necessary.
Electronically controlled preparation
The Canal Pro Jeni is also very familiar with the common endodontic irrigation protocol: the device records mechanical reprocessing progress and notifies the chairside dentist or assistant, acoustically, when and how often irrigation should be performed between file changes. This is incredibly important when the longterm success of treatment depends largely on thorough irrigation of the prepared root canals.
The internationally recognised, leading dental specialist, COLTENE, has achieved a breakthrough with a virtually-self-propelled endo motor: the fully automatic CanalProTM Jeni, named after its developer Prof. Dr. Eugenio PedullĂ , finds its way through the root canal autonomously and thus accompanies mechanical and chemical preparation step by step. Via touch screen, the Jeni connects directly to the selected NiTi file system such as the HyFlex CM or EDM or the files of MicroMega from the COLTENE group of companies. What is new is that the user can work forwards continuously from coronal to apical applying only slight pressure and the motor decides independently on the progress of movement. For this purpose, the Jeni assistance system uses complex algorithms and controls
Synchronised endo instruments With the CanalProTM Jeni Motor, the COLTENE group of companies has added another useful tool to its range of ideally matched endodontic instruments and dental materials. COLTENE has always worked closely with international scientists, practice owners, key opinion leaders and dental teams to design and realise concrete solutions for everyday treatment routines. On www.coltene.com or one of the innovation leaderâ&#x20AC;şs social media channels, interested dentists can find out about the latest trends and ideas from the dental world. In addition, COLTENE also offers a wide range of training courses and practical workshops to ensure the optimal use of technical aids and digital assistants. This way, even endo beginners will be able to achieve competent and efficient preparation after only a short time.
Dental Prevention Ziad Al Aasali General Manager of EMS Middle East, Africa and India
Dental Prevention Assistants are Pros – not Amateurs Interview with Ziad Al Asali Signs of a certain easing in the midst of the corona crisis are on the rise. Many practices are successively ramping up their operations, while others are even back to working at almost full capacity. We wanted to hear from Ziad Al Asali, General Manager of EMS IMEA Region, how prevention can look in corona times and ways in which EMS supports its customers. Mr. ASALI, the corona crisis has hit the entire sector hard, starting with dentists and laboratories, but also industry and trade. Particularly the area of prevention was the first to be identified as «dispensable» and shelved as «unnecessary treatment». Can preventive treatments be dispensed with in the long term?
Ziad Al Asali: The importance of prevention has increased considerably during the corona crisis. This is not the time for us to revert to curative dentistry. Especially now, good oral hygiene and a healthy oral cavity is more important than ever. A healthy oral cavity is always a better immune barrier than a sick one. There has never been dentistry without a risk of infection. Those who choose a dental profession work at close quarters with the oral cavity and are aware of the risk of infection. Since infection prevention measures have always been a matter of course in dentistry, it is no surprise that only a small number of infections in Wuhan occurred in dentistry. The existing standard measures for infection protection according to the Robert Koch Institute (RKI) guidelines form the basis for infection protection, especially oral antisepsis and correct
EMS brochure «COVID-19 - Aerosols at the Dentist»
GUIDED BIOFILM THERAPY CARIES AND PERIO PREVENTION AND MAINTENANCE
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PROBE AND SCREEN EVERY CLINICAL CASE Healthy teeth, caries, gingivitis, periodontitis Healthy implants, mucositis, peri-implantitis Start by rinsing with BacterX® Pro mouthwash
HEALTHY PATIENT = HAPPY PATIENT Schedule recall frequency according to risk assessment Ask your patient if he or she liked the treatment
MAKE BIOFILM VISIBLE Highlight to patients the disclosed biofilm and their problematic areas with EMS Biofilm Discloser The color will guide biofilm removal Once biofilm is removed, calculus is easier to detect
MAKE YOUR PATIENT SMILE Do a final check for remaining biofilm Ensure calculus is fully removed Accurately diagnose caries Protect with fluoride
06 PIEZON® PS
RAISE AWARENESS AND TEACH Emphasize prevention Instruct your patients in oral hygiene EMS recommends Philips Sonicare toothbrushes, interdental brushes and Airfloss Ultra
REMOVE REMAINING CALCULUS Use the minimally invasive EMS PIEZON® PS Instrument supra- and subgingivally up to 10 mm Clean > 10 mm pockets with mini curette Use EMS PIEZON® PI Instrument around implants up to 3 mm subgingivally and on restorations
REMOVE BIOFILM IN >4 TO 9 MM POCKETS Use AIRFLOW® PLUS Powder on natural teeth in deep pockets and root furcations and on implants Use new and slimmer PERIOFLOW® Nozzle
ems-dental.com Copyright: 2018 EMS. Electro Medical Systems.
REMOVE BIOFILM, STAINS AND EARLY CALCULUS Use AIRFLOW® for natural teeth, restorations and implants Remove biofilm supra- and subgingivally up to 4 mm using AIRFLOW® PLUS 14 μm Powder Also remove biofilm from gingiva, tongue and palate Remove remaining stains on enamel using AIRFLOW® CLASSIC Comfort Powder
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MAKE ME SMILE.
Dental Prevention Assistants are Pros – not Amateurs: Interview with Ziad Al Asali
suction. There is no comparative study showing any difference in aerosol formation between suction in fourhanded and two-handed dentistry. Personally, the following also annoys me in the discussion about the one-practitioner technique: Dental prevention assistants are pros – not amateurs. They are well trained and extremely experienced in dealing with infections and aerosols.
How do you perceive the reactions to the current situation among your customers in the practices and their patients? The EMS brochure «COVID-19 - Aerosols at the Dentist» provides concise recommendations for dental practices. Download at https://www.emsdent.com/DZW0520 Concomitant dental diseases represent a further risk factor in the case of infection with the coronavirus.
Following the many contradictory statements about the nature and scope of dental treatments and their respective risk of infection, it is now becoming apparent that dentists as an occupational group have generally always acted professionally in dealing with aerosols. Given heightened hygiene and precaution, are preventive treatments also conceivable again in your opinion?
Ziad Al Asali: The reactions are extreme. Especially for practice owners, but also for their prevention staff, there is a considerable drop in income and earnings. For practice owners who are debt financed as a result of founding a new practice or expanding, a large chunk of their practice refinancing has collapsed. Without successful prevention work, the dental practice cannot survive.
What GBT pros say To what extent can EMS support dentists and specialists in restarting the important field of prevention? Ziad Al Asali: In the GBT protocol, one of the first measures is the patient gargling and mouth rinsing with CHX. Here we discovered that COVID-19 viruses are not reliably destroyed with CHX. This is why we developed a new mouth rinsing solution, ViruProX, in our exclusive powder manufacturing plant, which we recommend alongside the current RKI guidelines. The main component of ViruProX is 1.5 percent H₂0₂.
Mr. ASALI, how does EMS support its GBT users beyond that? Ziad Al Asali: In order to make our customers› decision to return to GBT easier, we have worked with practitioners and scientists to develop a compact recommendation for dealing with aerosols containing COVID-19, which we are already communicating to our customers.
Mr. Asali, how do you see the «New Normal» in prevention? Ziad Al Asali: For me, the «New Normal» in preventive dentistry is and remains EMS Guided Biofilm Therapy, supplemented by our recommendation arising from COVID-19 for dealing with aerosols at the dentist. In one sentence: GBT practices stand for success, quality and patient satisfaction. Representative for the reactions of the users in prevention, here is a statement by Brigitte Schoeneich, graduate dental hygienist, longstanding president of the
important Swiss Dental Hygienists Association, and GBT trainer: «More than 50 percent of patients in our practice are canceling prevention appointments or requesting postponement. They only want to come back when GBT – Guided Biofilm Therapy – which is technologically based on Airflow and Piezon, is in use again. The patients consider regression into outdated methods of prevention with scratching and sanding as unpleasant and painful – and stay away. Due to the restrictive guidelines, the quality of my work suffers enormously, and I am no longer able to meet my claim to offer patients the best possible therapy. I even know colleagues who now refuse to work with hand instruments.»
Ziad Al Asali: Modern dentistry has never existed without aerosols. Over 90 percent of dental applications involve aerosols – turbines, high and low speed handpieces and contra-angles, multifunctional syringes, sonic, ultrasonic and powder-water jet devices. The recommendations from the professional organizations to avoid aerosol-generating applications only ever related to prevention, because a blanket ban (on aerosol-generating applications) would be tantamount to a ban on the profession.
For more information about this topic, visit EMS: www.ems-dental.com
THE RACE LEGACY SAFE. EFFICIENT. SOFT CONTROL.
SAFE. EASY. MINIMALLY INVASIVE.
Restorative Dentistry Dr. Oxana Naidyonova, Karaganda, Kazakhstan
Endocrown restoration made of proven VITABLOCS feldspar ceramic A full crown preparation of deeply damaged teeth often results in the loss of large parts of the tooth walls, and, as a result, leads to further weakening of the tooth substance, as well as loss of retention. For the greatest possible preservation of natural tooth substance, a defect-oriented procedure using endocrowns is therefore recommended. In this case documentation, the VITABLOCS Mark II feldspar ceramic (VITA Zahnfabrik, Bad SĂ¤ckingen, Germany) was processed for the time-saving and economic production of such a crown. The worldâ&#x20AC;&#x2122;s first CAD/CAM material has proven itself millions of times since its first clinical use over 30 years ago. Clinical studies show a survival rate of 99.6% for endocrown restorations made of feldspar ceramic, after an observation period of seven years. Dr. Oxana Naidyonova explains her process below.
Fig. 1: Initial situation: Tooth 34 was severely damaged. Gingival tissue had overgrown into the cavity.
Fig. 2: Status following revision, pin setting and build-
Assessment and pretreatment A 48-year-old female patient came to the practice because tooth 34 was fractured and had previously been classified as not worth preserving by another practitioner. The clinical inspection showed an extensive disto-oral defect. The gingival tissue had overgrown into the cavity. X-rays showed an insufficient root canal filling.
Fig. 3: Care was taken during the preparation not to leave any sharp edges in the cavity.
Since a full-crown preparation would have resulted in a loss of the vestibular and mesial wall portions of the tooth, the practitioner opted for an endocrown made of VITABLOCS Mark II.
Tooth 34 was constructed with composite after a gingivectomy with laser, and a revision treatment was carried out. September 2020
Preparation and intraoral scan Before the preparation, the tooth shade 2M2 was determined using the VITA Toothguide 3D-MASTER (VITA Zahnfabrik, Bad SĂ¤ckingen, Germany), and the appropriate blank was selected.
Fig. 7: The minimum layer thicknesses were maintained in the construction of the restoration.
CAM and finalization
Fig. 4: The remaining cavity walls were shortened only occlusally.
A glass fiber pin was adhesively introduced for additional retention of the subsequent composite structure. During the preparation, the walls were merely shortened and a groove was created in the defect area. Sharp edges in the cavity were consistently rounded off.
The endocrown was then digitally designed and fabricated from VITABLOCS Mark II with the My-Crown Mill grinding unit (FONA Dental, Bratislava, Slovakia). After separation from the attachment, the restoration was tried in and then gently finalized with a fine diamond.
Fig. 8: The virtual endocrown in the CAD software from the occlusal view.
Fig. 5: After the intraoral scan, the preparation margin was determined.
Prior to the intraoral scan, the proximal caries on tooth 34 could be mesially and minimally invasively treated with composite, thanks to its good accessibility. Fig. 9: The construction in the lingual view.
This was followed by the characterization of the fissures with VITA AKZENT Plus EFFECT STAINS (ES06, rust red) and the final glaze.
Fig. 6: The habitual intercuspation was transferred with a vestibular scan.
Since a reliable adhesive bond to the tooth substance is a key component of long-term clinical success, a rubber dam was inserted to ensure freedom from contamination and absolute dryness.
Endocrown restoration made of proven VITABLOCS feldspar ceramic
Conditioning and integration The feldspar ceramic was then etched with hydrofluoric acid to create a microretentive etch pattern and then silanized. The cavity was conditioned with phosphoric acid and an adhesive. For adhesive bonding, the composite Micerium (Micerium, Avegno, Italy) in the shade UD2 was heated to make it flowable for insertion.
Fig. 12: No transition between the restoration and the tooth can be seen from the vestibular view.
Fig. 10: The VITABLOCS Mark II clamped in the grinding unit.
After light-curing and removal of composite residues, the restoration was well integrated into the natural tooth structure, thanks to its outstanding light-optical properties.
Fig. 11: The feldspar ceramic restoration during the clinical try-in.
Fig. 13: The occlusal view of the fully adhesively integrated endocrown.
Fig. 14: Result: The highly esthetic integration of the restoration at the time of follow-up after six months.
A CATASTROPHIC SITUATION More than 200 dead and 6,000 injured. On August the 4th, two gigantic explosions blew the city of Beirut, Lebanon, even though the country has been suffering, for several months, from a serious economic crisis aggravated by the Covid-19 epidemic. Two dental surgeons, who live and work on site, recount. On August 4, around 6 p.m., Gabriel Badr, 59, already left his office. “I was visiting my brother, three to four kilometers from Beirut,” he explains. He still heard the two powerful explosions that destroyed a whole part of the city. «It was apocalyptic,» he recalls. Fortunately, his relatives were not affected. His house and adjoining office, located about 600 meters from the port, suffered various damage. “All the glass doors and windows were smashed, the waiting room in my office was devastated; only my treatment room and my equipment were miraculously spared and remained intact, ”he summarizes. Nearby, Saint-Georges Hospital, one of the most famous in Beirut, has been «completely destroyed».
Devastated dental offices Joseph Ghoubril, 61, also feels he has escaped the worst. The walls of the polyclinic in which he practices with his son, an orthodontist like himself, and his daughter, who specializes in paro-implantology, are still standing. The walls but... «the doors, the glass surfaces, the electric curtains or the vinyl floor must be replaced.» We are really one of the lucky ones, he says. Of our four dental chairs, only one was hit. On the other hand, the office of one of his colleagues «is completely demolished». At the Faculty of Dentistry, Saint Joseph University, where he teaches, was badly affected and must undergo major repairs.
A major economic crisis... Today, the refurbishment of his premises has not been completed, but Dr Ghoubril has been able to resume his activity to ensure the follow-up of his patients. “Most of them only have a small amount to pay each month for their orthodontic care and can usually afford the cost,” he notes. For Dr Badr, the situation remains complex. While he too was able to resume his work, he mainly deals with emergencies. It must be said that this double explosion comes in the context of an economic crisis that has hit the country hard since October 2019. The Lebanese pound has considerably lost in value. The prices are soaring. Banks block accounts and the Lebanese can hardly withdraw money, even if they have savings. “Faced with this, some patients postpone their care for several months and, in particular, their dental care,” explains Dr Ghoubril. In Beirut, «with winter approaching, the urgency for them today is rather to repair their houses» continues his colleague.
...and the impact of Covid-19! In this context, some dental surgeons are still wondering how they will be able to rebuild their practices. Not to mention that Lebanon was not spared by the pandemic linked to Covid-19. «Some colleagues, close to retirement, have decided to close their practice permanently,» says Dr Badr. A decision that is not easy to make, because for their retirement, the self-employed have to rely mainly on their own savings... very often placed in the bank!
Infection prevention Shelly Miller, Professor of Mechanical Engineering, University of Colorado Boulder Shelly.Miller@Colorado.edu
How to use ventilation and air filtration to prevent the spread of coronavirus indoors The vast majority of SARS-CoV-2 transmission occurs indoors, most of it from the inhalation of airborne particles that contain the coronavirus. The best way to prevent the virus from spreading in a home or business would be to simply keep infected people away. But this is hard to do when an estimated 40% of cases are asymptomatic and asymptomatic people can still spread the coronavirus to others.
I am a professor of mechanical engineering at the University of Colorado Boulder.
Masks do a decent job at keeping the virus from spreading into the environment, but if an infected person is inside a building, inevitably some virus will escape into the air.
Once the virus escapes into the air inside a building, you have two options: bring in fresh air from outside or remove the virus from the air inside the building.
Much of my work has focused on how to control the transmission of airborne infectious diseases indoors, and Iâ&#x20AC;&#x2122;ve been asked by my own university, my kidsâ&#x20AC;&#x2122; schools and even the Alaska State Legislature for advice on how to make indoor spaces safe during this pandemic.
Itâ&#x20AC;&#x2122;s all about fresh, outside air The safest indoor space is one that constantly has lots of outside air replacing the stale air inside. In commercial buildings, outside air is usually pumped in through heating, ventilating and air-conditioning (HVAC) systems. In homes, outside air gets in through open windows and doors, in addition to seeping in through various nooks and crannies.
Simply put, the more fresh, outside air inside a building, the better. Bringing in this air dilutes any contaminant in a building, whether a virus or a something else, and reduces the exposure of anyone inside. Environmental engineers like me quantify how much outside air is getting into a building using a measure called the air exchange rate. This number quantifies the number of times the air inside a building gets replaced with air from outside in an hour.
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While the exact rate depends on the number of people and size of the room, most experts consider roughly six air changes an hour to be good for a 10-foot-by-10-foot room with September 2020
three to four people in it. In a pandemic this should be higher, with one study from 2016 suggesting that an exchange rate of nine times per hour reduced the spread of SARS, MERS and H1N1 in a Hong Kong hospital.
A well ventilated room will have around 800 ppm of CO2. Any higher than that and it is a sign the room might need more ventilation. Last year, researchers in Taiwan reported on the effect of ventilation on a tuberculosis outbreak at Taipei University. Many of the rooms in the school were underventilated and had CO2 levels above 3,000 ppm. When engineers improved air circulation and got CO2 levels under 600 ppm, the outbreak completely stopped. According to the research, the increase in ventilation was responsible for 97% of the decrease in transmission.
All of the air in a room should be replaced with fresh, outside air at least six times per hour if there are a few people inside.
Since the coronavirus is spread through the air, higher CO2 levels in a room likely mean there is a higher chance of transmission if an infected person is inside. Based on the study above, I recommend trying to keep the CO2 levels below 600 ppm. You can buy good CO2 meters for around $100 online; just make sure that they are accurate to within 50 ppm.
Many buildings in the U.S., especially schools, do not meet recommended ventilation rates. Thankfully, it can be pretty easy to get more outside air into a building. Keeping windows and doors open is a good start. Putting a box fan in a window blowing out can greatly increase air exchange too. In buildings that don’t have operable windows, you can change the mechanical ventilation system to increase how much air it is pumping. But in any room, the more people inside, the faster the air should be replaced.
Using CO2 to measure air circulation So how do you know if the room you’re in has enough air exchange? It’s actually a pretty hard number to calculate. But there’s an easy-to-measure proxy that can help. Every time you exhale, you release CO2 into the air. Since the coronavirus is most often spread by breathing, coughing or talking, you can use CO2 levels to see if the room is filling up with potentially infectious exhalations. The CO2 level lets you estimate if enough fresh outside air is getting in. Outdoors, CO2 levels are just above 400 parts per million (ppm).
CO2 levels can be used to estimate whether the air in a room is stale and potentially full of particles containing the coronavirus.
Air cleaners If you are in a room that can’t get enough outside air for dilution, consider an air cleaner, also commonly called air purifiers. These machines remove particles from the air, usually using a filter made of tightly woven fibers.
How to use ventilation and air filtration to prevent the spread of coronavirus indoors
They can capture particles containing bacteria and viruses and can help reduce disease transmission. The U.S. Environmental Protection Agency says that air cleaners can do this for the coronavirus, but not all air cleaners are equal. Before you go out and buy one, there are few things to keep in mind. The first thing to consider is how effective an air cleaner’s filter is. Your best option is a cleaner that uses a high-efficiency particulate air (HEPA) filter, as these remove more than 99.97% of all particle sizes. The second thing to consider is how powerful the cleaner is. The bigger the room – or the more people in it – the more air needs to be cleaned. I worked with some colleagues at Harvard to put together a
tool to help teachers and schools determine how powerful of an air cleaner you need for different classroom sizes. The last thing to consider is the validity of the claims made by the company producing the air cleaner. The Association of Home Appliance Manufacturers certifies air cleaners, so the AHAM Verifide seal is a good place to start. Additionally, the California Air Resources Board has a list of air cleaners that are certified as safe and effective, though not all of them use HEPA filters.
Keep air fresh or get outside
Both the World Health Organization and U.S. Centers for Disease Control and Prevention say that poor ventilation increases the risk of transmitting the coronavirus.
Crystal 1200 www.rolence.com.tw https://bit.ly/FBRolence
If you are in control of your indoor environment, make sure you are getting enough fresh air from outside circulating into the building. A CO2 monitor can help give you a clue if there is enough ventilation, and if CO2 levels start going up, open some windows and take a break outside. If you can’t get enough fresh air into a room, an air cleaner might be a good idea. If you do get an air cleaner, be aware that they don’t remove CO2, so even though the air might be safer, CO2 levels could still be high in the room. If you walk into a building and it feels hot, stuffy and crowded, chances are that there is not enough ventilation. Turn around and leave. By paying attention to air circulation and filtration, improving them where you can and staying away from places where you can’t, you can add another powerful tool to your anti-coronavirus toolkit.
Oral Health Campaign Survey: Orthodontics Markus Sebastian SVP & MD EMEA Region Align Technology
Q&A with Markus Sebastian 1. Tell us about the Align Oral Health campaign and what prompted you to start this campaign? The GCC region has seen steady progress towards extending the reach and support of healthcare services in the recent years, including dental. The UAE Government, in particular, has been a regional leader in implementing innovative initiatives to improve its citizensâ&#x20AC;&#x2122; lives and health, as part of its mission to make the country the happiest nation in the world under its National Agenda Vision 2021. A contributing factor in the UAE has been the introduction of mandatory insurance programmes. Dental cover, however, is not currently included within mandatory health insurance plans. At Align Technology, we strongly believe that oral health can play a key role as a preventative measure for other health issues. These may include heart disease, diabetes, the damage caused by smoking - all very prevalent in the region. As governments across the region work towards achieving their ambitious visions, we too have a duty to support these transformation goals within our sector, to serve patients better and achieve more efficient outcomes. We commissioned a YouGov survey to better understand the challenges facing oral hygiene in the region, and to provide
a context in which we can support a future where each and every personâ&#x20AC;&#x2122;s oral health is prioritised. By launching this campaign, our aim was to drive greater awareness of the role dental and orthodontic procedures play. We also wanted to collect and share objective insights into consumer trends that will contribute to the important conversations around accelerating future access to dental care, given its importance to a personâ&#x20AC;&#x2122;s overall health.
2. What are some of the key findings, which particularly stood out to you? The overarching finding of the research showed us that access to dental care within health insurance coverage, even the most basic of allowances, would encourage more people to regular dental visits. Through the survey results, we came to find that 89% of residents in the UAE believed dental care should be mandatory within their health insurance. We also found that more than half (55%) of the respondents surveyed in the UAE did not receive dental care when they needed it. This is despite 71% of respondents in the region reporting that they experienced a problem with their teeth or gums over the past year. Nearly two-thirds of UAE residents surveyed believed the main reason for this disparity was the cost, which acted as a leading barrier in receiving timely and proper dental care. September 2020
The survey results also highlighted that the dental and health community needs to do more to educate residents about the potential dangers of certain conditions and habits that are directly linked to poor oral health. From a more social perspective, the survey revealed that more than half of respondents (55%) have occasionally felt self-conscious because of poor oral health in the past year. People felt that poor oral hygiene would particularly affect their social interactions and their professional interactions.
When it comes to the region, The United Arab Emirates (UAE) and the Kingdom of Saudi Arabia (KSA), both have been regional leaders in promoting the importance of oral health and can be lauded for these efforts. I am happy to see that both countries have developed long-term development programs and have been so supportive of technological progress and innovation. the region along with these two nations are making significant strides in digitisation that the rest of the world is watching closely.
3. Tell us more about the implications of health insurance coverage and how having access to dental coverage can make a positive impact?
The speed of adoption of digital dentistry is accelerating, with more doctors introducing clear aligners and intraoral scanners in their practice, and more consumers than ever visiting doctors to get their teeth straightened.
We believe that there is still room to do more to educate patients about the potential dangers of such conditions and habits, by explaining their link to poor health. However, when dental cover in one’s overall health insurance only covers medical procedures, patients can potentially miss out on regularly checking on their dental health and benefiting from hygienic and even cosmetic procedures – such as scaling. With this in mind, our research indicates that offering UAE residents the access to dental insurance coverage will encourage more people to regularly visit their dentists and this will, in time, play a critical role in a patient’s long-term health.
4. How is Align Technology helping to drive digital innovation and how do you see our region doing in comparison to other markets? While digitisation will not replace the role of the specialist, we believe it has the power to support healthcare practices in the Middle East and beyond. Digital technology in the healthcare field – in the Middle East and globally – enables large amounts of data to be gathered, analysed and used to improve treatment modalities. Technology and innovation is at the core of Align as it enables the evolution of digital dentistry. We are dedicated to transforming lives by improving the journey to a healthy and beautiful smile. We believe that a better smile has the power to create a better future, so we create digital technology and experiences to help people move forward in life.
5. What role can healthcare practitioners play to help drive awareness of the importance of oral health for communities? We know that poor oral health may increase the risk of health of a patient’s overall wellbeing. Our survey shows we need to do more to educate our communities about the potential dangers of such conditions and habits, explaining their link to poor oral health. Primary-care physicians and general practitioners (GPs) can, as part of their general health care, promote and contribute to improved oral health care. Physicians establish early relationships with some dental patients and are a considered a trustworthy source. Right from informing their patients on the link between oral health and overall health to suggesting ways to promote oral hygiene and by referring patients to the dentist. While there were positive indications from the survey, including the fact that more than half (53%) of respondents said they’ve been to the dentist within the past year, it is clear that there is still work to be done to support a future where each and every person’s oral health is prioritised.
For more information about this topic, visit Align Tech: www.aligntech.com
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GBT as a solution for Clear Aligners
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The pharmacies No. 1 oral care brand in Switzerland for the treatment and prevention of irritations in the oral cavity TEBODONT, with tea tree oil, has already been recognized as a herbal alternative in the treatment of gingivitis and periodontitis by the Dental Profession all over the world. This is due to the clinically proven antimicrobial/fungicidal effects of tea tree oil and the excellent therapeutical results achieved with TEBODONT since the introduction in the market. The TEBODONT oral care products sooth and strengthen the gums, provide longlasting freshness and stop the formation of plaque and caries. TEBODONT is available as gel and spray for intensive treatment,
as mouthrinse for acute treatment and prophylaxis and as toothpaste and floss for daily oral hygiene. All the products do not contain alcohol and preserving agents and are suitable for long term treatment. Mouthrinse and toothpaste are available with and without fluoride. TEBODONT - The herbal alternative for optimal oral and dental hygiene. Effective. well tolerated and successful!
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«It’s in your hands» Infection Control
Professional hand hygiene is more important than ever! Responsibility for hygiene is literally “in our hands”, because hands are a major source of disease transmission. They can act as a vehicle for micro-organisms or as a source of infection if pathogenic germs multiply on the skin and are subsequently spread. For this reason, hand hygiene is the most important key factor in ensuring the prevention of infections in clinics, surgeries and laboratories. The Robert-Koch Institute recommends that you carry out hygienic hand disinfection before each treatment, after interrupting treatment, when changing your gloves and after completing treatment. These measures should be supplemented by washing your hands several times a day (when you blow your nose or go to the toilet, for example).
Using the correct techniques during hand disinfection, observing the prescribed reaction times and the quality of the disinfectant product are crucial factors in the success of cleaning and disinfection. The recommendations of the European Commission (CEN/EN 1500) stipulate the correct method for hygienic hand disinfection. The aim is for all of the hands and wrists to be disinfected when the hygiene measures are carried out. The recommended technique has six steps. Disinfection is only complete once the movements described in each step have been carried out several times and the prescribed rubbing time has expired. Both hands must be damp with disinfectant for the entire duration of the procedure.
This procedure requires discipline, time and effective products. After all, even the best disinfectant can only work if it is applied for long enough and in sufficient quantities. Depending on the product, reaction times for hygienic disinfection are between 30 and 60 seconds. For surgical disinfection, the hands must be washed for approx. 1 minute and then disinfected for 5 minutes (1.5 minutes with HD 410 from DÜRR DENTAL). Naturally, it’s difficult to accurately judge the required time during the stress of everyday surgery life unless you actually set a stopwatch. Another important consideration is that disinfectants must be applied to dry hands only. Wet hands will dilute the disinfectant and impair its effectiveness. Using too little disinfectant or not rubbing the product in properly can leave behind contaminated areas on the skin. The wearing of jewellery, watches and rings is absolutely forbidden during treatment, since the skin underneath them is difficult to disinfect. Last but not least, product quality is critical. Only disinfectants listed by the Association for Applied Hygiene in Germany (VAH) should be used. All DÜRR DENTAL hand disinfection products have VAH listings. Naturally, DÜRR DENTAL’S products are gentle on the skin, too. DÜRR DENTAL’S range thus comprises products which act reliably whilst protecting your skin. They include HD 410 perfume-free hand disinfectant with rehydrating components, HD 412 essential scentfree and colorant-free hand disinfectant (suitable for people with allergies), mild HD 435 cleansing lotion and pleasant-smelling HD 440 care lotion for stressed and sensitive skin. DÜRR DENTAL even offers contactless options for product application with the Touchless universal dispenser – a sensor dispenser for 500 ml and 1 l bottles. A dispensing station for the Touchless universal dispenser was launched in July 2020. The station can be set up as a mobile unit, making it ideal for areas in which wall-mounting is not possible. Website: www.duerrdental.com
Minimally Invasive Surgery in 2020 The First Live Webinar organized by Dental News was presented by the leading speakers and panelists in the world of dentistry on July 28th, 2020, with more than 1000 registered dentists and specialists from around the world. The Topic of this Webinar was â&#x20AC;&#x153;Minimally Invasive Surgery in 2020â&#x20AC;?, with Prof. Alain Romanos as main speaker. After the presentation, our international panelists: Dr Arwa Alsayed, Dr Emad Salloum, Dr Muna Abbadi, Dr Bassam Rabie, Dr Luis Bessa discussed the topic and answered the questions asked by the participants.
Abstract We live in a world where patients who will undergo surgery prefer to have less pain, swelling & bleeding. This should be a priority for the dental surgeon as well, in addition to being predictable with minimum risk of complications. This lecture will focus on the use of the Piezo surgery device that can be used for
bone surgery in a variety of dental surgical specialties. The advantage of piezosurgery is that it can precisely cut hard tissue, while precluding injury to soft tissue. Minimal heat is generated during cutting, thus maintaining vitality of adjacent tissue. It provides substantial improvement in dental/implant surgery, sinus lift & bone graft procedures
Speakers Dr. Luis Bessa has graduated from ISCS-N
(Instituto Superior de Ciencias da Saude do
University with honour in 1989. In 1993 She
Norte) in 2008. As an oral surgeon he has
did training in Periodontology at Dalhousie
a strong focus on minimally invasive ridge
University in Halifax - Canada. In 1996
she obtained a Master of Dental Implants
He is also part of several researches on Dr Luis Bessa
biomaterials and blood concentrates.
from the University of Toronto in Toronto Dr Arwa Alsayed
Canada - she developed a new design for
Dr. Luis Bessa is the clinical director of the WHITE CLINIC in
the Endo-Pore dental implant system and won the prize of the
Porto, Portugal, and the head of the Oral/Reconstructive Surgery
best thesis in Toronto for that year. In 2001 She obtained a second
Department, where he practiced advanced digital dentistry
Master degree in advanced clinical training in Periodontology
protocols to enhance the outcome of the treatments.
and Dental Implant from Eastman Dental Institute at University
College London in UK - she graduated with distinction. In 2009
@northeducation where he teaches his philosophy of work
she became the chief editor of the dental section at the Saudi
during the one-year clinical residence program and promotes
Medical Journal. In 2010 she was awarded the King AbdulAziz
several hands-on courses with top international speakers.
First Medal Prize at the Kingdom of Saudi Arabia for discovering gene polymorphism in drug-induced gingival hyperplasia in kidney transplant patients. In 2013 she obtained the fellowship of
Dr. Salloum Graduated from Dental School
the American College of Dentists from New Orleans, USA.
Damascus University in 1981, where he completed his residency program in Oral
Dr Emad Salloum
& Maxillofacial Surgery in 1986. He also
Dr. Muna Saed A.Abbadi has been working
attended an extern fellowship training at
as periodontist at Academic Specialized
Emory University and Emory clinic 1989,
Dental Center, Jordan.
She is the member of various associations
He is also a Diplomate of ICOI, a board member of Syrian
to her credit namely Jordanian Dental
Association of Oral & Maxillofacial Surgery, and editorial board member of the Syrian Association of Implant Dentistry, Dr.
Association - GDP, DGZI German association Dr Muna Abbadi
Salloum is an international Ambassador for ICOI, and Ambassador
for Implantologists, International Group for Oral rehabilitation
of Digital Dentistry Society. Dr. Salloum has been lecturing in
(IGOR) and many more. She has graduated along with a Master
several regional and international conferences and published
Program in Periodontology from Jordan University of Science
several clinical studies. He is a chief surgeon and director of
and Technology, Irbid, Jordan.
Salloum Dental Clinic and training center.
Diplomat International Congress of Oral Implantologists.
Continuing Education Dept. Tufts University, Dr Bassam Rabie
Periodontics Dept. Milan University, Italy. 2007. Visiting lecturer, Periodontics Dept. Harvard University, USA. 2010. Visiting lecturer LSU Luisiana State University USA. Visiting lecturer, Dental School of Sharjah University, United Arab Emirates. 2009 Owner ONE Dental&Facial Concept EGYPT-PORTUGAL
The Carotta Technique: easy, safe, predictable Webinar
A Minimal invasive bone augmentation without biomaterials As part of the Webinar Series organized by Dental News, another successful Webinar happened on Thursday the 26th of August, 2020, featuring some of the most prominent speakers and panelists in the world of dentistry, with more than 600 registered dentists and specialists from around the world. The Topic of this Webinar was “THE CAROTTA TECHNIQUE: EASY, SAFE, PREDICTABLE – A Minimal invasive bone augmentation without biomaterials”, with Prof. Charles Khoury as main speaker. After his presentation, our international panelists: Dr. Nikos Krompas, Dr. Philip L. Keeve, Dr. Pierre Keller, Prof. Bach Le, Prof. Antoine Khoury discussed the topic and answered the questions asked by the participants.
Abstract There are different ways and techniques for the reconstruction of small bony defects with simultaneous implant insertion. Techniques using biomaterials in combination with resorbable or non resorbable membranes have been mostly published to treat such defects. As alternative to these expensive methods, the bone core technique or “Carotta
Technique” has been described as a minimal invasive method, which is safe and less expensive since it is based on the use of autogenous bone grafts harvested directly from the implant bed using special and easy devices and without any biomaterial or membranes. A 5 years prospective study published in 2018 demonstrate very low complications with a high success rate.
After 3 months
During this presentation Dr Khoury developed:
The “Carotta technique” is a minimal invasive bone augmentation technique that can be used:
1- An easy harvesting technique: autogenous from the implant bed preparation site with special kit (no need for second wound) 2- Safely fixed graft: with special fixation devices that doesn’t alter blood supply for optimal angiogenesis and remodeling 3- Predictable and reproducible results as confirmed in the 5 years prospective study.
1- Simultaneously with implant insertion (inside of the bony contour or housing) 2- By a general practitioner under certain conditions of hygiene and equipments 3With minimal cost by not using biomaterials and Membranes.
Speakers Periodontist training
Former Head of department of Oral Surgery,
St Joseph University. Beirut - Lebanon
of Periodontology (Head: A. Friedmann,
Coordinator of the implantology program,
Director of post-graduate diploma in Oral
1997 – 2020: Coordinator of the Society of
2013 – 2017 Postgraduate training in Oral
Arab Dental Faculties.
1997 – 2000: President of the Lebanese
Schellenstein, International Centre for Implant Dentistry and Oral
surgery (Head: F. Khoury, PhD), Olsberg, Germany.
2000 – 2017: Member of Arab Board of Medical Specializations.
Head of the Department of Periodontology, Private Dental Clinic
2004 – 2010: President of the continuing education committee of
Schloss. He has a Master of Science in “Implantology and Dental
the Lebanese Dental Association.
Surgery”, International Medical College. Graduated in 1983 from the Aristotelian
Completed his specialty training in Oral
University of Salonica, He was trained in
& Maxillofacial Surgery at Oregon Health
Implant Dentistry in 1991 in the Brånemark
Sciences University and is currently Clinical
Clinic at the University of Gothenburg,
Associate Professor at the Herman Ostrow
Sweden. He practices in Athens, Greece
School of Dentistry at USC. Dr. Le has
the past 35 years with his wife Dr. Nota
authored over 14 chapters in textbooks on
Stefanopoulou. The focus of his practice
bone regeneration and dental implants and
is concentrated in Implant Dentistry and
has published extensively in peer-review
Fixed Prosthodontics. In March 2013 in collaboration with Prof.
journals. He has been an invited speaker at numerous organizations
PI Brånemark, he established the ‘’ Brånemark Associated
including the AAOMS, Academy of Osseointegration, Academy
Osseointegration Center, Greece’ ABOCG as a certified center of
of Prosthodontics, American Academy of Esthetic Dentistry,
excellence in Osseointegration. Dr . Krompas is also involved for
American Academy of Implant Dentistry, American College of
more than 18 years in teaching dentists advanced concepts in
Prosthodontists, Greater New York Academy of Prosthodontists,
Occlusion, Esthetics and Implantology, and has established the
and the International Congress of Oral Implantologists. Dr. Le
KROMPAS SEMINARS institute.
was inducted as an Honorary Member of the American College of Prosthodontists and is a recipient of the Charles E. English Award in Clinical Science.
– DMD, Oral Surgeon, Private praxis, oral surgery and implantology, Strasbourg-Kehl – Consultant in oral surgery, University of
Medicine In Implantology, University of Münster, Germany – Postgraduate oral surgery, Clinic Schloss Schellenstein, Germany (Prof. Dr. F. Khoury)
Dentaurum Implants has reason to celebrate
25 years of know-how in implantology 2020 is a very special year for Dentaurum Implants: The specialist for dental implants, based in Ispringen, Germany is celebrating its 25th anniversary. Along with its parent company Dentaurum, the oldest family-run dental company worldwide, Dentaurum Implants has much to offer: quality products manufactured in-house, digital solutions and a wide range of services and courses. «Made in Germany» forms the basis of the company philosophy, together with constant research and development and a close cooperation with universities and customers. Customers can look forward to some special offers over the coming months.
How it all began ... It became official on 26th July 1995: TIOLOX Implants GmbH was entered into the German Commercial Register – the company is now well known under the name Dentaurum Implants. From the very start of implantology, the management at Dentaurum recognized the positive development worldwide and the potential of implants for modern dentistry. The TIOLOX® implant system was added to Dentaurum›s range of products with the acquisition of the implant division of Cerasiv. This helped the Dentaurum portfolio become one of the widestranging assortments in the dental market, with complete solutions for patients and users. As your digital partner, Dentaurum Implants places value on process sequences that are efficient and easy to follow, using materials that have been validated – from scanning through to manufacture. The system offers solutions that are flexible, efficient and tailor-made for the patient. Comprehensive services and a wide range of courses round this system off. Website: www.dentaurum-implants.com
29 June - 1 July 2021
Quick Connect by W&H:
the innovative adaptor solution for the Assistina Twin The W&H reprocessing device Assistina Twin has been improved with the new adaptor solution «Quick Connect by W&H». This makes it even easier and faster to change the adaptor and offers optimised workflows and efficiency for the practice. With Quick Connect by W&H, the Assistina Twin now offers even more advantages for the quick and easy maintenance of transmission instruments.
The release button on the Quick Connect by W&H connection in the Assistina Twin supports quick and easy assembly and removal of the straight and contraangle handpieces and turbines. Another advantage is the possibility of preassembling the adaptors that are actually needed to prepare the transmission instruments. The Quick Connect by W&H adaptor solution includes the two different adaptor types with Quick ISO and Quick RM-connection. As well as both of the chambers of the Assistina Twin being able to be setup with the appropriate adaptors, the new adaptors can also be coupled to the instruments outside the device allowing this step to take place before, or even during a maintenance cycle. All in all, a quick and easy solution for an efficient maintenance workflow in the practice.
New Denmat Hydrogen Peroxide Oral Rinse Safety starts here.
DenMat Holdings, LLC (“DenMat”) announced the launch of a new hydrogen peroxide oral rinse to compliment the recently launched hand sanitizer and hard surface cleanser products in the newly created Infection Control category. DenMat’s Hydrogen Peroxide Oral Rinse is formulated with 1.5% hydrogen peroxide and xylitol® to significantly reduce bacteria in the mouth. The alcohol-free formulation features a fresh mint flavor and is sweetened with xylitol to help keep a neutral pH level in the mouth and prevent bacteria from sticking to the teeth. The foaming action created by the release of oxygen also helps to inhibit bacteria growth and aids in the removal of oral debris and healing of minor mouth irritations. The large half-gallon and gallon bottles with dispensing pumps are ideal for chairside application for practices using this rinse as an infection control agent with patients prior to and after treatment. DenMat also offers a convenient 16 oz. size for patient at-home care.
Hydrogen Peroxide Oral Rinse Offers: • significant reduction in bacteria and facilitates healing • foaming action that cleanses between teeth and hard to reach areas • mint flavor that freshens breath • alcohol-free formula website: www.denmat.com/stayhealthy
Purevac® HVE System Dentsply Sirona is proud to announce the launch of the Purevac® HVE System. The Purevac® HVE System enhances the line of infection prevention products managed by Dentsply Sirona. It fits our overall mission of stopping the spread of infectious diseases in dental offices worldwide. High-speed handpieces, ultrasonic scalers, air polishers and air/water syringes produce potentially infectious droplets, splatter and aerosols. It is recommended that dentists should utilize a multi-layered approach in order to minimize the risk of cross-contamination in a dental setting. Using high-volume evacuation (HVE) instead of standard saliva ejectors is an important component to reduce the amount of aerosol. Several studies published show that utilizing HVE can reduce the amount of aerosol by 90%-98%. The Purevac® HVE System is designed to provide oral high-volume evacuation, visualization, illumination, and retraction during dental procedures. It consists of the HVE Mirror Tip which is a high-volume evacuation tip with built-in dental mirror This enables a one-handed approach to evacuate the patient’s oral cavity of aerosols, splatter, fluid, and debris, while also providing visibility and illumination to the treatment area. An HVE Hose Adapter is available and consists of a flexible and lightweight HVE hose connected to a 360-degree swivel for the HVE Mirror Tip.
It offers: • Visibility and suction all in one hand • Increased safety HVE removes 90% more aerosols generated during ultrasonic scaling compared to a low-volume saliva ejector.1 • Better visibility Fog-free mirror with continuous suction of fluids and debris. • Greater fluid reduction 135% more than a low-volume saliva ejector.
• Easier maneuverability o 69% lighter and 130% more flexible than a standard HVE hose. o 5-foot, kink-resistant hose with 360° swivel connection for HVE Mirror Tip. • Reduced noise o 14% less than a standard HVE tip. o 5% less than a low-volume saliva ejector.
Success CD by Promedica The material for perfect temporary crowns and bridges Success CD is PROMEDICA’s composite-based, selfcuring paste-paste system for quick and easy chairside production of temporary crowns, bridges, inlays and onlays.
The material cures completely within a further 3 minutes and can then be polished. This procedure is timesaving and thus highly economical.
High-quality temporary restorations within 5 minutes After a retention time of 30 to 60 seconds in the oral cavity, the material takes on an elastic consistency, which facilitates removal without risking deformation.
Excellent physical properties and great aesthetic results As far as the material’s physical properties are concerned, Success CD convinces with its excellent flexural and overall strength as well as its capacity to withstand high functional loads. The product’s minimal polymerisation shrinkage results in precisely fitting temporary restorations. Success CD’s high colour stability and brilliant, enamel-like gloss ensure long-term aesthetic results. Moreover, its natural fluorescence and the choice of available shades promote perfect aesthetic results.
More efficiency with the vhf QuickFrame The new blank holder for S5 and S2 helps to save time and material With vhf’s new QuickFrame magnetic holder, discs are clamped into the S2 and S5 dental milling and grinding machines without the need of any tools. The discs are loaded in seconds; much faster than securing them with a screwdriver – a clear plus in speed and a work relief for the user.
With a wet grinding module, the range of applications can extend to include the grinding of glass-ceramic or milling of titanium. Using the new QuickFrame holder, vhf customers now save time instantly by opening the cover, inserting the blank into the holder and closing the cover again – all without tools.
The magnets of the QuickFrame efficiently secure the blanks. It is possible to clamp plastic blanks such as PMMA, zirconia and wax. With each new S5, vhf now supplies an innovative QuickFrame magnetic holder in addition to the eight standard holders at no charge. The QuickFrame is available as a cost-efficient accessory for both the S5 and the S2.
The new QuickFrame shows its full strength especially when fabricating restorations in highly translucent zirconia. With any conventional holder, there is a risk that parts of the blank rim may break off if the screws are over-tightened.
The S5 and S2 are particularly versatile five-axis milling and grinding machines for wet and dry machining. They are especially suitable for users who want to machine a wide range of materials, as their eight-fold blank changers allow convenient non-stop machining of all materials.
The new QuickFrame magnetic holder eliminates this risk.
website: www.vhf.com September 2020
Primary care of
• Unbeatably durable: Fully withstands masticatory forces, excellent physical properties1
13 miliolinos n restorat 2 worldwide!
• Unbeatably simple: Universal shade with chameleon effect, 4 mm bulk fill • Unbeatably quick: Exposure time of only 10 seconds (x-tra fil), applied in one layer – only 35 seconds total working time (Futurabond M+)
Tiba A et al., Journal of American Dental Association, 144(10), 1182-1183,2013.
based on sales figures
VOCO GmbH · Anton-Flettner-Straße 1-3 · 27472 Cuxhaven · Germany · Freecall 00 800 44 444 555 · www.voco.dental
Digital Dentistry Your Way Henry Schein ConnectDental® Making the right solutions work for you
• Most comprehensive line of digital materials: anterior, multi, 16+, Acetal, and more • Exceptional restorations that are aesthetic, strong, and metal-free
• Highly automated wet and dry milling and grinding • Utmost precision with maximum stability regardless of material
Rely on Us for innovative and efficient milling solutions
• High Temperature Furnace up to 1.506°C for outstanding results • Space for all common bridge sizes or up to 40 units in level
For more information about our Henry Schein ConnectDental Trusted Digital Solutions, please contact your local Henry Schein dealer or Ghassan.Nasser@henryschein.com or Rami.Aburadwan@henryschein.com