dental asia jul

8/18/2019 Dental Asia Jul

1/96

Behind the Scenes

User Report

Clinical Feature

JULY / AUGUST 2015www.dentalasia.net

Periodontal In

ammation:Periodontal Inflammation:Simpli

edSimplifiedPeriodontal Inflammation:

Simplified

Masking of FluorosisMasking of Fluorosisby Resin In

ltrationby Resin InfiltrationMasking of Fluorosisby Resin Infiltration

What’s inside:

There’sThere’sSandblasting...Sandblasting...

And Then There’sAnd Then There’sSandblastingSandblasting!

There’sSandblasting...

And Then There’sSandblasting!

Special Feature:

Focus on Italy

http://www.dentalasia.net/http://www.dentalasia.net/


2/96


3/96

http://www.nsk-inc.com/


4/96

Dental Management21 C l e a n i n g o f T r a n s m i s s i o n

Instruments: What do you Expect?

Under the Spotlight24 Dr. In-Woong Um: Breaking New

Ground in Alveolar Bone Repairthrough Tooth Recycling

Up Close & Personal28 Kymata Dental Arts: Small in Size,

Big on Quality

Dental Profile31 Morita: The Perfect Fusion of

E r g o n o m i c s a n d A e s t h e t i c

Excellence34 Continuously Making a Mark in

Dentistry

Clinical Feature38 Modern Approach in Directly Placed

Restorations for Endodontically

Treated Teeth40 Per iod on ta l In f l a m m a t ion :

Simplified

48 Essential Factors to Achieving aHigh-Quality Cure

51 Smilefast: The Predictable Short-

Term Cosmetic OrthodonticTreatment

User Report55 Masking of Fluoros is by Resin

Infiltration

58 Digital Impression: The FinalFrontier for Full Digital Integrationin Restorative Dentistry?

62 Charisma® Classic Shows ExcellentColour Match due to its Microglass®

II Filler Technology

Behind the Scenes64 There’s Sandblasting... And Then

There’s Sandblasting!

Do You Know 66 A Ceramic Furnace that Leaves

Nothing to be Desired67 SIROLaser Blue: Surgical Precision in

Blue68 Classic Surtex® Post

Show Review 86 Sixth Annual Zimmer Dental/ NYU Global Implantology Week

88 Colgate at APDC: Prof. SeymourTalks about Periodontal Health

Show Preview 89 CDS 2015 Increases Exhibiti on

Space due to Greater Demand

Regulars4 First Words

6 Dental Updates70 Product Highlights90 Events Calendar

92 Advertisers’ Index

Speci a l Fea t u r e 80 Focus on Italy

olour Match due to its Microglass®

I Filler Technology

64

40

31

55

88

2 DENTAL ASIADENTAL ASIAJ ULY AUGUST 2015 J ULY / AUGUST 2015

CONTENTS


5/96

http://www.3shape.com/TRIOS


6/96

Dr. Audrey Abe l a Assistant Editor

Rips are strong, localised currents that occur in shallow open waters. It cuts through the lines of breaking waves that caneventually sweep swimmers into the deep. As it is not a commonphenomenon, swimmers are unwary of the imminent dangerlurking at the shoreline.This thought came about as I browsed through dental news. Inoticed that there has been a wave of stories on DIY dentistrylately, and this might just be that rip tide prowling around thedental field – an undercurrent that can pull patients into thedanger zone.

Nowadays, simple DIY treatments that do not require strict medical attention have been deemed“acceptable”. Home tooth whitening kits are instant tickets to million-dollar smiles. Patients tendto favour DIY methods due to convenience and the promise of aesthetic improvement on the spot .

However, what makes the situation alarming is the growing number of patients assuming the roleat an advanced level: filling cavities,filing tooth edges, re-cementing crowns, or worse – performingsurgical procedures like extraction – all on their own. Worse still, videos and tutorials on how tobe a “street-smart and practical” patient have invaded the online platform, offering easy accessand immediate dental solutions.There has to be limits to this DIY age, especially when health is involved. DIY dentistry re flectshow much value patients put on their health – which is a critical matter that should only be leftto qualified hands. Nevertheless, patients who prefer DIY treatments would always have theirown reason to validate their judgment.Imagine using superglue for wood to bond a crown, or a concrete filing tool to even out a chippedfront tooth, or backyard tools to pull out an infected molar that has been causing sleepless nights.These all sound absurd – but these are happening. A quite “reasonable” factor is its practicality.Failure is regarded as normal and acceptable as long as they can redo the procedure. However,complicationscould lead to a different story. The repercussions could be devastating, eventuallytranslating to more costs, pain and, perhaps, irreversible results.These stories have significantly caught my attention, and I realised how DIY dentistry has becomeone facet of the practice that has been left in the shade amidst the digital dentistry uproar. As thedigital side continues to elevate the practice to a more ef ficient platform, DIY dentistry is somehowsilently killing the practice and slowly pulling down the nobility of the profession.Money factors in as a primary reason why patients seek cheaper alternatives. However, it is amatter of priority. In spite of having insurance coverage or money, not everybody puts dentaltreatment on the top of their list. The one thing that truly compels patients to seek treatment is when pain is present and when it has reached an unbearable state. Although not directly stated in the Hippocratic Oath, “F i r s t do no ha rm ” has been the classic medicalcreed. But when patients have assumed responsibility, how can dentists reverse the situation?These waves of thought incessantly ran through my mind as I reviewed my interview withProf. Greg Seymour ( p. 88), an internationally acclaimed specialist in periodontal disease. Whatstruck me is his statement, “Education a l o n e is n o t a guarantee of behavioural change”. Hestressed that patients have to be mo r e motivated than educated, as awareness without a strongdrive can only go so far.In the case of DIY dentistry, patients are highly motivated because they have reason to be so. Butit appears that they are not putting their know-how to good use or maybe there’s not enough of it.There should be a symbiosis between education and motivation to achieve positive results. Apurpose-driven action must be accompanied by proper knowledge to help pull patients awayfrom the DIY dentistry quicksand.Superglue can merit space in the dental clinic or laboratory for out-of-mouth procedures. Butthere is definitely no room for flat-nose or tongue-and-groove pliers in the dental clinic. Dentalprofessionals and organisations need to mobilise efforts to continuously raise awareness aboutDIY dentistry and keep patients’ motivational juices flowing – in the right direction. Otherwise,the number of carpentry tool and superglue users in dentistry could gradually escalate in time.DA

The Dow nward

Spiral

Dr George Freedman

Prof Alex Mersel

Prof Urban Hägg

Dr Chung Kong MuDr William O’Reilly

Dr Choo Teck Chuan

Prof Nigel M. King

Dr Fay Goldstep

Dr Adrian U J Yap

Dr Derek Mahony

Dr How Kim Chuan

Dr William Cheung

Dr Ramonito Lee

Dr Ryan Seto

Dr Christopher Ho

Dr Kevin Ng

A D V I S O R Y B O A R D

FIRST WORDS


7/96

http://sirona.com/http://sirona.com/


8/96

3Shape unveiled several new solutions for dental labs at the IDS2015. These include upgraded versions of its desktop scanners,two new desktop scanners and the latest release of its industry-leading CAD software solution, Dental System™ 2015 .

“Our new CAD/CAM solutions demonstrate 3Shape’scommitment to providing dental labs with more opportunitiesto grow their product portfolios and serve more customers,” saysFlemming Thorup, President & CEO at 3Shape.

Improved speed and performanceThe new versions of the D-series benchtop scanner (D750and D850) are major upgrades of the former D700 and D800models. The two, along with the presently available D900L,now feature a new technology platform combined with a largerinterior space and blue LED for reduced scan noise.

Three years of LABcare™The D750, D850 and D900L also include a three-year subscription

bundle to 3Shape LABcare™ , which features free yearly softwareupdates, product training and service. The subscription offer is valid up until September 30, 2015. The D-series also containsthe D500 desktop scanner and includes a cost-effective optionto extend the LABcare™ package to three years.

Two new D-series lab scannersTwo new lab scanners (D2000 and D1000) were introduced atthe Chicago Midwinter Meeting. Both are equipped with 4 x 5.0MP cameras and high-quality mechanics to improve scanningaccuracy and the aforementioned new multi-line technology forincreased scanning speeds.The new D2000 benchtop scanner reduces handling time

by 40 per cent andincludes severalother new featureslike “All-in-One”

scanning and a largeinterior with roomfor two models.

All-in-Onescanning

New Chief

Production

Ofcer

at Ivoclar

VivadentMarkus Heinz assumes

position as head of the

company’s worldwide

production.

Markus Heinz is the new Chief Production Of ficer of

Ivoclar Vivadent Group. He succeeds Wolfgang Vogrin, Dipl. Ing., from July 1, 2015, who will retire. Vogrin has headed up the production and logistics of

the company since 2002. With a comprehensive man agement experience,Heinz has been working for Ivoclar Vivadent since

1985. He took over the responsibilities for the globaltooth production in 2002. Since 2014, he has also

been responsible for the production site in Schaan/

Liechtenstein. “Markus Heinz is a proven productionexpert, manager and leader,” commented RobertGanley, CEO Ivoclar Vivadent, upon the nomination of

the new Chief Production Of ficer. Within the context ofhis function, Heinz will join the Corporate Management

from July 1.

Significant contribution to growthChairman of the Supervisory Board Christoph Zeller and CEO Robert Ganley have thanked Vogrin “for his contribution as managerto the rapid development of Ivoclar Vivadent on a global level”. Above all, the build-up of the ceramic production centre in USA,as well as the expansion of numerous other production sites, can be credited to Vogrin. DA

All-in-One scanning and the D2000’s large interior enabletechnicians to capture both upper and lower models, inserteddies, and occlusion information in a single scan. The technologyalso enables the D2000 scanner to “see” around dies in themodel so that there is no need in most cases to remove diesduring scanning.* This process can eliminate four out of the fi ve

work flow steps used to scan (i.e., a three-unit bridge), therebysaving up to 40 per cent of handling time for dental labs.

Additionally, 3Shape Auto-Occlusion Technology makes aseparate bite scan unnecessary. Auto-Occlusion Technologymerges the previously simultaneously scanned models withinthe software to create a correct bite.*An additional die scan may be required for cases with exceedingly limited interproximal

space between dies and neighbouring teeth. All dies must be trimmed and models sectioned.

Dental System™ 20153Shape Dental System™ 2015 introduces several new dentalsculpting tools including full digital work flows for creatingdentures, a simplified order form, boosted scanning speedsand more restorative component libraries and compatibilityintegrations with third party dental product makers.DA

Faster and More Accurate CAD/CAM

Solutions for Dental Laboratories

6 DENTAL ASIA J ULY / AUGUST 2015

DENTAL UPDATES


9/96

http://www.gcasia.info/


10/96

Roland DG’s New Wet GrindingMill Steals Attention at the IDS

The DWX-4W was developed for the

production of crowns, bridges, inlays,onlays and veneers from popular glass-ceramic and composite resins with

precision and reliability. Simultaneous4-axis grinding of up to three standardpin-type blocks results in high ef ficiency.

Along with the DWX-4W, Roland DGexhibited its DWX series of affordableCAD/CAM milling devices for dental labs

and clinics. The mills were demonstratedin conjunction with dental scanners,software and a wide range of milling

materials to illustrate their versatility andcompatibility.

According to Takuro Hosome, Manager of

Dental Business Development at RolandDG, the user-friendliness, reliability,open architecture and compact size were

the DWX-4W’s most-valued features asper visitors. “Like all our dental mills, itfeatures open architecture,” he said. “This

means that users can easily integrate theunit in their existing work flow, as thegrinding unit works perfectly with all

popular scanners and software. Rather

than being locked into one source, userscan also choose the material supplier

they prefer.”Roland DG continues to promote thecost-saving and productivity advantages

of operating separate wet and dry millingsolutions. Their multiple device solutionallows for the combination of dry and wet

milling, but with the benefit of being ableto handle the simultaneous processing

of different materials without the

inconvenience and delay of a changeover.“I very much like the concept of separatemachines for wet and dry milling,”

said Tomonari Okawa, Master DentalTechnician at Organ Dental Technologyin Hamburg. “This is highly efficient

since you don’t need to clean the machineextensively between jobs and you canstart your next task immediately.”

Visitors at the IDS were very positiveabout this new grinding machine, which

will be launched in the second half of

2015. “The success of the show underlinesour growing success in the dental marketand sets high expectations for the future,”

Hosome said.

Affordable 5- and 4-axismilling unitsThe Roland 5-axis and 4-axis dry mills

were also presented at the IDS. TheDWX-50 features 5-axis simultaneousmachining capability, a five-station

automatic tool changer with tool lengthsensor, and a diagnostic notification

system that allows for minimal operatorinvolvement. An integrated air blowersystem and advanced dust collectionsystem contribute to the popularity of

the DWX-50. Additionally, the mill offersmulti-cast capability, making it possibleto connect up to four machines to one

computer.The DWX-4 is the world’s most compact

yet professional dental mill. It combinessimultaneous 4-axis milling with simple

one-button operation. An included

automated tool changer provides twotools for precision milling from start to

finish. The DWX-4 can be enhanced withthe addition of an optional four-positionautomatic tool changer (ATC), which

supports up to four different tool sizes.Moreover, the DWX-4 can mill up to fourdifferent pin-type materials – including

hybrid ceramics – simultaneously withan optional multi-pin clamp. As a result,prosthetics for up to four different

patients can be produced in a singleproduction run, thus saving time, labourand costs.

Both milling units are compatible witha vast range of materials, includingzirconia, PMMA, wax and composite

resins. This allows dental labs (big orsmall) to produce all sorts of prostheticcomponents digitally. Examples include

crowns, bridges, frames, inlays, onlaysand veneers. DA

Cancellation of Publicly Held

Nobel Biocare Shares andDe-Listing from Six SwissExchange as of June 10, 2015

By decision dated May 13, 2015, theCommercial Court of the Canton of

Zurich cancelled all registered shares

of Nobel Biocare Holding AG notdirectly or indirectly held by Danaher

Corporation based on Article 33 of theFederal Act on Stock Exchanges and

Securities Trading.Holders of cancelled shares were paidcash compensation in the amount of

CHF 17.10 for each cancelled share,corresponding to the offer price paid byDanaher Corporation in its public tender

offer for all publicly held shares of NobelBiocare Holding AG. It was reported that

the compensation was paid on or around June 16, 2015.By decision dated (June 1, 2015), SIX Exchange Regulation definitively approvedthe de-listing of the registered shares of Nobel Biocare Holding AG from SIX Swiss

Exchange as of June 10, 2015. The last trading day of the registered shares of NobelBiocare Holding AG was on June 9, 2015. DA


DENTAL UPDATES


11/96

Scientists Reveal SixSimple Tongue Exercises

that can Stop Snoring A Brazilian study found that oropharyngeal

exercises significantly reduced the frequency of

snoring by 36 per cent and total power of snoring

by 59 per cent in patients with primary snoring

or mild obstructive sleep apnea (OSA).Snoring is one of the most common symptoms associated

with OSA and is caused by the vibration of the soft tissuesobstructing the pharynx during sleep. However, most people

who snore do not have OSA. The prevalence of snoring in the

general population varies widely (from 15 per cent to 54 percent) mainly because most studies rely on patients’ self-reports.Despite evidence revealing snoring as a major burden to society,

the management of patients with primary snoring or mild OSAhas been poorly investigated.Treatment of primary snoring varies widely and includes

avoiding alcohol and sedatives, avoiding lying flat on the back

to sleep, weight loss, treatment of nasal problems, palate and

upper airway surgeries, and use of dental sleep devices.“Previous studies have focused on self-reporting questionnaires.New forms of treatment for snoring focusing on objective

measures were needed. We tested the effectiveness of

oropharyngeal exercises to reduce snoring,” said GeraldoLorenzi-Filho, MD, PhD, study author. “The exercises

significantly reduced snoring in our study group,” he revealed.The 39 patients in the study were randomised for three monthsof treatment with nasal dilator strips plus respiratory exercises

(control) or daily exercises (therapy).

The six exercises

• Push the tip of the tongue against the roof of the mouth andslide the tongue backward.

• Suck the tongue upward against the roof of the mouth andpress the entire tongue against the roof of the mouth.

• Force the back of the tongue against the floor of the mouth

while keeping the tip of the tongue in contact with the lowerfront teeth.

• Elevate the back of the roof of the mouth and uvula while

saying the vowel “A”.• Put a finger in your mouth on each side and press outward.• Alternate chewing on either side when you eat. DA

9DENTAL ASIA

JULY / AUGUST 2015

www.dentalasia.net

http://www.dentalasia.net/mailto:[email protected]://www.hzsmaco.com/http://www.dentalasia.net/


12/96

Zimmer Will Sell US Assets toComplete Biomet Merger

Zimmer Holdings, Inc. recently

announced that it will sell off some of itsUS-based business assets to comply withpre-conditions set by the Federal Trade

Commission (FTC) as part of Zimmer’sproposed merger with fellow orthopaedicproducts manufacturer Biomet, Inc.

According to a press release, Zimmer hasfinalised deals with unspecified buyersto sell certain assets among its Zimmer

Unicompartmental High-Flex KneeSystem, Biomet Discovery Elbow System,

and Cobalt Bone Cement product lines.“Zimmer continues to work constructively with the Bureau of Competition Staff of theUS Federal Trade Commission and is highly

confident that within the next few weeks,it can finalise the agreement in principle

it reached previously with FTC Staff toresolve FTC Staff's competitive concernsregarding the proposed acquisition,” the

company stated in the release.The deals are subject to further FTC reviewand approval by the FTC Commissioners

and will have to satisfy the usual closing

conditions for divestiture agreementsunder federal law.Biomet’s proposed $13.4 billion merger

with Zimmer is believed to be the fifthlargest medical device industry transactionover the past decade. The deal between

the erstwhile cross-town rivals (both based in Warsaw, Indiana) will create thesecond largest company in the $45 billion

orthopaedic and dental product market,trailing Johnson & Johnson.

Such a sizeable deal warranted antitrustconcerns from the FTC, which, last year,requested additional information aboutthe deal from both companies. Both

manufacturers have since provided theFTC with the additional data.“Zimmer and Biomet will continue to

work closely with the FTC as it conductsits review of the proposed transaction.The proposed transaction remains subject

to the expiration or termination of the waiting period under the HSR Act (Hart-

Scott-Rodino Antitrust Improvements

Act of 1976), antitrust clearance in certainforeign jurisdictions, as well as othercustomary closing conditions,” stated a

joint news release from both companies.European regulators also requestedmore information about the transaction,

and Zimmer provided a “revised remedypackage” to facilitate the review. In

April, the European Commission (EC)

granted conditional clearance to thepending merger, contingent upon Zimmer

divesting two of its European kneeimplant businesses and one elbow implant business in the near future.The Japan Fair Trade Commission also

recently granted clearance to the proposedmerger, leaving the FTC as the sole majorregulator yet to approve the transaction.

However, Zimmer stated in its pressrelease that finalising the divestiture of itsU.S. assets may be only weeks away, and

the company expects its deal with Biometto close as planned by mid-June.DA

American Dental Association Welcomes RuthLipman, Ph.D., as Director, Scientic Information

Dr. Ruth Lipman has accepted the role ofDirector, Scientific Information for the American Dental Association (ADA).

Dr. Lipman will manage the development,review and publication of objectivescientific information, providing the

ADA membership with clinically relevantdental research and information.“I’m thrilled to be part of the ADA,”

said Dr. Lipman. “I look forward toserving ADA members and leading thedevelopment of scientific information

that will help promote better oral health.”Prior to joining the ADA, Dr. Lipman

wa s the Chie f Sc ie nce and Pr actice

Officer for the American Associationof Diabetes Educators (AADE) whereshe oversaw research efforts, reviewed

evidence for practice documents and worked to increase opportunities fordiabetes educators. While at the AADE,

Dr. Lipman was the Principal Investigatoron projects that received awards fromthe Agency for Healthcare Research and

Quality (AHRQ), Bristol-Meyers SquibbFoundation’s Together on Diabetesprogramme and the Aetna Foundation.

She was also the Principal Investigator ona cooperative agreement with the Centresfor Disease Control that increased access

to, participation in and sustainabilityof the National Diabetes PreventionProgramme.

Dr. Lipman has held various facultyappointments at Harvard UniversitySchool of Medicine, Tufts University

School of Nutrition and WorcesterPolytechnic Institute. She received herPh.D. in Biomedical Sciences and a

Bachelor of Science in Life Sciences from Worcester Polytechnic Institute.DA


DENTAL UPDATES


13/96

www.dentalasia.net

Experts Call for ConsistentDigitisation in Healthcare

Digital systems are essential for modern dentistry.However, they are not consistently applied in

practices. Dr. Axel Wehmeier discusses the newtrends in the industry and how dentists can take

advantage of the digital world in the new edition of VISION,Sirona’s innovation international customer

magazine.

In the health sector, a lot of potential for digitisation is wasted, said

Dr. Wehmeier, Managing Director of Deutsche Telekom Healthcare& Security Solutions GmbH. While Denmark has set up a patient-centred digital infrastructure and all patients in Singapore have an

electronic medical record, digital networking in other areas and

regions is progressing at a sluggish pace. “We take our digital x-rayimages from one doctor to the next on DVDs,” said Dr. Wehmeier.

This inconsistent handling of patient data is anachronistic. Onlythose who are willing to make their patient data digitally available

will be able to take part in the tremendous progress occurring

in medicine and benefit from innovative, life-saving measuresin emergencies. Dr. Wehmeier is one of the experts who deals

with the key issue of “digitisation” in the customer magazine.

The fact that digital systems are essential for modern dentistryis emphasised by Jeffrey T. Slovin, President & CEO of Sirona.In the magazine’s foreword, Slovin wrote: “Whether during

diagnosis, planning or treatment – they make processes better,faster, safer and more ef ficient. We believe that by integratingand combining different technologies, digitisation can be the

basis for completely new treatments.” VISION shows the advantages for dentistry and patients – i.e.,in the treatment of craniomandibular dysfunction (CMD),

obstructive sleep apnea or the production of transparent alignersto straighten teeth. In addition, users and testers describe theirfirst experiences with the innovative ORTHOPHOS SL 3D x-ray

system and the new CAD/CAM inLab MC X5 milling machine fordental laboratories. Participants from around the world reporton the presentation of the new blue laser technology at the first

“Sirona Laser Days”. In addition to the print edition, VISION is available on Sirona’s website

as an e-paper and as a free tablet magazine for the iPad. DA

Lef : Sirona informs

dentists, practice

teams and dental

technicians about new

trends in dentistry

through VISION,

which will come

out twice a year in

German and English.

Right : Illustrative

infographics explain

effi cient workows

with integrated digital

technologies to users.

http://www.dentalasia.net/http://www.dmg-dental.com/http://www.dentalasia.net/


14/96

Ultradent Receives Prestigious Top NationalHonour for Ethics and Truth in Advertising

Following a nationwide nomination and voting process,Ultradent Products, Inc. was selected out of over 3,000other companies evaluated to receive the Golden Hands Awardof Xcellence for Ethics and Truth in Advertising. This was heldon April 30, 2015 at the California Dental Association meetingin Anaheim, California.Initial nominees for the prestigious award were selected by arespected group of clinicians and leaders in the dental industry,including numerous well-known key opinion leaders. Nominees

were selected based on criteria that include ethical conduct,

placement of public health before profits, dependable products,knowledgeable personnel, and excellent customer service.Nominees were then voted on by thousands of practicing dentistsacross the nation to select one winner.Dr. Dan Fischer, President & CEO of Ultradent Products, Inc.,said, “We’re so honoured to have received this recognition.

Additionally, it must be said that the true honour for this awardgoes to the men and women at Ultradent who work tirelesslyevery day to uphold the values upon which Ultradent hangs itshat: integrity, care, quality, innovation and, lastly, hard work.They embody these values in the way they contribute to our

vision every day, regardless of their personal job description orthe continent on which they serve. We are humbled to receivethis recognition and will use it as a critical reminder of our dutyto continue to be responsible and caring to those we serve, bothinside and outside Ultradent. Indeed, we are truly fortunatehumans. Onward and upward!”The Golden Hands Award of Xcellence has the distinction of

being the most elaborate award in Dentistry. Conceptualised by Amir H. Motamed, DDS, the sculpture was designed and made bycommissioned artist and master craftsman, Donjo. The sculptureis made of casted bronze over an Italian marble base. It stands 16inches tall and weighs 18.4 pounds. The sculpted Golden Handsof Dentistry are shown upholding the four coloured triangles ofthe dental profession: Dental Education, Dental Professionals,Dental Organisations and the Dental Industry—all pointing toa common core. DA

Dr. Amir Motamed and Dr. Dan Fischer (right),

President & CEO of Ultradent Products, Inc.

Dental Calculus Analysis Reveals Mushrooms wereConsumed as Early as the Upper Palaeolithic

The human diet during the Magdalenian phase of Europe’s UpperPalaeolithic between 18,000 and 12,000 years ago is poorlyknown. This is particularly a problem regarding food resourcesthat leave little trace such as plant foods. An internationalresearch team led by Robert Power of the Max Planck Institutefor Evolutionary Anthropology in Leipzig, Germany has nowexplored diet in the period through dental calculus analysis onMagdalenian individuals found at El Mirón Cave in Cantabria,Spain. The researchers found that Upper Palaeolithic individualsalready used a variety of plant foods and mushrooms, in additionto other food sources.

Although the Magdalenian in much of northwest Europe iscommonly characterised as the period of the “reindeer hunters”,this is unlikely to have been the case in Iberia. Other lines ofevidence showed diet included substantial amounts of meatsupplied from red deer and Ibex, but until now, it was unclear iffoods such as plants were a component of their diet.Robert Power, a PhD candidate in the Max Planck ResearchGroup on Plant Foods in Hominin Dietary Ecology, and hiscolleagues took dental calculus samples from Magdalenian

individuals found at El Mirón Cave in Cantabria, Spain. Usingoptical and scanning electron microscopy with energy-dispersivex-ray spectroscopy, they detected a diverse assemblage ofmicro-remains from the dental calculus. These micro-remainsfrom plant, fungal, animal and mineral sources provide someindication of the Magdalenian diet. “These types of micro-remains show that the individuals at El Mirón consumed a varietyof plants from different environments, as well as other foods,possibly including bolete mushrooms,” says Power.

Archaeologists know almost nothing about the early use offungi. Although their use is poorly understood in pre-history,ethnographers have noted that recent hunter-gatherers haveoften used fungi as food, flavouring and medicine. Mushroomuse has firmly been identified from as early as the EuropeanChalcolithic. The Chalcolithic Tyrolean Iceman “Ötzi” carriedseveral types of fungi on his person. “This finding at El MirónCave could be the earliest indication of human mushroom useor consumption, which, until this point, has been unidentifiedin the Palaeolithic,” says Power. DA


DENTAL UPDATES


15/96

http://wcli.org/http://wcli.org/2015taipeihttp://wcli.org/2015taipei


16/96

Natural Plant ChemicalCould Help Fight Tooth Decay

Primarily known as a sickly sweet candy that causes

tooth decay, liquorice could actually be holding the key to

conquering it, a new study suggests.

University of Edinburgh researchers stated that a naturalchemical extracted from plants acts against harmful mouth

bacteria and could improve oral health by helping to prevent

plaque build-up.The biological compound known as trans-chalcone is relatedto chemicals found in liquorice root. The study shows that it

blocks the activity of a key enzyme that allows bacteria to thrivein oral cavities.The bacteria – Streptococcus mutans – metabolise sugars

from food and drink, which produces a mild acid and leadsto the formation of plaque. Without good dental hygiene, thecombination of plaque and mouth acid can then lead to tooth

decay.The researchers found that blocking the activity of the enzymeprevents bacteria from forming a protective biological layer

(biofilm) around them. Plaque is formed once bacteria attachthemselves to the teeth and construct biofilms. Preventing theassembly of these protective layers would then help stop bacteria

forming plaque, the team said.

Oral care products that contain similar natural compounds could

also help improve dental hygiene, the researchers said.This study is the first to show how trans-chalcone prevents

bacteria-forming biofilms.The team worked out the 3D structure of the enzyme Sortase

A, which allows bacteria to make biofilms. By doing so, the

researchers were able to identify how trans-chalcone preventsthe enzyme from functioning.The study, published in the journal Chemical Communications,

was supported by Wm. Wrigley Jr. Company and the Universityof Edinburgh.Dr. Dominic Campopiano of the University of Edinburgh's

School of Chemistry led the study. He said: “We were delightedto observe that trans-chalcone inhibited Sortase A in a test tubeand stopped Streptococcus mutans biofilm formation. We are

expanding our study to include similar natural products andinvestigate if they can be incorporated into consumer products.This exciting discovery highlights the potential of this class of

natural products in food and health care technologies.” DA

Faecal Matter inYour Toothbrush?!

The toothbrush you keep in the communal washroom

may be inviting the uninvited, serving as a vector forfaecal bacteria, according to new research.

Recently presented at the annual meeting of the American

Society for Microbiology, the study revealed that more than 60per cent of toothbrushes stored in communal washrooms testedpositive for faecal matter, which are potentially pathogenic

organisms. A more worryingfinding is that there was an 80 per cent chancethat the contamination came from other people using the same

bathroom.“The main concern is not the presence of your own faecal matteron your toothbrush but rather, being contaminated with faecal

matter from someone else, which contains bacteria, viruses orparasites that are not part of your normal flora,” says Lauren

Aber, MHS, a graduate student at Quinnipiac University inHamden, CT, USA.The researchers noted that Enterobacteriaceae and

Pseudomonadaceae are some of the bacterial species that canpotentially contaminate toothbrushes. Both can be found innormal gut flora, though some forms can be pathogenic.

The data is based on an analysis of toothbrushes that camefrom participants (students) who use communal bathroomsat Quinnipiac University. Each bathroom had an average

of 9.4 occupants. The researchers also found that there

was no difference in the level of effectiveness for different

decontamination methods including rinsing with cold or hot water or mouthwash.Toothbrushes stored open in the bathroom are especially

vulnerable to contamination with material from the toilet orfrom other occupants. However, covering them is apparentlynot the best solution against bacterial growth either.

Aber said that using a cover does not protect a toothbrush from bacteria – it actually creates a fertile environment, presenting asuitable breeding ground for bacteria as it keeps bristles moist

and does not allow the toothbrush head to dry out between uses.She added that people who share bathrooms should use betterhygiene practices to store their toothbrushes, including those

recommended by the American Dental Association (ADA):• Avoid sharing toothbrushes;• Rinse toothbrushes thoroughl y with tap water after

brushing to remove remaining toothpaste and debris andallow them to air-dry;

• Do not use toothbrush covers or store brushes in closedcontainers;

• Replace toothbrush every three to four months or sooner

once bristles become frayed. DA


DENTAL UPDATES


17/96

http://www.invisalign.com/


18/96

Larger naesthesia NeedleLarger Anaesthesia NeedleBore Fails to Reduce PainBore Fails to Reduce Pain

A local anaesthetic is often given during dental work to

lessen pain, but for many patients, the injection is as bad

or as scary as the experience of dental treatment itself.

Dentists are constantly looking for ways to reduce the

pain produced by injecting the numbing agent.

An art icl e in the journal AnesthesiaProgress describes a novel needle designthat attempts to reduce pain. This new

dental needle has the same outsidediameter as a standard needle, but the

opening inside the new needle is larger.The authors speculated that this largeropening inside the needle might decreasethe pain of both inserting the needle, as

well as injecting the anaesthetic.Many patients avoid visits to the dentist

because they fear pain, which dentists

have attempted to reduce – first withgeneral anaesthesia and now mainly

with local anaesthesia. While generally

effective, the injection can still bepainful for patients. Many attempts

have been made to diminish injectionpain, ranging from smaller needles andtopical numbing agents to distracting the

patient in various ways.In the current study, 20 dental patients

were given four anaesthesia injections on both sides of the mouth using two typesof needles from Septodont. The injectionsites chosen are those commonly used

for dental anaesthesia. The new largerinner bore needle was used on one sideof each patient’s mouth, and a standard

inner bore needle was used on the other.Patients then rated the amount of painthey felt.

The authors found that the needle withthe larger inner opening did not decrease

pain while the needle was inserted or

the anaesthesia was injected. Comparedto the standard bore needle of the samegauge, there was no significant difference

in the amount of pain reported by thepatients.The same patient received injections

using both inner bore sizes (the outer bore being the same size) and rated the painimmediately after the anaesthesia was

injected. The injection rate was carefullycontrolled so that it did not affect thelevel of pain experienced by the patients.

Half of the patients received injectionsusing the larger inner bore needle firstand half had their first injections from

the standard inner bore needle, so thatthe order of injection will not appear to

be a factor in the patients’ pain ratings.The authors noted that this is the firstpublished study to assess the effectof inner needle bore size on pain with

anaesthetic injections. Therefore,independent studies are needed toconfirm their finding. Although this

attempt to decrease pain was not effective,dentists continue to try to find waysto improve the experience of dental

treatment that is still very disconcertingfor many people. DA

3M Technologies Receive TopHonours at 2015 Edison Awards

3M True Definition Scanner recognised for innovative excellence

3M , a science-based company thatinspires creat ive col laboration,announced recently that two of its

powerful technologies have been selectedto receive a 2015 Edison Award – aprestigious global honours programme

highlighting excellence in creative

innovation. The 3M™ True DefinitionScanner from 3M ESPE Dental earned a

silver Edison Award in the Science andHealth category.More than 3,000 leading business

executives comprised of previous winners and academic leaders in thefields of product development, design,

engineering, science and medicine madeup this year’s panel of judges. Winners

were chosen based on concept, value,

delivery and impact.

Silver Award-Winning 3MTrue Definition ScannerR&D minds at 3M are constantly usingnew sciences to make a better world, and

with the 3M True Definition Scanner,they are revolutionising the consumer’s

experience at the dental office. Thescanner is an intraoral optical impressionsystem that quickly captures a 3D video“impression” of teeth – eliminating the

need for traditional dental impressions.This scanner, born of advanced opticsand data analysis algorithms, is the

most consistently accurate system andhas the smallest handpiece on themarket, resulting in ease of use for the

dentist and comfort for the patient. With secure cloud-based data storageand validated workflows, the system

integrates seamlessly to allow access tonumerous treatment options. With thisscanner, digital impressions are not only

fast and easy; they are changing the waydentistry is practiced.“With new systems in use in more than a

dozen countries, the 3M True Definition

Scanner is bringing advanced digitaloral care and truly accurate results to

patients and dentists across the globe,”said David Frazee, Vice President ofDigital at 3M ESPE Dental. “Recognition

from the prestigious Edison Awards is anhonour, and validates the commitment toresearch, development and innovation

that is so important at 3M.” DA


DENTAL UPDATES


19/96

>Toshio FukumuraManaging Director, Japan

New experiences. New possibilities.

“ Invisalign is not just a product but anexperience for both the doctor andpatient. Achieving a great smile is our

mission and purpose.

”

We are makingchanges toimprove yourexperience.

invisalign-experience.com

Invisalign. Improving your experience.

http://invisalign-experience.com/http://invisalign-experience.com/


20/96

Joachim Weiss Celebrates his 90th BirthdayJoachim Weiss, senior partner of dental specialist BEGO, invited guests from industry

and politics to a reception to mark his 90th

birthday on March 17. Staff and friends ofBEGO also celebrated together with the jubilarian in the Bremen company headquarters.

The celebrations were of ficially opened by Christoph Weiss, Joachim Weiss’ sonand Managing Partner of the BEGO

Group. He is the fifth generation to standat the helm of this medium-sized familycompany. The afternoon got underway

with a funny yet thoughtful poem written by Weiss junior, which took a look backat his father’s life. Former mayor of

Bremen Henning Scherf then listed Weiss’s achievements for the city of

Bremen. Mr. Scherf was visibly impressed by BEGO’s corporate principles, which Weiss developed together with the staffat BEGO 25 years ago and still remains

valid even today. Here, the focus is verymuch on working in partnership. “Youhave provided the city with an example

of partnership and are a role model forBremen,” said Scherf.

Arend Vollers, former chairman of the East

Asian Association in Bremen (OAV) andlong-standing friend of the Weiss family,described other stages in the life of his

companion and friend Joachim Weiss.Over the course of six decades, the two

have shared many private and professional experiences.

Master Dental Technician Henning Wulfes, Head of the BEGO Training Centre, recalled Weiss’s years at the company in a picture presentation and showed that “he was ableto make far-sighted decisions when it mattered, and set the course for the company’s

further development in doing so.” Together, Wulfes and Weiss senior witnessed the various phases of development in dental technology which – according to Wulfes – Weiss senior played a key role in shaping.

A presentation of a sculpture produced using the selective laser melting techniqueconcluded the affair. Presented by Carsten Vagt, Head of Technology at BEGO Medical,the sculpture represents the latest milestone in BEGO’s history – the Varseo 3D

printer – and symbolises the progressiveness of the company which, without the solid

foundations established by Joachim Weiss, would not be possible today.DA

Christoph Weiss greets guests.

Carsten Vagt Head of Technology atCarsten Vagt, Head of Technology at

BEGO Medical presenting the 3DBEGO Medical, presenting the 3D

Varseo printer which was producedVarseo printer, which was produced

using the selective laser meltingusing the selective laser meltingtechnique.technique.

Steven W. KessReceives the 2015Harry StrusserMemorial Award

Henry Schein, Inc. recently announced that Steven W. Kess, the company’s VicePresident of Global Professional Relations, received this year's Harry Strusser Memorial

Award. Presented annually by the New York University College of Dentistry (NYUCD),the award recognises outstanding contributions to public health.Dr. Charles N. Bertolami, Herman Robert Fox Dean and Professor of Oral and

Maxillofacial Surgery at NYUCD, presented Mr. Kess with the award at NYUCD’sGraduation Ceremony, held on June 1 at Madison Square Garden in NYC.“Steve has been a leader in the field of public health for decades, during which he has

been instrumental in forging innovative public-private partnerships, which have helpedadvance the promotion of public health on a global scale,” said Dr. Bertolami. “Fromconceptualisation to implementation, Steve’s keen talent for spurring collaboration, his

wealth of knowledge, tireless service, and sustained leadership and vision have madehim a touchstone for all of us who are committed to increasing awareness about andaddressing public health issues.”

Mr. Kess has a long history of supporting public health outreach programmes on behalfof Henry Schein, and is a co-founder of Henry Schein Cares, the company’s globalcorporate social responsibility programme. In recognition of his work, Mr. Kess was

awarded a Presidential Citation by the American Dental Association (ADA). In 2013,the ADA created the Steven W. Kess Give Kids A Smile Corporate Volunteer Award torecognise outstanding achievement and commitment to the ADA Foundation’s “Give

Kids A Smile®” programme. DA

From L to R: Dr. Michael P. O’Connor, Dr. Charles N. Bertolami, Mr. Steven W. Kess, Dr. Stuart M. Hirsch,

Dr. Cosmo V. De Steno. (Photo: Henry Schein, Inc.)

Carsten Vagt, Head of Technology at

BEGO Medical, presenting the 3D

Varseo printer, which was produced

using the selective laser meltingtechnique.


DENTAL UPDATES


21/96

http://www.amanngirrbach.com/mailto:[email protected]


22/96

http://www.facebook.com/cappasiapacifichttp://www.capp-asia.com/


23/96

Cleaning of Transmission Instruments:

What do you Expect? by Mr. Christian Stempf The dental profession, treatments and related techniques have evolved over the years, as have hygiene procedures.Today, reprocessing instruments involves complex hygiene procedures and protocols that need to be regularlyquestioned, optimised and updated according to the latest developments in science and technology. Someproducts are more challenging to decontaminate than others such as transmission instruments, i.e., (high- andlow-speed) turbines and straight and angled handpieces. They are complex to clean and sterilise without adequateequipment and specific processes, with greater requirement on validation to prove that the process is correct.

P

roper cleaning is the foundation of the wholereprocessing cycle and is fundamental for safe

sterilisation. During sterilisation, residues, debris, blood proteins and lipids present an obstacle tosteam. As most guidelines specify, “only clean

instruments can be sterilised.”Instruments must be clean and visually free from organicresidues (blood proteins, lipids, biofilm), mineral deposits,

debris and stains prior to steam sterilisation. Appropriatecleaning contributes to reducing the microbial population.

As illustrated by theSinner Circle,

cleaning combines fou r factorsinteracting in variable proportions:• Chemical action

• Mechanical action• Temperature• Contact time

If one factor is reduced, the loss mustbe compensated by increasing one ormore of the other factors.

Chemicals represent the action ofan acidic or alkaline detergent solution. Detergents containsurfactants with cleaning properties acting as wetting, foaming,

emulsifier and dispersant agents. Its ef ficiency is increased ordecreased by its concentration. However, higher concentrationsof detergent may lead to greater usage costs and additional

rinsing, and may cause damage to instruments. The choiceof detergent depends on the type of contamination (organic,mineral, microbial, etc.), type of surface, surfacefinish (smooth,

rough, scratched) and shape of the instrument.The mechanical factor generates friction and pressure, i.e.,the force needed to remove dirt, as well as renewing the cleaning

solution in contact with the instrument. Additionally, it helpsdisperse the dirt. If no equipment is used, the person doing themanual cleaning provides the mechanical action by scrubbing

and brushing the instruments.Temperature reduces surface tensions of liquids, speeds upchemical reactions (wetting, foaming), softens soil and debris,

and improves surfactant penetration. Temperature improvesdetergency but more importantly, it should not exceed 45°C to

prevent fixing of blood proteins onto the surfaces.The contact time, which is strictly linked to the duration of thecleaning process, is the result of the other three factors.

The challenge of manually processingtransmission instruments

The internal parts of transmission instruments are constantlyminiaturised and complex, resulting in rising challenges for

cleaning processes. They mount components made of differentmaterials (composite, rubber, steel alloys), as well as electronics.Unless the instruments can be disassembled, it is challenging to

manually clean all internal parts, i.e., gears, chucking system, ball bearings, tiny spray channels and nozzles. They cannot be soakedor cleaned in an ultrasonic bath – which does not help either.

It is normally recommended to clean the external surfaces with soft brushes under running water whilst avoiding toomuch tap water inside the instruments. After cleaning and

drying, instruments must be lubricated prior to packaging andsterilisation. Completing this step manually with propellantlubricant may lead to over-lubrication if not done correctly, thus

increasing the cost of handpiece maintenance whilst not beingenvironmentally friendly.

With this in mind, anyone would agree that maintlaining and

reprocessing transmission instruments is really challenging.If these operations are not performed properly, it will likelyreduce the lifespan of instruments by up to 50 per cent. More

importantly, it may lead to non-sterilised instruments with

direct implications towards the safety of the team and patients.Transmission instruments go from one patient’s mouth into

another, increasing the risk of transmitting blood-borne diseasessuch as Hepatitis B, C and D, as well as HIV.

What about automated maintenance?The hygiene protocol for reprocessing transmission instruments

starts with pre-disinfection immediately after use. Usually,the dental assistant will wipe the instruments with a disinfectantcloth whilst disconnecting them from the coupling or motor drive.

The four essential steps can be performed by specificprocesses/machines. However, it must be underlined

21DENTAL ASIA J ULY / AUGUST 2015

DENTAL MANAGEMENT


24/96

that n o t e v er y m a c h i n e f u l fi l sa l l f o u r s t ep s . Some machinesexclusively clean the inside and

lubricate; others simply lubricate.Thermal washer disinfectors cleaninside and outside but do not

lubricate. In these cases, one or moreextra manual operations are stillrequired. Prior to purchase, it is vital

to understand the manufacturer’sclaim, i.e., which pre-treatment steps

does the machine fulfil?

How can machines correctly processtransmission instruments?

When they designed the new

Assistina 3x3, the goal was tofulfil the four essential steps ofthe pre-treatment process by combining

the relevant parameters, to provide

the highest level of safety for usersand patients, and to preserve the long-

term integrity of the instruments. Theengineers succeeded in designingan innovative reprocessing device

that offers thorough cleaning ofinternal components and optimalexternal cleaning, thanks to the

cleaning ring that travels along theinstruments, spraying a cleaningsolution at a very high pressure

through six spray nozzles.Following the Sinner

Circle principles, the chemical actioncould be drastically reduced to a very

mild concentration, thanks to the highmechanical action. This patented system avoided heating both

the cleaning solution and the instruments. It also shortened theoverall cycle time to 6:30 min and reduced the preparation costper instrument to a few cents. This type of external cleaningcannot be reproduced manually. By eliminating brushing and

scrubbing, we also avoid micro-scratches on the instruments, which can harbour future debris. DA

Clearly, we are talking about “all-in-one” devices that

clean inside AND outside, rinse, dry and lubricate –

which is fulfilling the four essential steps.

About the Author

Mr. Christian Stempf , Hygieneadviser of the W&H Group, has

worked extensively within the

European dental industry. Hehas been involved in infection

prevention and sterilisation forover 20 years. He is a memberof the European normalisationcommittee, which formulated

the first norm on small steamsterilisers. He has gathered

valuable practical knowledge and experience through his

daily activities and contacts with healthcare professionalsand experts in thefield of infection prevention throughoutthe world. He shares this experience offering vendor

independent lectures in all objectivity on the topic ofsterilisation and infection prevention to expert audiences.

Thorough internal cleaning of instruments is c r u c i a l f o raseps i s and the challenge for an automated process is toensure that the spray channels, gear parts and ball bearingsare thoroughly cleaned. Usually, internal cleaning is done via

pressurised diluted detergent flushed through the internalcomponents of the instrument. This satisfies the previouslydescribed cleaning principles (Sinner Circle), combining

chemicals, mechanical forces and temperature for a defined time.Some devices flush the instruments with steam.Ef ficient cleaning requires the four factors in the Sinner Circle to

be correctly balanced. There is no issue for applying chemicals ata defined temperature for a certain period to the outer parts of

the instruments. However, the challenge lies in the missing mainfactor – how to generate the mechanical action. As mentionedearlier, if one factor is reduced, the loss must be compensated

by increasing one or more factors. Therefore, if little or no

mechanical action (nebulisation) is applied, the concentrationand/or harshness of the chemical must be intensified. Working

temperature and/or contact time must also be augmented. A very high concentration of chemicals may damage instrumentsand certainly requires additional rinsing. Over-application of

chemicals on transmission instruments could also lead to drasticreduction of their lifespan and increased repair costs.High-end devices offer perfect lubrication. A tiny oil droplet

is blown through the mechanical parts by pressurised air. The

extra oil is removed in a second phase by a flow of compressedair that only leaves a thin layer of lubricant on the mechanical

components. This system of lubrication is very ef ficient and moreeconomical when compared to propellant cans.

Processing with Assistina 3x3For over 125 years, W&H Dentalwerk has been one of the leadingproviders of dental instruments and devices in the world. The

core business is the manufacturing of transmission instruments,maintenance and cleaning devices, as well as steam sterilisers.

W&H has gathered significant know-how and experience by being

active in these fields for decades.


DENTAL MANAGEMENT


25/96

http://www.shofu.com.sg/mailto:[email protected]


26/96

by Dr. Audrey Abella

It’s not about the environment, but you’ve read it right:Tooth recycling might just bethe missing link between flat or

thin alveolar ridges and a highlysuccessful implant outcome.

A utogenous Tooth Bone Graft Material (AutoBT) isa concept pioneered by Dr. In-Woong Um, an oraland maxillofacial surgeon in Korea. Read on as he

walks us through this revolutionary procedure that

is gaining ground in the dental field.

Dr. Um obtained his degree from Seoul National University (SNU). After graduating, he completed his oral and maxillofacial surgery

(OMS) training in 1987 and obtained his Ph.D. at SNU in 1992.He was a professor at the Department of Oral and MaxillofacialSurgery at WK University from 1990 to 1996, specialising inorthognathic surgery, as well as cancer and bone graft research.

He is currently an af filiate professor in several university hospitalsin Korea and running his own private practice.His interest mainly revolves around s u r ge r y . He particularly

chose bone reconstructive surgery (post jaw amputation) as hisspecialisation. His Ph.D. thesis on “ Allogenic Bone Graft ” fuelledhis search for a suitable graft material; hence his devotion to

this speciality, which eventually led him to founding the firstKorea Bone Bank in 1993. He has also achieved a Certified TissueBank Specialist (CTBS) status, which was given by the American

Association of Tissue Banks (AATB).

He related a particular experience that pushed him to investigatemore about AutoBT. “I remember my first visit to the Bone Bank

in the Philippines to learn how to develop a material under theguidance of the International Atomic Energy Agency (IAEA).The idea of repairing alveolar bone to achieve a successful,

long-term clinical outcome became my strongest motivation.Since then, my interest shifted and I eventually specialised in

i m p l a n t d en t i s t r y when I started my private practice as an

OM surgeon.” With his surgical expertise and training, Dr. Um has authoredmore than 100 papers and three textbooks based on research

he conducted in 1993.

Breaking NewGround in AlveolarBone Repair throughTooth Recycling

Dr. In-Woong Um:

Failure: A motivational springboardDr. Um revealed his general thoughts on his role as a surgeon.“I always have several questions in my mind when treatingpatients: Would my treatment and materials be the right

choice? Do I understand and did I study the material enoughso that it would give highly successful, long-term results?” Heconstantly asks himself these questions as patients seek consult

and treatment. He related that the impact only becomes greater when he is met with failures or poor results. “I ask myself, ‘whatdo I know – and what do I n o t know?’”

That window of failure gave him the idea to look further into a partof the surgical process that can significantly change the procedure.He reiterated that dentists should not confine their roles to

what was learned in the past. “Dentistry involves continuouslearning. Along with the responsibility to provide treatment, wealso have to constantlyfind suitable materials for our patients.”

This mindset motivated him to conduct more studies to find amaterial solution. Eventually, he developed AutoBT and foundedthe Korea Tooth Bank (KTB) in 2009.

AutoBT: The gold standardDr. Um described the AutoBT procedure in detail. “The idea

of utilising an autogenous tooth as a bone graft material wasinspired by Dr. Urist, who discovered bone mo r phogenet i c

p r o t ei n ( BM P ) in bone and dentin in 1965. After ten years with

the Bone Bank, I realised that a Demineralised Dentin Matrix(DDM) could be the gold standard in reconstructing alveolar

bone, most especially for implant dentistry cases.”

He added, “AutoBT is not a discovery but an ultimate collectionof scholars’ past discoveries and scientific research. Our mission

was to organise the data and facts and roll them into one, which

became the core of our system.”


UNDER THE SPOTLIGHT


27/96

http://www.voco.com/


28/96

The p r o c edu r e

Extracted teeth are collected fromclinics and sent to the KTB. AutoBT isthen manufactured in the processingfacility and undergoes demineralisation,

lyophilisation, sterilisation and othernecessary procedures. After which, theprocessed AutoBT would be sent back to

the clinics.

The p r odu c t

Samp l e case

Restoration of an edentulous leftmandibular first molar area. Extraction site

was treated with AutoBT block and powder.

P r o c edu r e

Fig. 1: Saucerisation of buccal wall on #36.

Fig. 2: Repair of the buccal wall with blockand powder without any membrane.Fig. 3: Afterfi ve months, the block and powder

completely transformed into new bone.Fig. 4: Implant installation on the newly

formed bone.

1. AutoBT (powder): Osteoinductive,

osteoconductive and regenerative.

2. Root form (block type): Three-dimensional scaffold for alveolar

bone repair and osteoconduction.3. AutoBT (mouldable type): Powder

is converted to an injectableand mouldable material formanipulability and fitting into the

defect surrounding an implant.4. AutoBT BMP: Growth factor (BMP)

that is loaded on the powder, which

enhances osteoinduction at an earlystage.

I n d i c a t i o n s

AutoBT can be used to r e p a i r a l v e o l a r b o n e i n i m p l a n t d e n t i st r y . Specific

indications are socket preservation, guided bone regeneration (GBR), vertical andhorizontal augmentation, sinus augmentation, and onlay grafting. It can also be used asan alternative to a mixture of conventional materials that can be used for the above-listed

procedures. Furthermore, due to its osteoinductive, osteoconductive and remodellingcapacities, it can act as a secondary or tertiary material in failed (alveolar bone) repair cases.

Advan t a ge s

1. Biocompatible: The components of AutoBT are identical to dentin (Type I collagen,HA and non-collagenous protein).

2. Dentin matrix macro-structures are very similar to cortical or cancellous bone.3. Abundant microporous dentinal tubular structures provide nanostructural

micropores for movement of proteins.

4. The geometric assembly of the root dentin block make a unique and ideal 3Dscaffold for alveolar bone repair.

5. Recycling of a patient’s own extracted tooth compensates for the limitations of

other materials and eventually leads to positive results (with no pain, additional

cost, genetic illness or need for a membrane).

The influence of stem cell therapy Dr. Um expressed his thoughts on stem cell therapy and how it has influenced

AutoBT. “Like stem cells, BMP has already been known for decades due to its ability toreconstruct bone. However, an appropriate carrier had to be developed for the practical

application of BMP. It has been discovered that dentin could act as an excellent carrierof BMP. Thus, I continued to probe further on this field and eventually came up with

AutoBT,” he stated. “I believe we could utilise pulp stem cells in the future,” he added,reflecting his endless quest for noteworthy surgical solutions.

Special facility AutoBT requires an exclusive facility for material processing and storage. Dr. Um disclosed

that this is highly necessary, given the sensitive nature of the procedure. “AutoBT is beingprocessed and stored in our special facility in the KTB. Processing should be done withina strictly controlled area and only by highly qualified laboratory technicians.”

Sharing the knowledgeDr. Um’s active presence in several dental organisations in Korea has given him the

leverage to propagate AutoBT. “We have established and researched on AutoBT at theKorea Auto Tooth & Bone Bank (KABB) since 2009. We have lectured extensively aboutit, and this is supported by the Korean Academy of Implant Dentistry (KAID), Korean

Academy of Oral and Maxillofacial Implantology (KAOMI) and Korean Academy ofDental Science (KADS). In fact, ten university hospitals and approximately 1,000 dentalclinics are already using our product and system.”


UNDER THE SPOTLIGHT


29/96

These figures signify the growing interestin this new protocol. Additionally, with areported figure of about 10,000 operative

cases in a year, AutoBT has earned thenew Health Technology Ass essment(nHTA), which endows products with a

safety and ef ficiency mark approved by

the Korean government.

International attentionResearch and clinical studies have

proven the safety and clinical ef ficacyof AutoBT. Dr. Um revealed that threeinternational patents have already been

registered in Europe and China. He statedthat more than 80 articles on AutoBT

were already published, including 12

SCI (e) journal articles. In addition, anEnglish textbook, “ Advances in OralTissue Engineering”, which is a collective

writing of their research results, hasalready been published by QuintessenceUSA in 2014.

H e n a m e d s e v e r a l r e n o w n e dpractitioners from several countries

who have been using AutoBT. “Dr. Mario

Esquillo and Dr. Jonathan Acosta fromthe Philippines, Prof. Murata Mitsugifrom Japan, and Prof. Zhang Yi and Prof.

Zhang Shilei from China are already veryfamiliar with our product and system.”

The future of AutoBTHowever, Dr. Um pointed out thatthere are dentists who are still using

ready-made or conventional materials.He shared with us his views on this.“Unlike conventional materials, AutoBT

is manufactured and i n d i v i d ua l i s e d tofit a specific patient’s need or a dentist’s

diagnosis. But then again, accessibility would be a dif ficulty: Not every countryhas the facility that AutoBT requires.”

The lack of accessibility thus accounts forthe fraction of practitioners who resort toreadily available methods.

Despite this, he hopes that more dentists would embrace this concept in the future.

He related that they are on a constant roll to spread the news about it. “We wantour colleagues to learn about its exceptional results,” – noting that he does so bycontributing to scientific publications and conducting lectures in different countries.

“We also continuously upgrade AutoBT by adding several growth factors like

polydeoxyribonucleotide (PDRN) and BMPs. Mouldable AutoBT is already underclinical trial in Korea. I firmly believe that more dentists would be interested in our

system and product in the near future. As mentioned earlier, a stem cell-loaded AutoBTscaffold might be available soon.”

From textbook to chair-side applicationDr. Um sends this message to practitioners who are aspiring to explore the surgical field.

“We should always think as (and be on the side of ) patients when choosing the technologyand materials for their treatments. Clinical applications must be “ev idence-based ”.

Although new products seem to be as innovative and promising – which compels us

to conform to newer trends in the practical setting – we should still be able to confirmthe procedures we do through textbooks to ensure patients that we are using safeand proven measures,” he indicated. These words highlight the importance of a solid

theoretical foundation in formulating treatment plans and solutions.

Keeping it greenThe practice of recycling continues to go beyond the environmental line. Today, recyclinghas been introduced in dentistry through AutoBT, which would greatly contribute to

structural preservation. What was once discarded immediately after extraction isnow being recycled. “The next step after recycling would be the development of aneffective allogenic graft material under our system, and then implement the “tooth

donation” culture. Once this becomes a regular process, we could confidently say thatthis study has led us to the right path, which would eventually lead us to another goal:The development of a stem cell carrier at the end of the line, which we think would be

a significant contribution to the dental society,” he explained.

Spreading the wordBeing well-recognised in the field, Dr. Um has been a globally sought-after lecturer.He regularly conducts lectures, hands-on trainings and workshops to keep colleaguesin the loop. “Prior to AutoBT, I have regularly lectured about bone graft and implant

for more than ten years. Since its development, I conducted lectures in Seoul on amonthly basis.” He added that the lectures reached an international level of acclaimas interest from professionals across the globe grew further, with the aid of professors

from Japan, China and Vietnam. He has also held a Tooth Bank Specialised TrainingCourse through KTB thrice in the Philippines.

At the moment, he is geared towards conducting lectures in the Asian Congress of Oraland Maxillofacial Surgery (ACOMS 2016) in the Philippines and the InternationalConference on Oral and Maxillofacial Surgery (ICOMS 2017).

Dr. Um is constantly finding ways to innovate the procedure to present more satisfactoryresults. This groundbreaking concept is something that he would like to see in practices

in the future. “I would say that we are still at the starting point and we still need moreresearch and clinical trials. But before we can conduct further studies, I’d like to promoteawareness about our tooth storage system to other countries as early as now so thatthey can also reap the benefits of this promising material and procedure.”

Trash = Treasure We have been witness to the wonders and benefits of recycling: From practical home

solutions and now to dental applications. As they say, “One man’s trash is anotherman’s treasure,” and with this breakthrough, Dr. Um has allowed his colleagues toappreciate recycling from a dental perspective. This will definitely be a significant

contribution to more ef ficient dental surgery procedures, which will be instrumentalin changing the face of implant dentistry.DA

Korea Tooth Bank facility


UNDER THE SPOTLIGHT


30/96

Mr. Mike Dominguez has already been in the dental

laboratory industry since 1997. He progressed in this fieldand eventually decided to enter school and formalise histraining. Now a Certified Dental Technician (CDT), he

earned his B.S. in Dental Lab Sciences from the Universityof Texas Health Science Centre and graduated summa cum laude. He isone of the few technicians with the T.E. designation.

Armed with the experience and educational background, Mr. Dominguezestablished Kymata Dental Arts in 2009, a contemporary dental studio inSeattle, Washington, USA, which specialises in aesthetic, comprehensive

and implant dentistry.He lectures across the US about various dental lab topics such as marketing,aesthetic ceramic techniques, and dental lab materials. He also sits on the

board of the Washington State Dental Laboratory Association and servedas its Vice President (2013) and President (2014). He is also involved withthe Dental Technicians’ Guild, as well as the Inside Dental Technology as

one of its board of directors.Dental Asia had the chance to sit with Mr. Dominguez during the IDS 2015.He shared with us his insights on the digital dental laboratory scene, as well

as his feedback on the Renfert equipment that he has acquired for his lab.

Commitment to educationHis strong sense of commitment to dental lab education has fuelledMr. Dominguez’s enthusiasm even more. He immerses himself in the scene

by being actively involved in the state dental association. “I want to helplocal artists and small independent businesses. I want to see this industryprogress. I’m passionate about what I do, as well as about the health of the

industry and the success of small labs,” he started off.

Mr. Mike Dominguez

onQuality by Dr. Audrey Abella

Kymata Dental Arts:Small in Size,

BIG

Mr. Dominguez with Ms. Jeannette Giesche,

Renfert Area Sales Manager for Northern Europe

and Asia-Pacic, at the IDS 2015.


UP CLOSE & PERSONAL


31/96

The digital revolutionComparing the technology they had

back then to what the in dustry ha stoday, Mr. Dominguez indicated that

there is a huge difference. “In 2009, I feltlike it was going to be a very short time before we can do away with casting. I

didn’t want to buy a casting machine, nordid I want to have alloy inventory: I feltlike we were going to be printing metal

within a few years. This didn’t happen forme until last year. Obviously, technology

was not as advanced as it is now.”

He added, “Nowadays, it's easier for labsto afford technology, which is good. Ithink if we can automate the process, it

is a good thing as long as the technician isskilled. In 2009, the technology was not

where I wanted it to be. But at this point,as far as how I imagined the work flow togo, I can say we’re getting pretty close.Modern lab equipment lessens the

trial-and-error phase that usually happens with the conventional way. Digital hastrimmed down the process and time,

leaving very minimal room for error.”

The critical role of manualskillsDespite the advances in digital technologyfor dental labs today, dental technicians

still agree on the importance of manualdexterity, and Mr. Dominguez couldn’tagree more: The skill of the technicianstill greatly accounts for a successfully

fabricated prosthesis – in spite of theemergence of digital. He elaborated onthis further. “Technical knowledge is still

absolutely critical to the process. Theold argument is – and has always been– that the machines can and will replace

technicians. In my opinion, you need both.The technology is just a tool.”He also pointed out that there are still a lot

of traditional materials being used today, but they have somehow been modifiedto fit the digital picture. No matter how

many tools you have, the backgroundknowledge still accounts for about halfof the equation. “As technicians, we still

have to know morphology, occlusion,function and aesthetics. We cannot leaveeverything to the machines.”

He also stated that he does not see howlabs can get away with just machines.“What we don’t want to do is to allow

technology to lead us down the road to

mediocrity. We don’t want to sacrifice quality for ef ficiency. We want to demand the

technology to produce aesthetic results. Thus, whenever I am talking about technology,or whenever I try to buy technology, in my mind, I want that technology to producesomething pretty. We can’t settle for mediocrity just because it’s technology.”

The digital outputHe voiced out his insights as we talked about digital dentistry. “Almost everything is

digital, yes, but the end result – what does it produce? Does it put out inferior materialor aesthetics? So we definitely need to get over the infatuation with technology andget back to traditional aesthetics, and tie this with the modern process for the benefit

of the patient,” he remarked.

The Renfert experience Asked to describe the Renfert equipment that he has worked on, he went back to as faras his school days. “In lab school, I would use the Renfert wax and electric waxer. One

of the first automatic mixers I used was a Renfert mixer. The Renfert vacuum mixerthat I have now is a workhorse. We have their vacuum for sandblasting. We use theirmodel preparation. We also have their dye material.”

Tying the traditional and modern knots together As we went on, he took off from what he mentioned earlier pertaining to the marriage

of the traditional concepts and digital philosophy, and integrating Renfert into thepicture. “Dentistry is now a mix. And for our laboratory, this is where Renfert comes in.

Kymata’s Renfert line

Te Kymata staff (from L to R):

Ms. Jaime Miller, Mr. Dominguez,

CD/E, DG, and Ms. Virginia Kim.


UP CLOSE & PERSONAL


32/96

They have a digital line and they still have

a traditional one. They’re good at both.”He incorporated more input aboutRenfert and expressed his satisfaction

about the equipment that he has obtainedfrom them. “For me, Renfert hasexcelled in terms of the quality of their

materials and equipment. With the costof technology these days, we don’t wantto spend tens of thousands of dollars on

a piece of technology, only to be left witha broken trimmer or vacuum or a worn

out brush in a month. That is too much.If you’re going to invest in technology,it has to last and produce quality output

for you. Renfert is the perfect exampleof this. They guarantee their stuff andthey make it well. Perhaps that is even

an understatement – because they makeit too well.”He also shared his thoughts on the notion

of resorting to cheaper materials. “Attimes, it’s not even cheaper. You pay for

brand names but they lack the quality.

If the quality does not live up to itsexorbitant price, then it’s not worth it. But

with Renfert, it is nice and simple. Theyput their energy in quality. And this isthe type of lab that I have as well – we’renot too flashy but we produce the best

quality we can.”

Reliability and durabilityrolled into oneMr. Dominguez also noted that Renfert

equipment are very easy to use. “Apartfrom their excellent performance, theirtools are usually equipped with big dials

and buttons, thus adding up to its user-friendliness. I really recommend this brand tomy colleagues all the time.”

One big leap

“I think the biggest leap in dental technology at this point would be to refi

ne theprinting process,” he commented, referring to 3D printing – as this has been the path

that most labs have been walking on right now. Prostheses are being “printed” digitallythrough the three-dimensional mechanism. Gone are the days when dentures are“processed” or “fabricated”. It’s still a long way up as he observed, but if the concepts

that we have now have come into existence when nobody thought it to be possible,then high-definition printing is just looming in the horizon.

Small in size; great in valueIt’s not the size of the lab that matters; it’s the quality of the output. And Kymata

Dental Arts is just the epitome of a small lab that offers valuable creations. Dentistsseek their services because of the excellent results that they are capable of producing,

with technicians armed with the necessary skills and equipment to help them carry

out their expertise. “We get calls almost on a weekly basis from dentists wanting to

use our services – even from out-of-state. We’re very fortunate. We’ve been helped bya lot of good people,” he stated.

He added, “Since we are a small lab, there is not a lot of time for us to maintain a broken machine. We have checklists on how to maintain a working machine. Thatis part of our process. Because, for instance, we are in the middle of making a crown

and the vacuum or trimmer suddenly goes out, it would be dif ficult for us to stop ourproduction. It does not happen now with the Renfert tools that we have. I know thatit’s not going to fail me even in the worst possible moment. We get excellent after-sales

support from Renfert, and if anything does go wrong, we get answers immediately.Renfert has offered us peace of mind.”

Although he kept emphasising that Kymata is a small lab, he welcomed the idea of

branching out in the future. He indicated that their size does not hamper their plans ofspreading their wings. “Branching out would be good. As long as we stick to our guns

and keep producing quality work, I think that would be feasible. I can see technologyhelping us communicate and accept cases from out-of-state.”

Not just a small voiceMr. Dominguez is passionate about what he does, and he has a fervent vision to seesmall labs succeeding. Whenever he comes across products or manufacturers that help

small labs, he spreads the word so everyone in the circle can go with the flow of today’strend to create a homogenous environment amongst his peers. They are kept in the loopas to how they would be able to maximise their production despite being small labs.

“I believe it’s everyone’s responsibility to help each other. I believe incollaboration. And with regard to technology, I don’t want to push technology

to push more mediocre units; I want them to push more q u a l i t y in it. Biglabs may beat us on price, but they can’t beat us on quality,” he concluded.

These statements clearly indicate that Mr. Dominguez serves as a voice for small labs.

With a goal to provide high-quality restorations and excellent customer service in everycase, and a dash of his passion, it appears that he can get his message across all smalllabs – loud and clear. Kymata Dental Arts is indeed proof that success is not merely

measured by size. Clear-cut goals, emphasis on quality and reliable equipment – theyhave just the perfect formula for success in the arena of small dental labs.DA

Kymata workspace


UP CLOSE & PERSONAL


33/96

The Perfect FusionErgonomics and AestheticExcellence

Morita:

by Dr. Audrey Abella

Established as a dental importer andretailer in Kyoto, Japan in 1916,J. Morita Corporation now stands

as the J. Morita Group, which hasgrown to become one of the world’s

largest distributors of high-quality dental

equipment and supplies. With manufacturingfacilities in Japan, Morita has dedicated itsefforts to innovation in product design and

development. Having the ability to adapt tothe changing market conditions and a strongcommitment to industry leadership, Morita

helped redefine the direction of dentistry.In 1964, Morita introduced the Space l i ne , acomprehensive dental treatment unit designed

to accommodate patients in a supine position

while the dentist sits comfortably in a 12-o-clock position. This particular unit became the subject

of our conversation as we sat down withMr. Masanori Mori, Director of Morita Dental

Asia Pte. Ltd. According to Mr. Mori, this is what

they would consider as the “ Morita edge”. Readon to know how Morita has positively transformednot just the conventional dental treatment unit, but

the general dental practice as a whole.

Traditional (stand-up) dentistry Back in the day, patients had to settle fornon-reclining chairs while dentists performed

procedures while standing. “The whole process boils down to an uncomfortable experiencethat both patients and dentists had to endure,”

Mr. Mori began. Today, although some dentistsmay still prefer to stand, sit-down dentistryhas become the standard treatment position.

And as for patients, they mostly assume thehorizontal position, as treatment centres aretypically designed to be in a reclining position to

accommodate patients in the most comfortable way.

Mr. Masanori Mori, Director,Mr. Masanori Mori, Director,

Morita Dental Asia Pte. Ltd., with the


Soaric treatment unit foreground) andSoaric treatment unit (foreground) and

Veraviewepocs imaging unit behind).Veraviewepocs imaging unit (behind).

Mr. Masanori Mori, Director,


Soaric treatment unit (foreground) and

Veraviewepocs imaging unit (behind).


DENTAL PROFILE


34/96

The Spaceline: Not just another dental chairMr. Mori revealed that the Spaceline holds a prime spot in theirelite line of dental treatment units. An innovative patented

concept from which others have taken off, and based on theprinciple of human-centred design, the Spaceline is the world’sfi r st horizontally-positioned treatment unit. It combines

aesthetic excellence, ergonomic refinement and comprehensivecross-contamination management to ensure a comfortabletreatment – for both dentists and patients. He shared with us

the story of the Spaceline evolution.

Patient AND dentist comfort: Spacelineoffers bothDr. Daryl Beach was an endodontist who came up with the

Spaceline concept in the 1960s. Being an endodontist, henormally performs lengthy procedures, which give him back painand other musculoskeletal

dental asia jul

Documents