success is... - DENTSPLY Friadent

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EVIDENT SUCCESS ® 1_07
success is ...

...dynamic practice development

04 | IDENTITY
contents
04_Contents and Imprint
05_Editorial
06_Success is …
08_Success is …?
10_Looking at tomorrow from today
16_Evolution of a treatment method
20_Opening up new options
06
Imprint
26
38_Optimizing working paths in
the practice
42_Winning and motivating
patient consultation
46_Building up a referrer network
50_Transparency – the magic word
22_More convenience for the patient
with a highly atrophied alveolar ridge
26_Modern techniques and a highly
qualified dental laboratory
30_Easy, fast, reliable
32_Intelligent, exciting products
34_Corporate design
34 38
54_Being prepared for the future
58_TissueCare roadshow 2007
59_Always one step ahead
60_Preview of iDENTity 02/07
61_Fax form
63_Events 2007
iDENTity EVIDENT SUCCESS ® Publisher: FRIADENT GmbH · P.O. Box 71 01 11 · 68221 Mannheim/Germany · Tel.: 0049 (0)621 43 02-010 · Fax: 0049 (0)621 43 02-011 · Internet: www.friadent.de
Editor in chief: Nadine Dusberger (Medical Consulting Group/Düsseldorf/Germany) Editorial team: Ricarda Jansen · Christine Rohne · Claudia Schillinger · Vanessa Voll
Further collaborators of this issue: Eva-Maria Hübner · Dr. Jan H. Koch · Tanja Friedrich · Birgit Tambaur-Bischoff Design and Layout: WEGA Werbeagentur · Mannheim/Germany
Printer: Wörmann & Partner/ Mannheim/Germany Photo: Stefan Blume (S. 2-4, 8, 19, 26, 34-40, 42-45, 59) · Klaus Vyhnalek (S. 54-57) · pixland ® (S. 16)
iDENTity is published in German and English four times per year and adresses expert groups. Authors’ opinions do not necessarily represent those of the editors.
Some products or specific “indications for use” may not be cleared for use in all countries. Copyright: FRIADENT GmbH, Mannheim/Germany
Reprints and reproduction, even in part, on approval by the publisher only Circulation: 30,000 Subscription: free of charge – orders to identity@friadent.de
User notes: The instructions for use that we supply for every product are the final authority for the use of our products with the approved indications. Suggestions and reports
from users published in iDENTity are intended for scientific discussion. It is possible that the applications and indications that are described are not scientifically accepted
or they are not recommended by us in our instructions for use. The therapist is solely responsible for selection of the treatment method in every individual case.
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Please contact your DENTSPLY Friadent representative to obtain up to date information on the product range and on availability.

DEAR READER,
IDENTITY | 05
Success! For Woody Allen success means being different from other people.
For Erich Kästner it was the offspring of audacity. And for Nobel prize-winner
Elias Canetti it meant being mentioned in the newspaper.
You can see that success is as varied as the people who define it. You certainly
had your own very personal idea of success when you opened the door to this
journal. And you were surprised or possibly had your own idea of success confirmed
when you read what we mean by “success is …”: Dynamic Practice Development.
The routes to this goal are as varied as the definitions of success, and this is why
we have not tried to define “the” path to success. Instead we show you different
paths to your personal success in your practice. We describe therapeutic success
concepts and business aspects just as much as the views of your colleagues on
future success factors in implant dentistry. We also talked to Matthias Horx, one of
the best known trend researchers and futurologists in Germany, who describes his
estimate of future trends and megatrends for you. He also looks beyond implantology
to the wider world. Because success also means being fit for the future.
We should also mention the view through the spyhole in the door too. Not much
to it, I thought, until I found out more during my researches for this foreword.
Did you know that you can get door viewers with video cameras? Is that so you
can know who wanted to see you while you were away from home? Have you
heard of door viewers decorated by artists? Or the camera lens that simulates this
view? The spy novel? No? No problem – you have us. And your personal view of
dynamic practice development.
Enjoy your reading!
Sincerely
Nadine Dusberger
and the iDENTity editorial team

06 | IDENTITY
© Franco Vairani/MIT Smart Cities
© Litracon Bt 2001-2007
success is …
… everything! And what is better, more exciting,
more fascinating, more surprising and more
enlightening than the success of others.
... SUCCESS IS SUCCESS IS SUCCESS
For the research team at MIT Media Lab in
Massachusetts the urban future-mobile is not
only permanently mobile but also stackable.
web.mit.edu/francov/www/bitcar/
... IMPOSSIBLE
reddot design award for a concrete block?
Enlightening! Innumerable glass fiber inclusions
make the concrete creation of designers
Aladár Csontos and Áron Losonczi a unique
translucent view.
www.litracon.hu
... EFFERVESCENT
321,600,000 bottles – 4,000,000,000
euros in sales! Two sobering numbers
for record champagne sales in 2006.
... VERY FULL
Proven millions of times in diapers –
now irrigating the desert: “Superabsorbers”
can hold 200 times their
own weight in liquid – in soil and in
the diaper.
www.geohumus.com

... HEAVENLY
Everything inside, everything at hand and
a view of the sky from the top floor –
the ultimate garden shed. Almost 4000 mm
high and less than 40,000 euros.
www.moormann.de
... WELL TANNED
Who says that toast can only
crumble and fly apart?
This award-winning designer
roller toaster gently browns the
slices of bread in its soft rollers.
www.jarengoh.com
... SUGAR-SWEET
... WINGED
It flies and flies and flies. Lucellino
has been above all trends as a design
icon for more than 15 years.
www.ingo-maurer.com
Eye candy for the brain and it’s
always there for an experience
of success – for example, the
highest lump-sugar tower in the
world: 1405 mm
www.suedzucker.de
IDENTITY | 07

08 | IDENTITY
success is …?
DEAR READER,
Success for us is reflected in the trust of our numerous customers.
Last year Dentsply Friadent had the best sales results since the company was
founded. We would like to thank you all very much, because we know that so much
trust in our work is not a matter of course. We continue to work hard every day to
justify your trust in us. We will achieve this with our planned new products,
such as the Excelldent Guided Surgery System and our simplified surgery for the
Ankylos and Xive implant systems. We are also investing in increased capacity to
continue our success.
In recent months we have purchased a number of new CNC machines and started
the construction of new, modern production facilities so we can keep our warehouses
filled and supply you with what you want when you want it.

We will be presenting our Successful Implantology Practice at the IDS in Cologne,
Germany, this year for the first time. You will be able to experience all components
of a modern practice live. You will not only have the opportunity to find out more
about modern implantology but also to see and actually use all the products and
innovations that are part of the Successful Implantology Practice. Let us start in the
waiting room: you will be able to leaf through our new patient information literature
and experience how attractive and different it is. The first treatment room will
show you the prototypes of the new drills and live demonstrations of new 3D
Excelldent software, which you can test for as long as you like. In the operating
theater you will experience the simplified surgical protocol: new surgical trays, a
new surgical unit, instruments and contra-angle handpieces with practical designs
that will support you in your work and make surgery even easier. We have also
remembered the administrative part of the practice: you can test all modules of our
stepps customer success program.
Success is having the answer just when it is needed.
“Tissue stability” is the magic word in modern implantology. Platform-switching
was recently hailed as a great breakthrough in maintaining crestal bone stability
over time. However, if a wide implant shoulder with a narrow abutment is considered
in isolation, it is not the solution for this complex set of problems. The important
factor is to understand and take into account the interaction of the various factors
to achieve lasting success.
This is why Dentsply Friadent would like to present the TissueCare Concept and
invite you to participate in a complete change of perspective in implantology.
Find out which five factors lead to healthy, stable bone and harmonious soft tissue.
Learn the importance of keyed and friction-locked connections without micromovement
between implant and abutment to tissue stability and about the interplay
of a bacteria-proof seal between implant and abutment, platform-switching,
subcrestal placement and microroughness to the interface. In short, discover the
secret of lasting hard-tissue and soft-tissue stability with the TissueCare Concept.
And celebrate 20 years of clinical experience with us, the 20th birthday of the
Ankylos implant system. You will receive your invitation soon – but in any case:
We are looking forward to seeing you!
Sincerely
Dr. Werner Groll
IDENTITY | 09

10 | IDENTITY
success is …
looking at tomorrow
from today
The successful implantology practice
What are the important factors today for a successful practice offering a range of
implant therapies? What motivates young dentists to enter the field of implantology?
And what developments can successful implantologists expect in the near future?
iDENTity asked four dentists working in implantology and a dental technician these
questions and more.

successful development
IMPLANT DESIGN The situation in the implant market can
be compared with that of the automobile market. There the
designs and models of leading makers are looking more and
more alike. Implants today have also reached a standard at
which the implant designs of the various manufacturers are
becoming more and more similar. The only remaining differences
are marginal. However, I see major developments in the
area of the implant shoulder in coming years. Even now the
controlled trials of platform-switching are very promising.
Developments in this direction can be expected from all
implant manufacturers. This will give us better retention of
peri-implant bone. This will also have a positive effect in the
esthetic region. Unfortunately, this item is not as convincing as
we would like. Therefore, there will be developments in this
area that will allow the interproximal bone to be fully retained.
PORCELAIN IMPLANTS I view the growing market in zirconium
oxide implants with some skepticism. No randomized
controlled trials with these implants have yet been conducted.
Shouldn’t this be the basic requirement before recommending
these implants to patients. I do think we can assume that
urgently required controlled clinical trials will soon be conducted.
IDENTITY | 11
“What are the most promising developments for today and tomorrow in modern implantology”
| Prof. Dr. Markus Hürzeler, Munich (Germany)
SURGICAL TECHNIQUES Microsurgical protocols are becoming
more common. Implants are also increasingly being placed with
navigation equipment. Digitalization is simplifying implantology.
Dentists involved in implantology will sooner or later have to
consider simplifying their work with the available digital options.
The removal of connective tissue is still an invasive procedure.
However, I expect a connective tissue substitute to be developed,
perhaps tissue engineering or synthetic collagens. This will
make it unnecessary to remove connective tissue in the gum.
This development will be a milestone in esthetic implantology.
MEMBRANES We expect new materials in the area of bone
regeneration in coming years. Will growth factors be the great
breakthrough in the near future? This will make autologous
bone harvesting less and less necessary. The question of
the future will then be: can we dispense with a membrane
completely? This will also require improved properties, such
as a sufficiently long barrier function and, most important,
optimum integration into the tissues. This will be decisive
in the development of new membranes.
Prof. Dr. Markus Hürzeler
Privat Institut für Parodontologie
und Implantologie IPI GmbH
Rosenkavalierplatz 18
81925 Munich/Germany
Phone 0049 (0)89 928784-0
markus@huerzeler.biz

12 | IDENTITY
successful entry
“What motivated you to enter implantology?”
| Dr. Frederic Hermann, Karlsruhe (Germany)
OPTION FOR POSITIONING Implantology is exciting as a
developing, future-oriented dental discipline. Two factors were
significant in my decision to enter implantology: with demographic
developments patients are aging. An implant-supported
denture can help older people achieve better qualify of life. The
other factor was the ever-increasing economic pressure on dentists.
This makes it very important for dentists to position themselves
correctly on the ever more open market. A good position
is to specialize in implantology, implant surgery or implant
prosthetics. This gives not only the option of an expanded
range of treatment but also the option of becoming less dependent
on public health policy.
ENTRY BY DISSERTATION Another foundation stone for my
entry into implantology was the choice of my dissertation topic
in the direction of implantology and bone regeneration therapy.
During the course students gain at least an impression of the
theoretical aspects of implant-based treatment and the current
literature. After the course this basic knowledge makes it easy
to find a modern implant practice for the practicum.
The selection of the correct practice for this period is very
important for learning basic implant surgery. The new dentist is
also recommended to attend various professional continuing
education courses during the practicum period, such as confe-
rences for beginners in implantology, courses offered by wellknown
professional implantology societies, practical workshops
and regional study groups. Continuing education is essential
for dentists who want to enter implantology and to maintain a
high level of technical knowledge.
SIMPLER AND SAFER WITH DIGITALIZATION It is also
important to remain current with the increasing pace of development
in implantology. The advances in the area of 3D
diagnostics, virtual 3D implant planning and their implementation
with bone-based drilling templates are immense.
The procedures for computer-supported 3D implant placement
will offer greater safety in therapy and accuracy and reduce
the risk of complications. Entry is simpler.
Dr. Frederic Hermann
Partner in a practice specializing
in implantology
Ludwig-Marum-Str. 38
76185 Karlsruhe/Germany
Phone 0049 (0)721 5966300
frederic.hermann@gmx.de

successful practice
“What aspects of a successful practice must be discussed in future?”
| Dr. Fred Bergmann, Viernheim (Germany)
PLANNING AS A PREREQUISITE FOR SUCCESS
Implantology is a surgical discipline with a prosthetic component.
Thorough knowledge of oral surgery and diagnostics, as
well as periodontics, are essential for success. Successful
implantology is based on comprehensive therapy planning.
Casts and orthopantomographic images must be interpreted
correctly in their context. What teeth should be preserved,
which teeth require periodontal treatment beforehand? What
is the general concept – fixed or removable dentures? What
esthetics are possible? And what are the prognoses for longterm
success? The correct diagnosis is decisive for all of these
items. This means that this topic must be covered as part of a
structured training and continuing education program. The
options available with modern 3D planning do make it easier,
assuming that dentist, prostheticist and dental technician all
communicate adequately. However, three-dimensional diagnostics
can only yield predictions on the actual bone volume,
implant position and length, angulation and any possible
damage to neighboring anatomical structures. This information
is not enough for an overall planning concept. 3D diagnostics is
an important factor in the overall planning process, but it is not
the factor that can specify everything. Communication among
all involved and experience in planning and implementation are
the parameters for success, even in complex cases.
IDENTITY | 13
TROUBLESHOOTING The more implants placed and the
longer implants remain in the mouth the more frequently will
we have to deal with problems such as peri-implantitis and
with various components and abutments in prosthetics. It is
important to remain up to date, to learn new techniques and
to recognize trends.
IMPLANT DESIGN An implant design should include a bioactive
surface for even shorter healing periods and more intensive
bone contact. It may also be possible to avoid grafting in
many cases. Patients also prefer less traumatic procedures.
I see developments in the direction of greater prosthetic variety.
The internal design must be rotation-locked, positionable as
desired (e.g. Xive) or also suitable for abutments that can be
rotated 360° (e.g. Ankylos).
PORCELAIN IMPLANTS There will also be developments in
ceramic implants, but in the foreseeable future I see ceramic
implants only as solutions for very specific indications.
Research and development in this area still has a long way to
go and the implants have not yet reached the level of titanium
implants in flexibility or predictability.
MEMBRANES A great step forward would be the development
of a resorbable membrane with the positive properties of a
non-resorbable membrane. The results would be even more
predictable – possibly in the near future?
Dr. Fred Bergmann
Heidelberger Straße 5-7
68519 Viernheim/Germany
Phone 0049 (0)6204 912661
FredBergmann@oralchirurgie.com
www.oralchirurgie.com

14 | IDENTITY
successful practice concept
“How can implantology be successfully implemented in the practice concept?”
| Dr. Bernhard Saneke, Wiesbaden (Germany)
IMPORTANT PATIENT GROUP Implantology is the growth
market in dentistry. The dentist who rejects implantology
rejects an economically important patient group. Particularly in
the higher income range, patients increasingly use tooth replacement
as a means of feeling better and improving their quality
of life rather than as a functional chewing system. Patients
with statutory insurance coverage must pay virtually all the
costs of high-quality implants and it does not appear that future
reforms to the health system will include higher rebates. Even
privately insured patients are subject to increasing restrictions
on services. A dentist who adds implantology to the practice
will have more business freedom. This factor alone makes
implantology an important part of the services offered by the
practice, even without considering the increasing interest in
implant-borne dentures by patients.
IMPLANTOLOGY IN THE PRACTICE CONCEPT The wide
variety of information on implantology in the print media and
on television gives patients the feeling that everything is
possible from the single tooth restoration in the front tooth
region to immediate restoration of the complete jaw in only one
day. And that is true: the indications are becoming broader all
the time and the surgical protocols have developed greatly in
recent years to meet the demand. Now we are at a very high
technical level. However, complex grafting procedures with a
marginal bone volume require extensive experience in addition
to special training. This is frequently the sticking point for many
dentists in solo practices, because acquiring such experience
with their own cases is virtually impossible. However, such
practices can implement a high degree of basic implantology –
for example, the restoration of free-end edentulism and edentulous
mandibles with sufficient bone volume. But the critical
question is whether this is economical. The costs for structured
training and continuing education are high, as is the investment
in instruments. Where the case load is low experience
and economic considerations recommend that dentists in this
situation restrict themselves to implant prosthetics and leave
the surgery to a specialist.
COOPERATION BETWEEN SOLO DENTIST AND
SPECIALIST The infrastructure for cooperation between
surgical practices and dentists offering implant prosthetics is
available throughout Germany. However, statistics show that
patients specifically interested in implants are frequently
rejected by their dentist, whether because of insecurity or lack
of knowledge is unknown. But today we know that more
patients are deciding in favor of implants with a comprehensive
explanation of the options available in modern implantology.
All involved profit from this: the surgeon, the dentist and the
dental technician.
Dr. Bernhard Saneke
Gemeinschaftspraxis Dr. Droege,
Dr. Saneke and Partner
Egerstraße 7 · 65205 Wiesbaden/Germany
Phone 0049 (0)611 721358
saneke@dentalplus.de
www.dentalplus.de

successful implant prosthetics
“How can esthetically high-quality implant prosthetics be achieved?”
| Peter Lange, master dental technician, Göttingen (Germany)
SUCCESS FACTOR IMPLANT PROSTHETICS Implant prosthetics
today are one of the most important economic factors
for our laboratory. In recent years the demand has increased steadily
and we anticipate continuing increases in future years. Successful
implementation of implant prosthetics is based on three
points: the implant work is conducted in close cooperation with
the dentist customer. This requires teamwork emphasizing
development of a customized solution for problems. Additional
points are technical expertise, knowledge of leading implant
systems and functional and esthetic design of the individual
system components adapted to the actual situation.
PORCELAIN FOR IMPROVED ESTHETICS Esthetics is becoming
more important for patients. We prefer Cercon (Degudent,
Hanau/Germany) as the material of choice to manage the most
demanding esthetic situations. Today we fabricate 30 % of all
restorations from zirconium oxide. Even with comparatively
“minor” jobs the unique esthetic options are easily detected –
for example, a single-tooth crown in the front tooth region,
which is to be used as the superstructure for an implant.
Although this is not a particular challenge, it is practically
always possible to meet the wishes of the patient. In every
case the translucency of the material ensures a natural-looking
light appearance. The interdental space can also be reproduced
for a natural appearance and a harmonious gingival margin.
IDENTITY | 15
For full exploitation of the possibilities of zirconium oxide the
implant abutments should preferably be of the same material.
Depending on the clinical situation a custom-milled abutment
or a fabricated porcelain coping such as Friadent Cercon can be
selected.
ADVANTAGES FOR THE PRACTICE The low affinity for
plaque of zirconium oxide reduces the opportunity for bacteria
to colonize the peri-implant region. This high-performance ceramic
is an ideal prosthetic material for implant treatment. More
and more dentists are requesting it. ■
Peter Lange, master dental technician
Reprodent Dentaltechnik GmbH
Gerhard-Gerdes-Str. 15
37079 Göttingen/Germany
Phone 0049 (0)551 67773
dentaltechnik@reprodent.de

16 | IDENTITY
success is …
evolution
of a treatment method
Immediate implant placement in the esthetic region
| Dr. Steffen Kistler | Dr. Frank Kistler

Immediate implant placement, which is placement of an
implant immediately after extraction of the old tooth, is a treatment
method in modern implantology that does not involve
increased risk during healing if a few basic rules are followed.
Most publications describe long-term results that are practically
identical with the success rates of later implant placement.
This procedure has increasingly become the procedure of
choice in implant therapy in the esthetically demanding front
tooth region. Because immediate implant placement, preferably
with immediate restoration, allows retention of the existing
hard and soft tissue, demanding and high-risk treatment can
often be avoided in achieving an esthetically and functionally
satisfactory result.
Of course, structures can only be retained and restored with
this procedure. Therefore, improvements in methods are still
being made to achieve an overall situation with long-term
stability. Most parameters that affect a generally predictable
result in the front tooth region have been known for some time.
The “dos and don’ts” have been investigated in ever more
detail starting with the probably most cited study by Tarnow et al.
Retained proximal papillae are no longer a novelty, and also
the question of the correct implant diameter is now clarified,
after some initial confusion.
IDENTITY | 17
What are the problems in achieving a result with genuine
long-term stability after immediate implant placement?
Several parameters are becoming increasingly important here.
The first is certainly the long-term collapse of facial bone and
soft tissue. For a long time little attention was paid to permanent
prevention of vertical recession, also referred to as midfacial
collapse, possibly because it is practically impossible
to evaluate by x-ray. Discussion on the shape and material of
the abutment most compatible with the soft tissue is also still
continuing.
On point 1: how can atrophy of the facial bone be prevented or
minimized? The significant item here is the generally accepted
opinion of implant diameter and occlusal position. Today, no
one suggests implants with an alveolar diameter greater than
D 5.5, because the resulting failures are well known. In contrast,
the palatal displacement of the immediate implant compared
to the extracted tooth is undoubted. However, beyond the
positioning of the implant there is still no complete agreement
on the question of whether the gap between the facial bone
plate and the implant must be filled to provide stability against
resorption. The actual dimension of the “jumping distance” of
the bone is still being discussed. However, when considering
esthetics leading colleagues in this field agree that the gap
should be bridged.

18 | IDENTITY
1_Initial clinical situation with
infaust tooth 21
2_Atraumatic extraction of 21 with
retention of buccal bone
6_Filling the facial gap between
implant and buccal bone lamella
3_Verification of implant position
and implant diameter
7_Occlusal view after completion
of implant placement
The vertical positioning of the implant in the alveolar ridge
should be considered differently. While until recently a relatively
high position was displayed to compensate for the formation
of the biological width with the resulting bone loss, which was
considered the main reason for facial tissue loss, now the principle
of “platform-switching” offers new options. The possibility
of using single-component implants as a replacement, which
was considered the solution for many problems, has proven
to be too sensitive to technique and less flexible and has not
become standard practice. Both the Ankylos and the Xive
systems allow platform-switching. This can prevent formation
of the biological width and the resulting loss of facial bone
and soft tissue over the long term.
New trends have also appeared in the shape and material of
the abutment. The original concave emergence shape adapted
to the shape of the tooth has been replaced by a convex or
multiple in-drawn shape that stabilizes the soft tissue as a
result of some interesting studies. These shapes are designed
to improve the gingiva trophic to the outer areas, because an
4_Placement of a Xive implant,
diameter 4.5 mm
8_Preparation of temporary restoration
with Xive TempBase cap
5_Occlusal view with diameterreduced
Xive TempBase
9_Postoperative x-ray check with
easily visible platform switch

extremely thin gingiva extension to retain good esthetic results
is no longer necessary. Zirconium dioxide, at least in the front
tooth region, has proven to be a material with sufficient longterm
stability. It also allows hemidesmosomal deposition of
soft tissue, and shaping is much less complicated than with all
other materials used for abutments.
CASE STUDY
The case documented here includes some of the innovations
described above. Most of all, we have been able to improve our
clinical results. The use of a facial resorption stabilizer and
platform-switching improves the clinical situation and also the
radiological view in the section. It is still to be seen just how much
long-term stabilization of the hard and soft tissue can be
achieved. One obstacle is the current lack of a reproducible
and generally comparable variable for esthetics. Esthetics cannot
yet be quantified, and therefore specific studies cannot be compared.
Radiographic data and survival rates alone are no longer
sufficient to document esthetic success over extended periods. ■
Literature can be obtained from the authors on request
10_Status 3 months after surgery 11_Occlusal view with detectable
intact facial gingival structure
14_Finished zirconium crown 15_Facial view with delivered
final restoration
12_Support of soft tissue by
customized zirconium abutment
16_X-ray check 3 months after
end of treatment
Dr. Steffen Kistler
Dr. Steffen Kistler, dentist
Dr. Frank Kistler, dentist,
Area of interest implantology
IDENTITY | 19
Dr. Frank Kistler
Practice for dental medicine
Von-Kühlmann-Straße 1
86899 Landsberg am Lech/Germany
Phone 0049 (0)8191 42251
Fax 0049 (0)8191 33848
13_Facial view with zirconium abutment
and retained papillary structure
17_Gingiva status three months
after delivery of the final restoration

20 | IDENTITY
success is …
opening up new options
The tapered connection and the platform switch
| Dr. Roman Beniashvili
Osseointegration, which can be achieved by atraumatic surgical
technique and adequate primary stability of the implant, is now
the generally accepted healing principle for dental implants.
Now, the focus of implantological interest is much more on
long-term biological reactions of the peri-implant tissue under
functional implant loading. The stated goal is to prevent loadinduced
cervical bone resorption by correct implant positioning
and selection of the “implant hardware” specific to the situation
and indications.
The study by Cochran et al. (1997) demonstrates that there are
clearly constant soft tissue dimensions that generally correspond
to the biological width on the natural tooth with both
loaded and unloaded titanium implants. The position of the
microgap between the implant and the superstructure appears
generally to determine the apical proliferation of the marginal
epithelium (Weber et al., 1996). While with a conventional
implant-abutment connection the spatial separation of the
1_Initial situation with temporary
denture
5_Autologous grafting
microgap and the peri-implant bone always requires a supracrestal
implant position, the principle of an internal tapered
connection and the associated displacement of the joint zone
into the implant body enables independent implant positioning.
The biomechanical concept of the tapered connection in
the Ankylos implant (Dentsply Friadent, Mannheim/Germany)
achieves medialization and verticalization of the microgap simultaneously
with minimization of the gap width and elimination
of micromovements between implant and abutment, which also
allows changes in the surgical protocol. The advantages of a
tapered connection principle have been documented among
others by Norton in an in vitro study (Norton, 1997). Because
of the fact that today implants are mostly placed in partially
dentulous patients (Buser et al., 1997) and thus the esthetic
demands on the expected result are increased, the principle of
restoration-driven implant placement (Garber and Belser, 1995)
has become dominant. During this development the requirements
2_Initial situation 3_Initial situation 4_Status during surgery
6_Sandwich plastic surgery 7_Membrane cover 8_Postoperative status

for an implant system have continually become more precise.
It must be possible to handle the implant like a natural tooth
during planning of the tooth replacement.
This means:
■ implementation with use of natural teeth as toothimplant-supported
supra-structure
■ implants must be placeable in narrow gaps like natural
teeth without requiring a minimum distance
■ stability of the peri-implant hard and soft tissue after
chewing load initiation
■ subcrestal implant positioning, particularly in the
esthetic region
The Ankylos implant system can already meet a large part
of these requirements. This has been widely documented.
The study by Beniashvili et al. indicates that peri-implant
9_Postoperative OPG 10_4 months after surgery
13_Final restoration 14_Final restoration
11_Minimally invasive uncovery
Dr. Roman Beniashvili
Specialist Dentist for Oral Surgery
Day Clinic for Oral Surgery and Implantology
Wallstr. 2 · 73614 Schorndorf/Germany
Phone 0049 (0)7181 993866
Fax 0049 (0)7181 993867
load-induced bone resorption is not a typical result for toothimplant-supported
restoration or for restorations supported
by implants only. The fact that soft tissue always follows hard
tissue allows this study to come to the conclusion that longterm
result of the peri-implant soft tissue can be described as
stable. The positioning of Ankylos implants in narrow single
tooth gaps or with a small distance between one another
does not represent a higher risk in practice. However, we also
require a reliable base of data in this field. Further studies with
an appropriate line of enquiry are required. ■
Literature can be obtained from the author on request
15_OPG after final restoration
IDENTITY | 21
12_Placement of a sulcus former

22 | IDENTITY
success is …
more convenience for the patient with
a highly atrophied alveolar ridge
Membrane-supported augmentation and restoration with Xive implants
| Dr. Arnd Lohmann
1a_Initial situation of patient
Dr. Arnd Lohmann
Ostpreußische Straße 9
28211 Bremen/Germany
mail@dr-arnd-lohmann.de
Atrophied jaw sections can often not be restored with implants after extended
edentulism without additional measures. Cortico-spongiosa block grafts are
recommended for grafting. The postoperative pain in the donor region of these
transplants is frequently more unpleasant for the patient than at the graft site.
The following case describes an alternative procedure for reduction of the surgery
at a surgical site with less traumatization of the hard tissue.
1_CASE
The patient
1b_Initial x-ray image 1c_Initial bone situation
sex: female
age: 55 years
medical history: nothing unusual
medications: none
other: moderate smoker (5-10 cigarettes per day)

2a_Bone situation after
bone removal
2b_Membrane fixed with miniscrew
and still folded back for later support
The patient wore a bridge to replace tooth 36 and 37 for a
long time. It was to be replaced as a consequence of caries
in tooth 38 and an associated root-canal treatment. Because
the remaining retention area on tooth 38 was minimal and
there was danger of a new bridge becoming detached, the
patient decided to have a restoration with endosseous
implants in our practice. The initial situation shown in figure
1a and palpation of the region indicated an alveolar ridge
strongly atrophied transversally, while the vertical plane was
virtually completely retained as shown in Fig. 1b.
2_GRAFTING
Dec. 1, 2005 The primary incision was selected in a strongly
buccal direction. Preparation in the lingual direction was in
form of a mucoperiosteal flap; the buccal preparation was a
split flap, and a mucosal flap and a periosteal flap were
prepared separately. Grafting was required before implant
placement due to an inadequate alveolar ridge width shown
in Figure 1c. It was decided to select the donor and receiver
regions in close proximity to each other to reduce postoperative
3a_Grafted material under membrane
IDENTITY | 23
3b_Status after suturing
inconvenience to a minimum for the patient. If possible there
should only be one surgical site. In this case cortical bone
was removed apically to the graft site above the oblique line
(Fig. 2a). The donor region was suitable as its position below
the subsequently inserted membrane favored the growth of
blood vessels from the uncovered bone marrow into the
grafted material. Approximately 20 % of a granulated bone
replacement material was added to increase the volume of
the grafted material.
A miniscrew (Medartis, Basle, Switzerland) was inserted
from lingual direction to fix the titanium-reinforced membrane
(GoreTex TR6Y, W. L. Gore & Associates Gmbh, Putzbrunn/
Germany). As shown in Figure 2b, the screw also supported
the membrane on the buccal side. Once the graft had been
placed (Fig. 3a), the seating of the membrane was checked.
Make sure that the membrane is positioned on the bone
without gaps after adapation and that there is an adequate
distance from the periodontium of the neighboring teeth.
The membrane is fixed buccally by reshaping the previously
prepared periosteal flap on the buccal side. It was finally

24 | IDENTITY
4a_X-ray image before implant
placement
4b_Newly formed bone 4c_Status after implant placement 5a_Implants after 3 months
of healing
shaped with resorbable sutures (Vicryl 4-0, Ethicon, Norderstedt/
Germany), which stretched over the complete alveolar ridge
and were fixed deeply lingually. The remaining wound closure
used dense mattress and single-button sutures (Prolene 6-0,
Ethicon, Norderstedt/Germany). Pain medication was stopped
a day after the procedure because of the low postoperative
pain. Antibiotics were administered for five days.
3_IMPLANT PLACEMENT
June 15, 2006 After a six-month healing period for the graft,
the membrane was removed and the implant was placed in
the same session. The pilot hole was drilled with a trephine
drill to enable histological examination of the graft. The
implant was placed as recommended by the standard protocol
of the Xive system. It recommends preparation of the implant
site specific to the bone quality with the twist drill as the
final drill. This feature proved to be a great advantage in this
case because of the hardness of the graft (Fig. 4).
4_DISTANCE OPERATION AND VESTIBULOPLASTY
September 12, 2006 A vestibuloplasty was conducted to
fabricate a sufficient band of keratinized mucosa around the
implant on uncovery of the implants three months after implant
placement. After an incision placed in lingual direction a
mucosa flap was prepared in the buccal direction and fixed
to form an apical displacement flap. A gingiva transplant
was removed from the palate, transferred to the uncovered
periosteum and securely sutured in place (Fig. 5a-c).
5_PROSTHETIC RESTORATION
October 9, 2006 The impression was taken three weeks after
uncovery of the implants. Customized abutment components
with cast thread were fabricated for transverse screw retention
on the Friadent AuroBase. Figure 6 shows the restoration six
weeks after delivery.

5b_Transversal tomography after
three months of healing – the graft
can be clearly seen facially (arrow)
5c_Status immediately after
vestibuloplasty
6_CONCLUSION
A membrane-supported bone regeneration for lateral grafting
is a reasonable alternative to block grafting, even over a
wide area. The procedure can be strictly limited regionally
with this technique, which contributes to the comfort of the
patient.
With many implant systems there is a problem that an excessive
torque is required to screw in the implant in very hard
bone after the final shaping drilling. If the surgeon places the
implant under these conditions, bone necroses, which in the
worst case could lead to early failure, are virtually unavoidable.
To minimize the risk, the surgeon will attempt to widen
the implant site with the shaping drill – this is done by feel,
i.e. more or less uncontrolled. Various implant manufacturers
are attempting to resolve this problem with a wider shaping
drill for hard bone. In our experience this is inadequate in
very hard bone, as is expected after a graft of the above
type, and also with bone that has not been treated beforehand.
The crestal twist drill of the Xive system works better.
It is guided to the tip and can be used depending on the
6a_Prosthetic rehabilitation,
occlusal
IDENTITY | 25
6b_Prosthetic rehabilitation,
lateral
hardness of the bone. In the above case the drill was inserted
slightly deeper than recommended for D1 bone, which
means that the implants could be placed with the optimum
torque in spite of the hard tissue. ■

26 | IDENTITY
success is …
modern techniques and a highly
qualified dental laboratory
| Dr. Igor Cêch | Darryl Millwood
1_Initial situation: teeth in lower
jaw are to be extracted
INTRODUCTION
Dental implantology has become increasingly accepted as a standard therapy by
patients in recent years. With modern implant systems long-term success can be
planned for more and more indications. The quality of life that implants can offer
is an advantage that more and more patients want. The support of a full denture
in implants is certainly a relatively effective and economical procedure, but it is
particularly such patients who want “teeth that are really fixed.” These indications
can generally be successfully reconstructed for long-term success by selection of
the ideal implant and correct planning. We would like to present our successful
therapy for restoring a fixed denture for edentulous patients or patients with
partial edentulism with the example of a case study. In our practice we have been
working with the Ankylos system (Dentsply Friadent, Mannheim/Germany) for
seven years and we achieve high peri-implant bone stability and very good esthetic
results with our implant patients. The clarity and the ease of processing, particularly
in the laboratory with the Ankylos Balance System, yields a high degree of satisfaction
for all involved.
The specific design and the tapered connection of the Ankylos system allows us to
restore our patients with an esthetic denture even in cases that were significantly
more difficult in the past.
Our successful concept includes close cooperation with a highly qualified dental
laboratory that specializes in modern techniques.
2_X-ray image of the initial situation 3_Six placed Ankylos implants 4_Closing the wound after implant
placement

5_Three SynCone copings and one
sulcus former were used for the
temporary restoration
6_X-ray check with copings and
sulcus former
9_Master cast with gum mask 10_Customizing the Balance
posterior copings
7_Temporary denture fixed with
three SynCone caps
In particular, use of the Cercon technique (DeguDent, Hanau/Germany) in combination
with Galvano Solaris (DeguDent, Hanau/Germany) enables an accurate,
esthetic procedure with predictable fit and a natural appearance. Zirconium
oxide is an excellent material with high esthetic and biological potential, and the
desired perfect seating can be achieved in every restoration with Galvano mesial
constructions.
CASE STUDY
The 57-year-old patient, a computer expert in an executive position, presented
with severe pain. Advanced periodontitis in the lower jaw resulted in teeth becoming
loose, serious infections with permanent pain and gum bleeding. The teeth
were evaluated as not worth retaining after clinical and x-ray diagnosis.
TREATMENT PLAN AND PROCEDURE
The patient wanted a fixed restoration in the lower jaw. A new bridge construction
was also planned for the upper jaw. The time available for treatment was limited
because of the patient’s professional obligations. The surgery in the lower jaw
with temporary restoration and treatment of the upper jaw was to be completed
in 17 days. The second stage of treatment was six months later and was to be
completed within two weeks.
11_Waxing up the custom-fabricated
Cercon coping components
IDENTITY | 27
8_Impression with six transfer copings
of the Anyklos Balance System
12_Finished copings with the Cercon
component cemented to the titanium
copings

28 | IDENTITY
13_Transfer index for positioning
the copings
17_All components prepared in the
laboratory for the supra-structure
14_Galvano flaps as mesial structure,
passive fit procedure
15_Cercon scaffold fitted to mesial
construction
SURGICAL PROCEDURE AND TEMPORARY RESTORATION
The teeth in the lower jaw were extracted and six implants were placed interforaminally
simultaneously in region 33-43. The patient received a metal-reinforced
denture as a temporary long-term solution. A Cercon bridge was fabricated for the
upper jaw at the same time. This gave the patient a satisfactory functional and
esthetic solution for the next few months.
PROSTHETIC AND LABORATORY PROCEDURE
Ankylos Balance posterior copings were selected for the six lower jaw implants.
They were ground first and then fitted with custom-fabricated Cercon abutments.
The Cercon abutments were cemented to the Balance copings in the laboratory
and a transfer template was fabricated as an index. A single-component Cercon
bridge with Galvano mesial construction was planned. Galvano caps were fabricated
for later cementing to the Cercon bridge to prevent tension within the Cercon
bridge combination and to achieve a passive seating.
In the next step wax provisional of the lower jaw bridge over the Galvano caps was
fabricated. They were veneered with Cercogold spacer (DeguDent, Hanau/Germany)
beforehand to simulate the cement gap. The Cercon bridge was waxed up, scanned,
milled and sintered in the classical Cercon process and then fitted over the Galvano
caps and veneered. The Galvano caps were cemented in the mouth with the
finished Cercon bridge and plugged on the copings because of the accurate friction fit.
18_Fixing the copings in the mouth
with index
16_Detail view of the Cercon veneering
19_Customized copings screw-retained 20_Galvano caps prepared for
cementing

21_Intraorally cemented Galvano caps
with the Cercon supra-structure
22_Detail view of cementing
25_Lateral detail view 26_Lips and laugh line
23_X-ray check of finished
supra-structure
CONCLUSION
The advantages of working with the Ankylos system, in cooperation with a highly
qualified dental laboratory and the techniques described in the article mean the
achievement of improved predictability of the expected results and long-term
success rates. In the past it was often difficult to fit larger reconstructions in
particular accurately. In our practice we have found that all work in which we use
Galvano mesial construction has an absolutely accurate fit. The good results are
highly motivating for all involved. ■
Dr. Igor Cêch
Darryl Millwood C.D.T.
Dr. Igor Cêch
Kupelny ostrov 13
92129 Piestany
Slovak Republic
www.dental2001.sk
27_Harmonious nose and mouth view
IDENTITY | 29
24_Supra-structure after delivery
of prosthetics
Darryl Millwood C.D.T.
Von Brug Str. 2
82467 Garmisch Partenkirchen/Germany
Phone 0049 (0)8821 18882
28_After 12 months the white-red
esthetics has further stabilized

30 | IDENTITY
1_Initial situation
success is …
2_X-ray image 3_Status after treatment 4_Positioned gingiva former
easy, fast, reliable
Friadent EsthetiCap – esthetics in three dimensions
| Renzo C. Casellini M.D.T. | Dr. Adriana Kenney | Dr. Dennis Smiler
Beautiful teeth and a perfect smile – that is what most of
our patients want who decide to have an implant-supported
restoration after tooth loss. Implantology today offers easy,
fast and extremely successful therapy concepts.
PATIENT HISTORY
Male, 23 years old, very good health, Asian descent, loss of two
front teeth in a brawl, both side incisors and a cuspid broken,
intact bone structure.
INITIAL TREATMENT
Restructure of side incisors and cuspid with Crystobal composite
ORTHODONTIC SURGEON: DR. D. SMILER
■ After extraction of the root tips, placement of two Friadent
Xive implants (4.5 mm) to replace the two middle incisors.
■ Then delivery of two Friadent gingiva formers (4.5 mm)
and a removable plastic denture in the upper dental arch
of the patient.
9_Removal of Friadent EsthetiCaps
after 8 weeks
10_Perfect Friadent gingival contour 11_Transfer abutments with
transfer caps
■ The patient was advised to return to the referring dentist
for fitting the removable denture and to replace the
two gingiva formers with two prefabricated EsthetiCaps
(4.5 mm).
■ The patient did not follow the instructions and only visited
the dentist eight weeks later, resulting in damage caused
by the removable denture.
■ Damage to the labial surface and the interdental papillae
can be seen.
DR. A. E. KENNEY became involved in the case eight weeks
after placement of the implants.
■ She removed the gingiva formers and replaced them with
two prefabricated Friadent EsthetiCaps, cut off the cylinder
of the EsthetiCaps and adjusted the removable denture.
■ After eight weeks the status of the soft tissue had improved
greatly and the gingival contour was virtually perfect.
■ After removal of the EsthetiCaps two transfer abutments
with transfer caps were placed for making the impression.
12_Delivery of Friadent Cercon
implant abutments

5_After removal of gingiva formers 6_Delivery of Friadent EsthetiCaps
■ Then two Cercon copings were fabricated using two Cercon
zirconium oxide implant abutments.
■ Impression of porcelain crowns for perfect esthetics and
function of this implant-supported restoration.
The interplay of technical knowledge, prior planning and
technology is the key to the success of prosthetic implants.
IMPLANTS START WITH THE FINAL RESULT IN MIND
Clinical trials with our specially developed, custom-shaped
healing abutment, the EsthetiCap, started in 1997. The results
achieved with placement of the healing abutment at the time
of implant placement were absolutely outstanding.
The EsthetiCap was developed on the basis of the ProTect
abutment. By now we have conducted more than 3500
successful single tooth restorations and we have not observed
any changes to the normal anatomy in the region of the
implant. From this we can conclude that under ideal conditions
there is no loss of soft or hard tissue and an additional
surgical procedure to reconstruct lost tissue is not required
so long as the existing anatomy is supported by an anatomically
shaped transgingival healing abutment. The result is not
only significantly less stress and cost for the patient but also
a restoration that meets the highest esthetic requirements. ■
Special thanks to Irene Casellini
13_Screw-retained Cercon abutments 14_Placement of the final abutments
and closure of the screw holes
7_Healing after eight weeks
Renzo C. Casellini,
Master Dental
Technologist
Adriana E. Kenney,
D.D.S., MS
IDENTITY | 31
8_Adjustment of the removable
denture
Dr. Dennis G. Smiler,
D.D.S., M.Sc.D
SWISS QUALITY DENTAL CERAMICS &
DENTAL IMPLANT STUDIO
10921 Wiilshire Blvd. Ste. 1004,
Los Angeles, CA 90024, USA
www.renzoswissquality.com
15_Cementing in 16_Final result: "a beautiful smile”

32 | IDENTITY
success is …
intelligent, exciting products
Dentsply Friadent presents a comprehensive range of new products for 2007
LEAN SURGERY – IMPLANT SURGERY FOCUSSED ON THE ESSENTIAL
■ Completely new designs for modular surgical kits for
Ankylos and Xive implant systems
■ Optimized surgical procedures for both systems,
rationalized instrument set for Xive.
NEW from
summer 2007
NEW from
summer 2007
OPTIMIZED SURGICAL INSTRUMENT SET FOR XIVE
1_New surgical ratchet with torque indicator, adjustable for
clockwise and counterclockwise operation, greatly improved
handling and more safety for manual placement of implants.
2_Number of seating instruments reduced by more than half.
Only one seating instrument for use with ratchet and contraangle
handpiece.
■ The new Frios Unit S/i, a surgical unit specially
designed for implant surgery.
■ New Frios contra-angle handpieces with completely
new design and technology.
NEW SURGICAL KITS –
CUSTOMIZED FOR YOUR REQUIREMENTS
■ Simple, flexible and economical due to modular equipment
and the essential minimum number of instruments.
■ Additional modules can be added as required.
■ Instruments securely held with silicone retainers.
■ Clear and unambiguous user guidance during surgery.
■ Light plastic trays with integrated organizer for holding used
instruments, making complete cleaning of tray unnecessary.
■ Easy to clean thoroughly in accordance with EN ISO 17664.
3_Simplified attachment of the new single-component threadcutter
to surgical ratchet and contra-angle handpiece.
4_Thread-cutter and seating instrument fitted to the hexagon
clamping system of the new Frios contra-angle handpieces
for improved transmission of force, maximum user safety and
longer instrument service life.
1 2 3 4
=
=

COMPUTER-SUPPORTED IMPLANT HANDLING
WITH EXCELLDENT
Creating Dental Excellence: the introduction of Excelldent starts
in 2007 – our contribution to digital treatment planning and
template-guided implant placement. Excelldent by Dentsply
Friadent guides you securely and accurately to predictable
implant success in three steps.
■ Excelldent – virtual implant planning:
excellent esthetics becomes predictable with minimized risk
■ Excelldent – patient-specific drill templates:
developed to reduce pain and stress for your patients
■ Excelldent – sleeve-on-drill drilling system:
easiest handling and safe guidance
THE NEW LIGHTNESS OF
IMPLANTING
The new Frios Unit S/i, a surgical
unit specially designed for implant
surgery
NEW
IDENTITY | 33
Excelldent software is an open system designed for use with all
implant systems for maximum economy during implant treatment.
The unambiguous predictability of all stages of treatment
allows accurate planning of costs. Planning and treatment time
are significantly reduced, particularly in complex cases.
Manufacturer of software and drill template
Materialise Dental NV, 3001 Leuven, Belgium
XIVE VIDEO DVD “BEAUTY & SPEED”
Quintessence Publishers has issued a DVD set with clinical
videos and presentations by Dr. Orcan Yüksel.
The two cases described in the videos give an excellent
impression of the virtually limitless possibilities of restorations
with Xive:
■ Beauty: esthetically demanding single tooth crowns
on Xive S implants
■ Speed: immediate restoration of the edentulous mandible
with fixed denture on transgingival Xive TG implants
Available from Dentsply Friadent, order no, 66-7011

34 | IDENTITY
success is …
corporate design
Luxury or necessity?
| Betina Hubrich
Surveys show that physicians are among the most trusted professionals compared
to other professions. However, physicians need to consider the professional
appearance of their practice to maintain this feeling of trust in patients when they
enter the reception area and the waiting room.
The term “corporate design” is familiar to everyone now. But what must a physician
consider when modifying the appearance of the practice? Identity talked to
Betina Hubrich, corporate identity consultant and owner of the Corporate Design
Management agency. She knows what obstacles must be overcome and answers
questions about how to proceed when implementing a new look.

IDENTITY | 35
MS. HUBRICH, WHY DOES A DENTAL PRACTICE NEED A
CORPORATE DESIGN?
A unified professional theme helps to distinguish the profile of the practice,
emphasize its strengths and to differentiate it from the competition – particularly
when considering the increasing information requirements of patients. The increasing
complexity of services needs to be made more transparent for the “health consumer”.
The patient who can understand the dentist will trust him or her. Marketing in addition
to technical competence is becoming ever more important with the increasingly
wide range of services. And this includes corporate design.
WHAT DO DENTISTS NEED TO CONSIDER CAREFULLY IN THE
DEVELOPMENT OF A PROFESSIONAL THEME?
The philosophy and range of services of the dental practice must be unambiguous
and clear for patients. This includes not only the corporate design and all its components,
such as the logo, but also the behavior of the practice team, the corporate
behavior. Corporate design and corporate behavior must be harmonious and
authentic – no forced.
AND WHAT ARE THE REQUIREMENTS FOR THE DEVELOPMENT
OF THE NEW THEME?
Three questions must be answered before the actual design work, regardless of
whether the organization is a dental practice, a company or an institution:
Who are you? What do you do? What is special about what you do?
This sounds very simple, but it is actually the most difficult component of the entire
process. You need a concept of the strategic direction of your practice to be able
to answer these questions. You also need to discover what is special about your
practice. For example, do you have particularly short waiting times, do you have
special services (disposable toothbrushes, softdrinks, reminders of appointments
or similar) or do you offer specialist experience and services? It is often the little

36 | IDENTITY
things that are noticed in addition to your dental competence, things that make
the time spent in your practice more pleasant for patients and keep them loyal to
your practice. The important factor here is the benefit to the patient. Obviously it
is becoming more and more difficult to find or create something special. The principle
of speed is also applicable here. Once a competitor near by has taken over a
specialty, it is difficult to stand out in the same field. However, it is important to
note that every practice has its own special strengths.
ONCE ALL PREREQUISITES HAVE BEEN MET IS THE LOGO THE
NEXT STEP TO THE NEW THEME?
Not necessarily, because the logo is only a part of the corporate design. What is
important is the harmonious design of all components, such as letterhead, business
cards, practice brochures and the internet presence. They must all have a unified
esthetic design for the best effect. A logo standing by itself does not make a corporate
design. How memorable a logo can easily be tested for yourself. Take a pencil and
draw the logo of Mercedes, Porsche or another brand you know well. Not so easy, is
it? The reason why is that an effective theme is a comprehensive, well planned design
system and it is perceived as a whole with all its parts. It consists of many single components
of a mutually interdependent visual and verbal communications system. For
example, this includes visual language, choice of colors, selection of fonts, referred to

A harmonious design: all materials
from logo to home page with the
same theme
Betina Hubrich
Corporate Design Management
Spohrstraße 60
60318 Frankfurt/Germany
info@cd-management.de
IDENTITY | 37
as typography, and the tactile feeling of the selected materials that make up the interior
design, which is one of the major factors in a successful implementation of the
corporate design of a dental practice. Think of the Yes-Torty. Do you remember that
logo? Or think of the emotional communication in the commercial with the birthday
cake with a candle on it.
WHAT SHOULD DENTISTS TAKE INTO ACCOUNT WHEN SEARCHING FOR
THE RIGHT PARTNER FOR THEIR NEW CORPORATE DESIGN?
The partner should have the following expertise: marketing, design, production
and assistance with the development of all materials. Select a partner whom you
trust and who has confirmed expertise in all areas. Both are the basis for achieving
professional results. Don’t forget that you not only need to find a suitable partner
outside your practice but you also need to plan the resources in your
practice for this task.
IS IT ALL WORTH IT?
Of course. A suitable corporate design certainly costs money and also time. But
from a long-term point of view the expenditure of time and money is a good investment.
The return on investment is reflected in patient loyalty and gaining new
patients. The development of the corporate design increases the identification of
your staff with the practice, which is a profitable factor at several levels. The key to
success, apart from selection of the right partner, is sensible, structured planning
of the process, and this can also be done with a low budget. The most important
thing is to make a start. To do nothing will also prove to be expensive over the longterm.
■
WHAT ARE THE ADVANTAGES OF A PROFESSIONAL CORPORATE DESIGN?
■ Trust and sympathy
■ Prominence and recognition
■ Orientation and clarity
■ Differentiation from the competition
■ Identification internally and externally
■ Long-term cost savings with unified design system
■ Basis for efficient and effective marketing campaigns
■ Increasingly positive image
■ Reinforcement of customer loyalty
■ Interest by new patients and improved prominence

38 | IDENTITY
success is …
optimizing working paths
in the practice
So energy is not wasted.
| Dorothee Holsten
Particularly when you as a specialist work in a large hospital you know how
tiring long distances can be, such as walking between outpatients and the operating
theatre. This wastes not only working time but also energy. The goal is
success over the shortest possible distance – defined as patient consideration
and qualitatively good surgical services. Dr. Dr. Reinhard Lieberum, oral,
orthodontic and maxillofacial surgeon specializing in implantology in Koblenz,
Germany, shows us how to save walking in the implantology practice.
DR. LIEBERUM, TWO YEARS AGO YOU EXTENDED YOUR PRACTICE WITH
A SECOND FLOOR. HOW HAVE YOU ARRANGED THE FUNCTIONAL AREAS?
DR. LIEBERUM The original level contains the central reception area, digital radiology
and the anesthetic department. Technically seen, this level contains the complete
dento-alveolar range. The new level contains primarily rooms and equipment for
implant surgery including all grafting techniques and esthetic maxillofacial surgery.
Dr. Dr. med. Reinhardt Lieberum
Specialist for oral, orthodontic
and maxillofacial surgery
Area of interest implantology,
Koblenz/Germany

The central reception area provides
immediate service – and saves walking
Eye contact between waiting room and reception –
convenient and practical for employee and patients
IDENTITY | 39
VERY FEW COLLEAGUES ARE IN THE ENVIABLE SITUATION OF BEING
ABLE TO DESIGN A NEW BUILDING FOR THE REQUIREMENTS OF AN
IMPLANTOLOGY PRACTICE.
YOU YOURSELF, DR. LIEBERUM, WORK IN A CENTRALLY SITUATED
BUILDING FROM THE 1970S WITH A LARGE WINDOW AREA.
WHAT PRINCIPLES HAVE YOU FOLLOWED?
DR. LIEBERUM Even though the options for dividing space are restricted by
windows and supports, it is still important to set up the functional areas correctly
and at the same time create an atmosphere that is pleasant for patients – like a
concerto that has to sound harmonious.
Optimizing working paths in the implantology practice saves time,
which can be used for more attention to patients.

40 | IDENTITY
TO BE MORE SPECIFIC: WHAT FUNCTIONAL AREAS MUST BE CLOSE TO
THE OPERATING ROOM, THE HEART OF IMPLANTOLOGY TREATMENT?
DR. LIEBERUM The following rooms should be directly accessible from the operating
room – possibly with air locks: patient preparation room, recovery room and sterilization
room. Important factors here are small details, for example so the patient
will feel well looked after in the recovery room but does not feel under close
observation.
THE LARGE WAITING AREA IS IN THE RECEPTION AREA OF YOUR PRACTICE.
VERY ATTRACTIVE, BUT THERE MUST BE MORE TO IT THAN THAT …
DR. LIEBERUM Attractive ambience and generous use of space make patients
feel relaxed. The room has multimedia facilities so films explaining procedures to
patients can be shown and internet access is also available. The waiting room can
also be easily converted into a seminar room – an important factor for us as a
referrer practice. It can also be used for social occasions. Everyone establishing a
practice should tell the interior architect about the multifunctional requirements.
AN IMPLANTOLOGY PRACTICE SHOULD BASICALLY HAVE A GENEROUS
AMOUNT OF SPACE?
DR. LIEBERUM No. You should try to implement your own interior style so
patients and referrers will feel relaxed. This may be different in Munich and different
again in Kiel. Every patient certainly looks for a friendly atmosphere – and a
spacious room alone is not the answer. Quite the contrary: in times of not knowing
what the returns for implant procedures will be in future it would be wise to be
moderate.
Around the operating room:
rooms for preparing the patient,
recovery and sterilization

IDENTITY | 41
HOW CAN YOUR EMPLOYEES BENEFIT FROM THE INTERIOR OF THE
PRACTICE?
DR. LIEBERUM Our employees also need short paths. A lot of unnecessary walking
can be saved by making sure that the workstation has eye contact with neighboring
functional areas (e. g. reception has a view of the waiting room, anesthetists and
assistants observe the recovery room). This ensures immediate action when needed
but saves unnecessary walking.
AND FINALLY, A TIP FOR THE COLLEAGUES!
DR. LIEBERUM When establishing or modernizing a practice contact the local health
authorities as the regulations differ regionally. Discussion beforehand may take
time but it also helps, and it is certainly better than having to
engage in bureaucratic warfare to defend what you have invested and implemented.
THANK YOU FOR THE INTERVIEW, DR. LIEBERUM. ■
Important sources:
■ Publication of the Commission for Hospital Hygiene and Prevention of Infection
“Requirements for hygiene in surgery and other invasive procedures”.
Available from the Robert-Koch Institute, Federal Gazette 43
■ Contact your local health authorities.
Klaus Keifenheim
Managing Director of Bruns + Klein, suppliers of dental equipment
A dentist specializing in surgery must implement legal requirements in interior
planning. An important factor here is the hygiene requirements as part of quality
assurance in outpatient surgery. Construction (ventilation systems, conductive
floor coverings, preparation rooms etc.) and organizational measures (donning
protective clothing etc.) must be considered. The classification of surgical procedures
(every competent planner has this list) defines the space that is required in the
vicinity of the operating room. If the planner is given a free rein in space without
outside walls, one can speak of an ideal layout for an implantology practice.
However, this is rarely the case, and planning is always a very specific challenge.
Bruns + Klein
Dentalfachhandel GmbH · Rübenacher Str. 112a · 58072 Koblenz/Germany

42 | IDENTITY
success is …
winning and motivating
patient consultation
| Editors
Informing patients is one of the most important parts of practice communications.
To support dentists to address patients appropriately, Dentsply Friadent is now
presenting new information material that communicates the topic of implantology
in all its variety to inform and motivate patients.
What is the first step to successful implant treatment? Consultation that communicates
with the patient exactly where he is. This was the starting point in the design of
the new Dentsply Friadent patient information material. There is certainly more
than enough information in today's media landscape – in implantology new brochures
or web sites appears almost daily. However, orientation can quickly turn into
confusion. The question becomes: “What is really relevant for me in this wasteland
of information?”
FIGHTING THE FLOOD OF IRRELEVANT INFORMATION
The problem: there is no such person as “the implant patient.” When talking to a
patient it is essential to consider the target group. The basic factor in motivating
patient communications is precise analysis of requirements. Dentsply Friadent
has identified various factors that are intended to clarify exactly what information
the patient needs. Customer interviews, analysis of sales representatives feedback
and a workshop with one of the largest German medical call centers have given
more insight into what information various patient groups require.

efore
PICKING UP THE PATIENT
The result: “one-size-fits-all” information does not meet patients’ requirements.
The new patient materials distinguish three target groups and present persons
with whom patients can identify.
■ Matthew: “young and desperate” after traumatic tooth loss
■ Ian: “established and successful” now with the first age-related dental problems
■ Heather: “old but not old-fashioned” searching for a fixed “third set of teeth”
that feel like the second set
The brochures communicate more than just information. They embed the necessary
information in typical patient case histories and are intended to establish the
necessary basis for trust, allay fears and motivate the patient to decide to have
implant treatment.
Matthew after
Heather after
IDENTITY | 43
Ian after

44 | IDENTITY
AROUSE INTEREST IN THE WAITING ROOM
The Dentsply Friadent information brochures and the waiting room posters communicate
with patients where they are particularly open to dental information:
the waiting area of the dental practice. People in waiting rooms are particularly
interested in reading, whether out of curiosity, nervousness or even fear. Here
patients can be made aware of the existence of implant treatment. The information
brochures and the waiting room posters encourage patients to discuss the possibilities
with the dentist and provide opportunities for an initial consultation on the
options of implant treatment. The brochures and the posters address all three
patient types, meaning that they address three important types of indications:
implants for single tooth gaps, larger gaps and implant solutions for the edentulous
jaw. The brochures provide information on the significance of customized solutions
with the slogan: “Implants. One hundred percent yourself!”
TARGETED CONSULTATION
If the patient is now interested in implants, Dentsply Friadent has developed information
brochures for the specific indication and information posters for the consultation.
Starting from the various indication groups the basic stages of implant
treatment are explained in easily understandable terms. Three information brochures
describe the experiences of the characters Matthew, Ian and Heather, and
deal with objections in personal consultation and explain what actually happens
during treatment step by step. They also include a collection of frequently asked
questions to answer any specific questions patients might have.
All materials from the posters to the implant passport are
available for the Xive and Ankylos implant systems.

DOCUMENTATION AND CARE
The one-on-one consultation is the prerequisite for a decision for implant treatment.
And then? The Dentsply Friadent dental implant pass accompanies the complete
implant placement process from the start. It is the same size as the bonus brochure
and is included in the layout of the posters and brochures. The dental implant pass
is multilingual and provides space for personal information, recall appointments
and for documentation of treatment with up to ten implants. The patient is always
kept informed and the treatment plan is always available.
DENTSPLY FRIADENT PATIENT LITERATURE IS DIFFERENT – AND BETTER
The new patient literature is intended for more than just information. It is not enough
to show the patient happy people with “restored quality of life.” The new brochures,
the posters and the new dental implant pass support you as the dentist in your
efforts to attract the implant patient and address the patient's needs and objections.
The patient is treated as an individual from the start. The design also makes it clear:
the color and layout make the new patient literature more a part of patients' daily
life and avoid undesirable distance – a new and friendly form of communication. ■
IDENTITY | 45

46 | IDENTITY
success is …
building up a referrer network
| Dr. Jan H. Koch
Dentists who want to expand their implantology practice require intensive continuing
education. And nothing will work without networking with colleagues.
Both can be done best in quality circles or with a regional initiative.
One successful example is the Euregio Lake Constance Implantology Study Group
[Studiengruppe Implantologie Euregio Bodensee]. Founder and president
Dr. Hans Gaiser describes his personal concept.
DR. GAISER, YOU HAVE BEEN OPERATING YOUR IMPLANTOLOGY PRACTICE SINCE
1977. WHY DID YOU ESTABLISH YOUR OWN STUDY GROUP TWO YEARS AGO?
DR. GAISER Most of all because I enjoy it. I have been working in implantology
since the early 1970s. But the developments in the field still make it exciting and
I still want to be in the forefront. For this reason I invite experienced, renowend
colleagues to Constance. Exchanging information among the best in the field helps
us all to advance. All involved benefit when the quality and also the breadth of
implantological restorations is improved.

YOU HAVE BEEN ABLE TO ATTRACT WELL-KNOWN LECTURERS SUCH AS
ZÖLLER, KIRSCH, BAYER, GRUNDER, ACKERMANN AND GUTOWSKI.
HOW DID YOU MANAGE THAT?
DR. GAISER Many of them are personal friends of mine. But our interdisciplinary
concept may also have attracted some. Not only the quality but also the short
distance to travel is important for our members. They receive practical continuing
education at a very high level right where they live. And at moderate costs. This
has greatly increased the membership of our group and we have actually grown
very fast (see box, editor’s note)
OPPORTUNITIES FOR BEGINNERS
ANYONE WHO WANTS TO BUILD UP AN IMPLANTOLOGY PRACTICE STEP BY
STEP DOES NOT NECESSARILY BENEFIT FROM COURSES AT THE HIGHEST
LEVEL. HOWEVER, BEGINNERS OFTEN SEARCH FOR CUSTOMIZED
COURSES IN VAIN.
DR. GAISER Our study group includes the young implantologist group, which
offers seminars for beginners. Colleagues who are more experienced in implantology
invite younger colleagues to accompany them in their work. Our practice in
Constance also offers regular courses for advanced and expert practitioners. Last
year we had a total of 12 events with eight to 15 participants each.
IS THE STUDY GROUP ALSO INTERNATIONAL?
DR. GAISER We have been working very well with colleagues in Austria. It has
unfortunately been somewhat more difficult to make contacts in Switzerland.
Universities in particular have reservations. We do not need to be shy – German
implantology is advancing.
Surgical team: Dr. Gaiser with course participants (l.), live surgery in the practice (r.)
IDENTITY | 47

48 | IDENTITY
DEVELOPING REFERRER STRUCTURES
IS THE STUDY GROUP USEFUL FOR YOUR OWN PRACTICE?
DR. GAISER Of course. In recent years we have been able to expand our referrer
network greatly. We have close contacts with enthusiastic colleagues in the region.
The study group has contributed to this. But the initiative is not just for our purposes.
I invest innumerable voluntary hours every year with colleagues and employees to
maintain the quality and quantity of continuing education.
The Euregio Bodensee program is not restricted to implantology but also includes
related disciplines such as periodontics, endodontics, dental technology and
accounting. As a Gutowski student I would like to remind you how important for
example gnathology is. With the study group colleagues have the opportunity for
interdisciplinary education. This makes them more competent in estimating their
abilities and limitations.
HOW IS YOUR PRACTICE ORGANIZED?
DR. GAISER I work in equal partnership with two young colleagues. My own areas of
interest are implantology, periodontics and gnathology. Dr. Andreas Sahm is a
specialist in oral surgery with a primary focus on implantology, periodontics and
red-white esthetics.
My other partner, Dr. Carsten Rien, works in endodontics, esthetic dentistry and
pediatric dentistry. We also have a practitioner in holistic therapy and an anesthetist
who comes into the practice when anesthetic treatment is required. Our practice
named Die Zahnärzte Dr. Hans Gaiser und Partner covers almost all areas of
dentistry. We have the goal of offering our patients everything from one source
based on almost 30 years of experience. Because appearances do count, we have
recently renovated our practice space. We hope this will make our demands for
high quality visible from outside.
“Ferrytales” summer event of the study group in 2006 – held on the ferry “Fontainebleau”

FROM NEEDLE IMPLANTS TO A SUPERVISION PRACTICE
HOW DID YOU GET INTO IMPLANTOLOGY?
DR. GAISER I started 30 years ago with needle implants, subperiosteal implants
and Linkow blades. I received my training in oral surgery with Horst Sauer, an
orthodontic surgeon in Constance, Germany. After establishing my own practice we
started with bone grafting for preparation of the implant site in the early 1980s.
Since the mid-1980s I have been working internationally as a lecturer in implantology,
I conduct surgery courses and surgical partnerships. We have been accredited as
a training and supervision practice by the German Society for Implantology (DGI)
since 2005.
WHAT GOALS DO YOU HAVE FOR YOUR STUDY GROUP?
DR. GAISER We want to develop a more interdisciplinary focus and continue bringing
experts in dental medicine to Constance. For example, this year Hans-Jürgen Hartmann,
Philippe Ledermann and Dieter Reusch are on the list of lecturers. We make
sure that our continuing education programs are always contemporary through our
contacts with German and international profession associations and with leading
implant manufacturers such as Dentsply Friadent. Our study group is open to all
who want to grow with implantology. ■
Dr. Hans Gaiser
Certified in implantology and periodontics (BDIZ, EDA, DGZI, DGOI),
Diplomate of Implantology (ICOI)
Teaching and Supervision Practice of DGI
IDENTITY | 49
LAKE CONSTANCE EUREGIO STUDY GROUP
Dr. Hans Gaiser established the study group in November 2004 in Constance,
Germany. With more than 300 members in Germany, Switzerland and Austria it is
the largest German-language continuing education initiative in implantology – and
so far the only international group. About 14 courses are offered every year, including
events for dental technicians and dental assistants. For the current program see
www.studiengruppe-implantologie.com

50 | IDENTITY
success is ...
transparency – the magic word
Business management in implantology
| Prof. Dr. Johannes Georg Bischoff
Progress in dental medicine depends on business success.
The implantology practice is oriented not only to dentistry
but also to business. Everything depends on professional
business management.
Now most patients expect implant treatment as part of the
services offered by their dentist. Practices specializing in
dental, oral and maxillofacial surgery that have discerned
this trend early enough have shown strong growth in practice
income and profit. Now more and more dentists are faced
with the decision of whether to add implantology services to
their repertoire. Professional practice management will help
assess whether it makes business sense.
IMPLANTOLOGY AS AN INVESTMENT
Integrating an additional specialty into the practice is a business
investment – just as with the purchase of an additional
treatment unit or a laser.
The dentist will finance his own implantology training and
will accept the opportunity loss to make money during training.
He will purchase instruments and materials.
Marketing will be required to announce the new specialty,
meaning more expenses. In short, the dentist will invest in
implantology.
Whether the investment pays will depend on two factors.
First, how many patients will take advantage of the new
services and what will the extra income be? Second, what
are the extra costs of implantology in the practice?
Modern practice management can provide answers to these
questions. The success of the implantology section of the
practice can be historically analyzed.

One example is a special evaluation for implantology.
Historical analysis of the costs and profits of implantology
services has also proven successful (Graph 1, 2).
YARDSTICK OF SUCCESS
However, it is even more important to know now what effect
the introduction of implantology into the practice will have
tomorrow. The current practice structure is “fed” with the
desired changes using the feed-forward thinking principle
out of interest, to estimate the risks better or to simulate
developments. How many treatments are required per quarter
to make implantology pay? You should know beforehand
where the yardstick of success is.
Graph 1_Development of implantology
compared to minimum values
Break-even
Income from implantology
treatment
Graph 2_Historical costing of
implantology services
Implant kits – other implied costs
Costs for treatment time
Yields from implantology
Euro
Euro
Quarter
I/06
II/06
III/06
IV/06
I/07
II/07
III/07
A calculation of this type includes:
IDENTITY | 51
■ treatment times for the implant-supported restoration
■ cost per minute of treatment for the dentist
■ cost of materials (particularly implants)
The greatest costs are not the materials, as would normally
be expected, but the cost per minute of treatment. Current
practice programs provide the exact actual costs per minute
of treatment every quarter for every dentist.
It is only a question of time before digital planning aids are
available in the internet to make such calculations easy and
fast. The practice owner can also input the initial investment
and receive the required implantology sales per quarter for
2005 2006 I/07 II/07 III/07 IV/07
Yield from
implantology
€ 31,500.00
€ 32,200.00
€ 33,000.00
€ 28,500.00
€ 34,200.00
€ 34,800.00
€ 36,100.00
Revenue
€ 4,415.15
€ 4,964.13
€ 4,665.25
€ 3,952.12
€ 4,756.66
€ 4,935.36
€ 4,736.09
Implant kits/
other impl.
costs
€ 27,084.85
€ 27,235.87
€ 28,334.75
€ 24,547.88
€ 29,443.34
€ 29,864.64
€ 31,363.91
Cost per min.
treatment
€ 9,300.00
€ 8,500.00
€ 11,900.00
€ 7,800.00
€ 8,100.00
€ 9,500.00
€ 10,100.00
Profit
€ 17,784.85
€ 18,735.87
€ 16,434.75
€ 16,747.88
€ 21,343.34
€ 20,364.64
€ 21,263.91
I/06 II/06 III/06 IV/06 I/07 II/07 III/07

52 | IDENTITY
various rates immediately. This tools saves the complex cost
structure and the dentist’s cost per minute of treatment
without requiring input from the dentist.
Interactive evaluations of this type also support planning in
practices that have already introduced implantology. The
practice owner can easily simulate changes on the computer.
For example, if changes to the share of implantology services
are input, the program immediately show how much more or
less would be returned.
THE CHALLENGE OF THE LARGE PRACTICE
Large practices with several dentists that offer specialties
other than implantology, such as prophylaxis, periodontics,
endodontics or high-end prosthetics, tend to develop in larger
centers. These practices have complex structures with capitalintensive
equipment and high fixed costs. However, such
practices have high potential returns with correct control
and management using routine and structured accounting
systems and exploitation of potential cost advantages. Such
practices are a real challenge for practice management.
It is not enough to evaluate figures from accounting or the
accounting software in isolation. Additional data sources,
such as treatment records, valid statistics and liquidity flows
must also be used to find useful information. Adding success
factors to a practice of this type requires in-depth and comprehensive
information using graphs for additional clarity.
Prosthetics
Implantology
Consulting/
surgical treatment
Prophylaxis
Miscellaneous
14.4
30.1
3.9 1.1
50.5
Comparisons show potentials for optimization. The economics
of specific treatment specialties are also documented
by professional practice control instruments. Incomes of
partners according to contracts must be monitored, successbased
payments must be calculated quarterly or monthly.
With some modern control programs this does not necessarily
require additional work for the practice. They provide all
information regularly without requiring additional hardware
or software and without additional time or money for practice
employees.
It is essential for an ambitious, professional managed large
practice to conduct regular analyses of the work in the
practice (Graph 3).
Only comparison of practice income, revenues and treatment
times of the individual specialties can provide real transparency.
It shows which areas contribute disproportionately to
the success of the practice and should be expanded – which
are not worth wasting time on (Graph 4).
Euro
Implantology Prosthetics Consulting/surgical
treatment
Miscellaneous
Graph 3_Is the strategic direction OK? Graph 4_Profit per minute of treatment by specialties

SPECIAL CONSIDERATIONS FOR REFERRER PRACTICES
Typical referrer practices have additional requirements. In particular,
oral and maxillofacial surgeons work successfully with
general dentists. The deciding factor in the success of such
practices is confident cooperation with the referring dentists.
Treatment and communications with the patient must go with
that between the dentist and the oral and maxillofacial surgeon.
This is the only way to ensure that the patient will perceive
the services provided by the referrer practice as part of the
competence of the referring practice. Graphs are essential for
referrer practices (Graph 5, 6).
They will show early indications of problems with working with
specific referrers and provide an opportunity of responding
early to unwanted developments or communications problems.
STAY AT THE TOP
Recent surveys have shown that successful practices often
have one thing in common: consistent implementation of a
well-designed concept. Such practices also have a continuous
improvement process with the slogan “the better is the enemy
of the good.” Not to correct major problems but to stay at the
top. The magic word for optimization is transparency in the
numbers. ■
Dr. Müller
Miscellaneous
Dr. Schuster
Dr. Schulze
Dr. Meier
19.0
9.0
Graph 5_Referrer statistics
3.0
25.0
44.0
50 %
45 %
40 %
35 %
30 %
25 %
20 %
15 %
10 %
5 %
0 %
Prof. Dr. Johannes Georg Bischoff
is a tax accountant and an official auditor
and teaches management accounting at the
Bergische University at Wuppertal. He is the
majority shareholder of Prof. Dr. Bischoff
Steuerberater Rechtsanwälte vereid. Buchprüfer
with about 50 employees in Cologne,
Chemnitz and Berlin. The group has been
supporting health professionals throughout
Germany for many years. The PraxisNavigation ®
management program has been used by
doctors and dentists since 2001 and in 2007
a digital planning assistant was added to
forecast future practice developments.
Common patient events
I/05 II/05 III/05 IV/05 I/06 II/06 III/06 IV/06 I/07 II/07 III/07
Graph 6_Number of patients referred by Dr. Müller
IDENTITY | 53

54 | IDENTITY
success is …
being prepared for the future
| Matthias Horx
“The best way to predict the future is to make it.” A nice quotation, but what
exactly do we mean by “making the future”? iDENTity wanted to find out more
and talked to Matthias Horx, one of the best-known trend researchers and
futurologists in Germany, to discuss trends and megatrends of the future.
MR. HORX, YOU ARE A TREND RESEARCHER AND FUTUROLOGIST.
WHAT EXACTLY DO YOU DO?
MR. HORX In essence trend research and futurology is a continuously developing
universal field in which we try to link sociological, economic, cultural strands and
theories. The idea is to understand and map change systems. Exciting developments
in many fields give us new impulses, such as in cultural sociology, evolutionary
sociology or semiotics, the study of cultural symbols.
Trend research and futurology as we do it has two aspects. In public we attempt to
be something like “advocates for the future”. We believe that we can initiate and
manage changes, we do not believe in the apocalypse that is predicted every
second day in the media and the gurus of decline. At the business level trend
research and futurology for companies is intended to be something like a look in
the mirror. The examination of the possible tomorrow allows us to understand better
what is happening today. If we do our job right, the company becomes better able
to act and make decisions and it learns to place itself in a better position to meet
future challenges. The goal of future research is to increase the future fitness of
companies, individuals and societies.
WHAT TRENDS SHOULD BE EXPECT IN THE FUTURE?
MR. HORX The first thing to do is to clarify the levels at which trends exist. Trends
can be found in the most varied areas of life – from the economy through politics
to the world of consumers. The term “trend” is an extremely general one, as can
be seen in its variety of uses in the media, advertising and product design. We
classify trends into product trends, fashion trends, sociological trends, sociocultural
trends, complex technology trends, metatrends and so on. Our work is basically

concerned with megatrends. Megatrends are particularly large and sustained change
processes. They affect all areas of human life: technology, culture, social relations,
work and consumption. They mark a change that lasts for at least half a century.
WHAT MEGATRENDS ARE INFLUENCING OUR LIVES?
MR. HORX Globalization is certainly the greatest force for change that we can
place in this category. Many economic processes are being reorganized on international
lines. The far east will develop into the central economic power by 2050 and
many jobs from the industrial era secured by the welfare state will be forced into
global competition.
Megatrend no. 2: the “silver revolution”, aging, which is not really aging but a
change in forms of behavior. People remain younger while their life span increases.
No less exciting is the “female megatrend”, the feminization of society, which can
be traced back to the 1960s, and is radically changing sexual relationships and
with it the form of the family and everyday lifestyles. Health is another megatrend,
because the idea of health is changing all social relationships. You only have to
think of the change in attitude to smoking with increasing prohibitions on smoking,
or the boom in organic foods, which is related to increased health consciousness
and also includes environmental considerations.
ARE THEIR COMPANIES THAT ARE LIKELY TO PROFIT?
MR. HORX Initially all companies that consciously and quickly work with these
trends and consistently implement innovation. European companies that have
intelligently and consistently globalized themselves are the winners of today.
Technical companies that develop products not only for men interested in technology
but also for a new generation of women will be successful on the world
market. Companies that develop new products in the field of health, wellness and
fitness will also do well. Consumer companies that understand that innovation is
more than bringing pseudo-products on the market but drive more radical innovation
that appeals to people. Everyone is talking about cheap markets and the drop in
IDENTITY | 55
Photo: Klaus Vyhnalek

56 | IDENTITY
prices. You should not wonder why people only look at the price when they stand
in front of 500 different types of tooth paste und do not understand the differences.
The consequence is to revert to the “price” argument. The discourse is always:
customers are wrong because they only look at the price and it is the fault of politics
because taxes are too high.
We present the counter-argument: we believe that we have been living in a developing
service society for a long time in which people would pay well for sensible
time-savings, convenience and services if they were offered correctly. The valueadded
chains must be rethought, systems made more intelligent and services
integrated into the product. Your customers will certainly notice this in their daily
life in the practice. Patients are not so much interested in the product, the dental
treatment, these days but more in what is linked to the product: longer hours,
shorter or no waiting times, the list can be extended indefinitely. The decisive
factor for future products is the new relationship between service and product.
We call this “deep support”. We offer the Future Award, the prize for innovation
awarded by the Future Institute, to honor companies and business ideas that
implement megatrends appropriately in the market.
EVEN IF SERVICES ARE BECOMING MORE IMPORTANT, A LOT OF GOODS
ARE STILL BEING MADE IN GERMANY. HOW ABOUT 2020? OR WILL ALL
MANUFACTURING BE OFFSHORE THEN?
MR. HORX Very complex products will always be made in Germany, but that is not
the significant factor here. In principle we could make everything in Timbuktu. If
the expertise remains here that would still mean an increase in our living standards.
Globalization is not evicting us but is driving us upstairs to higher value-added
ranges, to the creative and mental ranges. Value-added chains are being reorganized
all over the world to give people in other parts of the world a chance to increase
their standard of living. Many people think of this process in a binary pattern.
If the Chinese drive cars, we will no longer be able to drive. This is nonsense.
A good standard of living in Asia, then in Africa will give us huge new sales outlets.

Over the long term globalization benefits everyone.
To manage it properly we all have to change – in mentality, speed of innovation,
our mindset. The old industrial society has made us slow and lazy in many ways,
and also liable to complain about everything. We need a massive education
campaign, investment in our human capital. In Finland 90 % of 20-year-olds have
graduated from high school. The education system provides opportunities for everyone
offering innumerable paths to ever higher capacities. Our education system is still
selective and sorts out students. Our schools still offer the same old frontal teaching
systems. The new capacities that we need for the knowledge world, emotional intelligence,
ability for self-learning, are still marginal in our system. That must change,
because we will not be able to master the future with the same attitudes of the old
industrial world.
MR. HORX, WE THANK YOU FOR THIS INTERVIEW. ■
Matthias Horx is one of the best known speakers on the future and trends in the Germanspeaking
countries. He was a journalist and writer for 12 years for publications such as Zeit,
Merian and Tempo before he helped establish the TRENDBÜRO in the early 1990s.
Since 1998 he has been the owner of the FUTURE INSTITUTE (ZUKUNFTINSTITUT), based in
Kelkheim and Vienna. He edits the monthly FUTURE LETTER for VNR-Verlag and is well known
with a total of 15 books.
Matthias Horx works as a future consultant for large companies. His motivational speeches
serve as encouragement and orientation for future developments in all areas of business.
Horx is well known as a speaker to people who are prepared to look beyond the obvious.
His speeches cover the interactions of social, technological, economic and political trends.
The futurologist, born in 1955, lives in Vienna with his wife and two sons.
The “Trend Report 2007 – Key Sociocultural Trends for the Markets of Tomorrow” by
Matthias Horx has just been issued by the Future Institute.
Information and order: www.zukunftsinstitut.de
IDENTITY | 57
Matthias Horx
Photo: Klaus Vyhnalek

58 | IDENTITY
success is ...
tissuecare roadshow 2007
On Tour: Join the TissueCare Concept
| Editors
SUCCESS IS ...
HAVING EXACTLY THE ANSWERS YOU NEED WHEN YOU NEED THEM
The secret of success is seeing the interconnections and also being open to
other points of view. Dentsply Friadent invites you on a tour to see an innovative
change of perspective in implant dentistry.
It will concentrate on long-term stability of hard tissue and soft tissue.
Dentsply Friadent will be leading a discussion on new aspects of tissue stability
and will be presenting a total concept for achieving permanent red-white esthetics:
Join the TissueCare Concept.
SUCCESS IS ...
A TOTAL CONCEPT FOR LASTING RESULTS
Discover the new outlook at the roadshow in various cities and find out more about
the five success factors for long-term tissue stability. The TissueCare Roadshow
will be starting in September 2007. Visit us in a city near you. You can look forward
to exciting interviews and discussions with our experts. And you will also experience
an evening that you will never forget. You can find all the information and register
on the Internet. Find us at www.TissueCareConcept.com. Register now!
DENTSPLY FRIADENT TISSUECARE ROADSHOW
Join the TissueCare Concept –
and see how experienced experts present a new perspective in implantology:
■ Prof. Dr. Georg H. Nentwig, Frankfurt/Germany
■ Prof. Dr. Georgios Romanos, New York/USA
■ Dr. Dietmar Weng, Starnberg/Germany
■ Dr. Peter Gehrke, Ludwigshafen/Germany
■ Dr. Marcus Abboud, Bonn/Germany
■ Dr. Paul Weigl, Frankfurt/Germany
■ Dr. Nigel Saynor, Stockport/UK
■ Dipl.-Ing. Holger Zipprich, Frankfurt/Germany
COME ON TOUR WITH US. SEE US AT:
SEPTEMBER 7, 2007 – COLOGNE/GERMANY
SEPTEMBER 21, 2007 – THE HAGUE/NETHERLANDS
OCTOBER 12, 2007 – HAMBURG/GERMANY
OCTOBER 19, 2007 – MUNICH/GERMANY
NOVEMBER 23, 2007 – LONDON/UK
JANUARY 24, 2008 – NICE/FRANCE
FEBRUARY 8, 2008 – MADRID/SPAIN

success is ...
always beeing one step ahead
Continuing education for a successful practice
| Editors
Technological and scientific developments are coming thick and fast in implantology.
The importance of clinical and also marketing continuing education programs for
the successful implantology practice is growing. The Dentsply Friadent continuing
education concept 2007 offers a compact, qualified and practical training program
for your success. The modules can be attended in succession or can be combined –
depending on your schedule and your own requirements.
The Dentsply Friadent continuing education program will be international in 2007.
Internationally known lecturers and event sites will allow you to attend continuing
education outside your own country and gain new and interesting insights.
THE 2007 MODULE RANGES
■ Clinical education
14 topics for dentists, dental assistants and the laboratory
■ Practice marketing
6 successful marketing strategies for practice development
concentrating on management, communications and advertising law
■ Networking
practicum, supervision, implantology partnership,
clinical education centers in Germany and internationally
■ Conferences and symposia
international trends from practice, research and development
■ Events
networking in a relaxed atmosphere
IDENTITY | 59
The presenters are qualified experts from Germany and other countries who will
pass on their knowledge to you – with a high degree of clinical quality, product
knowledge and teaching experience. And the networking programs, conferences,
symposia and events will give you the chance to meet colleagues and exchange
knowledge at home and away. ■

60 | IDENTITY
iDENTity 2_07 featuring:
tissue care
the next iDENTity will appear
in July 2007

yes, i want:
INFORMATION ON STEPPS
I am interested in starting with stepps – please call me to make an appointment
PRODUCT INFORMATION
I am interested in the new Friadent bibliography
Ankylos Frialit
Xive Friadent plus
I am interested in more information on:
Excelldent
Lean Surgery – simplified surgery
the new Frios Unit S/i
the new Xive DVD
Please send me:
the new patient materials: for Ankylos for Xive
the new continuing education program for 2007
PUBLICATIONS IN IDENTITY
I am interested in publishing in iDENTity – please send the submission guidelines.
NOTES
NAME AND ADDRESS
Name
Street
City
Telephone
E-mail
Date/signature
CUT OUT AND FAX TO 0049 (0)211 516045-209 OR BY MAIL TO:
IDENTITY | 61
Please send iDENTity to me
regularly at my address

FAX: 0049 (0)211 516045-209
Medical Consulting Group
Tanja Friedrich
Mörsenbroicher Weg 200
40470 Düsseldorf
GERMANY

events 2007
MAY 3-5, 2007
20TH ANNUAL DGI MEETING 2007
MUNICH/GERMANY
• Dentsply Friadent Workshop with Dr. Frank Kistler and
Dr. Steffen Kistler, Landsberg, Dr. Marcus Abboud, Bonn,
and Dr. Bernhard Saneke, Wiesbaden
info: www.dgi-ev.de
MAY 10-12, 2007
INTERNATIONAL OSTEOLOGY SYMPOSIUM 2007
MONACO
• Dentsply Friadent Workshop with Prof. Dr. G.-H. Nentwig,
Dr. Bernd Giesenhagen and Dr. Steffen Kistler
• Dentsply Friadent Hands-on Workshop Ankylos with
Dr. Michel Layet, France
• Dentsply Friadent Industry Forum with Dr. Bernd Giesenhagen
info: www.osteology-monaco.org
JUNE 14-16, 2007
EAED – ANNUAL SPRING MEETING
BADEN-BADEN/GERMANY
SEPTEMBER 27-29, 2007
4TH INTERNATIONAL DGOI CONGRESS/
EUROPEAN MEETING ICOI
FRANKFURT/GERMANY
OCTOBER 25-27, 2007
EAO – EUROPEAN ASSOCIATION FOR OSSEOINTEGRA-
TION
BARCELONA/SPAIN
• Ankylos 20th Anniversary Show:
Future innovations based on long-term success
Ankylos Past – Present – Future
Workshop with broadcast of an operation via satellite with
Dr. Ashok Sethi, London, and live discussion of the Ankylos
Expert Board (Dr. Nigel Saynor, Stockport, Prof. Dr. Georgios
Romanos, New York, Dr. Paul Weigl, Frankfurt am Main,
and Dr. Dietmar Weng, Starnberg)
• Ankylos 20th Anniversary Birthday Party
Info: www.eao.org
IDENTITY | 63
DENTSPLY FRIADENT TISSUECARE ROADSHOW
SEPTEMBER 7, 2007 COLOGNE/GERMANY
SEPTEMBER 21, 2007 THE HAGUE/NETHERLANDS
OCTOBER 12, 2007 HAMBURG/GERMANY
OCTOBER 19, 2007 MUNICH/GERMANY
NOVEMBER 23, 2007 LONDON/UK
JANUARY 24, 2008 NICE/FRANCE
FEBRUARY 8, 2008 MADRID/SPAIN
DENTSPLY FRIADENT TISSUECARE ROADSHOW
Join the TissueCare concept – and see how experienced experts
present a new perspective in implantology:
• Prof. Dr. Georg H. Nentwig, Frankfurt/Germany
The TissueCare Concept – 20 years of clinical experience
• Prof. Dr. Georgios Romanos, New York/USA
The virtual one-piece implant system –
advantages in immediate loading
• Dr. Dietmar Weng, Starnberg/Germany
The implant-abutment connection: from the mechanical
to the biological aspect of the microgap
• Dr. Peter Gehrke, Ludwigshafen/Germany
Prosthetic concepts – the index as an option
• Dr. Marcus Abboud, Bonn/Germany
Precise prosthetics in navigated implantology –
a question of indexing?
• Dr. Paul Weigl, Frankfurt/Germany
Mechanical stability – the prerequisite for long-term stability
and prosthetic success
• Dr. Nigel Saynor, Stockport/UK
Excellent esthetics – the clinical result of the TissueCare Concept
• Dipl.-Ing. Holger Zipprich, Frankfurt/Germany
Mechanical stability – the prerequisite for healthy tissue
Info and registration: www.tissuecareconcept.com
NOVEMBER 29 – DECEMBER 1, 2007
4TH COMBINED CONFERENCE OF ÖGOCI, DGI, SGI
VIENNA/AUSTRIA
More information on Dentsply Friadent activities at the
above conferences and further events can be found at
www.friadent.com

Order Number: 4-002032