Download - Dental Asia

A s i a ’ s P r e m i e r J o u r n a l f o r D e n t a l P r a c t i c e a n d T e c h n o l o g y 

MICA (P) No: 033/05/2008 KDN: PPS 1452/09/2008(001054) ISSN: 0219-5682 • www.dentalasia.net • MAY / JUNE 2008 

Post-Minor Oral Surgery 

Pain Management 

• The Use of Motivation Theories in Dentistry 

• Eliminating Dental Stains 

• IDEM 2008 Review

Editorial 

Editor 

Desmond Teo 

desmondteo@pabloasia.com 

Senior Editor (Chinese Edition) 

Yu Dongzhan 

yudongzhan@pabloasia.com 

Sales & Marketing 

Publication Executive — Singapore 

Jamie Tan 

jamietan@pabloasia.com 

General Manager — Pablo Beijing 

Ellen Gao 

pablochina@tom.com 

Publication Executive — Pablo Beijing 

Snow Hou 

pablochina@tom.com 

General Manager — Pablo Shanghai 

Kelly Shen 

pabloshanghai@tom.com 

Design & Production 

Designer 

Edwin De Souza 

edwin@pabloasia.com 

Management 

Publisher 

William Pang 

williampang@pabloasia.com 

Executive Director 

Alistair Bryson 

pablogermany@t-online.de 

Associate Publisher 

Pamela Buckley 

pamela@pabloasia.com 

Circulation Executive 

Ai Ling 

circulation@pabloasia.com 

Published by: 

Pablo Publishing Pte Ltd 

Block 16 Kallang Place #07-01, 

Singapore 339156 

Tel: +65-6396-7877 

Fax: +65-6396-7177 

Email: info@pabloasia.com 

Printed by: 

Times Printers Pte Ltd 

Our Global Alliance Partners: 

CONTENTS 

May / June 2008 

18 The Promise of Salivary Diagnostics 

30 

Eliminating Dental Stains 

48 IDEM 2008 Review 

OTHER COLUMNS 

4 FIRST WORDS 

6 INDUSTRY BRIEF 

12 EVENT REPORT 

16 CORPORATE PROFILE 

24 CLINICAL FEATURES 

43 USER’S REPORT 

47 EXHIBITION PREVIEW 

57 PRODUCT UPDATE 

62 EVENTS CALENDAR 

64 AD INDEX 

The use of saliva as a diagnostic fluid for 

various human ailments is gaining popularity 

as it offers distinct advantages over serum. 

These include the non-invasive nature of 

saliva collection compared with phlebotomy, 

simplicity of collection and the cost-effective 

applicability for screening large populations. 

So, is saliva a reliable diagnostic tool? 

Dental stains are of great concern to the 

vast majority of the population. Tooth 

discoloration has been made socially and 

culturally unacceptable by the ubiquitous 

presence of bright, white smiles on 

television, in films, and the print media. 

From a professional perspective, dental 

stains contribute to plaque accumulation, the increased retention of 

bacteria and their associated acidic environment, and eventually, to tooth 

demineralization and decay. Dr George Freedman puts a commerciallyavailable 

dentifrice to test. 

IDEM 2008 has finally concluded. After much 

hype and anticipation, did the event live up 

to its name and outperform that of 2006’s? 

Dental Asia files this first-hand review of the 

misses and hits that were witnessed during 

the duration of the show. 

Cover photo: Courtesy of T32 Dental Center 

Dental Asia • May / June 2008 

1

ADVISORYBOARD 

Dr Graham J. 

Mount 

(Australia) 

Dr George 

Freedman 

(Canada) 

Prof Alex 

Mersel 

(Israel) 

Prof Urban 

Hägg 

(Hong Kong) 

Dr Chung Kong 

Mun 

(Singapore) 

Dr William 

O’Reilly 

(Australia) 

Dr Choo Teck 

Chuan 

(Singapore) 

Dr Saw Lip 

Hean 

(Malaysia) 

Prof Nigel M. 

King 

(Hong Kong) 

Dr Hien Ngo 

(Australia) 

Dr Adrian 

U J Yap 

(Singapore) 

Stefan 

Borenstein 

(Canada) 

Dr How Kim 

Chuan 

(Malaysia) 

Dr Elliot 

Mechanic 

(Canada) 

Dr Pranee 

Wattanapayungkul 

(Thailand) 

Dr Hong Yong 

Huat 

(Malaysia) 

2 Dental Asia • May / June 2008

FIRSTWORDS 

The Thing About Exhibitions... 

Exhibitions in and around the region are coming thick-and-fast and before we realize it, half the year 

is up. Since January, dental exhibitions and conferences — big or small — in this region were 

speeding in full throttle. IDEM has just concluded and will be followed by APDC in May, Sino Dental, 

MDA Convention and SIDEX in June. Prior to all these shows, there were the AEEDC in Dubai, ADX 

(Australia), APOC, etc. Interspersed with all these were events by the dental associations in 

Indonesia, the Philippines, Vietnam. No wonder manufacturers are feeling the exhaustion and the 

pinch. Even the delegates and visitors were spread thin by all these events. 

The starting point of the event organizers is good but much consideration must be given when 

initiating a totally new show just to plug the needs of the domestic market. Is revenue-making the 

main driving force behind such decisions? Can regional exhibitions not be able to suffice the needs? Do more exhibitions 

mean better for the dental industry in Asia or will they backfire eventually? Organizers should learn to listen more 

attentively. The noises of the exhibitors and visitors could not be wrong. 

In this issue, we highlighted a couple of events that took place during the past two months — Warwick University-UKM 

Implant Symposium and the celebration of IDS Dental’s 40th Anniversary. 

Prof Lakshman Samaranayake, Dean of Faculty of Dentistry of Hong Kong University, explores the effectiveness of using 

saliva as a diagnostic tool various human ailments and what does it hold for the future? 

Pain management is crucial especially after surgery. Applying the right method and the correct pain control products will 

greatly help in reassuring the patient. This article looks at the different ways where pain control can be administered. 

Also in this issue, we give you a first-hand review of IDEM 2008 right from the showfloor. For those who were not present 

during the event, the review will give you a glimpse of what you have missed. 

Happy reading! 

Desmond Teo 

Editor 

Disclaimer: All rights reserved. Views of writers do not necessarily reflect the views of the Publisher. 

No part of this publication may be reproduced in any form or by any means, without prior permission in writing from the Publisher and copyright owner. Whilst every care is 

taken to ensure accuracy of the information in this publication, the Publisher accepts no liability for damages caused by misinterpretation of information, expressed or 

implied, within the pages of the magazine. 

All advertisements are accepted on the understanding that the Advertiser is authorised to publish the contents of the advertisements, and in this respect, the Advertiser 

shall indemnify the Publisher against all claims or suits for libel, violation of right of privacy and copyright infringements. 

Dental Asia is a controlled-circulation bi-monthly magazine. It is mailed free-of-charge to readers who meet a set of criteria. Paid subscription is available to those who do 

not fit our terms of control.Please refer to subscription form provided in the publication for more details. 


INDUSTRYBRIEF 

Celfa Dental Group Acquires Castellini 

Italy — Celfa Dental 

Group has reinforced its 

position in the dental unit 

sector with its latest 

100% acquisition of 

Castellini SpA, which 

specializes in the 

development of systems 

for disinfection and 

sterilisation applications, 

as well as with regard to ergonomics. 

Despite the acquisition, Cefla Dental Group will maintain and 

implement the 

distinctive features of 

Castellini products, 

ensuring 

improvement in terms 

of quality and 

performance. 

Furthermore, the 

current distribution 

set-up will be 

retained while, on the 

other hand, Castellini will benefit from a significant “service 

package” upon entry into a Group of larger dimensions. 

DA 

Easy and Happy Brushing 

Singapore — A new toothbrush, the Happy Brush, specially 

designed for little teeth (children) has been introduced by the 

Health Promotion Board (HPB) of Singapore. 

The Happy Brush is designed to enable children to use the 

‘scrub’ technique which they are most comfortable with and 

yet allows them to achieve the same results as the more 

complicated techniques. This is made possible through a 

specially customized brush head and bristles. The Happy 

Brush has a single head with a semi-circular arc. Bristles are 

inserted into this arc to allow it to cap all the surfaces of a 

few teeth at a time. The shape and design of the Happy 

Brush also enables impatient toothbrushers, who tend to 

neglect the harder to reach areas, to brush those areas 

easily. 

“It is important to inculcate the habit of toothbrushing from a 

young age. The Happy Brush debunks the notion that 

toothbrushing is a chore, making it easier for children to get 

into a toothbrushing routine that they will more likely followthrough 

to adulthood. Good dental health in adulthood 

begins from childhood,” said Dr Eu Oy Chu, Senior Deputy 

Director, School Dental Service, HPB. 

The Happy Brush, designed and developed by HPB’s School 

Dental Service (SDS). DA 

Int’l Expodental Incorporated 1st Expodental Forum 

Italy — Italy’s premier dental exhibition, International 

Expodental, will be incorporating the first Expodental Forum 

in its edition this year. The forum will be a series of courses, 

conventions and workshops for all dental professionals and 

those working dentistry. 

The Forum, planned and organised in collaboration with 

Quadra Service and promoted by the UNIDI (Italian Dental 

Industries Association) will take place every morning for the 

entire duration of the exhibition, from 9:30 to 13:30. It will be 

held in the various halls of the Convention Centre, with 

individual or joint sessions for professional categories 

(Dental Surgeon / Dental Technician, Dental Specialist / 

Surgery Assistant, Industrials / Commercial Operators, etc.). 

The afternoons will be used for technological workshops set 

up and organised by exhibitors. 

The Scientific Committee will be coordinated by Dr Andrea 

Paolinelli, President of Quadra Service, and will include 

esteemed professionals like Mr Roberto Bonfiglioli, Dr Aldo 

Nobili, and Dr Marisa Roncati Parma Benfenati. 

To attend or request further information on the 1st 

Expodental Forum, email to: 

expodentalforum@quadraservice.com. DA 

Dentalbite ... 

• KaVo Dental GmbH has acquired Shirokusu Dental Supply Works, a Japan-based distributor of dental medical 

devices, thus giving the former a wider access into the Japanese market. 

6 

Dental Asia • May / June 2008

INDUSTRYBRIEF 

T32 Dental Center Opens Dental Academy 

Singapore — T32 Dental Center has officially opened the 

International Dental Academy (IDA) — a private dental 

teaching facility that aims to raise the standards of dentistry 

in Singapore and around the region. 

The lab facilities that dentists and 

technicians will have access to at the 

International Dental Academy 

Based on the theory 

that there is only so 

much theory a dentist 

can learn in a 

classroom, the IDA 

has been set up with 

the purpose of 

providing dentists from 

around the region an 

opportunity to develop 

their skills in a real 

environment. 

“Dentists from all over 

the region regardless 

of their background and experience levels feel that there is 

always something new to learn. They are always looking for 

new ways to develop their skills, and ways to leverage new 

technology. The IDA provides dentists with the opportunity 

to do this and more” said Dr Wong Keng Mun, Director, 

IDA. 

With the recent implementation of the dental specialist 

register and compulsory continuing professional education 

for Singapore dentists, the International Dental Academy 

provides a valuable platform for dentists aiming to develop 

their skills. 

“Many dentists from around the world come to IDA to impart 

their knowledge, experience and skills to their fellow dentists. 

This provides a great opportunity to share best practices and 

raise the bar within the field of dentistry in the region”, noted 

Dr Wong. 

Since its soft launch in October 2007, the IDA has seen over 

250 dentists from countries all over the region participate in 

its courses, lectures and practical training sessions. Dentists 

have the option of signing up for individual courses or taking 

up the one-year program, where they will be invited to use 

the technology and facilities of T32 Dental Centre on a 

weekly basis to treat patients and further develop specialist 

skills. Dentists around the region can monitor courses at the 

IDA website at www.t32dental.com. DA 

Dental Asia • May / June 2008 7

INDUSTRYBRIEF 

Nobel Biocare Ties Up with DCI 

India — The Dental Council of India (DCI) has entered into 

partnership with Nobel Biocare to establish a Centre of 

Dental Excellence in the country. An agreement has been 

signed in this regard and a location is being sought in Delhi 

or Mumbai for the Centre. 

“The objective behind such a move is to constantly educate 

the dental fraternity on the latest techniques and 

developments in dentistry and simultaneously stressing the 

need for maintaining the highest standards in dental 

education and ethics,” said Dr Anil Kohli, President of DCI. 

According to Dr Kohli, the number of dental colleges has 

increased and more than 15,000 students pass out each 

year but there is an acute 

shortage of teachers with 

the result that educational 

quality suffers. 

“The council had 

apprised the central and state governments on this aspect 

though nothing has been done to rectify the problem,” he 

added. 

He also felt the need for a continuing dental education where 

dentists should undergo about 20 hours each year. He also 

recommended that dentists maintain strict vigilance 

concerning infection control and waste management. 

DA 

Operation Dental Smile in Vietnam a Success 

Vietnam — Nearly 5,000 children and young adults in Hue 

and Hanoi received free dental check-ups under American 

NGO Operation Smile’s 12th annual Dental Mission to 

Vietnam recently. 

The mission involved more than 30 dental professionals from 

US, including oral surgeons, endodontists, pediatric dentists, 

general dentists, and students from the University of Maryland. 

In Hanoi, it is being held at the Vietnam-Cuba Hospital and 

Hanoi Medicine and Pharmacy University, while in Hue, 

children received dental care at Operation Smile’s 

Comprehensive Care Centre. 

The volunteers said they considered the event an opportunity 

to share their experiences in dental care with their local 

colleagues. 

Dr Daniel Taub from Philadelphia, one of the team leaders, 

said: “I always glean interesting experiences from 

Vietnamese experts during my missions to Vietnam. This is 

the 13th time I am coming to the country. It recognise many 

things have improved.” 

Every person screened at the clinics is given a toothbrush 

and toothpaste, and told about the importance of oral 

hygiene. DA 

W&H Dental-Mechanik (Asia) Officially Opens 

Singapore — W&H Dental- 

Mechanik (Asia) was officially 

opened by, Mr Peter Malata, W&H 

Dentalwerk President, amid much 

fanfare. In his speech, Mr Malata 

outlined the importance of the new 

service center in Singapore and 

that it will play a major role in the 

future by holding workshops as 

well. The service center offers 

W&H premium services for the 

Asia-Pacific region. 

Mr Peter Malata (center) posing with his W&H team and local 

distributor, IDS Dental 

The center is currently 

managed by Mr Stephan 

Rauchenzauner, the technical 

services manager, and 

reporting to Mr Martin Rolfe, 

the Area Manager for Asia- 

Pacific region. The new 

service center will also be 

actively be looking for suitable 

candidates to fill the positions 

available during the next few 

months. DA 

Dentalbite ... 

• KaVo Dental GmbH has acquired Shirokusu Dental Supply Works, a Japan-based distributor of dental medical 

devices, thus giving the former a wider access into the Japanese market. 

8 


INDUSTRYBRIEF 

PDA Held 100th Annual Convention & Scientific Mtg 

Philippines — The theme for this year’s Philippine Dental 

Association (PDA) annual convention and scientific meeting 

was “Taking Philippine Dentistry to the Next Level”; and by 

that it hopes to provide continuing dental education to all 

dentists, in order to keep them updated on developments in 

the field, raise the standards of the profession, and share 

and replicate best practices. 

Several parallel symposiums were lined up for the 

weeklong event, geared to better understand current issues 

in dental practice. They covered the following major 

aspects of dentistry: Oral surgery, implant dentistry, 

pediatric dentistry, orthodontics, esthetic dentistry, 

endodontics, prosthodontics and dental laboratory 

technology, periodontics, and temporomandibular joint 

disorders. A panel discussion on understanding patients 

with disabilities was also held. 

Some of the topics discussed during the symposiums are 

pre-orthodontic treatment (to extract or not to extract), oral 

manifestations in patients maintained by hemodialysis for 

chronic renal failure, the legal aspects of risk management in 

today’s dental practice, knowledge of ethical responsibility as 

an essential element in today’s dental practice, practical 

infection control in the dental office and clinic, and forensic 

science and insights into forensic odontology. DA 

Revamped Detax Website Goes Online 

Germany — The new Detax website is 

online with a fresh design, even more 

information and improved simplicity. The 

focus is on maximum customer benefit, 

intelligent user guidance and ease-ofuse. 

With new, smart functions we aim to 

offer our customers useful added value. 

The complete product range, events in 

Germany and abroad, customer service, 

press center or just “what’s new” — 

WDES Donates $250k 

to NUS 

Singapore — The World Dental Education Society Singapore 

(WDES) donated S$250,000 (US$184,000) to the National 

University of Singapore (NUS). The donation, which is eligible 

for the dollar-for-dollar grant by the Singapore Government, 

will support undergraduate dental students to go on the 

overseas exchange programs. A portion of the donation comes 

from the partnership fees that WDES received as co-organizer 

of the last IDEM Scientific Conference. 

Dr Choo Teck Chuan, President of the WDES since its 

inception, hopes that the S$250,000 endowed gift, together 

with government matching grant of the same amount, will 

benefit 10 worthy students each year. The Award, to be 

known as the WDES-FDI World Dental Federation Award will 

be administered by the Faculty of Dentistry at NUS. 

whatever the user look for can be easily 

selected out of numerous options. 

Instructions of use and data sheets can 

be downloaded as well. 

The barrier-free website is open as far as 

the type of presentation selected is 

concerned. It provides optimum access 

on any media, no matter whether the 

user calls it up with a conventional web 

browser, a PDA or a mobile phone. DA 

VITA Renames Product 

Germany — VITA is re-naming 

the product “Dentine”. It shall now 

been called “Transpa Dentine”. 

This applies to the all-ceramic 

veneering materials VITA VM 7 

and VM 9, as well as the metal 

ceramic VM 13m — with effect 

from April 2008. The alteration, however, relates exclusively to 

the product name — the materials themselves remain 

identical, and shall continue to be available in the current 

versions. 

In addition, the more shade-intensive 2-layer VITA VM 

BASIC layering consisting of “Base Dentine” and “Enamel” is 

used. The VITA VM BASIC layering is ideal for high quality 

standard veneering and for the reproduction of tooth shades 

in the case of thin walls. 

DA 

SOMETHING TO SHARE? 

We want to hear from you! Email your story to the Editor: 

desmondteo@pabloasia.com 

10 


INDUSTRYBRIEF 

Cavity-Fighting Candy Helped Cut Tooth Decay? 

USA — Most children are told to stay away from chewy 

candies to keep their teeth cavity-free, but children in 

Venezuela who ate a special cavity-fighting candy had 62% 

fewer cavities than those who brushed their teeth regularly, 

according to researchers at Stony Brook University School of 

Dental Medicine. 

Children in the study were testing the effectiveness of 

BasicMints, an experimental fluoride-free treatment designed 

to mimic a component in human saliva that neutralizes acids 

in the mouth that can erode tooth enamel. 

The researchers, who developed the active compound in the 

mints known as CaviStat, tested them in 200 children in 

Venezuela aged 10 1 / 2 

to 11 who were getting their adult 

molars but still had some baby teeth left. 

Half the children in the study took two of the medicated mints 

in the morning after brushing with a fluoride toothpaste. They 

followed the same routine at night. The other half brushed 

normally twice daily with fluoride toothpaste and took plain 

sugarless mints. 

After 12 months, children who took the cavity-fighting mints 

had 61.7% fewer cavities than the placebo group. 

The soft mints are designed to be dissolved and chewed into 

the biting surfaces of the back teeth, where about 90% of 

cavities in children occur. 

“Unlike regular candies, we want this product to be stuck in the 

teeth,” said Mitchell Goldberg, President of Ortek Therapeutics 

Inc, that licensed the technology from Stony Brook. 

He said the company plans to seek US Food and Drug 

Administration approval to begin testing the product in the 

United States by year end. It may take several years of 

testing before it wins US marketing approval. DA 

Dentists Warn About Teeth Bleaching 

Hong Kong — The public has been warned to consult a 

dentist before getting teeth bleached to avoid possible 

complications. 

Dental Association President, Dr Sigmund Leung said the 

public should understand that patients with gum problems, 

cavities and defective fillings were unsuitable candidates for 

bleaching. 

He said the highly concentrated bleach used in the 

procedure could cause complications to the gums and teeth 

leading to pulpitis, an inflammation of the dental pulp or 

toothache, which might eventually require the affected teeth 

to be removed. 

He contended that teeth-whitening treatments should be 

done at dental clinics instead of beauty salons. 

No Clinics for Saudi 

Dentists 

Saudi Arabia — Despite 220 established new dental clinics 

across Saudi Arabia, unemployed dentistry graduates are still 

unable to find jobs. According to the Health Ministry, new 

centers are only employing specialized dentists, while new 

graduates keep looking for opportunities in big cities, while 

other regions are left unexplored. The government is allotting 

SR27 million (US$7.2 million) for the construction of new 

clinics all over the kingdom. DA 

Dr Leung said 

bleaching or 

whitening 

products sold over 

the counter 

contained low 

concentrations of 

bleach that might 

not give the 

expected results. 

Most whitening toothpastes contained abrasives used to rub 

the surface of the teeth for brighter effect, but that could 

cause thinning of the enamel. 

He also remarked bleaching was not necessarily the only 

way to make teeth look brighter, with tea and coffee stains 

and tartar able to be removed through scaling. DA 

Light Catalysted 

Toothpaste 

Japan — Tokyo-based Yoshimi has released “Aura Rose”, a 

low irritant gel-type toothpaste containing a titanium apatite 

light catalyst. The light catalyst helps remove plaque deposits 

by absorbing the proteins and sugars making up plaque itself 

and aids in the re-calcification of the tooth’s surface. Other 

ingredients include a vitamin C derivative, a low molecular 

hyaluronic acid to moisturise the inside of the mouth and a 

silver ion breath freshener. DA 


EVENTREPORT 

by Drs Lee Soon Boon • Lim Swee Seng • 

Dennis Lee • Eugene Tang • Ng Fooi Chin 

Renowned speakers present during the opening 

ceremony of the Symposium 

UKM-Warwick 

University 

Successfully 

Conclude Implant 

Symposium & 

Occlusion Course 

The University of Warwick and University Kebangsaan Malaysia jointly 

hosted a 3-days Implant Occlusion-Prosthodontic workshop and a 1-day 

Implant Symposium from 28 February 2008 to 2 March 2008 at UKM, Kuala 

Lumpur. 

The Implant Symposium attracted 300 dentists and trade exhibitors from China, 

Malaysia, Singapore, Indonesia, Korea, Pakistan, Bangladesh and the United 

Kingdom. The dental practitioners and supporters from the trade came to advance 

the art and science of implant dentistry for the benefit of patients. 

The international panel of speakers covered various aspects of implant dentistry 

with emphasis on current trends and techniques related to implant dentistry. They 

shared first hand knowledge of their clinical and research experience on immediate 

loading, bone graft regeneration, smile design and aesthetic implant restorations. 

The UKM Dean, Prof Ghazali commented that it was the largest attendance for a 

“one topic” programme held at the faculty. 

The intensive 3-days Occlusion-Prosthodontic course was one of the compulsory 

modules to fulfil the University Warwick MSc in Implant Dentistry degree. 

University of Warwick MSc in 

Implant Dentistry in Singapore 

Application for 2008 intake is now open! 

Intake 2008/09 Academic Calendar 

• August 2008 

• October 2008 

• January 2009 

• April 2009 

Contact: sgdentistry@warwick.ac.uk 

http://www.warwick.ac.uk/go/dentistry 

University of Warwick runs a rigorous flexi part-time implant course at both Diploma 

and Masters levels to meet the needs of the upwardly mobile practitioners who wish 

to enhance their implant practice. University of Warwick has established an 

international panel of implant faculty in UK, Middle East and Far East to provide 

didactic and clinical support for their programme. Warwick’s International Training 

Centre in Singapore coordinates the training programme for Southeast Asia. About 

200 practitioners are currently registered on the University Warwick’s MSc program. 

Both the MSc and Diploma in Implant Dentistry are both recognized as additional 

qualifications by the General Dental Council, UK. 

A Fellowship Dinner was also held in conjunction with the Implant Symposium. The 

dinner was held in a rustic ambience overlooking the silhouette of the imposing KL 

twin towers. The participants and implant exponents from the East and the West 


EVENTREPORT 

exchanged ideas as they partake in the gorgeous fusion menu. 

Every passing moment energized the atmosphere more to 

further loosen reservations. With gaiety and joviality on the 

ascent, many hidden talents surfaced. Each country strut the 

stage to put up impromptu “national” items, vying to make their 

contribution the “memorable item” of the evening. 

The warm fellowship and camaraderie forged during the dinner 

augusts well as many of us only met for the first time. At the 

dinner, a keynote speaker eloquently summed up the spirit of 

the symposium: “I am here not only to teach, but also to learn.” 

In the end we all learn… from different parts of the world. DA 

• Dr Lee Soon Boon, Dr Lim Swee Seng, Dr Dennis Lee are 

University of Warwick 2nd year MSc implant dentistry 

postgraduate students, Malaysia 

• Dr Eugene Tan is University of Warwick 2nd year MSc 

implant dentistry postgraduate student, Singapore 

• Dr Ng Fooi Chin is University of Warwick Hon Assoc 

Professor and Director of MSc in Implant Dentistry, University of 

Warwick International Training Centre, Singapore 

The Symposium was well attended by senior 

and junior dental professionals 

Fellowship dinner with live piano recital 

Rendition by Prof Chan Yew Ai (right) 

The trade exhibition is a draw among the visitors and delegates 

Dental Asia • May / Junel 2008 

13

EVENTREPORT 

by Desmond Teo 

IDS Dental 

Celebrates 40th 

Anniversary 

It’s not everyday you get to 

celebrate 40th anniversary and 

having past this point, it is a 

historical milestone worth 

celebrating and rejoicing. IDS Dental, 

a leading SIngapore-based distributor, 

did just that by inviting all its 

principals, as well as customers to 

come together for a nite of big bash. 

Despite their hectic schedules during 

the day at IDEM, everyone present 

interacted freely and let their hair 

down gamely. Apart from nostalgic live 

band performance, the guests were 

A group photo with the principals. Sophia Lim is 

standing second from left. Linda Teo is sitting third 

from left. 

very obliging and sporting to go on stage to perform karaoke singing, accompanied 

by the live band, and one must be present to realize the hidden talents in the dental 

industry that could possibly beat the daylight out of the contestants of American 

Idol. 

The night also saw IDS Dental presenting long service awards to its principals, 

some of whom have been with the former for 20 to 30 years long and they inlcude, 

Coltene Whaledent, Takara Belmont, W&H, Durr Dental, Planmeca etc. And from 

the speeches of these principals who received their awards, it would not be hard to 

realize how much they appreciated the service and effort that IDS Dental have put 

in in all these years of partnership. 

So, let’s look forward to another 40 years of excellent service from IDS Dental. 

Ms Linda Teo, herself a long 

service employee with IDS Dental 

giving her speech 

Mr Hidetaka Yoshikawa, Chairman & CEO of Takara 

Belmont giving his note of thanks to Sophia Lim, 

Country Managing Director of IDS Dental 

Mr Yoichi Okamura belting out a Japanese classic with full 

gusto. This was just one of the several live karaoke singing 

by the guests with live band. 


CORPORATEPROFILE 


DenMit - Plugging 

the Needs of 

Dentists 

Dynamism, sensitivity to customers’ needs and being mobile — these are the 

plus factors of DenMit Trading that one will come away with when you 

speak to one of the pioneers of the company, Claudia Ng, who is also the 

marketing manager. 

Said Claudia, who has experience as a solution provider for the dentists from her 

previous company, about DenMit: “Being a small outfit, we can adapt and change 

according to the situations better. We are not bound by hard-and-fast regulations 

and we take it upon our duties to provide an excellent before- and after-sales 

support for our clients.” 

Although DenMit Trading was incorporated in 2006, its staff are experienced in the 

field of dental solutions. “We may be a young outfit but our staff have years of 

experience in dental sales and technical competency. So far, I am proud to say that 

all our clients are satisfied with our service and support,” Claudia added. The 

technical support staff are qualified and trained to handle the different products that 

the company is carrying. 

Apart from meeting customers’ needs, another area that DenMit is proud of is in 

providing cost-effective customized solutions for its clients. In fact, it will go out of 

the way to facilitate its customers in their dental setups and making it hassle-free for 

them. “By being cost-effectiveness, I meant that we will try to meet the customers’ 

margin, the budgets they have, as well as offering innovative instalment plans for 

them.” 

Spreading its Wings 

DenMit is not contented with just making a name for itself in Singapore; in fact, it is 

looking further afield. According to Claudia, they have already made in-roads into 

Thailand, Australia and India “successfully” and are now eyeing the Indonesian 

market as well. 

“I am grateful with the support I have been getting from the local dentists since we 

started but it’s also our vision to have a share of the dental market in this region, 

and I am confident we can achieve that within the next three years,” revealed 


CORPORATEPROFILE 

Small and new as it might be 

but DenMit Trading is in no 

way hampered by that; on the 

contrary, it is systematically 

realizing its goals and 

growing from strength-tostrength 

Claudia confidently. Claudia also revealed that should 

opportunity arise, DenMit might look into “setting up a 

company” there. 

Already DenMit is carrying several established product lines, 

which are well-received by the dentists. Amongst them were 

Owandy, Rolence, Nouvag, just to name a few. 

But, being a young company, is it moving too fast and too far? 

Claudia thinks not. “I would say I am ambitious but not to the 

point of over-stretching ourselves. We take things one step at 

a time so that we don’t lose our focus and with the help of 

clients and associates, I am sure we heading in the right 

direction.” 

for nurses and/or dental assistants. “With technology advancing 

so rapidly, even the dentists have a hard time coping with it, let 

alone training or instructing their assistants on the handling and 

operation of the machines. So, this is where DenMit hopes to 

come in and assist in the training part, given our expertise in 

dental products.” 

In a Nutshell 

Small and new as it might be but DenMit Trading is in no way 

hampered by that. On the contrary, it is systematically realizing 

its goals and growing from strength-to-strength. 

Flexibility and variation of solutions are what dental 

professionals look out for nowadays, and DenMit understand 

these two areas perfectly. It is able to capitalize on its strength 

and nimbleness by adapting to circumstances better and turns 

things around quickly through its creative and customized 

digital dental solutions. 

As in the words of Claudia: “What set us apart from the others 

is that we don’t consider ourselves being just a product 

distributor or one that just provides technical support. We see 

ourselves as a clinical integrator because when we take on a 

project, we will assess it as a whole in terms of costs, technical 

support, as well as the product assurance.” 

Total concept — that’s the emphasis when one speaks to 

Claudia about DenMit Trading; and total concept may be the 

winning concept as the company aims to plug the needs of 

dental professionals. DA 

The Future 

Claudia sure has a clear vision of what 

holds for the DenMit in the future. “We are 

definitely looking at expanding our range of 

product lines so that we could offer our 

clients a more varied dental solution.” The 

company will be conducting market research 

on the type of products to bring in next. 

On the card, too, are two growth areas for 

dentistry — periodontics and aesthetic 

dentistry. Said Claudia matter-of-factly: 

“Currently, we are specialized in digital 

dental integrated solutions for general dental 

practitioners but in the middle to long run, 

we are looking at moving into periodontics 

and aesthetic dentistry. We foresee these 

two areas that have a huge potential for 

growth. 

According to Claudia, the company will also 

leverage on its technical support expertise 

by providing training and refresher courses 

Claudia Ng (right) with her principal, Boris Loyez, International Sales Manager of Owandy 


17

CLINICALFEATURE 

by Prof Lakshman Samaranayake 

The Promise of 

Salivary Diagnostics 

The use of saliva as a diagnostic fluid for various human ailments is 

gaining popularity as it offers distinct advantages over serum. These 

include the non-invasive nature of saliva collection compared with 

phlebotomy, simplicity of collection even for individuals with a modest 

training and, the cost-effective applicability for screening large populations. 

Whole saliva, is most frequently used for diagnosis of systemic diseases, since 

it is readily collected and contains serum constituents while gland-specific 

saliva is useful for investigating pathology of major salivary glands. Broadly, 

saliva analysis is currently used for the diagnosis of infectious and malignant 

diseases, hereditary disorders, auto-immune diseases, and endocrine 

disorders, as well as for the assessment of therapeutic drug levels, particularly 

in monitoring drug abuse. This review addresses the current status of salivary 

diagnostics and its future potential. 

In ancient Greece, phlegm and saliva were regarded by Hippocrates as one of 

the four humors fundamental to disease and health. Saliva indeed is a mirror 

of our blood as these biofluids and their molecular components share many 

similarities 1 . Realization of this fact and the possible utility of saliva as a 

diagnostic bio-fluid during the past couple of decades have led many 

researchers to develop saliva-based technology to detect the transition 

between health and disease. Furthermore, recent advances in technology 

including genomics, proteomics, transcriptomics and microfluidics have led the 

way for using saliva beyond basic assessment of oral health characteristics to 

where it could be used to evaluate features of overall health including disease 

progression. 

It is generally thought that the quality of saliva is highly variable and difficult to 

handle in the laboratory, due to its highly degradable nature, with millions of 

bacteria and other organic components. Further, compared with blood other 

factors that affect salivary quality include the type of saliva, i.e. mixed vs pure 

(glandular), the specific collection methodology used and the physiological 

factors such as diurnal quality variations 2 . However, recent research has now 

established defined ways to work with saliva that are consistent, reproducible, 

and which keep these molecules in a undegraded, stable state. Perhaps the 

widest current use of such technology is in the detection of viral infections, in 

particular human immunodeficiency virus (HIV) disease. 

As will be seen later the commercially available kits that are in current use 

have very high sensitivity with negligible false positivity rates (i.e., high 

specificity). Other recent studies from US have yielded promising results on 

the feasibility of the use of saliva for the diagnosis of cancers including breast 

cancer, and oral carcinomas. The relative advantages of saliva as a diagnostic 

fluid compared with blood are many and these include simplicity in collection 

essentially being non-invasive and pain free, relatively cheap technology 

compared to blood tests, and cost effective applicability for screening large 


CLINICALUPDATE 

populations. 

In order for a diagnostic method including salivary diagnostics 

to be widely applicable it should satisfy the following criteria: 

(i) the analytic precision and accuracy; (ii) excellent sensitivity 

and specificity (iii) good operational predictive value and 

efficiency and (iv) value for money or cost/benefit ratio in 

terms of rapid point of care diagnosis. 

What follows is a highlight of the uses of saliva in assessing 

the health and disease of individuals, and related uses in 

diagnostic sciences for miscellaneous applications such as 

drug abuse. It must, however, be stated at the outset that 

salivary diagnostic sciences is yet to mature and its true 

potential not yet realized. 

Viral Diseases 

A number of viruses that cause disease are either shed in 

saliva or egress into saliva through crevicular or serum 

exudates of the healthy or diseased periodontium 3 . Of these, 

the most important saliva diagnostic test that has been 

developed to date is a kit for detecting the human 

immunodeficiency virus (HIV) infection. Whole saliva can be 

used for detecting antibodies directed toward specific HIV 

viral protein epitopes and the test has very high sensitivity 

and specificity 3, 4 . For instance, in one study using an 

enzyme-linked fluorescence technique in combination with 

Western blot assays, saliva was superior to serum and urine 

with regard to both sensitivity and specificity 5 . 

Indeed the Federal Drug Administration (FDA) of USA 

approved saliva HIV testing kits for public use in as earl as in 

2003. Other developments in this regard include a 

commercially available, self-contained kit for use in 

community outreach and surveillance studies that does not 

require trained laboratory personnel. Further, saliva can be 

used to monitor the disease activity either in HIV-infection or 

other chronic inflammatory diseases through assessment of 

beta 2 microglobulin and/or soluble tumor necrosis factor a- 

receptor levels 6, 7 . 

Saliva is also a useful alternative to serum for the diagnosis of 

variants of viral hepatitis. For instance, acute hepatitis A 

(HAV) and hepatitis B (HBV) can be diagnosed based on the 

presence of IgM antibodies in saliva. Comparison of serum 

and saliva levels of antibody to HAV revealed excellent 

agreement 8 . Recently. Hepatitis A Virus RNA detection in 

saliva has been suggested as a useful marker for tracing 

A number of viruses that cause 

disease are either shed in 

saliva or egress into saliva 

through crevicular or serum 

exudates of the healthy or 

diseased periodontium 

and monitoring infection in community settings 9 . Similarly, 

analysis of saliva is highly sensitive and specific for the 

diagnosis of viral hepatitis B as well as hepatitis C with a 

sensitivity and specificity approaching 100%. 3, 10,11 Other 

uses of saliva for detecting viral diseases include determining 

immunization efficacy for measles, mumps, and rubella 

(MMR) vaccine 12 , and to monitor the immune response to 

vaccination and infection with the rotavirus infection – a 

common infant diarrhoeal disease in the developing world 13 . 

Whist the saliva diagnostics for the foregoing infections are 

far advanced there is a spectrum of other viral infections that 

await further technical refinements. These, essentially based 

on plolymerase chain reaction (PCR) methodology or its 

advancements such as mutiplex PCR include, tests for 

evaluation of human herpes viruses. As most human viruses 

ranging from HHV1 to HHV8 are shed in saliva the latter 

would be an ideal source for testing and monitoring the 

dormancy or the sub-clinical activity of these viruses either in 

health or disease states. 

A number of investigators have measured the shedding of 

Epstein-Barr virus, cytomegalovirus and herpes viruses 6, 7, 

and 8 in the saliva of HIV infected patients 14, 15 . It is highly 

likely that further refinements of molecular technology should 

lead to wide use of saliva as an effective, simple and a 

valuable diagnostic tool for evaluation of human Herpes virus 

carriage in saliva or indeed their clinical manifestations 16 . 

Bacterial Infections 

The two most common plaque related oral bacterial infections 

are caries and gingivitis. Many investigators have studied the 

feasibility of salivary diagnostics as a predictor of caries 

INFORMATIVE • INSIGHTFUL • INCISIVE 

For more information, email: info@pabloasia.com 


19


susceptibility or for gingivitis /periodontitis 17, 18 . With regard to 

caries saliva samples can be used to establish the numbers 

of Streptococcus mutans and Lactobacillus species – the two 

major caries associated pathogens. 

In order to detect caries associated flora, paraffin wax 

stimulated whole saliva samples are collected and a dip slide 

containing the selective growth medium (which permits the 

growth of only the specific organism) is dipped into the 

collected saliva. Afterwards the slide is incubated within the 

container at 37 º C for upto 24 hrs and the resultant colonies of 

the putative pathogen is assessed in a semi-quantitative 

manner. In general the approximate figures for the cariogenic 

flora are: 

• High caries activity > 10 6 /mL S mutans and/or 105m/L 

lactobacillus spp 

• Low caries activity : < 10 5 /mL S mutans and/or 104m/L 

lactobacillus spp 

The presence of high salivary levels of S mutans or 

lactobacilli does not necessarily mean that the patient has an 

increased risk of developing dental caries, as it is a disease 

of multifactorial aetiology 19 . Other factors such as the diet, 

buffering capacity of saliva, fluoride content of enamel and 

degree of oral hygiene should also be considered. Although 

this particular test is at best a generalized approximation of 

the caries risk it could be utilized to identify patients who have 

unusually high numbers of potential pathogens, so that these 

data can be taken into account when integrating all the 

factors that may contribute to carious process in an individual 

patient. In addition, the test could be utilized to monitor the 

efficacy of caries prevention techniques such as dietary and 

oral hygiene advice and the use of antimicrobial agents such 

as chlorhexidine 20 . 

Due to the foregoing reasons salivary-based tests for 

monitoring plaque-related infections can not be construed as 

truly diagnostic, rather they are harbingers of a patient’s risk 

potential for disease and the consequent need for preventive 

measures. This approach has proven successful as a public 

health, preventive measure especially in Scandinavian 

countries for many decades 21 . 

With regard to periodontal disease and the detection of major 

periodontopathogenic bacteria salivary diagnostics have 

proven less successful. Tests are however, now available for 

chair-side assessment of Porphymonas gingivalis, a 

pathogen closely associated with periodontal disease. Other 

salivary markers that have been studied as potential 

diagnostic tools for periodontal disease include proteins of 

host origin such as enzymes and immunoglobulins, host cells, 

hormones (cortisol), bacterial metabolites and volatile 

compounds. 

Of these, host-derived enzymes and other inflammatory 

mediators originating from the gingival crevice appear to hold 

the greatest promise as salivary diagnostic tests for 

periodontal disease both on an individual basis or on a 

community wide assessment of risk for periodontal disease. 

The recent exciting developments on the potential role of 

periodontal disease as a risk factor for cardiovascular and 

cerebrovascular diseases 22 and the incidence of pre-term lowbirth-weight 

babies 23 bring new impetus to this aspect of 

salivary diagnostics. 

It is now well recognized that Helicobacter pylori are the 

causative agents of a significant proportion of gastritis and 

duodenal ulcers (peptic ulcer disease) in humans and, it may 

also play a role in gastric cancer 24 . Studies have also shown 

that dental plaque biofilms may act as a reservoir of H pylori 

in some of these individuals. Hence attempts have been 

made to use saliva as a diagnostic aid for peptic ulcer 

disease. A nested PCR assay is now available to detect H. 

pylori DNA in saliva and confirm the presence of H. pylori 

infection in patients 25 . Other immunologic studies indicate that 

saliva may also be used for predicting risk for gastric 

adenocarcinoma 26 . 

Saliva from patients with a variety of other disorder including 

shigellosis, pigeon breeders disease and Lyme disease have 

been evaluated for the presence of specific antibodies, with 

mixed results 27 . But with the increased sensitivity of tests and 

advancing technology it is likely that saliva would be used as 

an important diagnostic fluid for such disease entities. 

Auto-immune Disorders 

When body defenses turn against itself as seen in many 

autoimmune disorders, diseases such as Sjögren’s syndrome 

may ensue. The latter is a chronic, illness characterized by 



In earlier studies, it has also 

been shown that the 

epidermal growth factor 

(EGF) is higher in the saliva of 

women with primary breast 

cancer or a recurrence of 

breast cancer when 

compared with women 

without diseases 

salivary and lacrimal gland dysfunction, serologic 

abnormalities, and multiple organ-system changes including 

rheumatoid arthritis 28 . Many have attempted to use saliva as 

well as other salivary parameters including sialography, salivary 

scintigraphy, and biopsies of minor salivary glands for the 

diagnosis of Sjögren’s syndrome, with mixed results 29 . 

Of these, salivary flow rate determination or sialometry is the 

simplest whilst other tests need to be conducted in special 

laboratories or clinics. As these are invasive and expensive, a 

panel of simple chair-side tests that could be conducted that 

include flow rate, pH, buffer capacity, lactobacillus, and yeast 

concentration has been suggested as useful for the purpose 30 . 

These tests, performed on whole saliva, can provide 

persuasive evidence for the presence of Sjögren’s syndrome 

that affects mainly the middle-aged, elderly population. 

Cardiovascular Diseases 

Cardiovascular disease is the commonest cause of death 

worldwide. Salivary markers such as salivary amylase have 

been used for postoperative follow up of patients undergoing 

cardiovascular surgery. Work of Adam et al. 31 , indicate that if 

salivary amylase levels were low in preoperative patients with 

ruptured aortic aneurysm, then this is associated with 

increased mortality. Others have found that salivary-amylase 

activity could be used as a good marker of catecholamine 

activity during evaluation of patients under a various stressful 

situations 32 . Such investigations, while indicating the possible 

utility of saliva to assess the general health of the body, are yet 

in the early stages of development and more work is required 

to confirm their general usefulness. 

Endocrinology 

Measurements of salivary hormone levels are of clinical 

relevance if they accurately reflect the serum hormone levels or 

if a constant correlation exists between salivary and serum 

hormone levels. Although there is wide disparity in these values 

for some hormones salivary steroid levels are in general good 

indicators of their blood concentrations. 

Consequently, the use of saliva for monitoring of steroid 

hormone levels is now feasible and commercially available with 

dedicated websites on the internet (e.g. http:// 

www.salivatest.com/journals/saliva_ref.html ). At present, the 

following steroid levels can be assessed using mixed saliva: 

cortisol, estradiol, estriol, dehydroepiandrosterone, 

progesterone and testosterone. As opposed to these serum 

levels of protein hormones such as prolactin and thyrotropin 

can not be evaluated by salivary analyses as the latter 

molecules are too large to reach saliva through passive 

diffusion. 

The clinical utility of steroid hormone evaluation have been 

demonstrated in a wide variety of situations ranging from 

assessment of child health and development, mood and 

cognitive emotional behavior, premenstrual depression, 

Cushing’s syndrome, ovarian function and monitoring full-term 

and preterm neonates. 

Oncology 

The use of saliva as a predictable and a sensitive marker for 

detection of either oral or systemic cancers appears to be a 

practical reality. In a recent landmark study Wong et al. 33 , 

noticed seven messenger RNAs in particular that were present 

at a 3.5-fold higher level in patients with oral carcinomas. 

(mRNA is the molecular intermediate between gene and 

protein, serving as a chemical record that an individual gene 

has been expressed). The latter workers then reduced their list 

of signature mRNAs to four, based on statistical models that 

indicated the synchronized rise in expression of these four 

molecules increased the probability that the saliva belonged to 

a cancer patient. 

These four mRNAs were from the following genes: Interleukin 

1-beta (IL1B), Ornithine decarboxylase antizyme 1 (OAZ1), 

spermidine/spermine N1-acetyl transferase (SAT), and 

interleukin 8 (IL-8). To put this idea to the test, Wong et al. 33 , 

Analytical • Authoritative • Acclaimed 



21


Table 1 Drug detection in saliva: Currently available methodolgy detects minute quantities of 

the following drugs and chemicals in saliva 

Therapeutic drugs 

Antipyrene 

Cyclosporin 

Digoxin 

Mathadone 

Paracetamol 

Quinine 

Carbamazepine 

Diazepam 

Lithium 

Oxprenolol 

Phenytoin 

Tolbutamide 

Recreational drugs and drugs of abuse 

Amphetamines 

Benzodiazepines 

Cocaine 

Nicotine 

Barbiturates 

Ethanol 

Marijuana 

Opioids 

Phencyclidine 

screened the saliva again to see how often they could correctly 

identify the samples from the cancer patients. The group could 

identify the saliva from cancer patients in nine out of 10 samples. 

Although this is a primary, exploratory study the data is exciting 

and paves way to further research in the direction. Previoulsy, 

Boyle et al. 34 , have shown the possible value of p53 in saliva as a 

marker for squamous cell carcinoma. Interestingly, they detected 

and identified tumor-specific mutations in p53 in preoperative 

salivary samples of individuals suffering from head and neck 

squamous cell carcinoma. 

Apart from these more recent molecular studies many have 

investigated the utility of proteins in saliva for the detection of 

systemic, non oral, malignancies. These results indicate that, 

for instance, higher levels of salivary kallikrein in patients with 

malignant tumors as compared with those with benign tumors 

or from healthy controls. Others have also shown that saliva 

contains the cancer antigen CA 125, a glycoprotein complex 

that is an often-used marker for ovarian cancer. Indeed 

according to some studies salivary CA 125 assay had a better 

diagnostic value than the comparable serum assay 35 . 

Saliva has also been used for monitoring patient response to 

chemotherapy for breast cancer or surgical treatment of the 

disease. Thus Streckfus et al. 36 , studied the protein product of 

the oncogene c-erbB-2, also known as HER-2/neu, and noted 

that it is elevated in the saliva of women diagnosed with 

breast cancer. In earlier studies, it has also been shown that 

the epidermal growth factor (EGF) is higher in the saliva of 

women with primary breast cancer or a recurrence of breast 

cancer when compared with women without disease 37 . 

The foregoing clearly illustrates the potential of salivary 

diagnostics in the management of both oral and non-oral 

malignancies. In particular, the salivary proteomic and mRNA 

studies and those in current development 38 including 

electrochemical enzyme immunoassay procedures 39 have the 

greatest promise in this regard. 

Hereditary Disorders 

Attempts have been made by several investigators to use 

saliva as a diagnostic fluid for hereditary diseases such as 

cystic fibrosis (CF), celiac disease and 21-Hydroxylase 

deficiency - an inherited disorder of steroidogenesis. 

However, these have been met with partial success. 

Drug Monitoring 

Various drugs taken internally either for medicinal or 

recreational purposes can appear in saliva. However, the 

salivary drug concentration is influenced by the molecular and 

physicochemical characteristics of the drug and its interaction 

with the salivary tissues, as well as the extravascular drug 

metabolism. Additionally salivary factors including the 

presence of food debris, sloughed epithelial cells, and pH 

determine the drug availability 40 . More improved saliva 

collection methods and preservatives that maintain the 

integrity have largely overcome these problems however. 

Monitoring of illicit drug use by salivary detection methods 

appears to be the most promising in this context. Currently, 

saliva can be used to detect opioids, barbiturates, 



Whilst saliva is an appropriate 

diagnostic tool for some 

diseases, more research is 

warranted to identify the ideal 

candidate markers for monitoring 

and diagnosis of others 

benzodiazepines, amphetamines, cannabinoids, cocaine, 

phencyclidine, and ethanol (for a review see Kaumman and 

Lamster 27 ; Table 1). Saliva can also be used to detect recent 

marijuana use by means of radiommunoassay. In psychiatry, 

saliva has been used with partial success, to monitor 

responses in the treatment of anxiety and post-traumatic stress 

disorder by measuring salivary levels of 3-methoxy-4- 

hydroxyphenylglycol (MHPG) 41 . 

Conclusions 

Whilst saliva is an appropriate diagnostic tool for some 

diseases, more research is warranted to identify the ideal 

candidate markers for monitoring and diagnosis of others. 

Furthermore, advances in genomics, proteomics and 

nanotechnology will contribute much to the understanding of 

the role of saliva as a diagnostic biofluid. The maturation of 

salivary diagnostics has much promise, and is bound to be 

widespread in the not too distant future. DA 

Acknowledgements: 

I am grateful to Professor Stpehen Moss (editor), Professor Emeritus, New 

York University, USA, for the kind permission given to modify and update my 

original text that appeared as a chapter in the monograph ‘The benefits of 

chewing’, published by Health Education Enterprises, USA. 

References 

1. Slavkin HC. Toward molecularly based diagnostics for the oral cavity. J Am Dent Assoc 1998 

129: 1138-1143. 

2. Dawes C. Considerations in the development of diagnostic tests on saliva. Ann NY Acad Sci 

1993 694: 265-269. 

3. Scully C, Samaranayake LP. Clinical Virology in Oral medicine and Dentistry. Cambridge University 

Press, 1992. 

4. Scully C. HIV topic update: salivary testing for antibodies. Oral Dis 1997 3: 212-215. 

5. Martinez PM, Torres AR, Ortiz de Lejarazu R et al. Human immunodeficiency virus antibody 

testing by enzyme-linked fluorescent and western blot assays using serum, gingival-crevicular 

transudate, and urine samples. J Clin Microbiol 1999 37: 1100-1106. 

6. Grant RM, Piwowar EM, Katongole-Mbidde E et al. Comparison of saliva and serum for human 

immunodeficiency virus type 1 antibody testing in Uganda using a rapid recombinant assay. Clin 

Diagn Lab Immunol 1996 3: 640-644. 

7. Nishanian P, Aziz N, Chung J et al. Oral fluids as an alternative to serum for measurement of 

markers of immune activation. Clin Diagn Lab Immunol 1998 5: 507-512. 

8. Stuart JM, Majeed FA, Cartwright KA et al. Salivary antibody testing in a school outbreak of 

hepatitis A. Epidemiol Infect 1992 109: 161-166. 

9. Mackiewicz V, Dussaix E, Le Petitcorps MF et al. Detection of hepatitis A virus RNA in saliva. J Clin 

Microbiol 2004 42: 4329-4331. 

10. El-Medany OM, El-Din Abdel Wahab KS, Abu Shady EA et al. Chronic liver disease and hepatitis 

C virus in Egyptian patients. Hepatogastroenterology 1999 46: 1895-1903. 

11. Thieme T, Yoshihara P, Piacentini S et al. Clinical evaluation of oral fluid samples for diagnosis of 

viral hepatitis. J Clin Microbiol 1992 30: 1076-1079. 

12. Brown DW, Ramsay ME, Richards AF et al. Salivary diagnosis of measles: a study of notified 

cases in the United Kingdom, 1991-3. Bmj 1994 308: 1015-1017. 

13. Jayashree S, Bhan MK, Kumar R et al. Serum and salivary antibodies as indicators of rotavirus 

infection in neonates. J Infect Dis 1988 158: 1117-1120. 

14. LaDuca JR, Love JL, Abbott LZ et al. Detection of human herpesvirus 8 DNA sequences in tissues 

and bodily fluids. J Infect Dis 1998 178: 1610-1615. 

15. Lucht E, Brytting M, Bjerregaard L et al. Shedding of cytomegalovirus and herpesviruses 6, 7, and 

8 in saliva of human immunodeficiency virus type 1-infected patients and healthy controls. Clin 

Infect Dis 1998 27: 137-141. 

16. Pozo F, Tenorio A. Detection and typing of lymphotropic herpesviruses by multiplex polymerase 

chain reaction. J Virol Methods 1999 79: 9-19. 

17. Lendenmann U, Grogan J, Oppenheim FG. Saliva and dental pellicle—a review. Adv Dent Res 

2000 14: 22-28. 

18. Rudney JD. Saliva and dental plaque. Adv Dent Res 2000 14: 29-39. 

19. Samaranayake LP, MacFarlane TW. Clinical Oral Microbiology. Bristol; Wright, 1989. 

20. Samaranayake LP. Essential Microbiology for Dentistry. 3rd ed, Edinburgh : Churchill Livingstone, 

2002. 

21. Birkhed D, Edwardsson S, Andersson H. Comparison among a dip-slide test (Dentocult), plate 

count, and Snyder test for estimating number of lactobacilli in human saliva. J Dent Res 1981 60: 

1832-1841. 

22. Joshipura KJ, Douglass CW, Willett WC. Possible explanations for the tooth loss and cardiovascular 

disease relationship. Ann Periodontol 1998 3: 175-183. 

23. Offenbacher S, Jared HL, O’Reilly PG et al. Potential pathogenic mechanisms of periodontitis 

associated pregnancy complications. Ann Periodontol 1998 3: 233-250. 

24. Kountouras J. Detecting Helicobater pylori. Diagnostic tests for Helicobacter pylori. Gut 1998 

42: 900-901. 

25. Jiang C, Li C, Ha T et al. Identification of H. pylori in saliva by a nested PCR assay derived from a 

newly cloned DNA probe. Dig Dis Sci 1998 43: 1211-1218. 

26. Vaira D, Holton J, Menegatti M et al. New immunological assays for the diagnosis of Helicobacter 

pylori infection. Gut 1999 45: I23-127. 

27. Kaufman E, Lamster IB. The diagnostic applications of saliva—a review. Crit Rev Oral Biol Med 

2002 13: 197-212. 

28. Daniels TE. Sjogren’s syndrome: clinical spectrum and current diagnostic controversies. Adv Dent 

Res 1996 10: 3-8. 

29. Streckfus C, Bigler L, Navazesh M et al. Cytokine concentrations in stimulated whole saliva among 

patients with primary Sjogren’s syndrome, secondary Sjogren’s syndrome, and patients with primary 

Sjogren’s syndrome receiving varying doses of interferon for symptomatic treatment of the condition: 

a preliminary study. Clin Oral Investig 2001 5: 133-135. 

30. Sreebny L, Zhu WX. Whole saliva and the diagnosis of Sjogren’s syndrome: an evaluation of 

patients who complain of dry mouth and dry eyes. Part 1: Screening tests. Gerodontology 1996 

13: 35-43. 

31. Adam DJ, Milne AA, Evans SM et al. Serum amylase isoenzymes in patients undergoing operation 

for ruptured and non-ruptured abdominal aortic aneurysm. J Vasc Surg 1999 30: 229-235. 

32. Chatterton RT, Vogelsong KM, Lu YC et al. Salivary alpha-amylase as a measure of endogenous 

adrenergic activity. Clin Physiol 1996 16: 433-448. 

33. Li Y, St John MA, Zhou X et al. Salivary transcriptome diagnostics for oral cancer detection. Clin 

Cancer Res 2004 10: 8442-8450. 

34. Boyle JO, Mao L, Brennan JA et al. Gene mutations in saliva as molecular markers for head and 

neck squamous cell carcinomas. Am J Surg 1994 168: 429-432. 

35. Chen DX, Schwartz PE, Li FQ. Saliva and serum CA 125 assays for detecting malignant ovarian 

tumors. Obstet Gynecol 1990 75: 701-704. 

36. Streckfus C, Bigler L, Tucci M et al. A preliminary study of CA15-3, c-erbB-2, epidermal growth 

factor receptor, cathepsin-D, and p53 in saliva among women with breast carcinoma. Cancer 

Invest 2000 18: 101-109. 

37. Navarro MA, Mesia R, Diez-Gibert O et al. Epidermal growth factor in plasma and saliva of 

patients with active breast cancer and breast cancer patients in follow-up compared with healthy 

women. Breast Cancer Res Treat 1997 42: 83-86. 

38. Vitorino R, Lobo MJ, Ferrer-Correira AJ et al. Identification of human whole saliva protein 

components using proteomics. Proteomics 2004 4: 1109-1115. 

39. Ivnitski D SR, Ivnitski N. Hand-held amperometric sensor for saliva and other oral fluid-based 

diagnostics. Analytica Chimica Acta 2004 504: 265-269. 

40. Siegel IA. The role of saliva in drug monitoring. Ann N Y Acad Sci 1993 694: 86-90. 

41. Aurer A, Aurer-Kozelj J, Stavljenic-Rukavina A et al. Inflammatory mediators in saliva of patients 

with rapidly progressive periodontitis during war stress induced incidence increase. Coll Antropol 

1999 23: 117-124. 

Prof Lakshman Samaranayake is the 

Dean and, the Chair Professor of Oral 

Microbiology at The University of Hong 

Kong and, the Director of the Prince 

Philip Dental Hospital, Hong Kong. He is 

also an Honorary Professor at the 

Eastman Dental Institute, London. He is a 

renowned expert in oral infections and 

infection control, has lectured in some 25 countries, and has 

authored more than 400 publications, including seven 

textbooks and monographs, translated into six different 

languages. He is also a World Bank Consultant in Problem 

Based Learning and the Vice-Chair of the Oral Medicine and 

Pathology Group of the International Association for Dental 

Research. Previously he has held teaching positions at the 

University of Glasgow, United Kingdom, University of Alberta, 

Canada and, the University of Peradeniya, Sri Lanka. He has 

been a Director of the FDI World Dental Federation and the 

Chairman of its Science. 


23


by Drs Fanny Young & Ricky Wong 

The Use of 

Motivational Theories 

in Dentistry 

This article reviewed the theories of 

motivation and suggested their applications 

in dentistry. These included Maslow’s 

hierarchy of needs theory, McGregor’s 

Theory X and Theory Y, Motivation-hygiene 

theory, Three-needs theory, Goal-setting 

theory, Reinforcement theory, Equity theory 

and Expectancy theory. An understanding of 

each theory can evolve a combined strategy 

that can motivate the most difficult patients. 

All dentists want to motivate their patients, for example, to improve the 

oral hygiene, to proceed to a certain treatment or to wear a certain 

appliance. Besides, as an employer or team leader, dentists would like 

to motivate their employees, subordinates or team members. In other 

words, understanding motivation can be a half way to success. Motivation is the 

process by which a person’s efforts are energized, directed, and sustained 

towards attaining a goal. It is the result of an interaction between the person and 

a situation; it is not a personal trait. In this article we would like to explore the 

theories of motivation in an attempt to improve our effectiveness in motivating 

others. We start with early theories of motivation, and then the more 

contemporary ones. 

Early Theories of Motivation 

Three early theories of motivation, namely: Maslow’s Hierarchy of Needs; 

MacGregor’s Theories X and Y; Herzberg’s Two-Factor Theory provide the bestknown 

explanations for motivation, even though their validity has been 

questioned. 

Maslow’s hierarchy of needs theory 

This was developed by psychologist Abraham Maslow 1 . This theory states that 

there is a hierarchy of five human needs, from bottom to top: physiological (basic 

food, drink, water, shelter, and sexual needs); safety (security and protection 

from physical and emotional harm); social (affection, belongingness, acceptance, 

and friendship); esteem (internal factors such as self-respect, autonomy, and 

achievement, and external factors such as status, recognition, and attention); 



It is necessary to identify the 

motivators of the patients. Focus 

on intrinsic factors like 

achievement, recognition, 

responsibility, and advancement 

in motivating patients. 

and self-actualization (a person’s drive to become what he/she 

is capable of becoming). In terms of motivation, Maslow argued 

that each level in the needs hierarchy must be substantially 

satisfied before the next is activated and that once a need is 

substantially satisfied it no longer motivates behavior. 

Therefore, according to him, if one wants to motivate someone, 

one need to understand what level that person is on in the 

hierarchy and focus on satisfying needs at or above that level. 

As each need is substantially satisfied, the next need becomes 

dominant. In addition, he separated the needs into lower-level 

needs (including the physiological and safety needs) and 

higher-level needs (including social, esteem, and selfactualization). 

The difference was that higher-order needs are 

satisfied internally while lower-order needs are predominantly 

satisfied externally. Satisfied needs will no longer motivate, 

therefore, motivating a person depends on knowing at what 

level that person is on the hierarchy. 

Applications to Dentistry: It is important to visualize patients 

have different levels of needs. Motivation is more effective 

when the patient’s need can be satisfied. We need to identify 

the underlying need of the patient. Note that this hierarchy is 

just a general trend, in some cases people will want to satisfy 

the need that is higher in the hierarchy first. 

McGregor’s Theory X and Theory Y 

These were developed by Douglas McGregor 2 and describe 

two distinct views of human nature. The first one, Theory X is 

the assumption that people dislike work, are lazy, avoid 

responsibility, and need to be closely controlled to work 

effectively. The second one, Theory Y is the assumption that 

people are creative, enjoy work, seek responsibility, and can 

exercise self-direction. Theory X assumes that Maslow’s lowerorder 

needs dominate individuals, while Theory Y assumes that 

higher-order needs are dominant. McGregor himself held to the 

belief that the assumptions of Theory Y were more valid than 

those of Theory X. Therefore, he proposed that participation in 

decision making, responsible and challenging work, and good 

personal relations would maximize motivation. There was no 

empirical evidence exists to confirm that either set of 

assumptions is valid or that altering behavior based on Theory 

Y assumptions will increase people’s motivation. 

Applications to Dentistry: It is important to identify what type of 

patient you have. If the patient belongs to Theory Y then after 

you have reasoned and discussed with them the situations they 

tend to follow your recommendations, such as improving oral 

hygiene or wearing oral appliances. If the patient belongs to 

Theory X, then you need more frequent reinforcements. 

Motivation-hygiene Theory 

This is developed by Frederick Herzberg 3 . This is the 

motivation theory that intrinsic factors are related to work 

satisfaction and motivation, whereas extrinsic factors are 

associated with work dissatisfaction. He asked people for 

detailed descriptions of situations in which they felt 

exceptionally good or bad about their jobs. He concluded from 

his analysis that the replies they gave when they felt good 

about their jobs were significantly different from the replies they 

gave when they felt bad. He then believed that the data 

suggested that the opposite of satisfaction was not 

dissatisfaction, as traditionally had been believed. The opposite 

of ‘satisfaction’ is ‘no satisfaction’, and the opposite of 

‘dissatisfaction’ is ‘no dissatisfaction’. According to Herzberg, 

simply removing dissatisfying characteristics from a work would 

not necessarily make the work satisfying. Extrinsic (Hygiene) 

factors are factors that eliminate dissatisfaction. They include 

factors such as supervision, company/institution policy, money, 

working conditions, and security — i.e., extrinsic factors 

associated with work context, or those things surrounding a 

work. Intrinsic (Motivators) are factors that increase work 

satisfaction and motivation. They include factors such as 

achievement, recognition, responsibility, and advancement — 

i.e., intrinsic factors associated with work content, or those 

things within the work itself. Herzberg’s theory has been 

criticized for the statistical procedures and methodology used in 

his study. In spite of these criticisms, Herzberg’s theory has 

had a strong influence on our understandings about motivation. 

Applications to Dentistry: It is necessary to identify the 

motivators of the patients. Focus on intrinsic factors like 

achievement, recognition, responsibility, and advancement in 

motivating patients. On the other hand, identify the extrinsic 

factors of the patient will discover potential reasons for 

dissatisfaction or complaint. 

Contemporary Theories of Motivation 

A number of contemporary theories represent state-of-the-art 

explanations of motivation. These contemporary theories have 

a reasonably strong degree of validity through supporting 

documentation. 

Three-needs Theory 

This is developed by David McClelland 4,5 , which says there are 

three acquired (not innate) needs: achievement, power, and 

affiliation. These needs are major motives in work. The need for 

achievement is the drive to excel, to achieve in relation to a set 



of standards, and to strive to succeed. The need for power is 

the need to make others behave in a way that they would not 

have behaved otherwise. The need for affiliation is the desire 

for friendly and close interpersonal relationships. A person’s 

levels of these three needs are typically measured by reacting 

to a set of pictures included in the Thematic Apperception Test. 

Predictions about motivation can be made from a study of the 

three-needs theory. McClelland found that high achievers 

differentiate themselves from others by their desire to do things 

better. High achievers like moderately challenging goals. They 

avoid what they perceive to be very easy or very difficult tasks. 

Individuals with a high need to achieve prefer and are strongly 

motivated in work situations with personal responsibility, 

feedback, and an intermediate degree of risk. 

Applications to Dentistry: On the one hand, try to identify the 

type of need your patient valued most and try to focus on that 

for motivation. On the other hand, similar to the Maslow’s 

theory, this theory gives us a remainder that there are different 

types of needs that the patient requires. Identification of 

individuals with a high need for achievement can be useful in 

selecting motivation methods. 

preferable to assigning goals whenever resistance is expected. 

People will do better when they get feedback on how well they 

are progressing toward their goals because feedback acts to 

guide behavior and self-generated feedback has been shown 

to be a more powerful motivator than externally generated 

feedback. Several contingencies exist in goal-setting theory. 

Feedback influences the goal-performance relationship. Goal 

commitment is most likely to occur when goals are made 

public, when the individual has an internal locus of control, and 

when the goals are set by the individual rather than assigned. 

The other contingency is self-efficacy. It is an individual’s belief 

that one is capable of performing a task. The higher one’s selfefficacy, 

the more confidence one has in one’s ability to 

succeed in a task. So, in difficult situations, people with low 

self-efficacy are likely to reduce their effort or give up 

;1altogether, whereas those with high self-efficacy seem to 

response to negative feedback with increased effort and 

motivation, whereas those with low self-efficacy are likely to 

reduce their effort when given negative feedback. Finally, 

national culture is a contingency that also affects goal-setting 

theory. One may conclude that intentions, as defined by hard 

and specific goals, are a powerful motivating force in goal- 

Goal-setting theory 

Would you have done better in dental school had 

your teacher in the phantom head course said, ‘you 

should strive for a grade B or above on all your tooth 

preparations’ rather than telling you just to ‘try your 

best’? Research on goal-setting theory addresses 

these issues, and the findings were impressive in 

term of the effect that goal specificity, challenge, and 

feedback have on performance 6 . This is the 

proposition that specific goals increase 

performance, and difficult goals, when accepted, 

result in higher performance than easy goals 6 . What 

is known about goals as motivators? Intention to 

work toward a goal is a major source of job 

motivation. Specific and challenging goals are 

superior motivating forces. Specific hard goals 

produce a higher level of output than do generalized 

goals. There is no contradiction that goal-setting 

theory says that motivation is maximized by difficult 

goals, whereas achievement motivation is 

stimulated by moderately challenging goals. As goalsetting 

theory deals with people in general; 

achievement theory is based only on people who 

have a high need for achievement. Difficult goals are 

still recommended to motivate the majority of 

people. The conclusions of goal-setting theory apply 

to those who accept and are committed to the goals. 

Difficult goals will lead to higher performance only if 

they are accepted. People will try harder if they 

participate in the planning and formulation of goals 

although it cannot be said that participation is 

always desirable. Participation is probably 


27


setting efforts. In the proper conditions, intentions can lead to 

higher performance. 

Applications to Dentistry: Try to set specific goals for the patient, 

for example, to wear the headgear for how many hours, rather 

than just using the vague term ‘try your best’. 

Reinforcement theory 

Reinforcement theory is counter to goal-setting theory. It 

proposes that behavior is a function of its consequences. While 

goal-setting theory proposes that an individual’s purpose directs 

his or her behavior, reinforcement theory argues that behavior is 

externally caused. Reinforcement theory ignores factors such as 

goals, expectations, and needs; it focuses on what happens 

when a person takes an action. The concept of reinforcement 

can be used to explain motivation. According to Skinner 7 people 

will most likely engage in a desired behavior if they are rewarded 

for doing so. These rewards are most effective if they 

immediately follow a desired response. Behavior that is not 

rewarded or is punished is less likely to be repeated. The 

emphasis is on positive reinforcement, not punishment, people 

should ignore, not punish, unfavorable behavior. Even though 

punishment eliminates undesired behavior faster than no 

reinforcement does, its effect is often only temporary and may 

later have unpleasant side effects including dysfunctional 

behavior such as conflicts, absenteeism, and withdrawal. 

Applications to Dentistry: Patient should be immediately praised 

(positive reinforcement) every time when a good response (e.g. 

good oral hygiene) is encountered. 

Equity Theory 

Being human, one tends to compare oneself with others. If 

someone offered one US$10,000 a month on one’s first job after 

graduating from a dental school, one would probably jump at the 

offer and report to work enthusiastic, ready to tackle whatever 

needed to be done, and certainly satisfied with one’s pay. How 

would one react, though, if one 

found out a month into the job that 

a coworker, your classmate with 

comparable school results and 

with comparable work experience 

— was getting US$11,000 a 

month? One would probably be 

upset! Even though in absolute 

terms, US$10,000 is a lot of 

money for a new graduate to make 

(and one knows it!), that suddenly 

is not the issue. One sees the 

issue now as relative rewards and 

what one believes is fair — what is 

equitable. The term equity is 

related to the concept of fairness 

and equal treatment compared 

with others who behave in similar 

Fig. 1 Expectancy theory of motivation 

ways. Equity theory was developed by J. Stacey Adams 8 , it is the 

theory that a person compares his/her work’s input-outcomes 

ratio with that of relevant others and then corrects any inequity. 

Equity theory recognizes that individuals are concerned with their 

absolute rewards as well as the relationship of those rewards to 

what others receive. When people perceive an inequity, they will 

tend to correct the situation 9 . They may distort either their own or 

others’ inputs or outcomes; behave in some way to induce others 

to change their inputs or outcomes; behave in some way to 

change their own inputs or outcomes; the result might be lower 

productivity, reduced quality of output, increased absenteeism or 

withdrawal from work. 

Applications to Dentistry: Patients like to compare themselves 

with one another. Inequity may be one of the sources of 

dissatisfaction or complaint even the actual services provided are 

satisfactory. Conversely, favorable comparisons may significantly 

motivate patients. 

Expectancy Theory 

Last but not the least, the most comprehensive and widely 

accepted explanation of motivation to date is Victor Vroom’s 

expectancy theory 10 . Although the theory has its critics, most 

research evidence supports it 11 . This is the theory that an 

individual tends to act in a certain way based on the expectation 

that the act will be followed by a given outcome and on the 

attractiveness of that outcome to the individual. Three 

relationships are important to this theory. Effort-performance 

linkage (expectancy) is the probability perceived by the individual 

that exerting a given amount of effort will lead to a certain level of 

performance. Performance-reward linkage (instrumentality) is the 

degree to which an individual believes 1that performing at a 

particular level is instrumental in, or will lead to, the attainment of 

a desired outcome. Attractiveness of the reward (valence) is the 

importance that the individual places on the potential outcome or 

reward that can be achieved on the work. The explanation of this 

theory can be summed up in the following questions: What 



perceived outcomes does the work offer a person? 

How attractive does that person consider these 

outcomes to be? What kind of behavior must the 

person exhibit to achieve these outcomes? How 

does the person view his/her chance of doing what is 

asked? The key to understanding expectancy theory 

to understand an individual’s goal and the linkage 

between effort and performance, between 

performance and rewards, and between rewards 

and individual goal satisfaction. According to 

expectancy theory, various choices of behavior are 

evaluated according to their expectancy, 

instrumentality and valence. This can be summed up 

as a mathematical equation. Motivation is related to 

the mathematical product of expectancy, 

instrumentality and valence (fig. 1). People are more 

motivated with higher value of the product. 

Applications to Dentistry: It is important to decrease 

the effort/cost needed, increase the association 

between the effort/cost and the reward/benefit and 

increase the attractiveness of the reward/benefit. 

Conclusion 

It can be seen that different motivation theories are 

complementary to each other. No single theory can 

explain all the responses of the patients. An 

understanding to each theory can evolve a combined 

strategy that can motivate the most difficult patients. 

DA 

References 

1. Maslow A. Motivation and Personality. New York; McGraw-Hill; 1954. 

2. McGregor D. The Human Side of Enterprise. New York; McGraw-Hill; 1960. 

3. Herzberg F, Mausner B, Snyderman B. The Motivation to Work. New York; 

John Wiley; 1959. 

4. McClellend DC. The Achieving Society. New York; Van Nostrand Reinhold; 

1961. 

5. McClellend DC. Power: The Inner Experience. New York; Irvington; 1975. 

6. Ambrose ML, Kulik CT. Old Friends, New Faces: Motivation Research in the 

1990s. Journal of Management 1999;25:231-92. 

7. Skinner BF. Beyond Freedom and Dignity. New York; Knopf; 1972. 

8. Adams JS. Inequity in Social Exchanges. In: Berkowitz L (ed.). Advances in 

Experimental Social Psychology, vol. 2. New York: Academic Press; 1965;267- 

300. 

9. Lord RG, Hohenfeld JA. Longitudinal Field Assessment of Equity Effects on the 

Performance of Major League Baseball Players. Journal of Applied Psychology 

1979; Feb:19-26. 

10. Vroom VH. Work and Motivation. New York; John Wiley; 1964. 

11. Van Eerde W, Thierry H. Vroom’s Expectancy Models and Work-related criteria: 

A Meta-Analysis. Journal of Applied Psychology 1996;Oct:575-586. 

Footnotes 

1 Business Administration, the Hong Kong Shue Yan 

University 

2 Orthodontics, the University of Hong Kong 

Dr. Fanny Y. F. Young is an assistant 

professor in Business Administration, 

the Hong Kong Shue Yan University. 

Dr. Ricky W. K. Wong is a clinical 

associate professor in Orthodontics, 

the University of Hong Kong. 


29


by Dr George Freedman 

Eliminating 

Dental Stains 

Dental stains are of great concern to the vast majority of the population. 

Tooth discoloration has been made socially and culturally unacceptable by 

the ubiquitous presence of bright, white smiles on television, in films, and 

the print media. From a professional perspective, dental stains contribute to 

plaque accumulation, the increased retention of bacteria and their associated acidic 

environment, and eventually, to tooth demineralization and decay. The elimination of 

dental stains by the dentist and the auxiliary staff on a regular basis (twice per year) 

has contributed greatly to the improvement of dental health in the general 

population over the past 50 years. 

As patients have become more aware of their own dental health, they have 

increasingly demanded not only healthier teeth, but healthier-looking teeth as well. 

Typically, more than 80% of individuals surveyed indicate an active interest in the 

whiteness (and thus an active concern for discoloration) of their teeth. The 

appearance of non-stained teeth is the major visible component of dental health, 

and as such, is used by patients to gauge their oral health and hygiene. Routine 

scaling and prophylaxis, on a bi-annual basis, is well accepted by both 

professionals and the public, and is effective in the removal of dental stain at least 

for a short time after the recare visit. However, the daily accumulation of dental 

stain, particularly after meals, is a recurrent problem that is more difficult to address. 

When these stains accumulate in public situations where the dental appearance is 

an important factor, they can adversely affect the outcome of the event, whether 

business or social. 

Certainly, brushing and flossing after eating 

can eliminate the most obvious 

discolorations, but these activities are not 

always practical, particularly in the typical 

restaurant or home setting of most meals. It 

would be preferable to have a relatively 

innocuous, but effective, destaining 

procedure that can be readily accomplished, 

unobtrusively and quickly, even under 

conditions of intense public scrutiny. Most 

people, consciously or subconsciously, tend 

to wipe their tongues across their anterior 

teeth to remove stains, but without a 

dentifrice agent, this action is largely 

ineffective. 

Figure 1 SuperSmile Quikee dentifrice 

The objective of this clinical study was to 

examine the effects of a commercially-available dentifrice (SuperSmile Quikee) 

upon the removal of food induced dental stains (Figure 1). This study was designed 

to objectively evaluate the immediate effect of SuperSmile Quikee on recently 



stained teeth, and its value as a rapid and effective decolorizing 

agent. It is a brushless dentifrice; a small amount of 

SuperSmile Quikee is squirted directly from the tube onto the 

teeth (or alternatively placed manually), and then spread over 

the maxillary and mandibular anterior teeth with the tongue and 

Brushing and flossing after 

eating can eliminate the most 

obvious discolorations, but 

these activities are not always 

practical, particularly in the 

typical restaurant or home 

setting of most meals 

Figure 2 The dentifrice is spread over the maxillary and mandibular 

anterior teeth with the tongue and the lips for several seconds 

the lips for several seconds (Figure 2). 

Materials and Methods 

Forty adult male and female subjects were selected to 

participate in this clinical trial and each subject acted as their 

own control. After qualification and a baseline dental 

examination, the subjects who met the criteria listed below 

were 8 males and 32 females with a mean age of 34.6 years. 

The inclusion criteria, among others, were as follows: Male and 

female subjects, aged 18-70 years, in good general and oral 

health, with all maxillary and mandibular anterior teeth present. 

Subjects were asked to refrain from brushing or rinsing for six 

hours prior to the initiation of the study. 

Exclusion characteristics included orthodontic appliances or 

anterior prosthetic crowns or veneers, tumors or significant 

pathology of the soft or hard tissues, moderate to advanced 

periodontal disease, extensive untreated carious lesions or 

restorations, bleaching within the previous 12 months or 

prophylaxis within the previous 30 days. 

The measurement of tooth shade can be highly variable between 

observers, and under differing metameric conditions. To avoid 

inter-investigator and sequential variability, two Vita Easyshade 

(Vident) intraoral dental spectrophotometer shade-matching 

devices were used to measure tooth coloration (Figure 3). A 

spectrophotometer consists of three principle elements: a light 

source; a wand to direct the source light to an object and in turn 

to receive the reflected light from the object; and a spectrometer 

to determine the received light intensity as a function of 

wavelength. The Easyshade’s CPU analyzes the spectrometer 

data, determining a shade match to Vita Classical or 3D systems, 

and displays the results on a touch screen (Figure 4). 

The Vita Easyshade is self contained, easy to use, and 

portable, consisting of a base unit and handpiece containing a 

fiberoptic probe assembly for illuminating and receiving 

light from a tooth. The two Easyshade units were calibrated 

with each other and were additionally self-calibrated prior to 

every shade measurement. 

For each subject, the shades of the six maxillary and six 

mandibular anterior teeth were each measured separately, in 

the middle third, at the mesio-distal center of the tooth, at three 

specific times. These measurements were at the Baseline 

(prior to stain accumulation), Post Eating or Stain Accumulation 

(after 15 minutes of stain accumulation), and Post Product 

Utilization (immediately after the use of the test brushless 

dentifrice). The shade of each tooth was scored by reading the 

Easyshade screen and recording the Classic Vita shade 

reference code. The overall change in shade was then 

obtained by averaging the scores as described previously by 

Eldiwany et al (2004). 

Figure 3 Two Vita Easyshade intraoral dental spectrophotometer shadematching 

devices were used to measure tooth coloration 

Analysis of variance (t-test) was employed to compare the 


31


mean Vita Easyshade scores at baseline, post-staining and 

post product usage. The chromogenic “meal” consisted of: 

• 3 ounces of red grape juice or red wine 

• 3 ounces of blueberry pie 

• one piece of milk chocolate 

• 4-6 ounces of coffee or tea 

The brushless dentifrice that was tested is a commercially 

available, non-prescription product that requires no post-use 

rinsing. Its active ingredients include Dicalcium Phosphate 

Dihydrate, Urea Hydrogen Peroxide, and Calprox. The 

instructions for use indicate that a small drop of the product be 

placed on the anterior teeth or the tongue and smoothed over 

the remaining anterior teeth with the tongue and the lips. 

Results and Discussion 

Tooth shade was calculated by ranking the Vita Classic Shade 

guide according to the degree of brightness as recommended 

The measured results indicate 

that eating a chromogenic 

“meal” caused the 

accumulated food induced 

stains to darken the subjects’ 

tooth shades by 

approximately 2 Vita tabs 

Statistical analysis by the t-test comparing: 

1. The Baseline data with the Post Stain Accumulation data 

indicated significant differences (p≥ 0.05) showing that 

chromogenic foods can indeed induce dental stains, darkening 

the appearance of the teeth. 

2. The Post Stain Accumulation data with the Post Product 

Usage data indicated significant differences (p≥ 0.05) showing 

that SuperSmile Quikee, the product under investigation, does 

remove dental stains acquired as a result of eating 

chromogenic foods. 

3. The Baseline data with the Post Product Usage data 

indicated significant differences (p≥ 0.05) showing that the 

product under investigation does remove previously acquired 

dental stains. 

Figure 4 The Easyshade’s CPU analyzes the spectrometer data, determining 

a shade match to Vita Classical or 3D systems, and displays the results on a 

touch screen 

by the manufacturer, assigning a numerical value to each tab 

and calculating the number of tabs as described by Manupome 

and Petty (2004). 

A summary of the changes in tooth shade during the study is 

provided in the following table: 

The measured results indicate that eating a chromogenic 

“meal” caused the accumulated food-induced stains to darken 

the subjects’ tooth shades by approximately 2 Vita tabs (Fig 5). 

The Baseline Vita Easyshade data for 480 (40 X 12) teeth in 

the study was 4.37 (SD±2.37), corresponding to a shade 

between Vita Classic tabs D2-A2. 

The Post Stain Accumulation Vita Easyshade data for 480 

(40 X 12) teeth in the study was 6.56 (SD±3.03), corresponding 

to a shade between Vita Classic tabs C1-C2. Statistical 

analysis by the t-test showed significant differences, indicating 

that eating a chromogenic diet as described above does, in 

fact, induce staining of teeth. 

The Post Product Usage Vita Easyshade data for 480 (40 X 

12) teeth in the study was 3.72(SD±2.33), corresponding to a 

shade between Vita Classic tabs B2-D2. 

Figure 5 Chromogenic ‘meal’ accumulated food-induced stain to be 

darkened 



This color change is readily visible 

even to the untrained eye, and on 

anterior teeth, can visibly detract 

from the aesthetics of the smile. 

The t-test analysis (green 

shading) confirms the significance 

of the staining. 

After the use of SuperSmile 

Quikee, the test dentifrice, the 

mean shade of the anterior teeth 

was calculated to be almost 3 Vita Figure 6 A whiter shade after dentifrice test 

tabs whiter than the coloration 

immediately Post Eating (Figure 6). Not only is this destaining statistically significant (blue 

shading), but it is also very visibly evident, representing a major aesthetic improvement of 

tooth shade. 

It is important to note that it can be applied very quickly and discreetly, and that its 

destaining action is rapid and effective. 

It is of interest that the tooth coloration after the use of SuperSmile Quikee was not only 

whiter than it was post staining, but was in fact significantly whiter than the baseline values 

(purple shading) taken at the beginning of the study. This is a clear indication that it not 

only removes recently deposited dental coloration, but in fact destains the teeth to a state 

whiter than at the baseline. Thus, it is effective as a bleaching agent as well. It may be 

prudent to quickly eliminate dental stain with a brushless dentifrice prior to shade matching 

in the course of routine restorative procedures. 

The destaining and/or bleaching actions of SuperSmile Quikee are mediated by the well 

documented active ingredients Urea Hydrogen Peroxide and Calprox. There were no 

adverse reactions attributed to product usage. 

Conclusions 

From this study, it can be concluded that Supersmile Quikee removes food induced stains 

from dental surfaces and, in addition, has a whitening effect upon the teeth. Its very 

convenient application modality, its rapid whitening action, and its significant results in 

dental destaining make it a very practical and portable tool for oral hygiene and aesthetic 

maintenance. 

DA 

References 

1. Eldiwany MS, Paravina RD, Powers JM (2004) Performance assessment of a new intra-oral spectrometer. J. Dent Res. 83:1933 (abst) 

2. Manupome G, Petty IA (2004) A closer loot at diagnosis in clinical dental practice: Part 4. Effectiveness of nonradiographic diagnostic 

procedures and devices in dental practice. J Can Dent Assoc 70:470-474 

Dr George Freedman is an Associate Director of the Esthetic Dental Education 

Center at the State University of New York. He is also the Director of Post-graduate 

Programs in Esthetic Dentistry at the Eastman Dental Center (Rochester); University 

Programs in Seoul; Schann, Liechenstein and Chairman of the UK Clinical 

Innovations Conference. Dr Freedman is a member of Dental Asia magazine 

advisory board. 

We Have Moved. Our new 

address is: 

Block 16 Kallang Place #07-01, 



33


by Prof Alex Mersel 

Stress Absorbing 

Frame Approach 

for Partial Edentate 

Patients 

As the number of elderly increases, so does the 

concern for their healthcare. Partial edentate 

patients will in the future represent the most 

common figure — very few elderly will be 

candidates for fixed Prosthodontics or implants 

supported dentures. Consequently the dental 

profession will have to challenge with patients 

presenting mainly a posterior edentulousness — 

unilateral or bilateral. Although removable 

partial denture is a favored solution, to overule 

these problems a design of the denture is 

proposed: a stress-absorbing frame, based on a 

back-action of the lever, with a springing action 

that returns the basis to its original position, thus 

avoiding traumatic pressure on the underlying 

tissues. 

The ageing of the elderly population is already a dramatic demographic 

fact. One of the most important challenges of the dental profession in the 

coming years will be in providing care to senior people. The new trend is 

that these patients will have more retained teeth and their expectation 

will be greater. On the other hand, the increase of their lifespans will increasingly 

affect their medical status; consequently an implant solution will be difficult to 

realize. 1 

The dental profession will have to challenge mainly with patients presenting 

posterior edentulousness, unilateral or bilateral (Removable Partial Dentures 

Kennedy Class 1 & 2), with usually important ridge resorption and poor 

periodontal conditions. 2-3 

Despite that removable partial dentures are a favored option for restoration of 

many situations, many patients are not satisfied with their dentures, especially 

when the restoration is not stable during mastication and implicate sores and 

pain. 



Main Problems in the RPD 

(Kennedy Class 1& 2) 

Instability 

The mandibular free-end distal extension RPD rests on both 

fixed and soft tissues. 

Consequently the RPD tends to 

rotate around a single place and 

move down on the soft 

underlying tissues. In a distal 

extension RPD case with one or 

more anterior teeth missing, the 

anterior part goes down as the 

posterior part goes up and vieversa: 

this is the “teeter-totter 

phenomenon. (Figure 1) 

Figure 1 (top & bottom) Lateral 

and horizontal movements of the 

frame 

Rocking can not only occur in a 

vertical plane but often also in a 

horizontal plane causing the wellknown 

internal posterior soars 

(Figure 2). RPD instability will 

develop unbalanced forces that 

will have consequence to slowly 

mobilizing the supporting teeth 

until they have to be pulled out. 4 

Usually the new missing teeth is 

already replaced and the clasp 

displaced to the next proximal 

teeth; increasing in this way the 

distal extension span, “a domino 

effect”. 

Carious Destruction of the Abutments 

Only a few of the most carious resistant teeth can survive the 

environmental changes brought by the presence of a clasp-type 

ackers and the constant food impaction between the saddle – 

guiding plane and the distal aspect of the teeth. (Figure 3) 

Destruction of Abutments by 

Periodontal Diseases 

A well known fact is the destructive potential of a RPD as 

consequence of the amplitude of the denture movement and 

the clasp mechanism which transfer these movements toward 

the abutment teeth. This suggests our analysis about the 

denture basis and its relationship to the denture instability. 5 

1. The Soft Tissue Support. 

Especially in the large distal extension cases, a very large 

mucosal support is recommended in order o provides the 

widest support under the saddle. The inaccuracy of the cast by 

a simple alginate impression, or an inadequate functional 

impression would produce negative consequences on the 

fitness of the final acrylic basis. (Figure 4) 

2. Altrough with good 

impression both anatomic 

and functional of the basis 

by the “altered cast 

technique “they are slight 

movement in function 

before that the basis 

reaches the rock-bottom 

of incompressibility of the 

soft underlying structures. 

Such kinds of movement 

in a simple clasp RPD 

drops the basis onto the 

soft tissue not in a 

simultaneous vertical 

drop, BUT act as a hinging 

mechanism or fulcrum 

around which the denture 

tips down in distal part and 

up in the mesial part. 

Stress breakers, 

Stress Equalizers, 

Trauma Absorbing 

Figure 2 (top & bottom) Internal 

Posterior lingual soars area 

These devices are promoted on the fact that they should allow 

to the denture basis to move slightly without straining on the 

abutment. There are mainly two types of stress-breakers: 

A. The most commons are the hinge type stress-breakers 

(Figures 5a & 5b). This concept provide a disarticulation 

between the basis and the retentive apparatus (clasp and 

precision attachment), but act only on vertical occlusal forces, 

they have no incidence in the lateral occlusal movements. 6 

B. Other stress breakers like the ball-and-socket type allow 

essentially the same tipping action and add to it lateral mobility 

which tends to allow lateral or rolling mobility and also some 

bucco-lingual rolling. (Figures 6a & 6b) 

In the two cases, the problem remain in terms that the stressbreaking 

leaves the denture basis in much the same situation 

with a fulcrum acting a few millimeters distally and much freer 

in its movement because the absence of retentive clasps. In 

addition this type of device allows an excessive space for the 

vertical drop and causes infra-occlusion on the posterior teeth 

and consequently an overloading of the anterior remaining 

teeth. Taking into the consideration the severe bone resorption 

in senior patients, this will be a major weakness of the system. 

(Combination Syndrome) (Figure 7a) 

The sequel of this action in particularly when bone resorption 

frequently occurs, is the continuing rocking of the denture when 

loaded occlusally. The rests of the last abutment are in this 

case acting as fulcrums. This phenomena establishes a selfperpetuating 

or rather a self-worsening situation where more 



Figure 3a Destruction of the supporting Tissues 

b: guiding plane 

h: food impaction 

g: fulcrum 

f: periodontal desease 

movements causes more resorption and more resorption 

Conduct automatically to more movement. 

The cost of the dental laboratory is relatively expensive, 

especially when related to precision mechanism. Repairs are 

time-consuming and are charged for high fees by the dental 

technician. 

Another consideration is that these appliances are involving 

crowns for the abutment teeth. For the senior patients, this 

could be a financial burden, and often is not recommended for 

anatomical or periodontal considerations . 

Figure 3b Posterior bone resorption 

acting as Stress 

absorbing device. 7 

Rationale of the 

Concept 

In opposition with 

the classic concept 

of stress breaking 

based on the Lever 

Type I, the SAF is 

based on the Lever 

type III, determined 

by a back action 

(Figure 7b). In this 

case the occlusal 

forces are acting on 

the mesial end of 

the Saddle and are absorbed by the frame (Figure 8). 

The component of the occlusal forces are working vertically 

parallel to the teeth axis. Moreover the spring resilience effect 

is relocating automatically the RPD on is initial place. In this 

way avoiding soars and accelerates bone loose. (Figure 9) The 

realization of a separation between the basis (saddle) and the 

supporting teeth abutment is forbidding the tilting movement on 

the distal abutment teeth. 

The saddle is in fact relied to the major connector on his distal 

part, allowing on the mesial segment a freedom of movement 

on the vertical and lateral direction. The resilience of the frame 

is absorbing the occlusal trauma. (Figures 10 & 10b) 

4. Maintaining a balanced occlusal contact and preserving in 

this way the life –span of the remaining natural teeth. 

The Stress Absorbing Frame (SAF) 

In order to overrule this problematic situation it is 

recommended to design of a RPD with a Frame which is also 

Discussion 

The classic stress-breaking concept was widely analyzed a 

discussed in the literature 8 , but very few authors paid attention 

Figure 4 Fixed prosthodontics and removable semiprecision 

lower denture 

Figure 5a Precision attachment Hinge Axis type 

Figure 5b Precision 

attachment Hinge Axis type 


37


Figure 6a Classic Dalbo 

attachment 

to the SAF 9 . At our knowledge this 

system is well admitted in some 

European Countries 10 . In the 

Geriatric Dental clinic of the 

Faculty of Dental Medicine of 

Jerusalem during five years the 

SAF was mainly indicated for 

senior patients with a high rate of 

success 11 . 

Advantages: 

1. Low cost ( both clinic and 

Laboratory ) 

2. Simplicity of the clinical 

The main advantages of the 

SAF are low laboratory 

expenses, the simplicity, 

minimal invasive, non traumatic 

treatment, easy handling and 

facility for rebasing when 

necessary 

Figure 6b Lateral or rolling actvities of the saddle 

Figure 8 Occlusal forces absorbed by the frame 

Figure 7a The combination Syndrome 

Figure 9 Mandibular stress absobing frames 

procedures 

3. Easy manipulation for the patient, simple vertical insertionpathway 

4. Easy relining or rebasing under the saddle 

Figure 7b A spring Frame built in Back action 

Disadvantages: 

There are some negative aspects. 

1. Light food impaction between the distal aspect of the 

abutment teeth and the mesial end of the saddle. 

2. In the case of a severe bone resorption there is not enough 



handling and facility for rebasing when necessary. In this way 

we can provide for our patients a comfortable solution taking 

care of the main conditions to a successful restoration: 

Affordability, Avaibility and Accessibility. DA 

Figure 10a Schema of the back action in a stress absorbing Frame 

place for the design of 

the back-axis lever. 

3. The metal might 

break after a long lasting 

period (five years in 

average) 

Conclusion 

The main advantages of 

Figure 10b Separation beteween the 

the SAF are low 

saddle and the guiding plane 

laboratory expenses, the 

simplicity, minimal invasive, non traumatic treatment, easy 

References 

1. R.Grahan ,and all. Determining the “need “ for a Removable Partial denture : a qualitative study 

of factors that influence dentist provision and patient use. British Dental Journal 

(2006);200,155-158. 

2. Mann,J.,Mersel,A.and Gabay,E.: Dental Status and dental needs of an elderly population in 

Israel. Community Dentistry and Oral Epidemiology. (1985 );13:156-158. 

3. Mersel,A.:Oral Health and dental needs in a Geriatric Institutionalized Population in Paris. 

Gerodontology (1989): 9:3 83-87. 

4. Eich, F.:The role of removable partial denture in the destruction of natural dentition. Dental Clinics 

of North America (1962); 8-3, 717-731 

5. Fisher, R. Z. and all. Removable partial denture and periodontal stress to the Periodontium. 

Int .J. Periodontics and Restorative Dentistry. (1984 ); 4:1 :34-37. 

6. Owall,B.: Precision attachment retained removable partial dentures. Int. J.of Prosthetic Dentistry. 

(1991 ); 4:3 249-257 

7. Reed, V. : Stress-equalizing removable partial dentures . Quintessence International. (1991); 21:4 

283-287. 

8. De Franco, R.L.: Designing removable partial dentures . Dental Clinics of North America ( 1984 ); 

307-32 

9. Tourtet, L. and all .: from the original to the removable stress breaking Framework. Journal of 

Canadian Dental Association (1988 ); 193-195 

10. Jourda, G.: Prosthetic comfort and restoration of the gnathologic Function; stress breaking framework 

and Gerodontics. J. Chirurgien – Dentiste de France .( 1989 );59: 456 33-37. 

11. Mersel, A. and Rudberg. O. : A stress repartition frame for the partial Edentate elderly. Israel 

Journal of Dental Medicine (1999 )16:1 25-31. 

Prof Alex Mersel is a current member of the FDI 

Council and a member of Dental Asia Advisory 

Board. He is also the Chairman for Continuing 

Education Working Group for FDI European 

Regional Organization. He also holds the post of 

Deputy Chairman for Israel Dental Association. 


39


by Dr Bertrand Chew 

Post-Minor Oral Surgery Pain 

Management with Oral Medication 

Pof Analgesics, there are the Acetaminophen, 

ain control is of paramount importance in post surgical 

management. The common drugs groups used are 

Analgesic and Anti-inflammatory Drugs. In the family 

Acetylsalicylic acid, NSAIDs(inclusive of the COX II-inhibitors) 

and the Opioids. 

In the pharmaceutical control of pain in the oral region, it acts 

on the pain pathways at different levels. The Spinothalamic 

(trigeminal-thalamic) tract is that carries the sensation of pain. 

The Chemical pathways of pain involves a cascade of events in 

cells, involving products of cells, enzymes, soluble factors, and 

blood vessels and their contents (Enwemeka & Spielholz 1992; 

Schmidt et al 1994; Tillman & Cummings 1992). 

Acetaminophen, 4'-hydroxyacetanilide, is an analgesic and 

antipyretic which occurs as a white, odorless, crystalline 

powder, possessing a slightly bitter taste. It has the following 

molecular formula C8H9NO2 with a molecular weight of 

151.16. It is discovered by accident when a similar molecule 

(acetanilide) was added to a patient’s prescription 

approximately 100 years ago. The medication is commonly 

known as Paracetamol = para-acetyl-amino-phenol. 

To date, the exact mode of action is still being discussed. The 

pain-reducing effect is more directly on the central nervous 

system by increasing the threshold of pain. There is an 

inhibition of the actions of chemical mediators that sensitize the 

pain receptors to mechanical or chemical stimulation. It also 

blocks activity by reducing the active oxidized form of cyclooxygenase 

to an inactive form and hence has little 

inflammatory actions (Lucas R et al 2005). The antipyretic 

activity is exerted by blocking the effects of the chemical 

pyrogen on the hypothalamic heat-regulating center. 

Others mention inhibition of nitric oxide formation that results 

from activation of substance P and N-methyl-D-aspartate 

(NMDA) receptor stimulation. Acetaminophen is metabolized by 

the liver. Therefore drugs that increase the action of liver 

enzymes that metabolize acetaminophen (eg carbamazepine, 

isoniazid, rifampin) may decrease the action of acetaminophen. 

The potential for acetaminophen to harm the liver is increased 

when it is combined with alcohol or drugs that also harm the 

liver. Acetaminophen is used in all stages of pregnancy. Breastfeeding 

is not a contraindication. (Gramham et al 2005) 

Drug Safety 

There is no clear evidence that taking paracetamol causes 

asthma, but more studies are suggesting that may be some 

association. Studies of patients with asthma suggest that 

acetaminophen challenge can precipitate a decline in FEV(1) > 

15% among sensitive individuals. (Eneli et al 2005). Some 

patients may have a specific sensitivity to the active ingredient 

or to any of the other components of the paracetamol. 

Paracetamol can be combined with many other drugs. 

They include the following: 

1. Orphenadrine citrate-analgesic properties. Also possesses 

anti-cholinergic actions. Good for muscle aches. (Aanarex) 

2. Caffeine (Panadol Extra) 

3. Codeine Phosphate (Panadeine) 

4. both codeine and Caffeine. (PACOFEN) 

5. Pamabrom: a diuretic to ease water retention. (for 

menstrual) 

6. Tramadol (Ultracet) 

Acetylsalicylic acid is commonly known as Aspirin. The chemical 

name 2-(acetyloxy) benzoic acid, are used as an analgesic, 

antipyretic and anti-inflammatory. It has also an anticoagulant 

effect and is used in long-term low-doses to prevent heart 

attacks. The bitter powder is extracted from willow bark that 

could ease aches and pains and reduce fevers. It was further 

modified by by researcher Arthur Eichengrun and Felix Hoffmann 

in1897.Aspirin was patented on March 6, 1899 by Bayer. 

Aspirin suppresses the production of prostaglandins and 

thromboxanes. This happens because cyclooxygenase (COX), 

an enzyme that participates in the production of prostaglandins 

and thromboxanes, is irreversibly inhibited when aspirin 

acetylates it. This makes aspirin different from other NSAIDS, 

which are reversible inhibitors. (John Robert Vane 1982). 

The topic on the safety of extractions on ling term aspirin 

patient has been discussed many times. The following 

statement would be a very useful guide: The scientific literature 

does not support routine discontinuation of oral anticoagulation 

therapy for dental patients (Jeske et al 2003).The 

management of oral surgery procedures on patients treated 

with anti-coagulants should be influenced by several factors: 

extent and urgency of surgery, laboratory values, treating 



physician’s recommendation, available facilities, dentist 

expertise, and patient’s oral, medical, and general condition. 

(Scully C 2002) 

Contraindications 

The following are contraindicated: 

Aspirin should be avoided by those known to be allergic to 

NSAIDs. Nonsteroid anti-inflammatory drugs (NSAID) 

crossreact with aspirin in aspirin-sensitive patients and vice 

versa (Settipane GA. 1998). Caution should be exercised in 

those with asthma or NSAID-precipitated bronchospasm due to 

the inhibition of COX in airways of the sensitive patients 

.patients with peptic ulcers are also encouraged to avoid 

aspirin. Children, including teenagers, are discouraged from 

using aspirin in cold or flu symptoms as this has been linked 

with Reye’s syndrome (MacDonald S 2002). Patients with other 

bleeding tendencies are also recommended to avoid aspirin. 

Aspirin-Induced Asthma, (AIA) has been reported. The 

frequency among asthmatics is around 8%-20%. Aspirin blocks 

the enzyme cyclooxygenase and this reduces the synthesis of 

prostaglandins. A further potential result of this blockade 

however is to shunt the cascade of reactions into a leukotriene 

pathway and leukotrienes are known to induce 

bronchoconstriction. Other theories are based on AIA patients 

having abnormal platelets, having abnormal thromboxane/ 

prostaglandin ratios in the lung or even having had a chronic 

viral infection. 

NSAIDs (including COX II), is the acronym for Non-Steroidal 

Anti-Inflammatory Drugs. They are peripherally-acting antipyretic 

analgesic anti-inflammatory drug. 

The latest addition are the COX II inhibitors, introduced in 

1998. It acts via the inhibition of the enzyme cyclooxygenase 

which in turn reduces the level of prostaglandins in the body. 

Therefore, it is a peripherally-acting antipyretic analgesic anti 

inflammatory drug. Likewise, it has weak anti-thrombotic effect, 

being a weak inhibitor of platelet aggregation. It is also safer on 

the stomach than aspirin . Cyclooxygenase, is an enzyme that 

occurs in at least two isoforms: 

1) COX1 (constitutive), which mediates formation of 

prostaglandins responsible for GI mucosal protection, 

hemostasis and renal blood flow. 

2) COX2 (inducible), which catalyzes production of 

prostaglandins that act as inflammatory mediators. The 

enzyme can play a homeostatic role in some situations 

(ulcer healing, maintenance of renal blood flow during 

stress, prostacyclin production).In general NSAID’s that 

inhibit COX2>COX1 are considered the drugs of choice in 

this class. 

The following are some common NSAIDs 

1. Diclofenac 

There is no clear evidence that 

taking paracetamol causes 

asthma, but more studies are 

suggesting that may be some 

association 

2. Diflunisal 

3. Etodolac 

4. Fenoprofen 

5. Floctafenine 

6. Flurbiprofen 

7. Ibuprofen 

8. Indomethacin 

9. Ketoprofen 

10. Meclofenamate 

11. Mefenamic Acid 

12. Meloxicam 

13. Nabumetone 

14. Naproxen 

15. Oxaprozin 

16. Phenylbutazone 

17. Piroxicam 

18. Sulindac 

19. Tenoxicam 

20. Tiaprofenic Acid 

21. Tolmetin 

The COX II Inhibitors include the following: 

1. Celecoxib Celebrex® 

2. Rofecoxib Vioxx®* 

3. Valdecoxib Bextra* 

4. Etoricoxib Arcoxia 

* withdrawn from market 

The drugs are recommended for use on patients with allergic 

reaction to aspirin or has had urticaria, rhinitis or asthma 

associated with NSAIDs .NSAID’s should be avoided in the 

presence of renal or hepatic dysfunction, coagulopathies, GI 

disorders, shock, hypotension/hypovolemia, hypoalbuminemia 

or pregnancy. 

In the Vioxx Gastrointestinal Outcomes Research (VIGOR) 

trial, there was a higher incidence of cardiovascular thrombotic 

events in the rofecoxib vs the naproxen-treated group: 1.67 vs 

0.70 per 100 patient years. (Konstam 2002) 

In a comprehensive analysis of 114 randomized trials with 

116,094 participants, rofecoxib was associated with increased 


41


renal and arrhythmia risks. Future safety monitoring is 

warranted and may benefit from an active and continuous 

cumulative surveillance system. (Zhang et al 2006) 

Opoids are agent that binds to opioid receptors, found 

principally in the central nervous system and gastrointestinal 

tract. There arefour broad classes of opioids: 

1. endogenous opioid peptides, produced in the body; (eg 

endorphins) 

2. opium alkaloids, such as morphine (the prototypical opioid) 

and codeine; 

3. semi-synthetic opioids such as heroin and oxycodone 

4. fully synthetic opioids such as pethidine and Fentanyl; 

Tramadol that have structures unrelated to the opium 

alkaloids (Fentanyl) 

The non-clinical use and off-label clinical use were criminalized in 

the USA by the Harrison Narcotics Tax Act of 1914, and by other 

laws worldwide. In USA, the Controlled Substances Act of 1970 

markedly relaxed the harshness of the Harrison Act. Opoids act 

on the following opioid receptors in the nervous system: 

Pharmaco Sci 1993) The common steroids used in dentistry 

are Dexamethasone and Prednisolone. 

Enzymes for anti inflammatory are a naturally occuring 

protease enzyme that digests non-living tissue, blood clots, 

cysts, and inflammation in all forms. The common ones are: 

1. Serrapeptidase: It acts via the hydrolysis of peptides into 

amino acids. It is a powerful proteolytic enzyme obtained 

from silkworms 

2. Papain: It is also known ascysteine protease (EC 3.4.22.2) 

and ispresent in papaya (Carica papaya) which is useful in 

tenderizing meat and other proteins. 

The exact mode of Action is unknown. However, preliminary 

studies show some potential in inflammation reduction. It is 

concluded that Serratia peptidase has anti-inflammatory, antioedemic 

and fibrinolytic activity and acts rapidly on localized 

inflammation. (Mazzone A et al, 1990 J Int Med Res) 

Finally, here is a diagram of the inflammatory process and the 

action of drugs used in dentistry for pain management. 

1. MU 

2. Delta (still in discussion) 

3. Kappa 

4. Sigma- 

5. Epsilon (still in discussion) 

Common adverse reactions include: tolerance, dependence 

and withdrawal issues, nausea and vomitting, drowsiness, 

dizziness, headache, orthostatic hypotension, itch, dry mouth, 

miosis, urinary retention, and constipation. (Rossi, 2005). 

Tolerance can be detected within 12-24 hours of the 

administration of morphine (Rang et al, 2003) and results in the 

necessity for increasing the dose over time to achieve the 

desired clinical effect. It appears to develop first to the 

analgesic, sedative, emetic, euphoric and respiratory 

depressive effects of opioids. The miotic and constipating 

effects are more resistant to the development of tolerance. 

(Rang et al, 2003) 

For anti-inflammatory drugs, the following are used: 

1. Steriods 

2. Enzymes, eg Serro-peptidase 

3. NSAIDs (as discussed earlier) 

Steriods are terpenoid lipid characterized by a carbon skeleton 

with four fused rings. All steroids, being terpenoids, are derived 

from HMG-CoA which itself is derived from the acetyl CoA 

biosynthetic pathway. For anti-inflammtory, these are usually 

Glucocorticoids. The mode of action is (Anti-inflammatory 

mechanism) by decreasing gene transcription of cytopkines, 

chemokines, inflammtory enzymes, decreasing T/B cells, 

macrophages,direct vasoconstriction. (Barnes PJ Trends 

Legends 

----------------- 

Confirmed mode of action 

Associated mode of action 

Dr Bertrand Chew has a Masters in Oral and 

Maxillofacial Surgery and is a Fellow of the Royal 

Australian College of Dental Surgeons. Currently, 

he is working with the Singapore Armed Forces as 

an Oral Maxillofacial Surgeon. He also lectures on 

the FDI Asia-Pacific circuit and is active with the 

Singapore Dental Association. 


USERREPORT 

by Drs Birgit Grubeanu-Block & Daniel Grubeanu 

Long-term Esthetic 

Stability Through 

Structure Retention 

Patients interested in implant therapy are particularly interested in an 

esthetic, friendly and simply brilliant smile. Advanced dental technology is 

being used to make the visible white components of the dental prosthesis 

more demanding esthetically. However, a really natural appearance can 

only be achieved in combination with an emergence profile that is 

indistinguishable from the neighboring teeth. An essential condition for acceptable 

peri-implant soft-tissue esthetics is therefore the retention of the structures around 

the implant. But exactly how can bone and soft tissue remain stable over the long 

term? And above all what factors must be taken into account for this? 

Figure 1 Pre-operative situation 

Biological Width, Dentogingival Complex 

of Teeth and Implants 

The term “biological width” describes the dimension of certain periodontal and 

peri-implant soft-tissue structures, the gingival sulcus, marginal epithelium and 

supracrestal connective tissue. Because marginal epithelium and supracrestal 

connective tissue can adhere to teeth and implants, this is referred to as epithelial 

and connective-tissue attachment. The basic principle of the biological width is 

that bone projecting into the oral cavity is always covered by periosteum, 

connective tissue and epithelium (Tarnow et al. 2000). The epithelial and 

connective-tissue attachment in this case has a specific thickness (dimension). 

Animal studies have demonstrated that the thickness of the peri-implant soft 

tissues remains relatively constant at 3 mm (Buser et al. 1992; Berglundh et al. 

1996; Cochan et al. 1997; Hermann et al. 2000; Todescan et al. 2002). 

Peri-implant Bone Resorption 

Possible causes for peri-implant bone resorption are among the following: 

1. Surgical trauma during placement of implant and abutment (Brånemark et al. 

1969; Adell et al. 1986; Cochran et al. 1997) 

Figure 2 Mucosa conditions 

2. Positioning of the implant relative to the alveolar ridge with supracrestal, 

Figure 3 View of the alveolar arch of maxilla Figure 4 Subcrestal placement of the Ankylos implant Figure 5 Facial bone deficit 


43

USERREPORT 

Figure 6 Grafting with autologous bone in 

contact with the implant surface 

Figure 7 Membrane placed over Frios Algipore as 

protection against resorption 

Figure 8 Suture with fitted gingiva former, 

open healing 

epicrestal or subcrestal positioning of the microgap and/or the 

transition from smooth to roughened implant surface 

(Hämmerle et al. 1996; Hermann et al. 1997; Davapanah et al. 

2000; Hermann et al. 2000a) 

Figure 9 Situation with external suture 

3. Biomechanical overloading of the bone with formation of 

microcracks (Adell et al. 1986; Brånemark et al. 1977; Pilliar et 

al. 1991a; Quirynen et al. 1992; Tonetti & Schmid 1994; Rangert 

et al. 1995; van Steenberghe et al. 1999) or lack of mechanical 

coupling between implant and bone by a roughened implant 

surface or screw threads (Wolff 1892; Cowin 1986; Pilliar et al. 

1991a; al-Sayyed et al. 1994; Hämmerle et al. 1996; Jung et al. 

1996; Vaillancourt et al. 1996; Hansson 1999; Wiskott & Belser 

1999; Hansson 2000b, 2000c) 

4. Violation of the biological width by insufficient dimensioning 

of the peri-implant mucosa (Berglundh & Lindhe 1996), 

microbial noxa (Tarnow et al. 1996) or mechanical noxa 

(Abrahamson et al. 1997; Tarnow et al. 2000) 

5. Type of connection between abutment and implant with 

varying width of microgap and force transfer to the crestal bone 

(Abrahamson et al. 1999; Jansen et al. 1997; Hansson 2000b) 

Figure 10 Occlusal situation before taking impression after three-month 

healing 

Requirements for Interdental and 

Interimplant Papillae 

The major factor in the presence of peri-implant papillae is the 

Figure 11 Facial View 

Figure 11 Impression making 

Figure 13 Zirconium oxide abutment try-in with seating 

instrument 


USERREPORT 

Figure 14 Abutment tryin 

Figure 15 Cercon scaffold try-in Figure 16 Unfired crown try-in Figure 17 Unfired crown 

distance of the contact point between bone and alveolar ridge. 

Tarnow et al. (1992) state that papillae are always present or 

are most likely to form between restored teeth if the distance 

from the cementum-enamel junction to the crestal bone is 3 

mm and interproximally the crown contact point is 5 mm to the 

interdental tooth tip. Other authors (Kois et al. 1994) have 

found that the probability of interdental papillary formation is 

particularly high if this distance is 4 mm. The distances 

described by Tarnow et al. have been defined for implants with 

an external implant-abutment connection. 

Microgap 

Two-component implant systems have a microgap between the 

abutment and the implant body. The microgap is contaminated 

with oral bacteria after initial uncovery and removal of the 

factory-installed retaining cover screw. If the implant is placed 

too deep and the microgap is subcrestal, the bone is resorbed 

around the implant by 1-2 mm over the first year (Lamb 2004; 

Buser et al. 2005). This is caused by the formation of a new 

biological width around the implant. A number of animal studies 

have demonstrated that the bone resorption is greater the 

further the microgap is apically (Hermann et al. 2000). Bacteriaproof 

implant-abutment connections have significantly less or 

no bone resorption compared to other systems (Weng 2005). 

Structure Retention and 

Soft-tissue Esthetics 

In addition to the optimum three-dimensional placement of the 

implant, the anatomical requirements of the neighboring teeth, 

the gingival biotype (Kan et al. 2003), the gingival genotype, and 

the correct dimension of the implants, the central problem of a 

predictable soft-tissue esthetics around implants appears to be 

the microbially colonized and mechanically loaded microgap. The 

existence of a microgap between the implant and abutment or 

implant crown and the surgical placement of the microgap in 

relation to the alveolar ridge are of critical importance and have 

significant biological and pathological consequences. 

The position and dimension of soft and hard peri-implant tissue 

(esthetics) and the degree of infectious reactions (periimplantitis) 

are directly affected. In the case of immediate 

implant placements in extraction alveoli the danger of a 

subcrestal placement of the microgap is large, particularly 

interdentally, because the vertical placement is oriented to the 

buccal height. If bone resorption occurs, the peri-implant soft 

tissue loses its support and unwanted gingival recession 

occurs, which over the long term results in unacceptable 

esthetic conditions. The Ankylos implant system has a special 

position here. With the reduced-diameter geometry of the 

implant-abutment connection with an integrated platform switch 

the biological width is not violated in the horizontal dimension; 

and with their bacteria-proof implant-abutment connection 

Ankylos implants can be placed subcrestally without violating 

the vertical dimension of the biological width. The peri-implant 

tissue is supported by bone and remains stable over the long 

term – a guarantee of long-term esthetic success. 

Case Study 

Assessment 

The 23-year-old patient was primarily interested in having the 

single-tooth gap at region 21 closed. 

Diagnosis 

The patient did not suffer from any disease, her oral hygiene 

Figure 18 Cemented-in 

crown 

Figure 19 Facial view after cleaning 

Figure 20 Status one week after 

cementing-in 

Figure 21 Three weeks 

after restoration 


45

USERREPORT 

Figure 22 After one 

month 

Figure 23 After six months Figure 24 Twelve months after cementing-in Figure 25 Eighteen months 

after cementing-in 

was acceptable. Status after motor vehicle accident with 

multiple enamel fractures in the front of the maxilla. 

Treatment Plan 

1. Hygiene phase, oral hygiene instruction and motivation 

2. Evaluation of compliance 

3. Implant placement in region 21 with open healing 

4. Fabrication of a porcelain Cercon crown (Degudent) 

Surgical Protocol 

An Ankylos plus implant (DENTSPLY Friadent), diameter 4.5 

mm, length 14 mm, was placed with primary stability in 

accordance with the standard placement protocol. The implant 

shoulder was placed 1 mm subcrestally. Small facial bone 

deficits and fenestrations were augmented with autologous 

bone, which was locally harvested with a bone scraper 

(Stoma). The bone replacement material Frios Algipore 

(DENTSPLY Friadent) was used as resorption protection for the 

grafted region and covered with a resorbable collagen 

membrane. The implant healed uncovered to establish 

optimum soft-tissue conditions. 

Healing Time 

Further treatment was delayed for four months to guarantee 

stress-free healing of the implant. There were no complications 

with the healing process. 

Prosthetic Protocol 

After four months an impression of implant 21 was taken with 

an open customized tray. One week after the impression, the 

zirconium oxide abutment (DENTSPLY Friadent) and the 

zirconium oxide crown (Degudent) were test-fit. After minor 

corrections the crown was finished and permanently placed. 

There were no complications or loss of soft tissue over the 

observation phase of over one year by now. 

Conclusion 

1. The Ankylos implant system simplifies restorations in the 

esthetic zone because the system with its TissueCare 

Figure 26 Eighteen months after cementing-in 

connection guarantees that the natural constant, the “biological 

width”, is not violated, which means the friction-locked and 

keyed, bacteria-proof tapered connection between the implant 

and abutment. 

2. The surgical process is minimized, because subcrestal 

implant placement is possible even in extraction alveoli and 

interimplant or interdental bone resorption processes of 2 mm 

do not occur. 

3. The spacing parameters described in studies are not 

obligatory for this type of implant. 

4. The thick soft-tissue collar formed by the special geometry of 

the implant-abutment connection alters the “thin” gingival 

biotype positively and ensures additional long-term stability. 

5. The open healing in the esthetic zone with a reduced-diameter 

healing cap allows the soft-tissue conditions to stabilize. 

6. A buccal resorption protection coating should be placed for 

long-term stability. 

The dental technology work was supplied by: 

Britz Zahntechnik dental laboratory, Trier/Germany 




EXHIBITIONPREVIEW 


Watershed Period for 

Asia Pacific Dental Congress 

Despite its long history, Asia Pacific Dental Congress 

(APDC) appears to be losing its appeal to many an 

exhibitor in recent years. This is due in part to the 

many regional and domestic exhibitions that have 

been sprouting up in the region, which have indirectly relegated 

APDC to a less significant role. Nonetheless, the influence of 

this regional dental grouping — Asia Pacific Dental Federation 

(APDF), the main sponsor of APDC — cannot be ignored all 

together. 

The 30th APDC this year will be held in Bangkok, Thailand from 

May 6-10 at the Bangkok Convention Center at Central World. 

The Dental Association of Thailand, organizer for this year’s 

APDC, is confident that it will be able to put up a good show 

this year, after witnessing what the successful conclusion of the 

29th APDC in Jakarta last year. The absence of the Thai 

contingent at the recently concluded IDEM in Singapore speaks 

volume of the support that APDC will be receiving from the Thai 

dental community. 

According to exhibitors, many felt that APDC has through the 

years transformed from a major regional exhibition to one that 

is more domestic in nature. This has in turn put them in the 

same league as other domestic dental exhibitions in the region. 

A number of major exhibitors are giving the show a miss and 

focusing their resources on major shows elsewhere. They are 

being represented by their local distributors/dealers instead. 

On the scientific program side, it is heartening to see that 

APDC still maintains a high standard for the papers presented. 

This time round, some established dental professionals and 

academics will be lending their support and sharing their 

knowledge and experiences with the delegates. 

Being Relevant 

Like all other dental shows in this region, Asia Pacific Dental 

Congress needs to constantly evolve and maintain its 

relevance for the dental community in this part of the world. 

Since its debut in 1955, APDC has undergone many changes. 

Dr Adirek S. Wongsa, President of the 

Local Organizing Committee for APDC 

2008 is confident that this year’s event will 

be one of the better ones in terms of 

participation and turn-out. “APDC will be 

the biggest event in the dental calendar of 

Thailand this year, hence, I expect strong 

support from the local dental industry, as 

well as the member countries.” 

Dr Adirek S. Wongsa 

APDC still has an important role to play, especially in bringing 

dental awareness and dental education to the lesser-developed 

countries in the Asia-Pacific region. Complacency, if there were 

any, must be banished at this critical juncture, if it were to avoid 

the fate of oblivion. APDC cannot stand still; it has to keep reinventing 

itself in order to restore its pre-eminent position in the 

face of on-coming ‘competition’. 

The ball is in your court, APDF. 

DA 


47

EXHIBITIONREVIEW 


IDEM 2008 Punches 

Above its Weight 

Rewind back to April 2006 where the dust of IDEM 2006 had barely settled 

and already the organizing team was planning and strategizing for 2008. 

Fast forward to IDEM 2008 — the biggest show since its inception in 2000 

— where many records were broken along the way. Kudos to koelnmesse 

(the organizer) for a job well done. 

Apart from the final day where the visitorship was thinner, days one and two were 

well-attended by both delegates and visitors from Singapore and around the region. 

With 35% larger exhibiting space than 2006’s, IDEM 2008 was well represented by 

more than 380 exhibitors from more than 30 countries, parading some of the latest 

technologies and equipment in the dental industry today. 

The Exhibitors 

For the visitors, it would not be difficult to notice that this year’s booths at IDEM were 

generally bigger and more creatively done. And one thing was for sure — it’s also 

getting higher. Said Mr Edwin Balchin, Director of GC Asia Dental: “Apart from 

location of the booth, we also need to spruce it up creatively in order to attract the 

visitors, and one way is to construct 

our booth ‘upward’ so that even from 

afar, you would not miss us.” 

The effort put in by the manufacturers 

to design their booths could not be 

discounted. In fact, it would be 

interesting if the organizer were to 

have a “Best Booth Design” award to 

spice things up a little. 

On a more serious note, the general 

consensus amongst the exhibitors this 

year was upbeat. The good mix of 

representation of returning and firsttime 

exhibitors from different parts of 

the world went to confirm the important 

status of IDEM. Apart from the 

Germany and USA pavilions, there 

Michael J Williams (left), Chairman of Board of GC 

Dental (Suzhou) posing with Edwin J Balchin, 

Director of GC Asia 

were also the Argentina, Brazil, South Korea, Taiwan, Australia, Swiss and French 

pavilions. 

Said first-time exhibitor, Mr Mikael Kaivola of Sendoline: “It’s our first time 

participating at IDEM together with our distributor IDS Dental. I must admit that I am 

very pleased with the quality of the visitors and the interests generated.” 

Another manufacturer, Owandy, made its presence through its local distributor, 



DenMit Trading. Remarked Mr Boris Loyez, International 

Sales Manager for Owandy, with a tinge of regret: “With the 

amount of enquiries that we are getting, I regret that I didn’t 

get a bigger booth and bring in our machine for a better 

demo. But we will be back in 2010 with a bigger booth and 

better exhibits.” 

However, there were also gripes from the exhibitors as well. 

Said Mr Milan Rajek, Managing Director of Bausch Articulating 

Papers: “IDEM is an important show for us and this year is no 

exception. We were expecting a better turn-out this time as 

compared to 2006 but I must say apart from Day 1, the rest of 

the days were generally disappointing in terms of visitors.” 

Conspicuously absence were the Thais and Vietnamese. 

Observed Heddie Ricci, General Manager of Bionnovation 

Biomedical: “We have a good share of visitors from India, 

Singapore, Malaysia and Indonesia but we didn’t get to see 

many Thais or Vietnamese attending this event.” 

IDEM — being an off-shoot of 

the more successful and 

illustrious IDS in Cologne, 

Germany — may find it difficult 

to emulate the immense success 

enjoyed by IDS but that should 

not stop it from aiming for the 

sky and developing its own 

characteristics 

The Vietnamese and the Thais have good reason to be 

absence as they have their own dental exhibitions in their own 

backyards, happening close to IDEM — April and May 

respectively. However, I believe that the absence of these two 

groups of visitors did 

not undermine the 

overall performance of 

the show. 

The Visitors 

Virtually all the visitors 

knew what they came 

for but there were some 

who came with an open 

mind and were 

pleasantly surprised 

with what they saw. 

Said Mr M. R. 

Chowdhury, General 

Manager (Dental) of 

UniMed Limited of 

Bangladesh: “I must say 

I am impressed with 

what I saw and I also 

managed to get in touch 

with some of the 

principals which I have been trying to meet up for quite some 

time.” 

Others like Dr Aris Sutanto from Indonesia and Dr Lilli Ann Dim 

Fernando from the Philippines were there to update themselves 

on the latest in the industry, as well as purchasing expendable 

products in bulks. “I am glad that I came as I am able to obtain 

first-hand information 

on the products that I 

have shortlisted for 

my clinic back home,” 

expressed Dr Lilli. 

Trade and Industry Minister Mr Lim Hng Kiang (center) officially opening IDEM 2008. On his 

right is Mr Oliver P. Kuhrt while Dr Benjamin Long is on his left. Dr Ng Jet Wei, Chairman of 

IDEM 2008 Committee, is standing first from the right and Dr Burton Conrod, President of FDI 

World Dental Federation is next to him. 

Seen on the 

showfloor, too, were 

personnel of military 

dental units from 

Singapore and the 

region. It was 

understood that 

several orders were 

being placed by these 

personnel for 

installation back in 

their military 

operations. 

Speaker Associate 

Professor Khalid 

Almas, for the Division of Periodontology at the University of 

Connecticut Health Center, School of Dental Medicine, also 




49


wished he could have more time on hand to have a thorough 

tour of the exhibition halls. “From the little time I managed to 

squeeze out of my schedule, I managed to have a quick 

glimpse of the exhibits in the [exhibition] halls and I like what I 

saw. I would also like to congratulate SDA for putting together 

an excellent scientific program, which had catered virtually to 

all areas of dentistry.” 

The Organizer 

Of course, nothing is perfect and there will always be that 

minority of exhibitors who feel that the show could have been 

better. Said Mr Adrian Sng, Senior Manager of koelnmesse Pte 

Ltd: “In any exhibition in the world, there will bound to be a 

small group of exhibitors who will be unhappy. No matter how 

hard we try make everything perfect, we cannot please 

everyone but we also get very encouraging and good feedback 

from many of our exhibitors. Overall, I would consider IDEM a 

success given the record delegates and visitors.” 

Conclusion 

Well, just as in back in 2006 when the organizing team did not 

immerse themselves wildly in a job well done, this time round, 

there is no difference. Already the koelnmesse team is back on 

the drawing board — planning for a more ambitious and bigger 

IDEM 2010. And the rumor is rampant that IDEM 2010 will be 

held at the new Marina Bay Sands integrated resort (which 

incorporates one of the two casinos in Singapore) at Downtown 

Marina. The organizer is not revealing much for now until 

everything is cast in iron. So, watch this space! 

On a personal note, I would like to see IDEM grow — not only 

in size but also in stature that is befitting of its regional 

importance. The past eight years have seen IDEM grown 

gradually in terms of exhibiting space and visitorship — which 

indicate the correct direction that the organizer has taken — 

but it’s time to bring the event to the next level. 

not stop it from aiming for the sky and developing its own 

characteristics. And for that, I have my little wish list that I have 

made (and hopefully I could see it being implemented for IDEM 

2010): 

• Product Premieres 

To proclaim that a show has truly arrived, apart from the 

number of visitors and exhibitors, another good barometer 

would be the number of product premieres at the exhibition. 

This time round, we only witnessed less than a handful of new 

products being launched at IDEM. 

Many manufacturers may have their own reasons and 

strategies to defer their launches till IDS but that do not stop 

them from having interim launches at IDEM. Product launches 

at such major exhibition is one way of attracting more visitors to 

the event. Visitors do not want to fly all the way to IDEM just to 

look at something which they can get back home. (So, 

exhibitors who lamented the lack of visitors, must have a relook 

at their gripes). 

• Broadcast of Live Surgery On-Site 

Currently, IDEM prohibits live surgery on-site due to hygiene 

and safety concerns. Perhaps, exhibitors could arrange for live 

broadcasts of final stages of dental surgery/implants to be 

beamed from dental clinics or dental schools. This will better 

explain the products and bring attention to the booths. 

More non-invasive demonstrations could also have been 

performed just like what Ivoclar Vivadent had when showing its 

OptraDam rubber dam. Although it was a simple 

demonstration, it attracted quite an attention with the visitors. 

As Singapore Minister for Trade and Industry, Mr Lim Hng 

Kiang, remarked in his opening speech: “IDEM augments our 

exciting pipeline of business events and enables us to 

showcase Singapore’s position in the field of dentistry in the 

Asia-Pacific region. IDEM 2008 is an excellent opportunity for 

the interaction among dentists — to learn not only the evidence 

or scientific basis of clinical practice but also new innovations 

that can change the way one practises dentistry.” 

Granted that what the Minister said was true but with more 

similar exhibitions sprouting up by the day in this region, IDEM 

must rise above the challenge and constantly find ways to stay 

ahead and increase its prominence. Only then will it hold truth 

to what Minister Lim had said. 

IDEM — being an off-shoot of the more successful and 

illustrious IDS in Cologne, Germany — may find it difficult to 

emulate the immense success enjoyed by IDS but that should 

The Scientific Program is a highly successful component of IDEM and are, 

more often than not, sold-out. A delayed excerpts of the papers presented 

would be a welcome move for the visitors, who might have missed the boat. 



IDEM is a good platform to 

matchmake manufacturers with 

dealers/distributors in this region. 

A glance at the show floor and it 

would not be difficult to notice 

manufacturers putting up signs to 

look for dealers/distributors. This 

was more apparent in the case of 

first time exhibitors 

• Delayed Excerpts of Scientific Program 

Many visitors who thronged the showfloor might not be there for 

Scientific Program that was going on next door. The IDEM 

Scientific Program is internationally recognized as being one of 

the best around. Many of the sessions at IDEM were sold out, 

leaving other would-be delegates outside the door. 

The organizer and Singapore Dental Association (SDA) could 

explore the possibility of having excerpts of some top-notch 

sessions being broadcast on big screens on the showfloor for 

2010. This could make the floor livelier and also stir up the 

interests of visitors towards the Scientific Program. 

• Matchmaking Agency 

Well, if you are thinking of a matchmaking agency for available 

singles at IDEM, please have your focus realigned. What I am 

painting here is about manufacturers and distributors. 

IDEM is a good platform to matchmake manufacturers with 

dealers/distributors in this region. A glance at the show floor and 

it would not be difficult to notice manufacturers putting up signs to 

look for dealers/distributors. This was more apparent in the case 

of first time exhibitors. 

And who’s in a better position to offer such a value-added 

service? The organizer, of course! I am sure the exhibitors, local 

dealers or visiting distributors would be very grateful to the IDEM, 

if it could provide such service on top of its usual agenda. 

If, some, if not all, of the items in my above wish list could be 

materialized, I am confident that IDEM 2010 would have scaled 

another level. And the day we get to see product premieres at the 

exhibition, it would be the day IDEM has truly arrived. 

IDEM 2010 will be held from 16-18 April 2010. DA 


51


From the Showfloor of IDEM 2008 

1 2 

3 

7 8 

4 

5a 

5b 

Figure 1 “Hmm... Am I in the right session?” 

Figure 2 IDEM is also a shopping haven for some dentists 

Figure 3 Live demo at Ivoclar Vivadent’s booth attract a big crowd 

Figure 4 “Okay, my X-ray goggle should be able to find something.” 

Figures 5a & 5b Cultural diversity during the opening ceremony 

Figure 6 Having a cuppa and talking business at the Swiss Pavilion 

lounge 

Figure 7 Free dental screening was held during the duration of IDEM 

6 

Figure 8 Dressed-up models making their presence felt with their 

smiles 



1a 

1c 

1b 

1d 

4a 

4b 

2 

5 

3 

6 

Figures 1a-1d Putting on their best smiles - Weston Pettersen, Zimmer 

Dental; Roland Reu (left) & Oon Lai Hong, Dürr Dental; (L-R) Joerg 

Brenn, Christian Brutzer & Marcel Ohri, Ivoclar Vivadent; Andrew Soh, 

Remedent Asia 

Figure 2 Never too young to start on good dental habit 

Figure 3 VIPs and Guest-of-Honor posing for the camera 

Figures 4a & 4b Letting their hair down during IDEM Nite 

Figure 5 The Scientific Program was always well received 

Figure 6 Never a dull moment for Mark Albanese of Microbrush 


53


7 

1 2 

8 

3 

4 

5 

6 

Figure 1 Dental Asia Advisory Board member, Dr George Freedman, 

presenting his paper at the Dental Innovations Forum 

Figures 2 & 3 Prof Edward Swift and Prof Steven Offenbacher respectively 

enthralling the delegates with their presentations 

Figure 4 Bob Weber of NTI-TSS (left) and his distributor, Sunny Chow of 

Cross Protection (right), posing with Her Excellency, Patricia L. Herbold, 

US Ambassador to Singapore 

Figure 5 Finally, a break from all the hustle-and-bustle of the 

showfloor 

Figure 6 Let me send a message to my wife first... 

Figure 7 Minister Lim Hng Kiang (center) chatting with one of the 

exhibitors 

Figure 8 Non-stop action at the registration counter 


PRODUCTUPDATE 

Temporary Esthetics from Ivoclar Vivadent Enquiry No. 01/05 

SR Ivocron has been successfully used to fabricate functional 

and aesthetic temporary restorations for many decades. An 

increasing number of dental laboratories use the popular PMMA 

veneering material as a temporization material in dental implant 

cases. The range of 20 Chromascop shades enables the 

application of SR Ivocron both for metal-free and metal-supported 

temporary restorations. The shades are coordinated with the 

Ivoclar Vivadent veneering materials and denture teeth. 

The three different liquids allow dental technicians to choose 

their individual working 

technique — casting, 

layering or pressing. 

Apart from long-term 

provisionals and 

repairs, SR Ivocron is 

also suitable for 

combination prosthetics 

and as a conventional 

veneering composite. 

Self-Adhesive Resin Cementing in a Breeze Enquiry No. 02/05 

Pentron Clinical Technologies 

has introduced Breeze Self- 

Adhesive Resin Cement, the 

versatile new self-etch, dualcure 

cement. It is formulated 

with 4-Meta technology to 

provide the strongest retention 

available in a self-adhesive 

cement with the quick and easyto-use 

auto-mix delivery system. 

This versatile cement exhibits low 

expansion properties ensuring 

compatibility with PFMs, composite, zirconia, alumina, and 

cementable ceramics such as 3GHS ®* crowns from Pentron 

IMTEC Solves Wrenching 

Problem Enquiry No. 03/05 

The use of FDA-approved long-term minis in securing 

loose dentures and the construction from single 

crowns to full mouth bridges has prompted IMTEC 

Corp to develop an adjustable torque wrench. 

No longer will there be a need for you to second 

guess the strength needed for the final seating of your 

minis in the jaw bones. With the adjustable torque 

wrench you can set the force needed so that no excess 

pressure will be applied to cause unwanted fractures of 

minis when you are self-tapping your minis in the mouth. 

The adjustable torque wrench allows you to set correct 

readings and thereby ensure that your minis are correctly 

seated in the jaw bones. 

Ceramics. 

Breeze Self-Adhesive Resin Cement is specifically designed to 

make the cementation of crowns, bridges, inlays, on-lays and 

posts faster and easier by eliminating individual etching, priming, 

bonding, and mixing steps. Its efficient auto-mix syringe with 

convenient intra-oral tips provides precise, direct and quick 

placement of cement, even in difficult to reach places. The 

unique formulation of Breeze Cement enables the dentist to prep, 

cement and place restorations quickly and efficiently to minimize 

chair time while also virtually eliminating post-op sensitivity. 

Available in three shades — A2, Translucent and Opacecous 

White. 

ZM390 Eliminates ‘Pointy’ 

Issues Enquiry No. 04/05 

Cylindrical or conical instruments are 

not particularly well-suited for work on 

pointy contacts, when correcting high 

spots of malocclusion. 

The special contour of the Busch 

ZM390 instrument with its rounded tip 

enables precision work whilst fully 

preserving the natural convexity of the cusp slopes. 

The two medium (without ring) and fine grit (red ring) diamond 

rotary instruments are for grinding of new and existing tooth 

restorations. The extra-fine grit instrument (yellow ring) is most 

suitable for precision finishing. 




PRODUCTUPDATE 

Natural Feel from VITABLOCS TriLuxe Enquiry No. 05/05 

The new VITABLOCS TriLuxe forte from Vita are the ideal 

solution for fabricating esthetically pleasing, high-quality 

dental prosthetics in a short period of time. 

In the new TriLuxe forte, the shades are even 

more compatible, the individual layers fit 

together even more harmoniously and the chroma 

in the intensive dentine and neck areas are even more 

intense. The soft nuances in the degrees of color 

saturation create an optimal chameleon effect, while the 

different degrees of fluorescence, more intense at the tooth 

neck than at the edge, perfectly reproduce a natural tooth. 

Affordable High Performance Implant 

Motor System 

The TriLuxe forte are particularly suitable for the fabrication of 

veneers, anterior and posterior crowns, and can also be 

used for inlays and onlays. The forte are 

available in three sizes: TF-12 (10 x 12 x 15 

mm), TF-14 (12 x 14 x 18 mm) and TF-14/14 

(14 x 14 x 18 mm) and can be used with both 

CEREC and inLab (Sirona Dental Systems). 

The material is distinctive due to its excellent 

machinability, both during the CAM machinegrinding 

process and during later hand grinding, 

which can be done gently and precisely in-situ with 

the usual instruments. 

Enquiry No. 06/05 

The AEU-7000-70V model 

by Aseptico is introduced to 

complement the AEU-7000 

series of implant motors. 

Offering high-end features at 

an affordable price, this new 

configuration includes the 

AE-70V Variable Speed Foot 

Control in the price of the 

motor. 

The AEU-7000-70V has a 

A Non-Compromising 

Dental Unit Enquiry No. 07/05 

Sinol S2318 dental unit from Northwest Medical is a leading 

Chinese brand that has not compromised on its standard and 

quality. In fact, it has passed the 

CE certification for its category. 

S2318 is manufactured with 

foreign technology and has 

three national patents. Its 

attractive design and clinic 

practicability conforms to 

modern oral development 

features. Clinically-required 

functions are fully embodied and 

future module upgrades are 

possible. The dental unit allows 

for easy-to-clean maintenance 

and the use of high temperature 

resistance material will minimize the chances of cross-infection. 

powerful 40,000 rpm and a brushless micro-motor. Its userfriendliness 

comes with a bright, easy-to-read display and an 

intuitive user interface. Its advanced calibration technology can 

automatically detect the handpiece reduction ratio and adjusts 

the motor to the unique properties of the contra angle at the 

time of treatment. 

The motor system also performs the complete implant 

procedure using a single, high-efficiency 20:1 reduction 

handpiece. AE-70V allows hands-free variable speed control, 

motor direction change, preset selection, pump activation, and 

torque adjustment. 

Lean but 

Efficient Enquiry No. 08/05 

Whip Mix Corp has introduced new LeanRock — a Type 4 diestone 

formulated specifically for laboratories who want to pour 

small batches (about 6 full arches) and have 

working models ready in 15 minutes. 

Small batch processing is 

based on lean principles 

to improve work flow and 

reduce wait time because 

models can be trimmed and 

pinned after only 15 minutes, 

decreasing downtime waiting for stone to set. 

The decreased processing time also speeds up remakes for 

those emergency repairs needed in a hurry. LeanRock is 

scannable for use with Cad Cam systems eliminating the need 

for specialty scan stone or spray. 

58 


PRODUCTUPDATE 

dentCeram LF Offers Multi-Application Enquiry No. 09/05 

The new dentCeram LF ceramic system from Dentaurum 

offers a large number of applications for everyday use in the 

laboratory. It is suitable for veneering precious metal alloys or 

of base metal alloys with high thermal expansion. The very 

good modelling properties of this ceramic facilitate rapid, simple 

and safe layering. The layering is very stable and thus it is 

possible to work quickly. The high stability of the ceramic acts 

positively during firing. With dentCeram LF the material does 

not run or become misshaped. Developed exclusively for 

shading the Dentaurum ceramic material, the thermal coloration 

method guarantees homogeneous and permanently stable 

shading, even after firing several times. This excellent firing and 

shade stability sets new standards. 

The product range of the dentCeram LF layering ceramics is 

rounded off perfectly with the 

new dentCeram LF press. It is a 

modern pressed ceramic on the 

basis of high purity technical 

raw materials. The pressed 

ceramic method for single tooth 

restorations is distinguished by 

easy processing as well as high 

stability of the esthetic 

substructure material. 

All system components of 

dentCeram LF have been 

matched perfectly to one another in development to guarantee 

the highest degree of safety. 

All-Round Protection Enquiry No. 10/05 

A modern casing with a large display and an upright synthetic 

bottle: that is what the new piezo smart ultrasound device by 

Mectron looks like. With its over 37 

different instruments, the piezo 

smart caters for all the traditional 

applications: scaling, perio, endo 

and restorative. The highlight, 

however, is the new non-spill bottle 

system. 

Mectron has designed the bottle in 

such a way that it remains upright 

and opens through the top. This 

means 

that the liquid cannot flow out. The 

path of the liquid is kept separate from the electrical 

components. The peristaltic pump is protected but accessible at 

all times, mounted on the bottom of the device. The fullyautomatic 

“Clean” function can by started by pressing a button, 

thus excluding any deposits in the circuit from the start. 

Control of the quantity of liquid is achieved by means of pushbuttons. 

The chosen quantity of liquid is shown on the large 

display. The display also indicates the selected ultrasound 

performance level. 

The feed-back system and the Automatic Protection Control 

(APC) function make sure of constant top performance. The 

built-in feedback system controls progress of the power level 

and adjusts it as needed in only a few hundredths of a 

second. 


PRODUCTUPDATE 

Painless in Seconds Enquiry No. 11/05 

QuickSleeper by Dental Hi Tec is designed to perform 

transcortical anesthesia as first-line treatment in the best 

possible conditions. 

It is ideal for alll types of anesthesia, including mandibular 

molars, incisor-canine blocks, single or multiple extractions, 

implantology work, etc. This work could be performed with just 

one single injection point, with no numbness of the lip, no lag 

time, no lingual or palatial injection, even for a single extraction 

and with 2 to 6 teeth anesthetized depending on the the 

quantity injected. 

The ‘pen grip’ handpiece of QuickSleeper is ergonomic in 

design where all the anesthesia are performed using support 

points for maximum precision. 

QuickSleeper features four programmed 

injection speeds and there is also a ‘Low’ 

mode for sensitive cases, like anesthesia 

of the frenum or with children. 

For difficult injections, the exclusive 

‘PAR’ system (Permanent Analysis of 

Resistance) automatically adapts the 

power of the motor according to 

resistance to the injection. It ensures a 

regular injection, whatever the density of the tissue infiltrated, 

and eliminates cartridge breakages. 

Reliable Precision - Every Time Enquiry No. 12/05 

A putty version of Flexitime ® A-silicone precision impression 

material is now also available from Heraeus that is suitable for 

automatic mixing with the new Dynamix ® Machine. The 

kneadable, high viscosity impression material now comes in the 

new Dynamix ® Cartridge on the market under the name of 

Flexitime ® Dynamix ® Putty. 

Flexitime Dynamix Putty is effortlessly mixed at the press of a 

button in the Dynamix automatic mixing unit for impression 

materials. The homogeneous, void-free mixture ensures 

reliable, reproducible precision and accuracy of fit. 

Rapid mixing and precise dispensing also save 

time as well as material and ensure a consistent 

quality and technique. 

It can be easily moulded in the same way as a manually mixed 

putty, as it has a low sticky consistency. Automatic mixing also 

makes the problem of sulphur on the hands of the operator a 

thing of the past. 

The real putty consistency of Flexitime Dynamix Putty has a 

high compressive strength — an advantage for controlled 

intraoral insertion. The impression can be removed easily from 

the mouth without causing the patient any discomfort. The 

material is easily cut for the putty-/wash impression. 

As the pre-filled Dynamix Cartridge is ready-to-use, the material 

can be applied easily and quickly. A dynamic mixer, the 

Dynamix Mixing Tip, and a fixation ring ensure that the base 

and catalyst pastes are mixed to the same homogeneous 

quality. This guarantees thorough mixing and stability with all 

consistencies. The cartridge is made of an eco-friendly, singlecomponent 

material; it is recyclable and marked with a green 

point to signify suitability for the dual-disposal system. It 

replaces the previous Magnum 360 foil bag. 

Rapid Pre-Grinding by Preparation Enquiry No. 13/05 

GlaxoSmithKline has introduced 

Sensodyne PRONAMEL, a nonprescription 

toothpaste to target acid 

erosion of the the teeth effectively. It 

is formulated with the optimum level 

of fluoride content and the FDAapproved 

sensitivity ingredient, 

potassium nitrate (5%). 

As everyone with natural teeth is at risk of tooth wear caused by 

acid erosion — and this condition is 

prevalent among people of all age 

groups — Sensodyne PRONAMEL’s 

unique formula will help to strengthen 

acid-softened enamel and makes it more 

resistant to acid attack. 

PRONAMEL is pH neutral and its nonabrasive 

formula protects against further tooth wear during 

brushing, making it suitable for daily use. 

60 


PRODUCTUPDATE 

Optimal Tissue Management 

for Implants Enquiry No. 14/05 

Straumann Bone Level Implant combines proven design 

elements with innovative concepts to achieve predictable highly 

esthetic results. One 

novel design feature 

that helps to ensure 

successful soft tissue 

management is its 

concept of Consistent 

Emergence Profiles . 

This harmonizes the 

emergence profiles of 

the prosthetic 

components throughout 

the treatment process, in 

addition to facilitating the production of temporary and permanent 

restorations, as well as minimizing the risk of complications. 

All prosthetic components of the Bone Level Implant line have 

consistent emergence profiles: the healing abutment, the 

temporary abutment, and the final restoration abutments. As a 

result, the soft tissue is prepared optimally from the outset 

through to the final restoration. Components with consistent 

emergence profiles can be inserted without pinching or causing 

the patient pain. 

Cost-effective Arch 

Trimmers Enquiry No. 15/05 

Millo and Millo pro are the two new dental arch trimmers from 

Renfert. Unlike the usual method of trimming with the 

handpiece, the dental arch is firmly held in position and guided 

on the trimmer by both hands. The cutter’s conical shape (no 

undercuts) makes it easy to free the arch from the plaster base 

without damage. This makes for absolutely smooth surfaces, 

even gradients and tapers, and thus, spotless models. 

These compact machines even rationalise the workflow during 

model fabrication and allow clean and efficient 

handling. The arch trimmer allows the 

technician to work twice as fast compared 

with a handpiece. Also, considerable 

material is removed during arch trimming. 

Specially positioned extraction vents on 

the arch trimmer ensure the field of vision 

around the object remains free and the 

workspace clean. Both machines allow 

simple and fast cutter replacement by 

lifting the work table and using the onboard 

tool. 


○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ 

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ 

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ 

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ 

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ 

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ 

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ 

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ 

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ 

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ 

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ 

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ 

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ 

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ 

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ 

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ 

EVENTSCALENDAR 

2008 

6 - 10 May — Bangkok, Thailand 

30th Asia Pacific Dental Congress 

Contact: Secretariat Office, SLM 

Mgt Co. Ltd 

Tel: +66-2-748-7183 

Fax: +66-2-748-7050 

Email: apdc2008@gmail.com 

URL: www.apdc2008.com 

16 - 20 May — Denver, USA 

108th Annual AAO Session 

Contact: AAO Snr Mtg & Exh Mgr 

Tel: +1-314-993-1700 

Fax: +1-314-997-1745 

Email: info@aaortho.org 

URL: www.aaortho.org 

29 - 31 May — Montreux, Switzerland 

Dental 2008 

Contact: Ueli Breitschmid, Swiss 

Dental Events Ag 

Tel: +41-41-319-4585 

Fax: +41-41-319-4590 

Email: info@dental2008.ch 

URL: www.dental2008.ch 

5 - 8 June — Beijing, China 

Sino Dental 2008 

Contact: Ms Sunny Yin, Int’l Health 

Exchange & Coopn 

Tel: +86-10-8839-3922 

Fax: +86-10-8839-3924 

Email: yinhaiyan@ihecc.org 

URL: www.sinodent.com.cn 

10 - 14 June — Lisbon, Portugal 

84th Congress and Exhibition of the 

European Orthodontic Society 2008 

Contact: Congress Secretariat, 

AIMS Int’l Congress Svcs 

Tel: +351-21-324-5052 

Fax: +351-21-324-5051 

Email: 

eos2008@aims-international.com 

URL: www.eos2008.com 

26 - 28 June — Madrid, Spain 

European Academy of Esthetic Dentistry 

Congress 2008 

Contact: Ms Deborah Augenblick, 

EAED Secretariat 

Tel/Fax: +39-2-295-23627 

Email: info@eaed.org 

URL: www.eaed.org 

27 - 29 June — Seoul, Korea 

SIDEX 2008 

Contact: The Organizer, SIDEX 

Tel: +82-2-498-9142 

Fax: +82-2-498-9147 

Email: sda@sda.or.kr 

URL: www.sidex.or.kr 

2 - 5 July — Toronto, Canada 

86th IADR General Session 

Contact: The Secretary, IADR 

Secretariat 

Tel: +1-703-548-0066 

Fax: +1-703-548-1883 

Email: research@iadr.org 

URL: www.iadr.org 

17 - 19 July — Orlando, USA 

Academy of General Dentistry 2008 

Contact: Ms Marge Palonis, AGD 

Tel: +1-312-440-4358 

Fax: +1-312-440-0513 

Email: margery.palonis@agd.org 

URL: www.agd.org 

30 July - 2 August — Orlando, USA 

IACA International Congress 2008 

Contact: The organizer, IACA 

Tel: +1-866-669-4222 

Fax: +1-702-233-9200 

Email: info@theiaca.com 

URL: www.theiaca.com 

9 - 12 Sep — Moscow, Russia 

Dental Expo 2008 

Contact: Dmitry Makarov, Dental 

Expo 

Tel: +7-495-155-7900 

Fax: +7-495-152-8549 

Email: makarov@dental-expo.ru 

URL: www.dental-expo.com 

24 - 27 Sep — Stockholm, Sweden 

FDI World Dental Congress 2008 

Contact: FDI World Dental Events 

Tel: +33-4-5040-5050 

Fax: +33-4-5040-5555 

Email: congress@fdiworldental.org 

URL: www.fdiworldental.org 

2 - 4 Oct — London, UK 

BDTA Dental Showcase 2008 

Contact: Ms Diana Keates, BDTA 

Tel: +44-1494-782873 

Fax: +44-1494-786659 

Email: dkeates@bdta.org.uk 

URL: www.dentalshowcase.com 

8 - 11 Oct — Milan, Italy 

36th International Expodental 

Contact: Melissa Dotto, Promunidi 

Tel: +39-02-700-6121 

Fax: +39-02-7000-6546 

Email: expodental@expodental.it 

URL: www.expodental.it 

11 - 14 Oct — Tianjin, China 

China Dental Int’l Exhibition 2008 

Contact: Mrs Kelly He, Beijing 

Globalstar & Exh Svcs 

Tel: +86-10-6216-4099 

Fax: +86-10-6216-4099 

Email: info@globalstar.org.cn 

URL: www.globalstar.org.cn 

16 - 19 Oct — San Antonia, USA 

ADA 2008 

Contact: ADA Exhibit Office, ADA 

Tel: +1-312-440-2876 

Fax: +1-312-4402707 

Email: annualsession@ada.org 

URL: www.ada.org 


ADVERTISERS’INDEX 

COMPANY 

Page Number 

DENTAL HI TEC 03 

DMG 33 

4T TECHNOLOGIES 15 

HERAEUS KULZER 07 

HERAEUS KULZER 39 

GC ASIA DENTAL PTE LTD 05 

GC ASIA DENTAL PTE LTD 51 

IVOCLAR VIVADENT AG 

Back Cover 

KOHLER GmbH 27 

NOBEL BIOCARE 

Inside Front 

NTI-TSS 55 

PROMUNIDI 63 

REMEDENT ASIA 29 

ROLENCE ENTERPRISE INC 59 

SHOFU INC. 25 

SINO DENTAL 2008 

List of Advertisers 

Inside Back 

VOCO 35 

ZIMMER DENTAL 09 

Dear Readers, 

If you have any news that wish to share with 

us, or feature story that you would like to 

submit for publication, please forward them 

to the Editor: desmondteo@pabloasia.com. 

We also welcome comments/feedback/ 

opinion about the magazine and/or any of 

the stories of featured within the issue. 

Publishing Office & Media Representatives 

Publishing Office 

Singapore 

Pablo Publishing Pte Ltd 

Block 16 Kallang Place #07-01 


Tel: +65-6396-7877 Fax: +65-6396-7177 

Mr William Pang, Publisher 

Email: williampang@pabloasia.com 

Europe 

Pablo Germany 

Kilian-Spiegel-Strasse 6 

D-64720 Michelstadt 

Germany 

Tel: +49-6061-925100 

Fax: +49-6061-925101 

Mr Alistair Bryson, Executive Director 

Email: pablogermany@t-online.de 

China 

Pablo Shanghai 

Rm 404, No. 858, Panyu Road 

Shanghai, P.R. China 

PC: 200030 

Tel: +86-21-6283-1681 / 6281-1839 

Fax:+86-21-6283-1836 

Ms Kelly Shen, General Manager 

Email: pabloshanghai@tom.com 

Pablo Beijing 

Room 1811, Jinglong Mansion 

225 Chaoyang Bei Road, Chaoyang, 

Beijing, P.R. China 

PC: 100026 

Tel: +86-10-6509-7728 / 6509-7548 

Fax:+86-10-6509-7719 

Ms Ellen Gao, General Manager 

Email: pablochina@tom.com 

Media Representatives 

UK, Ireland & Israel 

Lansdowne Media Services — Ms Marika Cooper 

2 Claridge Court 

Lower Kings Road Berkhamsted, Herts HP4 2AF 

England 

Tel: +44-1442-87-7777 

Fax: +44-1442-87-0617 

Email: marikac@lansdowne-media.co.uk 

Japan 

Echo Japan Corp. — Mr Ted Asoshina 

Grande Maison Room 303 

2-2 Kudan-Kita, 1-Chome Chiyoda-ku, 

Tokyo 102-0073 

Japan 

Tel: +81-3-3263-5065 

Fax: +81-3-3234-2064 

Email: echoj@bonanet.or.jp 

Italy, France, Spain 

Rancati Advertising Srl. — Mr Claudio Sanfilippo 

Milano San Felice Torre 7 

20090 Segrate Italy 

Tel: +39-02-703-00088 

Fax: +39-02-703-00074 

E-mail: csanfilippo@rancatinet.it

Download - Dental Asia

Create successful ePaper yourself

Delete template?

Save as template?