Human Resource Management - Its Impact on ... - 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 yMICA (P) No: 204/05/2007 KDN: PPS 1452/09/2008(001054) ISSN: 0219-5682 • www.dentalasia.net • MARCH / APRIL 2008<strong>Human</strong> <strong>Resource</strong> <strong>Management</strong> -<strong>Its</strong> <strong>Impact</strong> on Business Successof Dental Practices• Does the Diagnostic Criteria for a PulpotomyRequire a Third Dimension?• Aesthetic Solutions on ImplantsIDEM 2008Preview Special

FIRSTWORDSLet the Show BeginIDEM is back and we have been promised a bigger and more exciting show in conjunction with apremium quality scientific program. Apart from growing more than 100%, both delegates andattendees will be in for “some pleasant surprises”, according to Mr Oliver P. Kuhrt, Executive VicePresident of koelnmesse GmbH. Given koelnmesse’s track record, I am confident that they willdeliver more than what they have promised, as we eagerly wait for the show to commence.Being a supporting publication of IDEM, we have also dedicated this issue as a special previewissue for the exhibition. In our preview section, you will be able to quickly zoom in on some of themore interesting products that you will find on the show floor.Can the management of human resource have a direct impact on the business success of yourdental practices? Drs Fanny Young and Ricky Wong set about determining whether these two elements are related to eachother. Turn to page 30 to read about their analysis.Inadequacies in the diagnosis of pulpotomy have led to tissues, which can survive, to be extirpated and tissues, whichshould be excised, to be preserved. This article focuses on the rationale of conservative endodontic procedures andattempts to conclude on the need of more precise armamentaria for clinical diagnosis. See page 26.Our ‘Product Focus’ column zooms in on GlamSmile by Remedent. A revolutionary veneer solution that is simple enough forthe dentists, and yet affordable for the patients.Happy reading and drop by our booth (M18) at IDEM, if you are visiting the event. We sure would like to meet up with you.Desmond TeoEditorDisclaimer: 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 istaken to ensure accuracy of the information in this publication, the Publisher accepts no liability for damages caused by misinterpretation of information, expressed orimplied, 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 Advertisershall 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 donot fit our terms of control.Please refer to subscription form provided in the publication for more details.4 Dental Asia • March / April 2008

INDUSTRYBRIEFDr Jean Bausch Sets Up Japan SubsidiaryJapan — Dr Jean Bausch KG, a German manufacturer ofarticulating and occlusion test materials, has established asubsidiary in Nabari-Shi, Japan in order to offer and improvethe service in the Japanese dental market as well as toextend the company’s market share.As one of the world’s leading manufacturers in this domain,Bausch offers an extensive range of different articulating testfilms in different shapes, sizes and colors. Bausch productsare distributed in more than 130 countries worldwide.For further information on Bausch Japan, you may contactMr Akihiro Kitagiwa at:Bausch Articulating Papers Japan K. K.7-104, Kikyogaoka 2 Ban-Cho, Nabari-City, Mie, 518-0622,JapanPhone: +81 (0) 595-48-5780Fax: +81 (0) 595-48-5787E-Mail: info@bauschdental.jpWeb: www.bauschdental.jp(L-R) Ms Dagmar Lersch, Asst Manager for Director, Mr Akihiro Kitagiwa,Director of Bausch Japan, Mr Milan Rajek, Business Development Directorand Mr André Bausch, Director of Bausch Germany and JapanExtension of Dental Course DecriedIndia — India’s Kerala Health Services Dental SurgeonsAssociation, the service organisation of the dental surgeonsin the State health service, has protested against the moveon the part of the Dental Council of India (DCI) to do awaywith the compulsory internship programme and to extend thecourse to five years.The Association’s General Secretary, Dr K. Krishnakumar,and President, Dr A. Ajith Kumar, said the new policy wouldend up creating a generation of medical practitioners whohave no practical experience.The BDS course consists of four and a half years of regularclasses and six months of internship. The new move plans toend the six months practical training and extend the theorypapers to another six months.The Association alleged that the Council had not given anyreason for the new move and that this would only help to addto the financial burden of the students.IN ANOTHER DEVELOPMENT, the State chapter of IndianDental Association (IDA) has also taken strong exception tothe decision to remove house-surgeoncy from the Bachelorof Dental Surgery (BDS) programme and warned it wouldharm dental health in the long run. DANZ Steps Up Effort to Combat CavitiesNew Zealand — Colgate, Plunket and the New ZealandDental Association (NZDA) are working together to combatcavities and to raise awareness of good oral health practicesin our families and communities.“We believe good oral health habits start when you’re young,and are proud to support this campaign to raise awarenessabout good oral care practices,” says Dr Rebecca SchipperColgate’s Scientific Affairs Manager. “Colgate is committed toimproving the teeth and gums of all New Zealanders. Wewant to ensure that our country’s children have the best startthat healthy teeth and gums can give them and go on toenjoy a brighter smile later in life.”Said Erin Beatson, Clinical Advisor for Plunket: “With goodrole modeling from their parents and an understanding ofwhy it is important and how to maintain good oral health,children are more likely to continue looking after their teethinto adult life.“It’s not good enough that nearly half of all children havedeveloped dental cavities by the time they turn five. It’s up tous parents to stop that dental decay from happening,” saysDr David Crum NZDA’s CEO.DA6Dental Asia • March / April 2008

INDUSTRYBRIEFGlamSmile TrainingSingapore — Remedent Asia will be conducting its firstGlamSmile training session as follows:-Location: #10-02 CamdenMedical Centre, Singapore2 April 2008A new and exclusiveproduct of Remedent,GlamSmile is the world’sfirst full-arch minimallyinvasive veneer deliveryand placement system.Unlike traditional oneveneer-at-a-timeplacementmethodology, proprietaryGlamSmile technology features a patent-pending traydelivery system that provides the opportunity and the toolsfor any practitioner to expertly seat ten beautiful veneers atone time in less than one hour without compromising healthytooth structure.For more information, please contact Andrew Soh at +65-6462-6181. DADental Institute’sEffort LaudedIndia — The S. Nijalingappa Institute of Dental Sciences andResearch has added two more facilities — a major operationtheatre and a mobile dental unit.Executive committee member of the Dental Council of India(DCI) Dr B.H. Sripathi Rao, who is also principal of YenopoyaDental College in Mangalore, inaugurated the operationtheatre in the Department of Oral Surgery. Another memberof the DCI Pradeepchandra Shetty launched the mobiledental unit.Dr Rao lauded the efforts of the institute to provide qualityeducation to students and better facilities to the patients ofthe region, and to create dental awareness. Dr Shetty saidall possible help would be extended to the institute in itsfurther initiatives. DADentalbite ...• Families will get up to $150 a year for their children’sdental care under a $360 million three-year TeenDental Plan. The plan is effective from July 1.Dental Asia • March / April 2008 7

INDUSTRYBRIEFNobel Biocare Acquires AlphaBioTecIsrael — Nobel Biocare has agreed toacquire AlphaBioTec Ltd, a leading dentalimplant company in Israel and theinnovator of the predecessor toNobelActive. Nobel Biocare will buyall outstanding shares in thecompany for a consideration ofUS$95 million.With this acquisition, Nobel Biocare will reinforce its leadingposition by gaining immediate access to some of the fastestgrowingmarket segments in implant dentistry, such asorthodontic mini-screws and small diameter implants. At thesame time, the company will gain a market leadershipposition in Israel and further expand its position in Russia,Poland and Latin America.AlphaBioTec has more than 60% of the global market share.<strong>Its</strong> products are sold in more than 40 countries, and itsexport business has been growing at a pace in excess of35% over the past several years. AlphaBioTec has achievedleading positions in high-growth countries in Eastern Europe,Russia and is expanding quickly in India, Korea and LatinAmerica.Nobel Biocare will obtain all rights to AlphaBioTec’strademark, brand names, innovation pipeline, strong R&Dnetwork and proprietary manufacturing facility in Tel Aviv. Itwill retain all of AlphaBioTec’s more than 120 employees. MrOphir Fromovich, the current owner and CEO, will becomeChairman of the Board of AlphaBioTec andact as an advisor to Nobel Biocare.Said Mr Domenico Scala, CEO ofNobel Biocare: “This acquisitionexpands Nobel Biocare’s leadingposition by allowing us to enter newand fast-growing market segments.AlphaBioTec’s leading position in Israel, its attractivepipeline and strong innovation skills with excellent people willcomplement our innovation capabilities.”Under the terms of the agreement, the acquisition will bepaid in cash and existing Nobel Biocare shares. Thetransaction is expected to close in the second quarter of2008 and be accretive from the first year.IN ANOTHER DEVELOPMENT, Nobel Biocare and theAcademy of Osseointegration (AO) Foundation have jointlyawarded Professor Per-Ingvar Brånemark with the inauguralNobel Biocare Brånemark Osseointegration Award. Theaward was presented to him n honor of his life’s work and hisdiscovery of osseointegration and implant dentistry.The Nobel Biocare Brånemark Osseointegration Awardacknowledges individuals who demonstrate a driven desireto advance patient oral health and well-being throughhumanitarian, research, and educational excellence in thefield of implant dentistry. The monetary award of US$100,000will be distributed yearly by the AO Foundation. DAVITA 3D-Master Celebrates 10th AnniversaryGermany — VITA System 3D-Master iscelebrating its 10th anniversary thisyear. It was first introduced in March1998.In developing the VITA System 3D-Master, the goal from the verybeginning was to establish aninternational standard that leads togreater efficiency and understandingworldwide with regard to shade taking,shade communication, shadereproduction and shadecontrol.On the anniversary internetpage http://www.10years3D-Master.com/ you will find new,exciting offers and information,quizzes and prize competitionsdaily as well as the opportunityto exchange opinions on thepair of opposites “individualityversus standard”. DADentalbite ...• The Prison Department has started a dental treatment facility in Bangalore Central Prison so that inmates will nothave to go all the way to Government Dental College for problems related to their teeth. The new facility will help theinmates in filling cavities, cleaning, undergo root canal treatment and other dental problems.8Dental Asia • March / April 2008

INDUSTRYBRIEFCelfa Dental Group Reinforces China PresenceChina — Cefla Dental Group has announced acquisition ofSuzhou Victor Medical Equipment with a view tostrengthening its local presence in China — a market that iskey to Cefla’s strategic expansion into potential growthareas, in terms of markets, products and technologies.Following the launch in 2007 of Cefla Dental Group’s thirdbrand, MyRay, high-tech imaging solutions and digitalradiology for dental professionals, Suzhou Victor MedicalEquipment becomes the fourth name in the growing brandportfolio.In order to consolidate Cefla’s presence in Asia and furtherincrease business in line with local needs and those of theworld’s emerging markets, Cefla will be investing significantresources in the Suzhou-based production site. Throughacquisition of Suzhou Victor Medical Equipment, Cefla’sprimary objective is todevelop a product range, viathe Victor brand, specificallydesigned to respond to theneeds of dentists whosechoice of equipment isbased on the followingcriteria: long-term reliability,quality materials,outstanding value for money.Eros Nanni, Managing Director of Cefla Dental Group,states: “This recent acquisition brings us much closer to ourChinese customers. We are now an established localpresence and will be able to serve the market with the samedegree of professionalism and quality as we offer all ourEuropean customers.” DAFunding Cut for Teen Check-upsAustralia — The Australian Government has slashed a thirdfrom the A$510 million (US$470 million) funding it hadpledged to spend on its dental health scheme for teenagers.The Treasury found that only A$360 million (US$332 million)was needed to subsidize dental checks for one millionteenagers over three years.It was a A$150 million (US$132 million) windfall for a frugalopposition, which provided limited relief for the toothacheridden.Even teenagers eligible for subsidized care - or their parents- will need to shell out an average A$140 (US$129) copaymentfor the comprehensive check-up and potentiallyhundreds of dollars more if treatment is required.The funding cut has surfaced amid growing concerns fromdental leaders that Labor’s dental policy is under-funded andmisdirected. Labor has hailed its policy, which includesA$290 million (US$267 million) over three years to restart theold Commonwealth dental scheme, as a long-needed federalboost to ailing services for 650,000 Australians in urgentneed of care.But its decision to axe the Coalition’s existing scheme whichextended Medicare cover to $2,000-a-year (US$1,844)dental care for patients with significant medical conditionsaggravated by dental disease, was “horrifying”, a dentalscientist, Hans Zoellner, said.“I am appalled the Government is abandoning what was oneof the great steps forward for dental care in Australia,” saidAssociate Professor Zoellner, chairman of the Association forPromotion of Oral Health. “<strong>Its</strong> replacement was likely tomean many people would remain on the waiting list ofoverstrained public clinics.” DACrosstex Int’l Acquires Strong DentalUSA — Crosstex International, leading global dentalinfection control and single use disposable productsmanufacturer, has announced its acquisition of Strong DentalProducts, Inc, a manufacturer of comfort cushioning andprotective devices for X-ray film and digital X-ray sensors. AllStrong Dental products will now be available through theCrosstex network of distributors, along with the full line ofCrosstex products. DAFor more information, email: info@pabloasia.comSOMETHING TO SHARE? We want to hearfrom you! Email your story to the Editor:desmondteo@pabloasia.com10Dental Asia • March / April 2008

INDUSTRYBRIEFIvoclar Vivadent Awarded Innovations Prize 2007Germany — Over 1,500 German dentistshave chosen Ivoclar Vivadent AdheSE Oneas the most innovative dental product in acompetition conducted throughout thecountry. The prize was established by thetrade magazine “Die Zahnarzt Woche“ andthe dental company “Pluradent“ in 2005. Thecompetition takes place every two years.The self-etching single-step adhesive for direct restorativetherapy clearly outmatched the otherproducts and was chosen as the winner inthe category “materials and instruments“.AdheSE One is available in a uniquedelivery form: the economic VivaPen,which allows easy and clean applicationof the adhesive directly in the mouth ofthe patient. If additional adhesive isrequired, one click is enough to dispense more material. DALargest NZ Dental Group Opens New Look PracticeNew Zealand — Lumino The Dentists, New Zealand’s onlydental group offering dental care nationwide, has opened thefirst of its new look practices in Mt Eden, Auckland. Thelaunch was celebrated at a cocktail event on Tuesday, 4thMarch.Dr. Brett Hawkins, who has 15 years experience in dentistry,and a special interest in orthodontics, will share the practicewith highly trained dental surgeon, Dr Ewan Yun. Bothdentists believe that the new practice will be a great asset tothe local area.‘Our goal is to make the highest quality consistent dentalcare accessible for all of our patients and to help peopleachieve healthy, beautiful smiles’, says Dr Hawkins. ‘Ournew look is part of our commitment to a national identity forNew Zealand’s onlynational dentistry group.We are really lookingforward to becoming apart of the Mount Edencommunity.’W&H Opens Singapore Service CenterThe practice will offer specialist services such asorthodontics, cosmetic dentistry and hygiene servicesalongside more general treatments.Dr Hawkins and Dr Ewan Yun will be joined by one dentalhygienist and two orthodontic auxiliaries.Lumino The Dentists clinics can be found throughout boththe North and South Islands. DASingapore — W&H has recently expandedits well-known premium service networkwith the opening of its service center inSingapore.The center was opened in Singapore toprovide additional W&H premium servicesin the Asia-Pacific region. The serviceoperation of W&H Dental-Mechanik (Asia)begins last December. W&H premiumservice centers, like the one in Singapore, offer services forall W&H product categories.W&H Dentalmechanik Singapore offers benefits such as the24-hour service, personal telephone consultations andrealistic cost estimates. The center is part of a worldwideservice network that enables W&H to ensure the entire rangeof its products are maintained and serviced according to thehighest quality guidelines. The Executive Board shall betaken over by Martin Rolfe, Area Manger for Asia Pacific.The complete service offer can be found at the followingaddress:W&H Dental-Mechanik (Asia) Pte. Ltd18 Boon Lay Way#10-94 TradeHub 21Singapore 609966Tel: +65-6316-8370Fax: +65-6316-8371Email: service.sg@wh.comFor more information, visit www.dentalasia.net12Dental Asia • March / April 2008

INDUSTRYBRIEFSirona Dental Selects 3D Modeler for its inCorisUSA — Sirona Dental has chosen 3D Systems’ InVision®DP (Dental Professional) 3-D Modeler to launch the former’snew infiniDent wax pattern service.After extensive research and testing with the 3-D Printer,Sirona has decided to use the 3-D Modeler to fabricateinCoris WAX patterns as part of Sirona’s infiniDent servicebeginning in March 2008. The new inCoris WAX patterns areused by dental technicians who want fast, consistent andeconomical fabrication of full cast crowns, copings andbridge frameworks as well as full contour units for pressceramics or over metal and pure zirconium oxide (ZrO2)substructures.3D Systems’ InVision® DP (Dental Professional) 3-DModeler and new ProJet DP 3000 3-D Production Systemaccurately, consistently and economically manufactureprecision wax-ups. A dental professional scans a model,designs a virtual wax-up using 3-D software, then sends thedata to the InVision® or ProJet modelers to “print” wax-upsin layers; these systems can generate hundreds of units ineach cycle. With built-in VisiJet® DP 200 Material, the waxupshave a smooth surface finish and can be cast or pressedwith conventional techniques.“The introduction of inCoris WAXvastly increases infiniDent’sservice offering for existing inLaband inEos users and providesthem with more access to morematerials,” said Marcus Meier,MDT, manager of infiniDent. “Weare convinced that dentallaboratories utilizing these waxpatterns will substantially increasetheir efficiencies when fabricating waxpatternsthrough infiniDent.”InVision® DP 3-D Modeler“We are very pleased that a world-class dental player likeSirona selected our dental professional production system,”said Abe Reichental, 3D Systems’ president and chiefexecutive officer. “We believe that digital dentistryapplications represent a significant growth opportunity forour company and expect to broaden our presence in thisspace with additional Additive Manufacturing solutions fordental labs.” DADental Asia • March / April 2008 13

DENTALFOCUSacademia • dentalExtends itsEducation ProgramFigure 1 Teamwork between the trainer and theparticipants improves the efficiency of thecourse resultThe international school academia • dental offers perfect conditions for aqualified training at a high level. academia · dental won its internationalreputation due to its ambitious and excellent education program. Over thelast years, dental technicians from 30 nations have participated in thetraining program of academia • dental. The concept of academia • dental is notaimed at beginners but exclusively at experienced dental technicians withcompleted basic education.The highly trained and experienced instructor team stands for a high trainingcompetence in diverse subjects of dental technique. Participants enjoy studying inthe well equipped laboratories and functional areas. Coordinated training conceptsare geared toward a practical collaboration of the participants. Theory is an essentialpart, and presentations, lectures, and discussions perfectly round off the trainingprogram. The education at academia • dental is based on the knowledge andexpertise of BEGO in dental technique and education since more than 100 years.The standard education schedule of academia • dental includes two different fourweekprograms with diverse subjects of study. The present program focuses oncombination and milling techniques. Additionally, academia • dental introduces anew advanced training concept that causes an enormous interest in implantprosthetic supply.Figure 2 Experienced MDT of the academia • dental demonstrate theprocessing technique step-by-stepFigure 3 The challenge for every participant is to manufacture high-qualityimplant solutions in practical work14 Dental Asia • March / April 2008

DENTALFOCUSFigure 4 Complex tasks are solved in teamIn the dentistry, the demand for aesthetic procedures isincreasing exponentially. Hence, it becomes increasingly difficultto fulfill the patients’ aesthetic demands and desires. The desirefor natural looking implants which are not perceivable is animportant topic of discussion among patients and dentists. Thenew concept of academia • dental provides insight into allpossibilities offered by implant prosthetics, such that dentaltechnicians learn about best solutions on how to satisfyfunctional as well as aesthetic demands and requirements oftheir patients. academia • dental informs in detail about the widespectrum of solutions in implant prosthetics. The main aspectsare scientifically proven knowledge, new methods, andmaterials. A team of experienced master dental technicians whoare highly qualified specialists in diverse subjects providessupport to the participants of academia • dental.The intensive four-week implant prosthetic education focuses onthe manufacturing of a sophisticated restoration in the maxilla.What has been discussed in detail in advance is being put intopractice by the participants step by step. In such a way asophisticated dental-technical construction is being formedunder the instruction of experienced educators. Based on theavailable working model it is shown how situations with highaesthetical demands can be solved using implant prosthetics.The particular challenge is to choose a model situation thatreflects the entire spectrum of prosthetic solutions: for the front afull ceramic bridge is planned. In advance, the participantsprepare the BeCe zircon abutments using a water-cooledturbine. Then, the participants become familiar with the latestCAD/CAM technology by applying it to the sample of the frontdental bridge.After a scanning process the participants have the opportunityto model a bridge frame virtually. The zircon frame that hasbeen generated in a CAD/CAM procedure is finished with anindividual aesthetic ceramic layer technique. In this processingstep, the red-white aesthetic is of particular importance. In thelateral tooth area the advantages of over-pressing areexploited. A robust bridge construction out of a precious metalalloy provides the base for the over-pressing with BeCePRESS. The axial-divergent alignment of the implantDental Asia • March / April 200815

DENTALFOCUSFigure 5 Implant supported bridge with horizontal screwFigure 9 Functional occlusal surfaceabutments requires a dental-technically challenging horizontalscrew connection. Using two molar crowns the differencesbetween a cement-retained and an occlusally screw-retainedimplant are demonstrated. The abutments are prepared in anoptimal path of insertion and provide the basis for anaesthetic and functional veneering. Considering diversepractical dental constructions the participants learn to judgesituations, find constructive solutions, and put them intopractice.Figure 6 Horizontal screw in the anatomical tooth formFigure 7 Individually prepared zircon abutmentsThe features of materials used at academia • dental and theirprocessing are demonstrated and discussed in high detail.Among planning strategies and constructive aspects, thetraining program contains the following subject areas:avoiding screw loosening and veneer fractures, immediateloading, required passive fit, emergence profile/soft tissuesupport, etc.The patients who have implant prothetical requirements arealways a great challenge for dentists and dental technicians.Team work is crucial for the success of complex constructions!Alumni of academia • dental have the opportunity to obtain acomprehensive knowledge and many new gained experiences.The advanced training at academia • dental presents newmanufacturing technologies and methods to the participants.The intense and challenging training leads to the necessaryconfidence of the participants to successfully control and offernew processes.Interested dental technicians can get further information aboutadvanced training programs at www.academia-dental.de. Youwill see how the competence for milling and attachmenttechniques of academia • dental will be extended by the newprogram on aesthetic implant prosthetics. The next Englishspokencourse will be given from August 4th through 29th,2008 at academia • dental in Bremen, Germany. DAFigure 8 Virtual modulation by BEGO MedicalFor advertising &information, email:jamietan@pabloasia.com16 Dental Asia • March / April 2008

CLINICALFEATUREby Stefan BorensteinTime in a Bottle(Part II)In the previous articles we discussed tooth form and a practical and predictableapproach to achieving excellent results. The next hurdle is equally if not moreimportant because it has to do with the final functional and visual aspects of therestoration which will display harmony between patient, restoration and mouthIn this issue, we shall look at the questions regarding the selection of colours forboth teeth and gums.For the selection of colours in teeth, many shade guides exist, but as for gumcolours, very few and limited guides are available. The principal reason is that thereare far more gum colours than tooth colours and also there remains a simple fact ofmarketing, a question of profitability. Companies are not going to invest time anddollars into a product which is in essence a ONE time sale item. (Trust me. I havetried) Technicians will rant (justifiably) on and on about the critical importance ofsuch an assortment. The raw truth is that the kit will be sold once (only once) thencollect dust for years before there are any reorders .Therefore the marketing staffof companies have no interest in these products.We therefore came to the realization that we have to fabricate our own guides andpowders. After researching many diverse peoples of different ethnic backgroundswe fabricated a special shade guide to choose the gum colors of patients rangingfrom light pink to dark brown so that we could, if the occasion presented itself,emulate tissue of the same colour as exists in the patients mouth. These areavailable to our clients on a demand basis. To uncomplicate matters we decided onseven final tabs. These will allow us to compensate for tissue and bone loss andpermit fabricating very pleasing restorations by better controlling the final tooth sizeand shape.The following pictures are of a few of the colors we selected in relation to actualmouths:Figure 1 Gum color dark Figure 2 Gum color medium Figure 3 Intra oral18 Dental Asia • March / April 2008

CLINICALFEATUREFigure 8 Gum colors added to define shapeFigure 9 Aesthetics before addition of pinkFigure 10 As viewed with pink porcelainFigure 11 Viewed with lips in normal positionWe see here a full maxillary reconstruction over implants withpink added (Figure 10) and we then can see how the pink helpsdefine shape and natural appearance with lips in normalposition. (Figure 11)These gum colored porcelain have many applications andgreatly enhance the final appearance of the prosthesis .Now we turn to the question of selection of colour for thecrowns and bridges.Many computerised systems are now presented on the marketbut sadly only few are of any real applicable value. There existscolor spot meters which only take a contact color from aspecific spot on the tooth claiming that there is no interferencefrom outside sources. These may be accurate for the spot theycapture but have little value when trying to replicate an entirepicture with regard to shade blending, inscisal colour andeffects, etc. they even suggest taking six or more snaps ofdifferent parts of the same tooth in order to construct acomposite picture for the single tooth. Then there are elaboratecomputers and softwares sold to map out colors in teeth whichtake dollars, time and a phD in computer science tocomprehend.There is one colour matching program, Shade Analysis andCommunication known as ClearMatch®) developed by ClarityDental Corp, Salt Lake City UT, (Alan Morris) Phd. (which in itssimplicity allows us to capture all the information we need toproceed and produce restorations which match with uncannyaccuracy, and all at a fair low price. All that is required is adigital camera that is capable of taking a picture from canine tocanine (equipped with optical ,not digital zoom) and a specialblack and white tab. By white/black balancing and triangulatingbetween black, white and the known selected shade tab (i.e.A2) as reference the software can extract the exact colours andvalues of/in the desired teeth.They can be then be registered in patient files or the picturecan be sent via email to any computer which has theClearMatch® program installed for processing. This program isso powerful that it can even select colours in any area of thetooth A colour picture of the tooth is produced alongside agraph depicting colour variation, chroma and value scales thusmaking it easy to replicate even the most difficult cases whenrestoring a single crown or group of front teeth. This software20 Dental Asia • March / April 2008

DENTALUPDATEFigure 12 Clearmatchprogram can be obtained in Clinical or Dental Laboratory formatsIn the previous issue we discussed diagnostic wax-upprocedures. We can see here that it is also advantageous to usepink or red wax to better define and visualize what the finalresult may be. (Figure 12b)In other cases we can send the porcelain for try-in and applypink wax at try-in stageto give a good idea ofhow final restorationshould appear. (Figures12c & 12d)Figure 12b Waxed-up in ivorywax with redwax to depict gumsIn this case we haveimplants placed in veryorganized position. Webegan with a completeform diagnostic wax-upfollowed by fabricationof a silicon key as guide.We then proceeded tocast the abutments andDental Asia • March / April 200821

CLINICALFEATUREFigure 12c Porcelain bridge over implantsFigure 12d Porcelain bridge with pink wax to simulate gumsFigure 13 Well-placed implants (Dr Dwayne Karateew, Vancouver)Figure 14 NightmareFigure 15 Full denture over implantsFigure 16 Only 2 implants used for retentionFigure 17 The framework is produced utilizing a silicon stint takenfrom the existing dentureFigure 18 The framework wax-up is now hollowed to reduce themass22 Dental Asia • March / April 2008

DENTALUPDATEframe for try-in stage. Due to theexcellent positioning of the implant, wewere able easily produce a prosthesisboth pleasing aesthetically andfunctional resulting in a happy patientand future referrals. (Figure 13)And then there came this, “Nightmare onDental Street”. We all may stumbleacross one of these “specials”. (Figure14)Figure 19 Opaque application and problem areaImplants, AH! Yes! Implants, thatultimate solution. Or was that the 7 %solution. I invite ideas or explanations forthis array of metallic posts.Well, truth be said, at least it gives us, attimes, a nice “challenge”.Figure 20 Use of silicon stint as guideimplants. (Figure 16)In this particular case, a full denture(which was subsequently used as biteregistration) was sent to show us whatthe required result was expected toemulate. Here we mounted the case ona Denar articulator. At this point, we cutaway the excess plastic to clearlyexpose the implant and their relation tosaid denture and where the restorationwas to end. (Figure 15) Please note thatthis temporary denture was only fixedusing two of the implants thussuccessfully masking the positions of theStints , guides and wax-up were normally to be completed as discussed in previous issues.Now in this particular case the Prostodontist requested (insisted strongly) that a screwretained prosthesis, directly off of the implants, without the use of any angulation correctiveabutments was to be fabricated. Due to the miss-alignment of the implants this complicatedmatters just a “might” and brought us to the conclusion that we would have to consider theselection of a different material for the construction of this case. Conventional porcelainswould not work because the positioning of supportive structure and the mass of metal wouldbe so heavy that it would cause problems including fractures. After due consideration ,thematerial chosen was Ceramage (Shofu). A zirconium-silicate, light cured micro-filled indirectrestorative material designed specifically for implant cases. (Figures 17 & 18)The Ceramage comes complete with the classic Vita shades as well as gum colors. Theframework is prepared then opaqued with both regular and gum colored opaques. We canclearly see here one of the problem areas forced upon us by the misalignment of theimplants. This area between the lateral, as now stands, and cuspid cannot be attempted withporcelain. (Figure 19)The tooth forms are then constructed using similar layering procedures as found incontemporary porcelain build-up procedures. i.e. cervical dentin .opacious dentin and dentinand incisals. The original silicone guide is used to guide the build-up. (Figure 20)Once the teeth have been constructed to desired form, the pink Ceramage1 is added asrequired. Different shades of gum are used to create natural appearing results. (Figures 21-23)Dental Asia • March / April 200823

CLINICALFEATUREFigure 21 Ceramage built to formFigure 22 Gum-colored Ceramage addedFigure 23 Natural appearanceFigure 24 Under keyWe can see here when verified under the original silicon guidethat this case could not have been completed in porcelainwithout corrective abutments as understructure.This product (Ceramage) product of Shofu Dental, is verydurable and aesthetic. Benefits include no worry of metal massor thermal expansion as well as some supportive designcompromises. Further benefits are that it may be intra-orallycorrected, repaired or modified at any time before or afterinsertion and even over extended time. Just think about placinga heavy full mouth reconstruction off of implants, an alreadymulti-fired porcelain piece of work, and now after several weeksor months to have to be placed in a position to reinsert this intothe kiln with the all the potential risks of bubbling and orexploding.We are all stressed to function within short time frames andhave to avoid remakes and excessive try-ins for the comfort ofour patients and to preserve our own sanity These programsand techniques allow us to take charge of our work and thenoffer an all important element into our daily chores known aspredictability. DASpecial thanks to:Dr Dwayne Karateew and staffDr Alain Morris and Smart Dental Technology and ResearchFouad Daye, Kostas Sifakis, Victoria LisovaAcknowledgements to Shofu Dental Corp. Alexander Niessen.* the Ceremage case was not done by the office of Dr.D. KarateewStefan Borenstein graduated in Montreal with degreein dental technology at College Eduarde Mon Petit,specializing in full mouth reconstruction. He was theclinical insructor in JJH Hospital post-grad residencyprogram and has presented lectures in manycountries and events as well as the first EuropeanAcademy of Aesthetic Dentistry.INFORMATIVE • INSIGHTFUL • INCISIVEFor more information, email: info@pabloasia.com24 Dental Asia • March / April 2008

CLINICALFEATUREby Dr P.R. Chockalingam • Dr K.U. NallasivamDoes the DiagnosticCriteria for a PulpotomyRequire a ThirdDimension?Pulpotomy is a therapeutic invasive procedure whichimplies amputation of the irreversibly inflamedportion of the pulp, giving a chance for the reversiblyinflamed/uninflamed portion of the pulp to survive.Because of the inadequacies of diagnosticparameters/armamentaria, often, the tissue which cansurvive is extirpated and the tissue which should beexcised is preserved. This article focuses on therationale of conservative endodontic procedures andattempts to conclude on the need of more precisearmamentaria for clinical diagnosis.Pulpotomy is defined as the amputation of the coronal portion of the pulpleaving behind the uninflamed radicular pulp. (1-6) This procedure is based onthe rationale that when inflammatory stimuli on the pulp [may it be due tocaries/trauma] is of low magnitude or low duration the inflammatory changesare restricted to a coronal pulp [predictably] leaving the radicular pulp uninflamed.Indicating a tooth for pulpotomy in today’s practice is based on a history ofsymptoms and clinical examination for signs. Does this diagnosis require a thirddimension? Should this third diagnostic dimension be a comprehensive histologicalone?The results reported on the success of pulpotomy procedure are variable. The poor/variable results obtained could be attributed to the medicament or due to thediagnostic criteria devoid of a histological assessment of pulp. This pilot study wascarried out to:• Comment on the need of a histological assessment for indicating a tooth forpulpotomy• To comment if the success rates of pulpotomy could be improved by aninclusion of the histological dimension of assessment of pulp’sinflammatory status• To discuss of how could this histological criteria be probably designedMaterials and MethodsTwo recently traumatized [which had symptoms of pulpal inflammation but no26 Dental Asia • March / April 2008

DENTALUPDATEclinical exposure] permanent maxillary lateralincisors with complete root formation were selected.Time of elapsed since trauma for specimens A andB were 70 and 30 hours respectively. The accesscavity preparation was done with high speeddiamond points and the pulp was extirpated with no.25 sized barbed broach .the pulp was extirpated intoto and sent for histopathological examinationbeing fixed with formalin.Each of the specimens were studied under highermagnification (40x)at the coronal, mid root andapical portionsResultsSpecimen A: Under higher magnification showedvery high number of inflammatory cells withnumerous dilated blood vessels in the coronal• However there is no sharp line of demarcation between the inflamed anduninflamed pulp.• There is no differentiation as coronal/radicular pulp on observation.If a conventional pulpotomy procedure be performed on these specimens,this procedure on specimen A could have left inflamed pulp tissue [thatcould be irreversibly inflammed] beyond the cervical region, if the sameprocedure be carried out on specimen B, this conservative endodonticprocedure would have really not been conservative as the inflamed tissuewas only restricted to the rim of the coronal pulp.In present day practice, where partial pulpotomies [cvek] is also practiced,the criteria to limit the level of pulpal amputation is only clinical. [That is alevel is reached, at which hemostasis on pulp could be established].This could be a possible reason for pulpotomies to yield unpredictableresults, more possibly, could be termed as ‘‘missed diagnosis of level ofinflamed pulp”.Diagnosis could be more accurate, and the treatment results could be morepredictable if a histological dimension is incorporated into the diagnosticcriteria. Probable armamentaria could be a sphygmomanometer sensor probeFigure 1 Coronal portion of specimen A under highermagnificationportion. (Figure 1) The mid root portion showedboth these sign but to a lesser magnitude. Theapical portion was absolutely non-inflammatoryand simulated a normal pulp. (Figures 2 & 3)Specimen B: Under higher magnification showedovert signs of inflammation restricted to the coronalrim of the pulp. (Figure 4) The mid root portionshowed these signs to a lesser magnitude (Figure5). The apical portion was non-inflammatory andsimulated a normal tissue. (Figure 6)DiscussionAnalyzing these results on an analyticalperspective, we can conclude that:• There are varying levels/degrees of inflammationin a single pulp stump.Dental Asia • March / April 200827

CLINICALFEATUREFigure 4 Coronal portion of specimen B under higher magnificationFigure 2 Mid root portion of specimen A under highermagnificationFigure 5 Mid-root portion of specimen B under higher magnificationwhich could be inserted into the pulp chamber to read theinterstitial fluid pressure.The interstitial fluid pressure of pulp is normally 10 mm of Hg. (7,8)It is significantly elevated in inflamed pulp (9,10) . And when elevatedover 25 mm of Hg it is bound not to return to normal, due to thelow-compliance environment of the pulp. i.e. it is irreversibly(10, 11, 12)inflamed.Figure 3 Apical portion of specimen A under highermagnificationThis probe could assess the interstitial fluid pressure and pulpalamputation could be done to a level when a normal/high normalvalue of 15 mm of Hg is reached. Thus we could add ahistological dimension to the assessment of pulpal inflammatorystatus for a more precise diagnosis aiming at more predictableresults.ConclusionTo conclude, we could say that:• The present day clinical parameters might not be enough toassess the level of inflammatory involvement of the pulp• Diagnosis could be more precise and pulpotomy could be28 Dental Asia • March / April 2008

DENTALUPDATEFigure 6 Apical portion of specimen B under higher magnificationmore predictable if a histological dimension isincorporate into the diagnostic criteria.• The probable armamentarium could besphygmomanometer sensor probe to assess theinterstitial fluid pressure of pulp to assess itsinflammatory status before going ahead with pulpalamputation for a pulpotomy, which would definitely bebetter than an arbitrary excision. DAReferences1. PashleyDH.Dynamics of the pulpo-dentin complex. Crit Rev Oral Bio Med 1996;7:104-133.2. Heyeraas KJ, Jacobsen EB, Fristad I. Vascular and immunoreactive nerve fibrereactions in the pulp after stimulation and denervation . In:shimono M, maedaT,Suda H, Takahashi K, eds. dentin/pulp complex.Tokyo: Quintessence,1996;pp162-168.3. Tuener DF, Marfurt CF, Sattelburg C. Demonstration of physiological barrier betweenpulpal odontoblasts and its perturbation following routine procedures:a horseradishperoxidase tracing study in the rat. J Dent res1989; 68:1262-1268.4. Turner DF Immediate physiological response of odontoblasts.proc Finn Dent Soc1992; 88[Suppl1]:55-635. Thomas HF.The dentin-predentin Complex and its permeability: anatomical overview. J D ent Res1985; 64[special issue]:607-6126. BasleyWL, Holland GR.A quantitative analysis of the innervation of the pulp of thecat’s canine tooth. J Comp Neurol 1978; 178:487-494.7. Brannstorm M.Physio-pathological aspects of dentinal and pulpal response toirritants. In:SymonsNBB,ed. Dentine and pulp: Their structure and reactions. Dundee:DC Thomson & Co, 1968; pp231-246.8. Matthews B Vongsavan N.Interactions between neural and hydrodynamicmechanisms in dentne and pulp. Arch Oral Biol 1994;39[suppl];87s-96s.9. Heyeraas KJ, Berggreen E. Interstitial fluid pressure in normal and inflamed pulp.Crit Rev Oral Biol Med 1999; 10:328-336.10. Bishop M. Extracellular fluid movement in the pulp: the pulp/dentin permeabilitybarrier. Proc Finn Dent Soc 1992;88[suppl.1];331-336.11. Heyeraas KJ. Pulpal, microvasculature and pressure. J Dent Res1985; 64[specialissue]:585-589.12. Kim S. Regulation of pulpal blood flow.J Dent Res1985; 64[special issue]; 590-596.Dr P. R. Chockalingam is the AssistantProfessor for the Department ofPediatric and Preventive Dentistry at theTamil Nadu Government DentalCollege in Chennai, India.Dr K. U. Nallasivam is an internee atthe Tamil Nadu Government DentalCollege in Chennai, India.Dental Asia • March / April 200829

DENTALMANAGEMENTby Dr Fanny Young • Dr Ricky WongThe <strong>Impact</strong> of<strong>Human</strong> <strong>Resource</strong><strong>Management</strong> onBusiness Success ofDental PracticesThe aim of this project is to determine the associationbetween different <strong>Human</strong> <strong>Resource</strong> <strong>Management</strong>practices and business success in the dental practices inHong Kong. 200 dental practices were randomlychosen from the Dentist List. Anonymousquestionnaires containing sixteen questions were sentout to those dental practices and the number ofresponded questionnaires was 66. Based on thequestionnaires, the extent of each HRM Practice wascorrelated with the degree of business success. UsingSpearman Rank Correlation, Spearman r(s) wereranged from 0.6836 to 0.8203. In conclusion, HRMpractices were significantly correlated with businesssuccess in the dental practices in Hong Kong.In addition to be a clinician, dentists are having the role of manager in thedental practice. In his textbook on <strong>Management</strong>, Dessler (2004) stated “… it ispossible to do everything else right as a manager – lay brilliant plans, drawclear organization charts, set up modern assembly lines, and use sophisticatedaccounting controls – but still fail as a manager by hiring the wrong people or bynot motivating subordinates.” Similarly, in addition to having good clinicaltechnique and sympathetic patient care, good human resource management(HRM) skills are needed in order to ensure business success in a dental practice.Besides, nowadays dentistry is something more than giving treatments onpatients; it is also providing services to clients. These service jobs in dentalpractices require new types of “knowledge” workers, new HRM methods tomanage them, and a new focus on human capital (Moskowitz and Warwick 1996).Therefore, a study of different HRM practices and correlations among them withthe business success may identify which HRM practices may be more importantin contributing to the business success in dental practices.AimThe aim of this project is to determine the relationship between different HRM30 Dental Asia • March / April 2008

DENTALMANAGEMENTpractices and business success in the dental practices.HypothesesTraining and performance appraisal, as they are more relevant todental practices, were chosen to be the human resourcepractices to be investigated.H 1: The extent of training is related significantly to businesssuccess.H 2: The extent of performance appraisal is related significantly tobusiness success.MethodThe project was a quantitative study on dental practices using afield survey. 200 dental practices were randomly chosen from theregistered dentist list from the Hong Kong Dental Council.Anonymous questionnaires containing 20 questions were sentout to those dental practices and the number of respondedquestionnaires was 66. The questionnaires consisted of threesections, the first two sections were related to each humanresource practice to be investigated, namely, training andperformance appraisal. Based on previous studies on humanresource practices (Lussier and Pfeifer 2001; Lee andOsteryoung 2004; Rodermund 2004; Goh and Cheung 1989),the questionnaires were designed so that the summation of theresponses in each section would be the indication of the extent ofthat human resource practice in that dental practice.The last section of the questionnaires was to measure businesssuccess. Similarly, the questionnaires were designed so thatthe summation of the responses in that section would be theindication of the degree of business success in that dentalTable 1 Spearman Rank CorrelationName of points =Spearman r95% confidence interval660.6836 (No Gaussian assumptions, correctedfor ties)0.6254 to 0.7343 Figure 1 Plotting the extent of training (Q.1-Q.5 sum) of differentcompanies against their success index (summation Q.10-Q.16)Dental Asia • March / April 200831

DENTALMANAGEMENTName of points =Spearman r95% confidence intervalTable 1 Spearman Rank Correlation660.8203 (No Gaussian assumptions, correctedfor ties)0.7840 to 0.8510practice. The extent of each human resource practice was thenrelated with the business success using correlation analysis.ResultsResults showed that the two human resource practicesinvestigated were shown to have positive correlation withsuccess. Among them, training (Spearman r = 0.6836) andhuman resource planning (Spearman r = 0.6530). Statistic testshowed that r was significantly different than zero (The twotailedP value was < 0.0001, considered extremely significant).Training and SuccessTo test for H 1: the extent of training was related significantly tosuccess, the summations of the responses of items 1 to 5 ofdifferent dental practices (summation Q.1-Q.5) were correlatedwith their success indexes (summation Q.10-Q.16) usingcorrelation analysis. The results were shown on table 1.A plotting of the extent of training of different companies(summation Q.1-Q.5) against their success indexes(summation Q.10-Q.16) was shown on figure 1. Some linearrelationship between the extent of training and the successindex could be found.Performance Appraisal and SuccessTo test for H 2: the extent of performance appraisal was relatedsignificantly to success, the summations of the responses ofitems 6 to 9 of different companies (summation Q.6-Q.9) werecorrelated with their success indexes (summation Q.10-Q.16)using correlation analysis. The results were shown on table 2.A plotting of the extent of performance appraisal of differentcompanies (summation Q.6-Q.9) against their successindexes (summation Q.10-Q.16) was shown on figure 2.Some linear relationship between the extent of performanceappraisal and the success index could be found.DiscussionTraining and Business SuccessUsing correlation analysis, the summations of the responsesof items 1 to 5 of different dental practices were correlatedwith their success indexes. The Spearman Rank Correlation,Spearman r was 0.6836. The Spearman Rank Correlationwas used because it does not assume Gaussian distributionof the responses. The Spearman r showed that there was alinear relationship between the summations of the responsesof items 1 to 5 of different dental practices and the successindexes. As the summation of the responses of items 1 to 5 isan indicator of the extent of practice in training in the dentalpractice (Goh and Cheung 1989), therefore this Spearman rresult indicated that the extent of training was relatedsignificantly to business success, which was H 1.In addition, the 95% confidence interval of Spearman r was:0.6254 to 0.7343, which was much above zero.Furthermore, a plotting the extent of training of different dentalpractices against their business success indexes also showedsome linear relationship between the extent of training and thesuccess index (Figure 1).All the above analyses showed that the extent of training wasrelated significantly to business success, supporting H 1.Performance Appraisal and Business SuccessUsing correlation analysis, the summations of the responses ofitems 6 to 9 of different companies were correlated with theirsuccess indexes. The Spearman Rank Correlation, Spearman rwas 0.8203. The Spearman Rank Correlation was usedbecause it does not assume Gaussian distribution of theresponses.Figure 2 Plotting the extent of performance appraisal (summation Q.6-Q.9)of different companies against their success index (summation Q.10-Q.16)The Spearman r showed that there was a linear relationshipbetween the summations of the responses of items 6 to 9 ofdifferent dental practices and the success indexes. As thesummation of the responses of items 6 to 9 is an indicator ofAnalytical • Authoritative • AcclaimedFor more information, email: info@pabloasia.com32 Dental Asia • March / April 2008

DENTALMANAGEMENTthe extent of practice in performance appraisal in the dentalpractice (Goh and Cheung 1989), therefore this Spearman rresult indicated that the extent of performance appraisal wasrelated significantly to business success, which was H 2.In addition, the 95% confidence interval of Spearman r was:0.7840 to 0.8510, which was much above zero.Furthermore, a plotting the extent of performance appraisal ofdifferent dental practices against their success indexes alsoshowed some linear relationship between the extent ofperformance appraisal and the success index (Figure 2).All the above analyses showed that the extent of performanceappraisal was related significantly to business success,supporting H 2.It is possible that the motivation effect of performanceappraisal to employees is more consistent than training. Avariation of different training methods might cause differenteffects and this might explain the lower correlation of trainingto business success. Further studies are needed to identifywhich particular methods of these human resource practicesare more consistent and effective in bringing success. Inaddition, this study only showed the correlation, it did notprove the cause and effect relationship between HRMpractices and business success. The latter, obviously,involves a multitude of factors.ConclusionsIn conclusion, the results supported the hypotheses that theextents of training and performance appraisal were relatedsignificantly to business success of the dental practices.Among those, performance appraisal was more highlycorrelated with business success. DAReferences1. Dessler, G. (2004). <strong>Human</strong> <strong>Resource</strong> <strong>Management</strong>. New Jersey, Prentice Hall.2. Goh, P.Y. & Cheung, P.Y. (1989). Report of Hong Kong <strong>Human</strong> <strong>Resource</strong> <strong>Management</strong> PracticesSurvey. <strong>Management</strong> Development Centre of Hong Kong.3. Lee, S.S. & Osteryoung, J.S. (2004). A Comparison of Critical Success Factors for EffectiveOperations of University Business Incubators in the United States and Korea. Journal of SmallBusiness <strong>Management</strong>, 42, 418-4274. Lussier, R.N. & Pfeifer, S. (2001). A Crossnational Prediction Model for Business Success. Journalof Small Business <strong>Management</strong>, 39(3), 228-239.5. Rodermund, E.S. (2004). Pathways to successful entrepreneurship: Parenting, personality, earlyentrepreneurial competence, and interests. Journal of Vocational Behavior, 65, 498-518.Dr Fanny Young is the Assistant Professor ofBusiness Administration at the Hong Kong ShueYan UniversityDr Ricky Wong is the Associate Professor inOrthodontics, Faculty of Dentistry at theUniversity of Hong KongDental Asia • March / April 200833

PRODUCTFOCUSGlamSmile - AUnique VeneerSystem that BenefitsDentists andPatientsA new and exclusive product of Remedent,GlamSmile is the world’s first full-arch minimallyinvasive veneer delivery and placement system.Unlike traditional one-veneer-at-a-time placementmethodology, proprietary GlamSmile technologyfeatures a patent-pending tray delivery systemthat provides the opportunity and the tools forany practitioner to expertly seat 10 beautifulveneers at one time in less than one hourwithout compromising healthy tooth structure.Inventor, Dr Evelyne Jacquemyns, a renowned dental practitioner in Ghent,Belgium created GlamSmile to offer designer smiles to all of her patients, notjust the fortunate few who could afford costly porcelain veneers. A successfulcosmetic dentist for over 25 years, Dr Jacquemyns also wanted to create atime-saving, profit-generating delivery method that was easy to incorporate intoany practice, a non-technique-sensitive veneer placement system that wouldprovide excellent esthetics regardless of the practitioner’s level of skill orexperience.In collaboration with Remedent, Dr Jacquemyns embarked on years of researchculminating in the development of the unique GlamSmile Veneer Delivery Systemutilizing state-of-the-art digital scanning and CAD/CAM technology to produceindividually custom-crafted veneers fitted in a patent-pending tray for a preciselyaccurateplacement of up to 10 veneers simultaneously. Composed of pureporcelain or custom hybrid (composite/porcelain), GlamSmile veneers areextremely strong, yet ultra-thin with an inherent flexibility and luminosity.It is due to this unique tray delivery system that GlamSmile veneers can be placedfar faster and therefore far less expensively than traditional veneers. This presentsan almost unlimited income generating opportunity for practitioners and createsthe first non-invasive, low-cost cosmetic veneer solution for the estimated 50% ofAmericans who are unhappy with their smiles (AACD, 2004).34 Dental Asia • March / April 2008

PRODUCTFOCUSRemarkably, the whole GlamSmile process requires only twoshort patient visits. The first consists of taking “before”photographs and impressions and the second is for seating oneor both arches of up to 10 veneers per arch as well as “after”photographs. This significant reduction in chairtime andmaterial cost, coupled with the proven technique component ofthe delivery system directly impacts the consumer price pointmaking it attractively affordable and therefore very desirable toalmost every patient.In fact, compared to traditional veneers ranging in price fromUS$1,000 to US$2,000 per tooth, GlamSmile patients pay onlyslightly more for 10 veneers. The suggested retail price to thepatient is only US$3,500. Based on average practice statisticsprovided by the American Dental Association (ADA), the pretaxnet income (after overhead) per GlamSmile arch would bemore than US$1,500 — an impressive return for an hour or twobehind the chair.However, the GlamSmile procedure is not simply a profitgenerating service nor just a low cost alternative to traditionalveneers — indeed, it is also a healthier, more patient-friendlycosmetic solution as well. It is of great significance that theGlamSmile process suggests only a minimal enamelplasty ofthe healthy tooth surface. In addition, no anesthesia is neededbecause there is no pain or healing time associated with theprocedure.In support of affordable smile design solutions, recent researchconducted by Dr Anne Beall, social psychologist and marketresearch pro, on behalf of the American Academy of CosmeticDentistry (AACD) indicates that an “improved smile makespeople appear more interesting, intelligent, wealthy andsuccessful to other people”. Prior AACD (2004) research andstatistics also revealed that Americans place a high value ontheir smiles: 74% of adults feel an unattractive smile can affectcareer success while 99.7% believe that overall a good smile isan important social asset.This information probably comes as no surprise to dentalprofessionals. What is surprising and unfortunate is most dentalpatients interested in changing elements of their smile don’teven ask about the procedures available because they assumethe cost will be prohibitive. Until now, they were correct.At the placement visit, begin by cleaning the teeth with pumice and aprophy brushThe tooth surfaces are minimally altered with a long Komet bur (blackring). It is imperative that this is done systematically using light pressure.Upon completion, the appearance of the surface of the teeth should be likethat of an ice skating rink.Separate the teeth that are not involved with the treatment usinginterdental strips.In fact, results from a national survey of 9,000 dentists revealedthat of those patients who received consultations for cosmeticprocedures such as veneers, more than one-third consideredthe cost of the treatment to be the largest obstacle toovercome! (AACD, 2004) With half of the US populationdispleased with their current smile, this survey revealed that amere 3.6% of the participating practice’s patients elected topurchase veneers as a cosmetic solution. Doctors in the surveydisclosed that concern about cost was the most significantdeterrent to patients considering traditional veneers.With those statistics in mind, GlamSmile veneers are a viablesolution for both practitioners and patients. This technologicalEtch the teeth systematically with 37% phosphoric acid starting at theposterior right and ending at posterior left. In a likewise direction,thoroughly rinse the teeth.36 Dental Asia • March / April 2008

PRODUCTFOCUSadvancement makes it possible for dentists everywhere to offera cosmetic solution that is easy, technique-proven, noninvasive,extremely profitable and for the first time ever,affordable for the majority of their patients. GlamSmile offerspractitioners the opportunity to transform their patients’ lives aswell as their practice’s profitability.“It is easy, quick and patients love it. For a lot of people anddentists, it’s going to bring the joy back to dentistry!”-GeraldBittner, DDS, AACD San Jose, California.Leaving the teeth surfaces wet, use a wet bonding technique an apply alayer of bonding agent (Primer One Step Plus by Bisco) on each toothLight cure each tooth with a high-powered plasma light (Remecure fromRemedent) for 3 seconds. After curing the surface has a shiny look.Step-by-Step ProcedureFirst Visit1. Case SelectionGlamSmile addresses a myriad of patient’s cosmetic concernsincluding but not limited to:Tetracycline stainsFluorosisMild orthodontic correctionsAlignmentMicrodont teethPermanent whiteningThere are only three qualifying conditions for patients to beconsidered candidates for GlamSmile veneers. The patient’steeth must be healthy, his gums must be healthy and there canbe no missing teeth in the treatment/aesthetic area. Theexistences of bruxism or occlusal contacts are not disqualifyingcharacteristics.2. PhotographyPhotographic images play an important role in the designprocess. “Before” images provide a wealth of information to theGlamSmile laboratory artisans regarding to the aestheticcharacteristics of the patient’s face and existing smile. Sixphotographs are taken at various angles, with and withoutretractors, including one holding a shade guide between theupper and lower arch. Similar photographs will be taken againafter the procedure is complete as a comparison to the “before”photograph.Remove the interdental strips. Open the interdental connections usingdental floss3. ImpressionsAccurate impressions are created of both the upper and lowerarch utilizing precise GlamSmile techniques even if only onearch of GlamSmile veneers is being designed for the patient. Abite registration is mandatory. Impressions are created utilizingproven GlamSmile techniques critical to the proper fabricationof the precision tray delivery system.Second Visit1. Begin With PumiceAt the placement visit, begin by cleaning the teeth with pumiceand a prophy brush.Apply a layer of bonding agent on the inside of the veneers2. Light EnamelplastyThe tooth surfaces are minimally altered with a long Kometbur (black ring). It is imperative that this is donesystematically using light pressure. Upon completion, theDental Asia • March / April 200837

PRODUCTFOCUSappearance of the surface of the teeth should be like that ofan ice skating rink.3. Place Dental StripsSeparate the teeth that are not involved with the treatmentusing interdental strips.4. EtchEtch the teeth systematically with 37% phosphoric acid startingat the posterior right and ending at posterior left. In a likewisedirection, thoroughly rinse the teeth.5. Apply Bond — Leave Tooth Surface WetLeaving the teeth surfaces wet, use a wet bonding techniqueand apply a layer of bonding agent (Primer One Step Plus byBisco) on each tooth.6. Light CureLight cure each tooth with a high-powered plasma light(Remecure from Remedent) for 3 seconds. After curing thesurface has a shiny look.7. Open Interdental ConnectionsThe GlamSmile procedure is notsimply a profit generating servicenor just a low cost alternative totraditional veneers—indeed, it isalso a healthier, more patientfriendlycosmetic solution as wellRemove the interdental strips. Open the interdentalconnections using dental floss.8. Apply BondApply a layer of bonding agent on the inside of the veneers(Primer One Step Plus by Bisco again).9. Light CureLight cure each veneer for 3 seconds using the high-poweredLight cure each veneer for 3 seconds using the high powered plasma lightfrom Remedent (Remecure)A thick layer of light curing luting cement added (Variolink II by IvoclarVivadent) on the inside of the veneers away from bright ambient lightThe GlamSmile fabricated veneer deliver tray is carefully positioned in frontof each toothGlamSmile veneer delivery tray smoothly installed onto the teeth usingcontinuous even pressure38 Dental Asia • March / April 2008

PRODUCTFOCUSCleaning up of excess luting cement on thegingiva part and applying light pressure onveneer to secure gingival adaptationUse of curing light to create jelly state of luting cement,making it easier to removeTray removed evenly and bilaterally bypulling downwardsCleaning up and removing excess cementfrom the palatial side. Easily open up theinterproximal spaces with an interproximalsaw.The veneers have retention tabs put on by the lab ensuringproper tray placement, which could be removed with a diamondbur. Once done, this would be followed by a final light cure.A happy smile with 10 veneers in less thanone hour!Remecure plasma light from Remedent.10. Luting CementAdd a thick layer of light curing luting cement (Variolink II byIvoclar Vivadent) on the inside of the veneers – careful to dothis away from bright ambient light.11. Position Delivery Tray of 10 VeneersCarefully position the GlamSmile fabricated veneer deliverytray exactly in front of each tooth.12. Install Delivery Tray of 10 VeneersInstall the GlamSmile veneer delivery tray with a smoothmovement onto the teeth using continuous even pressure(light pressure is all it needs). Verify the flow of the lutingcement.13. Remove Excess CementClean up the excess luting cement on the gingiva with a brushand then give light pressure with an instrument on the gingivalpart of each veneer securing the gingival adaptation. If no moreluting cement is coming out after pressure, the veneer isperfectly seated.14. Light CureProceed with a swift sweep of the curing light – creating a jellystate of the luting cement that makes it easier to remove.Remove the excess cement with an explorer. Then curethrough the tray for 3 seconds per tooth (the tray has beencreated to allow maximum penetration of the light). Only curethe buccal and facial sides.15. Remove Veneer Delivery TrayRemove the tray by evenly and bilaterally pulling downward.Do not twist the tray. The resistance is similar to the removal ofan Impregum impression.16. Open Interproximal SpacesAt this stage, clean up as much as possible, removing excesscement from the palatal side. Easily open up the interproximalspaces with an interproximal saw. Protect the gingiva of thepatient.17. Remove The Retention Tabs And FinishThe veneers have retention tabs put on by the GlamSmile labensuring proper tray placement. Remove the retention tabswith a diamond bur – and finish with a paper disc making surenot to touch the incisal edge. Follow with a final light cure (3seconds palatal/ lingual and 3 seconds buccal/facial) for eachveneer. Check occlusion and adjust if necessary. Finish withpolishing materials and instruments18. Finished In Less Than One HourDone — a happy smile — 10-veneers in less than one hour!DADental Asia • March / April 200839

USERREPORTThe TissuecareConceptImportant factors for long-term stability ofhard and soft tissueLong-term hard and soft tissue stability forms the basis for perfect red-whiteesthetics. And at the same time it poses a major problem for implanttherapy. Sooner or later in many cases a dish-shaped depression forms inthe bone around the implant. The overlying soft tissue follows the hardtissue – forming unsightly gingival retractions. Even though the bone is resorbedby only a few millimeters, it is precisely these millimeters that make the differencebetween success or failure of an implantology procedure for patients with lowbone volume to start with, thin gingiva or particularly high esthetic requirements.Prosthetic complications can be repaired – but the situation is different forcomplications with hard or soft tissue. Such cases are where it is particularlyimportant to be able to be sure of the long-term stability of hard and soft tissue.And to be able to trust that the significant factors will form a harmonious wholewith the selected implant system to work towards the common goal: tissuestability. A wide range of implant systems are available to implantologists today.They all have one thing in common: they all claim to be the best.But what must the dentist look for when selecting the implant system? And whatare the important factors that must work together to provide real tissue stability?An important initial point to consider is the implant-abutment connection.Micromovements between the implant and abutment may irritate the surroundingtissues, resulting in bone resorption around the shoulder of the implant. The firstrequirement for an implant system for esthetically critical cases is therefore to forma mechanically stable and bacteria-proof connection between the implant and theabutment that has no micro-movement. Some implant systems achieve this byusing an internal friction-locked and keyed tapered connection. This connectionforms a virtual single-component implant, which ensures tissue stability andprosthetic reliability from the start.Implant patients are becoming younger. This means that implants are undermechanical loading for much longer. Prosthetic complications such as screws orabutments coming loose are more likely. But nothing can move in a friction-lockedand keyed implant – and nothing can come loose. This gives the implantologistnot only prosthetic reliability but also advantages with the prosthetic restorationbecause of the virtual one-piece system. The solid implant-abutment connectionalso allows transgingival healing without esthetic compromise and with optimumsoft-tissue regeneration.An implant with a fixed connection does not have it: The microgap. A microgapbetween implant and abutment allows bacterial colonization. Chewing loads causerelative movement between the implant and abutment, resulting in a pumpingeffect. The resulting distribution of endotoxins cause infection in the tissue at the40 Dental Asia • March / April 2008

USERREPORTWe have already noted two factors. But micromovement andmicrogaps are not the only enemies of stable tissue. Possiblenegative effects of the implant-abutment transition are alsoreduced by moving this connection away from the peri-implanttissue to prevent any irritation. This is done by displacing theimplant-abutment connection to the center by using anabutment with a smaller diameter than that of the implant. Thisdisplaces the biological width from the vertical to the horizontalplane. This procedure is referred to as platform switching.Platform switching is an important factor in tissue stability – butonly in combination with a connection design that preventsmicromovement and is bacteria-proof, which we call platformshifting ® .Figure 1 (left) X-ray image of the Ankylos implant-abutment connectionbefore starting the test (x-ray image: Holger Zipprich/Dr. Paul Weigl,Frankfurt am Main/Germany)Figure 2 (right) X-ray image of the Ankylos implant-abutment connectionafter 1,000,000 load cycles (x-ray image: Holger Zipprich/Dr. Paul Weigl,Frankfurt am Main/Germany)A bacteria-proof friction-locked and keyedconnection is only possible with the taperedconnection completely flushinterface level. Thebone responds withresorption below theimplant-abutmentconnection until thebiological width hasbecome established.The potential forinfection is reducedwithout the microgap– and in combinationwith no micromovementit iscompletelyeliminated. Withoutmicrobial leakage ofthe implant lumenthere is no microbialcolonization andwithout endotoxinsno potential forinfection. For these reasons when dealing with cases with lowbone volume, thin gingiva or particularly high esthetic demandsthe implantologist must look for connection that is as bacteriaproofas possible and with as little gap as possible whenselecting the implant system. This will keep the hard and softtissue stable.The smaller abutment also provides more space for periimplantsoft tissue and as a result improves the red esthetics.However, red esthetics alone is generally not sufficient,particularly for the esthetically sensitive front-tooth region.This is the area where the patient wants perfect whiteesthetics, a tooth that appears as if nothing had everhappened. The emergence profile is the key in this case. Theformation of a natural emergence profile often requiredsubcrestal placement of the implant to take full advantage ofplatform shifting. However, for implants with a connection thatallows micro-movements and a microgap this is a real“implant killer.”The bone will remain stable in spite of subcrestal placement ofthe implant only if there is absolutely no irritation, which meansa bacteria-proof and rigid connection design that alsoeliminates irritation by using platform switching. This results ina natural emergence profile that also leaves additional spacefor stable, thick soft tissue over the implant shoulder. It is clearthat this is not required in every case.Even if there are implant systems that can be placedsubcrestally, bone deposition above the connection level wasformerly not considered feasible because the microroughnessof the implant surface always ended below the implantshoulder. Implant concepts that make use of tissue depositionin the shoulder region of the implant simply extend thegrowth-activating implant surface over the shoulder regionof the implant.What happens then is demonstrated by the most recentstudies. Bone and connective tissue cells adhere to and spreadfaster and more extensively on a microroughened implantshoulder than on a machined surface. In combination withplatform switching, subcrestal placement and a connectiondesign that eliminates micromovements bone can even growon the horizontal shoulder surface and on the abutment. Thissupports the overlying soft tissue and gives patients longtermstability of esthetic results.Analytical • Authoritative • AcclaimedFor more information, email: info@pabloasia.comDental Asia • March / April 200841

USERREPORTPlatform switching is an important factor in tissue stability in itsinteraction with a stable, bacteria-proof connection design (x-ray image:Dr. Nigel Saynor, Stockport/UK)Deposition of bone tissue on the face of the implant by subcrestalplacement (histology: Dr. Dietmar Weng, Starnberg/Germany)SummaryLong-term bone stability and healthy soft tissue can beestablished by taking the following five factors into accountwhen selecting an implant system:1. No Micro-movement2. Bacteria-proof connection3. Platform switching4. Optional Subcrestal Placement5. Micro-roughness to the InterfaceYou as an implantologist know better than any company howimportant this is to patients with low bone volume, thin gingivaand high esthetic demands. And one thing is certain: only longtermtissue stability is genuine tissue stability, or as it is calledby DENTSPLY Friadent: TissueCare. DAIn a radiographic and histological animal study the implant shoulders wereplaced 1.5 mm below the bone margin in accordance with an estheticindication in the front-tooth region to simulate the low position of theimplant-abutment connection in the region of thebone support of the papillae.Standardized x-ray images were taken at monthly intervals. In addition toother results the peri-implant bone margin around the tapered connectionremained significantly higher over the six months of the study (top row)than with a blunt abutment connection with an external hexagon (bottomrow). (x-ray images: Dr. Dietmar Weng, Starnberg/Germany)42 Dental Asia • March / April 2008

USERREPORTby Rob LynockThe PerfectAesthetics′ FirstChoiceWhen faced with any aesthetically challengingsituation one of the first considerations is whichrestorative material to employ.In the past, all ceramic restorations haveoften been dismissed due to their lack ofstrength or maybe their disability tomask dark underlying colours. With thearrival of IPS e.max, all ceramicrestorations using this system can nowbecome our first consideration. It onlyremains for us to choose which of the fiveindividual components of the IPS e.maxsystem to use.Figure 1 Pre-operative viewIt is clear that our international marketrequires much more from restorativematerials than the promise of beautifulaesthetics. IPS e.max is one system tosatisfy all our requirements.With the case being presented it was arelatively straightforward selection to useIPS e.max press. The only possiblecomplication may have been an existingmetal post and core. Should this not havebeen able to be replaced with Cosmo postthen the IPS e.max Press HO (high opacity)ingot would have been selected. It isadvisable to select the HO ingot for bothcentral crowns as it is far easier to buildcolour equally from a uniform backgroundrather than attempting to match colour fromdifferent ingot bases.The shade of the prepared toothcorresponds to the shade ND 2 (Natural DieMaterial No. 2). With the desired shade ofthe final restorations being A2 theFigure 2 Shade determination of theprepared tooth with the natural diematerial shade guideFigure 3 Waxing around zirconia post,importantly the pressing is extended intothe coronal area44 Dental Asia • March / April 2008

USERREPORTFigure 4 Waxing to full contourFigure 5 1 IPS e.max Press copings once the reaction layer is removed, displaysuperb integrity of fitFigure 6 The sprinkle technique produces an even mechanical foundationlayerFigure 7 Wash firing using a combination of shade and incisal pastesFigure 8 One part Occlusal Dentine orange, two parts dentine used at thecervical margin and interproximal areasFigure 9 Dentine layering using allround liquidFigure 10 Incisal table completed intermittently with Opal Effect 3 and thedistal perimeters with Opal Effect 1Figure 11 Opal Effect 5 is placed as a contrastDental Asia • March / April 200845

USERREPORTbackground natural die colour can be virtually dismissed in thiscase, as it will only complement the final shade match.Figure 12 IPS e.max Ceram Essence material layered within theincisal thirdThe wax frameworks are produced on the master modelensuring there is enough support for subsequent layering ofIPS e.max Ceram. It is worth mentioning that there may be asimilarity drawn between IPS e.max Press and its predecessorIPS Empress 2. However, whilst they are both essentiallylithium disilicate glass ceramic, that is where the likeness ends.IPS e.max Press, due to its unique manufacturing process,offers a flexural strength of 400 MPa, the highest strengthavailable in a pressed ceramic ingot. Also the light handlingqualities of this new glass ceramic are greatly improved. Infact,the ingot colours available truly complement its layeringceramic IPS e.max Ceram in such a way that shade matchingis easily achieved.For this case the IPS e.max Press MO 1 (medium opacity)ingot was chosen and after investing and burn out procedures,pressed using the EP 600 Combi press furnace. After pressing,careful sandblasting and removal of the reaction layer, the unitsshow their typical integrity of fit. It is so pleasing to achievesuch accuracy with so little effort.Figure 13 IPS e.max Ceram – first firingFigure 6 shows the foundation firing using what is now referredto as the sprinkle technique. This is performed by lightlyapplying the IPS e.max Ceram glaze liquid to the surface of thepressing, then sprinkling neutral enamel powder over the entireunit and tapping away the excess. Take care not to over-loadthe glaze liquid as this can lead to the powder congealing onthe surface, resulting in a poor bond.Figure 7 illustrates the characterisation layer. In this instancethe body of the units were enhanced with IPS e.max Ceramshade whilst mesial and distal aspects were modified with theincisal shade material. The incisal shade material would onlybe used in this manner when the press frameworks are slightlyoversized.Fig 14 Enamel screen edition using one part Opal Effect 1, one partTranspa Incisal 1Fig 15 Completed restorationsOnce these initial firings are complete, we can commence withthe layering of IPS e.max Ceram. The low fusing nanofluorapatite glass-ceramic follows the Ivoclar Vivadent shadeconcept and enables the user to construct highly aestheticrestorations on whichever chosen IPS e.max framework. Theinitial layering as shown in Figure 8 is two parts A3 dentinemodified with one part occlusal dentine orange. <strong>Its</strong> purpose isto block light in the interproximal areas.The IPS e.max Ceram Modelling Liquid Allround has been usedduring build up as this is perfect for enabling precise layering ofinternal colours. A combination of Opal Effect powders 1,3 and5 are laterally segmented across the labial surface and asillustrated in Figure 12 flecks of essence colour can be layereddirectly into the unfired ceramic. The IPS e.max CeramEssence powders are intensively coloured and if layered asshown should be used in very small quantities.The fired ceramic exhibits a uniform shrinkage. The final46 Dental Asia • March / April 2008

USERREPORT1618layering consists of one part Transpa Incisal to one part Opal Effect1. In order to produce a higher surface lustre the restorations areglazed and then polished with fine synthetic pumice.I would like to thank Sat Kelley for the surgical work.DA17Figures 16 to 18 Restorations 2 weeks after fittingRobert Lynock is Ivoclar Vivadent’s ProductSpecialist in fixed materials. Prior to joiningIvoclar, he was a dental ceramist with DSD,giving lectures and teaching across UK, Far Eastand Europe. He has been working closely with agroup of clinicians on selected referral cases tobe used in tuition and publications.Dental Asia • March / April 200847

USERREPORTby Drs Steffen Kistler • Georg Bayer • Frank KistlerThe Beauty ofTutogen MembraneImplantWithout the use of membranes in bone tissue regenerationduring the last 20 years, the advance in oral implantologywould not have been possible. The introduction ofresorbable membranes has facilitated the surgical handlingand significantly reduced the risk of complication in suchprocedures.Figure 1 Case 1 – situation prior to implantation,with temporary crownThe Tutodent ® membrane, already used in orthopaedic surgery for a longtime, became available in the dental sector in the year 2000. Thismembrane, based on bovine pericardium, is manufactured by theTutoplast ® process, which differs in certain aspects from the othermanufacturing processes commonly used nowadays. This process maintains theextracellular matrix of the connective and supporting tissues, which alters theproperties of the membrane in comparison with other products, without affectingits safety with respect to pathogen transmission and antigenic reaction.The membrane has been used in our practice since 2000, in all areas of bone andsoft tissue regeneration; the main application is in bone augmentation before orduring implantation. For the user, the first feature that distinguishes the Tutodent ®membrane from other similar products is its availability in different sizes, includingmembranes with large surface areas, so that extensive defects can also besecurely covered with a single membrane.Figure 2 During operation, without temporarycrown, tissue defect easily recognisableThe surgical handling of the Tutodent ® membrane is not significantly different fromthe other collagen-based membranes on offer; it is resistant to tearing, has tensilestrength and is very adaptable when moist. In our practice, when used to coverbone reconstruction material, the membrane is usually fixed with nails asrecommended by the manufacturer. This brings a further advantage of themembrane into play: its somewhat coarse consistency also prevents too-rapidrestructuring of thematerial even whenit is in tension –something that isknown to reduceconsiderably thedegradation time ofa resorbablemembrane.Figure 3 Creation of the implant bedWe often use themembrane indouble thickness,taking advantage ofFigure 4 Insertion of a root-form implant48 Dental Asia • March / April 2008

USERREPORTFigure 5 Preparation of a vestibular mucosal pocketFigure 6 Double layer of Tutodent ® membraneFigure 7 Insertion of the membrane into the mucosal pocketFigure 8 Open healing after closure with suturesFigure 9 The patient’s lips and teeth with finished restorationFigure 10 Finished restoration 11 and 21 with harmonised soft tissueline 1 year post-opFigures 11 (left) & 12 Covering the site of bone resection in the chin with large Tutodent ® membrane50 Dental Asia • March / April 2008

USERREPORTthe fact that, depending on the healing process andrestructuring, the membrane volume will be almost completelyconverted into connective tissue. We therefore deliberately usethe membrane to increase the connective tissue around theincisors and canines and in this way can even spare the patientthe necessity of a connective tissue transplant and the secondoperation this would require. Since 2000, some 800 surgicalprocedures have been carried out in our practice using thisproduct. In comparison with other biodegradable or resorbablemembranes, no increased risk of complication has beendemonstrated. The membrane does not carry an increased riskof exacerbation with wound dehiscence and the stability of themembrane even in contact with saliva is so good that, as arule, there is no premature exposure of the augmentation –something that would severely limit the success of treatment.Below, we describe brief examples of the membrane’s use inpractice.Case 1: a 36-year old female patient for whom an electiveimplantation was planned following the traumatic loss of 21; aclearly visible soft-tissue deficit also had to be evened out(figures 1-2). After demonstration of the alveolar bone using aminimally invasive incision technique without release-incision, aroot-form implant 5.5 mm in diameter was inserted (figures 3-5). To even out the soft tissue deficit on the vestibular aspect, amucosal pocket was prepared by periosteal slit. A double layerof Tutodent ® membrane was then inserted into this pocket toincrease the volume (figures 6-7). Open healing was selectedin this case, i.e. a 5 mm healing cap was placed on the implantand the wound closed with resorbable sutures (figure 8). Evenimmediately after the operation, the increased vestibularvolume could be seen. The picture taken of the final restorationabout one year post-op. shows a harmonised gingival profilewithout soft tissue loss, making this case definitely a medicalas well as an aesthetic success (figures 9-10).The membrane does not carryan increased risk ofexacerbation with wounddehiscence and the stability ofthe membrane even in contactwith saliva is so good that, as arule, there is no prematureexposure of the augmentationFigure 13 Palatal fixation of a Tutodent ® membrane beforeaugmentation around the upper incisors and caninesFigures 11-15 show how the flexibility and surfacecharacteristics of the Tutodent ® membrane greatly facilitate itsuse in covering larger defects. The natural roughness of thesurface allows rapid tissue integration through adhesion. DADr Steffen Kistler graduated from FU Berlin andLMU Muenchen. Germany, where he was thesenior physician at the latter’s ZMK Clinic. Hismain focus is on prosthodontics andimplantology.Dr Georg Bayer graduated from FU Berlin,Germany and specializes in implantology. Hewas the VP of DGOI and an active member ofDGZI. He has written for numerous internationalpublications and also given lecturesinternationally.Dr Frank Kistler specializes in implantology andis an active member of DGZI and a Diplomate ofICOI. He has been giving lectures internationallyand written for numerous internationalpublications.Figures 14 (top) & 15 Occlusal and frontal views – largecovering of bone reconstruction around the incisors and caninesDental Asia • March / April 200851

EXHIBITIONPREVIEWby Desmond TeoIDEM 2008 Promises MorePunchGlobal economy, especially Asia’s, is chugging along at full speed last year andalthough there’s a shadow of anticipated recession for the United Stateseconomy looming large this year, Asian economies do not seem to be undulyperturbed. Ditto the dental industry in Asia albeit everyone iscautiously optimistic.Iorganizer is confident that IDEM this year will have that ‘X’DEM — back for the fifth time — is riding on the crest of astrong performing Asia economy and the show hasexpanded by at least 30 percent this time round. Theand ‘feel good’ factors to make the show a resounding success.According to Mr Oliver P. Kuhrt, Executive Vice President ofkoelnmesse, IDEM will build on its “winning concept” by havinga bigger floor space and more first time exhibitors. IDEM 2008is 35% bigger in floor space than the last’s. As at press time,340 exhibitors from 35 countries have already confirmed theirparticipation for the show.More than 5,600 trade visitors attended the last IDEM and weare likely to see about the same number of attendees, if notmore. A high number of foreign dental practitioners would beexpected because of the high quality scientific program beingput together by Singapore Dental Association (SDA) in cooperationwith FDI and the World Dental Education Society inSingapore. The conference, titled “Scientific Basis of ClinicalPractice”, will once again feature world-renowned researchersand speakers. Rated by experts as “top rank” and “hard tosurpass”, the speakers come from a wide range of fields andcountries: Prof Steven Offenbacher, Prof Edward J. Swift, DrStephen Chen and Prof Lisa Heitz-Mayfield, Profs Daniel Buserand Hans-Peter Weber, Prof Shimon Friedman, Dr MichaelMartin, Prof Gregory King, Assoc Prof Patrick Tseng, etc, willgive an outlook on dentistry covering topics like Endodontics,Periodontal Disease, Orthodontics and Implants.the first time. In addition, companies from Argentina, Taiwan,Brazil, Germany, Switzerland, USA and Korea will also be onhand with joint stands. Germany will once again provide thelargest group of exhibitors this year (54 exhibitors).Germany’s Federal Ministry of Economy and Technology, underthe leadership of Federal Minister Michael Glos, has once againsingled out IDEM as an ideal platform for German dentalcompanies in South-east Asia and will be sponsoring groupappearances from within the German dental industry, withexhibitors receiving a contribution toward the stand costs.All said and done, and every detail being attended to, IDEM2008, with all its cylinders firing and engine raving, is raring togo. We also can’t wait for it to begin. DAIn addition, special workshops and seminars are planned fordental assistants, while practical exercises round off theprogram.IDEM 2008 will feature joint stands and pavilions from countriesaround the globe. France will be present with a joint stand forVisitors can look forward to the latest and more high quality exhibits atIDEM 200852 Dental Asia • March / April 2008

EXHIBITIONPREVIEW“IDEM Will Be More Focused!”Dental Asia have the opportunity of an exclusive interview with Mr Oliver P. Kuhrt,Executive Vice President of koelnmesse GmbH, on his thoughts and the challengesfacing IDEM 2008. Excerpts.Dental Asia (DA): How different will IDEM 2008 be from thelast fair?Oliver Kuhrt (OK): After the positive impact of IDEM 2006 wedid not change the winning concept, which calls for having aconference and exhibition on one floor at Suntec. Therefore,IDEM 2008 will once again be much bigger. We have alsoupdated the list of product categories, so that the visitors willfind it easier than ever before to find the products they areinterested in — in this way, IDEM is also more focused thanbefore.DA: IDEM is now in its 5th edition. Can you give a progressreport on the fair since its inception in 2000?OK: The event has grown by more than 100 percent during theperiod in which the last four fairs took place. <strong>Its</strong> exhibitionspace and number of exhibitors has more than doubled — from168 exhibitors (in 2000) to more than 340 (in 2008), and fromapproximately 4,000 m 2 of exhibition space (2000) to 10,000 m 2(2008). We have steadily expanded the supporting programme,making the fair an important fixture in the trade fair calendars ofexhibitors worldwide and of dental professionals from theregion. New features were: CDE credits for dentists taking partin the Scientific Conference, the Dental Innovations Forum(Speakers’ Corner), and the Consumer Exhibition with freePublic Dental Screening in the foyer of the Suntec Venue.DA: How do you think IDEM will evolve in the future?OK: In view of the positive development since the first edition ofIDEM, we are confident that the trade fair will continue tosteadily evolve. In 2009 especially, the FDI Congress inSingapore will give new momentum to Singapore as a dentalbusiness hub. The numbers of exhibitors and visitors willincrease, which will make IDEM Singapore even more attractiveas a trade show, congress, and business platformplatform for theAsia Pacific region.DA: Every two years we will face the same problem whenIDEM is held, namely the event’s close proximity withAPDC. Is there any chance that IDEM and APDC mightwork together to organize a “super” dental exhibitioninstead?OK: Though we are open to discussing any type of sensiblecooperation that could benefit our customers, there may besome issues with this specific case. IDEM has been held inSingapore since the year 2000, and we believe that connectinga high-qualityevent like IDEMwith a high-qualitylocation likeSingapore hasbeen part of thesuccess IDEM hasenjoyed. APDC isheld at a differentlocation everyyear, organized bythe respectivenational/localdentalassociations. Thisis a very differentapproach, aimedat giving localdentalMr Oliver P. Kuhrt, Executive Vice President ofKoelnmesse GmbHcommunities access to international dental technology andequipment, as well as knowledge via the conference attachedto APDC.DA: Without revealing too much, what are the chances ofIDEM remaining at Suntec City in 2010, especiallyconsidering the completion of the integrated resort and itsnew convention facilities nearby?OK: We have not decided about the venue for IDEM 2010. BothSuntec and the upcoming Integrated Resort would be possiblevenues, and both have their very distinct advantages, with theIR being a new and exciting venue, and Suntec having hostedIDEM since its inception in 2000. We will further assess thesituation and decide in due course. The outcome of the race isabsolutely open, you could say.DA: Have you got any other comments for IDEM 2008 or topotential visitors to the show?OK: We recommend that all dental professionals should visitIDEM and form their own impressions of the event — andespecially that they should be sure to use IDEM to learn aboutthe latest developments in the dental industry and to share theirpoints of view with friends and colleagues. In addition, everyvisitor who registers in advance online is entitled to freeadmission to the IDEM exhibition and a complimentary tradefair catalogue. We hope you’ll accept our invitation!54 Dental Asia • March / April 2008

EXHIBITIONPREVIEWIDEM Products at a Glance...The followings are selected products that are making their presence at IDEM 2008 inSingapore. So, drop by their booths because seeing is believing:Bego (Booth #F10)New from BEGO Implant Systems is the modular metal traydesign for the two implant systems Semados® S and RI. Forbetter user guidance and easier handling, the number of toolshas been considerably reduced and rearranged in a moreergonomic fashion. Color codings, as well as clear andunambiguous inscriptions, minimize errors in tool selection andusage. The high-quality container with reusable filter allowsusers to store the sterilized cassette for up to 6 months. As forDenMit Trading (Booth #B27)Owandy’s Krystal-X range of sensors offer an unparalleled allpurposesolution that could effectively be used horizontally orvertically. It can obtain digitalresolutions in two sizes — 600mm 2 or 816 mm 2 . It also has avery high quality x-ray image ofCCD matrix — 26.3 lp/mm —where the clarity and sharpness isunsurpassed. The Krystal-X is fullyintegrated with QuickVision softwareand its portability and mobility give it an edgewhen moving from one surgery to another. It also reduced theamount of radiation exposure to patients and dentists.Dentsply (Booth #B4)Propex® II Apex Locator of Dentsply features anew generation full color visual display for improvedtracking of the files. It is a modern apex locatorbased on innovative electronic technologies and longterm expertise in field of endodontics. The latestmulti-frequency technology incorporated into this 5thgeneration apex locator and an extended apical zoomfunction, which activates when the file reaches theapical area, assisting the dentist to locate the apexin most types of root canal conditions.drilling tools, BEGO ImplantSystems continues to rely on thehigh-performance instruments madein Germany. With the new surgicalkit, the steadily growing usercommunity of BEGO Semados®implants always has a ready-to-usesystem on hand.The Owandy I-Max Plus is an improvedversion of I-Max Easy. Dentists will havegreater diagnoses precision using theQuickVision software. The I-Max Plus issupplied with a compact flash card thatcan be used to store images without a PCconnection. It can be used a standaloneunit or be connected to a bigger networkinstallation. Radiation dosage issignificantly reduced, thanks to moresensitive digital sensor technology beingemployed. The I-Max Plus comes with 16 programs thatinclude Ceph.It has been designed with consideration of practicalneeds of the dentists. The clearly laid out, fullscreencolor display offers a new LCD display tofacilitate the access to the exact file position. Aprogressive audio signal has been combined with thescreen information for use in blind conditions. <strong>Its</strong>ergonomic design makes the operation of thedevice easy and convenient.OPMI ProergoPropex® II apex locator has a small footprint andoperates on a rechargeable battery, so it can bemoved between dental surgeries with ease. Thewireless feature makes it extremely user-friendlyand offers the most modern multi-frequencytechnology.Analytical • Authoritative • AcclaimedFor more information, email: info@pabloasia.com56 Dental Asia • March / April 2008

EXHIBITIONPREVIEWDr Jean Bausch (Booth #E20)Bausch Arti-Scan CAD/CAM Spray byDr Jean Bausch is a newly developedsmooth and precise Scan Spray to use onplaster models. It forms a fine layer whichshields from reflections.It can be used for almost all CAD/CAMsystems and supports an optimal image quality. <strong>Its</strong> advantagesinclude micro-pulverised, thin spraying film, accurate and easyadministration, easy removal with water- or stream-jet, etc.Dürr Dental (Booth #G13)The new Dürr VC 45 ensuresreliable suction for oralsurgery and precise removalof larger amounts of blood ortissue. <strong>Its</strong> light and portabletable-top size provides exactlythe right dimensions for thesurgery. It is adjustable withup to 910 mbar of vacuumpressure if required — for up to four hours non-stop operationand with protection against excessive suction.‘VistaProof’ is a fluorescence camera capable of detecting cariesquickly and reliably. It distinctly shows caries attack, even infissures and on occluded surfaces where hard to be detected withthe naked eye or on X-ray photos. It’s the first caries diagnosissystem from Dürr Dental based on the fluorescence principle.GC Asia (Booth #B08)G-Coat Plus by GC Asiaenhances both the strength andvisual aspects of restorationswith a simple stroke of brush. Itis the first single dispersionnano-filled self-adhesive lightcured laminate that can be usedwith glass ionomer, compositeresin and temporary restorations.The infiltration of G-Coat Plusgives internal protection to restorations against cracks and voidsfor increased fracture toughness.G-CEM is a new generation of universal self-etch luting cementcombining the latest innovations from self-etch resin and glassionomer technologies. <strong>Its</strong> advanced formulation offers thesimplicity of one step cementation for luting metal and PFMcrowns, bridges and posts; composite inlays and onlays, and ascementation of high strength all-ceramic crowns, inlays andonlays, as well as medium strength press ceramics and insurgerymilled ceramics.Dental Asia • March / April 200857

EXHIBITIONPREVIEWGebr. Brasseler (Booth #E23)The ZR abrasives developed by Gebr. Brasseler/Komet considerably facilitate dentists’ work onzirconium oxide.The new ZR abrasives allow zirconium oxide to beHeraeus Kulzer (Booth #F4)The new all-in-one adhesive system iBOND ® SelfEtch from Heraeus Kulzer etches, primes, bonds anddesensitizes in just one step by applying a singlelayer. iBond Self Etch is used to provide durable,very strong adhesion of composites to thetreated with ease. They are provided with a special coating,which ensures a permanent bond of the diamond grains in thebonding layer. Their service life and the substance removalachieved are clearly superior to that of conventional diamondinstruments.tooth structure as well as retention of indirectrestorations in conjunction with light-curing lutingcements. It can also be used to treat hypersensitivecervical areas. Only a single layer of the new adhesive isrequired.KaVo (Booth #E4)Pelton & Crane’s new Spirit 3000 Series represents the finestin dental seating, lighting and delivery systems combiningstate-of-the-art technology with sleek design and ruggeddurability.a n dDeveloped to relax both the mindthe body, the vibration-freeunique ErgoSoothe TM massagetechnology reduces anxiety andcreates a positive, spainspiredpatient experience.Four independent air pillowsgently massage the lumbarand upper back areas,providing for the ultimate incomfort, support andrelaxation.The delivery system ensuresan enhanced range of motion.It is easily positioned within thedoctors’ reach providing comfortableaccess to handpieces and accessories.The unique design provides six positions all capable of airactuatedswitching.Pelton & Crane Spirit 3000Kohler Medizintechnik (Booth #G9)Kohler’s new WAVELINE ® Osteotomy Set is a multi-functioninstrument set that enables dentists to widen their range oforal surgery considerably. The WAVELINE ® Osteotomy setprovides for a wide range of ergonomic improvements. Thisoptimized handling enhances the quality of the outcome.TRINOVO ® is a new handle design for dental and oralimplantology instruments that fulfils any requests for safe andeasy cleaning and sterilization. The handle offers a perfect gripKaVo ESTETICA E80 dental unit is available with integratedendodontic and surgery drive systems. This means thatadditional costly instrumentation for endodontics orimplantology is superfluous, the workflow was optimised andthe working environment for the operator has been improved.Integrated in the ESTETICA E80, the new brushless,sterilizable KL 702 Motor offers a special endo-function withadjustable torque limitation, alongside its normal speed rangeof 2,000 to 40,000 rpm. Depending on the transmission ratio ofthe instrument, a torque value of between 0.15 and 8 Ncm canbe freely programmed.With the COMFORTdrive 200 XD motorized contra anglehandpiece, which is as light as a turbine and as powerful as ahigh-speed, KaVo is now setting a new standard in theinstrument sector, proving its unbroken strength for innovation.COMFORTdrive is provided with an integrated brushless motor,able to be sterilized. At present, it is offered exclusively for thepremium dental unit ESTETICA E80. Due to the integration ofthe motor in the instrument and the shifting of the centre ofgravity, an as yet unattainable degree of ergonomics isachieved. The reduction in weight of around 40%, and theshortened length of about 20%, prevent the onset of fatigue.both for tension and pressureand a non-exhausting workingdue to its large diameter butlightweight construction. TRINOVO ®handles can also be equipped with longlastingcolour markings for personalized dentalTRINOVOkits. The new handle design is offered for many single ordouble end instruments and supposed to replace the standardserrated handle in the long term.58 Dental Asia • March / April 2008

EXHIBITIONPREVIEWNobel Biocare (Booth #H4)Revolutionary and unique,NobelActive TM implants dont’scut through bone, they pressthrough it like a corkscrew.This bone condensing implantdelivers extremely high initialstability.The narrow neck is designed topreserve marginal bone tosupport long-lasting soft tissuePolydentia (Booth #G26)Polydentia offers a variety of matrices,particularly appreciated are the Contouredmicrothin (.001”) Tofflemire and Dispens-O-Mat,matrices with self-adhesive ends. The expertisein matrices is also reflected in the developmentof innovative matrix tensioning systems likeMaximat Plus, and Quickmat sectional matrixsystem for perfect contact points.Beside its well-known wood wedges, Polydentiastability. You will never be so confident of accurate placementwith such a minimally invasie procedure.Nobel Biocare’s World Tour Series will be coming toSingapore this year. It will be held from June 27-29, 2008.This year, there are an unprecedented number of livetreatment transmissions and in-depth one-on-one session withleading industry experts, which make this a uniquelystimulating event for every dental professional To register andfor more information go to: www.nobelbiocare.com/worldtourintroduces unique The Wedge, made in a softtransparent polymer and anatomically shaped.Fiber-Splint fiber-glass bands represent since1989 an alternative to metal reinforcements fortemporary bridges, splinting and NEW for postorthodonticretainers.Polydentia GF Posts are the “excellentalternative to metal posts” for aestheticrestorations.NTI-TSS (Booth #J11)The NTI Tension Suppression System is a prefabricated matrixwith approved indications for use by the United States Foodand Drug Administration for the prevention of TMD symptomsand migraine headache pain.This device can be fabricated in 15-minute, chair-side, in oneoffice visit with no impressions, models or outside lab fees.The NTI is being marketed worldwide andhas in excess of 45,000 dentalprofessionals currently using the device.There are an estimated 3 Million patientscurrently using the NTI. Further detailedinformation can be found atwww.HeadacheHope.comDental Asia • March / April 200859

EXHIBITIONPREVIEWRemedent (Booth #C38)GlamSmile is a revolutionary veneer solution byRemedent that is affordable, yet reducingchairtime and material costs, which are critical todentists.GlamSmile easily and painlessly delivers perfect,custom hybrid (composite/porcelain) or pureporcelain veneers to each desired tooth at aprice that fits the budget of the average dentalShofu (Booth #A38)Shofu’s 2nd GenerationGiomer offers a family ofrestoratives (Beautifil II,Beautifil Opaquer andBeautifil Flow) and anadhesive system (FL-Bond II)to provide a total solution forDirect Cosmetic Restorationswith predictable aestheticsand better function.Shofu succeeded to further improve on the patented S-PRGtechnology (Surface Pre-Reacted Type of Glass-ionomer) anddeveloped Beautifil II, a user-friendly direct aestheticrestorative material, ideal for restoring anterior and posteriorteeth due to its dependable physical properties, outstandinghandling characteristics, anti-plaque effect with fluoriderelease and recharge. FL-Bond II a 2-step, self-etching,radiopaque, fluoride releasing adhesive system that features aunique Primer and Bonding Agent to provide an excellent bondto both enamel and dentin. Beautifil Flow is an unique flowableVITA Zahnfabrik (Booth #E14)VITA CAD-Temp composite blocks consist of afiber-free, homogeneous, high-molecular andcross-linked acrylate polymer with microfiller. Asit is practically free from residual monomer, anypotential irritation of the pulp is avoided. Theblocks are suitable for the fabrication of multiunit,fully or partially anatomical long-termVOCO (Booth #G23)Amaris from VOCO can achieve highly aesthetic restorationsin both the anterior and posterior areas. Thanks to convenienthandling and simple shade selection, an endless number ofshapes, shades and surfaces can be quickly fashioned withthis novel composite system. The material flawlessly matchesthe tooth substance with its brilliance, natural opacity andcoordinated chroma so that even the highest aestheticdemands are satisfied.patient.GlamSmile veneers are super strong with a uniqueinherent flexibility. And, because they are ultra thin,the process requires no removal of heathly toothstructure or anesthesia.Two visits are all that are required for the smile tobe restored on the patients.restorative material was developed to present in two distinctviscosities “F10” (High Flow) and “F02” (Low Flow) whilemaintaining its aesthetics and physical properties. BeautifilOpaquer has been designed specially for maskingdiscolorations or stains on natural teeth during directrestorations and metal framework during repair.Shofu’s enhanced Ceramage shades to include Gum Colorsand Whitening shades. This new range of supplementarygingival and whitening shadeshas been developed on thesame basis of the wellestablishedCeramage Micro-Ceramic indirect compositesystem with 73% of ZirconiumSilicate Ceramic Filler.Ceramage offers aesthetics likeceramics with physical propertiesand handling of a composite,which makes it a user-friendlyindirect system even for a general dental practice.provisional restorations with up to 2 ponticsinLab or CEREC systems.VITA CAD-Temp blocks are available in size CT-40 and in the four shades 0M1T, 1M2T, 2M2Tand 3M2T. The bridge block is also suited for thefabrication of temporary crown restorations.The system includes two effectshades, HT (high translucent) andHO (high opaque), for specialaccentuations, which can be usedto create individual structures. Itfacilitates long-lasting, stable andabrasion-resistant restorationswith its 80% w/w filler content.60 Dental Asia • March / April 2008

EXHIBITIONPREVIEWW&H (Booth #J4)W&H Lisa 500/300 sterilizerscombine the latest technology withnew patented systems to maximisepatient safety. These sterilizersprovide exclusively medical gradetype-B cycles which guarantee thesafe sterilization of all load-typesincluding pouched, hollowinstruments. They also feature aspecial ECO-B cycle for the fast processing of smaller loads.Zimmer Dental (Booth #I24)Puros ® Block Allograft is the fastand effective solution forpredictable block graftingresults. Sterilized and preservedusing the proprietary Tutoplast ®Process, Puros Block Allograftoffers a high-quality alternativefor successful bone regeneration.PurosIt eliminates the need for asecondary surgical procedure to harvest anautogenous bone block, thereby saving time, reducing pain,The Synea turbines haved LED that are based onsemiconductor connections that convert electricity directlyinto light. This results in robust, long-lasting light sourcesthat barely heat up and are shock-resistant. With a colortemperature of 5,500 kelvin, the neutral white light conformsto daylight quality and enables the patient’s tooth colour tobe reflected exactly. The new Synea turbines TA-97 C LEDand TA-98 C LED represent the first time that this LEDtechnology has been successfully integrated into dentalinstruments.and shortening the patient’s rehabilitation period, whileretaining the natural collagen matrix and mineral structure ofhuman bone.The latest angled Zimmer One-Piece Implant — 3.0mmdiameter and 17” — uniquely addresses clinician and patientneeds in very challenging anterior areas where space islimited and an angled abutment is required. Like the straight3.0mm, the 17˚, the angled version is indicated for use in thetight inter-dental spacing of the maxillary laterals, andmandibular central and lateral incisors.Dental Asia • March / April 200861

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○EVENTSCALENDAR2008Email: prinya@yahoo.comURL: www.apoc2008.comEmail: apdc2008@gmail.comURL: www.apdc2008.com1 - 5 March — Gold Coast, Australia21st Australian Orthodontic CongressContact: The Organizer, Event PlannersAustraliaTel: +61-7-3858-5598Fax: +61-7-3252-7142Email: info@aso08.com.auURL: www.aso08.com.au4 - 6 March — Dubai, UAEAEEDC Dubai 2008Contact: Dr Matios Tcholakian,INDEX Conferences & ExhTel: +971-4-362-4717Fax: +971-4-362-4718Email: aeedc@index.aeURL: www.aeedc.com8 - 11 March — Guangzhou, ChinaDental South China 2008Contact: Ms Cherry Wu, GuangdongInt’l STETel: +86-20-8354-9150Fax: +86-20-8354-9078Email: cherry@ste.cnURL: www.dentalsouthchina.com27 - 29 March — Madrid, SpainExpodent 2008Contact: Ms Yolanda Cruz,IFEMATel: +34-91-722-3000Fax: +34-91-722-5791Email: expodental@ifema.esURL: www.expodental.ifema.es28 - 30 March — Bangkok, Thailand6th Asian Pacific OrthodonticConference 2008Contact: Dr Prinya PathomkulmaiTel: +66-2-398-5508Fax: +66-2-399-188628 - 30 March — Sydney, AustraliaAustralian Dental Expo 2008Contact: Jan Van Dyk, ADIATel: +61-2-9319-5631Fax: +61-2-9319-5381Email: adia@adia.org.auURL: www.adia.org.au4 - 6 April — SingaporeIDEM 2008Contact: Sharon Ng, KoelnmesseTel: +65-6500-6722Fax: +65-6296-2771Email: s.ng@koelnmesse.com.sgURL: www.idem-singapore.com22 - 25 April — Moscow, RussiaDental Salon 2008Contact: Dmitry Makarov, Dental ExpoTel: +7-495-155-7900Fax: +7-495-152-8549Email: makarov@dental-expo.ruURL: www.dental-expo.com26 - 27 April — Yokohama, JapanThe 51st General Session of theJapanese Society for Dental Materialsand Devices 2008Contact: Assoc Pro. R. Nomoto,Chairman of the ArrangementCommitteeTel: +81-45-581-1001Fax: +81-45-573-9599Email: nomoto-r@tsurumi-u.ac.jpURL: www.soc.nii.ac.jp/jsdmd/6 - 10 May — Bangkok, Thailand30th Asia Pacific Dental CongressContact: Secretariat Office, SLMMgt Co. LtdTel: +66-2-748-7183Fax: +66-2-748-705016 - 20 May — Denver, USA108th Annual AAO SessionContact: AAO Snr Mtg & Exh MgrTel: +1-314-993-1700Fax: +1-314-997-1745Email: info@aaortho.orgURL: www.aaortho.org29 - 31 May — Montreux,SwitzerlandDental 2008Contact: Ueli Breitschmid, SwissDental Events AgTel: +41-41-319-4585Fax: +41-41-319-4590Email: info@dental2008.chURL: www.dental2008.ch5 - 8 June — Beijing, ChinaSino Dental 2008Contact: Ms Sunny Yin, Int’lHealth Exchge &CooperationTel: +86-10-8839-3922Fax: +86-10-8839-3924Email: sinodental@sina.comURL: www.sinodent.com.cn10 - 14 June — Lisbon, Portugal84th Congress and Exhibition ofthe European Orthodontic Society2008Contact: Congress Secretariat,AIMS Int’l Congress SvcsTel: +351-21-324-5052Fax: +351-21-324-5051Email:eos2008@aims-international.comURL: www.eos2008.com62 Dental Asia • March / April 2008

ADVERTISERS’INDEXList of AdvertisersCOMPANYPage NumberANKYLOS 03BUSCH & CO 61DENMIT TRADING 31DMG 23DR JEAN BAUSCH KG 13DÜRR DENTAL 094T TECHNOLOGIES 43GEBR. BRASSELER 21HERAEUS KULZER 07HERAEUS KULZER 33GC ASIA DENTAL PTE LTD 05GC ASIA DENTAL PTE LTD 57IVOCLAR VIVADENT AG Back CoverKAVO 11KOHLER GmbH 27NOBEL BIOCAREInside FrontNTI-TSS 49OTTO LEIBINGER 19POLYDENTIA SA 47REMEDENT ASIA 29ROLENCE ENTERPRISE INC 59SHOFU INC. 17SINO DENTAL 2008 63TUTOGEN 53VITA ZAHNFABRIK 25VOCO 35ZIMMER DENTAL 55Publishing Office & Media RepresentativesPublishing OfficeSingaporePablo Publishing Pte LtdBlock 101 Boon Keng Road #07-04Kallang Basin Industrial EstateSingapore 339773Tel: +65-6746-8761 Fax: +65-6746-3649Mr William Pang, PublisherEmail: williampang@pabloasia.comEuropePablo GermanyKilian-Spiegel-Strasse 6D-64720 MichelstadtGermanyTel: +49-6061-925100Fax: +49-6061-925101Mr Alistair Bryson, Executive DirectorEmail: pablogermany@t-online.deChinaPablo BeijingRoom 1811, Jinglong Mansion225 Chaoyang Bei Road, Chaoyang,Beijing, P.R. ChinaPC: 100026Tel: +86-10-6509-7728Fax:+86-10-6509-7719Ms Ellen Gao, General ManagerEmail: pablochina@tom.comPablo ShanghaiRm 404, No. 858, Panyu RoadShanghai, P.R. ChinaPC: 200030Tel: +86-21-6283-1681Fax:+86-21-6283-1836Ms Kelly Shen, General ManagerEmail: pabloshanghai@tom.comMedia RepresentativesUK, Ireland & IsraelLansdowne Media Services — Ms Marika Cooper2 Claridge CourtLower Kings Road Berkhamsted, Herts HP4 2AFEnglandTel: +44-1442-87-7777Fax: +44-1442-87-0617Email: marikac@lansdowne-media.co.ukJapanEcho Japan Corp. — Mr Ted AsoshinaGrande Maison Room 3032-2 Kudan-Kita, 1-Chome Chiyoda-ku,Tokyo 102-0073JapanTel: +81-3-3263-5065Fax: +81-3-3234-2064Email: echoj@bonanet.or.jpItaly, France, SpainRancati Advertising Srl. — Mr Claudio SanfilippoMilano San Felice Torre 720090 Segrate ItalyTel: +39-02-703-00088Fax: +39-02-703-00074E-mail: csanfilippo@rancatinet.it64 Dental Asia • March / April 2008