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Dental Asia July/August 2021

For more than two decades, Dental Asia is the premium journal in linking dental innovators and manufacturers to its rightful audience. We devote ourselves in showcasing the latest dental technology and share evidence-based clinical philosophies to serve as an educational platform to dental professionals. Our combined portfolio of print and digital media also allows us to reach a wider market and secure our position as the leading dental media in the Asia Pacific region while facilitating global interactions among our readers.

For more than two decades, Dental Asia is the premium journal in linking dental innovators and manufacturers to its rightful audience. We devote ourselves in showcasing the latest dental technology and share evidence-based clinical philosophies to serve as an educational platform to dental professionals. Our combined portfolio of print and digital media also allows us to reach a wider market and secure our position as the leading dental media in the Asia Pacific region while facilitating global interactions among our readers.

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www.dentalasia.net

JULY / AUGUST 2021

Under the Spotlight:

Behind every success, there is

persistence

Clinical Feature:

Achieving predictable results with

Anthogyr Axiom Short Implant

Behind the Scenes:

Polishing of dental hybrid materials

Photo Courtesy of Dentsply Sirona


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© 2021 Align Technology, Inc. All rights reserved. Invisalign, the Invisalign logo, among others, are trademarks and/or

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U.S. and/or other countries. | MKT-0006429 Rev A


Contents

16

20

28

TRENDS

14 Supporting the dentists of tomorrow

16 Achieving 250% business growth with

an innovative business model and customer

service focus

UNDER THE SPOTLIGHT

20 Embracing modern-day dentistry

24 Behind every success, there is persistence

DENTAL PROFILE

28 Planmeca: Fifty years changing the face of

dentistry

CLINICAL FEATURE

32 Achieving predictable results with Anthogyr

Axiom Short Implant

34 Anterior implant aesthetics

32

USER REPORT

40 Effectively remove stains and biofilm

with Mectron COMBI touch

44 Enhancing quality assurance

BEHIND THE SCENES

48 Polishing of dental hybrid materials

51 Press ceramic, rediscovered

54 Use of a 3D printer in a fully digital

workflow

IN DEPTH WITH

56 Invisalign ® G8 with SmartForce Aligner

Activation

58 Compressed air: More than oil-free, dry

and clean

REGULARS

4 First Words

6 Dental Updates

60 Product Highlights

66 Giving Back to Society

67 Events Calendar

68 Advertiser’s Index

44

51

2

DENTAL ASIA JULY / AUGUST 2021


First Words

Leaping forward

Since most dental procedures inevitably generate aerosols that can put dental professionals

at high risk of acquiring the virus, the early days of the pandemic required them to close their

clinics and only attend to emergency cases.

However, as the industry adapts, dental professionals are now able to deliver dental care

through reduced contact with patients while streamlining their procedures, all without

compromising their safety.

For instance, Dr Ryan Tse from Hong Kong (p.24) and Dr Suchada Kongkiatkamon from

Thailand (p.20) share how digitalising their practices benefitted them and their patients in

these trying times.

Dr Marie Fluent from the United States underscores the need for quality assurance measures,

recommended by the Centers for Disease Control, to ensure instrument sterility as well as

instil a sense of calm and confidence in the dental team in case of procedural error (p.44).

In fact, the digitalisation of the industry also highlighted more dental innovations as featured

in this issue.

PABLO SINGAPORE

Publisher

Publications Director

Senior Editor

Assistant Editor

Graphic Designer

Circulation Manager

PABLO BEIJING

General Manager

PABLO SHANGHAI

Editor

William Pang

williampang@pabloasia.com

Jamie Tan

jamietan@pabloasia.com

Pang Yanrong

yanrong@pabloasia.com

Czarmaine Masigla

czarmaine@pabloasia.com

Liu Yu

liuyu@pabloasia.com

Shu Ai Ling

circulation@pabloasia.com

Ellen Gao

pablobeijing@163.com

Daisy Wang

pabloshanghai@163.net

Dr Frank Weber and MDT Manfred Tauber present a technical and scientific analysis depicting

how Renfert Polish hybrid materials addresses the challenge in achieving fast and economical

polishing for indirect restorations fabricated with a combination of ceramics and polymers

(p.48).

And it does not stop there — Mr Heikki Kyöstilä, founder and chief executive officer of

Planmeca, shares about the obstacles that came his way as he built one of the largest dental

manufacturing companies in the world from the ground up. For 50

years, the Finland-based company has been changing the face of

dentistry with their pioneering technologies (p.28).

HEAD OFFICE

PABLO PUBLISHING & EXHIBITION PTE LTD

3 Ang Mo Kio Street 62 #01-23

Link@AMK, Singapore 569139

Tel: (65) 62665512

Email: info@pabloasia.com

Website: www.dentalasia.net

Company Registration No.: 200001473N

Singapore MICA (P) No. 089/01/2021

Malaysia KDN: PPS1528/07/2013 (022978)

So, what more can the future bring?

With the industry’s forward-thinking mentality and resilience that we

are witnessing now, exciting times are indeed ahead of us.

LET’S CONNECT!

@dentalasia

Czarmaine Masigla

Assistant Editor

REGIONAL OFFICE (CHINA)

PABLO BEIJING

Tel: +86-10-6509-7728

Email: pablobeijing@163.com

REGIONAL OFFICE (CHINA)

PABLO SHANGHAI

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Email: pabloshanghai@163.net

ADVISORY BOARD

Dr William Cheung

Dr Choo Teck Chuan

Dr Chung Kong Mun

Dr George Freedman

Dr Fay Goldstep

Dr Clarence Tam

Prof Nigel M. King

Dr Anand Narvekar

Dr Kevin Ng

Dr William O’Reilly

Dr Wong Li Beng

Dr Adrian U J Yap

Dr Christopher Ho

Dr How Kim Chuan

Dr Derek Mahony

Prof Alex Mersel


Dental Updates

COVID-19 infection rate among dentists in the United States remains lower

than other health professionals

The cumulative COVID-19 infection

prevalence rate among United States (US)

dentists was 2.6% as of November 2020 —

lower than the infection rate of other frontline

healthcare professionals, including nurses

and physicians, according to a study from

the American Dental Association Science and

Research Institute and Health Policy Institute.

The study “COVID-2019 Among Dentists in

the United States: A 6-Month Longitudinal

Report of Accumulative Prevalence and

Incidence,” published in the June issue of The

Journal of the American Dental Association,

is based on online survey data collected from

8 June to 13 November 2020, from 2,196 US

dentists in private practice or public health

about the COVID-19 testing they received, the

symptoms they experienced and the infection

prevention procedures they followed in their

primary practice.

Dentists’ COVID-19 incidence rates ranged

from 0.2% to 1.1% each month, and the

average incidence rate over the six months

was 0.5%. In May 2020, a survey of US

frontline healthcare workers, including

nurses and physicians, found their reported

COVID-19 prevalence rate to be 29%.

Of the initial 2,196 respondents, 1,291

participated in the final survey and 785

participated in all six. Fifty-seven dentists

in total reported ever receiving a COVID-19

diagnosis. The likely source of COVID-19 was

identified via contact tracing by a health

agency or clinic in 23 of those cases, with

the dental practice identified as the likely

infection source in two instances.

Because many dental procedures generate

aerosols, practicing dentistry was originally

believed to present a high risk of transmitting

SARS-CoV-2 to dental professionals.

During the study period, the rate of dentists

performing aerosol-generating procedures

increased from 92.8% in the first month to

98.4% in the last.

At least 99.7% of dentists said they used

enhanced infection prevention and control

strategies in their practice each month. A large

number of dentists reported screening patients

and staff for COVID-19, disinfecting between

patient appointments and encouraging social

distancing among patients.

Strategies to optimise personal protective

equipment (PPE) supplies, such as not

changing masks after each patient

appointment, were encouraged by the Centers

for Disease Control and Prevention (CDC)

when supplies were limited. Over the course

of the study, dentists’ use of these strategies

decreased, as more changed their masks with

every patient. After the first month, during

which 17.6% reported changing their masks

between patients, the rate never fell below

25.5% in subsequent months. ■

A-dec and KaVo collaborate to offer additional integration solutions

A-dec and KaVo, two respected names in the

dental industry, have collaborated to deliver

premier products and world-class service to

dental professionals worldwide – Excellence

Amplified.

With a shared purpose and combined

experience of 169 years, the two companies

have partnered to offer additional integration

solutions aimed at enabling better clinical

outcomes and patient experiences.

KaVo’s legacy of world-class performance and

innovation combined with A-dec’s legendary

reputation for quality and customer service

make this a powerful collaboration.

Marv Nelson, president of A-dec, stated:

“The dental industry is all about human

connection, and the positive relationships we

forge to work for the betterment of dentistry.

A-dec’s commitment to this mission starts

with our first core value, Concern for People.

Our employees that create superior customer

solutions of the highest quality, and our

valued partners that share our high standards

for service and dedication to our mutual

customers. Our new collaboration with KaVo

represents our unwavering commitment to the

betterment of dentistry worldwide.”

Ronald Linke, vice president and general manager

of KaVo, added: “It’s a special opportunity when

two industry leaders, each with a proven track

record of excellence in their respective fields, can

come together and collaborate with a mutually

shared vision. We’ve devoted our business to

providing premium-quality products to dental

clinicians, for over 100 years. We continuously

seek to improve our business and service to

our customers. This collaboration, with an

organisation that demonstrates the same level

of commitment to its customers, presents a

clear opportunity for KaVo to support dental

professionals in new, innovative ways.” ■

6

DENTAL ASIA JULY / AUGUST 2021


ADIA awards Australia’s top

performers in the dental industry

Australia’s top performers in the dental industry have been

recognised at a gala event at the Showtime Events Centre at

South Wharf, Melbourne, Australia, on 7 May, 2021.

→ THE REVOLUTIONARY

INVENTION IN

BONE SURGERY

PIEZOSURGERY® touch

An initiative of the Australian Dental Industry Association (ADIA),

the peak business organisation representing dental product

manufacturers and suppliers, the awards were presented during

ADX Melbourne, Australia’s premier dental event.

“Australia’s dental industry has a strong reputation of supporting

oral health professionals in advancing the health of all Australians.

ADIA, along with the industry, is building a solid tradition of

recognising excellence across the wider dental community,”

said Kym De Britt, chief executive officer of ADIA. “Australian

businesses that provide world-leading products and services to

the dental industry have been recognised for their excellence,

innovation and professionalism. The ADIA was overwhelmed by

the calibre of entrants across all categories and congratulates the

winners on their achievements.”

→ best cutting efficiency and

maximum intraoperative control

→ perfect ergonomics

→ over 90 inserts specifically

designed for a wide variety

of clinical applications

→ more than 250 clinical and

scientific studies

An outstanding standard of entries was received which resulted

in fierce competition in each of the award categories. The award

categories and submission process, convened by the ADIA, are

designed not only as an industry accolade but also as a way to

reflect on business and goals going forward.

Martin Weigold, managing director of Dentsply Sirona Australia,

said the submission was a great chance for his team to look back

at all they had achieved and focus on what’s next.

ADIA congratulates the winners in all categories. ■

→ www.mectron.com

The Henry Schein team, winner of the Community Service Award

DENTAL ASIA JULY / AUGUST 2021 7

ad_PStouch_dental_asia_95x250_en_201210.indd 1 10.12.20 14:42


Dental Updates

AG.Live: The 360-degree service for digital infrastructure

As a pioneer in dental CAD/CAM technology,

Amann Girrbach supports laboratories in

organising digital dental workflows. With

the AG.Live digital platform, this project has

reached a new dimension.

AG.Live helps dental technicians to manage

all digital activities locally and to connect with

an ever expanding global network of digital

dental professionals.

Patient case management is at the core of

the platform, which replaces the previous

C3 customer portal where the patient case

is created, managed and processed digitally.

Patient cases can be shared with partner

laboratories for further processing and in the

foreseeable future, exchanged between the

dentist and the laboratory.

Not only will laboratories and clinicians be

networked, but machines and materials too.

For example, to access material availability

or, in the future, to the operating modes of

milling machines and many other relevant

factors of a dental fabrication process.

Thus, AG.Live will be able to keep track of all

digital activities from one place — anywhere

and any time.

In doing so, it is Amann Girrbach’s intention to

create a network of optimised as well as new

partnerships. Network participants will be

able to work and collaborate more efficiently,

to focus on their strengths and thus better

position themselves in the market.

This management portal, which is unique on

the market in terms of scope, breaks down

the linearity of dental restoration processes.

Cross-linking into patient cases is now

possible in a simple and straightforward

manner by making patient data centrally

accessible and editable.

The linking of previously separate data

sources creates synergistic effects from

which AG.Live users can profit sustainably

and gain a noticeable competitive advantage.

In a further step, Amann Girrbach will

implement access to the company’s own

“AG Academy” training portal with numerous

training and further education opportunities

as well as an extensive archive of webinars

and tutorials. ■

Dentsply Sirona and 3Shape announce strategic partnership

partnership opportunities in the future.”

For 3Shape, the new partnership means an

additional service to its customers.

As part of their steps to innovate dentistry

and lead the digital transformation, Dentsply

Sirona and 3Shape have agreed to work on

multiple strategic opportunities to improve

digital dentistry and oral health.

In the immediate term, the partnership will

focus on a collaboration for better access

of TRIOS users to SureSmile Clear Aligners.

Opening the platforms to the 3Shape system

allows dental professionals to benefit from

greater choices, more flexibility, and smoother

workflows in the future.

“The collaboration with 3Shape supports

our goal of tailoring our product solutions

to the needs of our customers. We want

to give dental professionals real added

value with digital technologies that can

be easily integrated and are an intelligent

advancement in their routine workflows,” said

Don Casey, chief executive officer of Dentsply

Sirona. “Open systems allow the integration

of new functions into existing practice and

laboratory structures. We are convinced

that we have an excellent partner for this

with 3Shape and look forward to additional

“3Shape’s goals and solutions are based

on an open ecosystem philosophy and on

working together with other companies

to provide better and more cost-effective

solutions that will benefit clinicians and

their patients,” said Jakob Just-Bomholt,

chief executive officer of 3Shape. “We’re

very excited that TRIOS users can now take

advantage of the leading SureSmile Aligners

treatment through a smoother workflow.”

Due to the different approval and registration

times, not all technologies and products are

immediately available in all countries. ■

8

DENTAL ASIA JULY / AUGUST 2021


DentalMonitoring continues to

disrupt the orthodontic market

with AI-powered solutions for

braces and aligners of all brands

VITA AMBRIA®

The company that pioneered the field of virtual orthodontics and

has been the market leader since 2014 is revolutionising the industry

once again with the only available artificial intelligence (AI) based

virtual monitoring solution applicable to both aligner and braces

treatments of all types and brands.

In an industry where a vast majority of practices are mixed users,

the DentalMonitoring’s solution now allows dental professionals

— whether in private practices or dental service organisations

(DSO)— to take full control of their aligner and braces cases. As a

result, DentalMonitoring expands its addressable market to about

75%, helping more practices scale up their business, become more

efficient and deliver an outstanding patient experience.

Brilliant dental restorations

deserve brilliant

press ceramics

“Our solution has made yet another major breakthrough, and we

are proud to unveil a new suite of functionalities of our platform,”

said Philippe Salah, chief executive officer of DentalMonitoring.

Dental professionals can now monitor all their aligner and braces

cases independent of brand with the same, highly scalable AIdriven

workflow. In addition to monitoring treatment progress, they

can now actively define and monitor clinical goals for each patient.

This results in more active control, productivity and a new level of

safety and confidence for their practice: a real mindset shift for our

industry.”

Salah, continued: “Doctors now have complete control over all

orthodontic treatment and can automatically track inter arch

parameters such as the overbite, the overjet, the transverse or class

correction of patients or detect the archwire and auxiliaries passivity

in addition to the intra arch parameters they were already able

to track with our solution. Dental professionals can virtualise and

automate all non-clinical procedures and schedule appointments

only when needed. At the same

time, the patients’ compliance and

engagement are improved, thanks to

the complete revamping of our highly

rated patient app.”

As the demand for remote care

technology increases within the dental

industry, DentalMonitoring continues

to lead the way with its virtual practice

solutions designed to engage, convert

and monitor patients. ■

VITA AMBRIA – the press ceramic

for dental technicians who simply

want to achieve more.

Learn more here right now:

www.vita-ambria.com

DENTAL ASIA JULY / AUGUST 2021 9

3586E_VITA ambria_anzeige_95x250.indd 1 09.06.2021 15:32:49


Dental Updates

Dentsply Sirona exclusively provides state-of-the-art equipment for new

dental department of MedPark Hospital in Bangkok, Thailand

MedPark Hospital in Bangkok, Thailand,

is one of the top hospitals for patient care

in South East Asia. The intention is for the

hospital to be the best provider of medical

treatments in the region. The new hospital

will provide quaternary care – an extension of

tertiary care – which is even more specialised,

such as for experimental medicine and

procedures or specialised surgeries.

Not every hospital can offer that level of

care. For this reason, installing modern

equipment was given a high priority. Dentsply

Sirona proved to be a partner with first-class

competence in consulting and planning for

such a project as well as being a full-service

provider of complete end-to-end solutions.

MedPark Hospital is equipped with six Sinius

and three Intego Pro treatment centres. The

SiroLaser Blue, the autoclave DAC Universal,

the imaging device Orthophos S 3D, Xios

Scan and Xios sensors, and a Heliodent Plus

were also integrated into the facility, along

with various Dentsply Sirona Restorative

products to provide the best possible

healthcare to patients to give them back their

smiles.

In the second phase of the project, MedPark

Hospital was equipped with everything

needed for completely digital dentistry,

including the CEREC system with the intraoral

scanner CEREC Primescan and the new

milling unit CEREC Primemill. This enables

the hospital to provide chairside restorative

treatment for its patients.

Also, Astra Tech Implant System EV and

several Dentsply Sirona Endodontics products

such as ProTaper Next and K-File were

delivered for best-practice dental solutions.

In time, the plan for MedPark Hospital is to

also become an important location for clinical

education.

“We are very pleased with the support of

our partner Dentsply Sirona in helping us

to succeed in establishing a modern health

care center,” said Dr Sonthi Sirimai, head of

Dental Department of MedPark Hospital, at

the recent opening ceremony. “It is good to

know that our teammates will now be able

to treat their patients using state-of-the-art

equipment with first-class instruments and

materials.” ■

Sources of SARS-COV-2 and other microorganisms in dental aerosols

COVID-19 was declared a pandemic in March

2020. Given the incomplete understanding

of the transmission of SARS-CoV-2 at that

time, the American Dental Association (ADA)

recommended that dental offices refrain from

providing non-emergency services. As a

result, 198,000 dentists in the United States

(US) closed their doors to patients.

The study “Sources of SARS-CoV-2 and Other

Microorganisms in Dental Aerosols”, published

in the Journal of Dental Research (JDR),

sought to inform infection-control science by

identifying the source of bacteria and viruses

in aerosol-generating dental procedures.

Researchers at The Ohio State University

College of Dentistry, Division of

Periodontology, Columbus, US, tracked the

origins of microbiota in aerosols generated

during treatment of 28 patients undergoing

ultrasonic scaling, implant osteotomy or

restorative procedures by combining reverse

transcriptase qPCR, to identify and quantify

SARS-CoV-2, and 16S sequencing, to

characterise the entire microbiome, with finescale

enumeration and source-tracking.

Thirty minutes following the procedure,

condensate was collected from the operator

and assistant’s face shield, the patient’s chest

and an area six-feet distant from the site of

operation. The results show that it is possible

to trace the source of contamination through

DNA microbiome analysis and that the major

source of microbes in aerosols came from the

dental irrigant.

Saliva did not significantly contribute as

infection control measures such as preoperative

mouth rinses and intra-oral highvolume

evacuation were used. The authors

conclude that the risk for transmission of

SARS-CoV-2 and other respiratory pathogens

from aerosolised saliva in dental operatories

is moderately low and that current infection

control practices are adequately robust to

protect personnel and patients alike. ■

10

DENTAL ASIA JULY / AUGUST 2021


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Dental Updates

FDI World Dental Federation Sustainability in dentistry initiative unites

eco-conscious dental industry partners around a common aim

FDI World Dental Federation (FDI) has

launched a new initiative, with commitments

from four founding industry partners –

Colgate, Dentsply Sirona, GSK Consumer

Healthcare, and TePe – to lead the charge on

sustainability in dentistry.

Over the next two years, FDI will work

collaboratively with its partners and other

key stakeholders to map out strategies and

implement solutions to help reduce the

environmental impact of dentistry and the

dental industry.

The work will lead to the publication of an

FDI Sustainability Code of Practice that

provides guidelines and objectives for

achieving a sustainable procurement and

supply procedure, which will be signed by cosignatories

across the supply chain.

Environmental sustainability in dentistry

is multifaceted and involves numerous

stakeholders. CO 2

emissions, plastics use,

waste generation and other environmental

impacts are major challenges at all levels of

the dental resource supply chain as well as in

care delivery.

Reducing the impact of the dental profession

on the environment will require action and

collaboration from many different actors. The

four founding partners are part of a proactive

approach to tackling these environmental

threats and developing concerted and farreaching

solutions.

The project will also equip dentists and their

teams with a suite of tools and resources

to help them improve sustainability in their

dental practices while informing the general

public of their role in sustainability in dentistry

through improved oral health and making

informed decisions.

“I am delighted to witness FDI’s Sustainability

in Dentistry project evolve into this highcalibre,

multi-partner initiative to achieve our

sustainability goals for the dental profession,”

said Dr Gerhard K. Seeberger, president of

FDI. “The project’s humble beginnings as a

way to encourage oral health professionals

and dental practices to ‘think green’ is now

moving into a phase of collaboration, action

and real results.” ■

The German dental industry looks to the current year with confidence

At the European press conference in

preparation for the 39 th International Dental

Show (IDS), Mark Stephen Pace, chairman of

the board of the Association of the German

Dental Industry (VDDI), was nevertheless

confident about the future economic

situation of the German dental industry in

view of the significant decline in sales in the

2020 financial year.

The association’s trust survey from the

beginning of 2021 shows the following

picture: In 2020, for the first time since 2015,

the VDDI member companies generated a

total turnover of less than €5bn (€4.82bn).

It was 13.1% below the 2019 result. Almost

€2.92bn of this was earned on the export

markets, a decrease of 16.5%.

The domestic market developed much more

robustly than the export markets. Domestic

sales in 2020 amounted to €1.90bn, 7.3%

below the comparable sales figure for the

previous year. Slightly more than two thirds

of the companies surveyed by the Dental

Association posted lower sales in Germany

than in 2019.

According to Pace, some companies will

still have to go back to 2019 levels. The

companies’ expectations for the current

financial year and IDS year 2021 now speak

of a positive general mood. The 51% of the

member companies forecast sales increases

for the entire trade fair year and a further 42%

forecast sales at the previous year’s level.

The results of the recently evaluated VDDI

economic barometer from the spring also

confirm the positive assessments and

expectations of the German dental industry

for the current year 2021.

In terms of domestic sales for the first half of

2021, almost 69% of those surveyed expect

higher sales compared to the same period of

the previous year. For the export business,

almost 70% of the participants anticipate

sales increases in this period.

The 39 th IDS from 22 to 25 September 2021

will play an important role in the further

progress of oral and dental health. ■

12

DENTAL ASIA JULY / AUGUST 2021


Dental Updates

exocad launches the Creator Centre

exocad GmbH (exocad), an Align Technology,

Inc. company and one of the leading dental

CAD/CAM software manufacturers, has

released more than 35 educational webinars

to showcase highlights and demonstrate

new features of exocad’s DentalCAD 3.0

Galway and other products under the new

educational umbrella — Creator Centre.

and educate exocad users about the latest

benefits our new features will bring to their

workflows,” said Michael Kohnen, head of

Global Application Support at exocad. “The

educational series is specially designed for

valued exocad customers and potential new

users who want to broaden their skillset and

boost productivity with exocad’s leading

CAD/CAM software.”

The seminars took place in June across

four time zones in the following languages:

English, German, Chinese, Italian, Portuguese,

French and Spanish. ■

exocad’s own experts will offer tips on how

to get the most out of the dynamic digital

dentistry software portfolio, with a special

focus on Instant Anatomic Morphing,

removables, Model Creator, Smile Creator,

PartialCAD and more. Participants at all levels

of expertise, from dental design beginners

to experts, can ask questions live while

watching the hour-long demonstrations.

“The webinars are a great way to connect

SprintRay and SICAT announce surgical guide validation and

workflow integration

SprintRay, the industry-leading manufacturer

of 3D production ecosystems for dental

practices, and SICAT, developer of 3D-based

analysis and treatment planning software,

have announced a validation and software

integration that will simplify the guidedsurgery

workflow.

This new software integration will simplify

the handoff step between SICAT IMPLANT

planning software and the SprintRay 3D

printing system, while the workflow validation

further bolsters SprintRay’s position as an

industry leader in the accurate production of

dental appliances.

Now, dental professionals will be able to scan,

plan, and print biocompatible surgical guides,

providing highly accurate implant placement

with rapid turnaround times.

“SprintRay’s mission is to simplify the

workflows of dental professionals by

giving them the tools to control every

aspect of treatment, from scan to print to

placement. This new integration with SICAT

represents another step forward, creating

new opportunities for efficiency and further

simplifying the workflows of SprintRay

customers,” said Amir Mansouri, chief

executive officer of SprintRay. “SICAT has a

reputation as the surgical guide accuracy

experts, and we’re proud to have met their

validation requirements, further showcasing

the accurate, repeatable results that are

possible with the SprintRay production

ecosystem.”

Craig Hennings, president of SICAT USA, said:

“Benefitting dentists and consumers alike,

this strategic partnership represents digital

dentistry at the highest level. By providing

dentists with a clear and economical path

to provide ‘same-day’ dentistry, SprintRay

and SICAT combine for the industry’s most

compelling and complete solution for digital

dentistry. Elegant workflow and increased

case acceptance have always been the

hallmark traits of the SICAT Suite. Now with

the incredible speed and accuracy of the

SprintRay 3D printers, dental professionals

provide today’s dental consumer with an

optimal dental experience.” ■

DENTAL ASIA JULY / AUGUST 2021 13


Trends

Dentsply Sirona Academic Edition – everything a

dentistry student will need to get started

Supporting

the dentists of

tomorrow

Mr André Foerster, head of Safe Treatments

Platforms at Dentsply Sirona

With the release of Dentsply Sirona’s

Academic Edition, Mr André Foerster,

head of Safe Treatments Platforms at

Dentsply Sirona, provides deep insights

into the making of this special set of

high-quality lightweight instruments,

specifically for dentistry students.

For optimum work results, the right

instruments are necessary — this is

especially true during the educational

years. With lightweight and easily

handled tools, a precise outcome can be

achieved.

For dentistry students, turbines as well

as straight and contra-angle handpieces

are important throughout the clinical and

pre-clinical studies.

14

DENTAL ASIA JULY / AUGUST 2021


Trends

With over a hundred years of experience

in innovating the realm of dental

instruments, Dentsply Sirona has

selected a collection of high-quality tools

to create the Dentsply Sirona Academic

Edition – everything a dentistry student

will need to get started in their journey.

What are some of the important

product features of the Dentsply

Sirona Academic Edition?

Low-cost tools tend to break easily,

meaning they have to be replaced often

— and don’t end up saving students

much money in the long run.

Whether clinicians work with a high-speed handpiece or a low-speed instrument, they can be

assured of top-class results for all indications

Our Academic Edition includes a selection

of high-quality tools “Made in Germany”

with a great price-performance ratio.

All of our instruments are built to last

— using materials that maintain their

precision over time, meet the highest

hygiene standards and run smoothly

and quietly, which is perfect for busy

classrooms.

What are some challenges that

instruments have to withstand in

everyday university life?

Our Academic Edition instruments

are perfectly suited for the training

environment and are built to withstand

countless endurance tests.

Students often underestimate an

instrument’s strength and apply too

much pressure on the tooth, damaging

both the enamel and the tool.

Our instruments are equipped with

Dynamic Speed Control to reduce

idling speeds and extend a turbine’s

operational lifetime.

They also have small head dimensions

to make it easy for students to clearly

see what they are working on and a

Protective-Head-System to prevent

contamination inside an instrument.

What measures are in place to

ensure the sustainable production of

instruments in Bensheim, Germany?

We are committed to achieving ambitious

energy-saving targets at our Bensheim

site in Germany.

For instance, separating and recycling

our waste (including hazardous materials)

to the best of our ability, reducing energy

resources by using thermal discharge to

temper our workspace and lighting our

site with LED bulbs.

We are also working towards reducing our

cooling lubricants down to one type, for

one cycle with less oil consumption. DA

DENTAL ASIA JULY / AUGUST 2021 15


Trends

Mr Sameer Merchant, chief executive officer of Laxmi Dental Group

Achieving 250% business growth

with an innovative business

model and customer service focus

In five years, Illusion Dental Laboratory, a subsidiary of Laxmi Dental

Group in India, achieved 250% business growth and doubled its

workforce from 950 to over 1,800. The group’s chief executive officer

and laboratory owner, Mr Sameer Merchant, gives light to this success.

In 2001, Mr Sameer Merchant joined

Laxmi Dental Group, an India-based

dental conglomerate.

For the past two decades, his visionary

leadership and fervor for technology

have led Laxmi Dental Group through

continuous growth and evolution. In fact,

the group has evolved from a homegrown

two-member dental lab to a

cohesive multi-faceted integrated group

with a presence in over 26 countries.

The company offers holistic vertically

integrated services, be it the fullservice

dental laboratories in India with

outsourcing hubs in the United States

(US) and United Kingdom (UK) or a dental

software service catering to the global

dental community with design support,

it has a well-established distribution

network for clinical, lab and dental

products.

In fact, Mr Merchant’s goal is to have India

known as a supplier of superior quality

dental restorations. He is constantly

investing in the most advanced digital

workflow, equipment and technology to

ensure fast, accurate and predictable

results — all reflected in the success of

Laxmi Dental Group and Illusion Dental

Laboratory, its Indian subsidiary.

AN INNOVATIVE BUSINESS MODEL

When digital dentistry revolution started

in the United States, Mr Merchant foresaw

16

DENTAL ASIA JULY / AUGUST 2021


Trends

that it was only a matter of time before it

came to India. So, about seven years ago,

he fully adopted the digital workflow in his

Illusion Dental Laboratory and partnered

with 3Shape — taking the business to the

next level.

Mr Merchant, said: “The software and

quality of the hardware propelled a multifold

growth. We made a tremendous

investment and saw a 100% ROI (return

on investment). And because of that, we

have been investing more, including a

plan to purchase 125 TRIOS scanners this

year.”

At the International Dental Show (IDS)

conference in Germany, Mr Merchant

recalled meeting Mr Nikolaj Deichmann,

co-founder of 3Shape, with whom he

shared his vision of growing his business

and 3Shape sales in India.

dentistry — on a daily basis and are able

to address commonly asked questions

such as “How the process is like?” or “How

long does it take to do the scan?”

“There are a lot of dentists who have

the capital to buy a scanner but are

questioning the need to experience

the ‘pain’ of change. Because of this,

it is important that we send a trained

dental professional to do a demo of the

scanners,” explained Mr Merchant.

He noted that only 30-40% of clients

want to use the scanner while others

prefer to observe.

“Either way, the clients get to see the

quality of the scan and how easy the

process is; giving the assurance that

intraoral scanners are something worth

investing in,” he shared.

“I believe that once you get into the habit

of digital dentistry, it will be hard to go

back to analogue. Once our clients see

the results and how beneficial digital

workflow is, they will become more

interested to buy their own scanner,” he

shared.

EXTENDING FINANCIAL HELP

In India, as around the world, the

scanners are considered expensive.

In order to support the dentists, Mr

Merchant bundles other products into the

deal to subsidise the cost.

“Dentists buy an intraoral scanner to

grow their practice. By helping them to

purchase a scanner, we are aiding them

in adopting a digital workflow to grow

the business. In turn, Illusion Dental Lab

gains business by being their partner. It is

a win-win situation,” he explained.

With Mr Deichmann’s encouragement, he

launched his innovative business model

(Fig. 1).

E & E: EDUCATION AND

EXPERIENCE

Branding his business model as the

“E & E”: Education and Experience, Mr

Merchant hired 30 young dentists in 20

different cities to act as digital dentistry

ambassadors.

Each dentist has a 3Shape TRIOS

intraoral scanner and visits local dental

clinics personally to provide scanning

services, which includes but not limited

to checking the tooth prep and occlusion;

and sending the scans back to the lab.

“Our trained and qualified dentists are

tasked to educate fellow practitioners

on digital dentistry as well as to provide

guidance on how to use the scanner,”

explained Mr Merchant.

His team of travelling dentists does

intraoral scan with hundreds of doctors

— with no prior experience with digital

Mr Merchant has also set up a call centre

for dental clinics to easily schedule an

appointment with his team of travelling

dentists.

How Merchant’s business model

benefits stakeholders:

1. The ease of the digital workflow

would impress dentists, and in

turn, they would want their own

scanner

2. Scans taken by Merchant’s team

of dentists would be sent to

Illusion Dental Lab, bringing in new

customers and spurring growth

3. Adopting digital dentistry would

drive practice growth for the

dentists

4. Illusion would become a reseller

partner for 3Shape hardware and

software

5. 3Shape brand and sales would

grow in the country

Fig. 1: E & E: Education and Experience

business model

In fact, Illusion Dental Lab has a client

who used to manage one clinic. After

purchasing the 3Shape TRIOS intraoral

scanner, the business grew tremendously

that in just a year and a half, the clinic

has now four branches — the client even

purchased an additional scanner.

“Most dentists are excited about the

results of going digital and these new

technologies have completely changed

the way they do dentistry,” he shared.

The dentists could have never imagined it

to be so simple and their clinic assistants

and patients benefit from it as well. This

is on top of their practice growth of 30-

40%.

THE IMPORTANCE OF SUPPORT

Mr Merchant also supports the

professional dive into digital dentistry by

emphasising on customer support. This is

done so by having an IT team on standby.

“The key for us is providing great

support. We understand that investing in

such devices and technology is not an

DENTAL ASIA JULY / AUGUST 2021 17


Trends

The workstation at Illustration Dental Laboratory

everyday expense and it’s inevitable that

our customers will be constantly worried

about their purchase,” he remarked.

The team has four IT technicians as

well as dentists who act as support too.

In fact, Illusion Dental Lab is the only

company in India with 30 on-call dentists,

making it possible to solve customer

issues within two hours.

“Because we are based locally, we do not

need to bring doctors out to our corporate

office. We can provide our clients the

needed services in their own clinic,” said

Mr Merchant.

A KEY DIFFERENTIATOR

Illusion Dental Laboratory also has

another key differentiator. As a lab,

by necessity, there is a need to keep

up to date with the latest software

and workflows and have deeper

understanding of it.

Through these hands-on experiences, it

places the laboratory in a better position

to teach the software and workflow to the

clients.

In fact, one of the dentists in Mr

Merchant’s team would always attend

3Shape webinars and relay the new

information back to the other 29 dentists

— ensuring the team is always updated.

Mr Merchant has also launched his own

YouTube channel to share tutorials on

digital dentistry which targets the local

professionals.

“Digital dentistry plays a major role in

improving the entire workflow: from

clinics to laboratories, especially in

growing practices. It is here to stay and it will

only grow,” he said. “In fact, it is growing at a

faster pace than expected in India. Of course,

COVID-19 has been a roadblock but we’re

positive that it’ll get back on track.”

Although his innovative business model has

been successful in driving digital dentistry

and his company’s growth in India, Mr

Merchant never loses sight of what Illusion

Dental Laboratory is all about.

He concluded: “Our mission at Illusion Dental

Laboratory is to provide only the highest

quality dental restorations delivered in a

timely fashion with attentive customer

service. We strive to provide the perfect blend

of technical expertise, personal service, and

dependable results. We strongly believe in

relationships based on communication and

feedback and we take pride in using only the

best restorative systems.” DA

18

DENTAL ASIA JULY / AUGUST 2021


3Shape TRIOS

Patient engagement

you can sense.

We’re creating an

emotional connection

with our patients.

Dentist, Chatswood, Australia

Boost case acceptance by engaging

– even more – with your patients.

Together, TRIOS 3D color scans and the TRIOS

engagement apps create a perfect opportunity

to show patients their unique dentition and

help them understand their treatment needs.

These visual tools make it easy to personalize

patient experiences and address all their

concerns. They’ll notice the difference. And

you’ll feel the engagement.

Explore more at 3Shape.com


Under the Spotlight

Embracing

modern-day

dentistry

Dr Suchada Kongkiatkamon, assistant

director of Dental Wellness Clinic at

BDMS Wellness Clinic in Thailand,

specialises in cosmetic dentistry and

digital treatment planning. She is one

of the many modern-day dentists who

is experiencing the full benefits of

digital dentistry, and remains confident

in providing precise and efficient

treatments to her patients despite the

pandemic.

Dr Suchada Kongkiatkamon, assistant director of Dental

Wellness Clinic at BDMS Wellness Clinic in Thailand

20

DENTAL ASIA JULY / AUGUST 2021


Under the Spotlight

What are some of the factors that

influence your choice of career in

the dental field?

Coming from a medical family

background, I was influenced to

pursue a career in healthcare even

at an early age. I considered it as a

natural progression to enter the field.

My student years in dentistry at the

Srinakharinwirot University in Thailand

was an informative journey where

I learned a lot of the conventional

practices in the field.

Why did you specialise in

prosthodontics and implant

dentistry?

I completed a prosthodontics and

implant dentistry residency at the

University of Illinois in Chicago, United

States, as well as a post-graduate

speciality programme in prosthodontics

with my passion in planning and working

on the details from the beginning

to the end. In fact, I also obtained a

Master of Science in Oral Sciences at

the same university. I find it fulfilling to

work closely with patients for long-term

dental management.

Dr Suchada while

treating a patient at

BDMS Wellness Clinic

How do you ensure that you meet the

patient’s treatment expectations?

I am a firm believer that listening is the

most valuable tool. So, I listen carefully

and thoughtfully to the patient’s

demands. Considering their lifestyle,

I personalise each case by selecting

appropriate tools, as enhanced by digital

dentistry.

What are the training and seminars

you had to go through to achieve

expertise in contemporary

dentistry?

As an avid student and educator at

the same time, I continuously strive

to grow my expertise and skills by

joining seminars frequently. But as an

educator, I receive better exposure

to new concepts and technology

in tune with the latest industry

developments. Various trainings that I

am regularly involved in is: training tools,

maintenance, digital dentistry as well as

protocol workflow involving treatment

plan, instrument, and material.

What are your criteria in choosing

the brand to partner and invest in

Fully-digital laboratory

when you equipped your office with

the latest technology?

Our team is selective and not influenced

by brand affiliation. We choose

equipment according to its usage,

benefits and quality. BDMS Wellness

Clinic is always on an endeavour to

utilise the latest technologies. Recently,

DENTAL ASIA JULY / AUGUST 2021 21


Under the Spotlight

the dental clinic installed Primemill and

Primescan from Dentsply Sirona to help

us produce crowns easily and quickly.

What are the must-have devices/

systems in your practice?

I ensure these three components work

well and are synergised seamlessly —

intraoral scanner, milling unit and its

software. Digital technology is used

for every case without exception due

to its precision. We can create multiple

crowns and restorations efficiently. In

addition, digital scans provide maximum

benefits to the patients that they may

never experience from conventional oral

impressions.

What do you consider as the

limitation of technology?

From my experience, technology has

a steep learning curve because it is

continuously changing. Many new

developments are not taught in dental

schools. There is a constant need to

keep up with the latest methodologies

and to update practical skills.

What dental innovations are you

looking forward to getting your

hands on?

For increased efficiency, I am looking

forward to the intraoral scanner that

gives faster result and a speedier milling

machine that is more forgiving in dental

situations. Also, for delicate crowns to

be tougher, more flexible and easier to

handle.

What is the best lesson to take away

from the pandemic situation as we

move forward?

Using tools and equipment to minimise

contamination such as the use of an

intraoral scanner is the best lesson to

take away as we move forward. The

pandemic situation has emphasised the

value of what digital dentistry can bring

to the practice.

For instance, it is now possible to deliver

a crown within a day while limiting

contact and minimising risk. Also, with

digital technology, we can now easily

perform repeated processing due to the

logged patient data. It has enabled us

to produce databases with enhanced

accuracy and efficiency.

What advice would you like to give

to your colleagues who are hesitant

to adopt digital technology in their

practice?

I used to have that mindset but I gave

it a chance and learned its usage

and possibilities. Being open-minded

enables continuous developments that

benefit our practice and patients. Now,

I am fully using digital technology in my

daily practice because of its ease of use,

simplicity and accuracy. It helps me in

communicating my treatment plan to

the patient too. DA

Dr Suchada’s keen eye for detail

22

DENTAL ASIA JULY / AUGUST 2021


Digital Impression

with Primescan

The right choice for all

your digital needs

dentsplysirona.com/primescan


Under the Spotlight

Behind every

success,

there is

persistence

Dr Ryan Tse, founder of Perfect Smile Esthetic Center

in Hong Kong, and chairperson of The Hong Kong

Society of Esthetic Dentistry

Over the years, Dr Ryan Tse has continuously challenged the

norm and seeks to improve himself as a dental practitioner. With

his hard work, persistence and willingness to adopt modern

concepts and techniques, he is now chairperson of The Hong

Kong Society of Esthetic Dentistry, which he co-founded with

trusted colleagues. Delivering patient-centric dental services

at Perfect Smile Esthetic Center in Hong Kong, Dr Tse is also

relentless in sharing his knowledge and expertise with fellow

practitioners.

PLANTING SEEDS

Armed with a master’s degree in

prosthodontic and implant dentistry,

Dr Ryan Tse embarked on a journey

specialising in aesthetic dentistry when

he joined a one-year course organised

by the Global Institute of Dental

Education (GIDE).

Through this programme, Dr Tse met

world-class speakers and educators

in the dental field such as Dr Mauro

Fradean, founder and director of

Fradeani Education; Dr Pascal Magne,

father of biomimetic dentistry; Dr Ed

Mclaren, chief executive officer of

ArtOral America; and Dr Didier Dietschi,

senior lecturer at Interdisciplinary Dental

Education Academy (IDEA), United

States (US), who inspired him to devote

himself to aesthetic dentistry.

He then attended Dr Magne’s course

in IDEA San Francisco, US, before

heading to Seattle, US, to enroll in a

24

DENTAL ASIA JULY / AUGUST 2021


Under the Spotlight

comprehensive programme in the Kois

Centre — a curriculum taught almost

exclusively by Dr John Kois, using the

Kois Research Center research. The Kois

Center is the only continuing education

programme in the US that conducts and

publishes independent research.

A great influence to Dr Tse’s career, Dr

Kois emphasises on the need to work

with a good technician.

“This advice brought my practice to a

totally different level. I am so glad that

I had a chance to work with worldclass

ceramists, Mr Naoki Hayashi and

Mr Lamberto Villiani, in my career,” he

admitted.

Dr Tse also mentioned that he

performed a huge case with Mr Villiani,

which got published in the Compendium

with Dr Kois in 2016.

In addition, Dr Tse also had the

opportunity to work as an instructor at

the University of Southern California

(USC) implant and aesthetic programme

in the US, alongside with the course

director, Dr Baldwin Marchack.

As former president of the American

Academy of Esthetic Dentistry (AAED)

and International Federation of Esthetic

Dentistry (IFED), Dr Marchack left a great

impact on Dr Tse when he invited the

latter to attend the AAED conference

which focused on multi-disciplinary

dentistry.

The conference was an eye-opener for

Dr Tse as he was able to witness how

the different disciplines in dentistry work

together to achieve even greater results.

GROWING THE ROOTS

With the knowledge and experience

gained from his overseas studies, Dr Tse

headed back to Hong Kong to set up a

local-based aesthetic dentistry group.

He said: “I shared this idea and insight

with my good friends: Dr She, an

orthodontist; Dr Ho, a periodontist; Dr

Chow, a specialist in oral maxillofacial

surgery; and Dr Tam, a general dentist.

They had the same vision as me and we

started the society.”

In 2017, they officially established The

Hong Kong Society of Esthetic Dentistry,

carrying the mission to promote the

advancement of art and science of

aesthetic and inter-disciplinary dentistry

among Hong Kong dental professionals

and the public.

Additionally, Dr Tse also founded

the Perfect Smile Esthetic Centre,

specialising in smile and facial

Perfect Smile Esthetic Centre in Hong Kong

DENTAL ASIA JULY / AUGUST 2021 25


Under the Spotlight

aesthetics. Located in Causeway Bay,

Hong Kong, with a panoramic view of

the Victoria Harbour, Dr Tse challenged

the traditional view of dental care by

developing patient-oriented services

and prioritising patient experience.

With his treatment philosophy leaning on

minimally invasive dentistry, he invested

heavily on equipment and technology

to ensure accurate diagnosis and risk

assessment as well as efficiency and

reliable service.

“I started to use digital technology

in 2012 with the purchase of my first

scanner and CAD/CAM machine, CEREC

Omnicam from Dentsply Sirona. The

company provided the basic training and

invited me to join an intensive training

in Germany. This is where I learned how

to integrate the technology into my daily

practice,” he said.

Partnering with an innovative and

supportive company was crucial when

Dr Tse started to equip his practice with

the latest technologies.

His requirements are: “The brand should

Digital smile design

be the pioneer in the industry and visualise the patient’s expectation

innovative. In addition, the support is before the treatment and discuss

also important, especially in education, the limitations to work out the final

training and technical support.”

treatment plan.”

In 2016, Dr Tse joined the Digital Smile Today, Perfect Smile Esthetic Centre is

Design (DSD) intensive training in Miami, fully digitalised with an intraoral scanner,

US, and met the founder, Dr Christian milling machine as well as a 3D printer.

Coachman, who inspired him to further

develop his skills in digital dentistry and These technologies allow his team to

become a DSD keynote speaker.

follow a digital workflow. In fact, they do

not take traditional impression anymore;

At DSD, he can work out a facialdriven

treatment plan, noting that the digitalised too.

mounting and wax up procedures are

management of patient expectation is

critical in dentistry.

“Digital wax up has many advantages.

We can have many proposals just by

Dr Tse, elaborated: “With the DSD design pressing one button and we can make

and drawing, the patient can visualise the wax up translucent for better

the treatment outcome. We can also assessment. We can also print out the

Dr Tse at the first annual symposium of the Hong Kong Society of Esthetic Dentistry in 2018

26

DENTAL ASIA JULY / AUGUST 2021


Under the Spotlight

model and do the mock up. This can

never happen in the analogue world,”

he said.

SOARING HIGHER

Despite the significant advancements

in digital dentistry, Dr Tse acknowledges

that some practitioners still prefer to

follow traditional methods as they feel

more confident in it.

While he understands their comfort

zone, he emphasises that a patientoriented

practice is what will succeed in

the future.

“Patients are now focused on the

experience, just like how we go to a

five-star hotel,” he explained. “You can

use Nokia an example. Although the

company was once considered as the

king of mobile phones, they eventually

got eliminated in the market. The same

thing can happen in dentistry. If you are

hesitant in adopting digital technology,

you will be eliminated.”

In fact, Dr Tse noted that dentistry has

evolved massively in the past decade.

Moving forward, he expects to see more

innovations such as digital guide on

tooth preparation or a robot to prepare

the tooth; as well as advancements on

materials such as “injectable ceramics”

or being able to print ceramic in the

clinic.

“Guided tooth prep has already

happened but it has so many

limitations. Sooner or later, it will have a

breakthrough,” he said.

In addition, he also foresees progress in

teledentistry: “I can imagine that every

patient will have their scanner at home

which can be used for examination and

diagnosis, and they will only go to the

clinic for treatment.”

According to Dr Tse, this phenomenon

has two different aspects, particularly

during the pandemic.

He explained, “With heightened alert

on infection control, as a patient, they

would want to minimise the travel and

visit to the dentist as well as to have the

treatment straight away. As a dentist,

clinicians spend tremendous efforts

in infection control thereby increasing

their workloads. Thus, they would also

prefer to minimise the patient’s visit and

appointment.”

NOTHING IS IMPOSSIBLE

Now in his 50s and with a successful

clinical practice under his belt, Dr Tse is

able to find more time to lead a healthy

lifestyle.

“I got fat when I turn old. I planned to

work on my abs last year but COVID-19

happened, resulting in closed gyms,

social distancing and the ‘quarantine 15’

(the 15-pound weight gain during selfisolation),”

he shared in jest.

He admitted that he had become

unmotivated to start his fitness journey

with the closure of gyms and being

surrounded with the instant ramen he

bought from panic buying.

“Finally, after a few months of social

distancing, I decided to jumpstart my

fitness journey after a family gathering

on Mother’s Day. I made the decision

to do the 12-weeks challenge — to gain

six packs even in this age and do what

some people consider impossible,” he

said.

After the 12-weeks challenge, he started

to train for his first-ever marathon, a

sport he used to hate.

He shared: “I finished three online

marathons since last year. First is

the London marathon on October

2020, followed by New York Marathon

in November 2020, and the Tokyo

Marathon on March this year.”

Dr Tse and his fitness challenge

Although Dr Tse misses traveling

and lecturing, he is grateful for the

opportunity brought by the pandemic as

the lockdown allows him to focus on his

fitness and to challenge himself to grow

— whether inside or outside the four walls

of a dental clinic. DA

DENTAL ASIA JULY / AUGUST 2021 27


Dental Profile

Mr Heikki Kyöstilä,

CEO and founder of

Planmeca

Planmeca: Fifty

years changing the

face of dentistry

Planmeca was founded by Mr Heikki

Kyöstilä in Helsinki, Finland, in 1971. From

developing dental stools and cabinets to

becoming the owner of the largest private

dental manufacturing company in the

world, his journey – Planmeca’s journey −

is definitely worth sharing and celebrating.

This is the story of the chief executive

officer and founder of the company.

A VISIONARY SALES

REPRESENTATIVE

Mr Heikki Kyöstilä began his career as

a sales representative for a Finnish

dental supply company in 1965, right

after graduating from business college

– making him familiar with dental clinics

and their equipment early on. However,

it did not take long for the businessminded

future entrepreneur to realise

that the products he was selling could

be improved in many ways.

“I noticed that especially the patient

chairs – their design and ergonomics

– could easily be improved. At the

time, almost all dental products sold in

Finland were imported from Germany, so

I thought why not do something about it

and start making products of our own,”

he shared.

SKYDIVING WITHOUT A

PARACHUTE

The first five years were pure survival

as the Finnish banks did not easily

grant loans to start-up companies, so

Mr Kyöstilä was financially on his own –

with an initial capital of 5,000 Finnish

marks (about the equivalent of today’s

€7,000*) which he earned by selling his

sail boat.

28

DENTAL ASIA JULY / AUGUST 2021


Dental Profile

The beginning was modest – he was

manufacturing dental stools and

instrument cabinets in a garage in

eastern Helsinki. But Mr Kyöstilä was

able to see the bigger picture and

immediately headed for the international

market, understanding from the get-go

that the Finnish dental market was

simply not big enough to build upon.

His foresight formed the backbone of

the company’s future success. In 1971,

the year that Planmeca was founded,

Mr Kyöstilä exhibited his first ergonomic

dental stool and an instrument cabinet

at the International Dental Show (IDS)

dental trade fair in München, Germany.

The demand was immediate, and orders

came in from around the world.

Mr Kyöstilä, said: “Finland was quite

unknown globally, and many customers

had no idea where we were located.

So, it took some time for us to establish

ourselves on the market. We had to work

really hard to put Finland on the map.

I often say that the beginning was like

skydiving without a parachute, but the

jump really paid off.”

and sophisticated technology.

From then on, it was one technological

breakthrough after another: the world’s

first microprocessor-controlled patient

chair and dental unit in 1983 and 1986,

respectively, followed by the world’s first

microprocessor-controlled panoramic

X-ray unit.

The 1980s was also the decade when

Planmeca’s university collaboration

began with an extensive equipment

delivery to the dental faculty of the

University of Helsinki.

In fact, Planmeca is now the choice

for over 300 dental schools worldwide,

and the company works in close

collaboration with university staff and

researchers.

In 1983, the company entered the

United States (US) market with the sales

of 10,000 patient chairs.

This, together with the company’s

record-breaking delivery agreement of

over 1,000 dental units to Saudi Arabian

dental institutions in 2012, continue to

be the largest individual sales deals in

the history of dentistry.

CHALLENGING TRADITIONAL

DENTISTRY

In 1990, Planmeca challenged traditional

dentistry with new innovations. The

company went digital, leading to the

world’s first direct digital panoramic

imaging unit and pioneering all-in-one

software concept that allowed dental

professionals to access all important

information from one user interface.

“The Planmeca Dimaxis all-in-one

software concept was a groundbreaking

and bold innovation of its time and was

launched long before the term ‘software

ecosystem’ became a buzzword. It

paved the way for many new ideas that

would further improve the daily dental

workflow,” explained Mr Kyöstilä.

Currently, all Planmeca’s dental

equipment offer network connectivity –

in fact, they have done so for more than

a decade already.

The company started immediately

building its global distribution network,

which today consists of over 760

distributors across 120 countries.

“We’ve had a global approach from day

one. Planmeca has never believed in

geographical limits − we have been

ready to travel anywhere in the world

where there are potential customers.

Building an active sales network,

founding local companies to support

the sales staff and staying close to our

customers have been crucial elements

of our success,” he remarked.

THE TURNING POINT

In 1975, Mr Kyöstilä finally had the

means to hire his first engineer, which

meant that the company could move to

developing more demanding products

DENTAL ASIA JULY / AUGUST 2021 29


Dental Profile

GROWING INTO A GROUP OF

HEALTHCARE BRANDS

Next year will mark another milestone in

Planmeca’s history – the 50 th anniversary

of Plandent, a one-stop dental supply

company that Mr Kyöstilä founded in

1972 to provide dental professionals with

all the services, equipment and materials

they need. The Plandent Division

operates in a dozen countries and is one

of the leading dental suppliers in Europe.

But the company group’s expansion did

not stop there.

In 1987, Mr Kyöstilä branched out

into medical technology by founding

Planmed, a company dedicated to

mammography and orthopaedic imaging

equipment. Today, Planmeca Group is

an industry leader consisting of several

successful healthcare technology

brands.

What started as a small-scale business

now has a turnover of €764 million,

nearly 2,900 employees, and six

hectares of company premises in Helsink

– where dental professionals from all

over the world are always welcome to

share their insights and ideas.

“Both 2D and 3D imaging systems

became major growth engines for the

company. Focusing on developing

pioneering imaging technology also

allowed us to expand our playing field

outside the dental clinic,” explained Mr

Kyöstilä.

For example, Planmeca’s unique cone

beam computed tomography (CBCT)

technology has been incorporated into

Planmed’s extremity scanner, a solution

used for veterinary 3D imaging too.

With the same groundbreaking imaging

technology used throughout different

product lines, Planmeca Group’s mission

is to bring the best image quality to all

healthcare professionals − from dental

clinics and hospitals to veterinary clinics.

Mr Kyöstilä, commented: “I am extremely

proud of our algorithm expertise.

We have already managed to lower

patient doses considerably and cancel

the effects of patient movement. We

continue to work tirelessly to keep

introducing new innovative algorithms

that will further improve image quality

and help provide the best basis for

diagnosis.”

Alongside its dental innovations, the

company continues to expand its medical

product portfolio, with a new full-body

CBCT scanner and a ventilator that are

currently under development.

BELIEVING IN FINNISH

EXPERTISE

It has taken half a century of

determination, perseverance, strong work

ethic as well as constant innovation to

build today’s Planmeca.

“Of course, not every day has been

smooth sailing. In times of recession

and in otherwise difficult times, we have

worked harder than ever, trying to sell our

solutions to customers in every corner of

the world – and continuing to bring the

latest technology into dental products.

Low technology has never been of any

interest to us,” admitted Mr Kyöstilä.

In fact, prior to the pandemic, thousands

of dental professionals visited

Planmeca’s headquarters every year.

Mr Kyöstilä, shared: “It’s a great way to

receive customer feedback in addition

to trade fairs and congresses. I have

always loved meeting our customers in

person − it has really been the spice of

my working career.”

THE LEADER IN IMAGING

The digitalisation of dentistry started in

the late 1990s and continued to evolve

rapidly in the early 2000s.

Hence, Planmeca’s early investment

in imaging and software development

began to pay off.

30

DENTAL ASIA JULY / AUGUST 2021


Dental Profile

Despite the company’s global success,

Mr Kyöstilä aims to keep the company’s

production in Finland and preserve the

agility, efficiency, low hierarchy and

entrepreneurial spirit of the company’s

early days.

“I have always believed in the Finnish

know-how and education. I also believe

that it is better to listen than to be

heard. Valuing the expertise of my

staff and hiring the best specialists in

each field are the secrets to building a

successful company,” he shared.

In fact, Finnish design has always been

close to Mr Kyöstilä’s heart, which can

be seen throughout the company’s

product lines.

“Timeless and recognisable design is

one of our key competitive advantages.

Design is so much more than just

product surfaces – it is the outcome of

having deep understanding of clinical

workflows and needs. Unlike in many

other companies, we have an entire

team of in-house industrial designers

who are involved in each stage of the

product development process,” he noted.

NO SHORTCUT TO SUCCESS

With 50 years of experience, Mr Kyöstilä

definitely knows a thing or two about

entrepreneurship.

“You need to see further ahead than your

competition and listen intently to what

your customers are saying. You have to

stay alert to even the tiniest of signals

and be prepared to change your course

accordingly,” he shared.

He is happy that today, unlike in his youth,

entrepreneurship is seen in a positive

light and young people are encouraged to

start their own business.

However, he reminds that there are

no shortcuts to success: “Quality is

everything, and you should never head

to the market with an unfinished product.

One successful product will often help

you come up with new ones.”

LOOKING AHEAD

Instead of sentimentalising the past, Mr

Kyöstilä prefers to focus on the future.

This means fearlessly expanding into

new territories and staying ahead of

technology trends.

For instance, providing orthodontic

treatment solutions through a new

company called PlanSmile is in the

future plans.

“We continue to deepen our knowledge,

expertise and involvement in different

specialty areas, such as orthodontics,

medical imaging and new 3D

applications. This will allow us to explore

new technological possibilities and

business opportunities,” he shared.

Despite the constant advances in

imaging technology and major medical

projects currently underway in the

company, Planmeca does not forget

about the product that started its

success − a dentist’s most important

working tool – the dental unit.

The company’s research and

development teams are working hard to

come up with new ways to introduce the

latest technologies and upgrades into

dental units to make the daily workflow

the smoothest it can be.

For Mr Kyöstilä, Planmeca is a way of life,

and meeting satisfied customers means

that the company has succeeded in

its primary goal: providing better care

through innovation.

He concluded: “I am grateful to

have been able to work with a highly

professional staff and to have been

surrounded by dental professionals that

I value so greatly. I want to continue to

stay close to my customers and staff. I

want to hear both the negative and the

positive. That is the only way to stay in

the game.” DA

DENTAL ASIA JULY / AUGUST 2021 31


Clinical Feature

Achieving predictable results

with Anthogyr Axiom Short

Implant

Due to bone resorption secondary to tooth extraction, clinicians

commonly perform maxillary sinus lift procedure to restore missing

upper first molar with an implant, especially if the site is left untreated

for a long time. But an alternative and more conservative treatment

approach using a “short and fat” implant from Anthogyr is able to reduce

surgical downtime and risk of complications.

By Dr Sebrina Abdul Malik

A 43-year-old healthy male patient had his

upper left first molar (tooth 26) extracted

three years ago due to a failed root canal

treatment. He is a regular patient in the

dental office, a non-smoker and has good oral

hygiene.

A panoramic radiograph revealed moderate

bone resorption at the edentulous site of

tooth 26 with a low scalloped-shape maxillary

sinus floor (Fig. 1).

Fig. 1: Pre-op panoramic radiograph

The patient had a prior consultation with

another dentist and was recommended to

undergo a maxillary sinus lift procedure to

restore his missing tooth 26 with a dental

implant. But he was concerned about

the complications of the aforementioned

procedure.

As an alternative, I offered him a more

conservative treatment approach by using a

short dental implant, which is 8mm or less in

length.

TREATMENT

Conservative open flap surgery with

Fig. 2: Post one-stage surgery

the insertion of an optimally positioned

Anthogyr’s “short and fat” dental implant PX

4.6x6.5mm was performed. Healing abutment

Fig. 3: Post-operative radiograph

(5mm diameter, 2.5mm gingival height) was used

to maintain the gingival emergence profile and aid

in healing the future prosthetic crown (Fig. 2).

32

DENTAL ASIA JULY / AUGUST 2021


Clinical Feature

Fig. 4 Fig. 5

Fig. 7

Fig. 8

Fig. 6

Fig. 9 Fig. 10

Fig. 4: The implant site after three months

Figs. 5-6: Pop-in Impression technique

Figs. 7-8: Delivery of screw-retained zirconia crown

Figs. 9-10: Post-operative radiographs

To verify the implant position, a postoperative

radiograph was taken showing that

the apex of the implant sits right below the

maxillary sinus floor (Fig. 3).

An advantageous surgical goal, bicortical

stabilisation was achieved effectively. This

phenomenon can sometimes be difficult to

attain as it occurs when a surgeon engages

more than a single cortical plate when placing

a dental implant.

Typically, this is done with the cortical bone

of the base of the mandible; or the floor of the

maxillary sinus or nasal cavity; and the crestal

cortical bone of the edentulous ridge.

Three months later (Fig. 4), a closed tray

impression technique was carried out (Figs.

5-6). The delivery of a screw-retained zirconia

crown was successful (Figs. 7-8).

Periapical and panoramic radiographs were

taken to verify the fully seated restoration

(Figs. 9-10).

CONCLUSION

This case delivered a high-quality dental

implant and crown treatment without the

need for more surgical downtime while

reducing the risks of complication that comes

with maxillary sinus lift procedure by using

a “short and fat” dental implant. Anthogyr is

one of the few implant systems that supply

short dental implants. DA

About the author

Dr Sebrina Abdul Malik

graduated from the Trinity

College Dublin, University

of Ireland, with a Bachelor

of Dental Science in 2009

and has been practicing

general dentistry since then. With special

interest in dental implants and dentoalveolar

surgery, she co-founded Azure Dental

in Singapore where she currently works.

A certified implant dentist, she is also a

fellow of International Congress of Oral

Implantologist and an active member of

the International Team of Implantology and

Academy of Osseointegration.

DENTAL ASIA JULY / AUGUST 2021 33


Clinical Feature

Anterior implant aesthetics

A variety of factors have to be considered when performing implant

restorations on the anterior maxillary region given its high aesthetic

demands. Dr Kuoching Chen (Taiwan) shares three cases to discuss novel

techniques addressing the challenges of anterior implant placement.

By Dr Kuoching Chen

CASE 1

A 50-year-old male patient with fair oral

hygiene was presented with a fracture on

tooth 11 which was associated with mobility,

swelling and pain.

Clinical and radiographic examination

revealed that the fracture affected the

palatal-cervical to facial-crestal region of

the offending tooth (Fig. 1). Fistula at the

periapical region of the facial gingiva was also

noted (Fig. 2).

Treatment procedure

The treatment plan included extraction of

tooth 11 followed by an immediate implant

placement. The patient’s extracted tooth will

be used as a temporary crown to maintain

aesthetics and papilla height.

Atraumatic extraction of tooth 11 was

performed using a periotome and elevator.

The socket was flushed with saline and the

granulation tissue was removed (Fig. 3).

Atraumatic implantation was done without flap

elevation and the gap was filled with Endobon

and freeze-dried bone allograft (FDBA).

Fig. 1

Fig. 2

Fig. 3

Fig. 4 Fig. 5 Fig. 6

Fig. 7

Fig. 8

Fig. 9

Fig. 10 Fig. 11 Fig. 12 Fig. 13

Fig. 1: CBCT- Tooth 11 oblique fracture from palatalcervical

to facial-crestal region

Fig. 2: Facial area swelling with fistula

Fig. 3: Atraumatic extraction, socket cleaned,

granulation tissue removed

Fig. 4: Atraumatic implantation without flap

elevation, gap filled with Endobon and FDBA

Fig. 5: The extracted tooth crown as temporary

restoration

Fig. 6: Hollow out the crown to create space for

cementation of temporary abutment

Fig. 7: Etching the inner surface

Fig. 8: Temporary abutment was fixed with flowable

resin, removing excess

Fig. 9: Filled the gaps with more resin, rounded out

and polished well

Fig. 10: Shaping the cervical outline

Fig. 11: Provisional crown was delivered

Fig. 12: Radiograph confirmation

Fig. 13: After four and half months (before

impression taking)

34

DENTAL ASIA JULY / AUGUST 2021


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Clinical Feature

Osteotomy procedure leans against the

palatal gingiva so the implant can be placed

slightly palatal to ensure sufficient buccal

bone.

The implant was placed 4mm below the

gingiva margin at the palatal side or 3mm

below the gingiva of the adjacent teeth (Fig.

4). Gingihue abutment was used to ensure

that the gingival space is maintained and the

emergence profile is good.

To use the crown of the extracted tooth as a

temporary restoration (Fig. 5), the crown was

hollowed-out to create space for cementation

of temporary abutment (Fig. 6). After the tryin,

the internal surface was etched (Fig. 7).

Resin bonding procedure was done and

temporary abutment was fixed to the crown

using flowable composite (Fig. 8). The gaps

were filled with more resin, rounded out and

polished well (Fig. 9). The occlusion was then

adjusted 0.55mm from the contact surface.

Additionally, the cervical outline was shaped

and the surface of composite was polished

(Fig. 10). Once done, the provisional crown

was delivered to the patient’s mouth (Fig. 11)

and periapical radiograph of post-implant

placement was taken to confirm its position

(Fig. 12).

After four and a half months, the patient

came back for the final impression (Fig. 13).

Fig. 14

Fig. 15

Fig. 16

Fig. 17

Fig. 18

Fig. 19

Fig. 20

Fig. 21 Fig. 22 Fig. 23

Fig. 24 Fig. 25

Fig. 26

Fig. 27

Fig. 14: Before delivery, symmetrical facial outline

form

Fig. 15: Interdental papilla was preserved

Fig. 16: Placement of abutment with positional jig

Fig. 17: Tighten gold-tite screw

Fig. 18: E-Max crown delivered

Fig. 19: Post-treatment photo

Fig. 20: Post-operative radiograph

Fig. 21: After seven months — papilla grown

Fig. 22: Interdental bone remodelling occurred

CASE 2:

Fig. 23: Before treatment

Figs. 24-25: Radiograph and CBCT before treatment

Fig. 26: After crown removal

Fig. 27: Checking of marginal bone depth

36

DENTAL ASIA JULY / AUGUST 2021


Clinical Feature

Fig. 28

Fig. 29

Fig. 30

Fig. 31 Fig. 32 Fig. 33

Fig. 34 Fig. 35

Fig. 28: Atraumatic one-stage implant with

placement of healing abutment

Fig. 29: Radiograph after implant placement

Fig. 30: Temporary crown was placed anchored to

adjacent temporary crowns with resin

Figs. 31-32: Abutment placed with positional jig

Fig. 33: Placement of zirconia abutment

Fig. 34: Crowns were issued

Fig. 35: Post-operative photo after three years

The temporary abutment and crown were

removed revealing symmetrical facial outline

form (Fig. 14) and preserved interdental

papilla (Fig. 15).

In delivering the final restoration, the

abutment was placed with positional jig to

ensure accurate placement (Fig. 16). Then, a

gold-tite screw was used for the placement

of gingihue abutment with porcelain core

(Fig. 17).

Finally, the E-Max crown was issued (Fig.

18). Post-treatment photo (Fig. 19) was taken

as well as a periapical radiograph to ensure

proper position of the abutment to the

implant (Fig. 20).

After seven months, patient came back for

recall presenting a satisfactory shape of

papilla (Fig. 21). Post-operative radiograph

was taken, revealing the occurrence of

interdental bone remodelling (Fig. 22).

Conclusion

There is not much difference between the

use of resin tooth and natural tooth as

temporary crown. But it is easier to use the

latter to maintain gingiva type and preserve

dental papilla.

CASE 2

A 35-year-old female patient came with a

request to redo the crowns on her upper

anterior incisors (Figs. 23-25).

The crowns from teeth 12, 11, 21, 22 were illfitting

(Fig. 26). The cervical margin on teeth

21 and 22 showed black tooth structure, and

the porcelain-fused-metal (PFM) crowns

revealed discrepancy in length. Teeth 12, 21,

and 22 are root canal treated with metal post

and cores for more than 15 years. Gingival

margin inflammation with exudate was noted

on tooth 11.

The rest of the teeth are restorable except for

tooth 21, which already had a short clinical

crown with not enough tooth structure

for ferrule. Thus, extraction and implant

placement were suggested.

Treatment procedure

The treatment plan included removal of

old crowns and fabrication of temporary

crowns for teeth 12, 11, 22; and atraumatic

extraction on tooth 21 with immediate implant

placement.

After confirming the marginal bone depth

(Fig. 27), atraumatic one-stage implant was

done with placement of healing abutment

(Fig. 28). Post-operative radiograph was

taken to confirm the implant position (Fig. 29).

Subsequently, temporary restoration was

done and anchored to adjacent temporary

crowns with resin (Fig. 30).

After five months, the final restoration was

fabricated and issued. The abutment was

placed with positional jig to ensure accurate

DENTAL ASIA JULY / AUGUST 2021 37


Clinical Feature

placement (Figs. 31-32). Then, the zirconia

abutment was issued (Fig. 33) followed by the

delivery of the crowns on the affected teeth

(Fig. 34).

Follow ups were done after three, four, and

seven years; and post-operative intraoral

photos and periapical radiographs were taken

(Figs. 35-40).

Conclusion

Immediate implant treatment with healing

abutment placed reduces the need to have

another incision done during the uncovering

stage.

CASE 3

A 45-year-old male patient had an immediate

implant placement done nine years ago on

tooth 11 (Figs. 41-45) and has returned to

seek treatment for an ill-fitting bridge on

teeth 21 to 23 (Fig. 46).

Intraoral and diagnostic examination revealed

that tooth 21 had a fracture from palatalcervical

to facial-crestal bone area, and

was unrestorable (Figs. 47-48). The patient

wanted to have a fixed provisional treatment

Fig. 36 Fig. 37

Fig. 38 Fig. 39 Fig. 40

Fig. 41

Fig. 42 Fig. 43 Fig. 44

Fig. 45

Fig. 46 Fig. 47

Fig. 48 Fig. 49 Fig. 50

Figs. 36-37: Post-operative radiograph after three years

Fig. 38: Post-operative photo after four years

Fig. 39: Post-operative radiograph after four years

Fig. 40: Post-operative radiograph after seven years

CASE 3:

Fig. 41: Tooth 11 was extracted and immediate

implant placement done nine years ago

Fig. 42: Periapical radiograph on the area of tooth 11

after implant placement

Fig. 43: Temporisation done on day of implant

placement

Fig. 44: Periapical radiograph taken one year after

final prosthesis was issued

Fig. 45: One year after immediate implant placed

with definitive prosthesis in place

Fig. 46: After nine years, tooth #21 fractured due to

an accident

Fig. 47: Radiograph of tooth 21 showing fracture of

post crown

Fig. 48: Crown fractured from palatal-cervical to

facial-crestal bone areaa

Fig. 49: Measurement of crestal bone height after

tooth 21 was extracted

Fig. 50: Measurement of socket width

38

DENTAL ASIA JULY / AUGUST 2021


Clinical Feature

Fig. 51 Fig. 52 Fig. 53

Fig. 54

Fig. 55

Fig. 56

Fig. 57

Fig. 58

Fig. 59 Fig. 60

Fig. 51: After implant placement, bone graft was

done and temporary abutments placed

Fig. 52: Temporary crowns issued

Fig. 53: After four months

Figs. 55-56: Abutments were placed with

positional jig

Fig. 57: Crowns issued

Fig. 58: Radiograph after prostheses placed

Fig. 59: One-year follow up

Fig. 60: Implant at space of tooth 11, 10 years after

implant placement

and requested for two implants to address his

missing tooth 22 as well.

Treatment procedure

Tooth 21 was extracted followed by

immediate implant placement (Figs. 49-50).

The gap was filled with FDBA and Xenograft.

Gingihue was used as a temporary abutment

and a temporary crown was constructed for

this implant.

Tissue punch method was done for the

implant placement of tooth 22 to preserve

bone without flap elevation. To create

interdental papilla with good emergence

profile, temporary abutment and crown were

issued (Figs. 51-52).

Patient came back after four months (Fig.

53) and the abutments were placed with a

positional jig (Figs. 54-56). The crowns were Conclusion

issued and post-operative radiograph was Immediate implant placement could preserve

taken (Figs. 57-58).

alveolar bone and gingiva height with gap

between implant and facial bone filled with

Follow up was done after a year — postoperative

photo and radiograph were taken distance between implants is crucial for

bone graft material. Keeping the required

(Figs. 59-60).

interdental area aesthetics. DA

About the author

Dr Kuoching Chen received his DDS from the Taipei Medical University,

Taiwan, in 1987 and studied implantology at the Boston University

Implant Center, Unites States, from 2000 until 2002. Currently, he is

an adjunct associate clinic professor of Taipei Medical University and

maintains his private practice in Taipei. He was also the president and

board of diplomat committee, Academy of Dental Implantology Taiwan,

R.O.C (ADI) in 2013, and at present, a consultant for ADI.

DENTAL ASIA JULY / AUGUST 2021 39


User Report

Effectively remove

stains and biofilm

with Mectron

COMBI touch

By Prof Gianna Maria Nardi

Mectron COMBI touch

combines a multifunctional

piezoelectric scaler and a jet

polisher in a single device

designed for complete dental

prophylaxis. To achieve

excellent results, this article

discusses the operating

procedure of this device

and how air-polishing can

be reliable, effective and

efficient in the mechanical

removal of bacterial biofilm.

40 DENTAL ASIA JULY / AUGUST 2021


User Report

Mectron COMBI touch

Air-polishing can be used on healthy

patients as an alternative to the use of

curettes, scalers or abrasive paste to

remove stains caused by tea, coffee,

red wine, tobacco or other staining

substances.

Since the diseases of the oral cavity

with the greatest epidemiological

significance (caries, gingivitis and

periodontitis) are induced by bacterial

biofilms, mechanical control of bacterial

biofilms is fundamentally important in

the prevention and management of

these diseases.

Air-polishing has been found to be

effective in removing biofilms from

above and below the gums and acquired

dyschromia (Europerio 2012, Vienna).

THE AIR-POLISHING SYSTEMS

The air-polishing systems use

compressed air, water and various

types of powder with different particle

sizes, specifically designed for different

treatments, to emit a well-controlled jet,

which sprays particles at the surfaces of

the teeth (Barnes et al., 2004).

The abrasive flow therefore consists

of water, compressed air and specific

powders with a controlled particle size

(Black R. Technique for non-mechanical

preparation of cavities and prophylaxis.

J Am Dent Assoc 1945; 32:955-965).

Currently available on the market, there

are numerous devices with an air/water

jet for preparing cavities, polishing tooth

surfaces and eliminating extrinsic stains

in patients that have trouble maintaining

adequate oral hygiene (Kozlovsky et al.,

1989; Horning et al., 1987).

In addition, the shape and design

of the spray nozzle are important

characteristics that may influence the

abrasive properties of the powders

used.

In fact, minor changes in the size of

the nozzle, such as the diameter of

the opening or the length of the tube

or its curvature may cause significant

changes to the efficacy of the

instrument (Momber A, 2008).

This factor underlines the importance

and responsibility of having an indepth

knowledge of the instrumental

technique used on any type of tooth or

root surface.

To determine how to treat each specific

case, the operator may be faced with

the challenge of excess deposits which

require removal.

In such cases, the more difficult

treatment areas will certainly require a

more thorough and lengthy treatment. It

is therefore important to avoid directing

the jet directly at the edge of the gums,

on the necks of exposed teeth and the

mucosa.

MECTRON COMBI TOUCH

Mectron COMBI touch combines, in

a single device, a multifunctional

piezoelectric scaler and a jet polisher,

designed for a complete dental

prophylaxis, above and below the gums.

The polisher supports the use of two

types of powder according to the type

of treatment to be performed: sodium

bicarbonate powder for supragingival

prophylaxis, and glycine-based powder

for subgingival treatment.

The operating principle of the polisher is

based on the mechanical action obtained

from a jet of crystals in various kinds

accelerated by a compressed airflow. The

kinetic energy applied to the particles is

dissipated almost completely when they

strike the enamel surface, producing a

gentle but effective cleaning action.

The action is completed by a water jet,

which, using the pressure drop created

around the nozzle, is arranged in the form

of a bell around the main flow. Thus, it

produces a dual effect: it largely prevents

the cloud of powder from bouncing and

being expelled; and continually washes

the treated area by dissolving the powder.

OPERATING METHOD

The COMBI touch device operates at a

working water pressure of one to six bars

and an input air pressure of between four

to eight bars (“Prophy” function = 3.5 bars;

“Perio” function = 2.7 bars). The direct jet

should not be directed at the gums while

the peripheral jet can be used close to the

gingival margin.

COMBI touch air-polishing produces

excellent hygienic and cosmetic results: it

removes even the most stubborn extrinsic

stains quickly, gently and under conditions

of absolute safety.

The enamel surfaces of the teeth remain

intact and shiny. When used below the

gums, it removes bacterial biofilms from

the periodontal and peri-implant pockets.

The abrasive nature of the jet of powder is

directly proportional to the selected level

of irrigation. In this way, by increasing

the level of irrigation at the end of the

treatment, the teeth above the gums can

also be cleaned.

Mectron recommends exclusive use of

their prophylaxis powder and glycine

powder. The manufacturer declines all

liability and the guarantee becomes

null and void if non-original Mectron

powders are used, in that they could

DENTAL ASIA JULY / AUGUST 2021 41


User Report

Fig. 1

Fig. 3

Fig. 5

irreparably damage the spray nozzles

and/or handpiece of the polisher, thus

jeopardising the operation and creating

a risk of injury to the patient.

With the supra- and subgingival

technique, the spray nozzle of the

instrument must be kept constantly

rotating at a distance of 4-5mm from

the tooth surface for about five seconds

per tooth.

For maintenance treatment, the

instrument should be held at an angle

of incidence of between 30° and 60°

between the powder jet and the axis

of the tooth; the correct angle of

the handpiece is essential to avoid

damaging the soft tissues and to reduce

the quantity of aerosol emitted (Barnes,

1991; Worrall et al., 1987).

The Mectron COMBI touch offers three

spray nozzles at different angles to allow

Fig. 2

Figs. 1-2: 120° spray nozzle

Fig. 4

Figs. 3-4: 90° spray nozzle

Fig. 6

Figs. 5-6: Periodontal spray nozzle with

periodontal subgingival tip

the operator to customise the operating

procedures according to every clinical

need.

A. The 120° spray nozzle for use

outside the periodontal pocket

(Figs. 1-2):

The use of the spray nozzle at this angle

provides an effective deplaquing action,

primarily in cases in which the operator

encounters difficulties due to particular

anatomical structures of the soft tissues

and positioning of teeth or prostheses

that are difficult to reach.

For healthy gum tissue and particularly

stubborn stains, the use of sodium

bicarbonate powder is recommended.

While in the presence of metal-free

prostheses, implants, exposed root

surfaces and in mouths with a thin

tissue biotype, the glycine powder

should be used.

This spray nozzle is also capable of

deplaquing subgingival surfaces with

glycine powder for periodontal pockets

with a depth of up to 5mm.

B. The 90° spray nozzle for use

outside the periodontal pocket

(Figs. 3-4):

Used for deplaquing the surfaces of the

front teeth using sodium bicarbonate or

glycine powder is recommended, with

the advantage of preserving the soft

tissues of the gums.

It is also used for cleaning the occlusal

surfaces of permanent teeth with

sodium bicarbonate powder or the

occlusal surfaces of deciduous molars

with glycine powder.

Ideal for treating acquired dyschromia,

as in the case of stubborn tobacco

stains, with sodium bicarbonate powder.

C. Periodontal spray nozzle for use

inside the periodontal pocket (Figs.

5-6):

Ideal for effective detoxification in the

presence of periodontal pockets with

a depth of over 5mm using the sterile,

disposable periodontal subgingival tip,

which enables the inside of the pocket

to be cleaned in a minimally invasive

manner.

In addition, its 120° angle enables the

operator to work under more favourable

ergonomic conditions with the correct

supporting points, without applying stress

to the carpal tunnel. The tip does not emit

the jet in the apical direction but orients

it sideways towards the root surface and

the wall of the pocket, preserving the

integrity of the junctional epithelium.

Having determined the clinical indexes,

if a site with a pocket having a depth

of over 5mm is found during the

examination, the periodontal subgingival

tip should be applied to the PERIO spray

nozzle, ensuring that it is fully inserted

so that the two parts must be in contact

with one another.

During the decontamination of the

periodontal pocket with glycine powder,

the tip is to be inserted gently inside

the pocket, against the root surface to

be decontaminated, making extremely

light and regular forward and backward

movements.

A time of about five to 10 seconds of

spraying is necessary to satisfactorily

detoxify a periodontal pocket (mesial,

distal, vestibular and lingual surfaces).

Consequently, it will take about 20-40

seconds for the instrument to clean a

single tooth.

CONCLUSION

The efficacy of sodium bicarbonate

in deplaquing and the elimination of

acquired dyschromia had been known for

some time now, but the true revolution

was the introduction of supra- and

subgingival air-polishing using glycine

powder.

42

DENTAL ASIA JULY / AUGUST 2021


The COMBI touch technology, which enables both powders to be

used at the same time due to the ergonomic spray nozzles oriented

at 90° and 120°, enables the operator to obtain an excellent clinical

result, with an advantage in the timing of the procedure much

appreciated by patients.

→ THE EVOLUTION

OF PROPHYLAXIS

COMBI touch

The highly sophisticated supra- and subgingival air-polishing

technique enables the operator to perform a complete, effective,

minimally invasive and repeatable clinical procedure without

interfering with the health of the hard and soft tissues of the oral

cavity.

→ AIR-POLISHING AND

ULTRASOUND IN ONE UNIT

For the therapy to be successful, the operator must adopt a

personalised tailor-made approach, shared with the patient, to

clinical supra- and subgingival air-polishing practice.

In fact, the skill of the operator is of fundamental importance, who

must be capable to work only after making an accurate diagnosis and

to establish the opportunities for using the subgingival air-polishing

technique. DA

→ easy switch from supra to subgingival

air-polishing by a simple click

→ subgingival perio air-polishing tip – flexible, soft

and anatomically adjustable to the periodontal pocket

→ more than 40 inserts for scaling, perio, endo and prosthetics

→ SOFT MODE: the ultra-gentle scaling

for sensitive patients

REFERENCES:

1.

Barnes CM. The management of aerosols with airpolishing delivery systems. J

Dent Hyg 1991; 65(6): 280-282.

2.

Barnes CM, Covey DA, Walker MP, Ross JA. An in vitro evaluation of the

effects of aluminum trihydroxidedelived via the prophy jet on dental restorative

materials. J. Prosthet. Dent. 2004; 13; 1.

3.

Barnes CM, Russell CM, Gerbo LR, Wells BR, Barnes DW. Effects of an airpowder

polishing system onorthodontically bracketed and banded teeth. Am J

Orthod Dentofacial Orthop 1990; 97: 74–81.

4.

Black R. Technique for nonmechanical preparation of cavities and

prophylaxis. J Am Dent Assoc 1945 ; 32: 955- 965.

5.

Kozlovsky A, Soldinger M, Sperling I. The effectiness of the air powder abrasive

device on the tooth and periodontium: an overview. Clin Prev Dent 1989; 114;

7-11.

6.

Horning GM, Cobb CM, Killoy WJ. Effect of an air-powder abrasive system on

root surfaces in periodontal surgery. J Clin Periodontol 1987; 144: 213-220.

7.

Momber A. Blast Cleaning Technology. Springer-Verlag: Berlin Heidelberg

2008.

8.

Momber A, Kovacevic R. Principles of abrasive water jet machining. London:

Springer; 1998.

9.

Worrall SF, Knibbs PJ, Glenwright HD. Methods of reducing bacterial

contamination of the atmosphere arising from use of an air-polisher. Br Dent J

1987; 163(4): 118-119.

About the author

Prof Gianna Maria Nardi is a research fellow

and adjunct professor at the Sapienza

University of Rome, Italy. Director of the firstlevel

master degree course on “Advanced

technologies in Oral Health Science” at the

same university, she also served various

position in local and international dental hygiene associations.

→ www.mectron.com

DENTAL ASIA JULY / AUGUST 2021 43

ad_ct_dental_asia_95x250_en_201210.indd 1 10.12.20 14:4


User Report

*

Enhancing quality

assurance

By Dr Marie Fluent

Instrument processing is performed to

provide sterile dental instruments for

safe patient care. While the combination

of monitoring methods is intended to

safeguard the process, procedural error

may still occur. Quality assurance measures

recommended by the Centers for Disease

Control ensures instrument sterility as well

as instill a sense of calm and confidence in

the dental team.

The Centers for Disease Control and

Prevention (CDC) Guidelines provide

recommendations for instrument

processing and monitoring the

effectiveness of autoclaves using a

combination of mechanical, chemical,

and biological monitors (spore tests).

Spore tests remain the gold standard for

monitoring the sterilisation process as

it directly kills highly resistant bacterial

spores rather than merely testing

the physical and chemical conditions

necessary for sterilisation.

44

DENTAL ASIA JULY / AUGUST 2021


User Report

Although mechanical and chemical

indicators do not prove sterilisation has

been achieved, they allow the detection

of certain equipment malfunctions and

identify procedural errors.

Thus, it is recommended that sterilisers are

monitored with spore tests at least weekly,

and any load with an implantable device.

She placed the spore test in the

centre of an empty chamber per the

manufacturer’s instructions and mailed

it for processing.

On Thursday, she received “immediate

notification” from the sterilisation

monitoring service that her spore test

failed.

Unfortunately, incidents such as this still

exist but some measures can be taken to

prevent such situations.

This article will address quality assurance

measures to ensure instrument sterility

and instil a sense of calm and confidence

as well as a culture of safety to dental

personnel who reprocess instruments.

While the combination of monitoring

methods is intended to provide

safeguards and ultimately ensure

sterility, gaps in quality assurance do

exist as demonstrated in the following

case scenario.

CASE SCENARIO

Kim, an experienced dental assistant

was a relatively new employee at a

dental facility. She performed a spore

test early Monday morning on an

autoclave – a different brand from which

she was trained.

Recognising the implications, slight

panic and a series of questions raced

through her mind: “Why did it fail? What

happened to the instruments that have

been processed since the test, and have

they been used for patient care? Could

I identify unused packages, retrieve and

reprocess them? Should the patients

who may be impacted be notified? And,

what should I do next?”

Kim immediately reported this situation

to her infection control coordinator and

the owner/dentist.

“IMMEDIATE NOTIFICATION” MAY

NOT BE SOON ENOUGH

In the scenario above, over three days

of patient care had been performed

utilising numerous instrument packages.

There is a possibility that the autoclave

had been malfunctioning for the entire

three days (or more), or that this was an

isolated cycle-failure incident.

Potentially, one or more patients over the

course of the three days, may have been

treated with instrumentation that failed

a spore test.

Chemical Indicator Types

Type 1

Process indicator

(Both Internal and

External)

Demonstrates that an item has been exposed to a sterilisation process and

distinguishes between processed and non-processed items.

Type 2

Indicators for use in

specific tests

Used in specific test procedures in certain sterilisers (pre-vacuum sterilisers).

The most common example is the Bowie-Dick test.

Type 3

Type 4

Type 5

Single critical process

variable indicators

(Internal)

Multicritical process

variable indicators

(Internal)

Integrating indicator

(Internal)

Responds to only one critical parameter of the sterilisation process (usually

time or temperature). Note: The sterilisation process has more than one critical

parameter, and all must be reached for sterilisation to occur.

Responds to two or more critical parameters of the sterilisation process.

Responds to all critical parameters of the sterilisation process (time,

temperature, and pressure.) The stated values are generated to be equivalent to,

or exceed, the performance requirements for biological indicators.

Type 6

Emulating indicator

(Internal)

Responds to all critical parameters of the sterilisation process for a specified

sterilisation cycle.

Reference: ANSI/AAMI/ISO 11140-1:2014

Table 1

DENTAL ASIA JULY / AUGUST 2021 45


User Report

The answers to these possibilities are

unknown, and it is evident that a threeday

gap in the biological monitoring

process represents a gap in quality

assurance.

Before continuing with this scenario,

CDC recommendations for chemical

indicator use will be briefly discussed.

CHEMICAL INDICATORS

CDC Guidelines recommend various

types of chemical indicators (CI)

including the use of “external” and

“internal” CI stating that a “Type 1

CI be placed on the outside of each

instrument package, unless the internal

CI is visible from the outside.”

The guidelines also address “singleparameter”

and “multi-parameter” CI as

they provide a more reliable indication that

sterilisation conditions have been met.

Yet, there are no specific recommendations

for the use of these specialty indicators

within the guidelines.

The manufacturer’s instructions for use

of the CI will indicate the steriliser type

and cycle in which the CI should be used

– placement within the package, storage,

expiration date, and how to interpret the

exposed CI.

Table 1 provides a list of chemical indicator

types and a brief description.

TYPE 5 INTEGRATING INDICATORS

Type 5 integrating indicators mimic the

response of a biological indicator (BI).

These specialty indicators contain a

steam sensitive chemical that imparts a

physical change, such as movement of

the chemical along a strip or a change of

ink from one colour to another when all

critical parameters of sterilisation have

been met.

They do not guarantee that sterilisation

has occurred, nor do they replace the

need for weekly — or more frequent —

spore tests.

Yet, as integrating indicators allow

detection of certain equipment

malfunctions and aid in identifying

procedural errors; they permit dental

personnel to confidently release dental

instruments before the spore tests are

known.

Note that sterilisation loads containing

implantable devices must be

quarantined until a passed spore test

has been achieved.

Type 5 CIs are intended to be used at

least once per day in every load with or

without implantable device or even in

every pack as the internal indicator.

To use a Type 5 integrating indicator for

each load, the strip should be placed

in the middle of the chamber or within

the densest instrument pack. The load

should be processed according the

steriliser’s instructions for use.

The results may be read immediately

upon sterilisation cycle completion

and it should be interpreted per the

manufacturer’s instructions for use.

If the interpretation does not indicate

a safe or pass, the load may not be

released as these instruments are not

considered safe for patient care.

DISCUSSION OF THE CASE

SCENARIO

Kim may have averted much anxiety if

46

DENTAL ASIA JULY / AUGUST 2021


User Report

she had processed a Type 5 CI within

the same cycle as her spore test.

Upon completion, she would have

immediately identified a failed cycle.

As the majority of failed spore tests

are operator related, she would have

followed CDC recommendations

for BI failures, reviewed sterilisation

procedures, and retested the steriliser

using another Type 5 integrating

indicator and additional spore test.

If the subsequent cycle passed the

integrator test, Kim would have mailed

in the spore test for processing.

Most importantly, she would have

had confidence that the processed

instruments subsequently were safe for

patient care.

FOLLOW-UP

This situation with the failed spore test

is a true story. As events unfolded, the

infection control coordinator reviewed

the autoclave instructions, and it was

determined that the door of the steriliser

was unlocked during the failed cycle.

Hence, there was not adequate steam

and pressure for sterility to occur.

A Type 5 CI with an additional BI

was then run through an additional

sterilisation cycle.

The integrating indicator passed, the

autoclave was placed back into service,

and the owner/dentist deemed it was

not necessary to notify patients. The

repeat BI test was negative for growth

of spores, as anticipated.

To prevent future operator error

sterilisation incidents, several

education and training sessions were

implemented.

CDC recommendations for instrument

processing were reviewed utilising the

checklists in the CDC Summary.

Standard operating procedures were

established regarding the use of Type 5

integrators and logs for each steriliser.

The protocol for instrument packaging

and labelling were reviewed.

Finally, a training session with a

manufacturer’s representative was

arranged to review operation of the

steriliser and routine maintenance and

cleaning. The training sessions were

documented.

LESSONS LEARNED AND

CONCLUSIONS

As the above case scenario is reviewed,

there are numerous lessons to be

learned:

• Owner’s manuals of infection

prevention equipment should be

kept in a designated location where

they can be easily retrieved, and

responsibilities for reprocessing

should be assigned to personnel

with appropriate education and

training

• Rely on the expertise of

manufacturer representatives of

dental equipment and supplies

who may troubleshoot potential

errors when experiencing technical

difficulties as well as facilitate

loaned equipment and training on

About the author

Dr Marie T. Fluent is a graduate of the University of Michigan

School of Dentistry in the United States (US). Her dental

career spans 35 years and includes roles as dentist, both as

an associate and practice owner, infection control coordinator,

office manager, and dental assistant. Additionally, she has

extensive experience and expertise as a dental inflection

control clinical instructor, educator, speaker, author, and consultant.

Dr Fluent is passionate and deeply committed to improving dental infection

control and patient safety. Through her writing, webinars, and invited lectures,

she has educated thousands of dental professionals and students nationally and

internationally. She has written numerous peer reviewed articles on infection

control in the dental setting, OSHA compliance, and responsible antibiotic

prescribing.

proper use and maintenance

• CDC’s Summary of Infection

Prevention Practices in Dental

Settings and accompanying

checklists may serve as review or

evaluation of the infection control

policies and protocols within a dental

office, while the CDC Guidelines

provide steps to take in case of a

failed spore test

• There are many fail-safes within

the reprocessing system, and the

use of Type 5 integrating indicators

adds an element of consistency,

efficiency, and quality assurance to

the sterilisation monitoring process DA

*This article and its contents are based off of

recommendations provided by the Centers

for Disease Control and Prevention (CDC) and

was originally published for the US market

REFERENCES

• CDC. Guidelines for Infection Control in

Dental Health-Care Settings - 2003

• https://www.cdc.gov/mmwr/pdf/rr/rr5217.

pdf

• CDC. Summary of Infection Prevention

Practices in Dental Settings - 2016. Basic

Expectations for Safe Care

• https://www.cdc.gov/oralhealth/

infectioncontrol/pdf/safe-care2.pdf

• CDC. Infection Prevention Checklist for

Dental Settings – 2016. Basic Expectations

for Safe Care

• https://www.cdc.gov/oralhealth/

infectioncontrol/pdf/safe-care-checklist.pdf

DENTAL ASIA JULY / AUGUST 2021 47


Behind the Scenes

Polishing of dental

hybrid materials

While the use of hybrid materials has recently gained popularity

in fabricating indirect restorations, polishing such material

pushes conventional polishing agents to their limits. For this

reason, a technical and scientific analysis depicts how Renfert

Polish hybrid materials addresses this concern to achieve fast,

economical polishing with optimal outcomes.

By Dr Frank Weber and MDT Manfred Tauber

Uniting the positive properties of two distinct

materials, hybrids like CAD/CAM materials

and filled veneer composites are increasingly

used to fabricate indirect restorations (Fig. 1).

This combination of ceramics and polymers

exhibits a high load-bearing capacity with

improved abrasion behaviour while reducing

brittleness to easily process the restorations.

But polishing pushes conventional polishing

agents to their limits because each of the two

materials has distinct requirements.

Another complicating factor is the uneven

material ratio — high ceramic, low composite

content — which varies from supplier to

supplier. Thus, much more preparation and

polishing work was previously required to

achieve a satisfactory gloss level albeit with

limited results.

Renfert Polish hybrid materials comprises a

specialised diamond polishing paste which

does precise justice to the unique needs of

these hybrid materials (Fig. 2). The paste is

designed to account for both the complex

wetting behaviour as well as the different

degrees of hardness of the two material

proportions.

Why is it so important to polish the

surface to a high gloss?

In addition to aesthetic aspects, various

authors 1 have demonstrated that the

roughness of a surface correlates with the

gloss within the high-gloss range.

On the other hand, the surface roughness

has a critical mechanical impact on the

antagonist and affects the growth of plaque.

That means achieving a consistently longlasting

high gloss is the most viable indicator

of low roughness and, in turn, reflective of

high-quality work.

For that reason, Renfert develops,

investigates and compares internally as

well as through an external authoritative

institute the roughness and level of gloss as

defined by the gloss units (GU) of the various

materials. This is the only way to achieve

optimal outcomes, with consistently smooth

surfaces even upon closer inspection.

Fig. 1: The use of hybrid materials in the

fabrication of indirect restorations

Fig. 2: Renfert Polish hybrid materials – special

polishing paste for hybrid materials

Lubrication with oils and the application of

soft waxes can be used to easily imitate a

visual high gloss on the materials, creating a

short-term appearance, but that cannot be

the objective.

48

DENTAL ASIA JULY / AUGUST 2021


Behind the Scenes

Fig. 3: Graph view of the results/measured data and their spread

Fig. 4: MicroProf ® surface measuring tools by Felix Spalthoff, FRT GmbH

Particularly when using veneer composites

and modern hybrid materials with composite

content, the objective must be to reduce

the plaque affinity as effectively as possible

in order to extend the lifetime of the

restorations.

The following presents the comparative studies

of GU and topographic investigations of the

surface roughness measurements of CAD/

CAM-produced hybrid materials.

hybrid materials polishing paste. This not only

shows that excellent results can be achieved,

but also that they are more reproducible than

with comparator polishing sets or polishing

pastes (Fig. 3).

TOPOGRAPHIC INVESTIGATION OF

POLISHED MATERIAL SURFACES

Description of the topographic investigation

and measured data of polished material

surfaces (Felix Spalthoff FRT GmbH)

to describe error from the mean.

VITA ENAMIC ® Before After

Sa [µm] 0.30 0.02

Even more striking is the three-dimensional

plotting of the measurement results. Please

note the markedly magnified scale (colour)

representing the polished case. The scaling

of the heights/depths (z-axis) is the same,

thereby ensuring a direct comparison of

before and after polishing.

COMPARISON OF VARIOUS

POLISHING PASTES ON DIFFERENT

HYBRID MATERIALS

Description of the investigation and

measured data (Development Department,

Renfert GmbH)

For this investigation, at least three uniformly

shaped test specimens each produced from

the respective CAD/CAM block were prepolished

and then polished to a high gloss

according to the operating instructions under

the same conditions.

Subsequently, the test specimens were

measured with a Minolta CM2500d operating

on the basis of an Ulbricht ball. In particular,

the 20° angle required for high-gloss

measurement is not only maintained but

sharpened to 10° and the measured data is

determined in gloss units (GU).

In the investigations with VITA ENAMIC ® , the

highest GU > 120 with the lowest spread of

values was achieved with the Renfert Polish

Three surface measurements were

conducted respectively for each of the seven

hybrid materials on a non-polished sample

and a sample polished to a high gloss with

Renfert Polish hybrid materials.

As examples, the measured data of the

three hybrid materials with disparate surface

structures are presented. The following

examples show the measurement before and

after polishing.

The investigations were carried out using a

MicroProf ® with a CFM confocal microscopic

sensor and a 50 times objective at a

measuring field size of 375x278 μm² (Fig.

4). All measurements were used to analyse

the surface texture according to DIN EN ISO

25178.

Results of VITA ENAMIC ® before and after

polishing

A long list of parameters was evaluated to

investigate the surface roughness. Standard

deviation (SD) is commonly used measurand

The general processing tracks (Fig. 5),

could be reduced to a minimum by polishing

(Fig. 6).

Results on GC CERASMART ® before and

after polishing

For direct comparison, refer to the SD values.

GC CERASMART ® Before After

Sa [µm] 0.37 0.04

And in turn, even more striking is the threedimensional

plotting of the results/measured

data. The scaling of the heights/depths

(z-axis) is the same, thereby ensuring a direct

comparison of before and after polishing.

Polishing reduced the processing tracks and

one marked defect (Fig. 7) to a minimum (Fig. 8).

Results on 3M Lava Ultimate before

and after polishing

For direct comparison, refer to the SD values.

3M Lava Ultimate Before After

Sa [µm] 0.29 0.03

DENTAL ASIA JULY / AUGUST 2021 49


Behind the Scenes

Fig. 5

Fig. 6

Fig. 7

Fig. 8

Fig. 9

Fig. 10

Fig. 5: 3D test view 1 — Surface of VITA ENAMIC ® before polishing

Fig. 6: 3D test view 2 — Surface of VITA ENAMIC ® after polishing with Renfert

Polish hybrid materials

Fig. 7: 3D test view 3 — Surface of GC CERASMART ® before polishing

Fig. 8: 3D test view 4 — Surface of GC CERASMART ® after polishing with Renfert

Polish hybrid materials

Fig. 9: 3D test view 5 — Surface of 3M Lava Ultimate before polishing

Fig. 10: 3D test view 6 — Surface of 3M Lava Ultimate after polishing with Renfert

Polish hybrid materials

Here as well, note the three-dimensional

plotting of the results/measured data. With

same scaling of heights/depths (z-axis), it

can be directly compared.

Polishing reduced the parallel processing

tracks (Fig. 9) to a minimum (Fig. 10). DA

VITA ENAMIC ® is a registered trademark

of VITA ZAHNFABRIK H. RAUTER GMBH &

CO. KG

3D test view images © FRT GmbH.

About the authors

Dr rer nat Frank Weber joined Renfert GmbH in December 2016 as

head of the Chemical Development Department. Prior to this, he was

internationally active in various development and consulting positions

in the solar industry. Dr Weber also worked in process development and

evaluation for the chip industry at Infineon Technologies AG, especially

in the field of cleaning and chemical mechanical polishing for nine years.

This resulted in several patent submissions in Germany and the United States. Today,

drawing from this broad professional experience, he is able to find unorthodox approaches

to pragmatic solutions.

REFERENCES

1.

D.J. Donnermeyer, “Vergleich zweier Verfahren

zur Messung der Ober¬flächeneigenschaften

nach Zahnpasta-Anwendung [Comparison of two

meth¬ods for measuring surface properties after

toothpaste application],” Doctoral Thesis, University

of Münster (WWU Münster), 2015

MDT Manfred Tauber is an active speaker at international dental

congresses and conventions, as well as a publisher of many articles

published in the international dental press. He built up his expertise

through the 19 years of dental technician activities in Austria and

Germany.

50

DENTAL ASIA JULY / AUGUST 2021


Behind the Scenes

Press ceramic,

rediscovered

Dental Technician Ömer Gençtürk, owner of

Da Vinci Dental Studio in Antalya, Turkey

Despite the advent of digital processes,

analogue press ceramics remain an

economical method of fabricating dental

restorations today. With VITA AMBRIA,

the new generation of press ceramic,

Mr Ömer Gençtürk (Turkey) successfully

constructed a cosmetic veneer

restoration for four upper incisors of

a young patient in combination with

veneering ceramic, VITA LUMEX AC.

Everyone is talking about CAD/CAM,

which plays an even greater role in

the fabrication of dental restorations.

However, analogue press ceramics are

still used in many laboratories. It remains

an established, economical and efficient

fabrication method.

Until now, a reaction layer with the

investment material could lead to surface

imperfections and fit issues and has been

a challenge. The lithium disilicate that is

used often appears greyish and lifeless,

due to its crystalline structure.

However, that issue is not something

practitioners have to settle for, according

to Dental Technician Mr Ömer Gençtürk,

DENTAL ASIA JULY / AUGUST 2021 51


Behind the Scenes

owner of Da Vinci Dental Studio in

Antalya, Turkey.

He was given the new generation of press

ceramic, VITA AMBRIA, made of zirconiareinforced

lithium disilicate for testing,

in collaboration with Dr Ahmet Emre

Gülerik, a dentist from DentGroup Clinic in

Antalya, Turkey.

In combination with veneering ceramic,

VITA LUMEX AC, Mr Gençtürk achieved

a highly aesthetic result from the first

application and shares his experience

in using VITA AMBRIA in fabricating a

cosmetic veneer restoration.

Many dental technicians are reluctant

to implement new materials in their

laboratory. What was your experience

with VITA AMBRIA press ceramic?

There are always concerns, especially if

processes have generally been working

well in the past. In the end, curiosity

prevailed. I wanted to see whether I could

achieve better results by using the VITA

AMBRIA material system.

In fact, I simply followed the instructions

for use and there was no learning curve.

During the first usage, I could see that

VITA AMBRIA delivers what it promises.

So, there is no need for concern when

shifting to this new product.

When working together with the

dental practice, how important is

absolute shade accuracy of the

material to the VITA shade standards?

The VITA shade guides are a standard

worldwide. The material also has to

precisely match the corresponding shade

tabs. If I determine an A3.5 on the patient,

there should also be an A3.5 in the press

and veneering ceramic.

This is the only way I can reproduce the

shade appropriate for the patient and be

confident that my clients are satisfied

with my work. VITA AMBRIA, as the

shading element, proved to be true to the

shade in this patient’s case.

Removing the mould is always a tense

moment. What was your experience

with this process?

Removing the mould is the moment of

truth because I have never tried VITA

AMBRIA before. And, of course, it is also

the moment when you hope that the

ceramic will come out of the investment

material without any damage. The thin

Fig. 1

Fig. 2 Fig. 3

Fig. 4 Fig. 5a

Fig. 5b Fig. 5c

Fig. 6

Fig. 1: A young patient was not satisfied with the appearance of her anterior

aesthetics

Fig. 2: The anterior teeth in the upper jaw were positioned irregularly and

interlocked

Fig. 3: Tooth 21 was strongly tilted towards the palatal plate; the incisal edges

did not harmonise with the curve of the lips

Fig. 4: VITA AMBRIA press ceramic provides highly aesthetic restorations with

true-colour brilliance

Figs. 5a-5c: Fluorescence, natural translucency and opalescence are integrated

in VITA AMBRIA press ceramic

Fig. 6: The veneers modelled from wax were invested in VITA AMBRIA INVEST and

fired

52

DENTAL ASIA JULY / AUGUST 2021


Behind the Scenes

Fig. 7

Fig. 8 Fig. 9

For the shade gradient, I layered some

OPAQUE DENTINE A1 cervically so it

would be less chromatic after the incisal

DENTINE A1. I created the mamelon

anatomy effect using MAMELON saffron

and highlighted it with intermediate

layers of a one-to-one mixture of

DENTINE A1 and ENAMEL clear.

veneers in this case study proved to be

robust during the removal process.

Another thing I noticed right away was

the minimal reaction layer with the

investment material and the flawless

ceramic surfaces at the right furnace

temperature. The restorations came out

perfectly.

Fig. 10

Fig. 12 Fig. 13

Fig. 7: After the firing, VITA AMBRIA was pressed with the appropriate PLUNGER

Fig. 8: The investment material, VITA AMBRIA INVEST, generally ensures a completely minimal reaction layer

Fig. 9: Minimal individualisations can be made using the veneering ceramic VITA LUMEX AC

Fig. 10: The incisal edges and curve of the lips harmonised with each other

Fig. 11: Surface texture and gloss level could be realised in an age-appropriate manner

Fig. 12: The dental arch in the upper jaw had been levelled by the all-ceramic restorations

Fig. 13: The four veneers showed a vivid interplay of colour and light

How did you establish a shade gradient

with the veneering ceramic VITA

LUMEX AC and reproduce the dentin

core?

I managed to use VITA AMBRIA in

Fig. 11

producing the dentin core in the correct

base tooth shade, so I did not have to do

much more on the anatomically reduced

surfaces to get a three-dimensional result.

How exactly did you proceed with the

enamel layering using VITA LUMEX

AC? What is your advice for creating a

halo effect in the process?

I followed with alternating layers of

translucent ENAMEL light, neutral

ENAMEL clear, light blue OPAL

TRANSLUCENT opal-azure and light

yellow TRANSLUCENT light-blonde to

establish a natural play of colour and

light.

After the first firing, the incisal final

layering was then carried out with a light

blue TRANSLUCENT waterdrop. I was

able to achieve a halo effect from the

palatal plate using a balanced mixture of

OPAQUE DENTINE A1, ENAMEL light and

highly fluorescent FLUO INTENSE cream.

There you have it: high aesthetics with

only two firings. DA

VITA ® and the names of the VITA products

mentioned are registered trademarks of

VITA Zahnfabrik H. Rauter GmbH & Co.

KG, Bad Säckingen, Germany.

DENTAL ASIA JULY / AUGUST 2021 53


Behind the Scenes

Use of a 3D

printer in a fully

digital workflow

A fully digital workflow boosts accuracy,

flexibility and efficiency. But how does a 3D

printer contribute to making this possible?

The following clinical case discusses the role

of a 3D printer in a digital workflow.

A fully digital workflow has been the

subject of discussion and debate within

the dental industry for years. Today,

thanks to the development of cuttingedge

technologies, it is finally possible to

approach this working methodology to

allow the clinician, dental technician and

most importantly, the patient, to rely on a

predictable treatment with reduced time

and costs.

Within this workflow, the role of the

3D printer assumes considerable

importance, both for the production of

classic artefacts such as models, gingiva,

surgical guides and temporary elements.

It also offers the option of adopting

alternative approaches and creating, for

example, aesthetic and functional waxups.

By Simone Fedi

Fig. 1: Virtual design

Fig. 2: Aesthetic test

EVERES UNO 3D printer by SISMA

54

DENTAL ASIA JULY / AUGUST 2021


Behind the Scenes

On one hand, 3D printer allows the

dental technician and clinician to match

what was digitally designed to what was

created instantly. On the other hand,

it helps the patient to have a clearer

understanding of the treatment.

Fig. 3 Fig. 4

This process allows the professional

to adopt an approach considering not

only the clinical and functional side but

also the psychological impact of the

treatment, particularly in the case of

rehabilitation of total edentulism.

Figs. 3-4: EVERES TEMPORARY resin printed using EVERES UNO by SISMA

The following clinical case fits precisely

within this context:

• a fully-digital rehabilitation of

the maxillary arch with the aid of

radiographic images from conebeam

computed tomography (CBCT)

to obtain the data necessary for

implant planning

• .stl files acquired through intraoral

scanning

• photographs for the design of the

final prosthesis and smile design,

respectively

CLINICAL CASE

After acquiring the necessary clinical

data, performing the implant planning

and the subsequent surgery, we

designed the final prosthesis (Fig. 1).

Consisting of a bar screwed onto

implants (made by CNC) and its counterbar

with an abutment structure (made

using laser metal fusion 3D printing

technology), the dental element was

cemented as a single piece — for greater

versatility and easier maintenance over

time.

Before proceeding with the production

of the final counter-bar, the files relating

to the counter-bar and the individual

elements are merged into a single .stl file

that is printed in EVERES TEMPORARY

resin using EVERES UNO by SISMA.

The accuracy and speed of the printer

Fig. 5: The extreme precision of EVERES UNO allows to create a specimen that fully reflects what the

definitive prosthetic product will be

created an aesthetic wax-up in a short

time, perfectly matching the dimension

and geometry of the digital design.

This allows the team, made up of clinician

and dental technician, to present the final

result to the patient effectively, without

the need for modified images displayed

on the screen (Figs. 2-5).

The approach makes it possible to verify

the match between what has been

designed and what was created before

proceeding with the production of the

final prosthesis — allowing for changes

and corrections without incurring further

costs or time lengthening, which reduces

the number of required sessions for the

patient.

CONCLUSION

From this clinical case, it is clear how

a professional-level 3D printer allows

practitioners to approach treatments

innovatively. It reduces the time and

number of appointments needed for the

completion of the treatment. 3D printing

introduced a simplified protocol both in

terms of flexibility and variations with zero

impact. DA

About the author

Simone Fedi graduated with 60/60

in dental technology in 1997 at the

Istituto Professionale Statale Istruzione

Superiore (IPSIA) Gaslini in Italy. In

2003, he joined the company of his

current laboratory. He specialised first

in total prosthesis, following courses

on the Gerber and Passamonti method,

proceeding to techniques of reverse

layering in composite courses in

Bredent and casting using traditional

techniques. Expert in CAD/CAM

techniques in fixed and removable

prosthesis solutions, he won the

competition organised by Trasformer

system regarding the protocol on

injection prostheses in 2015.

DENTAL ASIA JULY / AUGUST 2021 55


In Depth With

Invisalign ® G8

with SmartForce

Aligner Activation

Greater control and improved clinical

predictability — Invisalign G8 with

SmartForce Aligner Activation is the newest

series of biomechanical innovations for

Invisalign treatment informed by tooth

movements from millions of patients treated

with Invisalign clear aligners.

Invisalign G8 is part of Align’s ongoing

commitment to further enhance

Invisalign as a force driven system.

It focuses on improving deep bite,

crowding and cross bite cases. These

cases are improved by adding the

Aligner Activation feature to aid in

anterior intrusion for deep bite cases

and posterior arch expansion for crowding

and cross bite cases.

SmartForce features are even smarter

SmartForce Aligner Activation ensures

areas on the aligner surfaces are contoured

to apply forces to the tooth in the proper

direction.

Throughout every stage of treatment,

the location, direction and intensity of

the force work in harmony to create

optimal force system unique to the

patient (Fig. 1).

Predictable deep bite correction

Invisalign G8 improves clinical

predictability of incisor intrusion in deep

bite cases by up to two times 1 . Intrusion

force levels are optimised for each

tooth, and the precision bite ramps are

clinically proven to improve lower incisor

intrusion by up to 30% 2 (Fig. 2).

Posterior arch expansion in

crowding and crossbite cases

Automatically programmed to apply and

distribute the required force to each

posterior tooth, Invisalign G8 is designed

to deliver more predictable posterior

arch expansion for resolving crowding

and crossbite cases (Fig. 3).

Reduction in the likelihood of

posterior open bite

Invisalign G8 provides more predictable

anterior intrusion, which may reduce

premature anterior contacts – a

common cause of posterior open bite.

Invisalign G8 also controls unwanted

buccal crown torque or tip during

expansion which is another common

cause of posterior open bite (Fig. 4). DA

Fig. 1: SmartForce Aligner Activation

Fig. 2: Deep bite correction

REFERENCE

1.

Based on analysis of 190,040 primary

treatments requiring incisor intrusion. Analysis

shows that cases with sufficient activation

increased clinical predictability of incisor

intrusion by up to 2X compared to cases with

lower level of activation. Data on file at Align

Technology, as of 25 July 2019

2.

Up to 30% is based on comparison of the

lower incisor intrusion achieved in Invisalign

G5 cases with bite ramps and without bite

Fig. 3: Posterior arch expansion in crowding and

crossbite cases

Fig. 4: Reduction in the likelihood of posterior

open bite

ramps. Data on file at Align Technology, as of

15 November 2019

56

DENTAL ASIA JULY / AUGUST 2021


BioSonic ® UC150

Ultrasonic cleaning system

´ Data logging capability for validation

´ Offers customizable and quiet operation

´ Online activation of optional

heater function

´ Fits up to 4 cassettes

´ Can be used as a countertop or

recessed unit

STATIM ® G4 2000 and 5000

Cassette Autoclaves

´ Fast

STATIM G4 is the fastest cassette sterilizer

from start to sterile.

´ Smart

G4 Technology - information at your

fingertips.

´ Reliable

For over 25 years, STATIM’s speed,

reliability and dependability have made it

the ideal sterilizer for every practice.

www.coltene.com

facebook.com/COLTENE.AsiaPacific/

006714 05.21


In Depth With

Compressed air: More than

oil-free, dry and clean

A dental facility cannot operate without

a dependable supply of compressed

air. Whether it be a simple handheld air

nozzles or modern CAD/CAM systems —

oil-free, dry and clean compressed air is

an essential ingredient in the success of

a dental laboratory.

But in the advent of digital technologies,

which includes milling and grinding

machines in the dental laboratories,

these simple requirements to the

compressed air are not sufficient

anymore.

Modern CAD/CAM milling and grinding

machines require a stable supply of

compressed air to function optimally. The

following tackles a solution to achieve

consistent, high-quality compressed air in a

dental facility.

The present manufacturers of CAD/

CAM systems frequently ask for a clearly

defined quality of compressed air. Most

of the time, they look for the 1-4-2

classes of quality.

These classes refer to the ISO 8573-

1:2010 for compressed air — the

international norm that defines the

purity classes and regulates how much

water, oil and particles are allowed

to remain in the compressed air after

treatment.

These three characteristics are the

following:

Class 1 particles

Maximum particle count per m 3 of a

particle size with d [µm]*)

0.1 < d ≤ 0.5 ≤ 20,000

0.5 < d ≤ 1.0 ≤ 400

1.0 < d ≤ 5.0 ≤ 10

Class 4 water

Pressure dew point, in °C

≤ +3 °C

A CAD/CAM system needs a constant air quality and a pressure of seven bar.

For the remain equipment in the dental laboratory it will be recommended to reduce the pressure

to 5,5 bar. This helps to reduce leakages, drop energy costs and save environment.

A nightly separation of the remain laboratory from the air supply enhances these effects

58

DENTAL ASIA JULY / AUGUST 2021


In Depth With

Existing compressed air stations can be equipped with a dryer and filters to purify air required for milling machines quality

A modern compact compressed air station like

the Aircenter is a profound solution for dental

laboratories

Class 2 oil

Total oil concentration (liquid, aerosol +

gaseous) [mg/m3]*)

≤ 0.1

*) At reference conditions 20°C, 1 bar (a),

0% humidity

Modern CAD/CAM milling and grinding

machines represent a significant

investment, which needs to be amortised

as swiftly as possible. In order to achieve

this, the systems should run round the

clock, ideally even at weekends.

But to function seamlessly, this

equipment requires a stable supply of

quality compressed air at a minimum

pressure of seven bar.

If the requirement regarding pressure

and air flow is fulfilled, the existing

compressed air system can be equipped

with filters and a refrigeration dryer

without loss of compressed air output

in the form of purge air. This allows

compressed air quality to be adjusted

according to the new requirement.

However, if there is a need for a

completely new compressed air supply,

screw technology is the best solution,

economically and technically.

Designed for 24/7 operation, a screw

compressor along with proper air

treatment equipment is suitable to

operate in a laboratory which has a

ready-to-use milling machine or has

intention to use one in the future.

In a dental facility using a CAD/CAM

system, the demand for compressed air

enlarges dramatically and the working

hours of the compressor increase by 10

to 15 times in comparison to conventional

dental labs. This mode of operation is

best handled by compressors based on

screw technology.

When a new compressor is to be installed,

it is also important to consider the

compressed air supply of the remaining

equipment in the laboratory. DA

DENTAL ASIA JULY / AUGUST 2021 59


Product Highlights

Coltene

The fifth-generation of root canal files

The new HyFlex EDM files from COLTENE cleaning and shaping during root canal

constitute the fifth-generation of root canal treatments without compromising the

files. HyFlex EDM NiTi files have completely preservation of the root canal anatomy.

new properties due to their innovative

manufacturing process using electric HyFlex EDM files exhibits high flexibility,

discharge machining (EDM).

extreme resistance to fracture and centred

canal preparation.

Workpieces are machined in the EDM

manufacturing process by generating a In fact, tests have shown that HyFlex NiTi

potential between the workpiece and the files are significantly more resistant to

tool. The sparks generated in this process fatigue than conventional NiTi files. In the

cause the surface of the material to melt new HyFlex EDM NiTi files, this effect is

and evaporate. This creates the unique further increased by 300-700%. The new

surface of the new Niti files and makes the EDM manufacturing process results in

HyFlex EDM files stronger and more fracture another form fit and hardness of the surface

resistant.

of the file.

and regain their shape after heat treatment.

A normal autoclaving process is enough to

return the files to their original shape and

to regenerate the crystal structures and

resistance to fatigue.

Should the file fail to regain its shape after

heat treatment, it is plastically deformed,

thus increasing the risk of fracture.

These files should not be used after

visual inspection. The number of reuses,

which can be determined by the user by

visual inspection, is higher than that of

conventional NiTi files. ■

This entirely unique combination of flexibility

and fracture resistance makes it possible

to reduce the number of files required for

Additionally, HyFlex NiTi have a built-in

shape memory. They prevent stress during

preparation by changing their spiral shape

Dentsply Sirona

Power performer solution

Orthophos SL 3D from Dentsply Sirona

offers revolutionary technology, patented

positioning solutions, and extremely

versatile 2D/3D hybrid unit features to

create a unique imaging solution.

The 2D/3D high-end system with excellent

image quality is for practices with a flair

for technology and those who simply want

more.

Practitioners can achieve clinical confidence

with its 3D Low Dose and HD function along

with fields of view of ø 5cmx5.5cm to ø

11cmx10cm. These numerous volume sizes

ensure flexibility in everyday practice. For

instance, clinicians can examine a precise

area or evaluate the complete dentition

including wisdom teeth.

The integrated Direct Conversion Sensor

(DCS) defines the standard for panoramic

imaging and delivers a high level of

sharpness. The “Sharp Layer” technology

ensures autofocused panoramic images

even in anatomically difficult cases.

Orthophos SL offers optimum user

comfort through auto-positioning,

intuitive operation via the EasyPad and an

individually adjustable Ambient Light for an

exclusive look and feel.

It also has an optional right or left

cephalometric arm, which can be retrofitted

at any time.

Orthophos SL also features Sidexis 4,

an intuitive imaging software for easy

reporting and integrated workflows for

orthodontics, implantology, sleep apnoea

and endodontics. An open interface, Sidexis

4 is compatible with over 200 practice

management software packages.

Integration into large clinics and Dental

Service Organisation (DSO) networks is

possible through connectivity to PACS, RIS,

DICOM Worklist and DICOM Printers. ■

60

DENTAL ASIA JULY / AUGUST 2021


Product Highlights

Fotona XPulse ® diode laser line: Unmatched possibilities

Fotona

XPulse ® diode lasers from Fotona are

the modern and professional choice for

soft-tissue treatments, haemostasis and

disinfection.

With a broad range of clinical presets,

handpieces and multiple pulse modalities,

XPulse ® allows practitioners to perform

optimised treatments with superior battery

or plug-in operation for ultimate portability.

Depending on the indication for use,

XPulse ® allows for the choice of the most

appropriate wavelength and specific

settings that will achieve the desired type

of laser-tissue interaction to produce the

intended effect.

Fotona XPulse ® laser systems can be used

either in contact or non-contact mode.

Energy is delivered through a flexible

quartz-fibre delivery unit. The contact

tip provides the practitioner with tactile

feedback on where the laser is working.

An additional green laser aiming beam is

delivered simultaneously through the laser-

beam delivery system, which allows the

operator to see the position of the treatment

laser on the target tissue.

XPulse ® is easy to use for both new and

experienced laser practitioners. Users can

simply select from the preset parameters

or directly input the preferences on the

application screen, and begin the treatment.

Available in two models:

XPulse ® : 810nm, 980nm, 1064nm

XPulse ® II: 445nm, 810nm, 980nm ■

Due to differences in registration

procedures, the device might not be

immediately available in all countries.

Contact your local representative for more

information.

SHOFU Block HC and Disk HC: Superior features, consistent quality

Shofu

SHOFU HC Hybrid Ceramic is designed

with exceptionally natural aesthetics,

superior mechanical properties, shock

absorbing capabilities and is faster to mill

and is easily polished to lasting, life-like

lustre.

Decades of experience in indirect resin and

unique filler technology provided expertise

for the development of SHOFU HC Hybrid

Ceramic, that has an array of clinical

applications— inlays, onlays, veneers,

anterior/posterior crowns as well as implant

supported restorations.

SHOFU Hybrid ceramics HC-Blocks/Disks

increase productivity and profitability,

as they can be seamlessly incorporated

into the digital workflow, save processing

time and provide predictable outcomes

with precise margins and easy intra-oral

adjustments.

Created through a rigorous manufacturing

process, SHOFU Block HC/Disk HC exhibits

consistent quality:

• Life-like aesthetics with natural

opalescence

• Excellent polishability for lasting

aesthetics

• Kinder to the natural antagonist and

supporting hard/soft tissues

• Remarkable stain and wear resistance

• Greater flexural strength and flexibility

Compatible with a range of CAM systems,

Shofu Block HC comes in UNIVERSAL/

CEREC pins

LT – Low Translucency: Matches VITA

Classical shades with lower translucency for

posterior crowns

HT – High Translucency: Higher

translucency is ideal for inlays and anterior

crowns

Enamel: Designed to replicate the enamel

layer (59 - Incisal / OC - Occlusal)

HC Primer (Specialised Hybrid Ceramic

Primer): The novel primer is developed

for optimal surface pre-treatment and

ensures reliable adhesive cementation of

SHOFU Block HC/Disk HC restorations. An

innovative monomer formulation enables

HC primer to infiltrate the Hybrid Ceramic

Matrix and create a strong, durable bond. ■

DENTAL ASIA JULY / AUGUST 2021 61


Product Highlights

Renfert

SYMPRO: Completely MDR-compliant cleaning system

An effective, automated process for

fully comply with the relevant regulations

cleaning dentures that can bring high time and have much more to offer.

savings compared to manual methods

is now possible with SYMPRO cleaning For example, the field of application of

system. Renfert has redesigned this

the compact SYMPRO high-performance

system in view of the increased quality cleaning unit now includes orthodontic

management requirements for dental appliances in addition to dentures, occlusal

offices.

splints and other dental restorations.

All the relevant components (unit,

accessories and cleaning liquids) have been

adapted to meet the requirements of the

Medical Device Regulation (MDR). The range

of applications and fluids supplemented

with a powder have been expanded under

the new product name — help:ex.

According to the MDR, products that are not

medical devices themselves but are used,

for example, to clean medical devices, are

also defined as medical devices.

SYMPRO and the associated cleaning liquids

The ready-to-use cleaning liquids

SYMPROfluid Universal and Nicoclean are

now available in proven quality under the

new names help:ex plaque f (plaque and

tartar) and help:ex discolour f (nicotine/tar

stains).

As an alternative, the new help:ex plaque p

powder can be used for plaque and tartar

in a practical portion sachet with a unique

neutraliser for easy disposal.

The temporary cement remover temp:ex

can be used in the SYMPRO to dissolve

residues of temporary cements based on

zinc oxide safely, quickly and gently.

True to the motto “making work easy”, the

new version of the Renfert cleaning system

stands for cleaning processes that are both

efficient and effective.

The basis for this is the high performance of

the SYMPRO needle cleaning device and the

well-thought-out selection of help:ex and

temp:ex cleaning liquids specially adapted

to different types of staining – and all of this

in complete compliance with the MDR. ■

TeKne Dental

QUARK CAL: compact contra-angle handpiece

QUARK CAL from TeKne Dental is a

compact contra-angle handpiece with

ergonomic design and is available with or

without fibre-optic rod. It has an internal

spray, direct 1:1 ratio (blue) and push-button

grip. The handpiece is compliant to EN ISO

14457 standard.

The reduced weight and its perfectly

balanced shape provide good tactile grip

whereas the reduced head size facilitates

access to the molar area. Its maximum

rotation speed is 40000rpm.

The handpiece features smart chrome

coating and is equipped with high-precision

ball-bearings and gears which allow

superior reliability and high resistance to

wear and corrosion.

The head locking mechanism is made for CA

burs (2.35mm diameter) and the connection

is standard so that handpieces can be

connected to any brand of micromotors.

QUARK CAL comes in two versions:

• QUARK CA (REF 650.00)

• QUARK CAL (REF 652.00)

Intended for professional use in dentistry

for prophylaxis, restoration and endodontic

works, this medical device meets the

requirements of the European Directives

93/42/EEC (Class IIa) and 2007/47/EC. The

handpiece can be used with any pneumatic

or electric micromotor with internal spray

and coupling compliant to ISO 3964

standard. ■

62

DENTAL ASIA JULY / AUGUST 2021


Product Highlights

Ideal shade fidelity, excellent light dynamics, precise processing

VITA

VITA LUMEX AC is a leucite-reinforced,

glass-ceramic veneering system with an

innovative material formula for vivid and

reliable results with shade accuracy.

efficiently and precisely, thanks to the ideal

modelling properties, remarkable shape

stability and universal applicability for all

substructure ceramics.

VITA LUMEX AC includes GINGIVA, OPAQUE,

OPAQUE DENTINE, DENTINE and ENAMEL

materials, as well as a multitude of effect

materials such as OPAL TRANSLUCENT

and FLUO INTENSE. It also has an ideally

matched system components such as

brushes, firing trays, and glazing materials.

Durable restorations are produced because

of the high fracture resistance of the

leucite-enhanced glass ceramic matrix and

a reliable bond to the substructure.

It reliably reproduces tooth shades as well

as a natural play of shade and light; its

ceramic materials have outstanding shade

fidelity and excellent light dynamics.

Users can process veneering ceramic

VITA LUMEX AC is indicated for the

veneering of all common full ceramic

substructure materials (zirconia, LiSiglass

and feldspar ceramics) and for the

production of reconstructions without a

substructure such as veneers. ■

Minimally invasive, maximum power

W&H

Piezomed from W&H puts all the

advantages of innovative ultrasound

technology at the fingertips: high-frequency

micro-vibrations allow cutting with

incredible precision. In addition, with the

“cavitation effect”, users can ensure an

almost blood-free surgical site.

Additionally, Piezomed adapts to a clinician’s

personal way of working: The device saves

their last selected settings and supports them

with three individual operating modes. Its

wireless foot control also allows for controlling

multiple W&H devices, such as Implantmed and

Piezomed.

Piezomed facilitates the surgeon’s and

implantologist’s work: thanks to innovative

ultrasound technology, onlay bone

substance is resected with high precision

and the surrounding soft tissue remains

uninjured. This is a noticeable relief for the

patient: less pain, quicker healing.

Practitioners can benefit from automatic

instrument detection which detects the

instrument and assigns it to the correct

power class. This not only facilitates

operation but also increases safety. The risk

of overloading the instruments is reduced

and the service life of the instruments is

considerably extended too.

The device features temporary 20% power

increase due to its boost function and with

its LED ring illumination, ideal lighting of the

operating field can be achieved.

Piezomed cools efficiently thanks to the spray

opening close to the instrument’s working area.

The handpiece has LED socket and cable, which

is thermo-washer disinfectable and sterilisable.

Ultimately, Piezomed consists of: control

unit, foot control S-N1, handpiece with 1.8m

or 3.5m cable and clips, irrigation tubing set,

mains cable, motor support, stand, instrument

changer, sterilisation cassette, and instrument

kit “Bone”. ■

DENTAL ASIA JULY / AUGUST 2021 63


Product Highlights

Zimmer Biomet Dental

Optimisation is key to aesthetics

The BellaTek Encode Impression System Customised treatment solutions:

from Zimmer Biomet Dental provides

Clinicians can choose a simple impression

optimised solutions to clinicians by

method above the gingiva to create

eliminating the need for implant level

aesthetic BellaTek Patient Specific

impressions, which streamlines the

Abutments in titanium or gold-coloured

treatment process for the surgeon,

titanium nitride.

restorative clinician and laboratory.

In addition, patients have a better

Practice growth through better patient

experience and a beautiful aesthetic

care: End-to-end treatment solutions for

outcome as compared to traditional

the team involved allow for a more efficient

techniques using material and impression workflow, less inventory to stock and

copings.

provide a vehicle for practice growth. ■

Calvo-Guirado JL†, Tarnow DP†. The effect of

abutment dis/reconnections on peri-implant

bone resorption: A radiologic study of platformswitched

and non-platform-switched implants

placed in animals. Clin. Oral Impl. Res. 00, 2011, 1.

†Clinicians have financial relationships with

Zimmer Biomet Dental resulting from speaking

engagements, consulting engagements, and other

retained services.

Key features include:

Hard and soft tissue maintenance: No

need to remove the healing abutment,

preserving tissue and resulting in aesthetic

outcomes 1,2 .

1.

Canullo L, Bignozzi I, Cocchetto R, Cristalli

MP, Iannello G. Immediate positioning of a

definitive abutment versus repeated abutment

replacements in post-extractive implants: 3-year

follow-up of a randomized multicenter clinical trial.

Eur J Oral Implantol. 2010 Winter;3(4):285-96.

2.

Rodrıguez X†, Vela X†, Mendez V, Segala M,

VOCO

VisCalor – the world’s first thermoviscous restorative material, now

available for all cavity classes

With VisCalor, a universal variant indicated

for all cavity classes is now added to

the world’s first thermoviscous bulk fill

composite. While the bulk-fill variant,

VisCalor bulk, focuses on simple and quick

posterior restorations, VisCalor makes highly

aesthetic anterior restorations possible,

thanks to its large range of VITA shades,

including an additional, translucent shade.

Both products are based on the unique

thermoviscous technology. VisCalor reaches

a low viscosity through extraoral heating,

allowing for an application that resemble like

flowables.

The material flows optimally onto cavity

walls and undercut regions. Then it cools

down to body temperature quickly, becomes

highly viscous and can be modelled like a

classic packable composite without any

delay. Uniting two different viscosities in

one product guarantees fast and easy

handling, since separate steps such as

lining and covering layers are no longer

required.

In addition, VisCalor is compatible with all

conventional bonding agents. Thus, VisCalor

offers not just a high-quality and aesthetic

restoration, but also an economical

alternative to conventional composites.

VisCalor SingleDose Caps are characterised

by their particularly long and slender

cannula. This allows direct application,

even in hard-to-reach areas and narrow

cavities, as well as bubble-free application,

which contributes to the durability of the

restoration.

The longevity and stability of the material

are the result of its excellent physical

properties: with a filler content of 83% by

weight as well as low shrinkage of only

1.4%, VisCalor is in a class of its own among

composite materials.

The Caps Warmer is ideally suited for

heating VisCalor and allows for up to four

caps to be heated at the same time. This is

especially advantageous when working with

multiple increments or also with multiple

shades.

Thanks to its unique technology, VisCalor

creates the ideal preconditions for excellent

handling, simple application, as well as

high-quality and long-lasting restorations of

highly aesthetic appearance – for all cavity

classes. ■

64

DENTAL ASIA JULY / AUGUST 2021


Product Highlights

A smarter way to scan

Intelligent scanning, powerful results:

The CS 3600’s acquisition software includes

a set of warnings that provide feedback

in real-time, indicating areas of the scan

that lack detail and require additional

scanning to optimise clinical outcome.

This continuous feedback not only helps to

ensure a high-quality scan, but also enables

users to quickly reach expert level.

Carestream

Carestream Dental CS 3600 is the ideal

choice for clinical excellence. With intuitive

and accurate scanning, users can create

vibrant full HD 3D images — helping them

achieve outstanding clinical results.

The CS 3600 scans in a continuous and

uninterrupted pattern, making dual arch

and quadrant imaging fast and easy.

In addition, the digital impressions can

streamline restorative, orthodontic and

implant planning.

Perfect for any dental procedure:

Carestream Dental’s intraoral scanners

improve efficiency by simplifying and

accelerating the process of creating digital

impressions and models. With dedicated

restoration, orthodontic and implant-borne

restorative workflows, the CS 3600 family

meets the clinical needs seamlessly.

CS MeshViewer: The complimentary CS

MeshViewer allows the users, their lab and

referrals to view the DCM files acquired by

the CS 3600 in full HD colour. Additionally,

it also enables the export of DCM, STL and

PLY files and includes margin line details

once they have been marked. The CS

MeshViewer also provides an orientation

converter, which enables reorientation of

the mesh so that it is compatible with the

lab’s preferred CAD/CAM software. ■

The correct, detailed recording of the

occlusion is still the main focus of the

Bausch company. Based on decades

of experience in the manufacturing of

articulation and occlusion test materials,

Arti-Bite, a new intraoral vinyl polysiloxane

bite registration material, has now been

added to the product range.

In various areas of dentistry, the material is

suitable for recording occlusal conditions

as well as for restorative and prosthetic

treatments.

Bausch introduces Arti-Bite BK 400 and BK 402

• Detailed representation of the occlusal

contacts

Arti-Bite is a high-quality product that not

only achieves precise results but also makes

• Short setting time of 30 seconds

daily work easier. The price-performance

• Less than 0.1% shrinkage and is

ratio of Arti-Bite is outstanding compared to

dimensionally stable

similar products.

• Due to the hardness of 92 Shore A,

Arti-Bite is easy to rework in the dental

laboratory

Arti-Bite BK 400 includes four cartridges

• Balanced viscosity to make the

material easy to process

and 12 mixing tips, Arti-Bite BK 402 consists

of two cartridges and 14 mixing tips. ■

Bausch

In the development of Arti-Bite, Bausch

focused on user-friendliness, which is

achieved through the high-quality of the

raw materials.

Five outstanding features reflect the main

advantages of Arti-Bite:

DENTAL ASIA JULY / AUGUST 2021 65


Giving Back to Society

Henry Schein donates more than 2.5 million personal protective equipment

and infection control items in Brazil and India

Henry Schein, Inc., in partnership with C.H.

Robinson and the C.H. Robinson Foundation,

has donated more than 2.5 million personal

protective equipment (PPE) and infection

control items through Henry Schein Cares,

the company’s corporate social responsibility

programme, to enhance the safety of

frontline healthcare workers in Brazil and

India as they combat the recent surge in

COVID-19 cases.

The donation includes N95 face masks, levels

1 and 2 face masks, coveralls, hand sanitiser,

pulse oximeters, isolation gowns, and face

shields. In collaboration with logistics partner

C.H. Robinson, Henry Schein will distribute

these products to several non-government

organisations (NGOs). The NGOs are then

planning to redistribute the supplies to health

systems and key areas in Brazil and India.

The recipients in India currently include:

Baptist Hospital in Bangalore, LNJP Hospital

and All India Institute of Medical Sciences in

New Delhi, Deenanth Mangeshkar Hospital

in Pune, Nair Hospital in Mumbai, and the

State of Maharashtra. In Brazil, items will be

distributed to healthcare workers in Rio de

Janeiro and the State of Sergipe.

“It is critical that we help combat the rise in

COVID-19 cases in Brazil and India where

the outbreak is particularly severe,” said

Stanley M. Bergman, chairman of the board

and chief executive officer of Henry Schein,

Inc. “Together with our NGO partners, we will

continue the urgent task of enhancing the

safety of the heroic health care professionals

caring for patients battling the COVID-19

virus.” ■

Planmeca and Midwestern University Dental donate CAD/CAM equipment

to the Kingdom of Tonga

Midwestern University College of Dental

Medicine Arizona, United States, and

Planmeca has announced cooperative

efforts to expand restorative dentistry to the

Kingdom of Tonga by donating CAD/CAM

dentistry equipment and software.

This donation, coordinated by P. Bradford

Smith, DDS, dean of Midwestern University

College of Dental Medicine Arizona, and

Don Erickso, sales manager of Planmeca

USA Schools and Institutions, increases the

level of dental care in the form of indirect

restorations for the first time to the population

of over 100,000.

With the donation of a Planmeca mills, two

Planmeca intraoral scanners with laptops,

and Planmeca Romexis ® and Planmeca

PlanCAD ® Easy Design and Mill software, the

Tongan dental team at the Vaiola Hospital can

help the people of the island nation save their

teeth by fabricating restorative crowns onsite

at the clinic at a significantly reduced cost.

In addition, the group of nine dentists will

complete onsite restorations within a single

patient visit, critical time savings for those

who may travel from the outer islands.

population as well as the extended time in

sending impressions overseas to be milled

and returned for placement.

Midwestern University College of Dental

Medicine Arizona has been conducting

mission trips to Tonga for over 10 years,

assisting in providing dental equipment and

continuing education to advance the levels of

dental care.

Previous mission trips resulted in

implementing a dental assistance programme

for four-handed dentistry, advancing

orthodontia care, and providing didactic and

hands-on training on implantology.

Dr Smith remarked that this is possibly the

first instance of an intraoral scanner and mill

in the small island chains of the South Pacific.

Unfortunately, the cost of manufacturing

crowns has been prohibitive to the Tongan

Planmeca partners with organisations

through donorship and outreach to provide

needed dental care to the underserved,

ultimately enhancing their wellness and

quality of life. ■

66

DENTAL ASIA JULY / AUGUST 2021


2021 EVENTS CALENDAR

JULY

2 – 11 Association of Orthodontists (Singapore) Congress

2021 (Virtual)

https://www.aoscongress.com

14 6 th International Conference on Dentistry (Virtual)

https://dental.madridge.com

16 – 17 SIDO-AIDOR International Spring Meeting 2021

Naples, Italy

https://sido-aidor-spring2021.sido.it/it

21 – 24 The 2021 IADR/AADR/CADR General Session &

Exhibition (Virtual)

https://www.iadr.org/2021iags

22 – 23 39 th Asia Pacific Dental and Oral Health Congress

(Webinar)

https://www.dentalcongress.com/asia-pacific

26 – 27 27 th World Congress on Dentistry and Oral Health

(Webinar)

AUGUST

https://dentistrycongress.dentistryconferences.com

12 – 14 Vietnam Medi-Pharm Expo 2021

Ho Chi Min City, Vietnam

Venue: Saigon Exhibition and Convention Centre

http://hcm.medipharmexpo.com/en

12 – 14 12 th IFEA World Endodontic Congress

(Online)

www.ifea2020india.com

21 – 22 3 rd International Conference on Dentistry & Oral

Health (Virtual)

https://dentistry.bioleagues.com

28 – 29 Dentsply Sirona World Taiwan 2021

Kaohsiung, Taiwan

Venue: The Lin Palace

https://dentsplysironaworldtaiwan2021.meetstat.co/all

SEPTEMBER

1 – 5 ITI World Symposium 202ONE (Online)

https://events.iti.org/worldsymposium

2 – 3 Dental Professional Days 2021

Copenhagen, Denmark

Venue: Bella Centre

https://tandfagligedage.dk

9 – 11 Expodental Meeting 2021

Rimini, Italy

Venue: Rimini, Fiera

https://www.expodental.it/en

10 – 12 3 rd Indonesia Dental Exhibition & Conference

Jakarta, Indonesia

Venue: Jakarta Convention Centre

https://indonesiadentalexpo.com

22 – 25 39 th International Dental Show

Cologne, Germany

http://www.ids-cologne.de

25 – 28 23 rd CSA Annual Meeting & 2021 China Dental Show

Shanghai, China

Venue: National Exhibition and Convention Centre

https://www.chinadentalshow.com/en

26 – 29 ADA FDI 2021 - World Dental Congress (Virtual)

Sydney, Australia

https://www.world-dental-congress.org

27 – 30 50 th Moscow International Dental Forum and

Exhibition

OCTOBER

Moscow, Russia

Venue: Crocus Expo, Pavilion 2

https://www.dental-expo.com/dental-expo

9 – 10 31 st Annual NYU/ICOI Implant Symposium

New York, United States

Venue: NYU College of Dentistry

https://www.icoi.org/events

With the evolving COVID-19 situation, kindly check with organisers for updates on the related

events. Please refer to the local airports’ websites for the latest travel advisories too.

DENTAL ASIA JULY / AUGUST 2021 67


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prior permission in writing from the Publisher and copyright owner. Whilst every care is taken to ensure accuracy of the information in this publication, the Publisher accepts no

liability for damages caused by misinterpretation of information, expressed or implied, within the pages of the magazine. All advertisements are accepted on the understanding

that the Advertiser is authorised to publish the contents of the advertisements, and in this respect, the Advertiser shall indemnify the Publisher against all claims or suits for

libel, violation of right of privacy and copyright infringements. Dental Asia is a controlled-circulation bi-monthly magazine. It is mailed free-of-charge to readers who meet a set

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68

DENTAL ASIA JULY / AUGUST 2021


A

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biological integration

With more than 30 years of experience

in implantology, Anthogyr launched the

Axiom® implant system 10 years ago to

improve access to implantology by

offering innovative and accessible

solutions, a greater comfort for practitionners

and performance in their

everyday practice.


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