Dental Asia September/October 2021

www.dentalasia.net 

SEPTEMBER / OCTOBER 2021 

Dental Profile: 

3D Systems as a 

forerunner in digital 

revolution 

User Report: 

Harness the power 

of air with the Primea 

Advanced Air turbine 

handpiece 

Behind the Scenes: 

Maxillary premolar 

inlay restorations with 

Permanent Crown 

Resin 

Photo Courtesy of 3D Systems

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multidisciplinary scope for every profession in the dental industry. 

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Contents 

TRENDS 

16 The digitisation of practices 

18 Bioflavonoid spray efficacy against 

respiratory viruses 

UNDER THE SPOTLIGHT 

22 Envisioning the future of orthodontics 

DENTAL PROFILE 

26 exocad with its largest-ever presence 

at the IDS 2021: 12 software demo 

stations for DentalCAD, ChairsideCAD, 

and exoplan 

30 3D Systems as a forerunner in digital 

revolution 

CLINICAL FEATURE 

34 Updated literature review on 

accelerated orthodontics with 

relevant case reports 

38 Aesthetic restoration at the gingiva 

42 Be selfie ready 

USER REPORT 

48 Harness the power of air with 

the Primea Advanced Air turbine 

handpiece 

52 Apicoectomy — Chronic apical 

periodontitis treatment 

BEHIND THE SCENES 

54 New era in all-ceramics 

56 Maxillary premolar inlay restorations 

with Permanent Crown Resin 

IN DEPTH WITH 

60 Treatment solutions for Molar Incisor 

Hypomineralisation 

62 Axiom BL ® : when convenience meets 

expertise 

63 Digital endo assistance: CanalPro 

Jeni Endo Motor navigates through 

treatment 

64 Versatile solutions for successful 

bone and tissue regeneration 

SHOW REVIEW 

69 AOSC 2021 Online Edition performed 

beyond expectations 

SHOW PREVIEW 

70 IDS 2021 prepares for the 

international dental industry 

72 Rediscover dentistry at the 23 rd CSA 

Annual Meeting and 2021 China 

Dental Show 

73 Dentsply Sirona World 2021: Back to 

a live event 

REGULARS 

4 First Words 

6 Dental Updates 

65 Product Highlights 

74 Giving Back to Society 

75 Events Calendar 

76 Advertisers’ Index 

22 

54 

16 

70 

2 

DENTAL ASIA SEPTEMBER / OCTOBER 2021

First Words 

Momentum builds success 

The evolving variants of the COVID-19 virus 

have continued to affect healthcare systems 

worldwide. As if in a race, the vaccination 

drive and virus mutation are moving headto-head. 

Thus, policies are constantly 

changing, and strict border controls are still 

enforced. 

For the dental industry, however, there is no 

slowing down. In fact, the 39 th International 

Dental Show (IDS) will open its door in 

Cologne, Germany, from 22 to 25 September 

2021, where dental professionals and 

companies can network and have personal 

dialogues under the necessary measures 

deemed relevant by the responsible health 

authorities (p.70). 

In line with this, dental companies such as 

exocad are looking forward to the event. Mr 

Novica Savic, the company’s CCO, shares 

what visitors can expect at the exocad 

booth and other insights regarding their 

participation at the IDS 2021 (p.26). 

This issue also features Mr Stef Vanneste, 

vice-president and general manager of 

Dental at 3D Systems, giving light on how 

the company revolutionises the industry with 

their wide range of trusted and reliable digital 

solutions (p.30). 

Moving forward, dental professionals 

have also continued to demonstrate 

unwavering efforts in adapting to this 

challenging situation. 

For instance, Dr Zeeshan Sheikh, Dr 

Henriette Lerner, and Dr George Freedman 

tackle a practical approach of using 

an oral spray to create a barrier on the 

mucosa of the mouth and throat, and 

boost host protection (p.18). 

Dr Seojung Park, the executive director 

of the Orthodontic Branch at Korea 

Association of Digital Dentistry, shares her 

journey in digital orthodontics and how it 

became beneficial to her and her patients 

during this time (p.22). 

In the past year, the key players in the 

dental industry have shown resilience and 

solidarity. May we find inspiration from 

each other to move forward and face the 

future with optimism. 

Czarmaine Masigla 

Assistant Editor 

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 

Goh Meng Yong 

mengyong@pabloasia.com 

Shu Ai Ling 

Ellen Gao 

pablobeijing@163.com 

Daisy Wang 

pabloshanghai@163.net 

HEAD OFFICE 

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LET’S CONNECT! 

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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 

SOTA Imaging launches extraoral aerosol evacuator designed to help 

mitigate COVID-19 risk 

SOTA Imaging, leading manufacturer of 

dental imaging hardware, software, and 

accessories, has launched Cazoo, an 

extraoral aerosol evacuator that reduces 

dental aerosols, helping protect dentists, 

dental staff, and patients from dangerous 

particulates that can transmit COVID-19. 

Safeguards to protect dental staff are 

of particular importance today with the 

majority of hiring dentists reporting 

recruitment challenges. Dental staff who 

are in the workplace, or are considering 

returning to the workplace, need to feel 

safe and protected. 

“Many shortages, especially in dental 

hygiene and chairside assistant, existed 

prior to the COVID-19 virus,” said Duc 

“Duke” M. Ho, DDS, chair of the ADA 

Council on Dental Practice, to ADA News. 

“However, these shortages have been 

exacerbated by the pandemic, as more 

employees have left the workforce for 

a variety of reasons, including early 

retirement, concerns about safety at 

the time and a desire for more work-life 

balance.” 

Cazoo connects directly to standard 

high-volume evacuator (HVE) lines, 

allowing dental practices to quickly begin 

reducing aerosols. With an extraoral HVE 

attachment in place, dental practices can 

significantly reduce airborne particulates. 

In fact, research shows a reduction 

of particulates by up to 90.8% when 

compared to an intraorally positioned 

standard saliva ejector. Cazoo can be 

applied using a lip attachment or can be 

attached to most leading cheek retractors. 

“Cazoo was designed to help mitigate the 

risk of COVID-19,” said Albert Kim, vicepresident 

of SOTA Imaging. “It not only 

helps reduce dental aerosols in a costeffective 

way, it’s also easy to incorporate 

into virtually any dental practice.” 

A splash guard (sold separately) can 

also be attached to Cazoo for additional 

protection from aerosols. The ability to 

apply directly on the lip or use a cheek 

retractor allows for hands-free use. An 

arm accessory (sold separately) is also 

available, providing practitioners the 

ability to precisely position Cazoo and 

further enable two-hand dentistry and 

hygiene procedures. ■ 

SprintRay introduces new NightGuard Materials 

SprintRay, manufacturer of dentistry’s 

leading solution for in-office production, 

has introduced two all-new 3D printing 

resins: NightGuard Flex and NightGuard 

Firm. These revelatory materials will allow 

dental professionals to use the SprintRay 

frictionless ecosystem to design, print, 

process, and place 3D-printed flexible and 

rigid nightguards in-house. 

These new resins will allow clinicians to 

unlock revenue streams and cut treatment 

lead times for occlusal care, empowering 

them to compete with DTC (direct-toconsumer) 

offerings on convenience while 

delivering fully supervised care. 

SprintRay, thanks to its unique Cloud 

Design lab service and full ecosystem of 

3D manufacturing products, is uniquely 

positioned to help dental professionals 

deliver more occlusal guards to those who 

need them with these two new materials: 

• NightGuard Flex, formulated to be the 

fastest, most comfortable 3D-printed 

nightguard in dentistry 

• NightGuard Firm, a fast-printing rigid 

splint resin with industry-leading 

strength and aesthetics 

“With NightGuard Flex, we’re able to 

provide a comfortable occlusal guard 

that’s easy for the dentist to deliver while 

being comfortable and flavourless for 

patient satisfaction. This material has 

been clinically developed from scratch 

to help dentists address rising occlusal 

issues,” said Ehsan Barjasteh, head 

of SprintRay Resin Development. “As 

parafunctional habits like grinding and 

clenching are on the rise, our NightGuard 

resins will play a key role in helping 

doctors provide fast, cost-effective, 

long-term relief to thousands of patients 

across the world.” ■ 

6 


Anthogyr Simeda Luxembourg 

and DOCERAM Medical Ceramics 

expand their strategic cooperation 

Anthogyr Simeda Luxembourg and DOCERAM Medical Ceramics 

GmbH from Dortmund, Germany, have further expanded their 

strategic cooperation. This means that customers will receive ceramic 

restorations combining the best of both worlds — implants and dental 

ceramics. The result will be high-quality restorations that fulfil all the 

requirements in terms of technical perfection and aesthetics. Both 

companies have considered that the cooperation will put them in an 

excellent position for all the future challenges in the dental market. 

Dr Karl-Heinz Klotz, director of Business Unit at DOCERAM Medical 

Ceramics GmbH, said: “We are very happy about the flourishing 

cooperation with Anthogyr Simeda. We have come to know and 

appreciate them as a very agile and innovative company in the dental 

market. With Anthogyr Simeda, another internationally active milling 

centre recognises the potential of Nacera® Pearl Natural. We see 

the integration of Pearl Natural as a starting point for a mutually 

successful future.” 

→ THE EVOLUTION 

OF PROPHYLAXIS 

COMBI touch 

→ AIR-POLISHING AND 

ULTRASOUND IN ONE UNIT 

→ 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 

The first project carried out by this closer partnership is the use of 

Nacera® Pearl Natural ceramic for Simeda® implant-supported 

zirconium oxide restorations, including the AxIN® single tooth 

restoration with non-adhesive bonding, without adhesive or cement, 

as well as angulated screw access. 

These include implant bridges on multi-unit abutments or inLink 

retaining screws, which can also be used with the option of nonadhesive 

bonding, without adhesive or cement, as well as angulated 

screw access. As a result, the customer receives a biologically safe 

restoration that takes into account the natural anatomy of the tooth. 

Sebastian Gronsfeld, executive manager of Anthogyr Centre, said: 

“There are numerous suppliers of zirconium oxide. At Anthogyr 

Simeda, we always want to deliver the best quality to our customers, 

for which we need a top-quality base product. Nacera® Pearl Natural 

is a perfect fit. With DOCERAM Medical Ceramics, we believe that 

we have a material expert as a partner with whom we are ideally 

prepared for future challenges in the fast-moving dental market.” ■ 

→ www.mectron.com 

DENTAL ASIA SEPTEMBER / OCTOBER 2021 7 

ad_ct_dental_asia_95x250_en_201210.indd 1 10.12.20 14:42


A-dec partners with Surgically Clean Air 

A-dec, one of the largest privately-owned 

dental equipment manufacturers in the 

United States, has partnered with Surgically 

Clean Air to provide air purifying products to 

the dental industry. 

Surgically Clean Air’s JADE Air Purifier, 

which will be offered to the dental industry 

exclusively by A-dec, is an industry-leading 

air purification system, with premium, 

contemporary styling, and performance at 

the forefront of its design. 

Marv Nelson, president of A-dec, has 

announced the partnership to employees 

and partners: “A-dec’s mission is to support 

the betterment of dentistry worldwide. 

Our partnership with Surgically Clean Air 

represents our unwavering commitment to 

helping our customers maintain a safe and 

healthy environment for their practice, team, 

and patients. Combining the innovation that 

Surgically Clean Air has accomplished with 

A-dec’s reputation for quality, reliability and 

taking care of the customer will serve as a key 

differentiator.” 

In response to the pandemic and shutdown 

of dental offices in 2020, A-dec pivoted their 

engineering and manufacturing capabilities 

to develop and manufacture face shields for 

hospital workers fighting COVID-19. 

Continuing to focus on dental staff health and 

patient safety, the company launched A-dec 

360, a growing line of products designed 

to guard the dental office. With personal 

protective equipment, sanitation stands, large 

bore with third-hand HVE holders and now air 

management solutions, A-dec continues to 

expand products and services to promote a 

safe and healthy environment for the dental 

industry. 

This complementary device and associated 

consumables and services was launched 

initially to the dental market in United States 

and Canada. 

Douglas Eaton and Marshal Sterio, cofounders 

of Surgically Clean Air, addressed 

the news about the partnership: “We couldn’t 

be happier to be partnering with A-dec to 

continue our quest to keep dental health 

care workers safe from the dangers of bioaerosols. 

Aligning our dental product offering 

and combining our expertise in this field with 

A-dec’s brand reputation for exceptional 

products and service is a perfect fit. We look 

forward to a long-lasting partnership that 

will accelerate the bio-aerosol messaging we 

have been talking about in dental since 2010, 

to the global market.” ■ 

Dentsply Sirona strengthens global partnerships 

in supply chain and procurement 

As a global industry leader, Dentsply Sirona is 

focused on ways to become a more sustainable 

business. The company is committed to 

minimising supply chain risks that could impact 

customers, reducing environmental impacts 

from its global operations and to fostering 

global ethical standards and diversity and 

inclusion throughout its workforce and supply 

chain. In order to increase the impact of these 

commitments, Dentsply Sirona is working to 

engage its global supply chain partners in these 

efforts. 

In that context, the Global Supplier Forum 2021 

took place as a hybrid event on 30 June and 

1 July with a number of speakers on site 

at the Dentsply Sirona headquarters in 

Charlotte, United States, while the keynote 

address took place through a virtual venue. 

The event began with an introduction 

from Don Casey, chief executive officer; 

Dan Key, senior vice-president and chief 

supply chain officer; and Joanne Couture, 

vice-president of global procurement at 

Dentsply Sirona. 

“I was very pleased to have this opportunity 

to speak to representatives from many of 

our top suppliers. We are excited to work 

with our partners to improve processes 

and meet goals on sustainability, in order 

to ultimately grow together,” said Key. 

Eileen Bartholomew, a principal at 

Bessemer Alliance and frequent speaker 

as well as writer on the topic of growth 

through innovation, gave the forum’s 

keynote address on exponential change 

in technology and how companies 

can adapt their thinking to the pace of 

innovation. 

Dentsply Sirona also introduced its 

new Supplier Awards Programme for 

suppliers deemed to be “Exceptional 

Partners”. Suppliers have the opportunity 

to compete across all direct and indirect 

spend categories. The award programme 

criteria are based on Dentsply Sirona’s 

supply chain goals: sustainability, quality, 

delivery, innovation, value, diversity. Each 

supplier will work with its Global Category 

Manager to learn how to meet the criteria 

and compete against other suppliers to 

win. Official nominations will be submitted 

in early Q2, year 2022, and winners will be 

announced that June. The competition is 

open to all Dentsply Sirona suppliers. ■ 

8 



Dentistry largely 

exempted from the new 

COVID-19 workplace 

regulations in the 

United States 

The American Dental Association (ADA) 

is pleased that dental practices have 

been exempted from the new emergency 

temporary standard (ETS) for COVID-19 issued 

for healthcare settings by the Occupational 

Safety and Health Administration (OSHA). 

“The strengthened infection control 

guidance and very low COVID-19 infection 

rate for dentists and dental hygienists prove 

that dental practices are safe workplaces,” 

stated Dr Daniel J. Klemmedson, DDS, MD, 

president of ADA. 

The new OSHA workplace ETS provides 

guidance to be implemented in healthcare 

settings where all employees may not be 

screened for COVID-19, and non-employees 

and patients with suspected or confirmed 

COVID-19 are allowed to enter and may 

be treated. Dental offices most likely to be 

affected by this standard would include 

hospital-based oral surgery practices 

or those who provide care for COVID-19 

patients. 

According to the OSHA’s guidelines, every 

dental office must have a COVID-19 plan, 

regardless of practice setting. Dental practices 

must also conduct a workplace-specific 

hazard assessment for COVID-19. Based on 

OSHA’s Hazard Identification and Assessment, 

the ADA has already created a guide and 

checklist to walk dentists through this process, 

accessible from the ADA website. 

OSHA’s recommendations stated that 

dentists should continue pre-appointment 

patient screenings to identify individuals 

with suspected or confirmed COVID-19, 

rescheduling their appointments if possible or 

referring them as necessary. 

As the pandemic restrictions across the United 

States are reviewed at the federal, state 

and local government levels, the safety of 

patients, dentists and dental team members 

will remain ADA’s utmost concern. The ADA 

notes that per the OSHA guidelines, employers 

are encouraged to follow Centers for Disease 

Control and Prevention (CDC), state and local 

regulatory guidelines. ■ 

MediDent International launches Orasyl, Singapore’s first bacteria and 

virus-killing povidone-iodine mouthwash 

MediDent International, a Singapore-based 

medical and dental equipment supplier, 

has launched the first locally manufactured 

povidone-iodine mouthwash that can kill 

both oral bacteria and viruses. Povidone- 

Iodine, the active ingredient in Orasyl Orange 

is particularly effective against COVID-19, and 

has also been proven to keep other viruses 

and oral bacteria at bay after each use while 

promoting good oral hygiene health. 

Founded by award-winning dentist and 

entrepreneur, Dr Samintharaj Kumar, 

MediDent International is a leading supplier of 

medical and dental equipment in Singapore, 

with an aim to provide consumers with easy 

and effective healthcare solutions. 

As the success of oral povidone-iodine 

against COVID-19 started surfacing in 

mid-2020, this birthed the idea within the 

MediDent team to create a practical and 

functional mouthwash that would protect 

their loved ones and patients from the effects 

of the global pandemic in the long run. 

Orasyl is available as either Orasyl Orange 

or Orasyl Green, providing added protection 

to users from a whole host of viruses and 

bacteria. Both types of mouthwash offer the 

added benefit of stabilising the mouth pH 

and reducing dry mouth syndrome due to the 

addition of red algae. They are also mintflavoured; 

and are soothing, refreshing and 

alcohol-free. Despite their strong green and 

orange hues, both mouthwashes do not leave 

a stain on teeth and tongue. Users simply 

have to gargle and rinse with 5-10ml of the 

solution for 30-60 seconds, up to three times 

a day. 

“My intention is to provide the mass market 

with a solution that is free of alcohol and 

artificial preservatives suited for daily usage. 

Orasyl was formulated to be used by people 

from all walks of life, providing them with a 

medical and dental grade solution that will 

arm them beyond this pandemic. Besides 

promoting the importance of dental care in 

tackling the effects of viruses and bacteria, 

our mouthwashes have been created to fit in 

seamlessly with everyone’s daily routine, and 

is perfect for future safe travelling plans,” said 

Dr Samintharaj Kumar, managing director and 

founder of MediDent International. ■ 

10 


New research links dental amalgam 

mercury fillings to arthritis 

Intelligent 

extraction 

SILENT CAM extraction units 

The International Academy of Oral Medicine and Toxicology (IAOMT) 

is raising awareness of research linking cases of arthritis to dental 

amalgam fillings. These silver-coloured fillings are 50% mercury and 

are still used in the United States, often in disadvantaged children 

and adults. 

In this new study, researchers David and Mark Geier report on a 

significant relationship between the number of dental amalgam 

filling surfaces and diagnoses of arthritis. They find that incidences of 

arthritis peak among adults with four to seven dental amalgam filling 

surfaces. 

It is important to note that the number of surfaces is not the same 

as the number of fillings. Each tooth has five surfaces, which means 

that a person with only one filling could have up to five surfaces. 

The authors examined data from the 2015-2016 National Health and 

Nutrition Examination Survey (NHANES) including demographics, 

dental exams, and arthritis diagnoses. Data about the patient’s type 

of dental filling recently became accessible. With this information, 

the researchers were able to discover higher incidences of arthritis in 

people with silver-coloured mercury amalgam fillings than those with 

other fillings such as tooth-coloured composites. 

In September 2020, the Food and Drug Administration (FDA) updated 

risks of dental amalgam fillings for susceptible groups. However, 

arthritis was not specifically mentioned when the FDA warned of 

“harmful health effects of mercury vapour released from the device.” 

SILENT CAM extraction units communicate 

in an intelligent way with the CAM 

milling machine via a PLC interface. 

All you need to do is connect the 

extraction unit to the CAM 

milling machine. 

The groups that FDA advised to avoid getting dental amalgam fillings 

include pregnant women; women planning to become pregnant; 

nursing women and their newborn and infants; children; people with 

neurological disease such as multiple sclerosis, Alzheimer’s disease 

or Parkinson’s disease; people with impaired kidney function; and 

people with known heightened sensitivity (allergy) to mercury or 

other components of dental amalgam. 

Find out more: 

renfert.com/silent 

FDA is currently open for comments on how information about 

medical devices including dental amalgam fillings should be shared 

with patients and providers. The Geiers’ study was partially funded by 

the IAOMT, a non-profit organisation that evaluates biocompatibility 

of dental products, including mercury filling risks. ■ 

making work easy 


20210122_CAM-Absaugtechnik_95x250mm.indd 1 03.02.2021 16:37:52


Extension of the integrated Ceramill CAD/CAM 

workflow: Digital solutions lead the way into the 

dental practice 

With its Ceramill Direct Restoration Solution 

(DRS), Amann Girrbach has extended its 

integrated digital workflow to the dentist, 

thus closing the existing communication 

gap between the dental practice and the 

laboratory. In this process, both partners 

contribute their core competencies to 

provide patients with definitive and functional 

dentures even more quickly and with less 

complication — smaller units are also possible 

on the same day, depending on the local 

distance between the two partners. 

Depending on the type of collaboration 

desired, three team workflows are available in 

combination with the corresponding Ceramill 

DRS Kits. In each case, the central basis of 

these workflows is the new AG.Live digital 

platform, which offers both infrastructure 

and patient case management at a realisable 

consistency and efficiency that was previously 

unattainable and takes the flow of information 

and work between the practice and the 

laboratory to an entirely new level. 

The Ceramill DRS Connection Kit acts as the 

basic and entry-level variant, with which 

dentists and laboratories can already take full 

advantage of digitisation. It consists of the 

intraoral scanner, the Ceramill Map DRS, the 

associated scan software and the connection 

to AG.Live. Any order data including all the 

required information can therefore be shared 

seamlessly and in real time with the laboratory 

via AG.Live. 

This eliminates the need for handwritten job 

sheets and conventional impressions. All that 

is necessary is a single physical transport: 

getting the restoration to the practice for 

insertion in the patient’s mouth, even on the 

same day in the case of simple restorations. 

This leads to a better dental experience for the 

patient and ultimately attracts new patients to 

the practice, generating more orders for the 

laboratory. 

And if the preferred material is zirconia, the 

High-Speed Zirconia Kit, consisting of the 

Zolid DRS high-speed sintering zirconia and a 

corresponding Ceramill Therm DRS sintering 

furnace, can optimally support the laboratory 

in fabricating straightforward zirconia 

restorations on the same day. 

To provide patients with dentures even quicker 

in a further step, the system can be expanded 

in the dental practice with the Ceramill DRS 

Production Kit at a later stage. This allows 

simple restorations to be fabricated in the 

practice and placed in the patient’s mouth in a 

single session. ■ 

Chemist Sumita Mitra, known for application of nanotechnology in dentistry, 

receives European Inventor Award 2021 

The European Patent Office (EPO) has 

honoured Indian-American chemist, Sumita 

Mitra, with the European Inventor Award 2021 

in the “Non-EPO countries” category. 

Mitra was the first to successfully integrate 

nanotechnology into dental materials to 

produce stronger and more aesthetically 

pleasing fillings, which are now used by 

dentists around the world. She and her team 

developed a technique for creating linked 

clusters of nanoparticles, which they called 

nanoclusters. These clusters combine single 

nanoparticles of varying diameters, resulting 

in a strong, durable, and shiny material. By 

adding tiny amounts of pigment, and altering 

the chemical composition of the nanoparticles, 

they were also able to create a range of 

different shades that can be matched to 

individual teeth and layered to create a more 

natural finish. 

“The use of nanotechnology gave me 

the opportunity to make a new material,” 

said Mitra. “It restores people’s smiles and 

improves the quality of their lives”. 

The 2021 European Inventor Award ceremony 

was held digitally, and for the first time, was 

open to the public who tuned in to the event 

from around the world. The Award, one of 

Europe’s most prestigious innovation prizes, is 

presented annually by the EPO to distinguish 

outstanding inventors from Europe and 

beyond who have made an exceptional 

contribution to society, technological progress 

and economic growth. 

“Sumita Mitra took an entirely new path in her 

field and demonstrated how technological 

innovation, protected by patents, can 

transform a sector, and in this case bring 

benefits to millions of dental patients,” said 

António Campinos, president of EPO. “Her 

invention remains commercially successful 

nearly 20 years after its launch – another 

reason why she is an inspiration to the next 

generation of scientists.” ■ 

12 



Roland DG expands factory in Thailand 

Roland DG Co., Ltd., which manufactures 

and sells commercial inkjet printers and 3D 

manufacturing tools, is expanding the floor 

space of its factory in Thailand under the 

jurisdiction of its manufacturing subsidiary 

Roland Digital Group (Thailand) Ltd. (Samut 

Sakorn Province, Thailand). 

This increase in floor space is in response 

to one of the basic policies of the mediumterm 

management plan (FY2021 to 

FY2023) announced on 12 February 2021, 

“Transformation into a muscular corporate 

structure”. 

By completely transferring the mass 

production function of their domestic 

factory (Miyakoda Office, Kita-ku, 

Hamamatsu City, Japan) to the Thailand 

factory, the company will promote the 

reduction of product costs and improve 

price competitiveness. 

On the other hand, the company has set 

“transformation of business portfolio” as the 

basic policy of the medium-term management 

plan, and is proceeding with the development 

of products for emerging markets where 

further market growth is expected. The 

expanded Thailand factory is also intended 

to serve as a receiver for the production of 

products for these emerging markets. 

The Thailand factory is their first overseas 

factory that started operation in October 2012. 

By maximising the strengths of their unique 

cell production method, Digital Stand, which 

backs up the work of operators with digital 

technology, Roland DG can provide a stable 

supply of high-quality products, as in the case 

of Japanese production. They are promoting 

local procurement of parts other than the main 

parts, and have established an autonomous 

production system that does not depend on 

the Miyakoda Plant. In line with the expansion 

of production volume, they increased the floor 

space for the first time in 2014, and the latest 

expansion will be its second. 

The layout will change after increased floor 

space and floor area of the entire plant. By 

transferring the production of mass-produced 

products such as inkjet printers and dental 

processing machines currently produced at 

the Miyakoda Plant, the number of production 

models will be increased from the current 

16 models to 32 models, and the production 

capacity will be converted to large commercial 

inkjet printers. ■ 

DENTAL ASIA SEPTEMBER / OCTOBER 2021 13


Dr Christian Ullrich joins Straumann Group’s Executive Management Board 

as the new group chief information officer 

The Straumann Group has appointed Dr 

Christian Ullrich as the new group chief 

information officer and member of the 

Executive Management Board (EMB). Digital 

transformation is a key part of the Straumann 

Group’s growth strategy, spanning all 

businesses, geographies and facets of the 

Group’s activities. This new executive role 

will drive and lead the acceleration of the 

company’s digital transformation. He will join 

the group on 1 October 2021. 

Guillaume Daniellot, chief executive 

officer of Straumann Group, 

commented: “Christian has 

an impressive track record in 

leading digital transformation of 

large global companies. He has 

successfully developed digital 

strategy and go-to-market 

models driven 

by platform 

approaches to 

increase product sales performances and 

create a positive experience for customers 

and health consumers. He will play a key role 

to further advance the digital strategy of the 

Group connecting it closely to the business 

strategy. Christian is also a personality with 

outstanding leadership skills and will be a 

great addition to the team, supporting our 

cultural journey.” 

Dr Ullrich joins Straumann from Bayer, 

a life science company with core 

competencies in the fields of 

health care and agriculture, where 

he was senior vice-president, 

global chief information officer at 

Bayer Consumer Health. He was 

instrumental in shaping the digital 

agenda of the Consumer Health 

Division and accelerating 

the business 

transformation with 

digital technology 

and data analytics across the entire 

value chain. He began his career at the 

company in 2006 and rose through a series 

of managerial positions with increasing 

responsibility, including divisional head of 

Accounting and Controlling, head of Post- 

Merger Integration United States as well as 

vice-president, global head of Marketing 

and Sales IT. Prior to joining Bayer, Dr Ullrich 

worked for Deloitte, a professional services 

company providing consulting, audit, 

advisory, and tax services. 

Born in 1972, Dr Ullrich is a German citizen 

and holds a master’s degree in Business 

Administration and Mechanical Engineering 

from the Technical University of Darmstadt, 

Germany, and a PhD in Economics from the 

University of Lüneburg, Germany. He joins the 

company following the announcement of the 

group to expand the role of chief information 

officer and elevate it to the Executive 

Management Board. ■ 

Keystone Bio advances a more complete explanation of Porphyromonas 

gingivalis toxic virulence factors as major driver of sporadic Alzheimer’s 

and chronic inflammation 

Keystone Bio (KB), a biotechnology company 

and frontrunner in developing precision 

biologics to eliminate Porphyromonas 

gingivalis (Pg), has presented a groundbreaking 

data that shows bacterial toxic 

proteins from Pg in the mouth are released 

into the blood and cross the Blood Brain 

Barrier (BBB) as the major driver of sporadic 

Alzheimer’s and chronic inflammation. 

This new data supports a “Peripheral” model 

of Pg blood-transported toxic proteins 

delivered into the blood and brain versus the 

earlier literature in which human and animal 

model studies support the “local gingipains” 

Alzheimer’s Disease brain model. What this 

means for Alzheimer’s patients and those at 

early risk is that KB is developing a specific 

diagnostic and treatment to eliminate Pg 

and the flow of these toxic proteins to the 

brain. 

This data can now be integrated into a more 

unifying “Concept” and explanation for the 

“Infection Hypothesis” for Alzheimer’s Disease 

(AD) and other Dementia-related disease(s). 

A larger HagA Domain virulence factor is 

found in many AD and some aged matched 

control brain tissues. Its complex role in 

local and systemic inflammatory diseases is 

well understood and further demonstrates 

systemic blood borne delivery for the 

bacterial source of “gingipains” in the brain. 

This ground-breaking data was presented in 

three posters at the Alzheimer’s Association 

International Conference 2021: 

• Porphyromonas gingivalis Outer Membrane 

Vesicles as the major drivers of and source 

for the toxic insult and iron accumulation/ 

deposition in Alzheimer’s Disease 

• Further Preclinical Development of a 

Clinically Effective Bio-therapeutic Against 

Porphyromonas gingivalis 

• A Study on the Distribution of 

Porphyromonas gingivalis Repeated 

Epitope in Hemagglutinin/Adhesion and 

HagA gingipains Domain Antigen and DNA 

in Alzheimer brains 

14 


ESTHETIC RESTORATIONS 

Straumann® XenoGraft and XenoFlex 

Versatile solutions for successful 

bone and tissue regeneration. 

Straumann® XenoGraft and XenoFlex for successful bone 

regeneration in dentistry. Our biomaterials are designed to eliminate 

antigenicity and provide a favorable environment for new bone 

growth. Slow resorption increases stability, improving the likelihood 

of long-term implant survival rates. Available in a selection of 

practical containers for enhanced handling. 

Straumann® XenoGraft and XenoFlex: 

ѹ Are easy to handle 

ѹ Have long-term volume stability 

• Already successfully applied in over 500,000 cases worldwide 

Straumann® XenoGraft 

delivered in a practical 

bowl container, consists 

of 100 % bovine bone 

granules. 

Straumann® XenoFlex available as a block or 

in a practical syringe, consists of 90 % bovine 

bone granules and 10 % porcine collagen. 

See explanatory handling video 

of Straumann® XenoFlex 

Enquire via a Straumann representative. 

visit https://bit.ly/enquire-stsg 

A06SG/en/A/00 08/21

Trends 

The digitisation of practices 

Artificial intelligence is at the heart of patient care: 

what solutions will meet patient expectations? 

In recent years, the way patients view 

healthcare has rapidly evolved. They 

are no longer willing to leave the house 

unless it is necessary, and they expect 

to use the latest technology for fast and 

easy communication with their medical 

providers. 

And this also applies in the orthodontics 

field. 

Technological innovations changed 

the face of healthcare, but the key to 

unlocking “Orthodontics 2.0” was still 

missing. The industry needed the right 

tool to completely digitise every stage of 

patient care. 

The good news is, the missing piece was 

found. 

DentalMonitoring is a virtual practice 

solution that brings the digital world to 

the dental world, providing patients with 

the ease and efficiency they expect from 

their medical providers. 

ARTIFICIAL INTELLIGENCE PUTS 

THE FOCUS BACK ON CARE 

DentalMonitoring uses artificial 

intelligence (AI) to automate parts of 

a patient’s treatment plan and issue 

alerts in the case of any irregularities 

detected during oral scans. This 

technology allows doctors to perform 

initial oral exams remotely, simulate 

treatment options, and even plan 

future treatments from a distance. 

Using the industry’s largest dental 

image database, DentalMonitoring’s 

artificial intelligence helps doctors 

locate, calculate, and evaluate 

96 different observations with an 

accuracy that the human eye cannot 

16 


Trends 

achieve. It allows the practitioner to take control over data they 

lack when the patient is outside the practice, while significantly 

improving the communication established with the patient. 

The result: a better managed schedule and optimised care 

efficiency thanks to a highly scalable workflow throughout the 

entire patient journey. 

VITA AMBRIA® 

THE DENTALMONITORING VIRTUAL PRACTICE, A KEY 

SUCCESS FACTOR 

Like other solutions appearing on the market, notably in the 

United States, DentalMonitoring’s solutions have several 

advantages. 

Photos are not enough to follow the oral health of a patient from a 

distance. Without artificial intelligence, they are limited to being a 

simple visual control tool. While some follow-up solutions focus on 

a single particular treatment; with a virtual practice, all treatments 

can be controlled, such as retainer use and oral hygiene. 

Brilliant dental restorations 

deserve brilliant 

press ceramics 

The platform offers features that patient expects: video 

consultation, a clear written report encouraging a better 

understanding of their oral condition, and ultra-realistic 

simulations of their smile during and after orthodontic treatment. 

It also includes a dedicated patient application so patients can 

receive advice from their orthodontist regularly. 

All the tools are there to offer a comfortable and connected 

treatment path. 

WHAT PRACTITIONERS ARE SAYING 

Practitioners quickly understood the many advantages of 

the “VirtualPractice DentalMonitoring” platform. Convinced 

of the advantages of AI and enthusiastic about its efficiency, 

they see virtual offices as the digital shift that will ensure the 

sustainability of their business and their short-term competitive 

advantage. DA 

DentalMonitoring ® , Smilemate ® and Vision are products designed and 

manufactured by Dental Monitoring SAS, under the DentalMind ® brand for 

health care professionals (HCPs). They are also used by patients under medical 

supervision by health care professionals (HCPs). 

DentalMonitoring ® and SmileMate ® are designed to help health care 

professionals remotely observe intraoral situations (and orthodontic treatments 

for DentalMonitoring). Consult your health care provider and/or the operating 

instructions before using them. 

DentalMonitoring ® and SmileMate ® are medical devices, registered as such and 

bearing the CE mark. 

Vision simulations are generated by artificial intelligence. They are not binding 

and may differ from the final results of the patient’s treatment. Vision is 

registered with DentalMind ® . 

Product availability, claims and status may vary from country to country 

depending on local regulations. Contact local representative for more 

information. 

VITA AMBRIA – the press ceramic 

for dental technicians who simply 

want to achieve more. 

Learn more here right now: 

www.vita-ambria.com 


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

Trends 

Bioflavonoid spray 

efficacy against 

respiratory viruses 

In the event of exposure, preventing respiratory viruses from 

adhering to the oral or nasal mucosa may decrease the risk of 

infection. Hence, with the evolving pandemic situation, this 

paper tackles a practical approach of using an oral spray to 

create a barrier on the mucosa of the mouth and throat, and 

boost host protection. 

By Dr Zeeshan Sheikh, Dr Henriette Lerner, and Dr George Freedman 

COVID-19 has raised new concerns 

about respiratory viral infections (RVI). 

This virus can reproduce within the 

cells that line the human respiratory 

tract and the resulting infections 

cause respiratory issues that may 

infect multiple other sites. At this time, 

there are more than 200 known viral 

strains that cause respiratory infection, 

including the coronavirus, influenza 

virus, and human rhinovirus. Other 

viruses of interest include parainfluenza 

viruses, metapneumovirus, adenovirus, 

respiratory syncytial virus (RSV) and 

human enteroviruses (HEV) 1 . 

Coronavirus can cause symptoms 

ranging from the common cold to 

pandemics. Influenza viruses are 

categorised into types: 

• A/B cause seasonal epidemics (flu) 

• A is also implicated with seasonal 

pandemics 

• C/D are generally mild and do not 

affect humans 

Each category has multiple subtypes. 

Rhinovirus has three main species 

including A/B/C with more than 160 viral 

types causing the common cold 2-4 . 

RESPIRATORY VIRUSES: 

EXPOSURE, ADHESION, 

REPLICATION, AND INFECTION 

Key respiratory viruses are transmitted 

via aerosols, respiratory droplets, and 

fomites. Factors known to increase 

the risk of infection include: proximity, 

ventilation, surface contact, and time of 

exposure. Thus, gathering areas without 

adequate ventilation, where distancing 

is not possible, increase infection risk. 

These include workplaces, grocery 

stores, shopping malls, restaurants, 

indoor gyms, schools, and airplanes. 

Indoor activities with significant 

aerosolisation increase risk; and while 

outdoor activities offer ventilation, 

physical distancing is not always 

possible. 

In the event of an exposure, the 

respiratory viruses must come in contact 

with oral or nasal mucosa of a new 

host to pose a risk of infection. While 

the mucosal epithelium offers a partial 

physical and innate immune barrier 

against viral infection, the virus can still 

attach and infect the individual 5 . It is 

extremely important to emphasise that 

for an infection to occur, the respiratory 

viruses must gain access to the mucosa, 

attach, internalise, and replicate within 

the host. 

A novel protection strategy is to break 

the chain of infection by neutralising the 

virus prior to adhesion and penetration 

of the host cell, either by a virus- 

18 


Trends 

encapsulating barrier, and/or via direct 

neutralisation. Both ultimately prevent 

infection and disease. 

PREVENTION OF RESPIRATORY 

VIRUS INFECTION 

The current challenge is two-fold: to 

reduce risk for COVID-19 and develop 

multiple strategies that reduce the risk 

associated with new viruses with the 

potential to cause another pandemic 

crisis. COVID-19 occurred a full 100 years 

after the Spanish Flu (H1N1), but the next 

pandemic may present sooner. Current 

approaches for minimising transmission 

are based on three common strategies: 

• Routine and widespread use of 

personal protection equipment 

(PPE), including masks, to create a 

physical barrier to transmission 6 

• Frequent and thorough disinfection 

of hands, surfaces and fomites 

to mechanically remove and 

chemically inactivate shed 

virus particles and prevent their 

translocation to new hosts 7 

• Delivery of aerosolised therapeutics 

to the mucosal microenvironment 

to dampen an aggressive immune 

response in respiratory infections, 

thereby improving clinical 

outcomes 8 

It is desirable to prevent viruses that 

have entered the human body via the 

nasal and oral passages from gaining 

access to the mucosal layers, adhering, 

and causing infection. One practical 

approach is an oral spray that targets 

the mucosa in the mouth and throat to 

create an additional barrier that protects 

the host from viruses. 

The ideal spray must be safe and 

use Generally Recognised as Safe 

ingredients (GRAS) with pleasant 

taste and sensation. Additionally, it 

must be easy to use, acceptable for 

all ages, and must provide rapid onset 

to target specific situations. Further 

desirable properties include: vegetarian 

compatibility, sustainability, non-GMO 

sourcing, and no banned substance 

ingredients. 

FLAVOBAC AND MUCOSAL VIRAL 

BARRIERS 

Flavobac is a plant-based, patented 

combination of specific water-soluble 

bioflavonoid molecules with known 

anti-microbial and anti-viral activity 9 . 

The pharmacological effects of 

flavonoids are linked to their antioxidant 

and free-radical scavenging activity 

in addition to their interaction with 

enzymes, adenosine receptors and 

bio-membranes 10 . Flavonoids have also 

been shown to possess anti-viral activity 

against influenza viruses HSV-1, HSV-2 

and the rotavirus 9 . 

There are several products designed 

Fig. 1: Cold & Flu Guard combines bioflavonoids with 

an effective mucosal barrier 

Fig. 2: Nasal and oral antiseptic spray solutions 

Compound 

Contact 

Cytotoxicity a Neut. 

Virus VC 

LRV d 

Time 

Ctrl b 

Titer C Titer c 

FLAVOBAC BCL 5% 1 min 1/100 None 1.9 

FLAVOBAC BCL 2% 1 min 1/10 None 2.9 

a Cytotoxicity indicates the highest dilution of the endpoint titer where full (80-100%) cytotoxicity was observed 

b Neutralisation control indicates the highest dilution of the endpoint titer where compound inhibited virus CPE in the wells after neutralisation 

(ignored for calculation of virus titer and LRV) 

c Virus titer of test sample or virus control (VC) in log10 CCID50 of virus per 0.1 mL 

d LRV (log reduction value) is the reduction of virus in test sample compared to the virus control 

Table 1: Virucidal efficacy against SARS-CoV-2 after contact with virus at 22 ± 2°C 


Trends 

Compound 

Contact 

Time 

Cytotoxicity a 

Neut. 

Ctrl b 

Virus 

Titer C 

VC 

Titer c 

LRV d 

OSI-20210203A 5 min 1/10 None 3.0 

OSI-20210203B 5 min 1/10 None 3.0 

a Cytotoxicity indicates the highest dilution of the endpoint titer where full (80-100%) cytotoxicity was observed 

b Neutralisation control indicates the highest dilution of the endpoint titer where compound inhibited virus CPE in the wells after neutralisation 

(ignored for calculation of virus titer and LRV) 

c Virus titer of test sample or virus control (VC) in log10 CCID50 of virus per 0.1mL 

d LRV (log reduction value) is the reduction of virus in test sample compared to the virus control 

Table 2: Virucidal efficacy against SARS-CoV-2 after contact with virus at 22 ± 2°C 

Fig. 3: Nasal and oral sprays function as 

supplementary layers of protection (in 

addition to face masks) to short circuit cold 

and flu viruses 

to assist in preventing the onset 

of infection caused by rhinovirus/ 

coronavirus/influenza virus by creating 

a physical barrier to viral and bacterial 

adhesion at the nasal and throat 

mucosal membranes. 

Oral Science International (Brossard, 

Canada) has a unique formulation, 

Cold & Flu Guard TM (Fig. 1), that unites 

bioflavonoids with the mucosal 

barrier. Glycerin and hyaluronic acid 

components form a barrier/film over 

the mucous membrane, and act as a 

delivery method for the bioflavonoids 

and menthol. 

FLAVOBAC EFFICACY VS 

RESPIRATORY VIRUSES 

In vitro efficacy studies of Flavobac 

aqueous solutions have demonstrated 

concentration-dependent activity 

against a range of bacterial, fungal 

and protozoal pathogens 11 . Antiviral 

studies have confirmed activity against 

various viruses 12-14 . Retroscreen 

Virology Laboratories (now hVIVO, 

London, United Kingdom) and 

Biobest Laboratories (Edinburgh, 

United Kingdom) have independently 

demonstrated that Flavobac 

formulations are efficacious in the 

inactivation of two different subtypes 

of Influenza A: H5N1 (Bird Flu) and H1N1 

(Swine Flu) 13,15 . 

In 2004, Retroscreen Virology Ltd., 

Barts, and The London Queen Mary’s 

School of Medicine and Dentistry, 

evaluated the viricidal activity of 

Flavobac against Urbani SARS virus, 

Influenza A virus, Human Rhinovirus 

and HIV. The results demonstrated 

significant viricidal activity against all 

the viruses at all concentrations and 

time-points 14 . 

The first anti-SARS-CoV-2 evaluation 

of an oral spray formulation containing 

Flavobac as the sole active ingredient 

(developed specifically for routine 

intranasal or intraoral use) was reported 

in March 2021 by the Institute for 

Antiviral Research (IAR) at the Utah 

State University (Logan, Utah, United 

States) [*data pending publication]. 

The IAR employs recognised scientists 

to identify antiviral agents and vaccines 

against a wide range of human 

pathogenic viruses and has participated 

in the pre-clinical development of 

numerous FDA-approved antiviral 

compounds. 

Test compounds: Nasal and oral rinse 

antiseptic solutions (Fig. 2) consisting 

of aqueous Flavobac BCL concentrate 

as the sole active ingredient and 

OSI2021003 oropharyngeal spray 

solution and other natural ingredients 

were supplied by Oral Science 

International. 

Results: Flavobac aqueous solution 

reduced SARS-CoV-2 titer below the 

limits of detection at all concentrations 

tested (Table 1). These results generate 

dose optimisation and guide product 

dosage and concentrations. 

After incubation with Flavobac 

commercial solutions OSI-20210203A 

and OSI-20210203B, SARS-CoV-2 virus 

titers and LRV were reduced below 

the limits of detection (LRV>3.0) (Table 

2). Each Flavobac containing solution 

evaluated was effective at reducing 

>3 log10 CCID50 infectious virus, from 

4.7 log10 CCID50/0.1 mL to 1.7 log10 

CCID50/0.1 mL or less (Table 2). This 

represents a >99.9% efficacy of viral 

reduction. 

RELEVANCE 

The challenge in developing oral and 

nasal sprays is to create effective 

topical preparations that are safe 

20 


Trends 

and have the required efficacy against 

respiratory viruses. Ethanol >70%, for 

example, is known to be an effective 

viricidal agent but cannot be used safely 

in the nose. Flavobac solutions and 

formulations have been shown to be 

effective against a variety of viral strains 

and are non-toxic (GRAS status in the 

United States via the FDA). 

Given their efficacy and safety profile, 

Flavobac oral and nasal spray products 

such as Cold & Flu Guard TM and Flavobac 

Health Guard TM , can be considered as 

a supplementary layer of protection in 

addition to face masks in combatting 

respiratory viruses (Fig. 3). This is 

particularly beneficial and important for: 

• High aerosolisation situations 

• Individuals at higher risk of 

respiratory viral complications 

• Those not yet vaccinated 

• Children 

• Gatherings where appropriate 

distancing is not possible DA 

REFERENCES AND RESOURCES 

1. 

Mäkelä, M.J., et al., Viruses and bacteria in 

the etiology of the common cold. 1998. 36(2): 

539-542. 

2. 

Couch, R.B.J.e.L., Rhinoviruses. 2001. 

3. 

Peiris, J.J.M.m., Coronaviruses. 2012: 587. 

4. 

Zhang, Y., et al., New understanding of the 

damage of SARS-CoV-2 infection outside the 

respiratory system. 2020: 110195. 

5. 

Gwaltney Jr, J.M.J.T.A.j.o.m., Clinical 

significance and pathogenesis of viral 

respiratory infections. 2002. 112(6): 13-18. 

6. 

Organization, W.H., Rational use of personal 

protective equipment (PPE) for coronavirus 

disease (COVID-19): interim guidance, 19 

March 2020. 2020, World Health Organization. 

7. 

Cohen, M.S. and L. Corey, Combination 

prevention for COVID-19. 2020, American 

Association for the Advancement of Science. 

8. 

Oslund, K.L. and N.J.F.v. Baumgarth, 

Influenza-induced innate immunity: regulators 

of viral replication, respiratory tract pathology 

& adaptive immunity. 2011. 6(8): 951-962. 

9. 

Bylka, W., I. Matlawska, and N.J.J. Pilewski, 

Natural flavonoids as antimicrobial agents. 

2004. 7(2): 24-31. 

10. 

Harborne, J.B. and C.A.J.P. Williams, 

Advances in flavonoid research since 1992. Zika virus infection. 2020. 177: 113962. 

15. 

2000. 55(6): 481-504. 

Carrouel, F., et al., Antiviral Activity of 

11. 

Hooper, S.J., et al., Antimicrobial activity of Reagents in Mouth Rinses against SARS- 

Citrox ® bioflavonoid preparations against oral CoV-2. 2020: 0022034520967933. 

microorganisms. 2011. 210(1): E22-E22. 

12. 

Lalani, S. and C.L.J.V. Poh, Flavonoids as https://www.cdc.gov/coronavirus/types.html 

antiviral agents for Enterovirus A71 (EV-A71). https://www.cdc.gov/flu/about/viruses/types. 

2020. 12(2): 184. 

html 

13. 

Reis, A.C.C., et al., Anti-Zika virus activity https://www.lung.org/ 

and chemical characterization by ultra-high *Pending publication: Efficacy of FLAVOBAC 

performance liquid chromatography (UPLC- Nasal and Oral Preparations Against Severe 

DAD-UV-MS) of ethanol extracts in Tecoma Acute Respiratory Syndrome-Coronavirus 

species. 2020. 20(1): 1-15. 

2 (SARS-CoV-2), A. Barbour, M. Mendenhall, 

14. 

Zou, M., et al., Structure-activity relationship G. Darlington MD, M. Glogauer (Pending 

of flavonoid bifunctional inhibitors against Publication in medRxiv). 

About the authors 

Dr Zeeshan Sheikh is trained as a dental clinician and a 

biomaterial scientist with degrees of BDS, MSc and PhD in 

dentistry from Baqai Dental College, Pakistan; Queen Mary 

University of London, United Kingdom; and McGill University, 

Canada. He also has completed two post-doctoral fellowships 

at the Faculty of Dentistry, University of Toronto, Canada, and at 

the Mount Sinai Hospital, United States. He is currently a periodontics and implant 

surgery resident at Dalhousie University, Canada, and his research expertise 

lies in developing novel biomaterial options for bone grafting and maxillofacial 

regenerative applications. 

Dr Henriette Lerner is a graduate of Temeschburg University 

(DMD), and Carol Davila University (Postgraduate Programme 

in Oral Surgery). Director of HL Dental Clinic and Academy in 

Baden-Baden, Germany, she is also a tutor in the Master of 

Aesthetic Dentistry Programme at Johann Wolfgang Goethe 

University, Frankfurt on Main, Germany. Dr Lerner is the 

immediate past president of the Digital Dentistry Society International (DDS). 

Dr George Freedman is co-founder and past president, 

American Academy of Cosmetic Dentistry; co-founder, 

Canadian Academy for Esthetic Dentistry; regent and fellow, 

International Academy for Dental Facial Esthetics, and 

diplomate and chair, American Board of Aesthetic Dentistry. 

He is adjunct professor of Dental Medicine, Western University, 

Pomona, California, United States, and professor and programme director, 

BPP University, London, UK, MClinDent Programme, Restorative and Cosmetic 

Dentistry, and author of 14 textbooks, more than 900 dental articles, and 

numerous webinars. 


Under the Spotlight 

Envisioning 

the future of 

orthodontics 

Dr Seojung Park, executive director of the Orthodontic 

Branch at Korea Association of Digital Dentistry 

The world is changing faster 

than ever. With the latest trends 

and technology in orthodontics, 

it is paramount for dental 

practitioners to stay ahead of the 

curve. In this regard, Dr Seojung 

Park from South Korea shares her 

journey in digital orthodontics 

and how it drastically improved 

her practice. 

22 



Dr Seojung Park, the executive director of 

the Orthodontic Branch at Korea Association 

of Digital Dentistry (KADD), graduated from 

the Dental College of Chonnam National 

University, South Korea, in 1989. She initially 

specialised in paediatric dentistry and 

performed a wide range of treatments from 

tongue tie surgery to orthodontics for five 

years, which sharpened her clinical skills and 

developed her holistic view on patients. 

While she was completing her PhD thesis on 

orthodontic wires, she became fascinated 

with orthodontics, inspiring her to pursue 

expertise of the field. On top of that, the 

subject excited her as orthodontic treatment 

engages more closely with the patient’s life 

and requires a bilateral relationship with 

them. 

She explained: “An orthodontic treatment 

cannot be done without the patient’s 

cooperation. When we work as a team, a 

successful treatment brings tremendous 

fulfilment and joy to both the patient and the 

doctor. I tend to think of it as a marathon and 

I truly enjoy finishing the race together with 

my patient.” 

Dr Park completed a two-year course in Korea 

Orthodontic Research Institute and became 

a regular member of Korean Association of 

Orthodontics (KAO). In 2010, she worked as a 

visiting fellow in the Orthodontic Department 

of Baylor Dental College of Texas A&M, 

United States, as well as a researcher and 

a trainee at Orametrix, the parent company 

of SureSmile in Richardson, Texas, for three 

years. 

This remarkable experience served as 

a turning point of her career in digital 

orthodontics. 

EMBRACING DIGITAL ORTHODONTICS 

Adopting digital technology has widely 

known advantages such as efficiency and 

more precise treatments. However, when Dr 

Park started to adapt the digital practice, she 

noticed how it drastically improved the way 

she communicated with her patients too. 

“First of all, I get more face-to-face time with 

my patients, but before it was more like next 

to the face!” she joked. “Kidding aside, the 

biggest change is that I can literally have 

the patient’s case at the palm of my hand by 

using a digital model.” 

As influenced by the late Dr William Proffit, 

the author of “Contemporary Orthodontics”, 

Dr Park emphasised that it is crucial to listen 

thoughtfully to the patient and/or their 

parents’ concern before even starting the 

diagnosis and treatment plan. 

“This allows me to approach each patient with 

an unbiased mindset, free of any prejudice or 

misconception. There is no perfect solution in 

orthodontic treatment. Every case is different 

and each patient requires a treatment that is 

specifically designed for them,” she shared. 

To communicate her treatment plan with the 

patients, she reinforces the discussion with 

digital tools. 

“As strangely as it might sound, the most 

challenging case for me is not necessarily 

a difficult case. Even with the perfect 

treatment of malocclusion, patients often are 

not satisfied with the result. In most cases, 

the issues are minute but from a patient’s 

perspective it is not so trivial,” she said. 

For instance, she had a patient with a 

slightly asymmetric torque, black triangles, 

minimally different vertical positions of 

anteriors and tiny premature contacts 

after debonding. With the help of digital 

technology such as IOS, SureSmile, and 3D 

printing, she resolved the issue efficiently 

and effectively. 



She highlighted: “There is a saying in Korean 

that goes: ‘Showing it once is better than 

hearing it thrice’. Allowing the patients to 

visualise the treatment by using digital 

orthodontics tools is the key to ensuring that 

their expectations are met.” 

DIGITAL WORKFLOW 

On top of meeting the patient’s expectation, 

Dr Park’s adoption of digital workflow in her 

practice has significantly streamlined their 

clinic operations. Now, the clinic staffs can 

preview her orders and prepare for the case 

before the patient’s visit. She can also access 

the record of her patients virtually at any time, 

as the digital model is stored in the Cloud. 

“We try to standardise and systemise our 

workflow to minimise interruptions and 

achieve seamless operations. Going digital 

also means tidier workspace as there is no 

need for impression materials and plaster 

stone,” she added. 

In terms of treatment, digitalisation of 

orthodontics also proved to be highly 

beneficial to the patient. 

Recently, Dr Park has been recommending a 

‘Hybrid Treatment’ — a combination of a fixed 

treatment using brackets and finishing up with 

a clear aligner. The benefits include: 

1. Leading instead of pushing treatment 

2. Quicker soft tissue adaption 

3. Better oral hygiene 

4. Finer tuning 

5. Shorter bonding period 

6. Faster occlusal seating 

7. Wrapping up treatment with patients’ 

agreement and satisfaction 

She noted: “I have encountered a lot of 

orthodontists from various places and I 

got an impression that they see digital 

orthodontics as a new system just like 

when SWA (straight wire appliance), TAD 

(temporary anchorage device), and selfligating 

system were first introduced.” 

However, Dr Park strongly believes that 

digital orthodontics can assist doctors to 

have an in-depth view of their patients, and 

to execute their treatments precisely. 

“Digital and conventional orthodontics can 

always coexist. Digital concept will support 

various applications, innovations and 

integrations in orthodontic profession,” she 

stated. 

ADVANCED TREATMENT SOLUTIONS 

With her advocacy in digital orthodontics, 

Dr Park became a key opinion leader of 

SureSmile, a clear aligner brand from 

Dentsply Sirona, to help her fellow 

practitioners maximise the benefits of 

contemporary orthodontics. 

She expounded: “In this aspect, SureSmile 

gives precise digital control for the doctors. 

The software offers extremely accurate 

digital model including bone and roots, with 

convenient functions for digital diagnosis and 

planning.” 

Dr Park added that SureSmile started its own 

digital platform from custom-made arch 

wire for labial and lingual bracket treatments, 

allowing it to collect numerous data over 

the years about precise digital modelling. 

SureSmile also offers various services from 

the start to the end of treatment such as 

digital diagnostic tools, digital set-up, autosimulation 

function, IDB (indirect bonding) and 

surgery simulation. 

“This allows me to be free of any restriction, 

thus achieving a better and faster treatments. 

Like an unlimited open source, I can perform 

various procedures precisely,” she remarked. 

However, Dr Park noted that although these 

aligners are made using the latest technology 

and proven materials, any cutting-edge digital 

tool cannot treat a patient on its own and it 

still requires the doctor’s knowledge and skill to 

maximise its benefit. 

She recognises the steep learning curve 

that might pose as a challenge to both 

orthodontists and general practitioners: 

“Although we are using 3D digital models and 

3D digital imaging, we are still looking at the 

3D model in a 2D plane. This often creates 

an optical illusion that we are not familiar 

with — it lacks detailed tooth morphology, 

especially occlusal shape and proximal shape. 

Sometimes, there are exaggerated overjet, 

occlusal contacts and gaps between teeth.” 

Nonetheless, she is positive that it would be 

possible to look at the 3D model and 3D images 

on a 3D platform in the future as evidenced 

by rapid advancements in 3D printing, artificial 

intelligence and low dose CBCT. She is also 

hoping to see the introduction of artificial 

reality (AR) in orthodontics. 

Upper and Lower IDB tray design 

ORTHODONTIC TRENDS 

With the introduction of these newer 

technologies, orthodontics has evolved 

24 



rapidly over the years. For instance, novel 

techniques along with easier access to 

materials and equipment has increased the 

number of general practitioners performing 

orthodontic treatment. 

As a specialist, Dr Park said that she 

is aware of this practice and many 

orthodontists are also concerned about 

the competition for patients, possible 

malpractice, and lowering of cost. 

She acknowledges that it has become a 

norm and there is no way to avoid it, but 

noted that orthodontists should be the 

ones to lead the trend by being flexible to 

changes. 

In fact, Dr Park embraces the phenomenon 

with optimism: “This creates a much bigger 

pie in orthodontic market by making the 

treatment more approachable, and it will 

eventually accelerate the development 

in orthodontics in various ways. A little 

bit of competition brings new ideas and 

inventions.” 

Dr Park is looking forward to technology 

showing the post treatment image of not only 

dentition, but also the face of her patients. 

“I integrated a face scanner with CBCT 

and IOS. They are not adequate yet for 

consultation and planning of treatment, but I 

look forward to the day when the technology 

will allow us to do so,” she shared. 

On top of this, she also mentioned that there 

will probably be many different directions in 

orthodontic field. As an example, she raised 

the ‘prosumer’ philosophy of the late Mr Alvin 

Toffler, an American author, businessman, 

and futurologist, can be applied in the future. 

“A combination of producer and consumer, 

thus the term ‘prosumer’, I believe that 

doctors can be a consumer of digital 

equipment or software and at the same time, 

a producer who creates a new digital concept 

with it,” she said. 

FUTURE IS NOW 

Dr Park shared that she read an interesting 

article saying that the technological 

advancements in the past 20 years exceeded 

that of in the past 100 years. She agreed 

to this completely, adding that digital 

technology is no longer a new thing and we 

are now living in the digital era. 

“The pandemic has fast-forwarded the 

digital transition in almost every aspect of 

life. People are getting hired after a Zoom 

interview without meeting face-to-face. 

Online shopping has allowed us to purchase 

almost anything with a click. A usual business 

trip has been replaced with a Zoom call,” she 

said. 

For this reason, the patients are also wellinformed 

and accepting of digital treatment. 

Dr Park shared that her consultations with 

her patients and their parents are done via 

Facetime to minimise the number of visitors in 

her practice. 

“I understand that abrupt change is never 

easy. But I strongly believe that digital 

technology will help us break many barriers 

and limitations not only in orthodontics but 

also in other field of dentistry,” she said. 

Sending a gentle reminder to her fellow 

practitioners that they have a responsibility 

to educate and lead the next generation to 

digital dentistry, Dr Park concluded: “As my 

favourite saying goes: The human mind is 

like parachute and can only function when 

it is open. I look forward to meeting and 

making more colleagues in digital world and 

share and discuss our ideas. Stay healthy 

everyone!” DA 

In the long term, she foresees that 

the correction of malocclusions will 

be addressed by combining multiple 

treatments rather than a single procedure. 

She said: “Hybrid treatment for patients 

will increase steadily as the alignment 

of teeth plays a role in better implant 

placement, as well as in aesthetic and 

prosthetic restorations especially with the 

rise of elderly patients. This is in addition 

to targeted treatments on anteriors, single 

arch or specific tooth.” 


Dental Profile 

exocad will participate in 

the International Dental 

Show (IDS) 2021. Their 

commitment to IDS as the 

most important leading 

trade fair in the industry 

is unwavering. 

Novica Savic, CCO of exocad 

exocad with its largestever 

presence at the IDS 

2021: 12 software demo 

stations for DentalCAD, 

ChairsideCAD, and exoplan 

26 



Committed to expanding the 

possibilities of digital dentistry and 

providing its distribution partners 

with flexible, reliable, and easy-touse 

software, exocad GmbH (exocad), 

an Align Technology, Inc. company, 

has expanded its presence at the 

International Dental Show (IDS) 2021 

taking place from 22 to 25 September 

2021 in Cologne, Germany. 

The trade show is one of the most 

important dates on exocad’s calendar. 

Novica Savic, the CCO of exocad, 

explains why the company’s 

commitment to IDS as the dental 

industry’s most important leading trade 

fair remains unchanged and what 

visitors can expect at the exocad booth. 

exocad is taking part in IDS 2021 

with a larger booth – why this 

decision? 

After IDS 2019, exocad decided that 

we needed a larger booth space. There 

were so many users, technnology and 

sales partners who visited our booth 

two years ago that large crowds formed 

around the software presentations. To 

ensure that visitors now have a better 

view of the demonstrations and that 

hygiene regulations can be complied 

with, we are enlarging the stand by over 

50%. 

Our commitment to IDS as the most 

important leading trade fair in the 

industry is unwavering. I also see it as a 

driver for innovation; many companies 

are aligning their development and 

innovation cycles with IDS. This 

underlines its function as the world’s 

leading trade fair. Therefore, there was 

never any question at exocad whether 

we would participate in IDS. The 

platform has successfully supported 

us in presenting our products to 

customers and pushing them further 

into the market. In fact, we are working 

closely with the organiser KölnMesse 

to comply with the necessary hygiene 

requirements. 

How did exocad adapt the booth 

concept to the current situation? 

exocad still has a very open presence 

at the trade fair stand, in line with 

our philosophy of an open software 

platform. A total of 12 different software 

islands are planned with plenty of space 

between them. Visitors will still be able 

to move freely around the stand to 

find out about our products and talk to 

our software specialists. After all, it is 

precisely this personal exchange that 

makes the trade fair so appealing. 

Due to the pandemic, however, the 

stand will have a transparent glass 

railing at the aisles. If necessary, we will 

measure the flow of visitors to the stand 

and adapt the respective distancing 

measures. Thanks to the larger stand 

area, we are able to ensure that visitors 

have adequate space. Transparent 

protective walls, disinfection facilities, 

and following the doctrine of ‘hands, 

face, space’ (disinfecting hands, wearing 

a face mask, and keeping a distance) will 

provide a safe experience at the booth 

for both our employees and visitors. 

I would also like to note that, in my 

view, KölnMesse can implement the 

applicable hygiene measures with a 

well-developed hygiene concept. I 

believe that with the measures planned 

and rules in place, we will feel safe there 

overall. 

What can IDS visitors expect at the 

exocad booth? 

The booth will be the meeting point for 

the exocad community. After all, IDS is 

one of the few opportunities for users 

to engage in direct, personal exchange 

with our software specialists and 

developers. Our software developers are 

also looking forward to this date and to 

meet the end customer. Getting direct 

feedback from users motivates and 

inspires them to improve and enhance 

the product even further. 

Which products are the focus of the 

IDS presentation? 

Our software portfolio has expanded 

greatly over the past few years. 

exocad now has three core products: 

DentalCAD and ChairsideCAD for singlevisit 

dentistry, and exoplan for implant 

planning. New features for individual 

software products are planned as well 

as some surprises, which we can’t reveal 

just yet. 

Since the IDS will be held as a hybrid 

trade fair, what are exocad’s online 

plans? 

The new hybrid element of IDS will 

allow those who cannot travel yet to 

experience the trade fair feeling to 

some extent online. KölnMesse has 

developed a platform by which IDS can 

be streamed live worldwide. It’s exciting 

that online participants can actually 

stroll virtually through the trade fair 

and visit the stands of all participating 

companies. exocad will also use the IDS 

platform to interactively attract online 

visitors. Offering such an online option 

is a new challenge but we already had 

a very positive experience with exocad 

Insights 2020, the hybrid congress we 

organised last year. 

What trends should dentists and 

dental technicians keep an eye on? 

For dentists, the topics of intraoral 

scanners and, for some time now, 3D 

printers continue to be topical – for 

example, printing splints, models, 

or mock-ups for smile design. While 

for dental technicians, the topic of 

digital total prosthetics is particularly 

interesting. There are still new 

developments to be expected in the 

area of software, but also in terms of 

equipment and materials. In general, 

there’s the overall topic of increasing 

efficiency, particularly on how to achieve 

higher productivity through digital 



technologies and reach goals even 

faster and more precisely. 

What do you personally expect from 

IDS 2021? 

What we are currently witnessing is 

that people everywhere are seizing 

every opportunity to finally meet up in 

person again. I think that many dental 

technicians and dentists are looking 

forward to attending IDS onsite to see 

colleagues and their contacts at the 

companies in person again. I expect an 

amazing event and a great atmosphere. 

Of course, IDS 2021 will be different than 

before. But one thing remains: we will 

definitely see many new products and 

that makes us look forward to IDS. 

What are you most looking forward 

to in the next three years with 

exocad? 

We are proud to continue on the path 

that we are on as an open system 

provider and continue to expand our 

broad base of strategic partnerships. 

exocad continues to embrace the open 

platform idea and, as part of Align 

Technology, will take things further into 

orthodontics; it will be very exciting. 

And of course, I’m looking forward to 

continuing to work with my awesome 

team. We are very productive and laugh 

a lot together. All of this makes me feel 

extremely positive and motivated. DA 

28 


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3D Systems as a forerunner 

in digital revolution 

Now that the dental field is going through fundamental changes, 

coming from analogue and moving towards digital workflows, 

Mr Stef Vanneste shares 3D Systems’ role in revolutionising the 

industry with their wide range of trusted and reliable digital solutions. 

In driving new levels of speed, 

productivity, efficiency, and precision 

at a lower cost, 3D Systems remains 

a forerunner in the ongoing digital 

revolution in dentistry. Thus, with the 

increased demands for digital dental 

solutions, Mr Stef Vanneste, vicepresident 

and general manager of 

Dental at 3D Systems, faces exciting 

times ahead of him. 

Passionate about making a meaningful 

difference in a patient’s life, he believes 

in building a strong team and strives 

to inspire his colleagues to be the best 

version of themselves through open 

leadership and coaching. Despite his 

extensive background in the healthcare 

field, deciding to focus on the dental 

industry came easy for him since 

his grandfather was also a dental 

technician. 

He said: “It is rewarding to make 

people smile — and in the most literal 

sense. When the opportunity to join 

3D Systems crossed my path, I didn’t 

hesitate. What better way to step into 

3D printing in dentistry than with the 

company that invented and pioneered 

it?” 

Mr Stef Vanneste, vice-president and general manager of Dental at 3D Systems 

PAVING THE WAY 

Despite the promising outlook of digital 

dentistry, there are still practitioners 

who are taking a conservative approach 

to adopting it. Mr Vanneste recognises 

this issue but is positive that with the 

right support and guidance, they will 

eventually appreciate its true value and 

jumpstart their journey. 

“Traditional lines are blurring making 

3D printing more and more embedded 

within essential parts of providing oral 

healthcare. As conventional dentistry 

30 



NextDent 5100 printed models 

has a long and proven history, it is 

not surprising that new technology is 

approached in a rather conservative 

manner. Still, I expect that most dental 

care providers will find the intraoral 

scanner as a more accurate and 

convenient alternative to analogue 

impression materials,” he said. 

Considering the use of an intraoral 

scanner as the first step towards digital 

dentistry, the next question would now 

be: what can be done with this digital 

scan? 

And that is where the expertise of 3D 

Systems comes in. 

“I believe it is a great opportunity for 

us to show the many advantages of 

3D printing to dental professionals. 

The foremost being better patient 

outcomes,” he shared. 

Jumpstarting one’s digital journey is 

not an easy feat, thus, 3D Systems 

emphasises education and provision of 

training to support dental professionals 

through 3D Systems Academy and 

NextDent Academy. 

Mr Vanneste, explained: “Our 3D 

Systems Academy and NextDent 

Academy were specifically designed 

to provide such training and guide 

both clinicians and technicians in their 

journey towards digital dental workflows. 

With our experience in the dental field, 

our global trusted reseller network, and 

24/7 support system, we can assist the 

dental professional in every field.” 

With these programmes, dental 

professionals can explore every 

possibility of 3D printing and how it can 

help them optimise their treatment. 

Mr Vanneste shared that although 

3D printing is widely used as dental 

model for aligners, he sees the growing 

adoption of 3D printing for temporary 

and final prosthetics. Dentures have 

demonstrated incredible growth in 

the market since last year too, closely 

followed by the gain in popularity of 

splints and night guards. 

He commented: “The transformation 

towards 3D printing is progressing 

rapidly. Dental 3D Printing will play 

an important part in the digital future 

of dentistry as 3D printing materials 

will become more advanced and the 

number of applications will grow.” 

UNMATCHED SOLUTIONS 

3D Systems provides complete digital 

solutions and end-to-end workflows for 

dental laboratories and dental clinics 



to leverage their practice. They offer 

both smaller and bigger dental labs and 

clinics a selection of complete digital 

dental solutions to match their specific 

requirements; from entry-level dental 

3D printers and mid- and large-platform 

batch 3D printers, to rapidly scalable 

workflows, materials, and software. 

In fact, even smaller practices can 

benefit from using a digital workflow or 

outsourcing to a lab with a 3D printer 

because of the higher speed, accuracy, 

and lower costs. 

Mr Vanneste shared that since 3D 

printing of orthodontic models for 

thermoforming is volume-oriented, 

they leverage not only large-scale 

manufacturing, but also offer high 

productivity on the clinic/lab-sized 

NextDent 5100 3D printer, with the 

stacking feature. 

He expounded: “3D Systems’ NextDent ® 

5100 is part of a fully integrated and 

certified digital workflow that facilitates 

high-speed 3D printing for dental 

devices and fixtures. The NextDent 

5100 enables dental labs, dental clinics, 

and production centres to provide the 

best solution for dental applications, 

such as models, crowns and bridges, 

temporaries (long term provisionals), 

surgical guides, splints and many more.” 

In terms of dental materials, he shared 

that permanent restorative and 

prosthetic resins are some of the highlyanticipated 

products in their portfolio. 

“NextDent C&B MFH and NextDent 

Denture 3D+ for denture bases are still 

new applications in 3D printing but are 

expected to have a huge impact on 

the way dental labs and denturists are 

fabricating dentures. With workflows and 

materials still evolving every year, the 

interest in these applications is growing 

and the implementation ongoing,” he 

explained. 

Recently, 3D Systems also launched 

NextDent Ortho Flex to address the 

growing demands for dental splints and 

retainers. It was developed with unique 

raw materials, some exclusively by 3D 

Systems, to solve some problems from 

older generation 3D printing resins and 

can be almost perfectly glass clear 

printed on a 405nm light source. 

“NextDent Ortho Flex is a true nextgeneration 

3D printing resin. The 

material and workflow are developed 

100% with the application in mind and 

therefore it has the perfect mechanical 

properties for dental splints and 

retainers,” he said. 

DEFYING LIMITATIONS 

To stay ahead of the curve, 3D Systems 

pushes the boundaries with expert 

additive manufacturing solutions and 

consultation to make the existing 

solutions even better. Noting that the 

inventor of 3D printing, Chuck Hull, 

founded 3D Systems, Mr Vanneste 

3D Systems Academy and NextDent Academy 

32 



NextDent Denture 3D+ Classic Pink 

NextDent Ortho Flex 

strongly believes that their core 

expertise in 3D printing technology can 

help practitioners propel their practices 

forward. 

“We have different 3D printing 

technologies that we can utilise to 

determine the best solution for any 

application. So, by building further on 

our partnerships with industry-leading 

manufacturers in 3D scanning and 

dental CAD we will keep ensuring the 

best solution for our customers,” he 

said. 

When it comes to technology, Mr 

Vanneste expects to see a shift 

towards bigger build volumes in the 

years to come due to technological 

developments. 

However, he is convinced that the 

ground-breaking innovations will be 

found within the development of 

dental materials and through this, 

new applications will emerge while 

the existing ones will benefit from 

improved formulations. 

Moving forward, he remains 

optimistic that there would be 

a positive long-term effect on 

the digital market trend with the 

pandemic situation accelerating the 

need for more efficient treatment 

solutions. 

He said: “It goes without saying 

that the pandemic has impacted 

everyone heavily. My heart goes out 

to all who have lost loved ones and 

are going through dire straits but I’m 

convinced we’ll eventually make it 

through this horrible period. 

“The pandemic forced us to stay 

indoors, keep our distance and 

avoid contact as much as possible. 

Still, the need for dental care 

remained, triggering the digital 

revolution due to the advantages 

that come with its workflows, such 

as the need for fewer visits and 

sending of virtual files to be printed 

instead of shipping parts.” 

Inspiring the practitioners in the 

Asia Pacific region to kickstart 

their digital journey, he said: 

“I strongly believe in sharing 

information and providing training 

that’s why we actively work 

on our applications team and 

NextDent Academy to provide 

you with the needed support. 

Our regional representatives 

are always available to help. I’m 

looking forward to our joint digital 

journey!” DA 


Clinical Feature 

Updated literature review 

on accelerated orthodontics 

with relevant case reports 

Several conflicting studies on the use of vibration to shorten the 

treatment time of orthodontics had been noted in the recent 

literature. For this reason, Dr Kevin Ng, Dr How Kim Chuan and 

Dr David Tan share two case reports demonstrating how to safely 

accelerate tooth movements using an orthodontic vibrator. 

By Dr Kevin Ng, Dr How Kim Chuan, and Dr David Tan 

Orthodontic tooth movements take a 

long time to complete with an average 

treatment time of about 24 to 36 

months, and this has been one of the 

main reasons that hinder patients from 

receiving treatment. 

To avoid long-term suffering and 

enhance patient cooperation and 

compliance, tooth movement can be 

accelerated by mechanical vibrations to 

shorten treatment times. 

Although every clinician holds different 

views regarding the effects and 

outcomes of accelerated orthodontics, 

two complicated cases were reported in 

this paper performed using 0.2N 30Hz 

vibrator for 20 minutes daily. 

It was revealed that there is a 50% 

treatment time gained for the whole 

Invisalign treatment course with 

acceptable results. 

CASE REPORT 1 

Mr YKC, 24, came to the clinic requesting 

for correction of his teeth in preparation 

for his wedding photoshoot scheduled 

in about a year’s time. 

The chief complaint was anterior 

cross bite with severe crowding in 

both arches. The treatment plan was 

to remove all four first premolars and 

use Invisalign with vibrator (0.2N Force 

30Hz) to accelerate the treatment time. 

The ClinCheck was set up after the 

extractions and there were 68 pairs of 

aligners for the first set. The patient was 

advised to wear two aligners per week 

(previously one aligner per week) with 

vibrator for 20 minutes daily. 

After 34 weeks, all the extractions 

spaces were closed but presented with 

posterior open bites. A second scan was 

done to order refinement aligners. The 

second set included 28 aligners and 

the patient completed the treatment in 

48 weeks. Radiographic findings were 

normal. 

The Vivera retainer was ordered and all 

Case 1: 

Fig. 1 Fig. 2 Fig. 3 Fig. 4 

Figs. 1-2: Extraoral photos before and after treatment 

Figs. 3-4: Intraoral photos before and after treatment 

34 



Case 2: 

Fig. 7 

Fig. 5 Fig. 6 

Fig. 8 

Figs. 5-6: Extraoral 

photos before and after 

treatment 

Figs. 7-8: Intraoral photos 

before treatment showing 

5mm space between the 

central incisors 

Fig. 10 Fig. 11 

Fig. 9: Intraoral photo after treatment 

Figs. 10-11: ClinCheck before and after treatment 

attachments were removed. The patient 

had a perfect smile in time for his 

wedding photoshoot (Figs. 1-4). 

CASE REPORT 2 

Mr JHC, 50, suffered from 

supernumerary central, which was 

removed due to mobility. 

The wide 5mm diastema has caused 

concern and he was suggested to close 

the gap by Invisalign with the use of 

0.2N 30Hz vibrator for 20 minutes daily. 

The first 40 sets of aligners were 

finished in 20 weeks to close the space 

and a total of 26 refinement aligners 

were ordered to correct the root torque. 

The case was completed in 33 

weeks. The patient was happy with 

the outcome and now on Vivera for 

retention phase. No root resorptions 

were found in X-ray examinations (Figs. 

5-11). 

DISCUSSION 

Prolong tooth movement under 

constant pressure could cause root 

resorption 9 . During force application, 

fluid movement was reported in the 

periodontal ligament space causing 

distortion of the cellular matrix. 

Biomodulators activities were 

increased, and these chemicals include: 

Prostaglandin E1, E2, Misoprostol, IgA, 

and parathyroid hormones 10 . 

Pati et al. reported that injection of 

parathyroid hormones could act directly 

on osteoblasts and osteoclasts which 

could promote osteoblastogenesis 

and bone remodelling. In addition, 

Prostaglandins E2 were shown to 

increase during tooth movement 

facilitating bone resorption. PGE 1 were 

also shown to increase by mechanical 

stress to induce bone remodelling 10 . 

In the past, surgical procedures such as 

corticotomy were used to facilitate tooth 

movement. However, the post-operative 

complications and discomfort could be 

severe. 

Several other non-surgical stimuli 

were attempted including laser 

stimulation, electric current stimulation, 

pulsed electromagnetic fields and 

photobiomodulation. 

Among all these methods, vibration 

stimulation that is used mainly 

commercially in recent years, showed 

promising results. Most dentists 

choose this non-invasive approach 

to accelerate tooth movement. Thus, 

it gained popularity in the market of 

orthodontics. 

They were used in experimental 

animals 8,10 and few clinical reports 

had confirmed the positive effects 

of accelerated tooth movements by 

vibrators 2 . 



Although root resorption has caused 

concerns for prolonged tooth 

movement, a study done by Pavlin et 

al. suggested that while there was a 

significant enhancement in retraction 

velocity, there was no canine root 

resorption after patients received 

vibration treatment 11 . 

The popular brands of vibrator include 

AcceleDent (Fig. 12) and VPro (Fig. 13) 

from the United States (US). 

MICROVIBRATION 

The common brand of orthodontic 

vibrator used in the US with FDA 

approval are AcceleDent and VPro. The 

patient utilises the device by biting 

lightly on to the plastic plate for about 

20 minutes per day. It will deliver a 

light force of 0.25N with a vibrating 

frequency of 30Hz. 

Alihani et al. studied the vibrators with 

a controlled group, and they found 

that the mechanical vibrations could 

affect tooth movement time due to the 

induction of anabolic and catabolic 

effects on bone around the teeth 1 . 

Liao founded that the periodontal 

ligament responses were amplified due 

to the vibrations applied. The responses 

were recorded by computational 

stimulation, the volume-average 

hydrostatic stress in the periodontal 

ligament was found at higher level 

with vibration when compared with the 

control group 6 . 

Proffit studied the principles of vibrators. 

They were used in traditional fixed 

orthodontic appliances and in removable 

Invisalign aligners. The treatment time 

was 20 minutes per day, with a vibration 

of 30Hz and has force of 20g 12 . 

They could neither confirm nor fully 

understand the exact mechanism of 

alveolar remodelling at that time but 

he had proposed two hypotheses: the 

first one referred to piezoelectricity 

that could generate within the alveolar 

bone, the second one is related to the 

pressure‐tension established within the 

periodontal ligament 12 . 

Grimm, stated: “Piezoelectricity is 

generated by orthodontic forces 

bending alveolar bone to produce an 

electrical charge which, in turn, induces 

an osteogenic response’’ 3 . 

This is agreed by Shapiro and he 

recommended “that orthodontic 

forces should not be continuous as the 

piezoelectric charges are only created 

when stress is applied and released” 13 . 

Kau, concluded: “mechanical vibrational 

appliance may be suitable for initiating 

these stress‐induced charges as forces 

could be applied and released at a rapid 

rate”. 

A number of cases were reported which 

support the use of microvibration to 

accelerate tooth movement 4 . 

Leethanakul reported an increase in 

movement for patients using vibratingelectric 

toothbrush head (125Hz) on one 

side when compared with the control side. 

Gingival crevicular fluid was collected and 

measured at the mesial and distal aspects 

of each canine at monthly intervals. 

Interleukin-1β levels were analysed using 

an enzyme-linked immunosorbent assay. 

The exact movement of canine was 

measured monthly revealing accelerated 

movement 5 . 

Pavlin et al. found that AcceleDent could 

shorten the time of tooth movement 

when the technique was used during 

orthodontic treatment, and noted 

increasing reports on the use of the 

vibrating devices. 

However, Woodhouse and Miles et al., 

did not agree with Pavlin and pointed 

out that there was not enough data that 

vibration is accelerating tooth movement 

significantly 7,14 . 

Fig. 12: AcceleDent vibrator 

Fig. 13: VPro vibrator 

Woodhouse compared the time for lower 

arch teeth alignment to the insertion of 

the correction wire in orthodontics for 

extraction cases. They concluded that 

there was no evidence supporting that 

additional vibrational force can increase 

the rate of tooth alignment significantly 

or aid in the reduction of total treatment 

period 7,14 . 

36 



At present, it is important to note 

that the researches associated with 

tooth movement acceleration by nonsurgical 

methods are insufficient and 

most papers only provide low quality 

evidence. 

More well‐designed randomised control 

trials (RCT) are encouraged to determine 

the predictability and safety of the nonsurgical 

interventions, and whether they 

are clinically significant in the reduction 

of orthodontic treatment time. 

CONCLUSION 

Accelerated tooth movement can 

be achieved safely with vibration 

including canine retraction. No severe 

harmful effect such as root resorption 

and pain were reported by the latest 

available literature. It is important to 

point out that there are limitations of 

such methods and require patient’s full 

cooperation to use it properly. 

A detailed comprehensive treatment 

option should be provided to the 

patients, so they can understand 

the risks and complications involved. 

Patients should be able to make an 

informed choice about the most suitable 

methods for them to achieve the most 

satisfactory outcome of the treatment 

as planned. DA 

REFERENCES: 

1. 

Alihani M et al (2015) Vibration Paradox in 

Orthodontix : Anabolic and Catabolic effects 

Am J Orth & Dentofac Orthop 148:440-449 

2. 

Bowmann SJ (2014) The efffect of vibration 

on the rate of leveling and alignment J Clin 

Orthod 48:678-688 

3. 

Grimm FM (1972) Bone bending, a feature of 

orthodontic tooth movement. Am J Orthod; 

62: 384– 93. 

4. 

Kau CH, Nguyen JT, English JD (2010) 

The clinical evaluation of a novel cyclical 

force generating device in orthodontics. 

Orthodontic Practice US; 1: 1– 4. 

5. 

Leethanakul C, Suamphan S et al (2016) 

Vibration stimulation increases interleukin- conventional and self-ligsating brackets Am J 

1beta secretion during orthodontic tooth Orthod Dentofac Orthop 134:646-651 

10. 

movement Angle Orthod 86:74-80 https://doi. Pati AK, Singh A et al (2018) Accelerated 

org/10.2319/111914-830.1 

Orthodontics DOI: 10.5772/intechopen.8092 

6. 11. 

Liao at el (2017) Computational and clinical Pavlin D, Anthony R et al (2015) Cylic loading 

investigation on the role of mechanical 

(vibration) accelerates tooth movements in 

vibration on orthodontic tooth movement orthodontic patients: a double blind, RCT. 

Journal of Biomechanics 60:57-64 

Semin Orhtod 21:187-194 

7. 12. 

Miles P (2017) Accelerated orthodontic 

Proffit WR (2007) Contemporary 

treatment ‐ what’s the evidence? First 

orthodontics. 4th edn. St Louis: Mosby pp331– 

published: ADJ Vol 62 issue S1 pp63-70 

8 

13. 

March 2017| https://doi.org/10.1111/adj.12477| Shapiro E, Roeber FW, Klempner 

8. 

Nishimura M, Chiba M et al (2008) 

LS.Orthodontic movement using pulsating 

Periodontal tissue activation by vibration: force‐induced piezoelectricity. Am J Orthod 

intermittent by resonance vibration 

1979; 76: 59– 66. 

14. 

accelerates experimental tooth movements in Woodhouse NR, DiBiase AT et al (2015) 

rats Am J Othod Dentofac Othop 133:572-583 Supplemental vibrational force during 

9. 

Pandis N, Nasika M et al (2008) External othodontic treatment: a randomized trial J 

apical root resorption in patients treated with Dent Res 94:682-689 


Dr Kevin Ng is a visiting professor at the Ghongzhou Medical 

University and Hon. a/clinical professor at the University of 

Hong Kong (2017-2019). His post-graduate qualifications 

include Membership of the Faculty of Dental Surgery (MFDS) of 

The Royal College of Surgeons of Edinburgh. He runs a private 

practice in Hong Kong. 

Dr How Kim Chuan graduated from the National University 

of Singapore in 1991, where he went on to specialise in 

orthodontics at the University of London Eastman Dental 

Institute and obtained his MSc in orthodontics in 1995. He later 

obtained his MOrth RCS from the Royal College of Surgeons of 

England as well as Edinburgh in 1996. Dr How is currently the 

chief consultant at the Imperial Dental Specialist Centre. He is also a speaker for 

the Invisalign System and has conducted multiple certification courses and study 

clubs in South East Asia and India. Presently, he is also an examiner for MOrth 

RCS Edinburgh. 

Dr David Tan Wei Hong received his Bachelor of Dental Surgery 

from the International Medical University, Malaysia. He 

continued to improve his knowledge on clear aligner therapy 

and has attended multiple Invisalign courses. He is currently 

practicing in Imperial Dental Specialist Centre under the 

guidance of Dr How. 



Aesthetic restoration 

at the gingiva 

The aesthetic correction of gingival recession, 

wedge-shaped defects or exposed cervical areas 

remains a challenge in today’s practice. But 

thanks to a novel gingival rectification technique 

of rebalancing the pink aesthetics at the gingiva, 

clinicians can now overcome this issue without the 

need for local anaesthetic or additional discomfort 

to the patient. 

By Dr George Freedman and Dr Paiman Lalla 

AESTHETIC DILEMMA OF THE 

GINGIVAL MARGIN 

The data is clear; porcelain and composite 

resin are both biocompatible at the gingival 

margin and well-tolerated 1-3 . The caveat 

is that composite tends to cause tissue 

irritation if it intimately or directly impinges 

on the gingiva 4-6 . This ultimately causes an 

unaesthetic gingival recession. Porcelain is 

less problematic but marginal plaque buildup 

activated by the thin layer of resin cement 

leads to a similar free gingival irritation and 

eventually, recession 7,8 . 

Even skilful subgingival margin placement 

will typically, within three to five years, lead 

to unaesthetic recession and full visible 

exposure of the darker dentinal tissue 9,10 due 

to ageing, gingival irritation, or lack of home 

maintenance on the patient’s part. Thus, the 

restorative conclusion is to locate composite 

margins supragingivally 3,11 , with the resin 

material reasonably away (0.25-0.50mm) 

from soft periodontal structures and thereby 

unlikely to cause tissue irritation. 

Today’s adhesives and restoratives make this 

a straightforward task 12-19 . Later generation 

adhesives bond equally well and predictably 

to both enamel and dentin 14,15 . Significantly, 

seventh and eighth-generation adhesives 

have similar bonding strengths to both 

enamel and dentin, eliminating the potential 

stresses caused by unequal polymerisation 

contraction 17-19 . It is clinically possible to 

create a continuous restoration through the 

dentino-enamel junction (DEJ), covering 

as much of the enamel and the dentin as 

necessitated by decay or abfraction (or both). 

However, a significant aesthetic predicament 

quickly presents itself. Dental restorative 

materials are designed to match the shade of 

the enamel position of the tooth. While some 

manufacturers offer “dentin” shades, these 

hues typically do not closely match the darker 

colouration of exposed dentin, particularly 

those observed in endodontically treated 

teeth. A typical central incisor measures 

approximately 10.5mm cervico-incisally (CI) 20 . 

A substantial increase in the apparent length 

of a tooth, specifically in the anterior labial 

region, detracts from the aesthetic smile. 

When restoring a Class V decay or abfraction, 

or perhaps a small gingival recession, an 

enamel-coloured resin is commonly placed 

at the labial DEJ. Increasing the maxillary 

central incisor’s vertical aspect (Fig. 1) by a 

mere 3mm adds 30% to the apparent vertical 

dimension, significantly altering the cervicoincisal 

to mesio-distal (CI:MD) ratio, totally 

upsetting the aesthetic parameters of the 

smile (Fig. 2). In situations where there is a 

moderate recession, the visual imbalance 

is even further impaired. The CI:MD ratio 

impact is even greater on maxillary laterals 

and mandibular incisors (average 9.0mm CI). 

Maxillary and mandibular cuspids (average 

10-11mm CI) are often the teeth that are most 

affected by gingival recession and are also 

highly visible both anteriorly and laterally. 

Individuals who have gingival recession, 

Fig. 1: Normal length maxillary central incisors – 

expected appearance 

Fig. 2: Maxillary incisors apparent length increased 

by 30% - very unnatural and unaesthetic 

Fig. 3: Beautifil II Gingiva Shades (Shofu Dental 

Asia-Pacific, Singapore) 

38 



abfraction and/or decay tend to look older 

than they really are (long in the tooth). 

Covering the darker root dentin with an 

enamel-like resin simply makes their 

teeth more visible, seemingly longer and 

correspondingly less aesthetic. 

The practitioner must solve this problem 

practically, aesthetically, and with minimum 

invasiveness. The restoration must be 

functional, replacing missing dental 

structures with natural dimensions and 

contours. It should restore the lost enamel 

with enamel-shaded composite resin, and 

the receded gingiva with gingival-shaded 

composite resin. By creating an artificial 

enamel-gingival junction in composite 

restorative material, the patient’s aesthetics 

and smile can be restored. 

SOLVING THE GINGIVAL AESTHETIC 

DILEMMA 

Beautifil II Gingiva (Shofu Dental Asia-Pacific, 

Singapore) has been specifically designed 

for the rebalancing of pink aesthetics in 

the cervical areas of the dentition (Fig. 3). 

Beautifil II Gingiva is indicated for wedgeshaped 

defects, cervical decay, aesthetic 

rectification of gingival recession, shielding 

exposed cervical areas and splinting of 

mobile teeth. The resin material is available in 

five tones (dark pink, light pink, brown, orange 

and violet) (Fig. 4) which can be layered and/ 

or blended to achieve custom shades that 

allow the treatment of patients with various 

hues of gingival pigmentation, according to 

their clinical needs (Fig. 5). 

Beautifil II is a highly aesthetic, fluoridereleasing 

composite resin material indicated 

for all classes of restorations. Numerous 

studies over the past 20 years have shown 

the absence of secondary caries, failures, 

post-operative sensitivity and high retention 

of both colour match and surface lustre. 

The material is based on Shofu’s proprietary 

Giomer technology (Fig. 6). 

The significant advantage of the Giomer 

class of resins is that they not only release 

fluoride to protect the tooth at the restorative 

margin, but that their fluoride content can 

be recharged by toothpastes, fluoride rinses 

and varnishes too. Thus, the Giomer’s fluoride 

releasing capacity does not decrease over 

time. 

Another important consideration is that the 

gingival margin of the restorative material 

(whether pink or enamel in colour) must be 

kept supragingival and slightly away from 

the free gingival margin 3,4,6 . While a very 

narrow band of darker root structure may be 

visible towards the apex, the restoration’s 

enamel (coronal) and pink gingival (radicular) 

colouration will focus attention away from 

this area. With gingivally blended restorations, 

the professional can deliver both aesthetic 

and supragingival margins within the 

same restoration. A supragingival margin 

facilitates ready access and effective home 

maintenance for the patient. 

It is imperative that a restoration that is so 

close to the free gingival margin be placed 

under conditions controlled for moisture 

and bleeding. Rubber dam placement is 

impractical (target area is positioned apically) 

and retraction cord may physically or 

chemically compromise the working area. 

Ideally, the patient’s oral hygiene creates 

a healthy gingival microenvironment, 

with minimal pocketing and no bleeding 

on probing. In most cases, however, the 

Fig. 4: The resin material is available in five shades (dark pink, light pink, brown, orange and violet) 

Fig. 5: Resins layered and/or blended to achieve 

custom gingival shades 

Fig. 6: Giomers continue to release fluoride because 

their fluoride content can be recharged with fluoride 

toothpastes, rinses and varnishes 

Fig. 7: BeautiBond seventh generation dental 

adhesive 



Fig. 7a: Fusion5 Curing Light 

(Dentlight, Plano TX) 

Fig. 8: Maxillary left lateral with decay and recession 

Fig. 9: Maxillary left lateral with mesial restoration 

and gingival restorative rectification 

Fig. 10: EyeSpecial Dental Camera (Shofu Dental 

Asia-Pacific, Singapore) 

Fig. 13: Mandibular anteriors with gingival restorative 

rectification 

practitioner must modify the actual situation 

to increase the likelihood of clinical success. 

The easiest and best technique for predictable 

tissue sculpting is the use of the diode 

laser 21-23 . Utilising low power (1.0-1.5 watts), the 

dentist can produce an ideal, dry, clean and 

blood-free working area in less than a minute. 

CLINICAL CASES 

Visible recession and decay 

Remarkably, the patient’s chief concern 

was the gingival recession on the left 

maxillary lateral, not the mesial caries (Fig. 

8). Fortunately, the patient’s oral hygiene was 

relatively good, and restoring the MLB decay 

was straightforward (BeautiBond, Fig. 7, and 

Beautifil Flow Plus X, Shofu Dental Asia- 

Pacific, Singapore). The steps for the aesthetic 

Fig. 11: Mandibular anteriors with labial gingival 

recession 

rectification of the buccal recession are: 

1. Gently micro-abrade the receded area 

and the apical enamel to remove food 

debris and plaque. The nozzle of the 

abrader should be angled incisally to 

prevent gingival irritation and bleeding. 

Rinse thoroughly and lightly air dry, 

leaving the surface slightly moist 

(although the degree of moistness is not 

critical). 

2. Apply BeautiBond, a seventh-generation 

dental adhesive, and leave for 10 

seconds. Thoroughly air dry the adhesive 

(very critical). Light cure with the Fusion 

5 Curing Light (Dentlight, Plano TX), 

offering deep cure of composite resins 

within three seconds with a uniform 

4000 mW/cm 2 output (Fig. 7a). 

3. Select the appropriate Beautifil II 

Gingiva shade (Light Pink and Violet for 

this patient) and apply to the receded 

area to restore the buccal dimension 

and contour of the original soft tissue. 

Light cure. It is important to leave a 

small (0.25-0.50mm) gap between the 

apical margin of the restorative and 

the free gingival margin (Fig. 9). This 

space prevents gingival irritation, is 

easily maintainable by the patient, and 

Fig. 12: Mandibular anteriors close-up 

is generally not visible even with close-up 

photographs. (All photography done with 

the Shofu EyeSpecial camera, Fig. 10, 

Shofu Dental Asia-Pacific, Singapore) 

Mandibular anteriors recession 

This is the most commonly encountered 

recession in the oral cavity. The mandibular 

anteriors are small, close together and not 

effectively cleaned by the tongue and lower lip 

(Fig. 11). Due to gravity, food debris and plaque 

tend to accumulate labially and interproximally 

(Fig. 12). In this case, the major culprit for the 

recession is the frenum that pulls the attached 

gingiva apically. The preliminary process is 

a diode laser frenectomy to eliminate the 

muscular forces 21-23 . The steps for the aesthetic 

rectification of the buccal recession are: 

1. Gently micro-abrade, in an incisal 

direction, the receded areas and the 

enamel nearest to the DEJ to remove food 

debris and plaque. Rinse thoroughly and 

lightly air dry, leaving the surface slightly 

moist. 

2. Apply BeautiBond and leave for 10 

seconds. Thoroughly air dry the adhesive. 

Light cure. 

3. Select the appropriate Beautifil II Gingiva 

shade (Light Pink in this case) and apply to 

40 


the receded area to restore the buccal 

dimension and contour of the original 

soft tissue. Light cure. Leave a small 

(0.25-0.50mm) gap between the apical 

margin of the restorative and the free 

gingival margin (Fig. 13). This procedure 

restores the expected gingival height 

and contributes to making the patient’s 

smile look younger. 

Long-term home maintenance is best 

accomplished with procedures that 

are familiar to the patient and easy to 

implement. Regular toothbrushing is effective 

and practiced by most dental patients. 

Interdental string flossing less so. Though 

well-documented, patient resistance to 

the process and irregular application limits 

its benefits. Water flossing (Water Pik Inc., 

Fort Collins CO) not only facilitates in the 

interdental leaning process but has been 

shown to improve the results 24 . While there 

are several models available, the Sonic Fusion 

offers a simultaneous water flossing and 

sonic brushing (Figs. 14-15). 

Fig. 14: Sonic Fusion (Water Pik Inc, Fort Collins, CO) 

Fig. 15: Combined sonic brushing and pulsating 

interproximal water flossing 

CONCLUSION 

Beautifil II Gingiva enables the practitioner to 

overcome the gingival aesthetic dilemma. The 

gingival rectification technique is predictable 

and can typically be accomplished without the 

need for local anaesthetic or discomfort to the 

patient. 

These restorations are totally functional and 

replace both hard and soft missing dental 

structures to natural dimensions and contours 

with minimum invasiveness. The restoration 

of the coronal anatomy with tooth-coloured 

composite resins is well established; the 

development of an artificial enamel-gingival 

junction and the reconfiguration of missing 

gingival structures with composite resins is a 

novel solution that restores the patient’s smile 

and facial aesthetics. DA 

REFERENCES 

1 

Freedman G: Ultraconservative Porcelain Veneers, 

Esthet Dent Update 2:224-228, 1997. 

2 

Freedman G: Ultraconservative Rehabilitation, 

Esthet Dent Update 5:80-85, 1991. 

3 

Freedman G, Fugazzotto PA, Greggs TR: Aesthetic 

Supragingival Margins, Pract Periodontics Aesthet 

Dent 2:35-38, 1990. 

4 

Newcomb GM: The Relationship Between the 

Location of Subgingival Crown Margins and Gingival 

Inflammation, J Periodontol 45:151, 1974. 

5 

Renggli H, Regolati B: Gingival Inflammation and 

Plaque Accumulation by Well Adapted Supragingival 

and Subgingival Proximal Restorations, Helv Odont 

Acta L6:99, 1972. 

6 

Waerhau SJ: Histologic Considerations which 

Govern where the Margins of Restorations Should be 

Located in Relation to the Gingiva, Dent Clin North 

Am 4:161, 1960. 

7 

Berman M: The Complete Coverage Restoration and 

the Gingival Sulcus, J Prosthet Dent 29:1301, 1973. 

8 

Marcum O: The Effect of Crown Margin Depth upon 

Gingival Tissues, J Prosthet Dent 17:479, 1967. 

9 

Freedman GA, McLaughlin G: The Color Atlas of 

Porcelain Laminate Veneers, St Louis, Ishiyaku 

EuroAmerica, 1990. 

10 

Freedman G: Contemporary Esthetic Dentistry, 

Elsevier Publishing, 2011 Chap 23; 551 

11 

Freedman G, Klaiman HF, Serota KT, et al: 

EndoEsthetics: Part II. Castable Ceramic Post and 

Core Restorations. Ont Dent 70:21-24, 1993. 

12 

Albers HF: Dentin-resin bonding. Adept Report 

1990; 1:33-34. 

13 

Munksgaard EC, Asmussen E. Dentin-polymer Bond 

promoted by Gluma and various resins. J Dent Res 

1985; 64:1409-1411. 

14 

Barkmeier WW, Erickson RL: Shear bond strength of 

composite to enamel and dentin using Scotchbond 

multi-purpose. Am J Dent 1994; 7:175-179. 

15 

Swift EJ, Triolo PT: Bond strengths of Scotchbond 

multi-purpose to moist dentin and enamel. Am J 

Dent 1992; 5:318-320. 

16 

Gwinnett AJ: Moist versus dry dentin; its effect on 

shear bond strength. Am J Dent 1992; 5:127129. 

17 

Freedman G, Leinfelder K: Seventh Generation 

Adhesive Systems. Dentistry 2003; January:15–18 


18 

Freedman G: 7th generation Adhesive Systems. 

Dental Asia (English) 2019; March-April:50-53 

19 

Freedman G: Adhesion: Past, Present, and Future. 

Oral Health 2019: July 109:7 8-14,82 

20 

Wheeler RC: A Textbook of Dental Anatomy and 

Physiology. W.B. Saunders 1965: 6:126 

21 

Goldstep F: Soft Tissue Diode Laser: Where Have 

You Been All My Life?. Oral Health 2009: 99:7;34-38 

22 

Goldstep F: Diode Lasers for Periodontal 

Treatment: The Story So Far. Oral Health 2009: 

99:12;44-46 

23 

Goldstep F: Diode Lasers: The Soft Tissue 

Handpiece. Dental Asia 2011: Jan-Feb; 28-32 

24 

Rosema NAM et al. The effect of different 

interdental cleaning devices on gingival bleeding. J 

Int Acad Periodontol 2011; 13(1):2-10 


Dr George Freedman 

is co-founder and past 

president, American 

Academy of Cosmetic 

Dentistry; co-founder, 

Canadian Academy 

for Esthetic Dentistry; regent and fellow, 

International Academy for Dental Facial 

Esthetics, and diplomate and chair, 

American Board of Aesthetic Dentistry. 

He is adjunct professor of Dental 

Medicine, Western University, Pomona, 

California, United States, and professor 

and programme director, BPP University, 

London, UK, MClinDent Programme, 

Restorative and Cosmetic Dentistry, and 

author of 14 textbooks, more than 900 

dental articles, and numerous webinars. 

Dr Paiman Lalla, 

graduate of the 

University of The 

West Indies, Jamaica, 

practices dentistry in 

Trinidad and Tobago, 

with a special focus on cosmetic and 

implant dentistry. Following his training 

at the Advanced Education in General 

Dentistry (AEGD) from Lutheran Medical 

Center, US, he has been accorded 

fellowships in the International Congress 

of Oral Implantology and the American 

Academy of Implant Prosthodontics. He 

serves on the medical panel of Ministry of 

National Security at Trinidad and Tobago. 



Be selfie ready 

There are numerous ways to restore someone’s smile, and a one-size-fitsall 

solution is almost impossible. Thus, the following addresses the common 

dilemma of clinicians in restoring a “borderline” case and how effective 

communication between patient, dentist and lab ceramist is crucial in 

achieving the desired results. 

By Dr Mansingh Patil 

Minimally invasive restorative treatments 

have become more of rule than an exception 

in today’s modern dental practice. In fact, it 

is not only restricted to restorative dentistry 

but also other treatment modalities like 

extractions and implants. 

In cases of failed orthodontic or borderline 

cases, restorative procedures also produce 

excellent results, particularly for patients who 

do not want to go through the orthodontic 

treatment again and prefer a quick fix remedy. 

The results are predictable and achieved in 

shorter duration as compared to conventional 

orthodontics. For this instance, the patient 

plays a huge role in deciding what they want, 

irrespective of what the clinician thinks is the 

ideal solution. 

The following discusses a similar case that 

hovered around the borderline of whether to 

treat the issue with conventional orthodontics 

or minimally invasive prosthetics. After the 

explanation of the pros and cons, the patient 

chose the latter procedure. 

CHIEF COMPLAINT 

A 27-year-old female patient approached 

our practice with a chief complaint of hating 

her right-side smile, as seen when she 

takes a selfie. She was also conscious of 

her unilateral open bite to the extent that 

she wanted immediate rectification of the 

situation (Fig. 1). 

As a result of a relapsed orthodontic 

treatment done a few years ago, the patient 

flatly refused to undergo the same procedure 

again. 

AESTHETIC ANALYSIS 

Intraoral examination revealed a unilateral 

open bite on the right side and an absence 

of occlusal contacts between maxillary and 

mandibular canines. 

The frontal view presented a canted midline 

to the right side (Fig. 2). The right lateral 

42 



incisor (tooth 12) was positioned palatally, and 

the right canine (tooth 13) and left central 

incisor (tooth 21) are on off-the-arch form 

as seen in occlusal view (Fig. 3). Mandibular 

canine (tooth 43) was deficient in height and 

short of the occlusal plane like tooth 13. 

The patient was warned that the canines will 

need aggressive preparation, which might 

jeopardise the pulpal health and necessitate 

endodontic therapy (Figs. 4-5, 1:1 Figs. 6-7b) 

DIAGNOSTIC PHASE 

The decision to treat the case prosthetically 

without mutilation of dental tissues and 

safeguarding the dentin-pulpal complex 

was paramount. Hence, before doing any 

irreversible tissue destruction, it was decided 

at the first appointment to do a direct freehand 

composite mock-up to assess if the 

case fitted into the restorative domain or not. 

Without etching or bonding enamel, an 

old, unused composite was sculpted onto 

teeth 13, 12, 11, 21, and 43. The patient was 

happy with how far the desired result could 

be achieved. She took some selfies using 

her mobile phone to seek her parents’ and 

friends’ opinions. 

Upon the patient’s approval of the direct 

composite mock-up, an appointment was 

scheduled to take a set of impressions in 

alginate for diagnostic casts. The casts, along 

with the entire preoperative photographs and 

related information, were sent to the ceramist 

to do the wax-up of the model (Figs. 8a-b). 

Three silicone indices (full-contour L/P, labial 

and palatal) were obtained from the wax-up 

to transfer it to the mouth and facilitate the 

preparation stages. 

Protemp 4 temporisation material was loaded 

in the full-contour index (Fig. 9) to create 

a mock-up or Aesthetic Pre-evaluative 

Temporaries (APT), a term coined by Dr Galip 

Gurel, founder and the honorary president 

of EDAD (Turkish Academy of Aesthetic 

Dentistry). 

Aesthetic and phonetic analysis of the APT 

were done to check the suitability of the 

additions. The APT is modified to the desired 

functional and aesthetic parameters by 

adding or subtracting resin (Figs. 10-11). 

TREATMENT PLAN 

Retreatment with orthodontics was outrightly 

rejected. The patient was happy with the 

mock-up and decided to go ahead with the 

restorative option. 

It was decided to use IPS E-max lithium 

disilicate veneers (Ivoclar Vivadent) on teeth 

13, 12, 11, 21, and 43 to improve her smile. The 

patient was warned about the implications of 

deep preparation on teeth 13 and 43. 

RESTORATIVE PHASE 

The APT was retained in the mouth so 

the preparations can be done through the 

mock-up composite. Local anaesthesia (2% 

lidocaine with 1/100000 epinephrine) was 

administered around the concerned teeth. 

A set of four burs — 0.5mm depth cutting, TR- 

12, TR-14 and TR-25F were needed. A coarse 

Soflex disc was used to round off sharp lines 

and point angles. 

With the APT in place, the preparation was 

done through it as it established the labial 

and incisal spatial position of the final 

restorations. First horizontal depth cuts of 

0.5mm were placed on the APT labial surface 

following the natural planes of the surface. 

The depth grooves were marked with a sharp 

pencil (Fig. 12). The tip of TR-14 was used 

Fig. 1: Pre-op right lateral smile 

Fig. 2: Pre-op full smile frontal view 

Fig. 3: Pre-op occlusal view 

Fig. 4: Pre-op retracted left lateral Fig. 5: Pre-op frontal retracted Fig. 6: Pre-op 1:1 frontal 



Fig. 7a: Pre-op 1:1 right lateral 

Fig. 7b: Pre-op 1:1 left lateral 

Fig. 8a: Maxillary wax up 

Fig. 8b: Mandibular wax up 

Fig. 10 Fig. 11 

Fig. 9: Protemp 4 temporisation material was loaded 

in the full contour index 

Figs. 10-11: The APT was modified to the desired functional and aesthetic parameters by adding or 

subtracting resin 

to reduce the incisal edge to approximately 

1.4mm. 

The APT was then flicked off with a sharp 

explorer to see which areas need preparation 

and which are untouched (Fig. 13). The TR- 

14 bur was used for gross reduction while 

the TR-12 was utilised to create a chamfer 

equigingival finish line and to perform the 

entire final reduction. 

The preparation on teeth 13 and 43 were in 

deep dentin but did not require endodontic 

intervention. Finally, the TR-25 EF fine grit 

bur was used to smoothen the enamel and 

the coarse disc was used to round off sharp 

edges (Fig. 14). 

Gingival retraction capsule (3M) was used for 

tissue deflection before taking the impression 

using polyether impression material (3M). 

An anterior stick bite and full occlusal Alu 

wax bite was recorded. It was followed by 

spot-etched and bonded direct composite 

provisional. 

LABORATORY COMMUNICATION 

Photographs of the prepared teeth with and 

without stump shade tabs were provided 

to the ceramist. The prescription to the 

laboratory contained the following: 

• Photographs of pre-operative situation 

• Shade tab photo aligned along with 

prepared and unprepared teeth 

• Stump shade photographs 

• Photographs of approved APT 

• Polyether impressions of prepared teeth 

• Bite registration, stick bite 

TRY-IN AND CEMENTATION 

When the restorations arrived from the 

laboratory, they were inspected on the 

models under magnification for crack lines, 

marginal fit and interproximal contacts. 

The teeth were cleaned with pumice and a 

prophylaxis brush. The veneers were first 

individually seated dry and inspected for 

precise fit under magnification. Next, they 

were seated with water-based lubricant to 

assess proper fit and aesthetics. 

To create micro-porosities in the ceramic 

surface, the internal surface was etched 

with 5% hydrofluoric acid for 20 seconds and 

thoroughly washed and air-dried. 

Two coats of silane coupling agent 

44 



(Monobond S, Ivoclar Vivadent) were applied 

for 60 seconds and allowed to evaporate and 

air-dry. Two coats of Single Bond (3M) were 

brushed on the surface, air-thinned and kept 

in a dark place away from any light source. 

Teeth 13 and 43 were etched with 37.5% 

phosphoric acid for five seconds while the 

remaining prepared teeth were etched for 15 

seconds. All were copiously rinsed with water 

and gently air-dried. 

Adjacent teeth were isolated with 

polytetrafluoroethylene tape to avoid contact 

with the etchant. Two coats of Single Bond 

were applied to the preparations, air-thinned 

and light-cured for 20 seconds. 

The restorations were filled with Variolink N 

base and catalyst (mix of transparent shade) 

and were gently seated, allowing the excess 

resin to flow out from all the margins. The 

excess resin was then grossly removed and 

the proper fit of veneers was verified. 

Subsequently, the veneers were spot-cured 

facially and palatally for three seconds each 

to achieve a rubbery consistency for easier 

clean up. Excess resins were further removed 

using a sharp explorer and #12 surgical blade. 

To facilitate the complete cure, DeOx gel 

(Ultradent) was applied to all the margins to 

prevent an oxygen-inhibited layer. The final 

cure of 20 seconds was completed on each 

surface. While curing, the light tip was moved 

in a fanning motion to avoid overheating the 

teeth. 

Occlusion, centric and excursive jaw 

movements were checked, adjusted, finished 

and polished with polishing points. Finally, 

post-operative X-rays were taken to check for 

any excess resin cement. 

Final photographs were taken at a 

subsequent appointment to allow gingival 

healing and teeth rehydration (Figs. 15-20). 

The patient was recalled after three months 

to assess the situation. There was an 

excellent tissue response which is classic of 

glazed and polished ceramic surface in the 

cervical area (Fig. 21). 

SUMMARY 

The dilemma of treating failed orthodontic 

cases with prosthetics can be easily 

overcome by effective communication 

between the patient, dentist and the lab 

Fig. 12: Depth grooves were marked with a sharp pencil 

Fig. 13: The APT was flicked off with a sharp explorer to see which areas need 

preparation and which were untouched 

Fig. 14: Final preparation 

Fig. 15: Post-op full smile frontal view 

Fig. 16: Post-op right lateral smile 

Fig. 17a: Post-op retracted right lateral view Fig. 17b: Post-op retracted left lateral view Fig. 18: 1;1: Post-op frontal 



The result was not just pleasing to the patient 

but very satisfying to the dentist and the 

ceramist as well. Best of all, the patient is now 

“selfie-ready.” 

Fig. 19a: 1;1: Post-op right lateral 

Fig. 19b: 1;1: Post-op left lateral 

ACKNOWLEDGMENTS 

The author would like to acknowledge Mr 

Rohit Naik, CDT, of Sai Dental Lab, Goa, India, 

for his artistic ability in carving out excellent 

piece of ceramic work. DA 

About the author 

Fig. 20: Post-op occlusal 

ceramist. Following a set pattern of doing 

direct composite mock-up first, followed by a 

detailed wax-up to set up APT which helped 

Fig. 21: Three months post-op 

in the most conservative teeth preparation, 

the future of dentistry has moved on to 

another level. 

Dr Mansingh Patil is a 

graduate of Goa Dental 

College and Hospital, 

Goa India. He has been 

in clinical practice for 

over two decades. 

46 


A 

Bone Level 

REG & PX designs for 

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.

User Report 

Harness the power of 

air with the Primea 

Advanced Air turbine 

handpiece 

Combining the benefits of 

an electric motor with those 

of a turbine handpiece, 

W&H Primea Advanced Air 

turbine features precise 

setting of the recommended 

rotary bur speed according 

to material and process 

step as well as the constant 

removal rate, even with 

increasing pressure on the 

bur during preparation. 

Dr Grant Dean shares his 

workflow and how using the 

Advanced Air technology 

has modified it. 

Dr Grant Dean, dental head 

and practice owner of the 

Central Dental Group in 

Wodonga, Australia 

48 


User Report 

Nowadays, the challenges on tooth 

preparations for prosthetic restoration 

are diverse. Combining top-quality 

preparations and safety with efficient 

operations is among the desired goals. 

Excellent ergonomics, good light 

conditions in the oral cavity, as well 

as simple and intuitive handling are 

requirements for dental devices and 

instruments. 

Good news is, the new W&H Primea 

Advanced Air turbine can fulfil all these 

expectations. A high-performance 

turbine, which has been awarded 

the Austrian National State Prize for 

innovation, meets different speed 

recommendations accurately and 

constantly. 

All bur manufacturers recommend 

predefined speeds for the optimum 

performance of their instruments. 

Dental burs are designed with different 

flute angles and cutting characteristics 

specific to its task 1 . Rotations per minute 

(rpm) varies depending on the outside 

diameter of the blade, material to be 

cut 2 and vibration characteristics 3 . To 

improve blade life, reduce wreckage 2 

and heat generation as well as 

maximise efficiency 3 and tactile sense 4 , 

it is important to run blades at the 

appropriate rpm 2 and follow the bur 

manufacturer’s specifications of speed 1 . 

By accurately adjusting the Primea in 

accordance with these recommended 

speeds, the user can get a much better 

clinical performance out of the bur. 

ACCURACY AND CONSTANCY IN 

A SINGLE DEVICE 

Dr Grant Dean, dental head and practice 

owner of the Central Dental Group in 

Wodonga, Australia, uses 180,000rpm 

to complete the initial shaping of the 

restoration, then reduces the speed 

to 100,000rpm for more intricate 

shaping, and sometimes even as low 

as 60,000rpm to get a super-smooth 

finish. He completes each step with a 

Fig. 1: Optimal speed ranges of the Primea Advanced Air according to the different steps of the treatment and related 

intended burs 5 

single bur, which is no problem for the 

Primea Advanced Air turbine, due to 

easy and quick adjustment of the speed 

on the display (Fig. 1). 

Adjusting the speed in this way ensures 

good cutting efficiency, which is 

impossible to achieve by using the foot 

control to supervise a conventional air- 


User Report 

driven turbine handpiece. Dr Dean gave 

an example of how this has expanded 

the range of his treatments: “I reduced 

the speed to control the bur in cutting 

a glass ionomer restorative placed in 

the distal of an upper tooth. Since it 

was difficult to place, I added surplus 

material so I could trim back to the tooth 

shape. Using the 60,000rpm speed, I 

have far greater control and can avoid 

the bur ‘burrowing in’ to the restorative 

– I could even use the root surface as 

a ‘guide’ to ensure a seamless margin 

without any effect on the root surface.” 

He added that it is also possible to 

perform a preparation with a constant 

bur speed, regulated on the device. 

With conventional air-driven turbine 

handpieces, increasing pressure 

during preparation was associated with 

decreasing performance, but the Primea 

Advanced Air turbine features constant 

performance during increased load as 

used with electric motors and speedincreasing 

contra-angles. 

After setting the required or 

recommended rotary speeds for the 

various applications on the module’s 

display, a sensor in the turbine head 

continuously measures the bur’s actual 

rotary speed on the tooth. The bur is 

then aligned with the rotary speed 

set. As soon as the speed threatens to 

slow, the control module adjusts the air 

supply immediately to ensure constant 

removal. 

In addition to the “Power” mode with 

constant rotary speed, there is also a 

“Tactile” mode, which permits reduction 

of the speed so users can perform 

sensitive steps with even greater control 

— encouraging minimally invasive 

treatment. 

BETTER RESULTS FOR PATIENTS 

AND DENTISTS 

Not only does this new technology 

enables Dr Dean to work in a more 

W&H Primea Advanced Air turbine 

precise, straightforward, faster and 

safer way, it also guarantees a smoother 

cutting pattern and result for the 

patient. 

“With a conventional turbine, loading of 

the bur slows the bur speed down. The 

consequent foot pedal ‘feathering’ that 

we all do, creates an uneven cutting 

pattern. Sometimes the bur will bounce 

or walk across the preparation creating 

uneven cutting depths. I found this 

almost never happens with Primea: 

completing intricate work like crown 

preps is made simpler and quicker,” 

explained Dr Dean. 

He added: “Bulk amalgam removal is 

also much faster now with the Primea 

Advanced Air. I have used a number of 

different bur types and shapes (both 

tungsten and diamond) but the Primea 

turbine does not slow down with any 

of them. I have gone back to an old 

favourite bur (JET FG TC 330), simply 

because I am used to working with small 

instruments, which supports my minimal 

intervention dentistry philosophy. 

“The new W&H 5x Ring LED+ system 

(RK-97 L) reduces reflection from 

moist surfaces and offers me perfect 

interpretation of the tooth surface, 

which is among others crucial for a 

minimally invasive performance as well. 

Due to superior distribution of the light, 

shadows are non-existent.” 

The lightweight design of the handpiece 

with its advantageous weight 

distribution and non-slip surface 

render the device highly ergonomic. 

Furthermore, the W&H Roto Quick 

coupling system RQ-24 allowing a 360° 

handpiece rotation without twisting the 

hose support an ergonomic operation. 

QUIET TREATMENT DESPITE 

HIGH PERFORMANCE 

Arranging the treatment to be as quiet 

as possible and without high-frequency 

noise creates a positive atmosphere for 

the patient. 

“A conventional turbine’s free-running 

speed is 350,000rpm or more. The 

Primea turbine is set to the application 

speed (i.e. 180,000rpm) and is therefore 

far quieter, and the pitch is far lower 

– which must be more convenient for 

the patient’s experience and which I 

certainly appreciate too. I’ve always 

linked the pitch/noise of the turbine 

to the performance, i.e. the higher the 

noise, the higher the cutting speed. 

Not anymore. Tremendous cutting 

performance but at a lower speed 

means less noise pollution and creates 

a far more pleasant atmosphere for me, 

my staff and the patient,” shared Dr 

Dean. DA 

REFERENCES 

1. 

Elias K, Amis AA, Setchell DJ. The magnitude 

of cutting forces at high speed. J Prosthet 

Dent. 2003 Mar;89(3):286-91. 

2. 

Manual of the UKAM Industrial Superhard 

Tools Division of LEL Diamond Tools 

International, Inc., Valencia, CA 91355 USA 

3. 

Vaughn RC, Peyton FA. The influence 

of rotational speed on temperature rise 

during cavity preparation. J Dent Res. 1951 

Oct;30(5):737-44. 

4. 

Krejci I, Lutz F, Boretti R. Resin composite 

polishing—filling the gaps. Quint Int 

1999;30(7):490-495. 

5. 

W&H Dentalwerk Bürmoos GmbH 

50 


40 YEARS 

1981 2001 2021 

DIATECH ® Diamonds 

Open up new perspectives 

Diamonds are industry’s first choice for efficiently milling even 

hardest materials. In dental practices, wear-resistant and highprecision 

diamonds can work through extremely tough materials 

like Zirconia. 

006904 08.21 

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User Report 

Apicoectomy — Chronic apical 

periodontitis treatment 

Technological advancement in dentistry has opened up more 

treatment possibilities to achieve better clinical results and 

upgrade patient comfort. The following discusses how the Er:YAG 

laser system can stimulate the healing process and reduce postoperative 

complications in cases of endodontic microsurgery. 

By Dr Igor Kriznar 

A 46-year-old female patient was 

referred to the clinic for the treatment 

of chronic apical periodontitis on tooth 

15. The tooth had been endodontically 

treated approximately five to six years 

ago and was not vital. The tooth was 

tender to percussion as well as palpation 

adjacent to the apex of the tooth. The 

mobility of the tooth was not increased. 

The gingiva was healthy in colour and 

the probing depth was not more than 

3mm. 

An X-ray showed an occlusal filling 

reaching all the way to the pulp chamber 

(Fig. 1). One root could be observed and 

the apex has a slight curve to the distal. 

The root filling deviated from the canal 

trajectory and a root perforation could be 

seen in the apical part. The periodontal 

ligament was normal in width but the 

periapical bone showed a small circular 

resorption indicating chronic apical 

periodontitis. 

CLINICAL CASE 

Apicoectomy was performed to eliminate 

bacterial infection in the root canal 

system by removing the tissue with 

inflammation as well as the excess root 

52 


User Report 

root; quicker healing; and fewer postoperative 

complications compared to 

conventional therapy. 

All steps of apicoectomy can be 

performed using Er:YAG laser light, 

including incision and granulation tissue 

removal. The latest protocols also involve 

the use of biomodulation (LLLT) with 

Fig. 1: Before treatment 

Fig. 2: Root resection after mucoperiosteal 

elevation 

Fig. 3: Degranulation tissue removal 

(SWEEPS mode) 

Nd:YAG laser to stimulate the healing 

process. DA 

About the author 

Fig. 4: Retrograde filling 

filling material from the periapical tissues 

to promote healing. After infiltration of 

anaesthetic, a marginal incision was 

performed along tooth 15 and a vertical 

incision at tooth 14. A muco-periosteal 

flap was elevated to reveal the apical 

region of tooth 15 (Fig. 2). 

The osteotomy was performed using 

Er:YAG laser wavelength with a cylindrical 

tip. When the osteotomy window was 

large enough, the granulation tissue 

was removed using an excavator. For 

the root resection, a cylindrical tip was 

used and the energy was raised to 

400mJ. The surface of the resected 

root was inspected under an operative 

microscope and a retrograde preparation 

was made. For complete removal of the 

granulation tissue as well as excess root 

filling material from the bone lacunae, the 

SWEEPS irrigation protocol using saline 

can be adopted from endodontics to 

encourage faster healing. 

For this reason, after the retrograde 

Fig. 5: One-week follow-up before 

suture removal 

preparation, the AutoSWEEPS mode was 

used, performing 30-seconds cycles of 

irrigation with saline solution in the bone 

lacunae (Fig. 3). After local haemostasis, 

the retrograde preparation was filled and 

tightly condensed using MTA (mineral 

trioxide aggregate) cement (Fig. 4) and 

the wound was sutured. 

Curasept rinsing solution (0.05% 

chlorhexidine) was prescribed for a week. 

On the follow-up appointment after a 

week, the patient had minimal pain. The 

healing of the wound was satisfactory; 

slight swelling persisted for only two 

days after surgery (Fig. 5). On the X-ray, a 

resected root and a tight retrograde filling 

could be seen (Fig. 6). The sutures were 

removed and the patient was scheduled 

for a follow-up appointment after a year. 

CONCLUSION 

Fig. 6: X-ray of one-week follow-up 

This clinical case showed that Er:YAG 

laser light can also be used in endodontic 

microsurgery cases. The main benefits 

include: less vibration, trauma and 

anxiety for the patient; increased 

decontamination of the apical part of the 

Dr Igor Kriznar 

graduated in 2006 

from the Faculty 

of Medicine 

in Ljubljana, 

Slovenia, and 

began working as an assistant 

at the Faculty of Medicine, 

Department of Endodontics and 

Operative Dentistry. He acquired the 

professional title of Dental Specialist 

in Endodontics in 2014. Until the end 

of 2015, he worked as an assistant 

at the Faculty of Medicine, where he 

was engaged in work with students 

of dentistry in clinical and preclinical 

practice. At the same time, 

he worked as a dental specialist at 

the University Medical Centre in 

Ljubljana. 

Dr Kriznar was also involved in 

research work and earned his PhD 

in endodontics from the same 

university in 2016. In December 

2015, he entered into full-time 

private clinical practice focusing 

mainly on endodontics. In 2019, he 

completed LA&HA Master in Laser 

Dentistry. Actively participating 

in many international and local 

conferences and symposia, he has 

also published numerous scientific 

papers in various journals. 


Behind the Scenes 

New era in 

all-ceramics 

IPS e.max ZirCAD Prime is 

redefining all-ceramics. But 

what makes this product 

so special? Master Dental 

Technician Vincent Fehmer 

talks about the material and 

what makes it distinctive from 

other zirconia materials in 

routine laboratory work. 

Vincent Fehmer, MDT, has been 

working at the Clinic for Fixed 

Prosthodontics and Biomaterials at 

the University of Geneva since 2015. 

In addition, he runs his own dental 

laboratory in Lausanne, Switzerland. 

In his numerous publications and 

presentations, the all-ceramics expert 

emphasises the importance of an 

efficient and effective workflow. This 

includes deciding on the appropriate 

material for the given indication, 

which calls for a sound fundamental 

knowledge of materials science. 

He is convinced that modern zirconia 

will play a key role in the development of 

future digital workflows. He sees great 

potential with regard to complex, multiunit 

restorations in particular. 

Fehmer belongs to a selected group of 

dental technicians who were given the 

opportunity to test the new all-ceramic 

IPS e.max ZirCAD Prime during the 

material’s development phase. IPS 

e.max ZirCAD Prime was presented 

to the public for the first time at IDS 

(International Dental Show) 2019. 

Fehmer describes his first impression of 

the zirconia material and reports about 

his experiences with it to date. 

What was your first impression of 

IPS e.max ZirCAD Prime? 

The material’s exceptional development 

potential within the field of zirconia is 

54 



exciting. The effective combination 

of properties – high strength and 

translucency in the incisal region due to 

Gradient Technology – is great. I really 

like the look and feel of the material, its 

excellent performance and lovely shade. 

All in all, I was pleasantly surprised. 

What impressed you the most about 

IPS e.max ZirCAD Prime? 

I am really impressed with the opacity 

of the disc in the core area and its high 

stability, which is essential in complex 

restorations. These properties give me 

the freedom to fabricate wide-span 

bridges with up to two pontics and 

with cantilevers. In addition, I have the 

possibility of applying additional ceramic 

layers. This material gives me utmost 

flexibility – that is one of the strengths 

of this product. 

characterisation materials), I hope to 

simplify my inventory and achieve highly 

predictable aesthetic results. 

What kind of potential does IPS 

e.max ZirCAD Prime have in your 

opinion? 

It has what everyone wants; laboratory 

and practice owners would like to have 

a disc with which they can manage all 

their indications. We’ll see how well the 

product performs in everyday laboratory 

situations in the future. The disc has a 

great potential, and I am looking forward 

to using it in the future and testing it in 

clinical situations. DA 

What is the difference between 

IPS e.max ZirCAD Prime and 

conventional multi-layer zirconia? 

Unlike conventional multi-layer zirconia, 

this disc features a beautiful progression 

of shade. Additionally, its colours 

are amazing and the combination of 

properties is fantastic. 

What makes the colour gradient in 

IPS e.max ZirCAD Prime so special? 

The colours seamlessly blend into 

each other. There are no visible layers 

of pigmentation where a transition is 

visible. This simplifies the handling as 

well as the positioning of restorations 

in the disc. All these characteristics are 

very important to me. 

What do you expect from IPS 

e.max ZirCAD Prime in your dental 

laboratory? 

Primarily, I expect it to simplify my work 

on a daily basis. I hope to keep fewer 

products in stock in my lab. I would 

like to achieve better aesthetic results 

and have more versatility and flexibility 

in my work. In combination with the 

existing products (layering ceramic, 



Maxillary premolar inlay 

restorations with Permanent 

Crown Resin 

3D printing of dental restorations 

addresses the increasing patients’ needs 

for more efficient treatment solutions. 

Thus, this paper presents a step-by-step 

overview of fabricating inlay restorations 

using an indirect CAD/CAM process, 

achieving an economical solution without 

compromising the aesthetic results. 

By Dr Édouard Lanoiselée in collaboration with Argoat Prothèse Dentaire 

Digital dentistry methods and materials 

have surpassed traditional ones in many 

ways. Digital tools particularly enhance 

interconnectedness and communication 

between patients, doctors, and laboratories. 

Additionally, the development of new dental 

materials for restorative dentistry opens up a 

new world of possibilities, allowing for shorter 

delivery times and reduced costs while still 

delivering high-quality restorations. 

Today, intraoral scanners and 3D printing 

systems perform at a high level while 

maintaining the simplicity of use. The 

Form 3B printer from Formlabs Dental is 

an excellent example of this; its plug and 

play operation puts it within equal reach of 

56 



Fig. 1 

Fig. 2 Fig. 3 

Fig. 4 Fig. 5 

Fig. 6 

Fig. 7 

Fig. 8 

Fig. 9 

Fig. 10 Fig. 11 

Fig. 1: Initial clinical situation 

Fig. 2: Teeth after preparation 

Fig. 3: Maxillary impression with trace of the limits of 

the teeth preparations 

Fig. 4: Black and white imprint control 

Fig. 5: Dynamic occlusion recording (Specific 

motion) 

Figs. 6 to 11: Inlay design 

printing experts and beginners. Permanent 

Crown Resin, also from Formlabs, is a 

restorative material released in 2020 that 

allows the direct printing of high-quality 

permanent single unit restoration at a 

reduced price. 

The clinical case presented here shows an 

indirect CAD/CAM step-by-step workflow 

for the production of inlay restorations. 

The intraoral impression was taken in the 

practice with the data then transmitted to 

the laboratory, where the prosthetic elements 

with Form 3B and Permanent Crown 

Resin were designed and 3D printed. The 

restorations were sent back to the practice, 

prepared for adhesive cementation, and the 

treatment was delivered to the patient. 

CASE PRESENTATION AND 

DIAGNOSIS 

A 58-year-old-female patient with treated 

hypothyroidism consulted us for sensitivity to 

cold in the area of her tooth 24. Upon clinical 

examination, we identified an occlusal-distal 

fracture of the dental amalgam on tooth 24. 

The restorations on teeth 25 and 26 were 

carried out at the same time and appeared 

to be infiltrated. Following the tests, we 

diagnosed reversible pulpitis on tooth 24. On 

the other hand, teeth 25 and 26 did not show 

pulpal symptoms (Fig. 1). 

TREATMENT PLAN 

The treatment plan consisted of the removal 

of amalgam restorations and the transition 

to direct composite restorations (26) and 

indirect printed composite resin restorations 

(inlays on 24 and 25). 



Fig. 12 Fig. 13 Fig. 14 Fig. 15 

Fig. 16 

Fig. 17 Fig. 18 

Fig. 19 Fig. 20 Fig. 21 

Fig. 22 Fig. 23 

Fig. 12: Print preparation in Preform 

Fig. 13: Inlay characterisation 

Figs. 14-15: Surface preparation of inlays 

Fig. 16: Preparation of tooth surfaces 

Fig. 17: Application of orthophosphoric acid 

Fig. 18: The tooth preparations after conditioning 

Fig. 19: Cementation of the inlay on tooth 25 

Fig. 20: Cementation of inlay on tooth 24 

Fig. 21: Fitting view 

Fig. 22: Polishing under surgical field 

Fig. 23: Final view after occlusion check and 

polishing 

The treatment was carried out in two 

sessions: a preparation session and a 

cementation session. 

EXECUTION OF TREATMENT PLAN 

The amalgams were placed under the 

operating field. In order to conceal the 

residual discolouration caused by the 

amalgam and to fill undercuts, the cavities 

were filled with composite. 

Tooth 16 was filled using the direct composite 

resin technique. The shade of the indirect 

restorations was determined by the shade 

selected to fill the cavities of teeth 24, 25 and 

the filling of tooth 26. The composite filling 

also protected against the risk of bacterial 

contamination and prevents possible pulpal 

sensitivities (Fig. 2). 

The teeth were then prepared using 

calibrated burs for onlays. After polishing, 

an intraoral impression was taken (TRIOS 

4, 3Shape) both statically and dynamically. 

The patient’s mandibular movements were 

recorded to improve the accuracy of the 

occlusion (Figs. 3-5). 

The impression was sent to the prosthetic 

laboratory (Argoat Prothèse Dentaire) via the 

secure 3Shape Communicate web portal. 

The provisional restoration was made using 

a flexible composite (Luxatemp inlay, DMG), 

which was selected for easy removal during 

the assembly session (Figs. 6-11). 

MANUFACTURING STAGE 

The restorations were modelled in the 

3Shape Dental System software. After the 

digital design was completed, the inlays were 

exported in STL format and imported into 

the PreForm software (Formlabs) and printed 

in Permanent Crown Resin A2 Shade in the 

prosthetic laboratory (Fig. 12). 

58 



The restorations were then characterised via 

staining (Optiglaze, GC) and glazing, and sent 

to the dental practice for cementation 

(Fig. 13). 

DELIVERY AND CEMENTATION 

PROTOCOL 

After the removal of temporary restorations, 

the inlays were tried in to validate their 

insertion and adaptation. Their internal 

surface was then prepared in three steps 

(Figs. 14-15): 

1. Micro sandblasting (50micron alumina) 

to create mechanical retention 

2. Cleaning to remove residual alumina 

particles 

3. Silanisation (G-multi primer, GC): after 

thorough drying, the primer was applied 

in a single layer, then the excess was 

evaporated with a blower and the 

prosthetic part was placed in a heater to 

activate the silane 

We then proceeded to the assembly by 

cementing according to the following 

protocol (Fig. 16): 

1. Setting up an operating field using 

multiple dental dams. This allowed us to 

isolate the site from the moisture of the 

oral cavity and improve visibility 

2. The cavities were conditioned using 

a micro-sander (27micron alumina). 

The sandblasting reactivates the 

composite for bonding, cleaning the 

cavity of possible residues of temporary 

cementation agent and restoration. We 

rinsed abundantly to remove alumina 

particles, which can decrease the 

adhesion value 

Orthophosphoric acid was applied for 30 

seconds on the enamel and 15 seconds 

on the dentin. The etching creates 

micromechanical keying and helps to finish 

cleaning the bonding surfaces (Fig. 17). 

The surfaces exhibited a matte appearance 

as a sign of the conditioning action of 

microsanding and acid etching (Fig. 18). 

For cementation, a universal cement agent 

(G-cem Linkforce, GC) with dual setting 

(chemical and light-curing) was used. The 

adjacent teeth were insulated with Teflon 

to avoid the adhesive and cementing agent 

getting to undesired surfaces. 

The adhesive was applied by actively rubbing 

it into the surfaces and applying the dry 

air blower to evaporate the solvents. The 

adhesive was applied to the prosthetic 

restoration, which was then gently placed 

into the prepared cavity (Fig. 19). 

The excess cementing agent was carefully 

removed with a brush and then the 

restoration was light-cured for 20 seconds. 

The second inlay was then placed following 

the same protocol (Fig. 20). Here again, the 

excess was removed with a brush before 

photopolymerisation. The two inlays were 

then light polymerised for one minute from all 

sides (Fig. 21). 

A first polishing was carried out using silicone 

polishers (Spiral Komet Kompoline) (Fig. 22). 

The rubber dam was then removed, the 

occlusion was checked and the final polishing 

was carried out (Fig. 23). 

FOLLOW-UP 

The aesthetic integration was satisfactory. 

The patient will be seen again in six months 

for follow-up. 

CONCLUSION 

Permanent Crown Resin is an excellent 

alternative to composite block for inlay 

applications. 3D printing allows an 

economical solution with a satisfactory 

aesthetic result both in terms of morphology 

and colour. 

While a composite block can cost between 10 

to 12 euros per piece, using 0.40ml per inlay 

reduces costs significantly to four to seven 

euros per inlay. The flow proposed here in 

collaboration with the prosthetic laboratory 

can easily be done within the dental practice 

in a direct CAD/CAM framework. DA 


Dr Édouard 

Lanoiselée is a 

general practitioner 

in a group practice 

in Nozay, France. In 

2008, he graduated 

from the Faculty of Dentistry in Nantes, 

France, but has always maintained a link 

with the faculty since his graduation, 

whether for clinical supervision of 

students or theoretical instruction at 

the graduate level. He is a lecturer for 

the University Diploma in Aesthetic 

Dentistry at the University of Nantes, 

for the Master 1 in Biology and Health, 

as well as for the higher education 

certificates. 

He has obtained several certificates in 

prosthetics (fixed, as well as partial and 

complete removable), and is a former 

teaching hospital assistant lecturer 

at the care, research and teaching 

centre of the same university under the 

prosthetics department. He has been a 

user of CAD/CAM systems since 2009 

and regularly speaks at conferences on 

topics related to aesthetic dentistry and 

digital workflow. 

Argoat Prothèse Dentaire is a dental 

laboratory combining conventional 

and digital techniques. To become 

autonomous, they have created an 

industrial machining and 3D printing 

centre for their own production. A team 

of technicians focused on prosthetists 

links digital impression, the machine 

and the prosthetist, the latter of whom 

can devote more time to optimising 

the aesthetic work. They machine 

and print all the materials available in 

the dental field. The digital workflow 

is accelerating the comfort of the 

patients and dental professionals. 


In Depth With 

Treatment solutions for Molar 

Incisor Hypomineralisation 

Molar Incisor Hypomineralisation (MIH) is a common developmental 

condition presenting as a discolouration on one or more affected permanent 

molars and the associated incisors. Children with MIH often develop dental 

anxiety due to invasive and even painful dental experiences at a young 

age. For this reason, GC Dental offers a variety of treatment solutions for 

enhanced clinical management and better patient experience. 

A global burden concerning one in seven 

children 1,2 , MIH affects primarily one or more 

first permanent molars. Central incisors may 

also be affected but this usually occurs to 

a lesser extent as with hypomineralisation 

of the second deciduous molars (HSPM) 

or canines 3 . Children with HSPM are up to 

five times more likely to develop MIH in the 

permanent dentition. 

Great varieties in severity exist, ranging 

from mild opacities to post-eruptive enamel 

breakdown (Figs. 1-3). However, at present, 

the aetiology of MIH is still unknown. Some 

correlations with prenatal, perinatal and 

postnatal illness; exposure to antibiotics 

or chemicals such as dioxin, bisphenol A 

and polychlorinated biphenyl have been 

described, but sufficient evidence is still 

lacking. 

Clinical management of MIH is challenging 

due to: hypersensitivity and rapid 

development of dental caries in affected 

teeth; difficulty in achieving anaesthesia; 

limited cooperation of the young child; 

repeated marginal breakdown of restorations; 

and often, it requires an increased number of 

dental visits. 

To ensure long-term compliance, it is 

essential to adapt the treatment of MIH to the 

individual patient’s conditions and create a 

positive dental treatment experience for the 

patient. For this reason, GC offers variety of 

treatment solutions especially suited for each 

individualised treatment plan. 

INITIAL THERAPEUTIC 

INTERVENTION 

Empowering the patient is the first step 

• The teeth should be brushed twice a 

day with a toothpaste containing at 

least 1000ppm fluoride. Fluoride content 

should be age-appropriate; in older 

patients, higher levels of fluoride may be 

desirable 

• Using identification tools such as Tri 

Plaque ID Gel (Fig. 4) can help identify 

cariogenic plaque and motivate patients 

to optimise brushing technique 

• Frequent intake of sugar and acidic food 

should be avoided 

Strengthen and desensitise 

• The application of Recaldent (CPP-ACP), 

containing high levels of bio-available 

calcium and phosphate, has been 

shown to be effective in this case 4,5 . 

Topical treatments such as Tooth 

Mousse (Fig. 5) and Tooth Mousse Plus 

(900ppm fluoride) (Fig. 6) are useful in 

strengthening teeth and decreasing 

sensitivity in MIH 

While both can be used for the same 

indications, Tooth Mousse is recommended 

below the age of six to avoid the risk of 

fluorosis and in cases where extra fluoride 

Fig. 1: Mild MIH (Photo courtesy 

: Prof van Amerongen, the 

Netherlands) 

Fig. 2: Moderate MIH (Photo 

courtesy: Prof Baroni, Italy) 

Fig. 3: Severe MIH (Photo 

courtesy: Prof Baroni, Italy) 

Fig. 4: Tri Plaque ID Gel 

60 


In Depth With 

supplementation is not needed or desired. 

For overnight application, Tooth Mousse is 

recommended until the age of 12 while Tooth 

Mousse Plus can be used above that age. 

• Fluoride varnish with Recaldent (CPP- 

ACP) such as MI Varnish (22600ppm 

fluoride) (Fig. 7) for quarterly in-office 

application after prophylactic cleaning 

seals the dental tubules tightly, 

desensitises teeth and leaves a film of 

varnish on the surface 

Protect surfaces 

• Fuji VII (Fig. 8), a fluid glass ionomer, 

helps protect the surface against 

caries formation and hypersensitivity. 

Since it can bond chemically in a moist 

environment, teeth can be protected 

even before they are fully erupted 

• The setting of Fuji VII can be accelerated 

with the dental curing light. It offers fast 

and easy application and is ideal for firstline 

treatment 

RESTORATIVE TREATMENT 

Long-term restorations 

• Glass hybrid EQUIA Forte HT (Fig. 9) 

is suitable as a long term, minimally 

invasive restorative. Its quick bulk 

Fig. 5: Tooth Mousse 

placement is a huge advantage in 

young, anxious patients 

• The chemical adhesion and moisture 

tolerance of EQUIA Forte HT offer 

a great benefit since adhesion to 

hypomineralised enamel is challenging 

• In cases where teeth are difficult to 

anaesthetise, the Atraumatic Restorative 

Treatment (ART) approach can be used 

— caries is manually excavated before 

application of EQUIA Forte HT 6 

Interim therapeutic restorations 

• Glass ionomers or stainless-steel crowns 

(luted with a glass ionomer cement) 

can be indicated particularly to young 

patients with severe cases of MIH if a 

definitive treatment such as a composite 

restoration is not yet possible 

RECALL 

The recall frequency is usually higher for 

patients with MIH due to the higher caries 

susceptibility. Several points have to be kept 

in mind: 

• Restorations need to be controlled 

regularly, as adhesion to 

hypomineralised enamel is challenging 

• It is important to maintain the patient’s 

compliance to home treatment and to 

Fig. 6: Tooth Mousse Plus 

evaluate its effects regularly 

• Oral hygiene (with Tri Plaque ID Gel) 

and dietary habits should be regularly 

evaluated 

• Interim therapeutic restorations need 

to be monitored and replaced when 

the circumstances have become 

appropriate for definitive treatment 

Ultimately, an important part of the 

preventive strategy is home care. It is crucial 

to motivate and educate both the child and 

caregiver on implementing good oral hygiene 

habits and healthy dietary intake. DA 

REFERENCES 

1. 

Schwendicke F., Elhennawy K., Reda S., Bekes K., 

Manton DJ., Krois J. Global burden of molar incisor 

hypomineralization. J Dent, 2018; 68: 10–18. 

2. 

Zhao D., Dong B., Yu D., Ren Q. & Sun Y. The 

prevalence of molar incisor hypomineralization: 

evidence from 70 studies. Int J Paediatr Dent, 2018; 

28: 170-179. 

3. 

Garot E., Denis A., Delbos Y., Manton D., Silva M., 

Rouas P. Are hypomineralised lesions on second 

primary molars (HSPM) a predictive sign of molar 

incisor hypomineralisation (MIH)? A systematic 

review and a meta-analysis. J Dent 2018;72:8-13. 

4. 

Baroni, C. & Marchionni, S. MIH supplementation 

strategies: Prospective clinical and laboratory trial. 

J. Dent. Res, 2011;90: 371–376. 

5. 

Wierichs, R. J., Stausberg, S., Lausch, J., Meyer- 

Lueckel, H. & Esteves-Oliveira, M. Caries-Preventive 

Effect of NaF, NaF plus TCP, NaF plus CPP-ACP, and 

SDF Varnishes on Sound Dentin and Artificial Dentin 

Caries in vitro. Caries Res, 2018; 52: 199–211. 

6. 

Grossi JA, Cabral RN, Ribeiro APD, Leal SC. Glass 

hybrid restorations as an alternative for restoring 

hypomineralized molars in the ART model. BMC Oral 

Health, 2018; 18;18(1):65. 

Fig. 7: MI Varnish 

Fig. 8: Fuji VII 

Fig. 9: EQUIA Forte HT and EQUIA Forte Coat 


In Depth With 

Axiom BL ® : when 

convenience meets 

expertise 

Launched more than a decade ago, the Axiom ® 

implant system was designed to democratise 

the practice of implantology through accessible 

protocols and philosophy resolutely focused on 

prosthetic results. 

THE RESULT OF HIGH-LEVEL 

EXPERTISE 

The Axiom BL ® Bone Level implant represents 

the culmination of a technical consensus: 

an internal conical and sealed connection 

designed to preserve alveolar bone; a single 

diameter connection which greatly facilitates 

prosthetics by allowing a choice of prosthetic 

components independent of implant diameter 

and limiting the number of references; and 

finally, the soft-tissue friendly “Platform 

switching” system. 

With this combination, Axiom ® achieved rapid 

commercial success, becoming the leader in 

its market segment in France. The added value 

of Axiom ® and the industrial expertise of the 

teams that have been producing implants on 

a subcontracting basis since the mid-1980s 

opened the doors to international markets. 

PREDICTABLE AESTHETIC RESULTS 

Axiom ® Bone Level is an endosseous implant 

designed to promote biological integration. 

With its single, stable and sealed Morse 

taper connection with “Platform switching” 

system, it contributes to the stabilisation of 

the alveolar bone and aesthetic durability of 

the restoration. The principle of a constant 

emergence profile between the healing screws 

and abutment allows the prosthetic restoration 

to be performed in a controlled manner, without 

exerting undue tension on the soft tissue. 

EXCELLENT BONE STABILITY 

The design of the Axiom ® BL implants has 

been studied to optimise primary bone 

anchorage and ensure an even distribution 

of occlusal loads on the surrounding bone. 

Axiom ® implants are made of medical-grade 

titanium allow, often referred to as “Grade 

V”*, whose extremely high-level mechanical 

properties allow for implant diameters 

designed to minimise surgical invasiveness, 

and benefit from a BCP ® surface treatment 

that has been shown to provide effective 

osteointegration. 

TWO PROFILES FOR ALL BONE 

CONDITIONS 

Available in two profiles: REG and PX, the 

Axiom ® BL implants range covers all bone 

situations. The highly versatile REG profile is 

suitable for most clinical indications, while the 

PX has been designed to promote anchorage 

in immediate post-extraction situations. One 

single surgical kit is needed for both designs, 

which provides the great advantage of 

simplicity. 

SURGICAL SIMPLICITY 

Axiom ® BL implants require a single, 

conveniently organised surgery kit for both 

REG and PX profiles. The practitioner is able 

to adapt the choice of implant right until 

the last moment during the surgery process 

in response to the clinical situation. The 

simple surgical protocol and the 

common prosthetic range offer 

greater flexibility of use. Drills 

with integrated stops ensure 

easier and safer surgical 

procedures. 

Axiom ® implants are 

presented in a practical, 

reliable and innovative 

packaging format. This patented solution 

provides a direct grip on the contra-angle and 

allows for the possibility of repositioning during 

surgery. 

THE PROSTHESIS IS THE END 

RESULTS 

The Axiom ® system is characterised by its 

great flexibility of use. The single conical 

connection enables the practitioner to benefit 

from total independence between the implant 

diameter and the various emergence profiles 

of the prosthetic components available, 

which makes it possible to propose the best 

solution for each indication while limiting the 

complexity of the prosthetic ranges. 

The comprehensive Axiom ® prosthetic ranges 

cover all the needs of the practitioners and 

laboratories: Lab-side solutions for machining 

customised prosthetics in the laboratory, 

integration with all-digital workflows, ranges of 

components for cemented or screw-retained 

prostheses, single or multiple units. 

EXCELLENT RESULTS AT FIVE YEARS 

In a study conducted on 60 partially 

edentulous patients requiring two implantsupported 

crowns, 120 Axiom ® BL REG 

implants were placed at six different centres. 

The results, presented in a publication in the 

Clinical Trials in Dentistry journal, demonstrate 

that Axiom ® BL implants offer exceptional bone 

stability and excellent aesthetic results. 

Discover the results here: https://www. 

straumann.com/anthogyr/en/home/news/ 

axiom-bl-reg-clinical-study-5years.html DA 

*Exact name of so-called “Titanium Grade V”: 

Medical-grade Ti6AI4V-ELI titanium 

62 


In Depth With 

Digital endo assistance: CanalPro 

Jeni Endo Motor navigates through 

treatment 

Autonomous driving, operations using a robot 

arm, or computer-aided design — there is hardly 

an area in which humans cannot be assisted by 

an electronic co-pilot. The more complex the 

application, the more useful the support is via 

algorithms. Endodontic treatment is no exception, 

requiring the utmost precision and reliability. 

ELECTRONICALLY CONTROLLED 

PREPARATION 

COLTENE has achieved a breakthrough 

with a virtually self-propelled endo motor: 

the fully automatic CanalPro Jeni. Named 

after its developer, Prof Dr Eugenio Pedullà, 

CanalPro Jeni finds its way through the root 

canal autonomously and thus accompanies 

mechanical and chemical preparation stepby-step. 

Via touch screen, it connects directly 

to the selected NiTi (nickel-titanium) file 

system such as the HyFlex CM or EDM or the 

files of MicroMega from the COLTENE group of 

companies. 

What is new is that the user can work forward 

continuously from coronal to apical by 

applying only slight pressure and the motor 

decides independently on the progress of 

the movement. For this purpose, the Jeni 

assistance system uses complex algorithms 

and controls the variable file movements at 

millisecond intervals by constantly regulating 

rotational movement, speed, torque and file 

stress. 

The endo motor adapts to the individual 

root canal anatomy and guides the 

preparation step-by-step. Integrated length 

measurement is available at the same time. 

The outstanding comfort and level of safety 

that Jeni delivers during preparation is 

unmatchable. In fact, it recognises the risk 

of a potential fatigue fracture of the file and 

informs the dentist with an acoustic signal 

that a file change is necessary. 

The CanalPro Jeni is also familiar with the 

common endodontic irrigation protocol: the 

device records mechanical reprocessing 

progress, and notifies the chairside dentist or 

assistant acoustically on when and how often 

irrigation should be performed between file 

changes. This is incredibly important when 

the long-term success of treatment depends 

largely on thorough irrigation of the prepared 

root canals. 

SYNCHRONISED ENDO INSTRUMENTS 

With the CanalPro Jeni Motor, COLTENE 

has added another useful tool to its range of 

ideally matched endodontic instruments and 

dental materials. COLTENE has always worked 

closely with international scientists, practice 

owners, key opinion leaders and dental teams 

to design and realise concrete solutions for 

everyday treatment routines. 

EXTENDED FILE SEQUENCE 

With its latest update, CanalPro Jeni Motor 

was upgraded with extended options. The 

motor now automatically finds its path 

through the root canal, working in unison with 

the mechanical and chemical preparation. 

Here, the user can choose from a number 

of popular sequences for the flexible NiTi 

files. The highlight of the latest update is 

the addition of Remover files, which make 

a significant difference to an endodontic 

revision treatment. The novel 30/.07 HyFlex 

and MicroMega Remover files fit perfectly to 

the established file systems, and quickly and 

reliably remove inadequate gutta-percha 

fillings, as well as similar ageing endodontic 

restorations. Due to their intricate shape, 

they adapt to the natural contour of the canal 

and efficiently loosen the existing obturation 

material. 

In addition, the reaction time of the motor and 

the touchscreen has been further reduced. 

Graphic optimisation and enhanced system 

performance make the Jeni even more 

attractive. The result of these improvements 

is that treatment becomes even safer and, at 

the same time, more comfortable. 

EXCLUSIVE SERVICE PAGE 

COLTENE has developed a special service 

page for dental practices, which provides 

regular access to the latest updates and 

information. Dentists can simply register with 

the serial number of their CanalPro Jeni at 

the company’s website. DA 


In Depth With 

Versatile solutions for successful 

bone and tissue regeneration 

Straumann® XenoGraft and XenoFlex are biomaterials designed to eliminate 

antigenicity and provide a favourable environment for new bone growth. 

Available in a selection of practical containers for enhanced handling, its slow 

resorption increases stability, improving the likelihood of long-term implant 

survival rates. 

MASTERING EVERYDAY CASES 

Straumann® XenoGraft, for bone defect 

treatment, is methodically processed from 

bovine bone, extensively tested to eliminate 

antigenicity and provides a favourable 

environment for new bone growth. Its limited 

resorption rate delivers extended stability, 

a critical advantage in cases that require 

a strong framework for long-term tissue 

support or aesthetic needs. 

Why Straumann® XenoGraft? 

• Volume preservation by providing a longlasting 

framework for excellent space 

maintenance (Fig. 1) 

• Fast and straightforward application for 

optimal handling 

• Innovative packaging for easy product 

handling and hydration 

• Limited resorption rate provides extended 

stability 

• Osteoconduction followed by organised 

integration and remodelling process (Fig. 

2) 

• Extended portfolio range 

MASTERING FLEXIBILITY 

Straumann® XenoFlex is composed of 

90% XenoGraft granules embedded in 10% 

purified porcine-derived collagen (type I). 

Straumann® XenoFlex is an optimal solution 

for graft applications required in extraction 

sockets and is available with a syringe 

applicator or as a block. 

Why Straumann® XenoFlex? 

• Efficient, easy to handle, volume stable: 

can be easily cut to match the size and 

shape of the individual defect after 

hydration 

• It can be placed into the defect in one 

piece using tweezers, shortening surgery 

time 

• Outstanding product stability after 

thorough hydration, supporting product 

application 

• Extended block and cylinder shape 

portfolio 

Versatile solutions for successful bone and 

tissue regeneration, Straumann® XenoGraft 

and XenoFlex are designed for the extraction 

sockets, sinus-floor elevation, horizontal 

augmentation, ridge preservation, periimplant 

and intraosseous defects. Following 

the well-established treatment protocol 

using deproteinised bovine bone granules 

for the efficient treatment of bone defects, 

these biomaterials are easy to handle, have 

long-term volume stability and had been 

successfully applied in over 500,000 cases 

worldwide. 

For more details, please visit: http://bit.ly/ 

stmbiomaterial DA 

Bone particles XenoGraft delivered in a 

practical bowl container, consists of 100% 

bovine bone granules 

Fig. 1: Long-lasting framework for excellent 

space maintenance 

Fig. 2: Four-week timepoint, rabbit model, new 

bone formation around Straumann® XenoGraft 

Block and syringe 

XenoFlex, consists 

of 90% bovine bone 

granules and 10% 

porcine collagen 

64 


Product Highlights 

DGSHAPE 

DGSHAPE Corporation releases 

new DWINDEX performance 

and remote monitoring software 

DGSHAPE Corporation, a wholly-owned subsidiary 

of Roland DG Corporation developing innovative 

3D products, has released the second version of its 

performance monitoring and visualisation software, 

DWINDEX2, which is now available for all users of DWX- 

52DCi, DWX-52DC, DWX-52D, and DWX-42W devices. 

→ THE REVOLUTIONARY 

INVENTION IN 

BONE SURGERY 

PIEZOSURGERY® touch 

The latest edition of the software builds on the 

strengths of its predecessor DWINDEX, expanding 

device monitoring features that capture business 

productivity for production teams in dental CAD/CAM 

milling environments and adding new support features 

to expedite solutions for devices that require technical 

assistance. 

DWINDEX2’s improved remote monitoring features 

require a mounted camera (sold separately) that records 

and reports any error activity from the milling device, 

facilitating troubleshooting and reducing downtime. 

New error and maintenance graphs help users keep 

their milling device optimised for consistent, efficient 

production. 

→ 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 

In addition to improved support, DWINDEX2 includes 

advanced device utilisation and job management 

capabilities. The job list feature offers an automated, 

clean way to track CAD/CAM production and helps dental 

professionals digitally monitor and manage jobs between 

milling and sintering processes. An improved material 

utilisation feature also tracks crown and bridge milled 

output by units for select CAM providers. 

DWINDEX2’s new uptime feature, a 24-hour production 

graph in the dashboard module, displays the daily 

timeframe for all completed jobs on each connected 

device, allowing users to remotely monitor the progress 

of their milling device both during and after work hours. ■ 

→ www.mectron.com 



NSK 

Go beyond with Surgic Pro2 

The internationally acclaimed Surgic Pro surgical micromotor 

system fron NSK has evolved into Surgic Pro2 offering three 

progress points: in operation, safety and wireless extensibility. 

As well as further improving the basic performance of Surgic Pro, 

its supreme adaptability in connecting to various external devices 

offers improved comfort, safety and efficiency for the operator 

during dental treatment. 

Synonymous with Surgic Pro, safer procedures are made 

possible with increased torque precision combined with the 

Osseointegration Monitoring Device, Osseo 100+. It also features 

a more compact new micromotor. In fact, as compared with the 

existing model, Surgic Pro2 is 24.9% shorter and 9.1% lighter. 

The operability during treatment has been greatly improved by 

moving the centre of gravity closer to the head of the handpiece. 

This increases efficiency and alleviates the stress during 

prolonged operation for strain-free, effortless operation. On top of 

this, the visibility was significantly improved with high resolution 

colour LED. 

Ultimately, thanks to its wireless connection, Surgic Pro2 can 

broaden user’s scope of implant treatment. It has extensive 

wireless function including a wireless foot control and can be linked 

with iPads or external devices. 

Professionals demand the reliability and sense of safety in clinical 

practice, and NSK has responded with their next-generation 

performance technology. ■ 

Ivoclar Vivadent 

IPS e.max® ZirCAD® LT: More shades, more options 

The IPS e.max® ZirCAD® LT discs 

Versatile and flexible 

from Ivoclar Vivadent are now 

The IPS e.max ZirCAD LT discs 

available in an extended portfolio 

offer high mechanical strength 

that includes nine new shades. 

(1200 MPa 1 ) and are therefore 

The high-strength zirconium oxide 

ideally suited for the fabrication 

material is suitable for single-tooth 

of stable multi-unit framework 

restorations and long-span bridges. 

structures. The material can also 

be used for minimally invasive 

Effective immediately, the IPS e.max 

single-tooth restorations. The 

ZirCAD LT discs are available in the 

restorations can be completed 

following nine additional shades: 

using a variety of techniques, 

A3.5, A4, B3, B4, C1, C3, C4, D3, and 

including monolithic, infiltration, 

D4. The new shades are available in 

partial, and full-coverage 

three thicknesses: 14mm, 18mm, and 

veneering procedures. 

25mm. With the extended portfolio, 

1 

it has never been easier to select a 

Typical mean value of biaxial 

disc that matches the thickness and 

flexural strength in relation to the 

desired shade of the clinical case at 

degree of translucency, R&D Ivoclar 

hand. 

Vivadent, Schaan, Liechtenstein. ■ 

66 



Busch 

STERI-SAFEwave: The innovative bur block 

The BUSCH STERI-SAFEwave bur block 

made from medical resin has outstanding 

benefits for use, safety and hygiene. 

The unique wave design enables up to 14 

FG and 12 RA instruments with varying 

insertion heights to be stored in the bur 

block at once. The instruments do not need 

to be secured with rubber rings and are 

completely accessible to ensure that there 

are no unwashed areas. 

This optimal cleanability with precontaminated 

medical devices was 

validated and certified by an external 

institute. The safety bar is locked closed 

during transport and reprocessing, 

preventing the instruments from falling out. 

The medical resin can be disinfected and 

sterilised and is suitable for all relevant 

reprocessing measures in the practice. If 

required, the user can label individuallyloaded 

STERI-SAFEwave by using 

different coloured silicone strips, which 

simultaneously provide a non-slip grip on 

suitable surfaces. ■ 

NEW 

VENUE 

8-10 

APRIL 2022 

MARINA BAY SANDS 

SINGAPORE 

THE LEADING DENTAL 

EXHIBITION AND 

CONFERENCE 

IN ASIA PACIFIC 

www.idem-singapore.com 

BOOK YOUR EXHIBITION SPACE NOW AND ENJOY EARLY-BIRD PRICING 

Connect with us 

Endorsed by 

Supported by 

Held in 

Organised by 

IDEM Singapore 

IDEM Singapore 

idem.sg 

@IDEMSingapore 

Singapore Dental Assocation 



COLTENE 

COLTENE launches MicroMega One RECI 

At a funfair, some love the ups and downs from COLTENE, regardless of which type of 

on the roller coaster, others love going motion they prefer to use. 

round in circles on the carousel. Mechanical 

root canal preparation follows a similar 

Safe, flexible and minimally invasive 

pattern of motion: dentists can choose Inspired from its patented cross section, 

between reciprocating and continuously MicroMega One RECI is characterised by its 

rotating systems. For fans of preparation cutting performance. Additionally, the C.Wire 

using reciprocating motion, dental specialist heat treatment gives the file its flexibility, 

COLTENE now features a new file in its controlled memory, pre-bendability and 

range. 

curvature conservation. 

And due to the system’s spectrum, optimal 

preparation of the root canal is possible for 

almost any clinical case. MicroMega One 

RECI is available in five sizes from 20/.04 to 

45/.04 and three lengths (21, 25, 31mm) and 

is supplied exclusively in sterile blisters. ■ 

For all situations 

Since the introduction of the first 

reciprocating file over a decade ago, 

reciprocating motion has become 

established among many dentists. 

COLTENE is now expanding its portfolio by 

adding to its proven NiTi rotary systems: 

MicroMega One RECI, the single shaping 

file in reciprocating motion. This enables 

dentists to choose their favourite file system 

Owing to the small file diameter of 1mm, 

MicroMega One RECI protects the pericervical 

area and minimises mechanical 

impact on the dental hard tissues. Its high 

cyclic fatigue resistance provides additional 

safety. As a result, dentists can enjoy an 

excellent compromise between cutting 

efficiency and safety, as well as flexibility 

and minimally invasive use in root canal 

treatment. 

Formlabs 

Form 3B: More smiles, all around 

The Form 3B is an advanced desktop 3D printer developed 

for healthcare. Formlabs’ precise, reliable ecosystem takes the 

guesswork out of dental fabrication so faster workflows are just a 

few clicks away. 

The easy choice for digital appliance production 

Users can reclaim their time and produce parts without the hassle 

or prohibitive costs. Formlabs brings unprecedented reliability, 

quality and ease of use, with validated workflows tested by a team 

of dental experts: 

1. Scan: Collect patient anatomy digitally using an intraoral 

scanner. Send scans to the lab with a digital prescription or to 

a design station. 

2. Design: Import scan data into dental CAD software to 

design treatments virtually, or send scans directly to print 

preparation. 

3. Print: Import the designed CAD files into PreForm print 

preparation software for print setup and send them easily to a 

Formlabs printer. 

4. Prepare: Wash, dry, and post-cure printed parts. These parts 

can then be used intraorally or be used to produce various 

indications. 

The next generation of dental 3D printing 

Advanced Low Force Stereolithography (LFS) technology uses a 

flexible resin tank and a custom-designed, user-replaceable Light 

Processing Unit (LPU) to produce consistent, accurate prints. 

Reduced peel forces lead to incredible surface finish and part clarity, 

right off the printer. 

Built for production 

Print two to three times more parts in a single build compared to 

small build plate DLP (digital light processing) printers to spend 

less time handling the printer and more time on high-value tasks. 

Production environments can see 55% less labour time and costs 

compared to DLP. A modular ecosystem allows for unmatched 

consistency, scalability, and redundancy. ■ 

68 


Show Review 

AOSC 2021 Online Edition 

performed beyond expectations 

The Association of Orthodontists 

(Singapore) Congress (AOSC), held 

from 2 to 11 July 2021, successfully 

concluded its first-ever online edition. 

AOSC 2021 performed beyond 

expectations despite the current 

global climate and attracted close to 

1,000 attendees from 50 countries. 

The AOSC 2021 Conference featured 

the highest number of speakers – 20 

local and international speakers who 

delivered 19 scientific sessions, made 

available live and on-demand for 

registered delegates. 

The line-up of renowned speakers 

from the orthodontic community 

saw the likes of keynote speakers, 

namely Dr Chris Chang, Dr Steven 

Lindauer, and Dr Ute Schneider- 

Moser enriching delegates by sharing 

detailed case studies and critical 

insights. 

The conference sessions addressed 

themes such as “A New Challenge 

- Amidst the Pandemic”, “Are we 

Defined by our Appliance?”, and 

“Shaping the Future of Orthodontics”. 

Delegates that attended the sessions 

also earned continuing education 

(CE) points to reflect their learning. 

Similar to the conference, AOSC 

2021’s exhibition also moved online 

for the first time. Over 100 represented 

brands, including leading orthodontic 

companies such as Invisalign, Ormco, 

Dentsply Sirona, came together for 

the digital exhibition and showcased 

their latest products and innovations, 

highlighting the current technological 

advancements in the industry. 

“We are heartened by the 

overwhelming response received for 

our first-ever online edition of AOSC 

with close to 1,000 participants from 

all around the world. The growth of 

AOSC over the years and even through 

a pandemic marks a great triumph 

and we are honoured to be becoming 

more recognised in the orthodontic 

community. We would like to thank all 

attendees, exhibitors, speakers and 

organisers for coming together and 

making AOSC 2021 a success,” shared 

Dr Bryce Lee, president of Association 

of Orthodontists (Singapore) and 

chairperson of AOSC 2021. 

Featuring the best in the field of 

orthodontics, the 2021 Scientific 

Poster Competition saw 19 presenters. 

Unlike the past competitions, 

this edition’s competition was 

fully conducted online with virtual 

presentations and digital posters. The 

poster competition was concluded 

with the top 3 winners: Dr Shivam 

Mehta from the University of 

Connecticut, United States; Dr Cheryl 

Lee from the National Dental Centre, 

Singapore; and Dr Xiu Ling Florence 

Kok from the University College 

London, United Kingdom. 

To round up the AOSC experience, 

attendees participated in a variety 

of virtual social programmes. 

The virtual cook-off, Food Wars, 

alongside a virtual networking and 

sharing session, Bring Your Own 

(BYO) Experience, brought together 

participants from around the world 

despite the backdrop of a pandemic. 

The iconic AOSC run allowed 

attendees to keep fit and take on 

challenges like competing with other 

runners virtually from the comfort 

of their own home, gym, or favourite 

park. 

“AOSC 2021’s success is a hopeful 

motivation, but we have to 

acknowledge that physical events have 

an immersive quality that cannot be 

replicated online. We look forward to 

welcoming our colleagues in person 

again for AOSC 2023,” said Dr Koo 

Chieh Shen, chairperson of AOSC 2023. 

The Association of Orthodontists 

(Singapore) Congress will return for 

its next edition in its established 

physical format at Marina Bay Sands, 

Singapore, from 17 to 19 February 

2023. ■ 


Show Preview 

IDS 2021 prepares 

for the international 

dental industry 

and communicative encounters will 

also be possible in September. 

Snack points, temporary food service 

offers and self-service restaurants 

with front cooking will satisfy the 

culinary needs of the visitors and 

exhibitors. An extensive space is 

designed and planned for all food 

service areas to guarantee sufficient 

social distancing. Additionally, a food 

court in Hall 4.1 with diverse culinary 

offers and generous layouts is at the 

disposal of all trade fair participants, 

where discussions can be continued 

over lunch. 

The 39 th edition of the International 

Dental Show (IDS) will open its doors 

in Cologne, Germany, from 22 to 25 

September 2021. The leading global 

trade fair of the dental industry is a 

secure, stable anchor in turbulent 

times and the best place to compare 

one’s company with the competition, 

and position it on the global market. 

Dentists and dental technicians 

can gather information and ideas 

here that will enable them to make 

future decisions for their practice or 

laboratory. The international dental 

industry is a strong community 

characterised by common values, 

which is reflected by IDS as the most 

important industry platform and with 

its role model function: flexibility, 

innovation, creativity, service and 

customer-orientation, cosmopolitan 

and community-promotion. 

The organisers of IDS 2021, the 

GFDI (Gesellschaft zur Förderung 

der Dental-Industrie mbH) and 

Koelnmesse have taken all conceivable 

precautions to make the extremely 

important personal exchange and 

networking between the international 

industry participants in Cologne safe 

and pleasant. 

The personal dialogue, networking 

within the industry and the extensive 

world of experience of IDS, which 

addresses all senses, are irreplaceable. 

Visiting IDS 2021 will take place under 

almost normal framework conditions. 

Regarding business discussions at the 

stands of the companies, hospitable 

The networking will also continue long 

after the trade fair closes. The city of 

Cologne and the local restaurants are 

looking forward to IDS 2021 and the 

trade fair participants, who will also 

come together in larger groups. The 

exhibitors and visitors of IDS can enjoy 

the late summer and the traditional 

Rhenish lifestyle in the cosy breweries 

and beer gardens. 

HIGH NUMBER OF 

REGISTRATIONS FROM HOME 

AND ABROAD 

To date, around 850 companies 

from 57 countries have confirmed 

their participation at IDS 2021 — a 

remarkable intermediate result against 

the backdrop of the past months. 

In line with the pandemic-related 

framework conditions, IDS is being 

70 


Show Preview 

staged in Halls 2, 3, 10 and 11. All halls 

are connected via a simple circular 

route that has been optimised for 

visitors. The four entrance areas of 

IDS 2021 — the South, East and West 

entrances and the entrance on the 

trade fair Boulevard — ensure that 

the visitors will be evenly distributed 

throughout the exhibition halls in line 

with the current protection regulation. 

The hall planning accommodates 

all necessary measures and official 

requirements for the protection 

of exhibitors and visitors, which 

Koelnmesse has taken into account 

in its safety and hygiene concept 

#B-SAFE4business. For its events at 

the Cologne fair grounds, Koelnmesse 

will take all precautionary measures 

deemed relevant by the responsible 

health authorities in accordance with 

the Coronavirus Protection Ordinance. 

The necessity of these procedures 

will be reviewed continuously until the 

event and prepared accordingly. 

In addition to the physical exhibition, 

IDS 2021 is also offering the exhibitors 

and visitors the digital platform, 

IDSconnect. This hybrid approach 

enables visitors all over the globe, 

who are not able to travel to Cologne, 

to discover attractive trade fair 

profiles and products and connect 

with contact partners via innovative 

channels. 

Because whether at a trade fair or 

during everyday business, the success 

of a company is based on three 

essential building blocks: inspiration, 

interaction and business. Where these 

crucial elements fall short, IDSconnect 

now offers additional opportunities. 

Extensive features make it possible to 

reach more potential customers easily, 

experience trends and presentations 

on demand and establish valuable 

contacts — from anywhere in the 

world. The digital platform of IDS is 

very easy and intuitive for everyone 

to use, even without previous digital 

experience, bringing the world’s 

largest dental show directly to their 

screen for an authentic trade fair 

experience. 

GLIMPSE OF THE EXHIBITION 

Align Technology, Inc. has confirmed 

its planned presence at the IDS. 

Together, the Align and exocad 

booths will represent Align’s biggest 

IDS exhibition space to date. Align’s 

interactive booth, located in sector 

A-030-C-031, Hall 3.2, will showcase 

its full portfolio of products and 

services. Align’s presence at IDS will 

be developed as a hybrid experience, 

with a physical space that will 

be compliant with public health 

guidelines for the limited number 

of in-person attendees, plus virtual 

experiences specially designed for 

those attending digitally. 

IDS 2021 attendees — including 

doctors, lab practitioners, and 

industry partners — will be able 

to learn about Align’s innovations, 

including the Invisalign Go Plus 

system, the latest addition to general 

dentists’ portfolio for mild to more 

complex cases. Attendees will also 

have the opportunity to see how 

digital workflows can be enabled 

by the Align Digital Platform for the 

Invisalign system, iTero intraoral 

scanners, and a suite of proprietary 

digital tools, including virtual solutions 

for continuity of care with existing 

patients. In addition, Align will also 

showcase its end-to-end workflows, 

including the ortho-restorative 

workflow and software solutions from 

exocad for restorative dentistry. 

exocad, on the other hand, will 

showcase its newest software 

releases and innovations for dental 

technicians and dentists in 360m² at 

booth A-020 in Hall 3 with a multitude 

of demo stations. Participants can 

experience exocad’s variety of 

software solutions such as DentalCAD, 

ChairsideCAD and exoplan. Attendees 

will also meet exocad’s very own 

experts as well as the renowned 

dental trailblazers Waldo Zarco Nosti 

and Dr Gulshan Murgai. The company 

will present a new booth design at 

IDS 2021, reflecting the company’s 

continued innovation and growth. 

Additionally, Amann Girrbach is also 

looking forward on its first major trade 

show since the pandemic started. In 

addition to a number of innovations 

to its proven CAD/CAM products and 

materials, the company will focus 

on solutions for the interdisciplinary 

cooperation between dental 

laboratories and dental practices at 

the IDS, on Stand No. A-010 – B-011 

in Hall 3.2. 

The focus will be on the AG.Live digital 

platform and the Ceramill DRS (Direct 

Restoration Solution) product family 

which was launched in April. With 

Ceramill DRS in combination with 

AG.Live, Amann Girrbach extends the 

laboratory’s integrated digital workflow 

to the dentist and enables laboratories 

and practices to easily enjoy the 

benefits of same day dentistry as a 

team. DA 


Show Preview 

Rediscover dentistry at the 

23 rd CSA Annual Meeting 

and 2021 China Dental Show 

Held alongside The China Stomatological 

Association (CSA) Annual Meeting, China 

Dental Show (CDS) is the leading trade 

show which covers brand and product 

promotion, continuing education, trade 

negotiation and equipment procurement. 

The 23 rd CSA Annual Meeting and 2021 

China Dental Show happening from 25 

to 28 September, 2021 will open the door 

in Shanghai to the largest number of 

dentists from private and public hospitals 

as well as clinics and distributors in China, 

showcasing products and services from 

the entire value chain of oral health. 

and undertaken by Reed Sinopharm 

Exhibitions, is held at the same time with 

CDS in Shanghai, China, every year. 

CSA is China’s only Level AAAAA dental 

association, enjoying the highest 

academic authority, influence and appeal 

in the country. 

In 2019, CSA altogether held 400 

academic seminar sessions, operation 

and demonstration shows, as well as 

prize competitions. More than 350 leading 

international and domestic experts 

attended its Annual Meeting. 

latest hi-tech amenities to facilitate a 

global show such as CDS. The venue 

is also planned in the most ergonomic 

fashion, allowing exhibitors and visitors 

within the same product portfolio to 

interact on the same floor, thus obtaining 

great results within limited time. 

CDS has responded to the growing 

demand for space by acquiring two entire 

halls to provide comfortable exhibition 

spaces and meeting rooms. Overseas 

exhibitors are formed into international 

pavilions, which indicate that CDS is 

gaining international reputation. 

Through the CDS, new products and 

technologies are presented by over 

500 companies, including leading 

international and local brands to tens of 

thousands of industry professionals who 

are there to learn, trade and network. 

CDS 2019 had an exhibition area of more 

than 60,000 sqm. Exhibitors come from 

over 30 countries and regions such as 

China, Germany, United States, France, 

Italy, South Korea, Japan, Switzerland, 

Finland, Denmark, Israel, Brazil, Hong 

Kong, and Taiwan. 

LATEST DEVELOPMENTS AT CDS 

It is no surprise that CDS is witnessing 

exponentially growing demands for 

exhibition space in National Exhibition 

and Convention Centre (NECC) Shanghai. 

NECC Shanghai is equipped with all the 

CDS looks forward to introducing new 

products and strengthening the product 

portfolio from each specific country. With 

better service, CDS will see another two 

to three countries’ pavilions in addition 

to the ones who have been participating 

regularly. DA 

Japan Dental Trade Association (JDTA) 

and Trade Development Authority 

of Pakistan (TDAP) have sent official 

delegates to CDS every year while 

obtaining USDOC/SIMAP/MEPRC/Seoul 

Dental Association support. 

CSA ANNUAL MEETING 

The CSA Annual Meeting, hosted by CSA 

72 


Show Preview 

Dentsply Sirona World 2021: 

Back to a live event 

“More than an event, the annual 

Dentsply Sirona World is an 

experience connecting dental 

professionals to share ideas and 

gain access to the latest education 

and innovations related to digital 

workflows. And, as can be expected, 

all of this will take place in an inspiring 

venue in Las Vegas. More than any 

other year, we are looking forward to 

the opportunity to be reconnected 

and remind the world that dentistry 

is essential,” said Eric Bruno, senior 

vice-president of the North America 

Regional Commercial Organisation at 

Dentsply Sirona. 

After a successful, completely virtual 

Dentsply Sirona World in 2020 in which 

more than 4,500 dentists, dental 

technicians and practice teams took 

part in over 70 courses, participants in 

the 2021 edition will have the option of 

once again joining this year’s Ultimate 

Dental Experience in person. 

The event will take place from 23 to 

25 September at Caesars Forum in 

Las Vegas, Nevada, United States 

(US). Participants can choose to join in 

person or via a live stream with special 

digital programming for those who 

cannot travel or who would prefer to 

take part virtually. This year’s event MC 

will be Dr Sameer Puri, vice-president 

of Education at CDOCS. Nearly 100 

speakers will lead over 100 courses 

across almost every area of dentistry. 

The educational tracks include: 

dental lab, endodontics, implant 

dentistry, dental hygiene, clear aligner, 

restorative, dental assisting, digital 

impressions CAD/CAM, CEREC CAD/ 

CAM, imaging systems, office design, 

institutions – school and government, 

and dental service organisations. 

In addition to the first-class 

educational experience, Dentsply 

Sirona World is renowned for its 

unique atmosphere. Participants 

will have the chance to listen to 

inspirational speakers such as Mel 

Robbins, known for her TEDx talk, 

which has been viewed more than 

25 million times, and for books such 

as The 5 Second Rule: Transform 

Your Life, Work, and Confidence with 

Everyday Courage. 

Attendees will also be treated to 

three evenings of unforgettable 

entertainment. This year’s headliners 

would be the The Chainsmokers, a 

Grammy-winning electronic music and 

production duo whose music blurs the 

lines between indie, pop music, dance 

music, and hip-hop. 

Dr Kristine Aadland of Aadland 

Dental in Vancouver, Washington, US, 

stated that Dentsply Sirona World 

is the event she has always looked 

forward to every year: “It’s not just a 

CE course. You can tangibly feel the 

vibe and energy of the doctors and 

team members who are excited to 

learn. The entertainment is fantastic, 

the exhibit hall is fun, and you can 

actually take tips from the lectures 

and apply them as soon as you get 

home. There is truly nothing like it!” 

In order to maximise the opportunities 

to reconnect with the year’s most 

exciting educational event, a basic 

registration to live stream the daily 

general sessions and live surgery 

is available for free. For interested 

participants who would like to join 

the full virtual experience and take 

advantage of the digital networking 

possibilities, health and wellness 

sessions, and access educational 

breakout webinars worth CE credits, 

tickets are available for purchase. DA 


Giving Back to Society 

Align Technology honours 10 million Invisalign smiles milestone with 

donation of one million USD to Operation Smile 

Align Technology, Inc., a leading global 

medical device company that designs, 

manufactures, and sells the Invisalign system 

of clear aligners, iTero intraoral scanners, 

and exocad CAD/CAM software for digital 

orthodontics and restorative dentistry, has 

announced that the Align Foundation, the 

company’s donor-advised fund through 

Fidelity Charitable, has donated US$1 million to 

Operation Smile, a global surgical non-profit, to 

help children around the world born with cleft 

conditions receive safe, effective, and timely 

cleft surgery and comprehensive care. 

“Operation Smile’s mission strongly resonates 

with Align’s purpose of transforming smiles 

and changing lives,” said Raj Pudipeddi, chief 

innovation, product and marketing officer and 

senior vice-president of Align Technology. 

“We are proud to support a future where 

more smiles can be transformed through safe 

surgery and medical treatment and hope to 

inspire others through our donation to help 

Operation Smile change the lives of more 

children.” 

The “10 Million Smiles. 10 Million Thanks” 

campaign is based on the transformative 

power of Invisalign treatment as seen through 

the eyes of Invisalign patients. The donation 

to Operation Smile builds on that goal and 

aims to help more children around the world 

to smile by raising awareness and generating 

support and funding for Operation Smile. 

Operation Smile provides surgery and ongoing 

care for people affected by cleft lip and cleft 

palate in resource-limited environments. 

“We are so appreciative of the dedication and 

support from Align Technology over the years 

and are excited for what we can do to bring 

families renewed hope, and help children 

around the world smile even more as a result 

of this latest donation,” said Kristie Magee 

Porcaro, chief strategy officer of Operation 

Smile. “Together, we’re improving the health 

of many children and ensuring that they have 

the opportunity for a better future.” 

Align Technology initiated a wave of photo 

sharing activity by asking its followers on 

social media channels around the world to 

share their smiles and to help change a child’s 

life using the hashtag: #10MInvisalignSmiles. 

The company is working with Operation 

Smile, Invisalign ambassadors and regional 

stakeholders to encourage their communities 

of followers to join with them in the 

awareness campaign. ■ 

Colgate Bright Smiles, Bright Futures® and Save The Children partner to 

support migrant families and children 

Colgate Bright Smiles, Bright Futures 

(BSBF) has partnered with Save the Children 

to provide oral health and hygiene products 

to respite shelters serving migrant children 

and families. 

Hosting new arrivals entering the United 

States (US) with documentation via border 

towns in California and Texas, the respite 

shelters will receive over 25,000 units of 

toothpaste, toothbrushes and soap from 

Colgate, as well as oral health educational 

materials, via a product donation to Save 

the Children. Hundreds of migrants from 

Guatemala, Nicaragua, and Honduras arrive 

weekly and sometimes daily at respite 

centres in such cities as San Diego, Mecca 

and Bell, San Antonio, Brownsville, El Paso, 

and Laredo. 

A temporary refuge, the respite shelters 

provide a place to sleep and bathe, clean 

clothing, oral health products, toiletries, and 

diapers, and with assistance from Save the 

Children and partners, safe care and activities 

for children. 

“As a global children’s health initiative, 

Colgate Bright Smiles, Bright Futures has an 

important role to play in helping to prevent 

disease and protect the health and well-being 

of vulnerable children and their families,” 

said Dr Gillian Barclay, vice-president of 

Global Public Health and Scientific Affairs at 

Colgate-Palmolive Company. “Last year in 

North America, Colgate Bright Smiles, Bright 

Futures donated more than three million units 

of oral care products and delivered oral health 

education to more than 27 million children 

and families. By partnering with Save the 

Children, a leading humanitarian organisation 

and authority on child health and education, 

we can positively impact the lives and health 

of vulnerable children now and in the future. 

Together, we are promoting lifelong learning 

opportunities and the promotion of wellbeing 

for all.” 

As a company, Colgate has supported Save 

the Children since 1999. It began its global 

partnership with the organisation in 2016, 

working together to increase access to oral 

health care for children in need in the US, 

Africa and Latin America. ■ 

74 DENTAL ASIA SEPTEMBER / OCTOBER 2021

2021 EVENTS CALENDAR 

SEPTEMBER 

1 – 5 (Virtual) ITI World Symposium 2020NE 

https://events.iti.org/worldsymposium 

2 – 3 Dental Professional Days 2021 

Copenhagen, Denmark 

Venue: Bella Centre 

https://tandfagligedage.dk 

9 – 11 Expodental Meeting 2021 

Rimimi, Italy 

Venue: Rimini, Fiera 

https://www.expodental.it/en 

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 (Virtual) ADA FDI 2021 - World Dental Congress 

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 

14 – 16 Central Asia Dental Expo 

Almaty, Kazakhstan 

Venue: Atakent-Expo 

https://cadex.kz/en 

14 – 16 Pragodent 2021 - 

28 th Annual International Dental Fair 

Prague, Czech Republic 

Venue: Exhibition Grounds PVA EXPO PRAHA 

https://pragodent.eu/en 

OCTOBER 

16 (Hybrid) 3 rd Annual ICOI Madrid Hybrid Symposium 

Madrid, Spain 

https://www.icoi.org/events 

21 – 23 Dentex 2021 

Brussels, Belgium 

Venue: Tour & Taxis 

https://www.dentex.be/en 

22 – 24 5 th Malaysia International Dental Show 

Petaling Jaya, Malaysia 

NOVEMBER 

Venue: Sunway Pyramid Convention Centre 

http://mids.com.my/100-about-us 

3 – 6 DenTech China 2021 

Shanghai, China 

Venue: Shanghai World Expo Exhibition 

and Convention Centre 

https://www.dentech.com.cn/en-us/index 

5 – 6 ID Infotage Dental 2021 

Frankfurt, Germany 

Venue: Messe Frankfurt 

https://www.infotage-dental.de/frankfurt-m 

24 – 26 IndoHealthcare Expo 2021 

Jakarta, Indonesia 

Venue: JIExpo Kemayoran 

https://indohealthcareexpo.com 

28 Nov – 97 th Greater New York Dental Meeting 2021 

1 Dec New York, United States 

Venue: Jacob K. Javits Convention Centre 

DECEMBER 

https://www.gnydm.com 

2 – 4 Vietnam Medi-Pharm Expo 2021 

Hanoi, Vietnam 

Venue: Hanoi International Center 

http://hn.medipharmexpo.com/en 

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. 


Advertisers’ Index 

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IBC 

Anthogyr France 47 

Carestream Dental 5 

COLTENE 51 

exocad GmbH 29 

Social Distancing? 

No problem! 

It’s safe. 

Connect your 

brand through our 

media platforms. 

IDEM Singapore 2022 67 

Mectron 7, 65 

Renfert 11 

Shofu inc 3 

Straumann 15 

Tekne Dental 13 

VITA 17 

For information, visit us www.dentalasia.net or 

contact us at sales@pabloasia.com 

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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 

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76 


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Dental Asia September/October 2021

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